Exam #2

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serious6
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106031
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Exam #2
Updated:
2011-10-03 13:07:11
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Hypertension Hyperlipidemia
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Pharm Prototype Drugs
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  1. What are the therapeutic and pharmacologic classification of Methyldopa (Aldomet)?
    • Therapeutic: Antihypertensive
    • Pharmacologic: Alpha2-adrenergic agonist
  2. What are the therapeutic effects and uses for Methyldopa (Aldomet)?
    • HTN that has not responded adequately to safter antihypertensives
    • hypertensive crisis
  3. What is the mechanism of action for Methyldopa (Aldomet)?
    • converted to a "false" neurotransmiller in the brainstem, thus causing a shortage of the "real" neurotransmitter and inhibition of the sympathetic nervous sysemt.
    • this creates less peripheral resistance, and BP declines
  4. What are the pharmacokinetics of Methyldopa (Aldomet)?
    • Route(s): PO, IV
    • Absorption: 50% absorbed from the GI tract
    • Distrubition: Completely, including crossing the BBB and placenta, secreted in breast milk
    • Metabolism: Liver and GI tract
    • Excretion: Renal
  5. What are the adverse effects for Methyldopa (Aldomet)?
    drowsiness, depression, headache, sedation, bizarre dreams, decreased libido, impotence, hepatoxicity, inability to ejaculate, menstral irregularities, gynecomastia
  6. What are the contraindications/precautions for Methyldopa (Aldomet)?
    serious lever disease, blood dyscrasias
  7. What are the drug interactions for Methyldopa (Aldomet)?
    • antihypertensives, athanol, phenothiazines, tricyclic antidepressants, NSAIDS
    • Herbal/Food: Hawthorn
  8. What is the pregnancy cateogory for Methyldopa (Aldomet)?
    Category B
  9. What is the treatment of overdose for Methyldopa (Aldomet)?
    gastric lavage, dialysis, and admin of a sympathomimetic such as epi
  10. What are the nursing responsibilities for Methyldopa (Aldomet)?
    • obtain complete HH
    • obtain a baseline ECG
    • ausculate heart and chest sounds
    • assess neurologic status
    • assess baseline and periodic labs
    • minimize daytime sedation
    • monitor fluid and electrolyte balance
    • supervise ambulation in older adults
    • assess for withdrawal, anorexia, or insomnia
    • discontinue drug if persistent evevation of serum hepatic transaminase or alkaline phosphatase valuse occur
  11. What is the patient and family teaching for Methyldopa (Aldomet)?
    • shake the suspention well before measuring the dose
    • take missed dose as soon as remembered
    • do not take other meds without approval
    • make position changes slowly
    • do not druve
    • do not abruptly stop taking med
    • do not breast feed
  12. What is the therapeutic and pharmacologic classification for Hydralazine (Apresoline)?
    • Therapeutic: Antihypertensive
    • Pharmacologic: Direct vasodilator
  13. What are the therapeutic effects and uses for Hydralazine (Apresoline)?
    moderate to severe HTN, usually in combo with other antihypertensives
  14. What is the mechanism of action for Hydralazine (Apresoline)?
    • by causing peripheral vasodilation, it acts directly to relax arterial smooth muscle
    • the decrease peripheral resistance is accomplished by an increase in heart rate and CO
    • the overal result is a reduction in afterload
  15. What are the pharmacokinetics of Hydralazine (Apresoline)?
    • Route(s): PO, IM, IV
    • Absorption: Rapidly absorbed PO and well absorbed IM
    • Distribution: Widely distributed; crosses the placenta and is secreted in breast milk; 87% bound to plasma protein
