final pharm review 2024 Flashcards
1
Q
lisinopril class
A
ACE
INHIBITORS
2
Q
lisinopril (ACE inhibitors) indications–2
A
hypertension
heart failure
3
Q
lisinopril (ACE inhibitors) contraindications–2
A
pregnancy
hx of angioedema
4
Q
lisinopril (ACE inhibitors) cautions–3
A
-black patients are at increased risk of angioedema
-ischemic heart disease
-renal dysfunction
5
Q
lisinopril (ACE inhibitors) side effects–2
A
-coughing
-hypotension
6
Q
lisinopril (ACE inhibitors) adverse effects–2
A
- angioedema
- acute renal failure
7
Q
lisinopril (ACE inhibitors) assess/monitor–4
A
- Obtain BP before administering; notify provider if SBP <90
- Renal/liver function
-Serum electrolytes - Signs of angioedema of the face, lips, throat or intestines
8
Q
lisinopril (ACE inhibitors) admin
A
- PO
- do not give at same time as ARB (losartan)
9
Q
lisinopril (ACE inhibitors) pt. ed
A
Change position slowly to prevent orthostatic hypotension
10
Q
losartan class:
A
Angiotensin II Receptor Blocker (ARB)
11
Q
losartan (ARB) indication—4
A
- HTN
- adjunct for HF
- used if ACE inhibitor not tolerated (coughing)
- prevent diabetic nephropathy if HTN
12
Q
losartan (ARB) contraindication
A
pregnancy
13
Q
losartan (ARB) MOA
A
blocks angiotensin II, causing dilation of veins and arteries
14
Q
losartan (ARB) adverse effects
A
Angioedema
Chest pain
Fatigue, weakness
Fetal harm
Renal failure
15
Q
losartan (ARB) assess/monitor
A
- kidney labs
- BP
- electrolytes
16
Q
losartan (ARB) admin
A
- PO with or w/out food
- do not give at same time as ACE inhibitor (lisinopril)
17
Q
losartan (ARB) pt. ed
A
- don’t take with ACE inhibitor (lisinopril)
18
Q
metoprolol class
A
beta blocker
19
Q
metoprolol (beta blocker) indication–3
A
-hypertension
-heart failure
-angina pectoris
20
Q
metoprolol (beta blocker) contraindications–3
A
- decompensated heart failure
-severe bradycardia
» 2nd or 3rd-degree
heart block
21
Q
metoprolol (beta blocker) cautions–3
A
- bradycardia
- diabetes
- liver disease
22
Q
metoprolol (beta blocker) side effects
A
- bradycardia
- hypotension
- dizziness
- fatigue
23
Q
metoprolol (beta blocker) adverse effects
A
- bradycardia
- heart failure
- hypoglycemia
24
Q
metoprolol (beta blocker) assess/monitor–2
A
- Obtain BP before administering; notify provider if SBP <90
- Obtain HR before administering; hold typically if HR <60
25
metoprolol (beta blocker) IV admin--1
* If given intravenously, patient should be on a
cardiac monitor
26
metoprolol (beta blocker) patient ed--3
* Change position slowly, especially with elderly, to prevent orthostatic changes
* Monitor blood glucose carefully if diabetic as beta blockers may mask symptoms of hypoglycemia
* Do not discontinue this drug abruptly
27
amlodipine class
calcium channel blockers
28
diltiazem class
calcium channel blockers
29
nifedipine class
calcium channel blockers
30
amlodipine, diltiazem, and nifedipine class
calcium channel blockers
31
amlodipine, diltiazem, and nifedipine (calcium channel blockers) indications--2
* hypertension
* stable angina
32
amlodipine, diltiazem, and nifedipine (calcium channel blockers) --contraindications --2
* symptomatic hypotension
* heart blocks
33
amlodipine, diltiazem, and nifedipine (calcium channel blockers) --cautions --3
* severe aortic stenosis
* hepatic impairment
* elderly patients
34
amlodipine, diltiazem, and nifedipine (calcium channel blockers) side effects --5
* edema, especially in
the feet
* abdominal pain,
nausea
* constipation
* flushing
* dizziness, headache
35
