Final Exam: Medications Flashcards
PRILs: Rami, Perindo, Lisino
Therapeutic Class: Antihypertensive
Pharmacologic Class: ACE Inhibitor
Action: vasodilation, lower BP
Side Effects: drowsiness, dizziness, headache, persistent dry cough
Caution: risk of angioedema
Nursing Considerations: monitor for hypotension (hold SBP >90_, change position slow, fall risk, advocate for change in medication if patient has trouble with cough, metabolized by liver, excreted by kidneys
SARTANs: Cande, Lo, Val
Therapeutic Class: antihypertensive
Pharmacologic Class: angiotensin II receptor blockers
Action: treat hypertension, lower BP
Side Effects: dizziness, headache
Caution:
Nursing Considerations: monitor for hypotension, may be appropriate for clients who cannot tolerate ACE inhibitors “PRILs”
OLOLs: Metor, Carvedi
Therapeutic Class: antihypertensives & Anti Dysrhythmics
Pharmacologic Class: Beta-blockers
Action: decrease HR/cardiac contractility, lowers BP, treat dysrhythmias, HF, HTN, acute MI, CAD
Side Effects: dizziness, light-headedness, hypotension/ ortho hypo, bradycardia, dry mouth
Caution: may worsen CHF over time; therefore, contraindicated in late-stage
Nursing Considerations: Assess VS prior to admin (hold in HR <60. SBP >90), change position slowly, medication may mask hypoglycemic symptoms – monitor T1-T2 diabetes
Amlodipine, Diltiazem
Therapeutic Class: antihypertensive & anti dysrhythmic
Pharmacologic Class: calcium channel blockers
Action: decreases HR/cardiac contractility, cause vasodilation, lowers BP
Side Effects: dizziness, light-headedness, hypotension/ortho hypo, bradycardia, peripheral edema, flushing, GI upset, constipation
Caution: avoid with CHF
Nursing Considerations: risk for hypotension (hold in HR <60. SBP >90), change position slowly, monitor I/O due to risk for edema, metabolized by liver, excreted by kidneys
Digoxin, Digitalis
Therapeutic Class: anti dysrhythmic
Pharmacologic Class: cardiac glycoside
Action: treats dysrhythmias, improves myocardial contraction to increase CO and slows conduction to decrease HR
Side Effects: dizziness, fatigue, bradycardia, N/V/D, visual disturbances
Nursing Considerations: Monitor HR, hold HR <50, monitor for toxicity (GI upset, abnormal HR, Visual disturbances), risk for toxicity with impaired kidney function as med is eliminated by kidneys
- Blocks inotropes
Nitroglycerine
Therapeutic Class: vasodilator (short-acting)
Pharmacologic Class: Nitrates
Action: decreases BP, decrease pre-load and afterload
Side Effects: dizziness, lightheadedness, headache, orthostatic hypotension, tachycardia, hypotension, flush
Caution: avoid sildenafil (viagara) = hypotension
Nursing Considerations: health teaching on use, monitor effects after use
Furosemide (Lasix)
Therapeutic Class: antihypertensive
Pharmacologic Class: loop diuretic
Action: lower BP by reducing fluid volume
Side Effects: dehydration, dizziness, headache, hypotension/ortho hypo, electrolyte imbalance (hypoK, hypoNAT, hypoCA)
Caution:
Nursing Considerations: risk for hypotension, monitor lytes, daily wts, I/O, falls risk with older adults, monitor kidney function
Hydrochlorothiazide
Therapeutic Class: antihypertensive
Pharmacologic Class: thiazide diuretic
Action: lower BP by reducing fluid volume
Side Effects: dehydration, dizziness, headache, hypotension/ortho hypo, electrolyte imbalance (hypoK, hypoNAT, hypoCA)
Caution: contraindicated with impaired kidney function
Nursing Considerations: risk for hypotension, monitor lytes, daily wts, I/O, falls risk for older adults, monitor kidney function
Spironolactone
Therapeutic Class: Antihypertensives
Pharmacologic Class: potassium sparing diuretic.
