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NR 508 / NR508 Advanced Pharmacology Final Exam Review | Highly Rated Complete Guide | Latest 2020 / 2021 | Chamberlain College

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NR 508 / NR508 Advanced Pharmacology Final Exam Review | Highly Rated Complete Guide | Latest 2020 / 2021 | Chamberlain College 1. Initial treatment choices for HTN - AceI- sartans - Arbs- ipine,... verapamil & diltazem - Thiazide- iaside, chlorthalidone, imdapamide, metolazone - calcium channel blocker 2. first line treatment options for HTN for African Americans without renal impairment. - Calcium channel blockers - Thiazide 3. First line option for HTN for anyone with chronic kidney disease - Ace inhibitors - ARB’s 4. Diuretics:  Types, Uses, Side effects - Thiazides (HCTZ) o Uses- HTN, CHF, edema, useful in decreases calcium stone formation o Off label HCTZ- osteoporosis and diabetes o AE- hypokalemia, hyperglycemia, arrhythmias, metabolic alkalosis, fatigue, postural Hypotension - Loop diuretics (furosemide, torsemide, ethacrynic acid) o *preferred diuretics for renal o Impairment o Uses- CFH, HTN, nephrotic syndrome, cirrhosis, pulmonary edema o AE-hypocalcemia, hyponatremia, hypokalemia, ototoxicity - Carbonic anhydrase inhibitors (acetazolamide) o *weak diuretic o Uses- edema, epilepsy, glaucoma, mountain sickness o AE- toxic epidermal necrolysis, agranulocytosis, aplastic anemia, thrombocytopenia, metabolic acidosis - Potassium-sparing (spironolactone, eplerenone) o Uses- CHF (in combo with thiazides or ACE and loop), HTN o AE-gynomastia, n/v, erectile dysfuction, electrolyte imbalance, metabolic acidosis o **postdiuretic sodium retention- It is important for pts to adhere to a low sodium diet. As drug concentrations fall, there is a period of positive sodium balance o ** If a pt has a sulfa allergy= take ethacrynic acid 5. Preferred diuretic with renal impairment- - Loop diuretics because they retain efficacy even with moderate renal insufficiency: such as furosemide, buetanide, torsemide, ethacrynic acid. - Uses: Edematous states (HF, cirrhosis, pulmonary edema, nephrotic syndrome), hypercalcemia 6. Side effect of post diuretic sodium retention - As drug concentrations decrease, period of + Na balance, this is the post diuretic sodium retention - If there is a high Na intake then Na lost with diuresis is offset.. diuretic resistance 7. Recognition that some diuretics are sulfa derivatives (carbonic anhydrase inhibitors, loop diuretics, thiazides, but NOT ethacrynic acid) - Loops- Examples: furosemide, bumetanide, torsemide, ethacrynic acid "The Loop FURiously BUMmed my TORSo like ACID" Common side effects: orthostatic hypotension, excessive diuresis, tinnitus, vertigo, hyperuricemia note all these are precursors to toxicity - Thiazides Hydrochlorothiazide, Chlorothoazide, , Chlorthalidone, Indapamide, Metolazone 1st line for HTN, Chronic Calcium Kidney Stones, HF, Idiopathic hypercalciuria, Nephrogenic diabetes insipidus, Osteoporosis. Other common side effects: orthostatic hypotension, dizzy, drowsy, syncope, weakness, nausea, GI irritation, elevated BUN, depressed respirations lethargy - Carbonic anhydrase inhibitors- Acetazolamide N/V/D, Drowsy, Parathesis, confusion, tinnitus, myopia, anorexia, change in taste; polyuria, mild electrolyte changes [Show More]

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