amlodipine, diltiazem, and nifedipine (calcium channel blockers) adverse effects--1
* Cardiac arrhythmias
36
amlodipine, diltiazem, and nifedipine (calcium channel blockers)--assess/monitor--4
* Obtain BP and HR before administering; notify provider
if SBP <90
* Presence of peripheral edema
* Liver and kidney function
* Serum electrolytes
37
amlodipine, diltiazem, and nifedipine (calcium channel blockers)--admin--1
* Intravenous administration of drips requires additional
monitoring (frequent vitals, cardiac monitoring)
38
amlodipine, diltiazem, and nifedipine (calcium channel blockers)--pt. ed--1
* Change position slowly, especially with elderly, to prevent
orthostatic changes
* Diltiazem: Avoid grapefruit
39
hydralazine, isosorbide, and nitroglycerine class
vasodilators
40
hydralazine, isosorbide, and nitroglycerine indications--2
* hypertension
* angina pectoris
* nitroglyerine is a rescue med for angina
41
hydralazine, isosorbide, and nitroglycerine contraindications--3
* coronary artery disease
* mitral valve disease
* cardiomyopathies
* taking while taking ED meds
42
contraindcation for nitroglycerine only --1
should not
be used for patients with
increased intracranial
pressure
43
hydralazine, isosorbide, and nitroglycerine caution--3
* valve disease
* history of stroke
* renal disease
44
hydralazine, isosorbide, and nitroglycerine-side effects--5 (1 unique to hydralazine)
* diarrhea, loss of
appetite, nausea,
vomiting
* headache
* dizziness
* hypotension
* hydralazine only: reflex tachycardia
45
hydralazine, isosorbide, and nitroglycerine adverse effect--1
* hypotension
46
hydralazine, isosorbide, and nitroglycerine assess/monitor--2
* Obtain BP and HR before administering; notify provider
if SBP <90
* Presence/resolution of chest pain
47
hydralazine, isosorbide, and nitroglycerine admin--2
* Nitrate patches must be taken off at night and reapplied in the morning — do not leave on overnight
* NTG: give one every 5 minutes as needed, checking BP between doses
* Intravenous nitroglycerin — use vented, low-sorb tubing
48
hydralazine, isosorbide, and nitroglycerine pt. ed
* Dangerously low blood pressure can result if patients are
taking nitroglycerin or other nitrates with erectile
dysfunction medications
* Tolerance to nitroglycerin may develop with excessive use
* Do not discontinue these medications suddenly
* Avoid alcohol (may increase risk of hypotension)
* Treat headaches with aspirin or acetaminophen
49
digoxin class
digitalis / cardiac glycoside
50
digoxin (cardiac glycoside) indications--3
* atrial fibrillation
* heart failure
* ventricular rate control
51
digoxin (cardiac glycoside) contraindications--1
* ventricular fibrillation
* K wasting diuretics (spironolactone is ok)
52
digoxin (cardiac glycoside) caution--2
* elderly patients
* renal impairment
* hypokalemia increases risk of toxicity
53
digoxin (cardiac glycoside) side effects--3
* fatigue
* bradycardia
* anorexia, nausea,
vomiting
54
digoxin (cardiac glycoside) adverse effects--2
* cardiac arrhythmias
* digoxin toxicity
55
digoxin toxicity
* weakness
* confusion
* n/v and abdominal pain
* visual disturbances
56
digoxin (cardiac glycoside) assess/monitor--5
* Assess apical pulse for a full minute before giving; hold for
HR <60
* Electrolytes
* Serum digoxin levels (0.8 - 2.0 ng/mL)
* Renal function
* Signs of toxicity (abdominal pain, confusion, weakness, anorexia,
nausea and vomiting, bradycardia, visual changes — blurred
vision, green/yellow color disturbances)
57
digoxin (cardiac glycoside) admin--1
