Thiazide & Thiazide like
What is the MOA?
Inhibits tubular resorption of sodium, chloride, and potassium ions
What are the most common/serious adverse effects of the loops? Also, what is the BBW?
CNS: Dizziness, tinnitus
Integumentary: Photosensitivity
Metabolic: Hypokalemia
BBW: Fluid and Electrolyte loss
When should you NOT use Beta Blockers?
Uncompensated heart failure, heart block, bradycardia, severe pulmonary diseases
What cardioprotective effects do ACE's have?
Prevent sodium and water reabsorption, they're diuresis, decreases preload and afterload, decreases work required for heart, prevents complications after MI
Order: Tylenol 0.4 g PO q4H PRN for temp >101 F
Available: Tylenol elixir 160 mg/5 mL
How many ml will you administer for this dose?
12.5 mL
What are the contraindications/interactions
Allergy, hepatic coma, anuria OR severe renal failure
What labs are essential to monitor with loops?
Potassium, sodium, magnesium, calcium, BUN and Creatine
Indications with Beat Blockers other than HTN?
Angina, post-MI, cardiac dysrhythmias, heart failure, essential tremor. Off label uses: migraine headaches and stage fright
For ACE's what contraindications are there? BBW?
Known drug allergy, potassium lvl. Higher than 5, pregnancy, lactation, children
BBW: fetal toxicity
Administer D51/2 NS at 30 mL/hr. Drop factor is a microdrop (60 gtt/mL)
30 gtt/min
What are the most common adverse effects?
Dizziness, headache, impotence, photosensitivity, hypokalemia
What adverse effects are most common with K sparing?
Dizziness, headache, nausea, hyperkalemia, weakness
What adverse effects to these drugs have commonly?
Bradycardia with reflex tachycardia, postural and postexercise hypotension, dry mouth, drowsiness, dizziness, depression, edema, constipation, and sexual disfunction
What interactions do both ACE's and ARB's have with common medications?
NSAIDS reduce effects and predispose acute renal failure, Other HTN meds cause an additive effect, potassium or potassium sparing diuretics could cause hyperkalemia, and lithium toxicity
Order: Ampicillin 1gram to be administered over 30 minutes.
Available: Ampicillin 1 gram/50 mL NS
How many ml/hr should you set your pump?
100 mL/hr
What does the creatinine clearance need to be for the thiazides? For metolazone?
Less than 30-50
Metolazone: 10
What contraindications/interactions are there with K sparing?
Allergy, hyperkalemia, severe renal failure, anuria
What are the adverse effects of Alpha 2 receptors?
Orthostatic hypotension, fatigue, dizziness, drowsiness, edema, sexual dysfunction
How do ARB's differ from ACE Inhibitors
They are equally effective for treatment of HTN, ARB’s don’t cause cough, ARB’s are associated w/ lower mortality after MI, not sure if ARB’s work as well w/ HR or renal protection compared to ACE’s
An IV medication in 60 mL of 0.9% NS is to be administered in 45 minutes. The drop factor is a
microdrop.
80 gtt/min
Names of meds in this class? (2 Thiazide and 2 thiazide like)
Hydrochlorothiazide, chlorothiazide, metolazone, chlorthalidone
What is the MOA of loops?
Increased renal prostaglandins resulting in the dilation of blood vessels and reducing peripheral vascular resistance.
What things can cause additive effects in Beta Blockers?
Digoxin, other antihypertensive meds, diuretics
What renal protective effects do ACE's have?
Reduce glomerular filtration pressure, reduces proteinuria, and they are a standard therapy for diabetic patients to prevent nephropathy
Administer 1000 mL D5 0.33% NS in 6 hours. The drop factor is 15 gtt/mL
42 gtt/min