NURS 617 Exam 1 Pharm concepts Latest
Update 2024-2025 Actual Exam 125 Questions
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- Can be given IV for acute or critically ill
- Rapid onset of action, immediate when given IV
- Short duration of action which results in rapid recovery from adverse effects
- Easy conversion to other nitrates, if necessary for long term nitrate therapy
- Very useful in those with acute CHF in association with ischemic heart disease or MI -
CORRECT ANSWER: Advantages of Nitroglycerin in treatment of heart failure
- Headache and Dizziness
- can cause hypotension and tachycardia
- Tolerance can develop - CORRECT ANSWER: Disadvantages of nitroglycerin in acute
congestive heart failure
- headaches that should become less likely with continuous use, usually accompanied
by facial flushing
- Tolerance and physical dependence can occur and can be decreased by incorporating
"drug holidays"
- Hypotension and tachycardia at higher doses.
- Occasionally provoke angina
- Withdraw slowly - CORRECT ANSWER: Disadvantages of Nitrates in treatment of
angina
- Highly toxic drug with very low therapeutic index
- GI adverse effects including anorexia, nausea and vomiting
- Bradycardia and arrhythmias are common
- Requires close observation of serum potassium because hypocalcemia increases the
risk of toxicity.
,- Use with St. John's wort may decrease plasma digoxin levels.
- Has not been shown to improve mortality - CORRECT ANSWER: Disadvantages of
Digoxin
- Hypotension
- Contraindicated in pregnancy
- Very expensive
- May cause some skeletal muscle cramping
- Some references report a persistent nocturnal cough in some patients though the
mechanism is unclear .
- headache and diarrhea are occasionally reported. - CORRECT ANSWER:
Disadvantages of ARBs (sartans)
- Nitrates
- ACE inhibitors
- Beta Blockers
- CCB
- Antithrombotic drugs
- Statins - CORRECT ANSWER: What categories of drugs are used to treat Angina
- Possible bradycardia and CHF
- Orthostatic hypotension
- Can cause a variety of arrhythmias (especially likely with verapamil and nifedipine)
- Constipation
- May worsen GERD symptoms
- More expensive
- Other than some limited studies with nifedipine, these are generally not safe in
pregnancy - CORRECT ANSWER: Disadvantages of Calcium Channel Blockers
- Reflex tachycardia
, - Sodium and water retention and edema
- Frequently requires concomitant use of Beta blockers and diuretics
- Not useful as mono therapy - CORRECT ANSWER: Disadvantages of Direct acting
vasodilators
- Selective alpha 1 receptor blockers and CCBs due to orthostatic hypotension risk
- CCB due to constipation
- Exercise caution with Beta blockers and CCBs due to risk of CHF
- Diuretics since older adults already have contracted blood volume (may have to use
lower than normal dose to begin therapy) - CORRECT ANSWER: Which
antihypertensives should be avoided in older adults?
- Those with bilateral renal stenosis
- Those with history of angioedema
- Pregnant patients - CORRECT ANSWER: ACE inhibitors are contraindicated in what
patients?
- tinnitus
- confusion
- hyper-reflexia
- metabolic acidosis
- arrhythmias
- hypotension
- death - CORRECT ANSWER: What are signs of Thiocyanate poisoning?
-May lower BP too much especially when being used with diuretics
-May produce severe hyperkalemia especially in those with renal insufficiency
-Angioedema
-May cause an increase in renal insufficiency
-Persistent nocturnal cough
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