ALL EXAM 3 EXEMPLARS

gemfibrozil is a

fibrate

niacin is a

niacin

atorvastatin is a

statin

ezetimibe is a

cholesterol absorption inhibitor

cholestyramine is a

bile acid sequestrant

drug action of gemfibrozil

reduce VLDL, LDL, and triglycerides

drug action of niacin

reduce VLDL and LDL

due to the large dose amount and large side effects of niacin

only 20% of patients can tolerate it

drug action of atorvastatin

inhibits HMG-CoA reductase, reduces all lipids expect HDL (slightly increased)

drug action of ezetimibe

inhibits cholesterol absorption in small intestine and reduces serum levels of chol, LDL, triglyc, and apoB levels

drug action of cholestyramine

1st antihyperlipidemic that reduces LDL level

side effects of gemfibrozil

gi upset, dyspepsia, dizziness, blurred vision, and cholelithiasis

side effects of niacin

gi upset, flushing of skin, hypotension, abnormal LFTS

side effects of atorvastatin

gi upset, dizziness, increase LFTs, and rhabdomyolysis

side effects of ezetimibe

diarrhea, infections, cholelithiasis, abdominal and back pain, and arthralgia/myalgia

side effects of cholestyramine

gi upset, constipation, peptic ulcer, GI bleeding

gemfibrozil should not be taken with

anticoagulants

niacin can also cause

hyperglycemia and hyperuricemia

statin overall is well tolerates but you should avoid

grapefruit juice and get annual eye exams

ezetimibe should be given with a

statin

cholestyramine should be given with a

stain

nitroglycerin is a

Nitrate

atenolol is a

beta blocker

diltiazem hyrochloride is a

calcium channel blocker

action of nitroglycerin

vasodilator, decreases preload and afterload

action of atenolol

blocks beta 1 and 2 receptors, blocks actions of catecholamines, and decrease heart workload and oxygen demands

action of diltiazem hyrochloride

relax coronary artery spasm and peripheral arterioles, decrease contractility, afterload, workload, O2 demands, and resistance of heart

side effects of nitroglycerin

headache, hypotension, flushing, weakness, syncope, dizziness

side effects of atenolol

bradycardia, hypotension, erectile dysfunction, peripheral edema, bronchospasms, dizziness, depression, fatigue

side effects of diltiazem hyrochloride

dizziness, flushing, headache, reflex tachycardia, edema, fatigue, hypotension

Routes of Administration for nitroglycerin

Sublingual, translingual, topical, aerosol spray

caution of atenolol

Do not abruptly discontinue... taper dose

Cautions for nitrates

Avoid heat or sunlight, if one dose isn't effective call 911

the exemplar hydrochlorothiazide is a

thiazide diuretic

the exemplar furosemide is a

loop diuretic

the exemplar mannitol is a

osmotic diuretic

the exemplar acetazolamide is a

carbonic anhydrase diuretic

the exemplar spironolactone is a

potassium sparing diuretic

action of hydrochlorothiazide (thiazide)

acts on the DCT and promotes sodium, chloride and water excretion

use of hydrochlorothiazide (thiazide)

hypertension and peripheral edema

side effects of hydrochlorothiazide (thiazide)

electrolyte imbalances, hyperglycemia and hyperuricemia

contraindications of hydrochlorothiazide (thiazide)

renal failure

drug interactions of hydrochlorothiazide (thiazide)

digoxin and lithium

electrolyte abnormalities with hydrochlorothiazide (thiazide)

HYPO: kalemia and magnesemia

HYPER: calcemia, glycemia, lipidemia, uricemia

action of furosemide (loop diuretic)

inhibits chloride transport of sodium into the circulation, inhibit reabsorption of sodium

side effects of furosemide (loop diuretic)

fluid and electrolyte imbalances, orthostatic hypotension, ototoxicity

electrolyte abnormalities with furosemide (loop diuretics)

