Drug Cards Flashcards
quinapril
Brand: Accupril
Generic: quinapril
Class: Ace-Inhibitor (all “-pril” meds)
Use: HTN, HF
Action: Blocks conversion of angiotensin I to angiotensin II (decreases BP)
Common SE: Hypotension, dry cough, dizziness, hyperkalemia
Adverse reaction: Angioedema, agranulocytosis
Nursing Considerations:
-Check BP prior to admin, hold if SBP <90
-Slow position changes/fall precautions
-Monitor WBCs (agranulocytosis)
-Monitor for facial swelling (angioedema)
-Monitor potassium
metoprolol
Brand: Lopressor
Generic: metoprolol
Class: Beta Blocker (all “-lol” meds)
Use: HTN, HF, acute MI, CAD, ventricular dysrhythmias
Action: Blocks stimulation of Beta I receptors in the heart, resulting in decreased BP/HR and overall workload of the heart
Common SE: Bradycardia, hypotension, fatigue, weakness, changes in BS
Adverse reaction: Pulmonary edema, HF
Nursing Considerations:
-Check BP and HR prior to admin, hold if SBP is <90, HR <60
-Slow position changes, fall precautions
-Monitor BS and s/sxs of hypoglycemia and hyperglycemia in diabetic patients
-Monitor for s/sxs of respiratory distress or respiratory edema
*What is important to know about metoprolol? It is cardioselective
furosemide
Brand: Lasix
Generic: furosemide
Class: Loop diuretic
Use: HTN, HF, renal insufficiency/ acute renal failure
Action: Works in kidneys (Look of Henle) to prevent reabsorption of sodium. This causes large amount of H20 to be excreted, as well as other electrolytes (particularly potassium)
Common SE: Dehydration, orthostatic hypotension, decreased electrolytes (K+, Cl-, Na, Mg, Ca)
Adverse reaction: SJS
Nursing Considerations:
-Check electrolytes prior to admin
-Check BP prior to admin
-Slow position changes, fall precautions
-Monitor kidney labs (BUN, creatinine, GFR)
-Monitor for rash
digoxin
Brand: Lanoxin
Generic: digoxin
Class: Inotropic agent, Cardiac glycoside
Use: HF, Afib, Aflutter, PAT (paroxysmal atrial tachycardia)
Action: Positive inotropic effect due to increased amounts of calcium in the myocardium - which enhances contractility of heart and increases cardiac output (CO)
Common SE: Bradycardia, fatigue
Adverse reaction: Dysrhythmias, toxicity (GI upset - N/V, abd pain, anorexia - vision changes, arrhythmias
Nursing Considerations:
-Check apical pulse x1 minute prior to admin, hold and notify provider if <60
-Check potassium prior to admin, as hypokalemia increases chances of toxicity
-Fall precautions (vision changes possible)
prednisone
Brand: Deltasone
Generic: prednisone
Class: Corticosteroid
Use:
-Treatment in chronic inflammatory, respiratory, and autoimmune diseases
-Treatment for acute inflammatory disorders/injury and allergic response
Action: Suppress inflammation and normal immune system response
Common SE: Mood changes, restlessness, nausea, decrease appetite, hyperglycemia, easy bruising, fluid retention
Adverse reaction: GI bleed, increased susceptibility to infection/decreased healing, adrenal insufficiency
Nursing Considerations:
-Monitor/assess mental status
-Administer with food
-Monitor BS, skin, I&Os, WBCs (for s/sxs of infection)
-Monitor for s/sxs of adrenal insufficiency (GI sxs, hypotension, weight loss, edema)
levofloxacin
Brand: Levaquin
Generic: levofloxacin
Class: fluoroquinolone
Use: Broad spectrum ABX for urinary, reproductive, respiratory, skin, GI infections
Action: Inhibits bacterial DNA synthesis
Common SE: GI upset (N/V/D/abd pain), Dizziness, headaches
Adverse reaction: Achilles tendon rupture, C diff, torsades de pointes, SJS
Nursing Considerations:
-Obtain specimens for culture prior to admin
-Give with food
-Slow position changes, fall precautions
-Monitor for headache, rash, GI, or cardiac symptoms
warfarin
Brand: Coumadin, Jantoven
Generic: warfarin
Class: anticoagulant
Use: Prophylactic or treatment for DVT, PE, Afib, MI, prosthetic heart valve
Action: Blocks enzyme that uses vitamin K to produce clotting factor, which leads body’s clotting abilities to lessen
Common SE: Bleeding
Adverse reaction: Toxicity (hemorrhage)
Nursing Considerations:
-Check PT/INR prior to admin, hold if over target range (typically 2-3 for patients on blood thinner)
-Monitor hemoglobin and hematocrit
-Monitor BP/HR for indications of hemorrhage
-Vit K is the antidote
*POSSIBLE CONTRAINDICATION WHEN GIVEN WITH HEPARIN, VERIFY WITH MD IF BOTH ARE ORDERED
heparin/enoxaparin
Brand: Lovenox
Generic: heparin/enoxaparin
Class: anticoagulant
Use: Prophylactic/treatment of thromboembolic disorders
Action: Enhances antithrombin, making it more effective at stopping certain clotting factors in blood
Common SE: Bleeding, anemia
Adverse reaction: Hemorrhage, heparin induced thrombocytopenia
Nursing Considerations:
-Check w/ another nurse
-Check platelets prior to admin
-Check BP/HR for indications of hemorrhage
-Monitor for s/sxs of bleeding
-For subcutaneous: give at least 2 inches from umbilicus
-For IV: monitor aPTT, should be no greater than 2x baseline
-Protamine is antidote
*POSSIBLE CONTRAINDICATION WHEN GIVEN WITH COUMADIN, VERIFY WITH MD IF BOTH ARE ORDERED
potassium chloride
Normal range: 3.5-5.5mEq/L
Brand: Klor-con, K-tab
Generic: potassium chloride
Class: Supplement, mineral/electrolyte replacement
Use: Treatment/prevention of potassium depletion
Action:
Side effects: GI upset (N/V/D/abd pain), arrhythmias, ECG changes, confusion, weakness, phlebitis of IV site, rash
Nursing Considerations:
-Check serum potassium levels, BP/HR prior to admin
-Assess for s/sxs for hypo and hyperkalemia
-Monitor labs (serum potassium, chloride, magnesium, renal function)
-Monitor ECG
-Monitor for GI symptoms
-Report sudden decrease in urine output to provider
-Take after eating and with full glass of water
Monitor for toxicity (hyperkalemia: arrhythmias, fatigue/weakness, decreased DTRs, palpitations, bradycardia)
hydrocodone-acetominophen
Brand: Norco, Lortab
Generic: hydrocodone-acetaminophen
Class: Opioid analgesic, opioid agonist, antitussive
Use: Management of moderate to severe pain, antitussive (usually in combination with decongestant)
Action:
-Binds to opioid receptors in the CNS, which alters perception and reaction to pain
-Suppresses cough reflex
Side effects: Hypotension, confusion, constipation, nausea, sweating, dizziness, sedation, medication tolerance/dependance, respiratory depression, dyspepsia
Nursing Considerations:
-Assess BP, pulse, respiration rate, level of consciousness, pain, bowel function
-If given as antitussive also assess cough and lung sounds
-Assess risk for opioid addiction
-Monitor for toxicity (naloxone is the antidote)
-DO NOT exceed 4g of acetaminophen/day
insulin regular
Brand: Humulin R, Novolin R
Generic: insulin regular
Class: short-acting insulin/antidiabetic
Use: Control of hyperglycemia in T1DM and T2DM patients
Action: Lowers BG by stimulating glucose uptake in skeletal muscle and fat, blocks glucose production in the liver
Side effects: Hypoglycemia, hypokalemia, anaphylaxis, pain/swelling/itching of injection site
Nursing Considerations:
-Have another nurse check type, dose, and expiration date prior to admin
-Check rapid glucose prior to admin
-Be sure that food tray or a good snack is in room
-Monitor weight
-Monitor labs (BG, electrolytes, A1C every 3 months)
-Monitor for toxicity (hypoglycemia)
-Rotate sites, give at least 2 inches from umbilicus
S/Sxs of hypoglycemia?
Headache, hunger, mood changes (irritability, trouble concentrating), diaphoresis, tremors, dizziness, confusion, fainting, weakness/fatigue, palpitations
insuline glargine
Brand: Lantus, Basaglar
Generic: insuline glargine
Class: Long-acting insulin/antidiabetic
Use: Control of hyperglycemia in T1DM and T2DM patients
Action: Lowers BG by stimulating glucose uptake in skeletal muscle and fat, blocks glucose production in the liver
Side effects: Hypoglycemia, hypokalemia, anaphylaxis, pain/swelling/itching of injection site
Nursing Considerations:
-Have another nurse check type, dose, and expiration date prior to admin
-Be sure that food tray or a good snack is in room
-Monitor weight
-Monitor labs (BG, electrolytes, A1C every 3 months)
-Monitor for toxicity (hypoglycemia)
-Rotate sites, give at least 2 inches from umbilicus