parental admin rarely used
58
digoxin (cardiac glycoside) pt. ed--2
* Report symptoms of digoxin toxicity
* This medication can increase the risk for falls
59
atorvastatin class
statins
60
atorvastatin (statins) indications--1
hyperlipidemia
61
atorvastatin (statins) contraindications--3
* acute liver disease
* pregnancy
* breastfeeding
62
atorvastatin (statins) cautions--3
* elderly patients
* renal failure
* liver failure
63
atorvastatin (statins) side effects--3
* diarrhea, abdominal
pain, constipation
* muscle or joint pain
* nasopharyngitis
64
atorvastatin (statins) adverse effects--2
* rhabdomyolysis
* hepatotoxicity
65
atorvastatin (statins) assess/monitor--4
* Lipid panel
* Liver function
* Serum creatine kinase
* Presence of muscle pain
66
atorvastatin (statins) admin--1
67
atorvastatin (statins) pt. ed--3
* Avoid alcohol while taking this medication
* Immediately report unexplained muscle pain, tenderness,
or weakness
* Consult provider before starting new medications,
due to numerous drug interactions
68
ezetimibe class
cholesterol absorption inhibitor
69
ezetimibe (cholesterol absorption inhibitor)
indication--1
hyperlipidemia
70
ezetimibe (cholesterol absorption inhibitor)
caution--3
* liver failure
* renal failure
* elderly
71
ezetimibe (cholesterol absorption inhibitor)
assess/monitor--2
* LFT
* lipids
72
ezetimibe (cholesterol absorption inhibitor)
admin--1
PO in evening with or without food
73
ezetimibe (cholesterol absorption inhibitor)
pt. ed--1
avoid ETOH
74
furosemide class
loop diuretics
75
furosemide (loop diuretic) indication
edema associated with heart failure, renal failure, and cirrhosis of the liver
76
furosemide (loop diuretic) contraindication--1
anuria
77
furosemide (loop diuretic) caution
* electrolyte imbalances
* renal failure
78
furosemide (loop diuretic) side effect--1
electrolyte imbalances
79
furosemide (loop diuretic) adverse effects --2
* hypotension
* severe electrolyte
imbalances may
result in cardiac
arrhythmias
80
furosemide (loop diuretic) assess/monitor--4
* Obtain BP before administering; notify provider if BP <90
* Potassium is the electrolyte that is most quickly
depleted — assess for signs of hypokalemia (weakness,
fatigue, increased PVCs on cardiac monitor)
* Serum potassium, sodium, and magnesium levels
* Urine output and kidney function (creatinine, BUN, GFR)
81
furosemide (loop diuretic) admin--1
* Rapid administration of IV doses can result in ototoxicity
82
furosemide (loop diuretic) pt. ed--2
* Change position slowly, especially with elderly, to prevent
orthostatic changes
* This drug will cause increased urine output
83
spironolactone class
K+ sparing diuretic
84
spironolactone (K+ sparing diuretic) indication--1
edema associated with liver
failure, heart failure,
or hypertension
85
spironolactone (K+ sparing diuretic) contraindications--2
* Addison disease
* hyperkalemia
86
spironolactone (K+ sparing diuretic) caution--1
renal failure
87
spironolactone (K+ sparing diuretic) side effects--3
* gynecomastia
* diarrhea, nausea,
vomiting
* somnolence
88
spironolactone (K+ sparing diuretic) adverse effects --3
* electrolyte
imbalances,
(especially
hyperkalemia)
* hepatotoxicity
* nephrotoxicity
89
spironolactone (K+ sparing diuretic) assess/monitor --4
* Obtain BP before administering; notify provider if BP <90
* Monitor urine output and reduction in edema
* Serum potassium levels
* Renal function
90
spironolactone (K+ sparing diuretic) admin--2
* Avoid use of potassium supplements
* Use PPE when handing tablets or crushing pills
