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Questions and Answers
What is the antidote to cholinergic drugs?
What is the antidote to cholinergic drugs?
- Norepinephrine
- Epinephrine
- Dopamine
- Atropine (correct)
Which drug is used before surgery to prevent aspiration?
Which drug is used before surgery to prevent aspiration?
- Anti-Cholinergics (correct)
- Flomax
- Atropine
- Methadone
What are the adverse effects associated with ACE inhibitors?
What are the adverse effects associated with ACE inhibitors?
- Productive cough
- Bradycardia
- Hypertension
- Dry, Non-productive cough (correct)
How do Clonidine and Methaladopa lower blood pressure?
How do Clonidine and Methaladopa lower blood pressure?
What is the mechanism of action of dobutamine?
What is the mechanism of action of dobutamine?
In what situation would you administer dobutamine to a patient?
In what situation would you administer dobutamine to a patient?
What is the primary effect of positive inotropes on the heart?
What is the primary effect of positive inotropes on the heart?
What distinguishes dobutamine from other positive inotropes?
What distinguishes dobutamine from other positive inotropes?
Which of the following is a potential adverse effect of ARBs?
Which of the following is a potential adverse effect of ARBs?
What is the recommended patient education related to adrenergic drugs to prevent adverse effects?
What is the recommended patient education related to adrenergic drugs to prevent adverse effects?
What is the general dietary recommendation for all hypertensive patients?
What is the general dietary recommendation for all hypertensive patients?
What is SLUDGE a toxic effect of?
What is SLUDGE a toxic effect of?
What is the antidote to cholinergic drugs?
What is the antidote to cholinergic drugs?
Which of the following describes the effects of cholinergic drugs?
Which of the following describes the effects of cholinergic drugs?
What are potential adverse effects of cholinergic drugs?
What are potential adverse effects of cholinergic drugs?
What is a potential risk associated with the use of anti-cholinergic drugs?
What is a potential risk associated with the use of anti-cholinergic drugs?
What is an important consideration for patient education regarding adrenic drugs?
What is an important consideration for patient education regarding adrenic drugs?
Why is it important to establish baseline vital signs for a patient receiving nonselective adrenic blockers?
Why is it important to establish baseline vital signs for a patient receiving nonselective adrenic blockers?
Which of the following is a potential adverse effect of beta blockers?
Which of the following is a potential adverse effect of beta blockers?
In what situation would you administer dobutamine to a patient?
In what situation would you administer dobutamine to a patient?
What distinguishes dobutamine from other positive inotropes?
What distinguishes dobutamine from other positive inotropes?
What is the primary action of beta blockers on the body?
What is the primary action of beta blockers on the body?
What is the mechanism through which Clonidine and Methaladopa lower blood pressure?
What is the mechanism through which Clonidine and Methaladopa lower blood pressure?
Which adverse effect should a nurse specifically educate a patient about when using beta blockers for hypertension?
Which adverse effect should a nurse specifically educate a patient about when using beta blockers for hypertension?
What is the mechanism of action of beta blockers?
What is the mechanism of action of beta blockers?
Which medication is an example of a beta blocker?
Which medication is an example of a beta blocker?
What distinguishes beta blockers from alpha blockers?
What distinguishes beta blockers from alpha blockers?
What is a potential adverse effect associated with beta blockers?
What is a potential adverse effect associated with beta blockers?
What is the potential adverse effect associated with ARBs?
What is the potential adverse effect associated with ARBs?
Which patient is most likely to be prescribed diuretics for hypertension?
Which patient is most likely to be prescribed diuretics for hypertension?
What is the primary education for patients taking aspirin for hypertension?
What is the primary education for patients taking aspirin for hypertension?
Which medication is an example of a nonselective beta blocker?
Which medication is an example of a nonselective beta blocker?
What distinguishes alpha blockers from beta blockers?
What distinguishes alpha blockers from beta blockers?
What is the primary therapeutic indication of dobutamine?
What is the primary therapeutic indication of dobutamine?
What is the primary reason for being cautious when administering nonselective beta blockers to a patient with hypertension?
What is the primary reason for being cautious when administering nonselective beta blockers to a patient with hypertension?
Which medication is commonly used to reduce heart rate and vasodilate in patients with hypertension?
Which medication is commonly used to reduce heart rate and vasodilate in patients with hypertension?
