Pharm 2 Final Exam With Questions And
Correct Answers Latest Version
Furosemide (Lasix) Answer: Loop diuretic for hypertension (if thiazide is not working), reduce
edema associated with heart, heapti cirrhosis, or renal failure
*MOA*- blocks the reabsorption of sodium and chloride in the loop of henle
*Side Effects*- electrolyte imbalance, hypokalemia, which can cause cardiac arrhythmias, orthostatic
hypotension
*Nursing Implications*- educate patient to stay hydrated and take potassium supplements and not to
take it at night, monitor hypokalemia as well as sodium and chloride, weight and I&Os, BUN, creatinine,
uric acid and blood glucose, *caution when giving with digoxin (cardiac glycosides becuase of
arrhythmias)*, can cause tinnutis if pushed too fast IV
Hydrochlorothiazide Answer: thiazide diuretic, most common med for hypertension (mild to
moderate) less effective than loop diuretics
*MOA*- blocks Na+ reabsorption and increases water and K excretion
*Side Effects*- lowers potassium but less so than furozemide, hypokalemia and hyponatremia, FVD,
hypotension, may cause hyperuricemia and gout attacks, can reduce effectiveness of antidiabetic drugs
*Nursing Implications*- educate patient to take even if BP is normal, check Na and K before
administration, check serum digoxin and monitor glucose, Pregnancy category B (contraindicated in
treating pre-eclampsia)
Spironolactone (Aldactone) Answer: potassium sparing diuretic
*MOA*: inhibits aldosterone meaning more K is reabsorbed and Na and water are excreted
*Side effects*: hyperkalemia, hyponatremia, GI disturbances, muscle weakness, impotence,
amenorrhea, gynecomastia
*Nursing Implications*- monitor potassium levels, BUN and creatinine, hypotension, do not give
potassium supplements
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,educate patient on hyperkalemia and dysrhythmias, pt taking lithium or digoxin can be at risk for
toxicity,
pregnancy category C,
drug can be given along with furosemide to help pt keep potassium, BLACK BOX- ACE inhibitors and
angiotensin receptor blockers increase risk of hyperkalemia
NaCl Answer: maintenance of fluid and electrolytes, treatment for hyponatremia (<130 mEq/L)
normal saline 0.9% NaCl isotonic
3% NaCl hypertonic- used specifically for hyponatremia < 115 mEq, *watch for pulmonary edema*
0.45% NaCl hypotonic
*Pregnancy category C*
*Nursing Implications*- signs of hypernatremia include lethargy, confusion, muscle tremor or rigidity,
hypotension, restlessness
KCl Answer: electrolyte, potassium supplement
side effects- gi irritation, hyperkalemia
Nursing implications- contraindicated in chronic renal failure or taking potassium sparing diuretics, acute
dehydration, heat cramps, digoxin toxicity w AV node disturbances DO NOT give push, dont infuse at a
rate greater than 10mEq in 50 mL/hr or 40 mEq/L total, monitor cardiac EKG, pregnancy category A, can
interact with ACE inhibitors and potassium sparing diuretics to cause hyperkalemia
Albumin Answer: drug used for shock, crystalloid solution
*MOA*- pulls fluid into the intravascular space to raise blood pressure and keep it up for hypovolemic
shock
*Side effects*- can cause hypertension causing fluid overload
Dextran 40 Answer: plasma volume expander colloid
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, *MOA*- quick mechanism of action, infuse rapidly (can double plasma volume in a few minutes via IV
1.2-2.4 g/min, effect lasts about 12 hours, dextran is a polysaccharide that is too large to fit though
capillary walls, it raises the osmotic pressure of the blood
*Side effects*- fluid overload (tachycardia, peripheral edema, hypertension, JVD)
*Nursing implications*- monitor bleeding due to prolonged bleeding time, pregnancy category C,
contraindicated for renal failure and dehydration as well as severe HF, not considered a blood product
*Indications*- hypovolemic shock secondary to burns, surgery, hemorrhage, can treat DVT due to
decreased platelet adhesivness
Atorvastatin (Lipitor) Answer: HMG-COA reductase inhibitors "Statins"
*MOA*: inhibits the hmg co a reductase pathway in the liver that creates cholesterol
*Side effects*: nausea and vomiting in the beginning
*Life threatening side effects*: muscle aches (myalgias)- muscle breakdowns-> creatinine ->
rhabdomylalysis-> kidney failure
*Nursing implications*: report diffuse muscle pain, monitor lipid panel, give at night because cholesterol
synthesis increased at night
Digoxin Answer: cardiac glycoside
*MOA*- negative chronotrope (slows heart rate) positive inotrope (increases contractility)
*Common side effects*- visual disturbances, predisposed for hypokalemia and dysrhythmias especially
taking Lasix
*Nursing implications*- hold for HR lower than 60, narrow therapeutic window, test for toxic level, test
potassium level, drug does not generally change the pt outcome but makes them feel better.
Lisinopril Answer: ACE inhibitor
*MOA*- blocks angiotensin 1 from becoming angiotensin 2 in the lungs by blocking converting enzyme
ACE
*Implications*- given for heart failure, hypertension control w other agents
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