* Take with food
91
spironolactone (K+ sparing diuretic) pt. ed--3
* Avoid high potassium supplements, foods, including salt substitutes
* Take this medication consistently with food
* This drug will cause increased urine output
92
hydrochlorothyazide (HCTZ) class
thiazide diuretic
93
hydrochlorothyazide (HCTZ) (thiazide diuretic) indications--2
* edema
* hypertension
94
hydrochlorothyazide (HCTZ) (thiazide diuretic) contraindication--1
anuria
95
hydrochlorothyazide (HCTZ) (thiazide diuretic) caution--3
* renal failure
* liver failure
* if taking lithium
96
hydrochlorothyazide (HCTZ) (thiazide diuretic) side effects--4
* photosensitivity
* hyperglycemia
* diarrhea, loss of
appetite, nausea,
vomiting
* dizziness
97
hydrochlorothyazide (HCTZ) (thiazide diuretics) adverse effects --4
* electrolyte
imbalances
* hepatotoxicity
* renal failure
* pulmonary edema
98
hydrochlorothyazide (HCTZ) (thiazide diuretics) assess/monitor--4
* Obtain BP before administering; notify provider if SBP <90
* I&O and/or daily weight
* Presence/resolution of edema
* Serum electrolytes
99
hydrochlorothyazide (HCTZ) (thiazide diuretics) admin--1
* Thiazides interact with many other medications
100
hydrochlorothyazide (HCTZ) (thiazide diuretics) patient ed--2
* Notify provider before beginning any new drug or
supplement
* This drug will cause increased urine output
101
warfarin class
anticoagulant
102
warfarin (anticoagulant) indications--3
* prevention of blood
clots for patients with
atrial fibrillation
* pulmonary embolism
* venous
thromboembolism
103
warfarin (anticoagulant) contraindications--2
* hemorrhage
* recent or potential
surgery or other
procedure with
potential for bleeding
104
warfarin (anticoagulant) caution--4
* vitamin K deficiency
* diabetes
* elderly patients
* renal impairment
105
warfarin (anticoagulant) side effects--1
* minor bleeding
or prolonged
bleeding time
106
warfarin (anticoagulant) adverse effect--1
GI bleeding
107
warfarin (anticoagulant) assess/monitor--3
* Assess for signs of bleeding before administering this medication
* Most recent INR (therapeutic range is most often 2–3)
* Signs of bleeding (black, tarry, or maroon stool, bruising,
hematuria, bleeding gums)
108
warfarin (anticoagulant) admin--4
* Use proper procedures for handling potentially
hazardous drugs
* If giving via feeding tube, pause the tube feeding as directed by
pharmacy
* This medication is typically given in the evenings so that INR
can be drawn and dose adjustments can be made before the
next dose
* Vitamin K is the reversal agent for warfarin
109
warfarin (anticoagulant) pt. ed--3
* Immediately report signs of bleeding
* Immediately report any falls, especially if a fall results
in hitting the head
* Avoid large amounts of foods containing Vitamin K
(such as leafy greens)
* use electric razor
* avoid situations that could lead to injury like contact sports
110
apixaban, dabigatran, & rivaroxaban class
direct acting oral anticoagulant (DOAC)
111
apixaban, dabigatran, & rivaroxaban (direct acting oral anticoagulants) indications--3
* prevention of thrombus
formation
* DVT
* pulmonary embolism
112
apixaban, dabigatran, & rivaroxaban (direct-acting oral anticoagulants) contraindications--1
* active bleeding
113
apixaban, dabigatran, & rivaroxaban (direct acting oral anticoagulants) cautions--3
* before procedures that
may cause bleeding
* hepatic failure
* ESRD (end stage renal disease)
114
apixaban, dabigatran, & rivaroxaban (direct acting oral anticoagulants) side effects--2