What distinguishes ACE inhibitors from ARBs in the treatment of hypertension?
What distinguishes ACE inhibitors from ARBs in the treatment of hypertension?
What is the primary mechanism through which Clonidine and Methyldopa lower blood pressure?
What is the primary mechanism through which Clonidine and Methyldopa lower blood pressure?
Positive inotropes increase the force of contraction on the heart.
Positive inotropes increase the force of contraction on the heart.
Cholinergic drugs decrease sweating, urination, and diarrhea.
Cholinergic drugs decrease sweating, urination, and diarrhea.
Atropine is the antidote for the toxic effects of cholinergic drugs.
Atropine is the antidote for the toxic effects of cholinergic drugs.
if you overdose a patient on anti-cholinergics, the antidote is PHYSOSTIGMINE.
if you overdose a patient on anti-cholinergics, the antidote is PHYSOSTIGMINE.
Antidote for atropine overdose is physostigmine
Antidote for atropine overdose is physostigmine
Diuretics are the first line of defense for hypertensive patients. Thiazide diuretics are the most commonly used diuretics for hypertension.
Diuretics are the first line of defense for hypertensive patients. Thiazide diuretics are the most commonly used diuretics for hypertension.
which of the following are used to reverse anticholinergic poisoning? (antidote)
which of the following are used to reverse anticholinergic poisoning? (antidote)
What are catecholamines?
What are catecholamines?
Ad drugs are sympathomimetic…..they mimic…..and effect SNS.
Ad drugs are sympathomimetic…..they mimic…..and effect SNS.
Catecholamines mimic so they are sympathomimetic
Catecholamines mimic so they are sympathomimetic
You have a patient who is 50 and is on a beta blocker, the nurse recognizes that this medication is used for ?
You have a patient who is 50 and is on a beta blocker, the nurse recognizes that this medication is used for ?
The patient has been diagnosed with BPH (benign prostatic hyperplasia) The nurse knows which of the following is primarily used to treat BPH?
The patient has been diagnosed with BPH (benign prostatic hyperplasia) The nurse knows which of the following is primarily used to treat BPH?
with ACE inhibitors and diuretics, your patient education should be on drinking water and preventing dehydration
with ACE inhibitors and diuretics, your patient education should be on drinking water and preventing dehydration
A patient walks in and presents with no kidney disease, no heart problems but has a family history and has hypertension. The nurse should prescribe which of the following?
A patient walks in and presents with no kidney disease, no heart problems but has a family history and has hypertension. The nurse should prescribe which of the following?
ACE inhibitors are for renal and hypertension so they are used for diabetic patients
ACE inhibitors are for renal and hypertension so they are used for diabetic patients
Match the following
Match the following
The mechanism of action for epi or epinephrine is increased hr, bp, and respirations and is used for a code.
The mechanism of action for epi or epinephrine is increased hr, bp, and respirations and is used for a code.
The patient presents with dyspnea and is wheezing turning blue, and constricted lungs. What would the nurse give to this patient?
The patient presents with dyspnea and is wheezing turning blue, and constricted lungs. What would the nurse give to this patient?
a patient comes in with acute cardiovascular instability, the nurse knows to administer which of the following immediately?
a patient comes in with acute cardiovascular instability, the nurse knows to administer which of the following immediately?
Nursing implications for nasal spray can cause rebound congestion and is addictive.
Nursing implications for nasal spray can cause rebound congestion and is addictive.
Alpha1 in the heart and blood vessels cause vasoconstriction which causes BP, HR, and oxygen demand to increase.
Alpha1 in the heart and blood vessels cause vasoconstriction which causes BP, HR, and oxygen demand to increase.
match
match
The mechanism of action in alpha-blockers is used for Hypertension medication and vasodilation by arterial and venous dilation, reducing peripheral vascular resistance and blood pressure (BP)
The mechanism of action in alpha-blockers is used for Hypertension medication and vasodilation by arterial and venous dilation, reducing peripheral vascular resistance and blood pressure (BP)
a patient walks into the ER in shock because he accidentally took a week's worth of his Alzheimers (cholinergic medication ). The nurse would expect which treatment?
a patient walks into the ER in shock because he accidentally took a week's worth of his Alzheimers (cholinergic medication ). The nurse would expect which treatment?
