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Hematological System

Hey guys today I want to go over the Hematological disorders that we will most likely encounter in your NCLEX exam.  So First lets go over a quick overview of the hematological system.  Now we all know that The Hematologic system is mainly composed of just the blood and plasma (So on the basic level the  components of the hematological system is just blood and plasma).  Lets look at the blood and the essential values that we need to know for the NCLEX.  The BLOOD is composed of several primary components

RBC (RED BLOOD CELLS/ERYTHROCYTES)
WBC (WHITE BLOOD CELLS/ Leuokocytes)
PLATELETS (THROMBOCYTES)

Lets look at the important blood values that we need to really know for the nclex.

CBC (COMPLETE BLOOD COUNT)

RBC’S= 4.2-6.2 million cells per microliter
HGB= 11.5- 17.5 Grams per deciliter
HCT= 36%- 52%

So again its very important to know our blood values by heart for the nclex.  And its very essential that we know our values to determine if its normal or abnormal so we can further assess our patients’ condition.   We can ask ourselves what can be the reasons for the High and Low Values of these components.  First lets analyze the red blood cells or rbc’s.   If we have a patient with cancer or Polycythemia Vera which is a bone marrow disease that leads to an abnormal increase in the number of blood cells (primarily red blood cells) of our patient, then the values of our patient’s red blood cell will obviously increase.
Now on the opposite side, what condition do you think tends to bring the red blood cell to be lower than normal: obviously anemia would come in mind.  Now lets look at our white blood cells or our WBC values.  The most common causes of increase of our WBC which we are all very familiar with is Infections.  So why is that , well as we all know our WBC or leukocytes is a vital part of the immune system that basically helps our bodies fight off any infection. So during an infection, our body physiologically will circulate more WBC’s in the blood and transport it to the area where an infection has developed

On the opposite spectrum, lets look at the circumstances of our patient in having a decrease in WBC count.  There are various of Autoimmune disorders such as Lupus which comes in to mind which is a disease of the immune system that leads to long-term or (chronic) inflammation that can destroy the white blood cells or decrease the WBC’s.

Now lets go on our next topic and go over one of the most important hematological disorder that we might encounter in the NCLEX exam which is ANEMIA.  We can basically define Anemia as a decrease in the number of red blood cells (RBCs) or if the patient has less than the normal quantity of hemoglobin within the blood.   So, with this disease THERE IS A DECREASE NUMBER OF RBC’S.   As a result, there will be a low amount of oxygen circulation within the body.

General symptoms of anemia:
– weakness
– fatigue,
– pale skin

As we know from nursing school There are several types of anemia:

– Sickle Cell Anemia
– Pernicious Anemia
– Aplastic Anemia
– Iron Deficiency Anemia

Now first lets go ahead and look at SICKLE CELL ANEMIA

  • – SICKLE CELL ANEMIA IS AN AUTOSOMAL RECESSIVE GENETIC DISORDER
  • – AN ABNORMAL SHAPE OF THE RBC’S (SICKLE CELLS).

So basically the cell has an abnormal kind of rigid, sickle shape and because of this it causes a decrease in the cells ability to be flexible and move freely in the body which results in the cell getting stuck within the circulation which is then manifested in pain and other various complications in our patient.

I will continue this review regarding anemia on the next few upcoming videos.  Again I want to thank you guys for taking the time to invest in making sure that you pass your NCLEX.

 

 

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hypert

HYPERTENSION

Lets continue on with the second segment of this series and go over one of the most important topics that we need to know for the NCLEX which is HYPERTENSION

so lets begin by defining HYPERTENSION?  what is hypertension
– we can simply define it as A SIGNIFICANT AMOUNT OF PRESSURE WITHIN THE BLOOD VESSELS
– in which a blood pressure EXCEEDS 140 MMHG (millimeters of mercury) SYSTOLIC AND 90 MMHG DIASTOLIC,

* as a nurse we can educate and Remind the patient that lifestyle changes such as smoking cessation and proper diet is essential.

