Drugs for Exam 3 Flashcards
Prostaglandin Inhibitor
Acetaminophen / Tylenol
indications: mild to moderate pain, fever
MOA: inhibits prostaglandin synthesis
side effects: GI upset
HEPATOXICITY
Patient Teaching: do not exceed 4 g/day
DOES NOT DECREASE INFLAMMATION
NSAIDs
Nonsteroidal
Anti-Inflamatory
Drugs
indications: mild to moderate pain, fever, inflammation
MOA: analgesia by lowering inflammation
contraindications: pregnancy, peptic ulcer disease (PUD), bleeding disorders
side effects: GI upset, nephrotoxicity, GI bleeding, increased risk of cardiovascular thrombotic events (MI, stroke)
interactions: corticosteroids, alcohol (concurrent use increases risk of GI bleed)
Salicylates
Asprirn (side effects: abdominal pain, salicyllism, peptic ulcer disease (PUD), intestinal blood loss, Reye’s syndrome, itchy rash, tinnitus)
Cyclooxygenase-1 Inhibitors (COX-1)
Ibuprofen / Motrin / Advil
Meloxicam / Mobic
Naproxen / Naprosyn / Aleve
Cyclooxygenase-2 Inhibitors (COX-2
Celecoxib / Celebrex
indications: pain, inflammation, fever, prevention of thrombotic events
MOA: inhibits prostaglgandin synthesis, decreases inflammation, decreases platelet aggregation
contraindications: pregnancy, peptic ulcer disease (PUD), bleeding disorders, DURING OR FOLLOWING FEBRILE ILLNESS IN CHILDREN (risk for Reye’s syndrome)
side effects: tinnitus, GI bleeding, GI upset, rash
nursing care: monitor for salicylism (tinnitus, vomiting, diarrhea, respiratory alkalosis)
Opiate Agonists
Hydromorphone / Dilaudid
Morphine / Morphine Sulfate
Oxycodone / OcyContin
Fentanyl
Methadone
indications: moderate to severe pain, promotion of sedation
MOA: binds to opiod receptors in the CNS
side effects: sedation, GI upset (constipation), hypotension, urinary retention
life threatening respiratory depression, addiction, abuse, neonatal opiod withdrawal syndrome
nursing care: monitor pain level, vital signs, respiratory status, administer naloxone for overdose (reverses analgesia and causes immediate withdrawal: hypertension, tachycardia, agitation)
you may need to RUSH to give naloxone to your patient in response to: Respiratory depression, Urinary retention, Sedation, Hypotension
patient teaching: increase fluid and fiber intake
Opiate Partial Agonists
Buprenorphine / Suboxone
indications: opiod withrawal and maintenance of opiod use disorder, management of severe chronic pain
MOA: binds to opiate receptors in the CNS, decrease pain via CNS depression
side effects: sedation, confusion, constipation, hypotension, abuse, addiction, life-threatening respiratory depression
nursing care: NALOXONE IS THE ANTIDOTE to these medications, monitor pain level, vital sighns, respiratory status
patient teaching: increase fiber and fluid intake to prevent constipation
Opiate Antagonists
Naloxone / Narcan
indications: opiod withrawal and maintenance of opiod use disorder, management of severe chronic pain
MOA: binds to opiate receptors in the CNS, decrease pain via CNS depression
side effects: sedation, confusion, constipation, hypotension, abuse, addiction, life-threatening respiratory depression
nursing care: NALOXONE IS THE ANTIDOTE to these medications, monitor pain level, vital sighns, respiratory status
patient teaching: increase fiber and fluid intake to prevent constipation
Naltrexone / Revia / Vivitrol
indications: alcohol use disorder (promotes abstinence)
MOA: supresses craving for alcohol
NOT INTENDED TO TREAT ACUTE ALCOHOL WITHDRAWAL
Benzodiazepines
Alprazolam / Xanax
Diazepam / Valium
indications: anxiety, seizures, muscle spasms, alcohol withdrawal, induction/maintenance of anesthesia
MOA: enhances GABA effect in the CNS
side effects: sedation, amnesia, respiratory depression, abuse , addiction, depencence, withdrawal, (insomnia, irritability, siezures)
PAM takes LORAZEPAM for her anxiety. She doesn’t drive her BENZ anymore because BENZOS cause sedation
patient teaching: DO NOT DISCONTINUE ABRUPTLY
SHORT TERM USE ONLY (antidote is flumazenil)
Antihistamines
Diphenydramine / Benadryl
Antidepressants
Trazodone / Deseryl
Doxepin / Silenor
indications: depression, insomnia
TraZodone helps me get some ZZZZs
MOA: serotonin antagonist and reputake inhibitor
side effects: sedation, hypotension, dry mouth, suicidal thoughts/behaviors
patient teaching: avoid alcohol, use hard candy or gum for dry mouth
GABA Receptor Agonists (benzodiazepine-like receptor agonists)
Zolpidem / Ambien
indications: insomnia
MOA: increases GABA in the CNS, promoting sedation/sleep
Side effects: daytime sleepiness, dizziness, abnormal thinking/behavior, complext sleep behaviors (sleep walking/driving)
patient teaching: allow for at least 7-8 hours of sleep
Dietary & Herbal Supplements
Melatonin
Valerian
Orexin Receptor Inhibitors
Lemborexant / Dayvigo
Fat Soluble Vitamins
Vitamin D
&
Vitamin K
Water Soluble Vitamins