The nurse recognizes that high blood pressure in a patient over 60 is:
The nurse recognizes that high blood pressure in a patient over 60 is:
The nurse recognizes that patients who have chronic kidney disease, diabetes or younger than 60 are to be considered high blood pressure when their bp reads:
The nurse recognizes that patients who have chronic kidney disease, diabetes or younger than 60 are to be considered high blood pressure when their bp reads:
Cholinergic-blocking drugs dry you out – decreased pooping, peeing, crying, sweating.
Cholinergic-blocking drugs dry you out – decreased pooping, peeing, crying, sweating.
Albuterol is used for a more acute situation whereas Salmeterol is used for maintenance.
Albuterol is used for a more acute situation whereas Salmeterol is used for maintenance.
Respiratory indications for Adrenic drugs stimulate beta2-adrenergic receptors of bronchial smooth muscles, causing relaxation, resulting in bronchodilation
Respiratory indications for Adrenic drugs stimulate beta2-adrenergic receptors of bronchial smooth muscles, causing relaxation, resulting in bronchodilation
Cholinergic drugs stimulate pupils (miosis, reduced intraocular pressure), intestines & bladder (increased gastric secretions, increased gastric motility, and increased urinary frequency), and your sweat glands (increased salvation and sweating)
Cholinergic drugs stimulate pupils (miosis, reduced intraocular pressure), intestines & bladder (increased gastric secretions, increased gastric motility, and increased urinary frequency), and your sweat glands (increased salvation and sweating)
The nurse recognizes that Gingko is used for:
The nurse recognizes that Gingko is used for:
Gingko may cause GI upset, headache, bleeding
Gingko may cause GI upset, headache, bleeding
Ginkgo may cause potential drug interactions with which of the following?
Ginkgo may cause potential drug interactions with which of the following?
The nurse is about to administer an anti-cholergenic, what is the most important a nurse should assess for?
The nurse is about to administer an anti-cholergenic, what is the most important a nurse should assess for?
Patient with urinary retention and GI obstruction and glaucoma Should be careful taking this anti-cholinergics and should contact their doctor if muscle weakness, abdominal cramps, and diarrhea, or difficulty breathing. Slide 142
Patient with urinary retention and GI obstruction and glaucoma Should be careful taking this anti-cholinergics and should contact their doctor if muscle weakness, abdominal cramps, and diarrhea, or difficulty breathing. Slide 142
Cholinergic Drugs: Mechanism of Action: Mimic the effects of acetylcholine
Cholinergic Drugs: Mechanism of Action: Mimic the effects of acetylcholine
if a patient comes in sweating due to nicotinic receptors from receiving high doses of Cholinergics, which would you
if a patient comes in sweating due to nicotinic receptors from receiving high doses of Cholinergics, which would you
SLUDGE, which stands for salivation, lacrimation, urinary incontinence, diarrhea, GI cramps, and emesis
SLUDGE, which stands for salivation, lacrimation, urinary incontinence, diarrhea, GI cramps, and emesis
a patient is having difficulty peeing, or urinary retention, from post operative non obstruction the nurse knows to administer which medication?
a patient is having difficulty peeing, or urinary retention, from post operative non obstruction the nurse knows to administer which medication?
Memantine (Namenda) is Not a cholinergic drug
Memantine (Namenda) is Not a cholinergic drug
Pyridostigmine For Myasthenia Gravis (an autoimmune disease)
Pyridostigmine For Myasthenia Gravis (an autoimmune disease)
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match
These are used for treatment of mild to moderate Alzheimer’s disease
Donepezil (Aricept)
Galantamine (Razadyne)
Rivastigmine (Exelon)
These are used for treatment of mild to moderate Alzheimer’s disease Donepezil (Aricept) Galantamine (Razadyne) Rivastigmine (Exelon)
ATROPINE! LEARN IT!! IF A PATIENT IS COMING IN W SEVERE SINUS BRADYCARDIA THEN THE ANSWER IS ATROPINE TO GIVE.
ATROPINE! LEARN IT!! IF A PATIENT IS COMING IN W SEVERE SINUS BRADYCARDIA THEN THE ANSWER IS ATROPINE TO GIVE.
PAY ATTENTION TO BOLD. IF EXAM HAS A PATIENT W COPD, W DIAGNOSED OR HAD CLASSIC SYMPTOMS -> GIVE A CHOLINERGIC BLOCKER.
