pharm 2 exam

• digoxin indication

  used to treat HF, rapid Afib. does not decrease BP
• digoxin therapeutic window

  0.5 - 2
• digoxin drug toxicity symptoms

  yellow halos and bradycardia
• digoxin antidote

  digibind or ovine
• digoxin nursing considerations

  apical pulse before administration, low patassium = risk for toxicity
• primacor and inocor indication

  treat end stage HF
• primacor and inocor inotrope

  positive. increase CO, stroke volume, contractility, vasodilation
• primacor and inocor route


  iv only
• primacor and inocor consideration

  must watch BP
• sublingual nitroglycerin indication

  anti-anginal
• sublingual nitroglycerin caution

  BP drop (vasodilator)
• nitroglycerin patch

  remove 8-12 hours for nitrate free interval
• nitrate side effects

  pounding headache
• nitrate adverse effect


  must taper dose to avoid rebound effect - severe pain to due myocardial ischemia
• nursing intervention for anti-anginal drugs

  monitor vital signs, do not use fingers when applying ointment (use gloves), do not apply to areas of defibrillator pad = skin burns, do not discontinue abruptly
• amiodarone (antidysrhythmic drug) indication

  treat afib or ventricular dysrhythmias during code
• amiodarone (antidysrhythmic drug) caution

  monitor thyroid and pulmonary function at start of therapy, 6 months, then yearly. may cause pulmonary fibrosis, myxedema coma
• verapamil and diltiazem (Ca + blockers and antidysrhythmic drug) indication

  treat rapid AFIB
• verapamil and diltiazem (Ca + blockers and antidysrhythmic drug) do not give

  AV block or heart failure
• Heparin (anticoagulant) indication

  rapid anticoagulation for thrombosis and prevention
• Heparin (anticoagulant) dose/effect monitored by

  PTT
• Heparin (anticoagulant) side effects

  bleeding and bruising
• Heparin (anticoagulant) adverse effect

  thrombocytopenia and bleeding
• Heparin (anticoagulant) do not give

  bleeding disorder
• Heparin (anticoagulant) nursing considerations

  ptt must be checked every 4 hours, monitor stool for melena and occult blood. therapeutic range to low = clotting, too high = bleeding
• lovenox (enoxaparin) - low weight heparin

  must give SQ only - 2 inches away from umbilicus. maintain air bubble in syringe. concern = bleeding
• warfarin (coumadin) indication

  anticoagulation afib, dvt/pe. treatment or prophylaxis
• warfarin (coumadin) dosed according to

  INR. increase INR = bleeding
• therapeutic range AFIB

  2-3
• therapeutic range for dvt/pe

  2.5-3.5
• therapeutic range for mechanical valves

  2.5-3.5
• antidote for warfarin

  vitamin k
• warfarin interactions

  food containing vitamin k (dark leafy greens) = decreased effectiveness/lower INR
• eliquis and xarelto (NOACs) indications

  new anticoagulants. treat afib
• eliquis and xarelto (NOACs) can't use

  mechanical valves
• eliquis and xarelto (NOACs) side effects

  bleeding and bruising
• eliquis and xarelto (NOACs) antidote

  praxibind
• eliquis and xarelto (NOACs) black box warning

  stroke or mi if discontinued abruptly
• plavix (clopidogrel) indication

  antiplatelet. prevent recurrence of MI or stroke and vascular death
• plavix (clopidogrel) loading dose

  300 mg then 75 mg daily