we also know that HYPERTENSION CAN LEAD TO

  • – Aneurysms
  • – Atherosclerosis
  • – Heart Failure
  • – Myocardial Infarction

Now our patient can have what we call a primary hypertension or the patient can also have
what we call a Secondary Hypertension which is usually caused by:
– Cushing’s Disease ( now remember that Cushing’s Disease is usually due to our patient having Too much Glucocorticoids)
– Brain Tumors
– Pheochromocytoma

Now lets go over the meat and potatoes of hypertension that we need to know for the NCLEX which
are the Pharmacology Drugs for Hypertension:

Lets first go over diuretics

DIURETICS

– Now basically diuretics Helps get rid of the sodium and fluid in the body.
– and it does this by interfering with the sodium absorption in the kidney.
–  as a result Increases the urine output.  Decreases the preload and afterload.

MAJOR SIDE EFFECTS:

  • now as a side effect or opposite reaction from these effects from diuretics our patient is at risk for having
  • – HYPONATREMIA
  • electrolyte disturbance in which the sodium ion concentration in the plasma is lower than normal.
  • yponatremia is generally defined as a serum level of less than 135 mEq/L and is considered severe when the serum level is below 125 mEq/L
  • milliequivalents per liter.
  • – ORTHOSTATIC HYPOTENSION
  • – DEHYDRATION

TYPES OF DIURETICS

(Drugs that you will ENCOUNTER IN THE NCLEX EXAM)

  1. POTTASIUM SPARING DIURETICS such as
    SPIRONOLACTONe (ALDACTONE)
  2. LOOP DIURETICS such
    FUROSEMIDE (LASIX)
  3. OSMOTIC DIURETICS
    and the most common drug is MANNITOL
  4. Lastly we have THIAZADE DIURETICS
    HYDROCHLOROTHIAZIDE (HYDRODIURIL)

We need to inform our patient that thiazides can
CAUSES THE DEPLETION OF SODIUM AND WATER.
CAN INDUCE HYPERGLYCEMIA

Now lets go over another group of medications
♣ BETA (ADRENERGIC) BLOCKERS

As you have learned in Nursing School, beta adrenergic blockers are drugs that help lower blood pressure, pulse rate and cardiac output.  Beta Blockers are an important set of drugs to know for the NCLEX.  Sometimes,there are also other uses of beta blockers
such as treating migraine headaches, treating glaucoma and can also be used to treat myocardial infarctions.

So, since beta blockers is an essential part of the NCLEX we need to understand how this medication functions
Well,  beta blockers simply act by blocking the sympathetic vasomotor response eventually decreasing the Blood pressure in the body.  For the NCLEX, try to remember that beta blockers usually end with the syllable (olol).  Potential side effects of beta blocker that is necessary to know for the NCLEX would include: Orthostatic hypotension, bradycardia, nausea and vomiting, diarrhea and some of the symptoms may MASK hypoglycemia.

Remember the NURSING INTERVENTIONS FOR CLIENTS TAKING BETA BLOCKERS:

With all this in mind, we need to Make sure that we monitor the client’s blood pressure, heart rate and rhythm, before administering the beta blocker.  we should also Monitor the client for signs of edema and assess the lungs sounds for signs of rales and ronchi.  When patient are taking beta blockers, it is also very important to monitor the changes in lab values such as (protein, BUN and creatinine) which can indicate nephrotic syndrome.

 

 

 

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NCLEX Pharmacology Review

NCLEX Review: Neurological Medications 

MAOI  (Monoamine oxidase inhibitors)

Important Medications in the NCLEX includes

  • Parnate (tranylcypromine sulfate)
  • Nardil (phenelzine sulfate)
Side Effects of MAOI

MAOI Side Effects

  • Dizziness
  • Dry mouth
  • Diarrhea
  • Weight gain

Remember: Do not take MAOI’s with TCAs and SSRIs

NCLEX Review: Remember to limit foods that contain high levels of tyramine, such as cheese, pickled foods, beer and wine

MAOIs or Monoamine oxidase inhibitors act by inhibiting the activity of monoamine oxidase, thus preventing the breakdown of monoamine neurotransmitters and thereby increasing their availability. Which gives off positive effects on depression and anxiety. so again basically MAOI’s helps balance certain brain chemicals called neurotransmitters and it does this by reducing the amount of monoamine oxidase which the substance that breaks down the neurotransmitters, hence there would be more neurotransmitter in the brain which helps decrease the symptoms of depression.