PAY ATTENTION TO BOLD. IF EXAM HAS A PATIENT W COPD, W DIAGNOSED OR HAD CLASSIC SYMPTOMS -> GIVE A CHOLINERGIC BLOCKER.
match the cholinergic blocking drugs
match the cholinergic blocking drugs
match
match
Angiotensin-Converting Enzyme (ACE) Inhibitors :
Captopril (Capoten)
Benazepril (Lotensin)
Enalapril (Vasotec)
Fosinopril (Monopril)
Lisinopril (Prinivil)
Perindopril (Aceon)
Quinapril (Accupril)
Ramipril (Altace)
Trandolapril (Mavik)
ACE lowers blood volume so again they also give your kidneys a break. ACE inhibitors: reduce glomerular filtration pressure
Who has a high risk of kidney injury? Diabetics.. A person w diabetes, can be on an ace inhibitors. They end in PRIL.
Angiotensin-Converting Enzyme (ACE) Inhibitors : Captopril (Capoten) Benazepril (Lotensin) Enalapril (Vasotec) Fosinopril (Monopril) Lisinopril (Prinivil) Perindopril (Aceon) Quinapril (Accupril) Ramipril (Altace) Trandolapril (Mavik)
ACE lowers blood volume so again they also give your kidneys a break. ACE inhibitors: reduce glomerular filtration pressure Who has a high risk of kidney injury? Diabetics.. A person w diabetes, can be on an ace inhibitors. They end in PRIL.
. A pt w diabetes has a new prescription for lisinopril she questioned this order because the physician has never told her she has high blood pressure. D- diabetic. 99.9% of diabetics will be on this even though they don’t have high blood pressure.
. A pt w diabetes has a new prescription for lisinopril she questioned this order because the physician has never told her she has high blood pressure. D- diabetic. 99.9% of diabetics will be on this even though they don’t have high blood pressure.
ACE inhibitors indications:
Hypertension
HF (either alone or in combination with diuretics or other drugs)
Slow progression of left ventricular hypertrophy after myocardial infarction (MI) (cardioprotective)
Renal protective effects in patients with diabetes
ACE inhibitors indications: Hypertension HF (either alone or in combination with diuretics or other drugs) Slow progression of left ventricular hypertrophy after myocardial infarction (MI) (cardioprotective) Renal protective effects in patients with diabetes
ACE Inhibitor patient education: Educate patients: may cause dizziness, stand up slow.
ACE Inhibitor patient education: Educate patients: may cause dizziness, stand up slow.
Heparin-induced thrombocytopenia (HIT)
Type I
Gradual reduction in platelets
Heparin therapy can generally be continued.
Type II
Acute fall in the number of platelets (more than 50% reduction from baseline)
Discontinue heparin.
Heparin-induced thrombocytopenia (HIT) Type I Gradual reduction in platelets Heparin therapy can generally be continued. Type II Acute fall in the number of platelets (more than 50% reduction from baseline) Discontinue heparin.
a patient presents with hematuria, melena (blood in the stool), petechiae, ecchymoses, and gum or mucous membrane bleeding. The nurse finds a recent history of heparin and realizes these are toxic effects. What will the nurse administer?
a patient presents with hematuria, melena (blood in the stool), petechiae, ecchymoses, and gum or mucous membrane bleeding. The nurse finds a recent history of heparin and realizes these are toxic effects. What will the nurse administer?
The nurse notices that a patient is displaying toxic effects of warfarin. What should the nurse do first?
The nurse notices that a patient is displaying toxic effects of warfarin. What should the nurse do first?
When warfarin effects were treated previously treated with vitamin K, warfarin resistance will occur for up to 7 days.
When warfarin effects were treated previously treated with vitamin K, warfarin resistance will occur for up to 7 days.
Idarucizumab (Praxbind) is the Specific antidote for dabigatran
Reverses the anticoagulant effects for dabigatran for emergency surgery or in life-threatening or uncontrolled bleeding
Idarucizumab (Praxbind) is the Specific antidote for dabigatran Reverses the anticoagulant effects for dabigatran for emergency surgery or in life-threatening or uncontrolled bleeding
the patient asks why she has been put on two anticoagulants .. heparin and warfarin. how should the nurse respond?
the patient asks why she has been put on two anticoagulants .. heparin and warfarin. how should the nurse respond?
