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Questions and Answers
What is the primary use of nitroglycerin?
What is the primary use of nitroglycerin?
Which of the following describes the action of digoxin?
Which of the following describes the action of digoxin?
What class of drugs do beta blockers belong to?
What class of drugs do beta blockers belong to?
Which side effect is commonly associated with loop diuretics?
Which side effect is commonly associated with loop diuretics?
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What is the action of an Angiotensin II Receptor Blocker (ARB)?
What is the action of an Angiotensin II Receptor Blocker (ARB)?
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What is a major contraindication for the use of ACE inhibitors?
What is a major contraindication for the use of ACE inhibitors?
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Which medication is considered the antidote for heparin?
Which medication is considered the antidote for heparin?
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What action does atorvastatin principally perform in the body?
What action does atorvastatin principally perform in the body?
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What common side effect is associated with spironolactone?
What common side effect is associated with spironolactone?
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Which side effect is most likely associated with metoclopramide?
Which side effect is most likely associated with metoclopramide?
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Which of the following is a characteristic of clopidogrel?
Which of the following is a characteristic of clopidogrel?
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What is the mechanism of action for ondansetron?
What is the mechanism of action for ondansetron?
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Which of the following agents is primarily used to treat urinary tract infections?
Which of the following agents is primarily used to treat urinary tract infections?
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What is the primary action of omeprazole and clarithromycin in the treatment of H. pylori?
What is the primary action of omeprazole and clarithromycin in the treatment of H. pylori?
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Which of the following side effects is commonly associated with H2 receptor antagonists?
Which of the following side effects is commonly associated with H2 receptor antagonists?
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What is a recommended intervention when using cimetidine or ranitidine?
What is a recommended intervention when using cimetidine or ranitidine?
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What is the primary action of sucralfate in treating ulcers?
What is the primary action of sucralfate in treating ulcers?
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What is the main use of lactulose in patients with liver disease?
What is the main use of lactulose in patients with liver disease?
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Which classification does aluminum hydroxide belong to?
Which classification does aluminum hydroxide belong to?
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What distinguishes rapid-acting insulin from short-acting insulin?
What distinguishes rapid-acting insulin from short-acting insulin?
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What is an action of metformin?
What is an action of metformin?
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What is the primary use of glucagon?
What is the primary use of glucagon?
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Which insulin type is classified as long-acting?
Which insulin type is classified as long-acting?
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What side effect is associated with the use of polyethylene glycol?
What side effect is associated with the use of polyethylene glycol?
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Which class of medication is famotidine?
Which class of medication is famotidine?
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What is a characteristic of insulin aspart?
What is a characteristic of insulin aspart?
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Study Notes
Nitroglycerin (Nitro)
- Use: First-line agent for angina relief.
- Mechanism: Generalized vascular and coronary vasodilation.
- Side Effects: Headache, hypotension, dizziness, weakness, and faintness.
- Routes: Sublingual, topical (ointment/patch), buccal (extended-release tablet), oral (extended-release capsule/tablet), aerosol spray, and IV.
Digoxin (Lanoxin)
- Action: Positive inotropic (increases myocardial contractility), increasing stroke volume and blood flow. Negative chronotropic (decreases heart rate) and negative dromotropic (decreases heart cell conduction).
- Side Effects: Anorexia, nausea, vomiting, bradycardia, premature ventricular contractions (PVCs), cardiac dysrhythmias, headaches, malaise, blurred vision, visual illusions, and confusion/delirium.
- Toxicity (Overdose): Digoxin immune Fab (Digibind) is the antidote. It binds with digoxin forming excreted molecules in urine.
- Nursing Interventions: Monitor apical pulse rate (greater than 60 bpm). Monitor serum digoxin level (therapeutic level 0.5–2 ng/mL), and monitor serum potassium (K+) levels reporting any hypokalemia. Avoid antacids.
Antianginal Drugs
- Nitrates: Reduce venous tone, decrease workload of the heart, and promote vasodilation.
- Beta Blockers: Decrease workload and oxygen demands.
- Calcium Channel Blockers (CCBs): Decrease workload and oxygen demands.
- Effectiveness: Effective for variant (vasospastic) angina pectoris.
Calcium Channel Blockers
- Action: Block calcium levels, promote vasodilation. Relax coronary artery spasm (variant angina), relax peripheral arterioles (stable angina), and decrease cardiac oxygen demand, contractility, afterload, and peripheral resistance. Thus, reducing workload.
- Side Effects: Dizziness, flushing, headache, hypotension, reflex tachycardia, peripheral edema, fatigue, AV block, and bradycardia.
