Drug cards Flashcards by Chloe Derks

Morphine

class- opioid analgesic- agonist
indications- pain relief, (mod-severe) pre-op sedation, dec anxiety, pulm edema

mech action- mimick opioid peptide, produce endogenous analgesia/gen. cns depression

assessment- b/a bp, rr, o2, LOC, bowl fun, pain location;type; and intensity

adverse e- RESP. DISTRESS, n/v, pupil constric, euphoria, constip, slow motil, bowl spasm, urinary reten, orthostat hypoten, sedation

interactions- mao (monoamine oxidase inhib) w/in 14 days, alcoh/antipsychotics- sedation, resp dep, coma, death
warfarin- inc anticoag effects

patient ed-avoid o/ cns dep and alcoh, abuse pot, drowsy/dizzy (fall precaut), how/when ask for pain meds

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HYDROcodone

class- opioid analgesic- agonist
indications- pain relif (mod-sev) or (constant/chronic)

mech action- bind opioid recep, alter percep/response pain, gen cns depress

assessment- b/a bp, rr, O2, LOC, bowl funct, brkthru pain- b/@peak, pain location, type, intensity, risk abuse

adverse e- confusion, dizzy, sedation, hypoten, n, constip, ingestion, urinary ret, RESP DEPRESS

interactions- mao inhib, benzodiazepines o/ cns dep- resp dep, sedation and coma
cyp3A4 inducers- dec fentanyl lvl anaelgesia

patient ed- avoid o/ cns dep and alc, abuse pot, drowsy/dizzy (fall precat), sugarl gum dec dry mouth

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Codeine

class- opioid analgesic-agonist
indications- pain rel (mild-mod) cough reducer

mech action-bind opioid recep, alter percep/response pain, gen cns depress

assessment- b/a bp, rr, O2, LOC, bowl funct, brkthru pain- b/@peak, pain location, type, intensity, risk abuse

adverse e- RESP DEPRES, hypoten, constip, n/v, confusion, sedation

interactions- MAO inhib, alcoh/ benzodiazepines- inc cns depres, CYp3A4 inhib- inc lvl/ risk resp depre, mixed agonist/antagonist- risk withdrawl, dec effects

patient ed-avoid o/ cns dep and alcoh, abuse pot, drowsy/dizzy (fall precaut), s/s respir deprssion

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fentaNYL

class- opioid analgesic- agonist
indications- pain supp for gen anesth, nerve block, pre/post op pain relief

mech action- bind opioid recep, alter percep/response pain, gen cns depress

assessment- b/a bp, rr, o2, LOC, bowl fun, pain location;type; and intensity, toxic overdose (hypoten, bradycardia, asystole)

adverse e- arrhyth, circ depress, hypoten, n/v, skel rigidty, confusion, APNEA, LARYNGOSPASM, RESP DEPRES

interactions- MAO inhib, alcoh/ benzodiazepines- inc cns depres, CYp3A4 inhib- inc lvl/ risk resp depre, mixed agonist/antagonist- risk withdrawl, dec effects

patient ed- sensations expect b4 surg, how/when ask pain m, dizzy/drowsy, avoid alc o/ cns depres at least 24hrs

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HYDROmorphone

class- opioid analgesics- agonist
indications- pain rel (mod-severe), suppression cough

mech action- *no active metab, bind opioid recep, alter percep/response pain, gen cns depress

assessment- b/a bp, rr, O2, LOC, bowl funct, brkthru pain- b/@peak, pain location, type, intensity, risk abuse

adverse e- RESPIR DEPRSS, hypoten, confusion, sedation, unusual dreams

interactions- MAO inhib (dc 2wk prior), alcoh/ benzodiazepines- inc cns depres
mixed agonist/antagonist- risk withdrawl, dec effects
antidep, SSRI- inc risk serotonin toxicity

patient ed- pot abuse, how as pain meds, s/s respir depress, drowsy/dizzy (fall precaut), avoid alc/ o/ cns depres

