Pharm quiz 3
How long does it take for warfarin full therapeutic effects ?
3-5 days
How long does the effects of anti platelet drugs last?
7-10 days
How long does it take for warfarin effects to establish?
8-12 hours
A nurse is caring for a client who has a prescription for clopidogrel. The nurse should monitor the client for which of the following adverse effects? A. Insomnia. B. Hypotension C. Bleeding D. Constipation
C. Bleeding
What do you give a patient who is overdosing on warfarin if vitamin k is not able to control the bleeding?
Fresh frozen plasma or whole blood to replace needed clotting factors
What foods should be consumed when taking furosemide?
High in potassium
How can acetazolamide be administered?
Orally and IV
What are some adverse effects of statins?
rnhabdomylosis, myopathy, CNS effects, increased liver enzymes ,acute renal failure
What age group should not take atorvastatin?
Children less than 8
What should be monitored when taking statins?
Creating kinase Liver function tests
What should a lactating mother do who is on acetazolamide and why?
Find another method of feeding Bc of potential risk on the baby
What drug class does simvastatin belong to?
HMG-CoA reductase inhibitor
When are statins cautioned?
Hx or current chronic liver impairment Pregnancy or lactation
What is a risk with the use of spironolactone ?
Hyponatremia
When should HMG-CoA reductase inhibitors be taken?
In the evening to mimic the normal patterns of lipid formation
At what rate should you administer Protamine?
No faster than 20 mg/min
What is the first line therapy for hypercholesterolemia?
Statins
How do you treat warfarin overdose?
Stop the drug and administer vitamin K via IV
Where is aldosterone produced?
adrenal gland
What drug class does warfarin belong to?
anticoagulants
What is Caduet?
atorvastatin + amlodipine Used in HTN
What drug class does acetazolamide belong to?
carbonic anhydrase inhibitors
What is the functional unit of the kidney ?
nephron
What is the expected INR range for a client taking warfarin?
2-3
How long does it take acetazolamide to peak?
2-4 hours
A nurse is caring for a client who has hyperlipidemia and is receiving simvastatin 40 mg PO daily. Which of the following items should the nurse remove from the client's breakfast tray before it is delivered to the room? A. Grapefruit juice B. Hardboiled eggs C. Coffee D. Oatmeal
A. Grapefruit juice
A client is taking bumetanide and spironolactone. You explain to the client that s=using these drugs together may reduce the risk of which adverse effects? A. Hypokalemia B. Hyponatremia C. Hyperglycemia D. Hypochloremia
A. Hypokalemia
A nurse is reviewing the medical record of a client. The medication administration record shows the client is taking clopidogrel. Which of the following events should the nurse expect in the client's medical history? A. Recent myocardial infarction B. History of hemorrhagic stroke C. Current outbreak of psoriasis D. History of hypertension
A. Recent myocardial infarction
A nurse is providing teaching to a client who is starting simvastatin. Which of the following information should the nurse include in the teaching? A. Take this medication in the evening B. Change position slowly when rising from a chair. C. maintain a steady intake of green leafy vegetables. D. Consume no more than 1 L/day of fluid.
A. Take this medication in the evening.
When are statins contraindicated?
Allergy to statins, fungal byproducts Acute liver disease
When is oxybutynin contraindicated?
Angle closure GLAUCOMA Myasthenia Travis GI obstruction Active cardiac dysfunction
What drug class does oxybutynin belong to?
Anticholinergic/ antispasmodics
What drug class is clopidogrel?
Antiplatelet
What statin is not affected by renal disease?
Atorvastatin
What are the high intensity statins?
Atorvastatin Rosuvastatin
What is the primary adverse effect of warfarin?
Bleeding
What are statins/HMG-CoA reductase inhibitors used for?
Block the complete synthesis of cholesterol Assist with prevention of MI, stroke
A nurse is completing a nursing history for a client who takes simvastatin. The nurse should identify which of the following disorders as a contraindication to adding ezetimibe to the client's medications? A. history of severe constipation B. history of hypertension C. Active hepatitis C D. Type 2 diabetes mellitus
C. Active hepatitis c
A nurse is caring for a client who takes warfarin 2.5 mg PO daily and has an INR of 6.2. The nurse should anticipate a prescription from the provider for which of the following medications? A. Protamine sulfate B. Fondaparinux C. Vitamin K D. Bivalirudin
C. Vitamin K
Which of the following drugs should you have ready in case of warfarin overdose? A. Aminocaproic acid B. Deferoxamine C. Vitamin K D. Protamine
C. Vitamin K
Where should heparin be administered into?
