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what side effect of atorvastatin (Lipitor) should pt. notify MD for?
*atorvastatin (Lipitor) is an antihyperlipidemic drug (HMG-CoA reductase inhibitor)
rhabdomyolysis: rare condition in which muscle damage results in the release of muscle cell contents into the blood; results in muscle pain; an acute sometimes fatal disease where the products of skeletal muscle destruction accumulate in renal tubules --> ARF
how do you know if simvastatin (Zocor) is working?
*simvastatin (Zocor) is an antihyperlipidemic drug (HMG-CoA reductase inhibitor)
- total cholesterol level is under 200
- *simvastatin (Zocor): inhibit the manufacture of cholesterol/promote breakdown of cholesterol; lowers blood levels of cholesterol, LDL's & serum triglycerides; used to tx hyperlipidemia
desirable levels for total cholesterol & HDL (high density lipoproteins)?
*high density lipoproteins: elevation decreases risk of heart disease, brings cholesterol from peripheral cells to the liver for metabolism & excretion
- total cholesterol: < than 200 mg/dL
- HDL: < than 40 mg/dL is low, level should be > than 60 mg/dL
bile acid resins (sequestrants) are not given w/ what type of juice?
*bile acid resins (sequestrants): [antihyperlipidemic drug] bind bile in the intestinal tract preventing absorption, causing the liver to use cholesterol to make more bile, this lowers serum cholesterol
*ex: cholestyramine (Questran, Prevalite), colestipol (Colestid), colesevelam (Welchol)
another name for niacin (Nicotinic Acid, Niaspan)?
*niacin (Nicotinic Acid, Niaspan): antihyperlipidemic drug
what med. is given w/ niacin (Nicotinic Acid, Niaspan), how much & why?
325 mg of ASA (acetylsalicylic acid aspirin) to reduce flushing & itching taken 30 min. prior to niacin (Nicotinic Acid, Niaspan)
what type of drug is gemfibrozil (Lopid) & what is it given for?
*gemfibrozil (Lopid): increases the excretion of cholesterol in the feces & decreases the production of triglycerides by the liver lowering serum lipid levels
gemfibrozil (Lopid): antihyperlipidemic drug (fibric acid derivative) given to tx pt. w/ very high serum triglyceride levels that are at risk for abd pain & pancreatitis & who do not experience a response to dietary modifications
what type of drug is HCTZ, hydrochlorthiazide (Hydrodiuril)?
- (thiazide) diuretic: [antihypertensive drug] increases the excretion of sodium w/ water passively following (blocks reabsorption of Na & Cl in the tubules)
- *check potassium levels
what type of drug is furosemide (Lasix)?
- (loop) diuretic: antihypertensive drug
- *check potassium levels
what type of drug is lisinopril (Zestril)?
angiotensin-converting enzyme inhibitor (ACE-inhibitor): [antihypertensive drug] slows the conversion of angiotensin 1 to 2; angiotensin 2 is the body's most powerful vasocostrictor, also stimulates secretion of Aldosterone whice causes sodium reabsorption
what should you be concerned about for a pt. taking furosemide (Lasix) or lisinopril (Zestril)?
dehydration, hypokalemia, electrolyte imbalance & hypotension
what s/s would a pt. taking furosemide (Lasix) exhibit if their potassium level is low?
dysrrhythmias, muscle cramps & twitching
nursing intervention prior to giving B/P or cardio med?
take B/P & apical pulse for 1 min.
what type of drug is metoprolol (Lopressor) & what is it used for?
- beta-adrenergic blocker: antihypertensive drug
- used for MI & HTN, stable angina, arrythmias, migraine headaches, HF & glaucoma
what VS is taken before administering furosemide (Lasix)/lisinopril (Zestril)?
- *hold med. if systolic pressure is below 100 or 110
why is grapefruit juice not given w/ furosemide (Lasix) or lisinopril (Zestril)?
- too acidic & deactivates med*grapefruit juice interferes w/ the liver's ability to rid the body of calcium channel blockers
pt. teaching regarding B/P med.?
when any antihypertensive drug is given, postural (dizziness & light headedness occuring when individual rises suddenly from lying/sitting position)/orthostatic (occurs when individual has been standing in 1 place for a long time) hypotension can occur; rise slowly from a lying/sitting position & avoid standing for long periods of time; *take in a safe place at home
what type of drug is bumetanide (Bumex)?
- loop diuretic: antihypertensive drug
- *monitor potassium levels
how do you apply a patch med.?
- cleanse & pat dry skin, use gloves (to avoid coming in contact w/ ointment) to apply patch in a hairless area
- *B/P & pulse must be taken prior to topical drug (nitrate) administration (don't give if pulse is > than 100 or < than 60 & if B/P is too low)
what type of drug is valsartan (Diovan)?
angiotensin 2 receptor blocker: antihypertensive drug
what does sublingual mean?
under the tongue
why do you get a headache w/ nitrate?
