Final Study Guides pharm.docx

By blocking calcium channels calcium channel blockers

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should you check before giving calcium channel blockers? By blocking calcium channels, calcium channel blockers cause vasodilation (decreases BP) Blockade at peripheral arterioles – reduces arterial pressure (BP) Blockade at arteries of the heart – increases coronary perfusion Blockade at SA node – reduces HR Blockade at AV node – decreases AV nodal conduction Blockade at myocardium – decreases force of contraction 26. What is postural (orthostatic hypotension)? What causes this? Which drugs are more commonly associated with this adverse effect? Fall in blood pressure when a person stands Phenothiazines Tricyclic antidepressants MAOIs Dopamine agonists
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Antianginals Antiarrhythmics 27. What is different about Nifedipine when compared to Diltiazem and Verapamil? Nifedipine – works primarily on the arterioles Verapamil and Diltiazem – act vascular smooth muscle and the arterioles Property Nifedipine Verapamil Direct Effects on the Heart and Arterioles Arteriole dilation Reduced automaticity Reduced AV conduction Reduced contractile force YES NO NO NO YES YES YES YES Major Indications Hypertension Angina Pectoris Cardiac Dysrhythmias Migraine Use during pregnancy YES YES NO YES YES YES YES YES YES Adverse Effects Constipation Dizziness Facial Flushing HA Edema Heart block Hypotension AV block Bradycardia Eczematous Rash Reflex tachycardia Increase angina pain Gingival hyperplasia NO YES YES YES YES NO NO NO NO YES YES YES YES YES YES YES YES YES YES YES YES YES NO NO NO NO Drug Interactions Digoxin Beta Blockers NO NO YES YES 28. What is the drug of choice for hypertensive emergencies? Why? What happens if this pt is on the drug for more than 3-5 days? Sodium Nitroprusside (Nipride) Onset is immediate and it has a short life (why it is first line for hypertensive crisis/emergencies) Provides rapid, controlled reduction of BP Direct acting vasodilator that relaxes smooth muscles of arterioles and veins Thiocyanate toxicity – occurs if pt is on med for several days (usually 3+)
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29. What are signs/symptoms of digoxin toxicity? What should you check before administering digoxin? What should you do if your patient is showing signs/symptoms of dig toxicity? S&S of Digoxin Toxicity (most common cause = diuretic induced hypokalemia) Dysrhythmias GI effects (anorexia, nausea, vomiting) CNS effects (fatigue, visual disturbances – yellow halos around lights) Before Administration Check potassium levels (normal = 3.5-5) – we want it to be at 4.0 If < 3.5 = HOLD DIGOXIN (request potassium supplement) Low potassium = increased risk of toxicity Check HR (if <60 – hold med) Tx of Digoxin Toxicity If potassium is > 4.0 and pt is having signs of toxicity – administer Digibind Digibind binds with Digoxin If potassium is < 4.0 and pt is having signs of toxicity = potassium supplements Increased potassium decreases the serum levels of Digoxin 30. What effects do you expect when administering digoxin?
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  • Fall '14
  • P.Smith
  • Pharmacology, adverse effects, digoxin, Hepatotoxicity

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