Med admin test 2
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Wh/ diuretics are most often RX as maintenance for HTN?
Wh/ class of diuretics could lead to hyperkalemia?
- K-sparing diuretics
- such as:
- Spironolactone (Aldactone)
- Triamterene (dyrenium)
- Amiloride (Midamor)
What is the best time of day for PT to take their diuretics?
- In the A.M.
- To pervent sleep disturbances
What is the suffix for ACE inhibitors?
What are the side effects of ACE inhibitors?
What is the action for ACE inhibitors?
They decrease peripheral vascular resistance without
- Increasing cardiac output
- Increasing cardiac rate
- Increasing cardiac contractility
What dose ACE stand for?
What is the mechanism of action for ACE inhibitors?
- Blocks the enzyme that converts angiotensin 1 to angiotensin 2
- They work throught the reini-angiotensin-aldosterone system
When should you notify the MD when administering furisemide?
If urine output dose not increase in 5-20 min
What could result from pushing furosemide too fast?
Could result in hearing loss
What is the push rate of IV furosemide?
What is the expected therapeutic outcome of diuretic therapy?
- Decrease B/P (diuretics are the 1st line agent HTN)
- Decrease edema
What is the relationship btwn bld glucose and diuretic?
- Thiazide and Loop diuretics promote hyperglycemia and hyperlipidemia
- (monitor bld glucose because exacerbate diabetes)
What are the S/S of K depletion/hypokalamia
- Muscle weakness
- ABD distension
- leg cramps
- cardiac dysrhythmia
What is angina?
(chest pain) occurs when the O2 supply demand of the heart is greater than the supply
How are Ca channel blockers effewctive as anti-arrhythmics?
- They block the Ca channel wh/ causes a slowing of conduction in the artial and AV node
- They are also used to control ventricular response to atrial fibrillation and flutter
How are beta blockers effective anti-arrhythmics?
Reduce cardiac stimulation by blocking stimulation of the beta1 receptors wh/ reduces HR and contractility
Wh/ classes of anti-HTN drugs can also be used as anti-arrhythmics?
- Beat blockers
- Ca channel blockers
what are the major S/E of nitrates?
- (Wh/ can be treated w acetaminophen and usu diminishes over time)
- Reflex tachycardia
How do nitrates relieve angina?
- By producing vasodilation of the venous system wh/ reduces preload and workload of the heart
- Dilate coronary arteries
Wh/ antihypertnasives are also used for dysrhythmias and angina?
Ca Channel blockers
What is important teaching on beta blockers?
- BB can mask the S/S of hypoglycemia
- Thye can cause activity intolerance and fatigue
- They blut activity induced heart increases
- May worsen CHF
What is the fxn of diuretics in managing hypertension?
Decreasing circulating bld volume
Why is it necessary for clients taking loop diuretics to eat food rich in K/take a k supplement?
Loop diuretics promote depletion of H2O, K, Na, Ca, Mg
What is the mechanism of action for K-sparing diuretics?
- Block aldosterone receptors in the distial tubules
- Interfere w Na/K exchange in the collecting and convoluted tubules
What are the most commonly used diuretics?
What is the mechanism of action of Thiazide?
- inhibit reabsorption of Cl and Na in the distial tubules
- Promote Ca reabsorption
- Promote hyperglycemia
What are loop diuretics more potent?
Because they block Cl
What is the mechanism of action for loop diuretics?
- Block absorption of sodium from the loop of henle
- They block Na and Cl reabsorption in the ascending loop of henle
What is the goals of HTN therapy?
- Reduce pump action
- Reduce volume
What is the suffix for Alpha-1 adrenergic blockers?
What is the suffix for beta blockers?
What class of anti-HTN drugs are associated w 1st pass phenomenon?
Alpha-1 Adrenergic blockers
What is the 1st dose phenomenon?
PT suffers from syncope and dizziness and are instructed to take medications a bedtime
Which anti-HTN drug has cough and hyperkalemia as a common S/E?
What is the peak of long acting insulins?
What is the onset of long acting insulins?
What is the duration of long acting insulins?
What is the peak of short acting insulins?
What is the duration of short acting insulins?
What is the onest of short acting insulins
Wh/ insilins are used for meal time coverage?
- Short acting
- regular insulin (novolin R and Humulin R)
Wh/ insulins are used for basal coverage?
- intermediate acting insulins
- (NPH, Isophane insulin suspension)
What should a PT do if they miss a dose of digixon?
- Take missed dose w in 12 hours of scheduled dose or do not take it at all
- DO NOT double doses
- Contact MD if 2 days of doses are missed
What is a sign that anti-arrhythmics are acheiving their therapeutic effect?
- Increase in cardiac output (positive intropic effect)
- Slowing of the heart rate (negative chronotropic effect)
What are the common S/E of digixon?
- Vision disturbances (yellow, green, blurry)
- electrolyte imbalances
What is the effects of diurectis on digixion levels?
- may cause hypokalemia
- (increase risk of toxicity)
What are some things that should be monitored w the PT on digitalis?
- hepatic and renal functioning
What are the effects of low K levels in the PT on digitalis?
Hypokalemia may make the PT more susceptible to digitalis toxicity
Wha are the expected outcomes of the PT on digixon?
- They have both a positive inotropic effect (increased cardiac output)
- Negative chronotropic effect (slowing of the heart rate)
What is dromotrophic effect?
- Effect the conduction of current
- Negative= decrease in conduction activity of a current
- Positive= increase in conduction activity current
What is chronotropic effect?
- Affecting the rhythm of the movements of the heart (heartbeat)
- Positive= increasing the HR
- Negative=decreasing the HR
What is an intropic effect?
- Affects the contraction of the muscles (especially the heart)
- Increases the myocardial contractility therefore affecting the force of muscle contractions
What is the antidote for digoxin?
Digoxin immune fab (Digibind) IV diluted in 50 mL of NS over 30 min
What is the therapeutic range for digixon?
- serum digixon levels sould me monitored closely
What are the S/S of digixon toxicity?
- Bradycardia (<60BPM)
- Premature ventricular contractions
- visual disurbances
How are BB helpful for MI
They block the stimulatioin of Beta 1 receptors wh/ results in reduced HR, conduction, and contractility
How do Beta adrenergic blockers relieve angina?
- BB decrease workload of the heart wh/ decreases the O2 need
- They also reduce angina by recucing contractility and arterial B/P wh/ reduces after load
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