*nitrate: antianginal drug
nitrate causes vasodilation: increases the lumen of the artery/arteriole & increases the amt. of blood flowing through the vessels; increases blood flow resulting in an increase in O2 supply to surrounding tissues
pt. teaching regarding nitrate administration?
- med. can be taken up to 3 doses, 5 min. apart
- *if not effective, might be an MI
is nitroglycerin long/short-acting?
is isosorbide (Isordil) long/short-acting, what is it used for & when is it taken?
*isosorbide (Isordil): antianginal drug
long-acting nitrate used for stable angina taken daily at the same time
which side effect of isosorbide (Isordil) should the pt. notify MD for in order to change dosage?
- headache (may be severe & persistent)
- dizziness, weakness
- flushing (capillary dilation)
- reflex tachycardia (bradycardia)
therapeutic level for pt. taking heparin?
*heparin: anticoagulant drug
1.5-2.5 times the control
which labs are done prior to administering heparin?
PTT & INR
which labs are done for warfarin (Coumadin)?
*warfarin (Coumadin): anticoagulant drug
PT & INR
what type of drug is enoxaparin (Lovenox) & what is it used for?
- low-molecular weight heparin (LMWH's): anticoagulant drug
- used in pt. at risk for DVT (ex: any kind of bone (hip) surgery)
what is the antidote for heparin?
what is the antidote for warfarin (Coumadin)?
vitamin K (AquaMEPHYTON)
what should a pt. taking heparin do if their gums begin to bleed?
notify MD (labs needed)
s/s of heparin overdose?
heparin dosage & route?
5,000-10,000 units vian injection (SQ/IV)
legal rule for heparin administration?
checked by 2 lincensed nurses
administration route for warfarin (Coumadin)?
- *heparin cannot be absorbed orally
tar-colored stool for pt. taking warfarin (Coumadin) indicates?
what type of drug is dalteparin (Fragmin) & in which route is it given?
LMWH: anticoagulant drug given SQ/IV
"clot buster" drugs?
- thrombolytic drugs:
- alteplase (Activase)
- reteplase (Retavase)
- streptokinase (Streptase)
- tenecteplase (TNKase)
- urokinase (Abbokinase)
too much streptokinase (Streptase) can cause what?
action of streptokinase (Streptase)?
- used to dissolve blood clots that have already formed w/in the walls of a blood vessel
- re-open blood vessels after they become occluded
- break down fibrin clots by convertin plasminogen to plasmin
another name for bloody nose?
what type of drug is clopidogral (Plavix)?
adenosine diphosphate (ADP) receptor blocker (antagonist): antiplatelet drug
what is digitalization?
a series of (digoxin) doses are given until therapeutic effect is exerted
antidote for digoxin overdose?
- atropine sulfate
- *life threatening toxicity is tx w/ digoxin immune fab (Digibind)
brand name for digoxin?
nursing intervention done prior to giving digoxin (Lanoxin)?
- take apical pulse for 1 min. (hold drug for AP < than 60 or > than 100)
- *dig level (0.5-2 ng/mL)
what type of drug is digoxin (Lanoxin)?
what is telemtry?
what type of drug is amiodarone (Cordarone)?
class III potassium channel blocker: antiarrythmia drug
which type of arrythmia is worse: atrial/ventricular?
what is a PVC arrythmia?
premature ventricular contractions: beat originating in ventricles instead of SA node
what type of drug is lidocaine (Xylocaine)?
- "membrane stabilizer"
- *class IB: antiarrythmia drug
action of filgastrim (Neupogen)?
*filgastrim (Neupogen): colony stimulating factor [immunostimulant drug]
glycoproteins that act on the hematopoietic (blood forming) cells to stimulate proliferation, differentation & maturation of WBC's
what is erythropoietin?
RBC's in the bone marrow
erythropoietin is not given when what VS is elevated?
what type of drug is epoetin alfa (Epogen, Procrit), which route is it given & what is it given for?
- hematopoietic: immunostimulant drug
- given SQ/IV to tx anemias (of chron's disease) associated w/ CKD, chemotherapy, Zidovudine (AZT) therapy for HIV, postsurgical blood replacement
what type of drug is darbepoetin alfa (Aranesp)?
erythropoiesis stimulating proteins (hormone): immunostimulant drug
pt. teaching for taking erythropoiesis stimulating hormone?
- contraindicated for pt. w/ htn
- taken daily at the same time to maintain hormone level
iron supplements are taken w/ what kind of juice?
what should you consume more when taking iron supplements?
fiber & fluids
iron supplements can turn your stool into what color?
what type of disease can develop w/ folic acid & iron deficiency?
autoimmune diseases: chron's disease, colitis, lupus
s/s of b12 deficiency/pernicious anemia?
beefy red tongue & paresthesia