    • Metabolism: GI mucosa and liver, extensive first-pass
    • Excretion: 90% renal, 10% feces
  16. What are the adverse effects of Hydralazine (Apresoline)?
    • headache, tachycardia, palpitations, flushing, nausea, diarrhea, orthostatic hypotension, fluid renention, peripheral edema, rash, urticaria, myalgia, fever, chills, fatigue
    • serious: blood dyscrasias such as agranulocytosis and leucopenia
  17. What are contraindications/precautions for Hydralazine (Apresoline)?
    lupus, cerebrovascular disease, rheumatic heart disease, renal impairment, CAD
  18. What are the drug interactions of Hydralazine (Apresoline)?
    • other antihypertensives or MAOIs, NSAIDs, beta blockers
    • Herbal/Food: Hawthorn
  19. What is the pregnancy cateogory for Hydralazine (Apresoline)?
    Category C
  20. What is the treatment of overdose for Hydralazine (Apresoline)?
    gastric lavage, activated charcoal and admin of a plasma volume expander, beta blocker
  21. What are the nursing responsibilties for Hydralazine (Apresoline)?
    • obtain a complete HH
    • obtain baseline ECG
    • Auscultate heart and chest sounds
    • report if pt has kidney disease, SLE, stroke, transient ischemic attack, pulmonary HTN, or high cholesterol or triglycerides
    • monitor labs, BUN, creatinine clearance, uric acid, serum potassium, blood glucose
    • monitor I&Os
  22. What is the patient and family education for Hydralazine (Apresoline)?
    • do not abruptly stop taking med
    • heeadache and palpitations may occur within 2-4 hrs after 1st dose
    • check for swelling of feet and ankles and weight gain
    • make position changes slowly
    • do not drive
    • take drug with full glass of water
    • do not breast feed
  23. What are the therapeutic and pharmacologic classifications of Nitroprusside sodium (Nipride, Nitropress)?
    • Therapeutic: drug for hypertensive emergency
    • Pharmacologic: direct vasodilator
  24. What are the therapeutic effects and uses of Nitroprusside sodium (Nipride, Nitropress)?
    aggressive, life-threatening HTN
  25. What is the mechanism of action for Nitroprusside sodium (Nipride, Nitropress)?
    dilates both arteries and veins; thereofre the hypotensive action or nitroprusside is die to direct relaxation of arteriolar smooth muscle and to blood pooling in the veins
  26. What are the pharmacokinetics of Nitroprusside sodium (Nipride, Nitropress)?q
    • Route(s): IV
    • Absorption: N/A
    • Distribution: Unknown
    • Metabolism: metabolized to thiocyanates in erthyocyes and other tissues
    • Excretion: renal
  27. What are the adverse effects of Nitroprusside sodium (Nipride, Nitropress)?
    hypotension, headache, dizziness, flushing, thiocyanate poisoning is characterized by hypotension, lethargy, blurred vision, metabolic acidosis, faint heart sounds, loss of consciousness
  28. What are contraindications/precautions for Nitroprusside sodium (Nipride, Nitropress)?
    inadequate cerebral circulation, compensatory HTN, serious renal impairment, high intracranial pressure
  29. What are the drug interactions for Nitroprusside sodium (Nipride, Nitropress)?
    • antihypertensive agents, ethanol, general anesthetics, ganglionic blockers, sympathomimetics such as epi, dobutamine (Dobutrex)
    • Herbal/Food: Hawthorn
  30. What is the pregnancy cateogry for Nitroprusside sodium (Nipride, Nitropress)?
    Category C
  31. What is the treatment of overdose for Nitroprusside sodium (Nipride, Nitropress)?
    Cyanide Antidte Kit, which contains amyl nitrate, sodium nitrate and sodium thiosulfate
  32. What are the nursing responsibilties for Nitroprusside sodium (Nipride, Nitropress)?
    • obtain complete HH
    • obtain baseline ECG and VS
    • ausculate heart and chest sounds
    • titrate (adjust) the IV infusion
    • slow or stop infuision if serious adverse effects are noted
    • notify the prescriber if BP rises
    • monitor I&Os and labs
    • check solution and discard if color turns dark brown
  33. What are the therapeutic and pharmacologic classifications for Atrovastatin (Lipitor)?

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