Pharmacology

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Author:
amgomez
ID:
107062
Filename:
Pharmacology
Updated:
2011-10-07 02:16:44
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Cardiovascular System Drugs
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Patient Instructions
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  1. What important instructions should the health care professional give the patient who is taking the calcium channel blocker (dihydropyridine) drug nifedipine (Adalat, Procardia)?
    • Report rapid heartbeat, increase in angina pain.
    • Do not perform hazardous activities such as driving, until effects are known.
    • Be aware that facial flushing may occur.
    • Report swelling of feet and legs.
    • Advise patient to take as prescribed and not to increase dosage.
    • Report dizziness, syncope.
    • Report bleeding gums, gum tissue growth.
    • Obtain regular dental care.
  2. What important instructions should the health care professional give the patient who is taking the nitrate drugs nitroglycerin (Nitrostat, Nitro-Dur, Nitro-Bid) and isosorbide dinitrate (Isordil)?
    • Take over-the-counter analgesic for unrelieved headaches (most subside spontaneously within 20 min).
    • Report dizziness, syncope.
    • Move slowly from lying down to sitting or standing to prevent injury.
    • Do not perform hazardous activity, such as driving, if dizziness occurs.
    • Take pulse, and report tachycardia above prescribed parameters.
    • Remove transdermal forms for part of each day.
    • Take only as many sublingual tablets as needed.
  3. What important instructions should the health care professional give the patient who is taking the sympathomimetic drug dobutamine (Dobutrex)?
    • Be aware that continuous monitoring is performed during administration.
    • Report chest pain immediately.
  4. What important instructions should the health care professional give the patient who is taking the phosphodiesterase inhibitor drug milrinone (Primacor)?
    • Be aware that laboratory monitoring is ongoing before, during and after infusion.
    • Be aware that ECG rhythm and vital sign monitoring is performed continuously during infusion.
    • Report chest pain during infusion.
  5. What important instructions should the health care professional give the patient who is taking the alpha1 adrenergic blocker drug doxazosin (Cardura)?
    • Report dizziness, syncope, rapid heartbeat, or palpitations.
    • Take this drug at bedtime.
    • Rise slowly from lying to sitting or standing to prevent injury.
    • Do not perform hazardous activities, such as driving, for at least 12 hr following first dose and subsequent dosage increases.
    • Report an increase in the frequency of headaches
  6. What important instructions should the health care professional give the patient who is taking the class II/beta adrenergic blocker drug propranolol (Inderal)?
    • Check pulse rate daily before taking drug and report pulse slower than 60 beats/min (or prearranged parameter).
    • Report shortness of breath, extremity edema, night cough.
    • Do not stop taking this drug abruptly; talk to the provider.
    • Report increase in angina or new onset of chest pain.
    • Report sensations of cold, numbness in hands or feet.
    • Protect extremities from severe cold.
    • Report confusion, fatigue, drowsiness.
    • Avoid hazardous activities, such as driving, until effects are known.
  7. What important instructions should the health care professional give the patient who is taking the cardiac glycoside digoxin (Lanoxin)?
    • Report nausea, loss of appetite, or vomiting.
    • Report headache, or visual disturbances.
    • Report heart palpitations.
    • Learn to monitor pulse rate and report decrease or increase beyond prescribed parameters.
    • To decrease risk of toxicity or low serum levels, take digoxin at the same time each day; do not skip or double a dose.
    • Report signs of hypokalemia, such as muscle weakness.
  8. What important instructions should the health care professional give the patient who is taking the fibrate drug gemfibrozil (Lopid)?
    • Report nausea, vomiting, diarrhea.
    • Report new inability to tolerate fried foods, upper abdominal discomfort and bloating.
    • Report muscle or joint pain.
    • Report abdominal pain, jaundice, fatigue.
  9. What important instructions should the health care professional give the patient who is taking the centrally acting alpha2 agonist drug clonidine (Catapres)?
    • Take at bedtime to minimize drowsiness, dizziness.
    • Do not perform hazardous activities, such as driving, until effects are known.
    • Suck hard candies, chew sugarless gum, sip water to minimize dry mouth.
    • Be assured that dry mouth will diminish with time.
    • Do not abruptly stop taking clonidine; when discontinued, taper according to instructions.