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Meperidine

class- opioid analgesics- agonist
*active metabolites

indications- pain relief

mech action- bind opioid recep, alter percep/response pain, gen cns depress

assessment- cns stimulation (risk toxicity), b/a bp, rr, o2, LOC, bowl fun, pain location;type; and intensity

adverse e- SEIZURES, RESPIR DEPRES, HYPRSEN RXNS, constip, n/v, hypoten, confusion, sedation

interactions- MAO inhib (dc 2wk prior), alcoh/ benzodiazepines- inc cns depres
mixed agonist/antagonist- risk withdrawl, dec effects
antidep, SSRI- inc risk serotonin toxicity, CYp3A4 inhib- inc lvl/ risk opioid toxicity

patient ed- pot abuse, how/when ask pain m, drowsy/dizzy, avoid alc and o/ cns dep, lying down dec n/v

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Methadone

class- opioid analgesic- agonist
*long-duration action

indications- pain rel for opioid tol pt (daily), constant and sympt control during drug detox

mech action- bind opioid recep, alter percep/response pain, gen cns depress

assessment- hx heart dis, syncope, arrhyth, order ekg (causes v-tach and cardiac arrest), opioid withdrawl (sweating, loss apetit, runny nose), risk abuse, bowl fun, bp, pulse, rr, sedation lvl, pain type, location and intensity

adverse e- RESPIR DEPRES, constipation, hypotens, VENT TACHY

interactions- MAO inhib, antiarrhyth/ca channel blockers, diuretics (inc risk hypo mg/kalemia and inc risk arrhyth), CYP inhib (inc risk opioid toxicity) CYP inducers (dec effect analge), benzo’s and cns dep (sedation, coma, resp dep, death), agonist/antagonist (inc risk withdrawl)

patient ed- inform abt pot arrhyth, abuse pot, how/when ask pain m

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oxyCODONE

class- opioid analgesic- agonist
*can be combo w/ acetamin. shrt/long acting

indications- pain rel (mod-sev)(daily, chronic)

mech action-bind opioid recep, alter percep/response pain, gen cns depress

assessment- b/a bp, rr, O2, LOC, bowl funct, brkthru pain- b/@peak, pain location, type, intensity, risk abuse

adverse e- RESPI DEPR, confusion, sedation, constip

interactions-MAO inhib, CYP inhib (inc risk opioid toxicity) CYP inducers (dec effect analge), benzo’s and cns dep (sedation, coma, resp dep, death), partial anagonist (inc risk withdrawl)

patient ed- oxycontin tab can appear stool, avoid o/ cns dep and alcoh, abuse pot, drowsy/dizzy (fall precaut), how/when ask for pain meds

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Naloxone

class- opioid antagonist

indications-reversal cns dep/resp dep due to overdose

mech action- blocks effects opioids, cns/resp depression, no agonist effects!

assessment- rr, rhythm, depth, pulse, bp, LOC (after peak conc), pain lvl, withdrawl s/s

adverse e- VENTR ARRHY, htn, hypoten, n/v

interactions- withdrawl (if phys dependant)

patient ed- explain purpose

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Metoclopramide

class- antiemetics (dopamine antagonist)

indications- prevent chemoinduced emesis, trt acute diabet gastroparesis, gastroesoph reflux, prevent postop n/v

mech action- block dopamine recep in chemorecep trigger zone of cns, stim motility upper GI, accel gastric emptying

assessment- b- n/v, abdom disten, during- extrapyram (tremors, shuffling, pill rolling, rigitidy, weakness)
tardive dyskinesia (uncont mvmnt face, mouth, extrem)
hyperthem, alt concious, tachycardia

adverse e- NEUROLEPTIC MALIGNANT SYDROME, anxiety, diarrh, gynecomastia, tremor

interactions- inc absorp , risk toxicity frm cyclosporine, affect gi absorp o/ drugs, exagg hypoten in anesthesia, opioids anatag effects, dec effectivess levodopa (parkinsons)

patient ed- drowsiness, no alco o/ cns depres, risk extrapyramidal/tardive dyskin/ neuro malig synd
not take when preg