* minor bleeding
* prolonged bleeding time
115
apixaban, dabigatran, & rivaroxaban (direct acting oral anticoagulants) adverse effects--3
* GI bleeding
* intracranial bleeding
* hematuria
116
apixaban, dabigatran, & rivaroxaban (direct acting oral anticoagulants) assess/monitor--1
* Assess for signs of bleeding before administering
this medication
* Monitor:
PLTs 150k-400k
aPTT 30-40
HGB f 12-16, m 14-18
HCT f 37-47, m 42-52
LFTs
INR if warfarin bridge
117
apixaban, dabigatran, & rivaroxaban (direct acting oral anticoagulants) admin--2
* May be taken with or without food
* Medication may be crushed and administered in a puree
or via a feeding tube
118
apixaban, dabigatran, & rivaroxaban (direct acting oral anticoagulants) pt. ed--4
* Notify providers that you are taking this medication,
especially if invasive procedures are ordered
* Do not discontinue this medication abruptly
* There are multiple significant drug interactions for DOACs;
consult with provider before starting new medications
* Report signs/symptoms of bleeding
119
heparin, enoxaparin class
anticoagulant
120
heparin, enoxaparin class (anticoagulant) indications--5
* atrial fibrillation
* DIC
* Venous thromboembolism
prophylaxis or treatment
* Venous catheter occlusion
* warfarin bridging
121
heparin, enoxaparin class (anticoagulant) contraindications--2
* severe thrombocytopenia
* uncontrolled active
bleeding
122
heparin, enoxaparin class (anticoagulant) cautions--4
* severe hypertension
* history of
thrombocytopenia
* hepatic disease
* major surgery
123
heparin, enoxaparin class (anticoagulant) side effects--2
* thrombocytopenia
* increased liver
amino-transferase
level (AST)
124
heparin, enoxaparin class (anticoagulant) adverse effects--3
* heparin-induced
thrombocytopenia
(HIT)
* anemia
* bleeding
125
heparin, enoxaparin class (anticoagulant) assess/monitor--6
* Assess for signs of bleeding before administering this
medication
* Heparin aPTT or AntiXa labs for dose titration for
patients on GTTs
* Platelets
* INR (if bridging to warfarin)
* Hgb and hematocrit
* Liver function
126
heparin, enoxaparin class (anticoagulant) admin--5
* Heparin can be administered intravenously or
subcutaneously (never orally)
* Enoxaparin is administered subcutaneously — avoid the
umbilicus area and rotate sites
* Do not remove air bubble from prefilled enoxaparin syringes
* Heparin lock flush should not be used for anticoagulation
* Protamine sulfate is the reversal agent for heparin
127
heparin, enoxaparin class (anticoagulant) pt. ed--2
* Rotate injection sites
* Report signs of bleeding or thrombocytopenia
128
aspirin, clopidogrel class
anti-platelet drugs
129
aspirin, clopidogrel (anti-platelet drugs) indications--4
* acute MI
* CVA
* Prevention of thrombosis
after PCI
* PAD
130
aspirin, clopidogrel (anti-platelet drugs) contraindications--2
* active bleeding
* do not take both meds
131
aspirin, clopidogrel (anti-platelet drugs) caution--2
* patients taking PPIs
* before major surgery
132
aspirin, clopidogrel (anti-platelet drugs) side effects--3
* rash
* diarrhea
* minor bleeding
133
aspirin, clopidogrel (anti-platelet drugs) adverse effects
* Agranulocytosis
* GI bleeding
* Intracranial
hemorrhage
134
aspirin, clopidogrel (anti-platelet drugs) assess/monitor--1
Assess for signs of bleeding before administering this
medication
135
aspirin, clopidogrel (anti-platelet drugs)
admin--1
* May be taken with or without food
136
aspirin, clopidogrel (anti-platelet drugs) pt. ed--4
* Report signs/symptoms of bleeding