  10. What important instructions should the health care professional give the patient who is taking the class III/potassium channel blocker drug amiodarone (Cordarone)?
    • Take with food or milk if nausea, vomiting, or constipation occur (but be sure to take at consistent times during the day).
    • Comply with chest x-ray and pulmonary function testing.
    • Report fever, dry cough, shortness of breath or other respiratory symptoms.
    • Report sensitivity to light and changes in vision.
    • Obtain regular ophthalmic checkups.
    • Wear sunglasses when out in sunlight.
    • Report dizziness, syncope.
    • For oral therapy, monitor pulse rate and report rates slower than 60 beats/min.
    • Report weight gain and edema.
    • Be aware that skin discoloration may occur.
    • Report tremor, dizziness, hallucinations.
    • Avoid hazardous activity such as driving if dizziness occurs.
    • Due to long half-life of this drug, avoid pregnancy and breastfeeding during therapy and for several months after therapy is discontinued.
  11. What important instructions should the health care professional give the patient who is taking the thiazide diuretic drug hydrochlorothiazide (HydroDIURIL)?
    • Eat foods rich in potassium (if indicated), such as citrus fruits, potatoes, bananas.
    • Report signs of electrolyte imbalance, such as confusion, muscle twitching or weakness, irregular pulse, nausea.
    • Patients who have diabetes mellitus need to carefully monitor blood glucose levels and notify provider for persistent hyperglycemia.
    • Be aware that uric acid levels may increase, usually without symptoms.
    • Patient with a history of gout needs to report symptom onset to a provider
  12. What important instructions should the health care professional give the patient who is taking the class IC/sodium channel blocker drugs flecainide (Tambocor) and propafenone (Rythmol)?
    • Report any visual changes (blurred vision, difficulty focusing).
    • Have regular ophthalmic examinations.
    • Report shortness of breath, edema.
    • Comply with temporary use of Holter monitor if necessary
  13. What important instructions should the health care professional give the patient who is taking the class IB/sodium channel blocker drug lidocaine (Xylocaine)?
    • Report numbness of lips, unusual sensations.
    • Be aware that continuous cardiac monitoring and frequent vital sign monitoring occurs during infusion.
  14. What important instructions should the health care professional give the patient who is taking the beta adrenergic blocker drugs atenolol (Tenormin) and metoprolol (Lopressor)?
    • Check pulse rate daily before taking the drug and report a pulse slower than 60 beats/min (or prearranged parameter).
    • Report shortness of breath, extremity edema, night cough.
    • Do not stop taking this drug abruptly; talk to the provider.
    • Report increase in angina or new onset of chest pain.
  15. What important instructions should the health care professional give the patient who is taking the class IV/calcium channel blocker drug verapamil (Calan)?
    • Take as prescribed; do not increase dosage.
    • Report dizziness, syncope.
  16. What important instructions should the health care professional give the patient who is taking the direct-acting vasodilator (hydralazine) drug hydralazine (Apresoline)?
    • Headache and palpitations may occur 2 to 4 hr following first dose; notify provider if these do not subside.
    • Plan to perform quiet, nonhazardous activities following first dose.
    • Beginning with a low dose will minimize the first dose effects
  17. What important instructions should the health care professional give the patient who is taking the adrenergic neuron blocker drug reserpine (Serpalan, Sk-Reserpine)?
    • Report feelings of depression, including insomnia, and loss of appetite and interest in daily activities.
    • Do not perform dangerous activities, such as driving, until effects are known.
    • Move slowly from lying down to sitting and standing to prevent falling.
    • Report dizziness, syncope to provider.
    • Report prolonged or severe gastrointestinal (GI) effects (diarrhea, cramps).
  18. What important instructions should the health care professional give the patient who is taking the HMG-CoA reductase inhibitor (statin) drug simvastatin (Zocor)?
    • Report muscle or joint pain.
    • Report abdominal pain, jaundice, fatigue.
    • Comply with periodic liver function testing
  19. What important instructions should the health care professional give the patient who is taking the loop diuretic furosemide (Lasix)?
    • Eat foods rich in potassium (if indicated), such as citrus fruits, potatoes, bananas.
    • Report signs of electrolyte imbalance, such as confusion, muscle twitching or weakness, irregular pulse, nausea.