Now the 2 important MAOI’s drugs that you might encounter in your NCLEX exam includes:

  1. Parnate  (tranylcypromine sulfate)
  2. Nardil  (phenelzine sulfate)

As we learn from our Psych class back in nursing school, We as nurses don’t usually offer MAOI because of the lethal dietary and drug interactions (and this is the most important thing that we have to know for the NCLEX in reagards with MAOI and this is also a big reason why MAOI is usually used as last line of treatment and is used only when other classes of antidepressant drugs (for example SSRI and TCA’s) have failed.

NCLEX Review Neurological Pharmacology

We need to know for the NCLEX that our patient needs to limit foods that contain high levels of tyramine, such as cheese, pickled foods, beer and wine.  And here is why…. well because Tyramine is an amino acid that helps regulate blood pressure. So basically if we combine tyramine with MAOIs the interaction cause dangerously severe high blood pressure it can trigger a hypertensive crisis… and we don’t want that on our patient.

So again, the biggest tip we can take away from this video is to remember that when giving MAOI’s… avoid food with high levels of tyramine…. so no cheese, pickles and beer or wine.

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NCLEX Review Shownotes:

I have mentioned before that pharmacology plays a big role and a big factor with the NCLEX exam. If we encounter the mid level which are basically the competent questions which is exactly what we need to know and what the NCSBN or Board of Nursing wants us to answer correctly in order to pass the NCLEX exam. Then it is expected from us to understand the management and prioritization aspects of certain medications that we have to know for the NCLEX.  That simply means to know and understand side effects or adverse reactions for certain medications and also how management and prioritization would be applied towards Pharmacology in correlation to the impact of the side effects or adverse reactions towards the patient. What it means is basically as a nurse or as a nurse graduate taking the NCLEX exam,  it is our job and our duty to be conscious and aware of certain side effects and how that impacts our client.  Also implications that we need to know for certain medications such as interactions or interventions that will become a priority for us as the nurse, in taking take care of our patient.  This entails knowing the specifics factors such as the ABG’s, vital signs and lab values and all of the symptomatic signs. Now let’s look at a few important examples of the most important pharmacological categories of medications that we will most likely encounter in the NCLEX exam.

NCLEX Review Cardiac Medications

Now let’s begin with the important medications that is used for hypertension, which is diuretics. Lets talk about diuretics, which helps get rid of sodium and fluid in the body. Diuretics is used to lower the blood pressure and therefore promotes excretion of sodium and water. Now with this in mind we can understand that diuretics interferes with the patient’s blood pressure (which means it can significantly drop) as a result: decrease in the preload and afterload in the body.   Therefore, a priority would be giving IV fluids to that patient.   And since there would be sodium absorption in the kidneys, it causes an increases the urine output.

Now let’s go over a specific type of diuretics and start with a potassium sparing diuretics. With a potassium sparing diuretic, it basically promotes the excretion of sodium and water while the retention of potassium (Important to know for NCLEX Review).  And basically is used usually for hypertension and edema and for a patient with hypokalemia or hypokalemic symptoms.   An example of a potassium sparing diuretics would include Spir0nolactone, which will usually be very common in the NCLEX exam. So what is the prioritization for this particular patient:  Obviously the patient could end up having too much potassium and that would cause hyperkalemia, so therefore then we would have to know the symptoms of  hypokalemia (now we all know that Potassium is needed for cells, especially nerve and muscle cells, to function properly) as a result the person can have symptoms that can include irregular heartbeat, nervousness, tingling in the hands, shortness of breath and nausea and vomiting.