Client's abdomen
What should you monitor for when taking clopidogrel ?
Coffee- ground emetics Black tarry stools Ecchymosis Any indication of bleeding Dizziness Headache Hypertension Diarrhea
What does an INR level of 5.5 mean?
Critical and places client at risk for bleeding
A nurse is assessing a client who has been taking simvastatin to treat hyperlipidemia. Which of the following statements by the client indicates an adverse effect of the medication that should be reported to the provider immediately? A. "I have had occasional constipation." B. "I have had some gas." C. "My head has been hurting for some days." D. "My legs feel weak and achy."
D. "My legs feel weak and achy."
A nurse is caring for a client who is taking warfarin. Which of the following laboratory values should the nurse recognize as an effective response to the medication? A. Hct 45% B. Hgb 15 g/dL C. aPTT 35 seconds D. INR 3.0
D. INR 3.0
Which of the following drugs should you have ready in case of heparin overdose? A. Aminocaproic acid B. Deferoxamine C. Vitamin K D. Protamine
D. Protamine
What does simvastatin do?
Decreases the body's production of cholesterol
What is another name for oxybutynin?
Ditropan
What are the ade of oxybutynin?
Dry mouth Constipation Mydriasis Dilated pupils Dry eyes Blurred vision Headache Dizziness Drowsiness Fever Heat exhaustion URINARY RETENTION
What type of razor should be used for patients taking warfarin?
Electric razor
What is Vytorin?
Ezetimibe + Simvastatin Lower lipid levels in patients who did not have good results with single drug therapy
What does oxybutynin interact with?
GRAPEFRUIT JUICE Ketoconazole Erythromycin Itraconazole
What should patients taking HMG-CoA inhibitors avoid?
Grapefruit juice
A nurse is caring for a client who has hyperlipidemia and is receiving simvastatin 40 mg PO daily. Which of the following items should the nurse remove from the client's breakfast tray before it is delivered to the room? A. Grapefruit juice B. Hardboiled eggs c. Coffee D. Oatmeal
Grapefruit juice Grapefruit juice is contraindicated for a client who is taking simvastatin because it raises blood levels of the medication significantly by inactivating a liver enzyme that is responsible for metabolism.
What does warfarin toxicity put you at risk for?
Hemorrhage
What should you monitor for with statins?
Hepatotoxicity
What should you monitor for in a patient taking warfarin and why?
Hypotension and tachycardia This can indicate hemorrhage
How would you observe warfarin toxicity?
Increased PT or INR
What is the dosage of simvastatin based on?
Lipid level
Which statin should be taken with food?
Lovastatin
What receptors does oxybutynin block? And what does this cause
MUSCARINIC receptors which blocks the effects of PNS Causes pupillary dilation, constipation, urinary retention
What is there an increased risk of for simvastatin 10/80 mg dose?
Myopathy= muscle pain = seen in 5-10% of ppl Rhabdomyolysis= kidney damage
Should you give warfarin during pregnancy?
NO It's a teratogenic drug, has a threat for a spontaneous abortion
What can loop diuretics like furosemide cause?
Ototoxicity
When used long term, what can warfarin do?
Prevents clot formation which will reduce the risk for stroke
How do you treat heparin overdose?
Protamine
What does spironolactone do?
Retention of potassium
How should vitamin k be administered?
Slowly and diluted To minimize risk of anaphylactic reaction
You should monitor a client through it continuous heparin therapy for which adverse reactions ?
Thrombocytopenia, hypotension DVT, fever
What blocks the spasms of urinary tract muscles caused by various conditions?
Urinary tract antispasmodics
What are patients taking anticholinergic drugs like oxybutynin at an increased risk for and why?
Urinary tract infections as urinary retrain can occur
When is the peak effect of HMG-CoA reductase inhibitors/ statins seen?
Within 2-4 weeks
What is another name for simvastatin?
Zocor
What does clopidogrel do?
inhibits platelet aggregation to prevent thrombotic events
What is oxybutynin used for?
overactive bladder, bladder spasms, URINARY INCONTINENCE
Which statin can be taken with grapefruit juice?
pravastatin