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dramamine

“dimenhyDRINATE”
class- antiemtics/antihistamines

indications- trt n/v, dizzin, vertigo, motion sickness

mech action- inhibi vestibular stim, cns dep properties

assessment- b/a n/v bowl sounds, abdom pain, chart I&O, dehydration s/s

adverse e- drowsiness, anorexia, hypoten, dysuria

interactions- inc cns depress effects, mask s/s ototoxicity, mao inhib inc anticholinergic effect antihistamine

patient ed- dry m, drowsy, no alco o/ cns depress, sunscreem

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Scopolamine

class- antiemetic, muscarinic, acetylchol. antagonist
*most effective for motion sick.

indications- prevent motion sick and post op n/v

mech action- inhib muscarinic act of acetylcholine, balances norepineph and acetylchol in CNS

assessment- s/s urinary renention

adverse e- dry m, urinary retention, blurred vision, drowsy, tachycard

interactions- inc anticholin effects w/ antidep/antihistam
inc cns dep w/ alc/opioid/ antidep, slow dwn gi tract (inhib absor Po drugs, inc gi mucosal lesions

patient ed- transderm precaut, no underwtr sports, drowsiness, heatstroke when exercising, no alco/cns dep, dry m, dont use if preg

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NSAIDS

class- nonsteroidal anti-inflam

indications- reduction fever, pain relief (mid to mod)

mech action- analgesic (ihib prostaglan syn), vasodilation

assessment- asthma, allergies (inc risk hypersen rxn), pain, fever, GI blood loss?

adverse e- GI bleeding

interactions- prolong bleeding time, inc effects warfarin/ antiplatelet, dec response diuretics and antihtn drugs

patient ed- take w/ 8 oz h20, no alcoh (gastric irritation/bleeding), do not take before surg

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Aspirin

class- antiplatelet, nonopioid analgesic

indications- trt RA, OA, mild-mod pain, fever, prophylaxis TIS/MI

mech action- pain/inflamm relief via inhib prostaglandin syn, dec platlet aggregation

assessment- asthma, allergies (inc risk hypersen rxn), pain, fever, s/s DRESS (fever, rash, facial swelling), monit serum uric acid, tsh, serum salicylate lvl, overdose

adverse e- drug rxn w/ EOSINOPHILIA, GI BLEEDING< HYPERSEN RXN (anaphylaxis)(laryngeal edema)

interactions-inc risk bleeding thrombolytic agents, ibuprofen (negate cardioprotect antiplat affects), inc act penicillins, serum salicylate lvl flucutate, blunt response diruects and ace inhib, inc risk gi irr w/ nsaids
inc bleeding w/ ginseng/ginkgo

patient ed- report tarry stool, tinnitus, fever longer 3 days
no alco (inc gi bleeding)
na restrictive diet, no vinegar-like tablets, hold wk b4 surg, not take in 3rd trimester or after 20 wks
*not use in kids (reyes synd)

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Acetaminophen

class- non-opioid analgesics

indications- mild-mod pain, fever, severe pain (IV)

mech action-inhib syn prostagland in cns
*no GI toxicity

assessment- alc usage, rash, stevens-johnson syndrome, blisters, oral lesions, fatigue, pain, fever, serum bilirubin, can lead false blood gluc lvls

adverse e- ACUTE GEN EXANTHEMATOUS PUSTULOSIS, STEVENS/JOHNSON SYNDROME, TOXIC EPIDERMAL NECROLYSIS, HEPATOTOXICITY, renal failure, hypokalemia

interactions- inc risk bleeding w/ warfarin, hepatotoxicity w/ alc, inc risk liver damage w/ barbiturates, inc risk renal dis w/ nsaids, dec propranolol metab

patient ed- no more 4g/ day, avoid alc (liver dam bc dec lvl glutathione), dc if rash, alters bg lvls

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Chondrotinin/ Glucosamine

class- nonopioid analgesic

indications- delay brkdwn joint cart., syn new cartilage
trt OA, ischemic heart dis, osteoporosis, hyperlip.