Action: lower BP by reducing volume
Side Effects: dizziness, headache, hypotension/ ortho, electrolyte imbalances (hyperK), photosensitivity, N/V/D
Caution: contraindicated with later-stage kidney function
Nursing Considerations: Risk for hypotension, monitor lytes, daily wts, I/O, falls risk for older adults, monitor kidney function
Acetylsalicylic Acid (ASA, Aspirin)
Therapeutic Class: Anti-inflammatory, antipyretic, analgesic & antiplatelet
Pharmacologic Class: NSAIDs
Action: decrease temp, inflammation, pain, and platelet aggregation
Side Effects: GI upset, bleeding
Nursing Considerations: health teaching on risk of bleeding
Clopidogrel (Plavix, Ticagrelor)
Therapeutic Class: antiplatelet
Pharmacologic Class: adenosine diphosphate receptor antagonist
Action: decrease platelet aggregation
Side Effects: headache, nausea, bruising, GI upset, bleeding, heartburn
Nursing Considerations: health teaching on risk of bleeding, monitor PT/INR, hepatic activation
Apixaban, Dabigatran, rivaroxaban
Therapeutic Class: oral anticoagulants
Pharmacologic Class: factor Xa inhibitors
Action: inhibit clotting
Side Effects: bruising, bleeding gums, nose bleeding, heavy menses, blood in urine/stool
Caution: risk for stroke
Nursing Considerations: monitor for PT/INR, health teaching on risks of bleeding
Statins: Atorvastatin, rosuvastatin
Therapeutic Class: antihyperlipidemic
Pharmacologic Class: HMG – CoA reductase inhibitors
Action: decrease LDL/triglycerides
Side Effects: Headache, dizziness, GI upset, insomnia, MUSCLE PAIN
Nursing Considerations: monitor lipids (**fasting), hepatoxic
Valproic Acid (epival)
Therapeutic Class: anticonvulsant
Pharmacologic Class:
Action: treats seizure disorders
Side Effects: abdo pain, constipation, increased appetite, N/V/D, dizziness, double vision, drowsiness, weight gain, rash
Nursing Considerations: tale same time every day, don’t stop abruptly, interact with other seizure meds (phenytoin and carbamazepine), routinely monitor blood levels, monitor liver, white blood cells/platelets
Carbamazepine (Tegretol)
Therapeutic Class: anticonvulsant
Pharmacologic Class:
Action: treats partial seizure disorders – ineffective for myoclonic/absent
Side Effects: dizziness, blurred vision, confusion, constipation, drowsiness, nausea
Nursing Considerations: take same time every day, don’t stop abruptly, interacts with other seizure meds (phenytoin and valproic acid), monitor blood levels routinely, toxicity: rash/liver symptoms
Phenytoin (Dilantin)
Therapeutic Class: anticonvulsant
Pharmacologic Class:
Action: treats partial seizure disorders – ineffective for absent/myoclonic
Side Effects: headache, constipation, NV, drowsiness/fatigue, gum swelling, nervousness, sleep disturbances, increased hair growth, depression, decrease HR/BP
Caution: suicidal ideation, skin rashes (Stevens-Johnson)
Nursing Considerations: Teach 1-hour pre meal or 2 hours post meal, take at same time daily, oral care (gingival hyperplasia), don’t stop abruptly, interacts with other meds – carbamazepine, valproic acid, and oral contraceptives, toxicity therapeutic range is 10-20; ataxia, tremors, slurred speech; monitor blood levels
Lorazepam
Therapeutic Class: anticonvulsant
Pharmacologic Class:
Action: treats seizure disorders, slows CNS
Side Effects: dizziness, confusion, drowsiness, NV, agitation, hyperactivity
Nursing Considerations: expect to notice effect in 5-10 mins of admin, for sublingual admin DO NOT force mouth open – place between lip or inside cheek (massage until dissolved), move with client while admin, do not restrain
Midazolam (versed)
Therapeutic Class: anticonvulsant
Pharmacologic Class:
Action: treats seizure disorders, slows CNS
Side Effects: Dizziness, confusion, drowsiness, fatigue
Caution: avoid in clients with glaucoma
Nursing Considerations: expect to notice effect in 5-10 mins of admin, for sublingual admin DO NOT force mouth open – place between lip or inside cheek (massage until dissolved), move with client while admin, do not restrain
Spironolactone
Therapeutic Class: Antihypertensive, diuretic
Pharmacologic Class: potassium sparing diuretic
Action: lower BP by reducing fluid volume
Side Effects: dizziness, headache, hypotension, ortho hypotension, electrolyte imbalance (hyperK), photosensitivity, nausea, vomiting, diarrhea
Caution: contraindicated with impaired kidney function
Nursing Considerations: risk for hypotension, monitor lytes, daily wts, I/O, falls risk with older adults, monitor kidney function
Norfloxacin
Therapeutic Class: antibiotic
Pharmacologic Class: fluoroquinolone
Action: treats infection
Side Effects: headache, nausea
Caution:
Nursing Considerations: take drug at same time daily
Vitamin K (phytonadione)
Therapeutic Class: vitamin
Pharmacologic Class:
Action: supports liver in generating clotting factors
Side Effects: decreased appetite
Caution: avoid with anticoagulants, NSAIDs and ASA
Nursing Considerations: in acute bleed, admin via IV; for routine management, admin orally with bile salts to increase uptake
Rifaximin (Zaxine)
Therapeutic Class: antibiotic
Pharmacologic Class: rifamycin
Action: breaks down bacteria in the colon to prevent ammonia production
Side Effects: dizziness. This med is not absorbed well so few side effects
Nursing Considerations: assess mental status during therapy for S&S of hepatoceph
Lactulose
Therapeutic Class: laxative
Pharmacologic Class: sugar
Action: promotes elimination by pulling water into colon, removes ammonia from GI by drawing into colon
Side Effects: bloating, cramping, diarrhea
Nursing Considerations: may experience loose stools or increased stools/day
Opioids (hydromorphone, morphine)
Therapeutic Class: analgesics
Pharmacologic Class: opiates
Action: treats pain
Side Effects: drowsiness, pruritis, N&V, constipation
Nursing Considerations: monitor resp rate, increased risk of overdose with older age, existing renal/hepatic dysfunction
