Exam 1 Medications Flashcards
Anti-Inflammatory Drugs - Aspirin
Analgesic
i.Uses – Produce analgesia and reduce inflammation and fever by inhibiting the production of prostaglandins. Decreased platelet aggregation.
ii. Side effects – GI bleeding, Allergic reactions including Anaphylaxis and Laryngeal edema. Dyspepsia, epigastric distress, nausea. Abdominal pain, anorexia, hepatotoxicity, vomiting, tinnitus, anemia, hemolysis, rash and urticaria.
iii. Special considerations – Take with full glass of water and remain in upright position for 15-30 minutes after administration. History of GI bleeding or ulcer disease, chronic alcohol use/abuse, severe hepatic or renal disease, OB (adverse effects on fetus and mother should be avoided during pregnancy), Lactation, and Geri (increase adverse reactions, GI bleeding).
iv. Contraindications – hypersensitivity to aspirin or other salicylates, cross-sensitivity with other NASIDs may exist (less with nonaspirin salicylates), bleeding disorders or thrombocytopenia, Pedi: may increase risk of Reye’s syndrome in children or adolescents with viral infections.
v. Toxicity – Monitor for the onset of tinnitus, headache, hyperventilation, agitation, mental confusion, lethargy, diarrhea, and sweating. If these symptoms appear, withhold medication and notify health care professional immediately.
Anti-inflammatory Drugs -
Ibuprofen
i. Uses: Decreases pain and inflammation. Reduces fever.
ii. Side effects: Myocardial Infarction, Stroke, GI bleeding, Hepatitis, Heart Failure, Headache, constipation, dyspepsia, nausea, vomiting.
iii. Special considerations: Take with meals or milks. Hypersensitivity when taken with other NSAIDs, pregnancy and pediatrics. Use cautiously with cardiovascular patients, geriatrics, pediatrics, pregnant women and lactating women.
Nonopioid & opioid Analgesics - Acetaminophen
Analgesia and Antipyresis
i. Max doses – Taken q4 at a max of 4g/Day. Or frequent users limit to 2000mg/day (2g/day) to avoid possibly hepatic or renal dysfunction.
ii. Uses – PO, Rect: Treatment of mild pain and fever. IV: Treatment of mild to moderate pain, moderate to severe pain with opioid analgesics and fever.
iii. Combination medications – Many medications; hydrocodone, codeine, oxycodone, aspirin, caffeine, dextromethorphan, doxylamine, guaifenesin, phenylephrine, chlorpheniramine, butalbital, methocarbamol, pheniramine,
iv. Side effects – Hepatotoxicity (Imegeuarr doses), Acute generalized exanthematous pustulosis, Stevens-Johnson syndrome, toxic epidermal necrolysis. IV: Agitation, anxiety, headache, fatigue, insomnia, atelectasis, dyspnea, hypertension, hypotension, constipation, nausea, vomiting, hypokalemia, muscle spasms, trismus. PO: inc liver enzymes, renal failure (high doses/chronic use), neutropenia and pancytopenia, rash and urticaria.
Morphine Sulfate
Opioid analgesic, Opioid agonists
i. Short and long-acting: normal release duration is 3-5 hours. Controlled-release morphine duration is 8-12 hours.
ii. Uses – Decrease in severity of pain
iii. Side Effects: Respiratory depression, Hypotension, confusion, sedation, constipation, nausea, vomiting, diarrhea, flushing, itching, hallucinations, headaches, dizziness, euphoria, sweating, physical/psychological dependence.
iv. Contraindications: Hypersensitivity. Use cautiously with: head trauma, severe renal/hepatic/pulmonary disease, hypothyroidism. Geri, OB, Lactation and Pedi.
v. Routes: PO, Rect, IM, IV, and Subcut, Epidural, IT.
Hydromorphone
Analgesic, Antitussive
i.Uses – moderate to severe pain, moderate to severe chronic pain in opioid tolerant patients requiring use of daily, around-the-clock long-term opioid treatment and for which alternative treatment options are inadequate.
ii. Side Effects – Respiratory depression. Confusion, sedation, hypotension, constipation. Dizziness, dysphoria, euphoria, floating feeling, hallucinations, headache, unusual dreams, blurred vision, diplopia, miosis, bradycardia, dry mouth, nausea, vomiting, urinary retention, flushing, sweating, physical dependence, psychological dependence, and tolerance.
iii. Contraindications – hypersensitivity with bisulfites, severe respiratory depression, acute or severe bronchial asthma, paralytic ileus, acute, mild, bintermittent or postoperative pain, Prior GI surgery or narrowing of GI tract, Opioid non-tolerant patients, and severe hepatic impairment.
iv. Routes – PO, IV, IM, SC, Rect. Depending on usage. Aanalgesic. PO, IV, IM, SC, and Rect (adults only). Hepatic impairment – PO, Renal impairment – PO, Antitussive – PO.
Oxycodone
Opioid, Opioid analgesics, agonists/nonopioid
i.Uses: Decrease moderate to severe and chronic severe pain.
ii. Side Effects: Respiratory depression, confusion, sedation, constipation, choking, hypotension, nausea, vomiting, dizziness, and dysphoria.
iii. Contraindications: Hypersensitivity, some contain alcohol and bisulfites. Use cautiously with: head trauma, increase intracranial pressure, severe renal/hepatic disease, OB, lactation and Geri.
iv. Routes: PO immediate-release tablets and extended-release tablets.