* Inform providers about use of drug prior to procedures that may cause bleeding
* Do not discontinue abruptly
* Do not take with NSAIDs or aspirin, due to increased risk for bleeding
137
acetaminophen class
non-opioid analgesic
138
acetaminophen (non-opioid analgesic) indication--2
* pain
* fever
139
acetaminophen (non-opioid analgesic) contraindication--1
severe hepatic disease
140
acetaminophen (non-opioid analgesic) caution--2
* ETOH abuse
* severe renal impairment
141
acetaminophen (non-opioid analgesic) side effects--2
* nausea, vomiting
* constipation
142
acetaminophen (non-opioid analgesic) adverse effects
* Liver failure
* Stevens-Johnson
syndrome
143
acetaminophen (non-opioid analgesic) assess/monitor--4
* Presence and resolution of pain
* Presence and resolution of fever
* Liver function
* Monitor for acetaminophen toxicity
* antidote is acetylcysteine
144
acetaminophen (non-opioid analgesic) admin--2
* Most often given PO
* Maximum daily dose is 4000 mg from all sources; be aware
of other medications that may contain acetaminophen
145
acetaminophen (non-opioid analgesic) pt. ed--2
* Many non-prescription drugs contain acetaminophen
* Do not drink alcohol while taking this drug
146
aspirin, celecoxib, ibuprofen, & naproxen class
NSAIDs
147
aspirin, celecoxib, ibuprofen, & naproxen (NSAIDs) indications--3
* pain
* fever
* inflammation
148
aspirin, celecoxib, ibuprofen, & naproxen (NSAIDs) contraindications--3
* history of adverse reaction
* CABG surgery
* weeks 20-30 of pregnancy
149
aspirin, celecoxib, ibuprofen, & naproxen (NSAIDs) cautions--5
* older adults
* severe heart failure
* when taking other drugs
that increase risk of GI
effects
* hepatic dysfunction
* renal dysfunction
150
aspirin, celecoxib, ibuprofen, & naproxen (NSAIDs) side effects--3
* headache
* constipation
* nausea, vomiting
151
aspirin, celecoxib, ibuprofen, & naproxen (NSAIDs) adverse effect--1
* GI bleeding
152
aspirin, celecoxib, ibuprofen, & naproxen (NSAIDs) assess/monitor--5
* Presence and resolution of pain
* Presence and resolution of fever
* Liver function
* Renal function
* Signs of bleeding — may increase bleeding time
153
aspirin, celecoxib, ibuprofen, & naproxen (NSAIDs) admin--1
* Give PO NSAIDs with food to reduce risk of GI bleed
154
aspirin, celecoxib, ibuprofen, & naproxen (NSAIDs) pt. ed--2
* Do not take with other NSAIDs (including aspirin)
* Do not drink alcohol or smoke while taking this medication
155
class: codeine
-codeine
-fentanyl
-hydromorphone
-morphine
-oxycodone
-codeine /acetaminophen
-hydrocodone /acetaminophen
-oxycodone /acetaminophen
opioids
156
indications--3:
-codeine
-fentanyl
-hydromorphone
-morphine
-oxycodone
-codeine /acetaminophen
-hydrocodone /acetaminophen
-oxycodone /acetaminophen
* acute pain
* chronic pain
* air hunger /shortness of
breath
157
contraindications --2
-codeine
-fentanyl
-hydromorphone
-morphine
-oxycodone
-codeine /acetaminophen
-hydrocodone /acetaminophen
-oxycodone /acetaminophen
* respiratory depression
* known or suspected GI
obstruction
158
cautions--4:
-codeine
-fentanyl
-hydromorphone
-morphine
-oxycodone
-codeine /acetaminophen
-hydrocodone /acetaminophen
-oxycodone /acetaminophen
* older adults
* hepatic dysfunction
* renal dysfunction
* impaired consciousness
159
side effects--5:
-codeine
-fentanyl
-hydromorphone
-morphine
-oxycodone
-codeine /acetaminophen
-hydrocodone /acetaminophen
-oxycodone /acetaminophen
* confusion
* sedation
* hypotension
* constipation
* nausea
*constipation
*urinary retention
160