Argatroban is used for HIT, is only given intravenously and Used for active HIT and percutaneous coronary intervention procedures in patients at risk for HIT
Argatroban is used for HIT, is only given intravenously and Used for active HIT and percutaneous coronary intervention procedures in patients at risk for HIT
Careful monitoring of the prothrombin time/international normalized ratio (PT/INR). normal (without warfarin) is 1.0 and with warfarin is 2.0-3.5
Careful monitoring of the prothrombin time/international normalized ratio (PT/INR). normal (without warfarin) is 1.0 and with warfarin is 2.0-3.5
aspirin is a big no-no for children and teenagers, if they take it- they run the risk of Reyes syndrome which is swelling in the liver and brain.
aspirin is a big no-no for children and teenagers, if they take it- they run the risk of Reyes syndrome which is swelling in the liver and brain.
Which can be given as an antidote in case of excessive anticoagulation.
Which can be given as an antidote in case of excessive anticoagulation.
a patient taking warfarin has a INR of 4.2. Does the nurse recognize this as?
a patient taking warfarin has a INR of 4.2. Does the nurse recognize this as?
Study Notes
Cholinergic Drugs and Antidotes
- Atropine is the antidote for cholinergic drug toxicity.
- In cases of anticholinergic overdose, physostigmine is the recommended antidote.
- SLUDGE is an acronym for a toxic effect of cholinergic drugs: salivation, lacrimation, urinary incontinence, diarrhea, GI cramps, and emesis.
Surgery and Aspiration
- Glycopyrrolate is used preoperatively to minimize the risk of aspiration during surgery.
ACE Inhibitors
- Common adverse effects include cough, hyperkalemia, and renal impairment.
- Patient education should include warnings about potential dizziness and the importance of hydration to prevent dehydration.
- ACE inhibitors provide renal protective effects, particularly for diabetic patients.
Blood Pressure Medications
- Clonidine and Methyldopa reduce blood pressure by central nervous system action, decreasing sympathetic outflow.
- Positive inotropes, like dobutamine, increase heart contractility and improve cardiac output.
- Dobutamine is used particularly in cases of acute heart failure or cardiogenic shock.
- Distinguishing feature of dobutamine compared to other inotropes is its balanced mechanism that stimulates both beta-1 and beta-2 receptors.
- Beta blockers primarily reduce heart rate and myocardial oxygen demand, and also lower blood pressure.
Beta Blockers
- Potential adverse effects of beta blockers include bradycardia, fatigue, and dizziness.
- Cautious administration of nonselective beta blockers is necessary in patients with respiratory conditions like asthma.
- Important to establish baseline vital signs when using beta blockers to monitor changes in heart rate and blood pressure.
Dietary Recommendations
- General dietary advice for hypertensive patients includes a low-sodium diet and maintaining adequate hydration.
Anticholinergic Drugs
- Cholinergic-blocking drugs can lead to decreased bodily secretions (e.g., urine, sweat), causing urinary retention and constipation.
- Patients with specific conditions, like urinary retention or GI obstruction, must be cautious when using anticholinergics.
Diuretics
- The first-line treatment for hypertension, with thiazide diuretics being most commonly prescribed.
Other Pharmacological Information
- Catecholamines are sympathomimetic agents that mimic the effects of sympathetic nervous system activation (e.g., increased heart rate, bronchodilation).
- For patients with a history of chronic illnesses, ACE inhibitors are typically combined with diuretics to manage hypertension effectively.
Specific Drug Class Information
- Examples of ACE inhibitors include lisinopril, enalapril, and ramipril; they lower blood volume and glomerular filtration pressure.
- Ginkgo biloba is noted for potential gastrointestinal upset and drug interactions, especially related to anticoagulants.
- Albuterol is utilized for acute bronchospasm, while Salmeterol is maintained for long-term control of asthma.
Anticoagulants
- Key information regarding anticoagulant therapy includes monitoring PT/INR levels and understanding the implications of elevated INR, which indicates a higher risk of bleeding.
Heparin and Warfarin Guidelines
- Recognize that severe side effects of anticoagulants may necessitate immediate intervention, including administration of antidotes.
- The common complication associated with aspirin in children under 18 is Reye's syndrome, leading to liver and brain swelling.
Patient Education
- Educate patients about the importance of reporting side effects and adhering to the prescribed treatment regime, especially concerning antihypertensive and anticoagulant medications.
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