mech action- building block articular cart

assessment- pain, gastric discom, bleeding

adverse e- n, heartburn, edema, bleeding

interactions- inc risk bleeding w/ nsaids/ anticoag

patient ed- take w/ glucosamine, reinforce consistent use, not take during preg

Capsicum

class- analgesic

indications- dec pain sensation, trt arthritis, dyspepsia (ingestion)

mech action- bind nociorec in skin= heightened sen/ cutaneous vasodil (densensitization by substance P depletion)

assessment- pain, liver/ kid function (can stim circ)

adverse e- buring, sweating, gi irrit, diarr, bleeding

interactions- inc risk bleeding w/ anticoag, inc absorp theophylline (bronchodilator)

patient ed- not during preg
gloves worn, rub in so no cream shows, burning expected (inc by heat ei clothes, exercise
diluted vinegar solution to remove
not apply if shingles lesions 
dc pain contin > 1 month

Cimetidine

class- antiulcer agent (Tagamet)

indications- shrt trt active duodenal ulcers, management GERD, trt acid indigestion/heartburn

mech action- inhib action histamine at H2 recep site in gastric parietal cells= inhib gastric acid secretion

assessment- abdominal pain, blood in stool/emesis, confusion, CBC blood levels, inc serum creatinine

adverse e- ARRHY, AHRANULOCYTOSIS, APLASTIC ANEMIA, confusion, diarr

interactions- inc risk toxicity as inhib drug-metab enzymes in liver
inc effect succinylcholine (musc relaxant)
inc absorb ketoconazole (skin infections)
dec antacid absorb

patient ed- cessation smoking, drowsy, avoid alc, nsaids and irritating foods, consipation common, report tarry stools, fever, diarr, rash, confusion

Famotidine

class- antiulcer agent, h2 blocker

indications-shrt trt active duodenal ulcers, management GERD, trt acid indigestion/heartburn

mech action-inhib action histamine at H2 recep site in gastric parietal cells= inhib gastric acid secretion

assessment-abdominal pain, blood in stool/emesis, confusion, CBC blood levels, inc serum creatinine

adverse e-ARRHY, AHRANULOCYTOSIS, APLASTIC ANEMIA, confusion, diarr

interactions- dec absorb ketoconazole (skin infections)

patient ed-cessation smoking, drowsy, avoid alc, nsaids and irritating foods, consipation common, report tarry stools, fever, diarr, rash, confusion

Ranitidine

class- antiulcer agent
r2 blocker

indications- healing/prevem ulcers, dec gerd sympt, dec secretion gastric acid

mech action-inhib action histamine at H2 recep site in gastric parietal cells= inhib gastric acid secretion

assessment-abdominal pain, blood in stool/emesis, confusion, CBC blood levels, inc serum creatinine

adverse e-ARRHY, AHRANULOCYTOSIS, APLASTIC ANEMIA, confusion, diarr

interactions- dec absorb ketonconazole, inc absor triazolam, inc effects warfarin

patient ed-cessation smoking, drowsy, avoid alc, nsaids and irritating foods, consipation common, report tarry stools, fever, diarr, rash, confusion

Omeprazole

class- antiulcer agent
PPI

indications- healing duodenal ulcer, gerd maintan, dec accum acid in gastric lumen

mech action-binds enzyme on gastric parietal cells in presence of acid pH, prevent transport H ion into lumen

assessment-bowl fun, abdom pain, Mg lvls

adverse e- CDAD, abdom pain, dizziness, pneumonia, hypomag, inc risk cdiff, rebound acid hypersec

interactions- HIV/AIDS drugs (atazanavir)
antifungal drugs- ketoconazole
enzyme metab- clopidogrel

patient ed- tarry black stools, avoid alc/nsaids, drowsy

Clopidogrel

class-antiplatelet

indications- reduc risk mI/ stroke

mech action- inhib plate aggre via inhib ATP bind to platelet recep

assessment- stroke, periph vasc dis/ MI
thromboitc thrombocytopenic purpura
platelet count

adverse e- STEVENS-JOHNSON SYNDROME, TOXIC EPIDERMAL NECROLYSIS, DRUG RASH, ACUTE GEN EXANTHEMATOUS PUSTULOSIS, GI BLEEDING, NEUTROPENIA, THROMBOTIC THROMBOCYTOPENIC PURPURA

interactions- aspirin inc risk bleeding, dec metab nsaids, opioids dec absorb/ effect of drug

patient ed- report s/s bleeding, fever, rash, weakness, jaundice
not mix w/ omeprazole
not use neuraxial blockade during preg