Vitamin B complex with emphasis on thiamine (B1), niacin (B3) and cyanocobalamin (B12)
Vitamin C ascorbic acid
Folic Acid
Niacin/B3
indications: hypercholesterolemia
MOA: lowers lipoprotein and triglyceride synthesis
contraindications: use cautiously in patients with diabetes
side effects: flushing of the face, GI upset, pruritus, hepatoxicity, hyperglycemia
My face doesn’t look very NICE because it’s flushed after taking NIACIN
Folic Acid
indications: megaloblastic and macrocytic anemia, prevent nural tube defects during pregnancy
MOA: stimulates production of RBCs, WBCs, and platelets
Cyanocobalamin (Vitamin B12)
indications: pernicious anemia
CYNthia keeps BABBLIN about taking CYANOCOBALAMIN for her pernicious anemia
MOA: synthetic form of vitamin B12, needed for hematopoiesis
nursing care: PO form NOT RECOMMENDED due to lack of intrisic factor
Minerals
Calcium
Magnesium
Phosphorus
Iron
Magnesium Supplements
indications: hypomagnesemia, preterm labor, pre-eclampsia, torsades de pointes
MOA: electrolyte needed for nerve and muscle function, slows uterine contractions
side effects: diarrhea, magnesium toxicity (S/S: lovers DTRs, lowers urine output, respiratory depression, hypotension)
Too much MAGNESIUM brought MAGGIE to her KNEES (due to cardiac and respiratory depression)
nursing care: monitor for signs of toxicity: CALCIUM GLUCONATE IS THE ANTIDOTE FOR MAGNESIUM TOXICITY
iron supplements
indications: iron defieciency, anemia
MOA: essential component of hemoglobin
side effects: oral- GI upset, constipation, teeth staining (DRINK WITH A STRAW, harmless), dark green/black stools
IM- staining at injection stie, hypotension, flushing
anaphylaxis (iron dextran)
nursing care: used Z-track method for IM injection
patient care: vitamin C increases iron absorption, calcium decreases iron absorption, take on empty stomach, increase fiber and fluid intake to prevent constipation, KEEP OUT OF REACH OF CHILDREN due to risk of fatal toxicity
Herbal Therapy
Garlic
Ginkgo
(and Ginger increase bleeding risk with aspirin, NSAIDS, warfarin - 3 Gs can make you bleed)
Green Tea
St. John’s wort
increases risk of serotonin syndrome with serotonin reuptake inhibitors, decreases effectiveness of oral contraceptives, anticoagulants, and digoxin
Melatonin
Carbonic Anhydrase Inhibitors
Dorzolamide / Trusopt
indications: glaucoma, heart failure, altitude sickness
MOA: inhibits carbonic anhydrase in the eye (resulting in decreased aqueous humor secretin and IOP) and in the kidneys (leading to excretion of Na, K, HCO3 and water)
side effects: flu-like symptoms, GI upset, electrolyte imbalances (Na and K), hyperchloremic acidosis
nursing care: monitor electrolytes
patient teaching: take with food to minimize GI upset
Normal IOP = 10 to 21 mmHg
Cholinergic Drugs (Miotic) – Opthalmic
Pilocarpine / Isopto Carpine
indications: open angle glaucoma
Now that PILOCARPINE fixed my glaucoma, I can see you big PILE O CRAP by the door.
MOA: decreases IOP by improving aqueous humor outflow
side effects: stinging, eye pain
nursing care: do not touch eye with applicator, hold lacrimal duct for 1 minute after application to prevent systemic effects
normal IPO = 10 to 21 mmHg
Alpha-Adrenergic Agents
Phenylephrine / Altafrin
indications: rhinitis
MOA: vasoconstriction of respiratory tract mucosa
contraindications: hypertension, CAD
side effects: nervousness, palpitations, insomnia, rebound congestion
interactions: caffeine, stimulants
nursing care: monitor HR and BP
patient teaching: because of the risk of rebound congestion, use sparingly
Beta-Adrenergic Blockers
Timolol Maleate / Timoptic
indications: glaucoma (primarily open angle)
TIMOLOL is for the eye. TIM stuck his finger in my eye and LAUGHED OUT LOUD (LOL)
MOA: non-selective beta blocker, decreases aqueous humor production and intraocular pressure (IOP)
side effects: temporary stinging of the eye
nursing care: do not touch eye with applicator, hold lacrimal duct for 1 minute after application to prevent systemic effects
normal IOP = 10 to 21 mmHg
Prostaglandin Agonists
Latanoprost / Xalatan
indications: open angle glaucoma
MOA: decreases IOP by improving aqueous humor outflow
side effects: irritation, increased eyelash growth, eye color change (increase in iris pigmentation)
Let’s raise our glasses and say “PROST!” (cheers in German) now that my glaucoma is fixed and I have longer/thicker eyelashes.
nursing care: do not touch eye with applicator, hold lacrimal duct for 1 minute after application to prevent systemic effects
normal IOP = 10-21 mmHg
Opthalmic Antibiotics
Bacitracin / Bacitracin ophthalmic
Neomycin-polymyxin B-bacitracin / Neo-Polycin ophthalmic
bacitracin
indications: minor skin injuries (burns, cuts, scrapes)
MOA: inhibits bacterial wall synthesis
side effects: allergic contact dermatitis
patient teaching: clean affected area, apply a small amount 1-3 times daily