Let’s talk about another category of cardiovascular medications which is beta-adrenergic blockers or beta blockers and basically beta blockers helps lower blood pressure and pulse rate.   It is also used to treat headaches, glaucoma and prevent MI or myocardial infartions by blocking the sympathetic motor response of the body.  Always try to remember that the beta blocker medications would usually end in syllables “lol” .  Common Beta Blockers that you can encounter in the NCLEX includes (Metoprolol, Carvedilol, Acebutolol).   Beta blockers block the action of catecholamines such as epinephrine (adrenaline) and as we all know this causes the fight-or-flight response of the body therefore the opposite effect can be manifested as the adverse reaction.  So, Side effects for patients taking  Beta blockers would include orthostatic hypotension, bradycardia, nausea and vomiting and diarrhea. We need to know that some of the symptoms may mask signs of hypoglycemia in the patient and is manifested as hypoglycemic symptoms.  This is due to the fact that beta blockers normally stimulate hepatic glycogen breakdown in the pancreas and causes the release of glucagon. So we need to take note of that for the NCLEX

Nursing interventions for clients with beta blockers would include interventions such as making sure that we monitor the clients blood pressure, and heart rate.  We also need to monitor the client for signs of edema.  So as the nurse, we should assess the lung sounds for the signs of rales and rhonchi which can be due to obviously fluid overload. When patients are taking beta blockers, it is also very important to monitor the changes in lab values such as protein, B UN and creatinine which can indicate nephrotic syndrome in the kidneys and that can be a problem. Nursing teaching for these patients would include teaching the client to rise slowly because the cause orthostatic hypotension which can become a safety issue and we also need to tell the patients to  report any signs of bradycardia, dizziness and confusion.

Focus on this Topic:

  • Potassium Sparing Diuretics
  • Beta Blockers

♣ Pharmacology Drugs for Hypertension:

DIURETICS

– HELPS GET RID OF THE SODIUM AND FLUID IN THE BODY.
– USED TO LOWER THE BLOOD PRESSURE.
– PROMOTES THE EXCRETION OF SODIUM AND WATER
– DIURETICS INTERFERES WITH THE SODIUM ABSORPTION IN THE KIDNEY.
– INCREASES THE URINE OUTPUT. DECREASES THE PRELOAD AND AFTERLOAD..
If the patients blood pressure drop to low, it is important to give IV FLUIDS to pt.

LETS GO OVER THE CATEGORIES OF DIURETICS ♠

♦ TYPES OF DIURETICS

♣ POTTASIUM SPARING DIURETICS

It promotes the excretion of soduium and water, while the retention of pottasium

Used for:

HYPERTENSION
EDEMA
HYPERALDOSTERONISM
HYPOKALEMIA
MEDICATION:

SPIRONOLACTON (ALDACTONE)
AMILORIDE (MIDAMOR)
TRIAMTERENE
Now lets go to the SIDE EFFECTS:

First, of course the person can have too much potassium or HYPERKALEMIA:

Signs of HYPERKALEMIA

IRREGULAR HEARTBEAT
NERVOUSNESS
TINGLING IN HANDS AND FEET
SHORTNESS OF BREATH
TIREDNESS OR WEAKNESS
OTHER SIDE EFFECTS:

NAUSEA AND VOMITING
CRAMPING AND DIARRHEA
DIZZINESS & HEADACHE

BETA (ADRENERGIC) BLOCKERS

– Helps lower blood pressure, puls rate and cardiac output.
– Can be used to treat headaches.
– Can be used to treat glacauma and prevent myocardial infarctions.
– Acts on the system, by blocking the symathetic vasomotor response.

For the NCLEX, try to remember that the syllable for beta blockers is usally (olol).