adverse effects--3
-codeine
-fentanyl
-hydromorphone
-morphine
-oxycodone
-codeine /acetaminophen
-hydrocodone /acetaminophen
-oxycodone /acetaminophen
* Respiratory
depression
* Orthostatic
hypotension
* Drug dependence/
drug withdrawal
syndromes
161
assess/monitor--7
-codeine
-fentanyl
-hydromorphone
-morphine
-oxycodone
-codeine /acetaminophen
-hydrocodone /acetaminophen
-oxycodone /acetaminophen
-BP
-HR
-RR
-LOC closely before and after giving
* Pain or sedation level
* Bowel function
* Signs/symptoms of respiratory depression or sedation
162
admin--5
-codeine
-fentanyl
-hydromorphone
-morphine
-oxycodone
-codeine /acetaminophen
-hydrocodone /acetaminophen
-oxycodone /acetaminophen
* Give the lowest dose in a range to avoid complications
* Stool softeners and laxatives are often prescribed and
given with opioid drugs
* Opioids are controlled substances and require a witness
if a portion of the dose is not given
* Have naloxone
* Understand the route of administration — can be given
via IV, IM, subq, sublingual, PO, transdermal
* Understand the peak for the medication and route of
administration
163
pt. ed--3
-codeine
-fentanyl
-hydromorphone
-morphine
-oxycodone
-codeine /acetaminophen
-hydrocodone /acetaminophen
-oxycodone /acetaminophen
* High potential for misuse; however, opioids are typically
not addictive when used as directed for acute pain
* Chronic use of opioids can result in drug tolerance,
which can result in higher doses needed to achieve
adequate pain relief
* Do not discontinue abruptly
164
cyclobenzaprine class
muscle relaxant
165
cyclobenzaprine (muscle relaxant) indication--1
muscle spasm
166
cyclobenzaprine (muscle relaxant) contraindications--5
* arrhythmias
* when using MAOIs
* CHF
* heart blocks
* hyperthyroidism
167
cyclobenzaprine (muscle relaxant) cautions--3
* elderly patients
* hepatic dysfunction
* history of urinary retention
168
cyclobenzaprine (muscle relaxant) side effects--5
* dizziness
* fatigue
* somnolence
* dry mouth
* constipation
169
cyclobenzaprine (muscle relaxant) adverse effects--2
* Cardiac
dysrhythmias
* Liver impairment
170
cyclobenzaprine (muscle relaxant) assess/monitor--2
* Presence and reduction of pain, muscle stiffness
* Monitor for increased risk of sedation and weakness
for elderly patients
171
cyclobenzaprine (muscle relaxant) admin-2
* Give extended-release capsules at approximately
the same time each day
* Administer cautiously for patients receiving other
sedating medications
172
cyclobenzaprine (muscle relaxant) pt. ed --1
* Muscle relaxants are intended for short-term use
173
class:
diazepam
lorazepam
anxiolytics
174
indications (anxiolytics)--3:
diazepam
lorazepam
* anxiety
* premedication for
procedures
* status epilepticus
175
contraindications (anxiolytics)--2:
diazepam
lorazepam
* acute narrow-angle
glaucoma
* respiratory insufficiency
176
cautions (anxiolytics)--5:
diazepam
lorazepam
* patients receiving other
CNS depressants
* elderly patients
* hepatic failure
* renal failure
* debilitated patients
177
side effects (anxiolytics)--3:
diazepam
lorazepam
* dizziness
* drowsiness
* lethargy
178
adverse effects (anxiolytics)--1:
diazepam
lorazepam
delirium
179
assess/monitor (anxiolytics)--4:
diazepam
lorazepam
* Level of consciousness, sedation
* Presence or resolution of anxiety
* Resolution of seizure if being used to control status epilepticus
* Respiratory status
180
admin (anxiolytics)--2:
diazepam
lorazepam
* Use caution when administering opioids or other
sedating medications