    • Have blood pressure monitored frequently.
    • Report dizziness, syncope.
    • Avoid hazardous activities, such as driving, until effects are known.
    • Report new onset of hearing loss, ringing in ears, or vertigo.
    • Patients who has diabetes mellitus needs to carefully monitor blood glucose levels and notify provider for persistent hyperglycemia.
    • Be aware that uric acid levels may increase, usually without symptoms.
    • Patient with a history of gout needs to report symptom onset to a provider
  20. What important instructions should the health care professional give the patient who is taking the class IA/sodium channel blocker drugs quinidine (Apo-Quinidine, Novo-Quinidine) and procainamide (Pronestyl)?
    • Take with food if nausea, vomiting, diarrhea occur.
    • Report gastrointestinal (GI) symptoms to provider.
    • Monitor pulse rate and report changes from prescribed parameters; keep record of pulse rate.
    • Report dizziness, syncope.
    • Avoid hazardous activities such as driving if hypotension occurs.
    • Do not change prescribed dose or dosage intervals; take at fixed times daily.
    • Be aware that monitoring of blood, ECG occurs.
    • Report sudden chest pain, dyspnea to provider; call 911 for severe symptoms.
    • Be aware of the reasons for use of the IV infusion pump, vital sign equipment, and cardiac monitors.
    • Report flushing, headache or feeling of faintness immediately.
    • Report symptoms of cinchonism to provider.
    • Report onset of rash, fatigue, muscle and joint pain.
    • Report fatigue, weakness, easy bruising or infection.
  21. What important instructions should the health care professional give the patient who is taking the potassium-sparing diuretic drug spironolactone (Aldactone)?
    • Report palpitations, irregular pulse, or other signs of hyperkalemia.
    • Avoid potassium supplements, large amounts of high potassium foods, and salt substitutes.
    • Report menstrual irregularities, abnormal hair growth, deepening of voice, gynecomastia.
  22. What important instructions should the health care professional give the patient who is taking the alpha/beta blocker drug carvedilol (Coreg)?
    • Report dizziness, syncope.
    • Move slowly from lying to standing position to prevent falls.
    • Do not perform hazardous activity, such as driving, until effects are known.
    • Check pulse rate daily before taking drug and report to provider for pulse slower than 60 beats/min (or prearranged parameter).
  23. What important instructions should the health care professional give the patient who is taking the angiotensin receptor blocker (ARB) drug losartan (Cozaar)?
    • Report minor swelling of mouth, throat to provider; call 911 immediately if severe reaction occurs.
    • Report frequent headaches or insomnia.
    • Report episodes of fainting, dizziness.
    • Do not take if pregnant or breastfeeding.
    • Tell provider if pregnancy is a possibility
  24. What important instructions should the health care professional give the patient who is taking the aldosterone antagonist drug spironolactone (Aldactone)?
    • Do not take potassium supplements or use potassium-containing salt substitutes or drugs that raise potassium levels unless prescribed by the provider.
    • Report palpitations, muscle twitching, weakness, or paresthesias in extremities.
  25. What important instructions should the health care professional give the patient who is taking the direct renin inhibitor aliskiren (Tekturna)?
    • Do not take potassium supplements, salt substitutes, or drugs that raise potassium levels.
    • Report palpitations, muscle twitching, weakness, numbness, and tingling.
    • Report persistent cough.
    • Report minor swelling of the mouth or throat; call 911 immediately for a severe reaction.
    • Report diarrhea and abdominal pain.
    • Stop taking aliskiren if pregnant; fetal injury may occur after the first trimester
  26. What important instructions should the health care professional give the patient who is taking the angiotensin-converting enzyme (ACE) inhibitor drug captopril (Capoten)?
    • Be aware that hypotension may occur following the first dose.
    • Lie supine if lightheadedness occurs.
    • Report dry cough.
    • Report rash.
    • Report metallic or decreased ability to taste foods associated with decreased intake and weight loss.
    • Report minor swelling of mouth, throat; call 911 immediately if severe reaction occurs.
    • Refrain from using potassium supplements and potassium-containing salt substitutes.
    • Report palpitations, muscle twitching, weakness or paresthesias in extremities.
    • Report sore throat or other signs of infection.
    • Do not take if pregnant or breastfeeding.

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