SIDE EFFECTS:

ORTHOSTATIC HYPOTENSION
BRADYCARDIA
NAUSEA AND VOMITING
DIARRHEA
NOTE: Some of the symptoms may MASK signs of Hypoglycemia

♠ HYPOGLYCEMIC SYMPTOMS

NURSING INTERVENTIONS FOR CLIENTS TAKING BETA BLOCKERS:

Make sure that you monitor the client’s blood pressure, heart rate and rhythm, before administering the beta blocker. Monitor the client for signs of edema. The nurse should also assess the lungs sounds for signs of rales and ronchi. When patient are taking beta blockers, it is also very important to monitor the changes in lab values such as (protein, BUN and creatinine) which can indicate nephrotic syndrome. Nursing teaching for the NCLEX would include: Teaching the Client to rise slowly (ORTHOSTATIC HYPOTENSION) * (A SAFETY ISSUE), report any signs of bradycardia, dizziness, confusion depression or fever. It is also very important to taper off the medication properly.

CARDIAC PHARMACOLOGY

♣ NCLEX Review Notes:.

♣ NCLEX REVIEW PHARMACOLOGY

Drugs Used for treating Hypertension:

BETA BLOCKERS
– REDUCES THE CARDIAC OUTPUT AND DECREASES THE SYMPATHETIC NERVOUS SYSTEM RESPONSE.
– BLOCKS THE BETA RECEPTOR, CAUSING A DECREASE IN BLOOD PRESSURE.
– MEDICATIONS INCLUDE THE “OLOL’S”: METROPOLOL, PROPANALOL, ACEBUTOLOL, NADOLOL.
– USED FOR HYPERTENSION, MYOCARDIAL INFARCTION AND ANGINA.
ADVERSE EFFECTS CAN INCLUDE: BRADYCARDIA, HYPOTENSION AND HYPOGLYCEMIA (DISTRUPTS THE LIVER’S ABILITY TO CONVERT GLYCOGEN TO GLUCOSE).

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NCLEX Pharmacology

A Quick Review on Pharmacology

♣ Show Notes

NCLEX Review on Pharmacology

The fact is that pharmacology will always be a big part in your NCLEX Exam, and can be a huge catalyst in whether you pass or fail your NCLEX Exam.  It is quite important for us to focus a lot on the content that pertains to medications, if we are reviewing for the NCLEX.  The NCSBN (who is responsible for developing the NCLEX Exam) defines the category of Pharmacological and Parenteral Therapies as a sub-category within the Physiological Integrity area (of the exam)  in which the nurse is basically providing care related to the administration of medications and parenteral therapies.

To be more specific, Pharmacological and Parenteral Therapy has contents that  includes but is not limited to:

  • Adverse Effects/Contraindications/Side Effects/Interactions
  • Expected Actions/Outcomes
  • Medication Administration
  • Blood and Blood Products
  • Parenteral/Intravenous Therapies
  • Central Venous Access Devices
  • Pharmacological Pain Management
  • Dosage Calculation

First, I want to take a step back and look at Pharmacology from a technical sense and look at it more in depth.

What is Pharmacology?

♠ PHARMACOLOGY

Pharmacokinetics– The study if how drugs are being absorbed, distribuited, metabolized and excreted by the body.
Pharmacodynamics– is the study of how drugs are being used by the body.
Pharmacotherapeutics– the study of how the client responds to the particular drugs.

What’s in a drug name?
Chemical Name:
This tells you the chemical makeup of the drug.
Generic Name
This name is given by the company that developed the drug.
Trade Name
This is the name given to the drug by the company in which the medication originated.

The Seven Rights of Administering Drugs

  • Right Client
  • Right Route
  • Right Drug
  • Right Dose
  • Right Amount
  • Right Time
  • Right Documentation
  • Right to refuse treatment

Any drug can have a CHEMICAL NAME, A GENERIC NAME AND A BRAND OR TRADE NAME.

  • The generic name of a drug is suggested by the manufacturer, and accepted by the international committee.
  • How the drug is being affected affects the body and the patient’s response is called the effect.
  • Efficacy refers to the degree to which a drug is able to induce it’s maximal effects.
  • Adverse Effect is any unexpected or unintended response to a therapeutic use of a drug, it is also called side effect.

During this review, I want to focus specifically towards the drugs that is mostly in patients with hypertension.