Sucralfate

class- antiulcer agent
gi protectant

indications- management duodenal ulcers

mech action- Al sal reacts w/ acid form protective paste

assessment- abdomin pain/ bloody stool

adverse e- constip, anaphylaxis

interactions- dec absob fat sol vitamins/ phenytoin
h2/ppi dec effectiveness via low pH

patient ed- constip precautions

Diphenoxylate/Atropine

class- antidiarrheal

indications- antidiarrheal

mech action- activ opioid recep in Gi tract - dec intest motility, reduces fluid in feces

assessment- freq/consis stools, dehydration, fluid bal, liver lvls

adverse e- drowsy, constipation, dry m, blurred vision, urinary retention

interactions- avoid alc, opioids o/ cns depress

patient ed- drowsy, dry m, no alc/ cns dep

Bismuth subsalicylate

class-antidiarrheal indications- relief diarrh mech action- inc intestinal absorp fluid/electrol, dec syn intestinal prostaglandins assessment- consis/freq stools, n, indigestion, dehydr, fluid bal, ulcers (epigastric pain) adverse e- constip, black stools interactions- aspirin- inc risk salicylate toxicity dec absor tetracycline patient ed- black color common, dc aspirin if tinnitus occurs, call if diarr contin 2+ days and fever

Ondansetron

class- antiemetics (Zofran) indications- prevent/ trt chemo induced n/v mech action- block serotonin recep in ctz *no extrapydram effects ei dry m assessment- n/v, abdom disn, bowel sounds, extrapyramidal effects, termor, seizures, rash, fatigue, joint aches, fever adverse e- headaches, diarrh, dizziness, STEVENS JOHNSON SYN, TORSADE DE POINTES, SEROTONIN SYNDROME interactions- apomorphine inc risk hypotension and loc phenytoin dec lvls maoi's inc risk serotonin syndrome patient ed- call if irreg heart beat, seroton syndrome, invol mvmnt eyes, face or limbs

Aprepitant

class- antiemetic (Emend) indications- dec n/v w/ chemotherapy mech action- block neurokinin 1 type recep for sub P in ctz assessment- n/v, bowel sounds, pain, rash, hydration, I/Os, allergic rxns, infusion site rxn adverse e- fatigue, hiccups, dizziness, diarrh interactions- inhib/induce metab liver enzymes patient ed- call if n/v persist

Prochlorperazine

dopamine antagonist class- antiemetic indications- post op n/v mech action- block dopamine 2 recep in ctz assessment-n/v, bowel sounds, pain, rash, hydration, I/Os, allergic rxns, infusion site rxn adverse e- eps, anticholinergic e, hypotension, sedation, irrit to tissue and veins interactions- avoid w/ pt with parkinsons dec effects warfarin inc lvl cyp3a4 substrates inc lvl pimozide= inc risk torsade de pointes patient ed- call if n/v persists

Albuterol

therap class- bronchodil beta 2 recep SABA (Proair) indications- trt/ prevent bronchospasm asthma/COPD mech action- bind beta 2 recep in sm musc airway to prevent bronchoconstriction ae- chest pain, palpations, nervousness, tremor, restlessness, PARADOXICAL BRONCHOSPASM assessment- lung sounds, bp, pulse, sputum, pulmonary function, wheezing, K+ lvs interactions- mao- hypertensive crisis, dec digoxin lvl pt ed- may cause bad taste, inform health care profess if SOB, chest pain etc, prime unit w/ 4 sprays before use- discard after 200 sprays

