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Pharm Test 3
Bile Acid Resins
Indications
Hyperlipidemia
Mechanism of Action
Bile Acid Reabsorption Prevented
Slight Increase HDL/Triglycerides
Decrease LDL
Drugs
Colestipol (Colestid)
Cholestyramine
Colesevelam
Side Effects
Cholesterol Gallstones
Decreased Absorption of Fat-soluble Vitamins
Patients Hate It
2 mins
Bile Acid Resins
Indications
Hyperlipidemia
Mechanism of Action
Bile Acid Reabsorption Prevented
Decrease LDL
Drugs
Colestipol (Colestid)
Cholestyramine (Questran)
Colesevelam (Welchol)
Side Effects
GI Distress
Cholesterol Gallstones
Decreased Absorption of Fat-soluble Vitamins
2 mins
Cholesterol Lab Values
LDL (Low Density Cholesterol)
< 100 mg/dL
HDL (High Density Cholesterol)
> 40 mg/dL Males
> 50 mg/dL Females
Total Cholesterol
< 200 mg/dL
1 min
Vitamin B3 - Niacin (Nicotinic Acid)
Mechanism
Decreases Triglycerides
Decreases LDL
Increases HDL
Indications
Dyslipidemia
Pellagra
Diarrhea
Dermatitis
Dementia
Side Effects
Flushing
GI Distress
Hepatotoxicity
2 mins
Atorvastatin (Lipitor)
Characteristics
-statin Suffix
Mechanism
HMG-CoA Reductase Inhibitors
Indications
High Cholesterol
Side Effects
Hepatotoxicity
Rash
Rhabdomyolysis
Myopathy
Considerations
Monitor Liver Enzymes
Administer at Bedtime
Avoid Grapefruit
2 mins
Gemfibrozil (Fibrates)
Mechanism of Action
Decreases Triglycerides
Increase in HDL
Slight Decrease in LDL
Indications
Hypertriglyceridemia
Side Effect
Hepatotoxicity
Cholesterol Gallstones
Myopathy
Considerations
Do Not Combine with Statins
Warfarin Toxicity
2 mins
Ezetimibe
Indications
Hyperlipidemia
Mechanism of Action
Cholesterol Absorption Blocker
Decreases LDL
Side Effects
Diarrhea
Increased LFT Values
1 min
Fibrates
Indications
Hyperlipidemia
Mechanism of Action
Upregulate LPL
Decreases Triglycerides
Slight Increase in HDL
Slight Decrease in LDL
Side Effect
Hepatotoxicity
Cholesterol Gallstones
1 min
Statins
Rhabdomyolysis
Hepatotoxicity
HMG-CoA reductase inhibitors
Decrease LDL
Decrease Triglycerides
Increase HDL
2 mins
Mannitol (Osmitrol)
Mechanism
Osmotic Diuresis
Indications
Reducing Intracranial Pressure
Reducing Intraocular Pressure
Renal Failure Prophylaxis
Side Effects
Edema
Fluid and Electrolyte Imbalance
Considerations
Avoid Use in Cardiac Patients
IV Administration
2 mins
Loop Diuretics
Mechanism of Action
Thick Ascending Limb of Loop of Henle
Inhibits Na+-K+-2Cl-
Sulfa Drug
Drug Names
Furosemide
Lasix
Side Effects
Ototoxicity from Rapid Injection
Gout
Dehydration
Hypocalcemia
Hypokalemia
Orthostatic Hypotension
2 mins
Loop Diuretic Education
Furosemide (Lasix)
Indications
Heart Failure
Pulmonary Edema
Acute Renal Failure (ARF)
Edema
Education
Notify the provider of weakness, dizziness, or muscle cramping
Increase Potassium Intake
Check BP Daily
Daily Weights and Monitor IandOs
1 min
Ethacrynic Acid
Mechanism of Action
Non-sulfa Drug
Phenoxyacetic Acid Derivative
Loop Diuretic
Inhibits Na+-K+-2Cl- Cotransporter
Thick Ascending Loop of Henle
Clinical Use
Diuresis
Side Effects
Hypokalemia
Ototoxicity
Gout
2 mins
Hydrochlorothiazide HCTZ
Mechanism of Action
Inhibits Reabsorption NaCl and H2O
Indications
Edema
Mild to Moderate Hypertension
Side Effects
Hypokalemia
Hyponatremia
Dehydration
Hyperglycemia
Gout
Contraindications
Sulfa Allergy
Pregnancy and Breastfeeding
1 min
Spironolactone (Aldactone)
Mechanisms
Inhibition of Aldosterone
Potassium Retention
Indications
Hypertension
Edema
Heart Failure
Side Effects
Hyperkalemia
Endocrine Effects
Consideration
Avoid Potassium Supplements
2 mins
Hyponatremia
Assessment
< 135 mEq Na+
Nausea and Vomiting
Decreased LOC
Confusion / Lethargy
Seizures
Priority Interventions
Assess Airway
Reduce Diuretic Dosage
Fluid Excess Hyponatremia
Mannitol (Osmitrol)
Fluid Restriction
Fluid Deficit Hyponatremia
Hypertonic Solution (3% or 5% NaCl)
2 mins
Hypernatremia
Assessment
> 145 mEq/L Na+
Change in LOC
Extreme Thirst
Orthostatic Hypotension
Dry Flushed Skin
Muscle Twitching
Seizures
Priority Interventions
Treat and Prevent Dehydration
Hypotonic Solutions (0.225% or 0.45% NaCl)
Sodium Restriction
Diuretics
2 mins
Hyperkalemia
Assessment
> 5.0 mEq/L K+
Abdominal Cramps
Muscle Weakness
Diarrhea
Arrhythmia
Tall, Peaked T Waves
Interventions
IV Calcium
Infusion of Glucose and Insulin
Loop or Thiazide Diuretics
Kayexalate
Dialysis
Prevention Education
2 mins
Hypokalemia
Assessment
< 3.5 mEq/L
Muscle Weakness
Arrhythmia
U Wave
Ileus
Hyporeflexia
Interventions
IV K+ Infusion at 5-10 mEq/hr
Give Orally with Food
Nursing Considerations
Monitor Respiratory Status
3 mins
Syndrome of Inappropriate Antidiuretic Hormone (SIADH) Pharmacologic Interventions
Diuretics
Hypertonic IV Fluids
Demeclocycline
Tolvaptan and Conivaptan
1 min
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