DRUGS USED WITHIN THE CARDIAC SYSTEM

Cardiac Pharmacology

♣ Pharmacology Drugs for Hypertension:

DIURETICS

  • – Helps get rid of the sodium and fluid in the body.
  • – Used to lower the blood pressure.
    – Promotes the excretion of sodium and water
    – Diuretics interferes with the sodium absorption in the kidney.
    – Increases the urine output.  Decreases the preload and afterload..

If the patients blood pressure drop to low, it is important to give IV fluids to pt.

LETS GO OVER THE CATEGORIES OF DIURETICS ♠

♦ TYPES OF DIURETICS

♣ POTTASIUM SPARING DIURETICS

It promotes the excretion of soduium and water, while the retention of pottasium

Used for:

  • Hypertension
  • Edema
  • Hyperaldosteronism
  • Hypokalemia

Medication:

  • SPIRONOLACTON (ALDACTONE)
  • AMILORIDE (MIDAMOR)
  • TRIAMTERENE

Now lets go to the side effects:

First, of course the person can have too much potassium or HYPERKALEMIA:

Signs of HYPERKALEMIA

  • irregular heartbeat
  • nervousness
  • tingling in hands and feet
  • shortness of breath
  • tiredness or weakness

OTHER SIDE EFFECTS:

  1. Nausea and vomiting
  2. Cramping and diarrhea
  3. Dizziness & headache

Loop Diuretics

  • BUMETANIDE (BUMEX)
  • FUROSEMIDE (LASIX)

Osmotic Diuretics

MANNITOL

  • Thizade Diuretics

HYDROCHLOROTHIAZIDE (HYDRODIURIL)
CHLOROTHIAZIDE (DIURIL)
CAUSES THE DEPLETION OF SODIUM AND WATER.
♣ CAN INDUCE HYPERGLYCEMIA

Very Important for the NCLEX:

SIDE EFFECTS OF DIURETICS

  • Frequent urination
  • Electrolyte abnormalitie
  • Muscle cramps or weakness
  • Blurred vision
  • confusion
  • headache
  • increased perspiration (sweating)
  • restlessness

BETA (ADRENERGIC)  BLOCKERS

– Helps lower blood pressure, puls rate and cardiac output.
– Can be used to treat headaches.
– Can be used to treat glacauma and prevent myocardial infarctions.
– Acts on the system, by blocking the symathetic vasomotor response.

For the NCLEX, try to remember that the syllable for beta blockers is usally (olol).

SIDE EFFECTS:

  • Orthostatic hypotension
  • bradycardia
  • nausea and vomiting
  • diarrhea

NOTE: Some of the symptoms may MASK signs of Hypoglycemia

♠ HYPOGLYCEMIC SYMPTOMS

NURSING INTERVENTIONS FOR CLIENTS TAKING BETA BLOCKERS:

Make sure that you monitor the client’s blood pressure, heart rate and rhythm, before administering the beta blocker.  Monitor the client for signs of edema.  The nurse should also assess the lungs sounds for signs of rales and ronchi.  When patient are taking beta blockers, it is also very important to monitor the changes in lab values such as (protein, BUN and creatinine) which can indicate nephrotic syndrome.  Nursing teaching for the NCLEX would include: Teaching the Client to rise slowly (ORTHOSTATIC HYPOTENSION) * (A SAFETY ISSUE), report any signs of bradycardia, dizziness, confusion depression or fever.  It is also very important to taper off the medication properly.

Cardiac Pharmacology

♣ Calcium Channel Blockers

  1. – PREVENTS THE MOVEMENT MECHANISM OF CALCIUM WITHIN THE CARDIAC SYSTEM.
  2. – THEREFORE DECREASING THE CARDIAC WORKLOAD, AND CARDIAC MUSCLE CONTRACTILIY.
  3. – MEDICATIONS INCLUDE THE “DIPINE” : DILITAZEM (CARDIZEM), AMLOPIDINE (NORVASC), NEFEDIPINE, NICARDIPINE.
  4. – USED TO TREAT ANGINA.
  • Remember:

– Blocks the calcium channels in the heart, causing a decrease in contractility.
Decreases the workload of the heart.

