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NR293 Pharm Exam 3 Study Guide (Latest-2022)/ NR 293 Pharm Exam 3 Study Guide/ NR293 Exam 3 Study Guide / NR 293 Exam 3 Study Guide: Chamberlain University | Complete and Latest Guide |

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NR293 Exam 3 Study Guide (Latest-2022)/ NR 293 Exam 3 Study Guide/ NR293 Pharmacology Exam 3 Study Guide / NR 293 Pharmacology Exam 3 Study Guide: Chamberlain University | Complete and Latest Guide | NR293 Pharm Exam 3 Study Guide (Latest-2022)/ NR 293 Pharm Exam 3 Study Guide/ NR293 Exam 3 Study ...

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  • February 20, 2022
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,  Slow progression of left ventricular hypertrophy after MI (cardio
protective)
 Renal protective effects in patients with diabetes
 Captopril and lisinopril can be used if a patient has liver dysfunction,
unlike other ACE inhibitors that are pro-drugs
 *Pro-drugs are inactive in their administered form and must be
metabolized in the liver to an active form so as to be effective
o Adverse Effects: hyperkalemia & dry, nonproductive cough
o Serious drug interaction: NSAIDs


 Angiotensin II receptor blocker “sartan” losartan (Dovan)
o Mechanism of Action:
 Allow angiotensin I to be converted to angiotensin II, but block the
receptors that receive angiotensin II
 Block vasoconstriction and release of aldosterone
 Well tolerated, do not cause a dry cough
 Indications: first-line treatment for heart failure & HTN
o Adverse Effects: URI, headache
 May cause occasional dizziness, inability to sleep, diarrhea


 Calcium channel blockers: Amlodipine “dipine” verapamil (calan), diltiazem
(cardizem)
o Mechanism of Action: cause smooth muscle relaxation by blocking the binding
of calcium to its receptors, preventing muscle contraction
o Adverse effect: constipation
 High-fiber diet with plenty of fluids will help prevent constipation
o Indications: hypertension
 Angina- ch. 23
 Ischemia:
o Ischemic heart disease: Poor blood supply to the heart
muscle (Atherosclerosis, Coronary artery disease)
o Myocardial infarction (MI): Necrosis, or death, of cardiac
tissue, disabling or fatal
 Therapeutic Objectives
o Minimize the frequency of attacks and decrease the
duration and intensity of anginal pain
o Improve the patient’s functional capacity
o Prevent or delay the worst possible outcome: MI


 Cardiac glycosides: Digoxin
o Therapeutic level: between 0.5-2ng/mL


2

, o Digoxin doses are held and the prescriber notified if the apical pulse is 60
beats/minute
o Negative chronotropic effect decreases HR
o Digoxin immune Fab (Digifab) is the antidote for a severe digoxin overdose
 Required use of digitab when potassium level is above 5 mEq/L, severe
sinus bradycardia that does not respond to cardiac pacing, or an
overdose of more than 10 mg of digoxin.
o Avoid bran muffins when taking digoxin
o Hypokalemia increases the chance of digitalis toxicity


 Class III drugs: Amiodarone (ch. 25)
o Mechanism of action: prolonging action potential duration
o Indications: ventricular dysrhythmias
o Contraindication: hypersensitivity and bradycardia or AV block
Adverse effects: FDA black box warning: pulmonary toxicity, hepatotoxicity arrhythmia
worsening-sinus bradycardia, constipation, QT prolongation, hypotension, blue-gray coloring
of the skin on the face, arms, and neck



 Unclassified antidysrhythmics: Adenosine (Ch. 25)
 Slows conduction through the AV node
 Used to convert paroxysmal supraventricular tachycardia to sinus
rhythm
 Very short half-life (less than 10 seconds)
 Flush with 20cc of normal saline
 Only administered as fast IV push
 May cause asystole for a few seconds
 Adverse Effects
 ALL antidysrhythmics can cause dysrhythmias!
 Hypersensitivity reactions, nausea, vomiting, diarrhea, dizziness,
blurred vision, headache
 Assessment
 Obtain a thorough drug and medical history
 Baseline BP, P, I&O, and cardiac rhythm
 Measure serum potassium levels before initiating therapy
 Conditions that may be contraindications for use of specific drugs
 Potential drug interactions
 During therapy,
 Monitor cardiac rhythm, heart rate, BP, general well-being, skin
color, temperature, heart and lung sounds
 Assess plasma drug levels as indicated
 Monitor for toxic effects

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