Hydrocodone
Analgesic
i.Uses: moderate to moderately severe pain. Used for antitussive purposes.
ii. Side Effects: Confusion, dizziness, sedation, hypotension, constipation, dyspepsia, nausea. Euphoria, hallucinations, headache, unusual dreams, blurred vision, diplopia, miosis, respiratory depression, bradycardia, QT interval prolongation, choking, dysphagia, esophageal obstruction, vomiting, urinary retention, sweating, physical dependence, psychological dependence and tolerance.
iii. Contraindications: Hypersensitivity to hydrocodone and acetaminophen/ibuprofen, significant respiratory depression, paralytic ileus, acute or severe bronchial asthma or hypercarbia, congenital long QT syndrome, Ibuprofen-containing products and Acetaminophen-containing products should be avoided, OB - Lactation: Avoid chronic use
Naloxone (Narcan)
Antidote, Opioid antagonists
i. Uses: Reversal of signs of opioid excess. (reverses effects of opioid overdoses)
ii. Side effects: Ventricular arrhythmias, hypertension, nausea, vomiting and hypotension.
Penicillin
i. Reason for use: treatment of a wide variety of infections including: pneumococcal pneumonia, streptococcal pharyngitis, syphilis, gonorrhea strains; Treatment of enterococcal infections, prevention of rheumatic fever, should not be used as a single agent to treat anthrax.
ii. Routes of administration: PO, IV, IM,
iii. Adverse Reactions/Anaphylaxis Reaction:
1. Interventions: Discontinue drug and notify physician or other health care professional immediately if these symptoms occur. Keep epinephrine and resuscitation equipment close.
iv.Patient Education: instruct patient to take medication around the clock and finish drug completely, advise patient to report signs of superinfection, instruct patient to notify health care professional if fever and diarrhea develop advise patient taking oral contraceptives to use additional nonhormonal method of contraception, and patient with an allergy to penicillin should be instructed to always carry an ID car with this information.
Amoxicillin
Broad-spectrum penicillin
i.Combinations: clarithromycin and lansoprazole.
ii. Reasons for use: treatment of skin and skin structure infections, otitis media, sinusitis, respiratory infections, genitourinary infections; endocarditis prophylaxis, post exposure inhalational anthrax prophylaxis, management of ulcer disease due to Helicobacter pylori.
iii. Routes of administration: PO – by mouth orally. Dosages depend on usages.
iv. Considerations: assess for infection, obtain a history before initiating therapy to determine previous use of and reactions to penicillins or cephalopsporins, observe for s&s of anaphylaxis, obtain specimens for culture and sensitivity prior to activity, obtain specimens for culture and sensitivity prior to therapy, Monitor bowel function.
Ceftriaxone (Rocephine)
Anti-infectives
i.Use: treatment of – skin and skin structure infections, bone and joint infections, complicated and uncomplicated urinary tract infections, uncomplicated gynecological infections including gonorrhea, lower respiratory tract infections, intra-abdominal infections, septicemia, meningitis, otitis media; and perioperative prophylaxis.
ii. Routes of administration: IM, IV rapid onset. Duration 12-24 hours.
iii. Considerations: assess for infection. Obtain history to determine previous use of and reactions to penicillins or cephalosporins, before initiating therapy. Observe patient for signs and symptoms of anaphylaxis. Monitor bowel function.
Cephalexin (Keflex)
Anti-infectives
i.Reasons for use: Treats skin and skin structure infections, pneumonia, UTIs, bone and joint infections, septicemia, and otitis media.
ii.Considerations: Monitor CNS for seizures. Monitor for adverse and allergic reactions such as rash/hives, and anaphylaxis. Monitor bowel function.
Cefdinir (Omnicef)
Anti-Infectectives
i.Reasons for use: treatment of the following infections caused by susceptible organisms – community-acquired pneumonia, acute exacerbations of chronic bronchitis, acute maxillary sinusitis, pharyngitis and tonsillitis, uncomplicated skin and skin structure infections and acute bacterial otitis media.
ii.Considerations: Observe patient for signs and symptoms of anaphylaxis, obtain specimens for culture and sensitivity before initiating therapy. Obtain history, assess patient for infection. Monitor bowel function. May cause positive results for Coombs’ test.
Azithromycin
Zithromax, Zmax
i.Uses: treatment of various infections, including; upper respiratory tract infections (streptococcal pharyngitic, acute bacterial exacerbations of chronic bronchitis and tonsillitis), lower resp tract infections (bronchitis and pneumonia), acute otitis media, skin and skin structure infections, and nongonococcal urethrititis, cervicitis, gonorrhea and chancroid.
ii.Side effects: Todsades de pointes, hepatotoxicity, clostridium defficile-associated diarrhea (CDAD), Stevens-Johnson syndrome, toxic epidermal necrolysis, angioedema. Abdominal pain, diarrhea, nausea.
Erythromycin
i. Uses: infections caused by susceptible organisms including- upper and lower resp tract infections, otitis media, skin and skin structure infections, pertussis, diphtheria, erythrasma, intestinal amebiasis, pelvic inflammatory disease, nongonococcal urethritis, syphilis, legionnaire’s disease, and rheumatic fever. Useful when penicillin is the most appropriate drug but cannot be used because of hypersensitivity including: streptococcal infections and treatment of syphilis or gonorrhea.
ii. Routes: PO and IV dosage dependent on age/WT and usage.
iii. Special considerations: assess for infection, obtain specimens for culture and sensitivity before initiating therapy. Monitor bowel function. Monitor liver function tests periodically on patients receiving high-dose, long-term therapy.