Used for:
Hypertension

Medications:

  • Nifedipine (Procardia)
  • Amplodipine (Norvasc)
  • Do not give Norvasc with grapefruit, causees increase in drug level.
  • Verapamil (Isoptin)
  • Diltiazem (Cardizem)

SIDE EFFECTS:

Constipation
Nausea
Headache
Rapid heartbeat (tachycardia)
Drowsiness

Remember:

  • Make sure to monitor the heart rate and the blood pressure.
  • Hold medication if HR is less than 60 or if BP is less than BP.

♠ ACE INHIBITOR

  1. – ACE INHIBITORS “BLOCKS” THE CONVERSION OF ANGIOTENSIN 1 TO ANGIOTENSIN 2.
  2. – ALTERS THE “BLOOD PRESSURE” MECHANISM THROUGH THE RENIN-ANGIOTENSIN SYSTEM.
  3. MEDICATIONS INCLUDES THE “PRIL” : CATOPRIL, ENALAPRIL, LISINOPRIL, RAMIPRIL.

SIDE EFFECTS:

  • COUGH
  • TACHYCARDIA
  • NAUSEA AND VOMITING.

Remember:
GIVE ON AN EMPTY STOMACH OR 2-3 HRS. AFTER A MEAL.

NCLEX Review Pharmacology

Drugs Used for treating Hypertension:

♣ ACE INHIBITORS

♥ BETA BLOCKERS

♦ CALCIUM CHANNEL BLOCKERS

 REMEMBER FOR YOUR NCLEX EXAM:

  • ACE INHIBITOR
  1. – ACE INHIBITORS “BLOCKS” THE CONVERSION OF ANGIOTENSIN 1 TO ANGIOTENSIN 2.
  2. – ALTERS THE “BLOOD PRESSURE” MECHANISM THROUGH THE RENIN-ANGIOTENSIN SYSTEM.
  3. MEDICATIONS INCLUDES THE “PRIL” : CATOPRIL, ENALAPRIL, LISINOPRIL, RAMIPRIL.
  4. SIDE EFFECTS: COUGH, TACHYCARDIA, NAUSEA AND VOMITING.
  5. GIVE ON AN EMPTY STOMACH OR 2-3 HRS. AFTER A MEAL.
  • BETA BLOCKERS
  1. – REDUCES THE CARDIAC OUTPUT AND DECREASES THE SYMPATHETIC NERVOUS SYSTEM RESPONSE.
  2. – BLOCKS THE BETA RECEPTOR, CAUSING A DECREASE IN BLOOD PRESSURE.
  3. – MEDICATIONS INCLUDE THE “OLOL’S”: METROPOLOL, PROPANALOL, ACEBUTOLOL, NADOLOL.
  4. – USED FOR HYPERTENSION, MYOCARDIAL INFARCTION AND ANGINA.
  5. ADVERSE EFFECTS CAN INCLUDE: BRADYCARDIA, HYPOTENSION AND HYPOGLYCEMIA (DISTRUPTS THE LIVER’S ABILITY TO CONVERT GLYCOGEN TO GLUCOSE).
  • CALCIUM CHANNEL BLOCKERS
  1. – PREVENTS THE MOVEMENT MECHANISM OF CALCIUM WITHIN THE CARDIAC SYSTEM.
  2. – THEREFORE DECREASING THE CARDIAC WORKLOAD, AND CARDIAC MUSCLE CONTRACTILIY.
  3. – MEDICATIONS INCLUDE THE “DIPINE” : DILITAZEM (CARDIZEM), AMLOPIDINE (NORVASC), NEFEDIPINE, NICARDIPINE.
  4. – USED TO TREAT ANGINA.