Flovent

class- corticosteroid indications- long term trtmnt asthma moa- anti-inflamm ae- headache, CHURG STRAUSS SYNDROME, dry mouth, oral fungal infection assessment- lung sounds, withdrawal, bone density, thrush interactions- cyp34 INHIB pt ed- 5min btw each breath, not used for acute exacerbations, rinse/gargle after use

Montelukast

(singulair) class- Leukotriene antagonist indications- prophylaxis asthma moa- block inflamm, vasc perm, dec inflamm cell migration/activation, dec bronchoconstriction, prevent leukotrienes attaching to recep on cells in lungs ae- churg strauss syndrome assessment- limit alcoh, liver function interactions- phenytoin- alters metab drungs in liver pt ed- not used rescue inhaler, important follow routine admin

Salmeterol

class- bronchodil beta 2 recep LABA indications- long term control bronchospasms moa- bind beta 2 recep in sm musc airway to prevent bronchoconstriction ae- severe asthma exacerbations (become tolerant) never use alone assessment- lung sounds, pulse bp, wheezing, K lvls interactions- beta blockers dec effect, mao/ cyp3a4- cardiovasc effects pt ed- don't exhale into disc, use as directed, use w/ ICS

theophylline

class- methylxanthines (bronchodil) indications- adjunct maintenance therapy COPD moa- relaxes sm usc in bronchi ae- diarrhea, vf, seizures, death, n/v, insomnia assessment- bp, pulse, rr, monitor for diuresis, pulmonary function interactions- caffine (inc effects), phenytoin dec effects, h2 recep inc risk toxicity pt ed- drink 2000mL/day, no smoking, routine serum lvl testing

Ipratropium

class- anticholinergic (bronchodil) (atrovent) indications- therapy for reversible airway obstruction due to COPD moa- bind acetylcholine recep to prevent ach frm binding, prevents bronchconstriction ae- inc intraocular p, dry mouth assessment- rr, pulse, wheezing, rhinorrhea (nasal spray) interactions- o/ ach drugs inc lvls pt ed-avoid Combivent if allergic peanuts, rinse mouth after use, do not inhale while spraying

Pseudoephedrine

Sudafed class- adrenergic- decongestant indications- management nasal congestion moa- stimulates alpha/beta-adrenergic recep, vasoconstriction respir tract mucosa ae- nervousness, anxiety, SEIZURES, palpations, CARDIOVASC COLLAPSE assessment- congestion, pulse, bp, lung sounds, maintain fluid intake 1500-2000mL/day interactions- mao- htn crisis, acidic foods dec effectiveness pt ed- caution w/ kids < 4 or breastfeeding

Phenylephrine

Sinex class- decongestant (nasal) indications- shrt term management nasal congestion moa- stim alpha-adrenergic recep in nasal mucosa producing vasoconstriction ae- rebound congestion, burning, drying nasal mucosa assessment- nasal congestion interactions- inc risk htn w/ antidepress pt ed- not take w/ lrg amnts caffeine

Diphenhydramine

Benadryl class- antihistamine indications- treat common cold, motion sickness, sleep aid, anaphylaxis, allergic rhinitis moa- anticholinergic effects- ae- dry mouth, drowsiness, constipation, changes vision, pupil dilation assessment- depends on intended use, cold- sneeing, rhinorrhea, nasal stuffiness interactions-inc risk cns depress w/ opioids/alcoh, mao inhib inc anticholinergic effects pt ed- not use w/ alcoh and opioids, can cause drowsiness and dry mouth

Loratadine

Claritin class- 2nd gen antihistamine indications- relief seasonal allergies moa- block effect histamine- dec vasodil, dec respir secretions, dec cap perm ae- confusion, drowsiness, blurred vision, dry mouth assessment- allergy symptoms (hives, conjunctivitis (pink eye)) interactions- mao inc effects, inc cns dep w/ opioids/ alcoh pt ed- sunscreen, avoid alcoh, good oral hygiene avoid dry m, caution while driving