- Examples: Verapamil, Diltiazem, Amlodipine, Nifedipine, etc.
Amlodipine (Norvasc), Nifedipine (Procardia), Diltiazem (Cardizem)
- Related to Calcium Channel Blockers.
Angiotensin II Receptor Blockers (ARBs)
- Action: Prevent aldosterone release and block angiotensin II from its receptors, preventing the renin-angiotensin-aldosterone system.
- Examples: Valsartan (Diovan), Losartan (Cozaar).
ACE Inhibitors
- Action: Inhibit the formation of angiotensin II and blocks the release of aldosterone.
- Examples: Benazepril (Lotensin), Captopril (Capoten), etc.
Heparin
- Examples: Low-molecular-weight heparin (LMWH) such as enoxaparin sodium (Lovenox), dalteparin sodium (Fragmin), tinzaparin sodium (Innohep).
- Antidote: Protamine sulfate.
Warfarin (Coumadin)
- Action: Inhibits hepatic synthesis of vitamin K, affecting clotting factors II, VII, IX, and X.
- Use: Prevention of thromboembolic conditions like thrombophlebitis, pulmonary embolism, and stroke.
- Monitoring: Monitor prothrombin time (PT) and international normalized ratio (INR).
- Antidote: Vitamin K.
Aspirin
- Use: Prevention of myocardial infarction (MI), thromboembolism, and stroke.
- Long-Term Use: Low-dose therapy.
- Mechanism: Inhibits cyclooxygenase, needed by platelets to synthesize thromboxane A.
Clopidogrel, Rivaroxaban
- Use: Antiplatelet, prevention of cardiovascular events.
- Use: Anticoagulant, prevention of blood clots.
Thrombolytic Drugs
- Action: Convert plasminogen to plasmin to dissolve clots.
- Examples: Alteplase (Activase), Streptokinase, etc.
Statins
- Action: Inhibit HMG-CoA reductase, thus reducing cholesterol biosynthesis.
- Examples: Atorvastatin (Lipitor), Fluvastatin (Lescol), Lovastatin (Mevacor), Pravastatin (Pravachol), Rosuvastatin (Crestor), Simvastatin (Zocor).
- Side Effects: Liver impairment, rhabdomyolysis (skeletal muscle disorder), Cataracts.
- Nursing Interventions: Monitor liver enzymes. Report unexplained muscle tenderness, weakness, fever, or malaise. Teach patients the importance of taking the medication as prescribed.
Metoclopramide
- Classification: Antiemetic.
- Action: Suppresses impulses to the CTZ (chemoreceptor trigger zone).
Ondansetron (Zofran)
- Classification: Serotonin antagonists, Antiemetic.
- Action: Blocks serotonin receptors in the CTZ and vagal nerve terminals in the upper GI tract.
Bisacodyl
- Classification: Stimulant laxative.
- Action: Increases peristalsis by irritating the intestinal mucosa.
Sucralfate
- Classification: Pepsin inhibitor.
- Action: Forms a protective paste that covers ulcers and prevents acid and pepsin damage.
Lactulose
- Classification: Osmotic laxative.
- Action: Draws water into the colon increasing bulk and stimulating peristalsis.
Aluminum Hydroxide
- Classification: Antacid.
- Side Effect: Constipation.
Polyethylene Glycol (PEG)
- Classification: Osmotic laxative.
- Use: Bowel preparation for surgery or diagnostic procedures.
Treatments for Helicobacter Pylori
- Examples: Omeprazole, and Clarithromycin
Insulin
- Types: Rapid-, Intermediate-, Long-acting.
- Examples: Lispro (Humalog), Aspart (NovoLog), etc.
- Classification: Combination. Short- & intermediate-acting, Rapid- & Intermediate-acting.
Metformin
- Classification: Non-sulfonylureas.
- Action: Decreases hepatic glucose production, diminishes postprandial hyperglycemia, blunts intestinal glucose absorption.
Glipizide
- Classification: Second Generation Sulfonylurea.
- Action: Stimulates pancreatic beta cells to secrete more insulin and increases tissue response to insulin.
Glucagon
- Classification: Hyperglycemic hormone
- Action: Increases blood sugar by stimulating glycogenolysis.
- Use: Used to treat insulin-induced hypoglycemia.
- Route: Parenteral (subcutaneous, intramuscular, intravenous).
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Description
Test your knowledge on the pharmacological agents nitroglycerin and digoxin. This quiz covers their uses, mechanisms, side effects, and nursing interventions. Perfect for nursing students and healthcare professionals looking to reinforce their understanding of these critical medications.