 

 

CARDIAC GLYCOSIDES

Digoxin

  • IS A CARDIAC GLYCOSIDE
  • AN ANTIARRYTHMIC
  • IT INCREASES CARDIAC OUTPUT
  • SLOWS DOWN THE HEART RATE

Watch for Digoxin Toxicity:

Assessment and Signs of Digoxin Toxicity:

  • VISION CHANGES (HALO EFFECT)
  • NAUSEA AND VOMITING
  • BRADYCARDIA AND ANOREXIA
  • ANOREXIA

 

Anticoagulants

Avoid Herbs such as  ‘G’ HERBS (GINSING, GINGER, GINKO, GARLIC) when using anticoagulant drugs.

Aspirin

  • CAN ALSO BE USED AS A BLOOD THINNER
  • IRRITATES THE STOMACH AND INTESTINES
  • WATCH OUT FOR “BLACK TARRY” LOOKING STOOLS (COULD BE A SIGN OF INTESTINAL BLEEDING)
  • NEVER GIVE YOUR CHILDREN ASPIRIN, CAN CAUS  REYE’S SYNDROME.

Heparin:

  • MAKE SURE TO CHECK THE PTT
  • ANTIDOTE IS PROTAMINE SULFATE
  • CAN BE SAFELY GIVEN DURING PREGNANCY.

Coumadin

  • CHECK THE PT AND THE INR
  • ANTIDOTE IS VITAMIN K

Lovenox

  • LOVENOX, ALSO CALLED ENOXAPARIN, IS A FORM OF HEPARIN CALLED FRACTIONATED HEPARIN.

NCLEX Review: Pharmacology Adverse Reactions/ Side Effects

CARDIOVASCULAR DRUGS

ACE Inhibitors

  • HYPOTENSION (MOST COMMON)
  • COUGH ♣(COMMON NCLEX QUESTION)
  • CHECK ELECTROLYTES FOR (HYPERKALEMIA)

Calcium Channel Blocker

  • FATIGUE, HEADACHE
  • DROWSINESS
  • DYSRHYTMIAS
  • DO NOT GIVE TO PT’S WITH 2ND OR 3RD DEGREE HEARTBLOCK

Vasodilators

  • PALPITATIONS, CRAMPS
  • NAUSEA & VOMITING
  • BONE MARROW SUPPRESSION
  • CONTRAINDICATED IN PT’S W/ CAD
  • TAKE W/ FOOD TO DECREASE GI UPSET.

Diuretics

  • THIAZIDE
  • LOOP
  • OSMOTIC

Watch for electrolyte imbalance and dehydration.

Pottasium Sparing Diuretics

  • NAUSEA AND VOMITING
  • WATCH FOR ELECTROLYTE IMBALANCE SUCH AS
  • HYPERKALEMIA AND HYPONATREMIA.

ENDOCRINE SYSTEM PHARMACOLOGY

  • PROPYLTHIOURACIL (PTU) : HYPERTHYROID MEDICATION
  • FATIGUE, DROWSINESS
  • BRADYCARDIA, HEADACHE

Cortisone, Prednisone (Cortisole Replacement)

  • WEIGHT GAIN ♣
  • DECREASED IMMUNITY ♥
  • NAUSEA & VOMITING

Iodine Product (Loguls Solution)

  • USED FOR THYROID STORM
  • NAUSEA & VOMITING
  • BRADYCARDIA, HEADACHE

Levothyroixine (Synthroid) : Hypothyroid Medication

  • TACHYCARDIA ♦
  • NAUSEA & VOMITING

Glimepride (Amaryl), Glipizide (Glucotrol)

  • USED TO TREAT HYPERGLYCEMIA
  • BE CAREFUL TO WATCH FOR HYPOGLYCEMIA ♣

ENDOCRINE SYSTEM DRUGS

Corticosteroids (decreases inflammation)

  • INCREASED BP
  • HYPERGLYCEMIA ♥
  • WATCH OUT FOR CUSHING’S SYNDROME

Bronchodilators (relaxed bronchial muscle)

  • HEADACHE, TACHYCARDIA
  • PALPITATIONS
  • NAUSEA AND VOMITING

TUBERCULOSIS DRUGS

Isoniazid (INH)

  • B6 DEFICIENCY
  • OBSERVE PT. FOR JAUNDICE

 

 

 

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