Drugs & Drug Toxicity – Pharmacology for Nurses

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Chapter 22: Antihypertensive Drugs Test, Drug Toxicity, Pharmacology for Nurses

The key terms in this Pharmacology course Anti-hypertensive Drugs, Calcium Channel Blocker, Hypotension, Hypertension, Angiotensin II, Blood Pressure, Sodium, Drug Toxicity, Water, Aldosterone, Cerebral Arteries, Symptom, Therapy, Smooth Muscle, Medication, Inhibitors, ACE, ARBs, Nurse, Pharmacology for Nurses: Practical Applications.


The nurse would question a prescription for a calcium channel blocker in a patient with which condition?

Hypotension

Increased intracranial pressure

Dysrhythmia

Angina pectoris

Calcium channel blockers cause smooth muscle vasodilation and thus a drop in blood pressure. They are contraindicated in the presence of hypotension.


The nurse is assessing the patient’s knowledge regarding drug therapy prescribed for the treatment of hypertension. Which statement by the patient indicates the need for further teaching by the nurse?

“I will move slowly from a sitting to standing position.”

“I will wear a medical alert bracelet.”

“When my blood pressure is over 140/90, I will take my medication.”

“Blood pressure drugs can cause changes in sexual functioning.”

Patients must adhere to prescribed antihypertensive regimen to prevent end-organ damage. Many patients do not adhere to this regimen because hypertension itself does not cause symptoms, but the medication may produce unwanted adverse effects. Patient teaching is essential.


What is the classification of carvedilol?

Dual-action alpha1 and beta receptor blocker

Alpha2 blocker

Beta blocker

ACE inhibitor

Carvedilol blocks both the alpha1 and beta receptors of the adrenergic nervous system.


During discharge teaching, which statement by the nurse would be most appropriate for a patient prescribed a transdermal clonidine?

“Prolonged sitting or standing does not cause hypotension symptoms.”

“The patch should be applied to a nonhairy site, and you should not suddenly stop using this drug.”

“Your blood pressure should be checked by your health care provider two to three times a week.”

“Occasional drooling is a common adverse effect of this medication.”

Transdermal clonidine patches should be applied to nonhairy areas of the skin, and application sites should be rotated. When the patch dosage form is used, it is important to remove the old patch before applying a new one. It must not be discontinued abruptly because it will lead to severe rebound hypertension (sudden high elevation of blood pressure). Prolonged standing can cause venous pooling and hypotension. Dry mouth, not drooling, is a common adverse effect of clonidine.


When administering nitroprusside by continuous intravenous infusion, the nurse monitors for which symptom of drug toxicity?

Hyperglycemia

Wheezing

Fever

Hypotension

The main symptom of sodium nitroprusside overdose or toxicity is excessive hypotension.


To prevent cerebral artery spasms after a subarachnoid hemorrhage, the nurse anticipates administering which calcium channel blocker?

Verapamil

Nimodipine

Amlodipine

Diltiazem

Nimodipine crosses the blood–brain barrier and has a greater effect on the cerebral arteries than on other arteries in the body; thus, it is indicated for the treatment of cerebral artery spasm after subarachnoid hemorrhage.


ACE inhibitors and ARBs both work to decrease blood pressure by which action?

Increase the breakdown of bradykinin

Prevent the formation of angiotensin II

Enhance sodium and water resorption

Prevent aldosterone secretion

Whereas ACE inhibitors block the formation of angiotensin II, ARBs allow the formation of angiotensin II but block its effect at the receptors. Without the receptors stimulated (because of either drug), aldosterone secretion is inhibited, preventing the reabsorption of sodium and water.