HYPO: kalemia, natremia, calcemia, magnesemia

HYPER: glycemia, uricemia

drug interactions of furosemide (loop diuretic)

digoxin and warfarin

action of mannitol (osmotic diuretic)

increase osmolarity and sodium reabsorption in the PCT and loop of Henle

use of mannitol (osmotic diuretic)

potent osmotic K+ wasting diuretic used in emergencies... decrease ICP and IOP

side effects of mannitol (osmotic diuretic)

fluid and electrolyte imbalance, N/V, pulmonary edema, tachycardia

contraindications of mannitol (osmotic diuretic)

heart disease and heart failure

action of acetazolamide (carbonic anhydrase inhibitor)

blocks the action of the enzyme carbonic anhydrase

use of acetazolamide (carbonic anhydrase inhibitor)

decrease IOP in patients with chronic glaucoma

side effects of acetazolamide (carbonic anhydrase inhibitor)

fluid and electrolyte imbalance, N/V, anorexia, confusion, orthostatic hypotension

contraindications of acetazolamide (carbonic anhydrase inhibitor)

contraindicated 1st trimester of pregnancy

action of spironolactone (potassium sparing diuretic)

blocks the aldosterone (Na-K pump, NA retention, K ecretion)

side effects of of spironolactone (potassium sparing diuretic)

hyperkalemia (N/D, cramps, numbness, tachycardia to bradycardia)

drug interactions of spironolactone (potassium sparing diuretic)

life threatening hyperkalemia when given with ACE inhibitors and ARBS

the exemplar metoprolol is a

beta blocker

the exemplar lisinopril is a

ace inhibitor

the exemplar hydralazine is a

direct acting arteriolar vasodilator

the exemplar losartan is a

ARB, angiotensin II receptor blocker

the exemplar diltiazem is a

calcium channel blocker

action of metoprolol (beta blocker)

inhibit beta 1 (heart) and beta 2 (bronchial) receptors.. this drug is selective for beta 1

side effects of metoprolol (beta blocker)

bradycardia, hypotension, erectile dysfunction, peripheral edema, bronchospasms, dizziness, depression, fatigue

nursing interventions of metoprolol (beta blocker)

Do not abruptly discontinue... taper dose

action of hydralazine (direct acting arteriolar vasodilator)

relaxes the smooth muscles of the blood vessels, mainly the arteries, causing vasodilation

side effects of hydralazine (direct acting arteriolar vasodilators)

reflex tachycardia, palpitations, edema, headache

action of lisinopril (angiotensin-converting enzyme inhibitors)

inhibits the angiotensin II enzyme that causes vasoconstriction and blocks the release of aldosterone

side effects of lisinopril (angiotensin-converting enzyme inhibitors)

irritating dry cough*, insomnia, hyperkalemia, tachycardia

contraindications of of lisinopril (angiotensin-converting enzyme inhibitors)

pregnancy, potassium-sparing diuretics, salt substitutes

adverse reactions of lisinopril (angiotensin-converting enzyme inhibitors)

angioedema

action of losartan (angiotensin II receptor blockers, ARB)

block angiotensin II from binding toangiotensin II receptors which constricts bloodvessels

side effects of losartan (angiotensin II receptor blockers, ARB)

dizzy, congestion, drowsiness, palpitations, blurred vision

action of diltiazem (calcium channel blocker)

Decrease calcium levels which promotes vasodilation and decreases strength of cardiac contractions (slows the excitability of the SA node)

side effects of diltiazem (calcium channel blocker)

flushing, headache, dizziness, ankle edema, bradycardia, and AV block

Vitamin A is responsible for

Bone growth and maintenance of tissues, skin, eyes, hair

hypervitaminosis A

Teratogenic effect on the fetus, hair loss, anorexia, N/V

hypovitaminosis A

blindness

some sources of vitamin K

Sweet Potatoes, Spinach, Fish Oil, Broccoli, Dairy, Carrots

Vitamin D helps with

regulating Ca and P metabolism and assisting Ca absorption

hypervitaminosis D

hypercalcemia, anorexia, N/V

hypovitaminosis D

soft bones, rickets, imperfection calcification, anorexia

some sources of vitamin D

Fortified milk, Eggs, Cereal, Fatty Fish

vitamin E is a

Antioxidant: protects cellular changes and RBC hemolysis

side effects of vitamin E

GI upset, Fatigue, Weakness, Headache, Bleeding

some sources of Vitamin E

Plant-based oils, Nuts, Seeds, Fruits, Vegetables

Vitamin E interactions

Prolonged PT time and don't give with iron

Vitamin K helps with the

Synthesis of prothrombin and clotting factors VII, IX, X and prevents hemorrhage

hypervitaminosis K

Clots or blockage of blood flow leading to MI or Stroke

hypovitaminosis K

Bruising, Bleeding, Dark stools

Fat souble vitamins include

A, D, E, K

Water soluble vitamins include

B complex, C, B12, and folic acid

B1 complex

thiamine

b1 complex thiamine defects

polyneuritis and Wernicke encephalopathy

B2 complex

riboflavin

b2 complex riboflavin defects

dermatologic problems

B3 complex

niacin

b3 complex niacin defects

pellagra, hyperlipidemia