PHARMACOLOGY DRUGS for ATI test with solutions 2024

Receptors - Answer Norepinephrine-Adrenergic (adrenergic comes from the word adrenalin) Alpha 1-all sympathetic target organs except the heart-constrict the blood vessels and dilation of pupils Alpha 2-Presynaptic adrenergic nerve terminal-inhibits the release of norepinephrine Beta 1-Heart and Kidneys (BETA 1-ONE HEART)-increased heart rate and force of contraction, release of renin Beta 2-All sympathetic target organs-inhibits smooth muscle (BETA 2-TWO LUNGS) EXAM 1 DRUGS!!!! - Answer ........... Beta blockers/olol's - Answer Beta-Adrenergic Blockers Metoprolol/Lopressor ENDING OLOL Beta Blockers are use with heart failure, hypertension, angina and with myocardial infarctions. Action = Blocks Beta-Receptors in the heart causing... Decreases = HR, force of contraction, Rate of atrioventricular (AV) conduction SE = Bradycardia, lethargy, GI disturbance, congestive heart failure, decrease BP, depression The beta blockers stop sympathetic nervous system stimulation of the heart. Does not allow the heart rate and blood pressure to rise with stress thus lowering the oxygen demand of the heart. It is very heart protective! Will slow the heart rate and lower the blood pressure Can have beta 2 blockage with larger doses-will constrict the bronchioles-watch for clients with known COPD, Asthma Nursing Interventions Check pulse-needs to be 60 or above Check blood pressure-if hypotensive do not give (Systolic below 100 is a good rule of thumb I go by) Monitor for sexual dysfunction-impotence for men-a good reason for non-compliance Drowsiness/Fatigue-operating heavy machinery, driving could put client at risk Insomnia- Contraindicated with Heart Blocks, Bradycardia, Worsening Heart Failure Increases Hypoglycemic effect of Insulin-monitor blood sugars and for hypoglycemia, may need to lower insulin dosage Beta Blockers have to be weaned slowly to prevent rebound hypertension and tachycardia-if a client wants to stop his beta-blocker they need to contract their physician CCB,/calcium channel blockers - Answer Nifedipine/Adalat/Procardia/Norvasc-controls blood vessels Diltiazem/Cardizem Verapamil/Calan/Isoptin/Verelan-controls heart rate and blood vessels Angina/Raynaud's/Vasospastic Angina/Atrial Arrhythmia's Blocks calcium channels in the myocardial and vascular smooth muscles, decreases the contraction of smooth muscle-relaxes the arteries-vasodilation. Blocking of calcium channels in the SA and AV node-Slows conduction through the SA and AV node. Decreases the force of contraction slows heart rate Grapefruit juice may increase absorption of nifedipine Side Effects: Relaxes smooth muscle and cardiac muscle- Headache Dizziness-Take lying, sitting and standing B/P, educate client to sit and stand slowly Peripheral edema-assess for edema, monitor for worsening (diuretic) Flushing Reflex tachycardia-monitor for elevated heart rate (may need a BB) Constipation-increase fibers and fluids (if not restricted) stool softener Fatigue-Due to low heart rate-monitor EKG, pulse rate and rhythm Weakness-Monitor B/P and Heart Rate Impotence and sexual dysfunction-Discuss possibility with client-have client to call and not just to stop medications Hepatotoxicity-ALT, AST, ALK PHOS, Bilirubin MI-Monitor for chest pain, dyspnea, increases fatigue, weakness CHF-Monitor for chest pain, dyspnea, edema, increasing weight, decreasing output, increasing HR and B/P Angioedema-edema in face, throat, trouble swallowing, trouble breathing, thickened tongue Grapefruit juice may increase absorption of nifedipine Acute Toxicity With an overdose or overmedicated Gastric lavage Monitor EKG-bradycardia-widening QRS, hypotension Norepinephrine to treat hypotension and decreased cardiac contractility Atropine or Isoproterenol-Bradycardia and Cardiac Blocks Verapamil (Calan, Covera, Isoptin Verelan) Class IV antidysrhythmic Calcium channel blocker Inhi Pril/ace inhibitors - Answer Enalapril/Vasotec PRIL-is the ending for ace's Reduces Angiotensin 2 and aldosterone levels Prevents Angiotensin 1 from converting to Angiotensin 2 in the lungs-leaves the Angiotensin 1 hanging in the lungs-creates irritation-cough Vasodilation-mostly arteriole (decreases afterload) Excretion of sodium and water-retention of K (decreases preload) Treats hypertension and heart failure Do not take 2nd and 3rd Trimester of pregnancy SE = Angioedema-allergic reaction-swelling of tongue, throat-stop taking and notify md Hyperkalemia-monitor for widening and slowing of pulse/qrs, weakness, fatigue, avoid high K foods, AVOID SALT SUBSTITUTES-usually very high in K, avoid potassium sparing diuretics, sport drinks are high in K also Orthostatic Hypotension-teach client to sit and stand slowly, enact fall precautions Neutropenia/Agranulocytosis-monitor CBC-WBC count, reoccurring infections Renal Insufficiency-Monitor weight, edema, I/O, BUN, Cr, and GFR Hepatic Insufficiency-Monitor AST, ALT, ALK PHOS, Bilirubin Cough-Cough lozenges, hard candy, increase fluid intake, sleep with HOB elevated, antihistamines ACE Inhibitors Discussed these medications with hypertension Arb's-Angiotensin receptor blockers, sartan's No Cough, same effects and side effects as Ace's-just not as potent Sartan's/angiotension blockers/arb's - Answer ... Arb's-Angiotensin receptor blockers, sartan's No Cough, same effects and side effects as Ace's-just not as potent Nitrates