NUR 2474 Pharmacology Exam 2
- How long do statins take to start working?
Answer 2-4 weeks to start seeing affects
- What time of day should a patient take statins?
Answer evening on an empty stomach is best
- dietary restrictions with statins?
Answer avoid grapefruit-can increase risk of rhabdomyolysis
- What do we want our ratio for cholesterol to be 3.1 LDL HDL 2.1 is more ideal, when it is
6.1 or 5.1 is when we start to medicate
- how does cholestyramine work?
Answer for elevated cholesterol.
It is a bile sequestrant (bile is made with cholesterol), so it binds to bile acids and prevents them from being reabsorbed/reused and accelerates their excretion. Therefore liver needs to make more using LDLs-the liver increases number of LDL receptors, increasing the LDL uptake (which decreases LDL plasma levels)
- What other labs will be needed when taking statins/HMG-COA inhibitors
Answer -
besides cholesterol and triglycerides, liver enzymes must me checked.
- what can happen if patient takes cholestyramine without dilution? 1 / 3
Answer it is like a cement and can lead to erosion in throat or GI tract.must mix with 4 oz of fluid/soup/applesauce 8 oz is more ideal
- how are colesevelam and cholestyramine different?
Answer Cholestyramine can affect absorption of fat soluble vitamins. frequently causes constipation, abdominal discomfort and bloating
Colesevelam does not affect absorption of the fat-soluble vitamins, minimal effects on other drugs, better tolerated. Can lower blood sugar-great for type 2 diabetes, but not type 1!
- What drugs can be used for hyptertension?
Answer ACE inhibitors CCBs
Beta blockers Diuretics alpha blockers ARBs DRIs
- What problems are caused by untreated HTN?
Answer stroke, heart attack, plaque, kidney injury/problems, heart failure
- how does plaque form
Answer HTN causes fissures in arteries, macrophages enter that bind with LDLs, platelets and debris adhere, plaque grows, impedes blood flow
- How is dilutional hyponatremia different from diuretic induced hypona- tremia
Answer Dilutional hyponatremia= too much water (diluted), so sodium is low
Diuretic induced hyponatremia= the diuretic causes sodium and water loss, too much sodium 2 / 3
has been lost. can also be dehydrated.
- What can dehydration present like?
Answer poor skin turgor, decreased blood pressure, tachycardia, increased thirst
- What is a common side effect of furosemide (Lasix)
Answer orthostatic hypotension
- if a patient's potassium is 2.8 mEq/L, can furosemide be given?
Answer NO! K+ normal range is 3.5-5, they are too low
furosemide is a loop diuretic-sodium, potassium and water will be excreted.
- If a patient's potassium level is 5.7 mEq/L, which medication will the nurse hold
Furosemide or Spironolactone?
Answer Spironolactone, it is a K+ sparing diuretic, their K+ is high
- if a patient's potassium level is 5.3 mEq/L, can furosemide be given?
Answer Yes, their potassium level is elevated, furosemide will cause it to lower, which is fine
- What happens when a patient on furosemide has tinnitus?
Answer can be a sign of ototoxicity. With furosemide, deafness is transient
with ethacrynic acid (another loop diuretic) hearing loss can be permanent
- What labs will a patient taking hydrochlorothiazide need?
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