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NUR20007 - Hurdle Meds Study Set Exam
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NUR20007 - Hurdle Meds Study SetExam
Digoxin drug class - Answer cardiac glycoside
Digoxin mechanism of action - Answer 1. Binds to, and inhibits the sodium-potassium
pump within cardiac muscle resulting in increased intracellular Na and Ca.
2. Causes increased stroke volume, contractility and cardiac output, slowing down HR.
digoxin indications for use - Answer 1. Congestive heart failure
2. Atrial fibrillation (AF)
3. Paroxysmal atrial tachycardia
Digoxin adverse effects - Answer - (GI) Nausea, vomiting, diarrhoea, abdominal pain
- Bradycardia
- Rash, blurred vision
- Digoxin toxicity arrhythmia
Digoxin contraindications and interactions - Answer 1. Increased risk of toxicity with
hypokalaemia.
2. Ineffective if the patient is hypocalcaemic.
3. Effects are reduced by antacids.
Digoxin Nursing Considerations - Answer 1. Take pulse for 1 min; <60 withhold
medication
2. Monitor electrolytes (K+, Ca, Mg), as low levels increase risk of toxicity.
3. IM and subcut injection is not recommended as distribution is unpredictible.
Metoprolol drug class - Answer beta-adrenergic blocker
Metoprolol mechanism of action - Answer Decreases cardiac workload by reduction of
heart rate (due to selective blockade of beta1-adrenergic receptors)
Metoprolol indications for use - Answer 1. Hypertension
2. Angina
3. Coronary artery disease
4. Secondary treatment of AF
, Metoprolol adverse effects - Answer - (GI) Nausea, vomiting, diarrhoea
- Cold extremities
- Hypotension
- Oedema
- Fatigue
Metoprolol contraindications and interactions - Answer 1. Calcium channel blockers
may cause bradycardia, hypotension and asystole.
2. May enhance the effect of other antiarrhythmics.
3. May cause loss of diabetic control and delayed recovery from hypoglycaemia.
Metoprolol nursing considerations - Answer 1. Monitor HR and BP before administration,
if HR is <55 gradually stop therapy.
2. Overdose is treated with Atropine.
3. Monitor BGLs (mechanism of action may mask the symptoms of hypoglycaemia).
Atorvastatin drug class - Answer HMG-CoA reductase inhibitor
Atorvastatin mechanism of action - Answer Reduction of synthesis of cholesterol in
liver; increase in LDL receptors in liver
Atorvastatin indications for use - Answer 1. Hypercholesterolaemia
2. Hyperlipidaemia
3. Prevention of cardiovascular disease
Atorvastatin contraindications and interactions - Answer 1. May increase serum level of
digoxin.
2. Serum levels may be decreased by antacids
3. Grapefruit
4. Increased serum levels may occur if used with antifungals, ciclosporin, erythromycin.
Atorvastatin nursing considerations - Answer 1. Serum lipid levels should be monitored
regularly (therapeutic effect takes around 2 weeks)
2. Caution use in patients with liver impairment as the drug is metabolised in the liver.
3. Should be taken in the evening to maximize efficiency as cholesterol synthesis in the
liver is at its maximum between midnight and 2 am
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