Exam 3 Flashcards
Anti- thyroid agents
tiomides
methimazole “zole”
propylthiouracil
Anti-thyroid solutions
sodium iodine
potassium iodine
Anti-thyroid side effects
drowsiness, N/V, skin rash
Anti-thyroid nursing considerations
Do not use in pregnant or nursing women.
Monitor liver, CBC for bone marrow suppression
Monitor for signs of hypothyroidism
Give iodine solution through a straw to decrease staining of teeth.
Another Folic acid (prescription form)
leucovorin
Folic acid side effects
anorexia, nausea, flatulence, abdominal distention
Folic acid nursing considerations
400mcg/0.4mg for all women of child bearing age.
4mg w/ a history or previous NTD
Foods rich in folic acid…pasta, bread, grits, rice, dark leafy greens, citrus fruits, milk, eggs
ADH replacement hormone
desmopressin
desmopressin side effects
increased sun sensitivity
N/V
abdominal cramps
desmopressin nursing considerations
Monitor for S/S of water intoxication and electrolyte imbalance
Monitor patients w/ HTN and vascular disease carefully - causes vasoconstriction
Monitor BP, and Pulse during infusion
Inspect drug for particles and discoloration before infusing
Histamine 2 blocker
famotidine
famotidine side effects
constipation, diarrhea, headache, and confusion
famotidine nursing considerations
QT interval prolongation and torasades de pointes w/ renal dysfunction patients
Assess for blood in stool, may increase BUN and Cr, and liver enzymes
Glucocorticoids
dexamethasone
hydrocortisone
methylprednisone
prednisone
Glucocortoids side effects
Elevated Blood Glucose
Mineralocortoids
hydrocortison
fludrocotisone
Mineralocortoids side effects
fluid retention
hypokalemia
corticoids nursing considerations
Monitor for infection, BG, occult blood in stool
Use with caution in children due to growth retardation
Monitor for S/S of FVO and electrolyte imbalance, long-term use can increase the demineralization of bone
Prostaglandin inhibitors
Ibuprophen, ASA, indomethacin
Prostaglandin side effects
headache, dizziness, depression, fatigue, somnolence, syncope, vertigo
CV: edema
Prostaglandin nursing considerations
Watch for bleeding and reduced urine output, nephrotoxic
Can cause hearing loss, tinnitus, HTN
PPI
pantaprazole
PPI side effects
hyperglycemia
PPI nursing considerations
Monitor lipid, BG, and hypomagnesium
thyroid agents
levothyroxine
liotrix
thyroid desiccated
liothyronine
Thyroid agent side effects
insomnia, tremor, headache, fever, fatigue, anxiety, emotional lability, tachycardia, palpitations,ARRHYTHMIAS, angina, pectoris, HTN
Thyroid agents nursing considerations
Give drug at same time each day on an empty stomach, 1/2 to 1 hr before breakfast. Patients w/ DM may need increased antidiabetic doses when starting thyroid hormone replacement. longterm therapy causes bone loss in premenopausal and postmenopausal women. Consider a basal bone density measurement and monitor patient for osteoporosis.
Antibiotic-Antimyobacterials
rifampin
rifampin side effects
GI- N/V, diarrhea, abdominal pain, depression of CNS
rifampin nursing considerations
Turns urine, sweat, tears orange- do not wear contacts as may discolor.
Monitor renal and liver function.
Use barrier contraception as may interfere with hormonal contraception.
Antibiotics- fluroquinolones
ciprofloxacin
ciprofloxacin side effects
N/V, diarrhea
ciprofloxacin nursing considerations
Potential for tendonitis and tendon rupture.
Monitor CBC - can cause bone marrow depression
Photosensitivity
Antibiotic- cephlasporin
ceftriaxone
ceftriaxone side effects
GI- N/V, diarrhea, abdominal pain, paresthesias
ceftriaxone nursing considerations
Sensitivity to PCN
Monitor renal function
May potentiate effect of anticoagulants
Anticoagulants
Heparin, LMWH
Heparin side effects
increased bleeding times
Heparin nursing considerations
monitor for signs of bleeding, and bleeding times
Antiepileptic
gapapentin
gapapentin side effects
fluid retention, insomnia, txn of neuropathic pain
gabapentin nursing consideration
CNS depression can lead to safety risks.
Monitor liver function.
Antifungal
Amphotercin B
Amphotercin B side effects
N/V, flush, fever, chills, hypotension
Amphotercin B nursing considerations
Monitor renal function, watch for hypokalemia, hypomagnesemia.
Don’t use a saline solution for reconstitution or infusion. Only give drug in D5W, use an infusion pump and, if desired, and in-line filter with mean pore diameter larger than 1 micron. After giving test dose, monitor patients pulse, RR, temp, and BP q30mins for 2-4 hrs.
ALERT: Rapid infusion may cause CV collapse: ensure drug is infused over 2-4 hours.
Antifungal
flucytosine
flucytosine side effects
Allergic rxn, chest pain, hearing loss
flucytosine nursing considerations
monitor renal and hepatic functions, and hearing
Beta 1 adronergic
Dobutamine
Dobutamine side effects
Increase contractility of the heart, SV, and CO.
Decreased preload, SVR, and afterload
Dobutamine nursing considerations
Monitor HR, and BP. Can cause HTN and exacerbate ventricular ectopy.
Monitor IV site for phlebitis
Monitor Na and K levels
Immunoglobulin side effects
N/V, chills, fever, headache, dizziness, weakness, anaphylaxis
Immunoglobulin nursing considerations
Dont freeze or shake vials
Inspect for particles and discoloration (liquid should be clear or pale yellow)
Bring to room temp before using
Keep epinephrine on hand d/t potential for anaphylaxis
Monitor renal function.
Ensure hydration before giving
Positive Inotropic
dopamine
epinephrine
vasopressin
isoproterenol
Positive Inotropic side effects
HTN, increased HR, angina, PVCs, phlebitis, nonspecific chest pain, ventricular ectopy, dyspnea, N/V, constipation
Positive Inotropic nursing considerations
Give through a CVAD or large peripheral vein using an infusion pump, watch for extravasation in smaller veins, ensure adequate hydration
Monitor for signs of hypokalemia
Alpha and Beta Adrenergic
norepinephrine
norepinephrine side effects
Bradycardia and HTN
norepinephrine nursing considerations
Use a Central Venous catheter or large vein, such as the antecubital fossa, to minimize risk of extravasation. Give in D5W alone or D5W/NS injection. Use continuous infusion pump. irritation w/ extravasation, necrosis and gangrene secondary to extravasation.
Beta Adrenergic
isoprterenol
isoprterenol side effects
tachycardia, ventricular arrhythmias, palpitation, angina, pulmonary edema, dyspnea
isoprterenol nursing considerations
Monitor pulse, BP
Assess for lung sounds
Monitor for arrhythmias
vasodilator
nitroprusside
nitroprusside side effects
hypotension, metabolic acidosis, ICP
nitroprusside nursing considerations
Protect from light
Monitor BP, dyspnea
S/S of metabolic acidosis
Monitor for ICP