Final Study Guides pharm.docx

If you give insulin you have to give glucose

Info icon This preview shows pages 25–27. Sign up to view the full content.

View Full Document Right Arrow Icon
If you give insulin you have to give glucose simultaneously so pt doesn’t become hypoglycemic Other treatments: Calcium gluconate (help heart with effects of hyperkalemia) Infusion of sodium bicarbonate (if pt is acidotic) – moves pH towards alkaloid state which increases cellular uptake of potassium – reduces serum levels Kayexalate – binds with potassium 20. How do ACE inhibitors work to lower blood pressure? ACE inhibitor = Captopril (Capoten) – first line drug for mild hypertension and HF!! Reduces levels of angiotensin II Dilates arterioles (less pressure in arteries = decreased BP) Reduces blood volume (less volume in vasculature = decreased BP) Increase levels of bradykinin Vasodilation (less pressure in arteries) 21. What are common adverse/side effects to ACE Inhibitors? First dose hypotension (stop diuretics 2-3 days before admin – can add back in 1-2 days later) Orthostatic hypotension Dry cough 24/7 (causes a lot of pts to not want to be on ACE inhibitor) Angioedema (life threatening severe inflammation of bottom lip and tongue – if this develops pt should never be on ACE inhibitor again) Hyperkalemia Renal failure (contraindicated for bilateral renal artery stenosis pts) FETAL INJURY (contraindicated during pregnancy at any time) 22. Why are diabetics commonly prescribed ACE Inhibitors? “Angiotensin-converting enzyme inhibitors” Angiotensin II receptor blockers Aldosterone antagonists Reducing levels of angiotensin II: decreasing angiotensin II leads to dilated arterioles and some venous action; reduce blood volume by its effects on the kidneys, and prevent or reverse pathologic changes in the heart and vessels caused by angiotensin II Increased bradykinin can cause vasodilation secondary to increased production of prostaglandins and nitric oxide Therapeutic: HTN, HF, MI, diabetic and non-diabetic nephropathy, prevention of MI, stroke and death in patients at high cardiovascular risk
Image of page 25

Info icon This preview has intentionally blurred sections. Sign up to view the full version.

View Full Document Right Arrow Icon
23. Teratogens / ace inhibitors? ACE inhibitors are category X Greatest damage comes from use in 3 rd trimester (not “safe” at any point during pregnancy) If planning on becoming pregnant – tell provider If sexually active – MUST be on form of birth control 24. How do Angiotensin receptor blockers differ from ACE inhibitors? How are they similar? Angiotensin receptor blockers (ARBs) = Losartan (Cozaar) Important difference ACE inhibitors decrease cardiovascular morbidity and mortality – ARBs have not been shown to have the same effect ACE inhibitors are preferred if a pt cant take an ACE inhibitor then ARBs are a good alternative therapy ARBs do not increase levels of bradykinin (like ACE inhibitors) Similarities Both block angiotensin II (causes dilation of arterioles and veins) Both prevent angiotensin II from inducing pathologic changes in cardiac structure Both reduce excretion of potassium (risk for hyperkalemia) Both are used in tx for hypertension and HF 25. How do channel blockers work to decrease blood pressure and ventricular rate in the heart? What should you check before giving calcium channel blockers?
Image of page 26
Image of page 27
This is the end of the preview. Sign up to access the rest of the document.

{[ snackBarMessage ]}

What students are saying

  • Left Quote Icon

    As a current student on this bumpy collegiate pathway, I stumbled upon Course Hero, where I can find study resources for nearly all my courses, get online help from tutors 24/7, and even share my old projects, papers, and lecture notes with other students.

    Student Picture

    Kiran Temple University Fox School of Business ‘17, Course Hero Intern

  • Left Quote Icon

    I cannot even describe how much Course Hero helped me this summer. It’s truly become something I can always rely on and help me. In the end, I was not only able to survive summer classes, but I was able to thrive thanks to Course Hero.

    Student Picture

    Dana University of Pennsylvania ‘17, Course Hero Intern

  • Left Quote Icon

    The ability to access any university’s resources through Course Hero proved invaluable in my case. I was behind on Tulane coursework and actually used UCLA’s materials to help me move forward and get everything together on time.

    Student Picture

    Jill Tulane University ‘16, Course Hero Intern