* Give the lowest ordered dose that is effective
181
pt. ed (anxiolytics)--3:
diazepam
lorazepam
* This drug has the potential for misuse
* Do not discontinue abruptly
* Avoid alcohol and other CNS depressants
182
class:
levetiracetam
phenytoin
anti-epileptics
183
indication (anti-epileptics) --1
levetiracetam
phenytoin
* seizures
184
contraindication (anti-epileptics) --3:
levetiracetam
-hypersensitivity
-angioedema
-anaphylaxis
185
contraindication (anti-epileptics) --1:
phenytoin
hypersensitivity
186
caution (anti-epileptics) --1:
levetiracetam
phenytoin
pregnancy
187
side effects (anti-epileptics) :
levetiracetam
phenytoin
* drowsiness
* ataxia
* weakness
* GI disturbance
188
adverse effects (anti-epileptics) :
levetiracetam
phenytoin
hypotension
189
assess/monitor (anti-epileptics) --2:
levetiracetam
phenytoin
* Presence or reduction of seizure activity
* Serum drug levels
190
admin (anti-epileptics) --2:
levetiracetam
phenytoin
* Use PPE for drugs with special handling precautions
* Some medications may interact with tube feedings
191
pt. ed (anti-epileptics) --3:
levetiracetam
phenytoin
* Do not discontinue abruptly (risk for seizure)
* Avoid antacids due to risk for decreased absorption
* Avoid alcohol due to risk of changes in drug serum levels
192
carbidopa/levodopa class
anti-Parkinson
193
carbidopa/levodopa (anti-Parkinsons) indication--2
* Parkinson’s disease
* Parkinsonism
194
carbidopa/levodopa (anti-Parkinsons) counterindication--2
* narrow-angle glaucoma
* history of melanoma
195
carbidopa/levodopa (anti-Parkinsons) cautions--4
* severe cardiovascular
disease
* endocrine disease
* hepatic disease
* renal disease
196
carbidopa/levodopa (anti-Parkinsons) side effects--4
* vitamin B6
deficiency
* nausea
* confusion
* dizziness
197
carbidopa/levodopa (anti-Parkinsons) adverse effects--5
* melanoma
* dyskinesia
* depression
* hallucinations
* suicidal thoughts
198
carbidopa/levodopa (anti-Parkinsons) assess/monitor--3
* Presence or improvement of Parkinson’s effects (rigidity,
tremors, shuffling gait, drooling)
* Liver/kidney labs
* For adverse reactions during the dosage adjustment period
199
carbidopa/levodopa (anti-Parkinsons) admin--2
* Can give with food to minimize GI upset
* Administer consistently at scheduled times if divided doses
200
carbidopa/levodopa (anti-Parkinsons) pt. ed--4
* Medication may wear off at the end of the dosing interval
* The oral form may discolor saliva, sweat or urine to dark red, brown, or black
* High-fat/high-protein/high-calorie meals may delay absorption
* Avoid sudden discontinuation of drug
201
class:
ondansetron
prochlorperazine
antiemetics
202
indication--2:
(anti-emetics)
ondansetron
prochlorperazine
-nausea
-vomiting
203
contraindication--2:
(anti-emetics)
ondansetron
prochlorperazine
* patients taking
apomorphine
* Prochlorperazine is
contraindicated for children
204
caution--3:
(anti-emetics)
ondansetron
prochlorperazine
* prolonged QT
* electrolyte abnormalities
* prochlorperazine should
be used cautiously with
elderly patients
205
side effects--4:
(anti-emetics)
ondansetron
prochlorperazine
* constipation
* diarrhea
* headache
* fatigue
206
adverse effects:
(anti-emetics)
ondansetron
prochlorperazine
* prolonged QT
interval
* torsades de pointes
* serotonin syndromes
* tardive dyskinesia
(prochlorperazine)
207
assess/monitor--3:
(anti-emetics)
ondansetron
prochlorperazine
* Presence and resolution of nausea/vomiting
* Monitor for prolonged QT
* Monitor for extrapyramidal side effects (prochlorperazine)
208
admin--3:
(anti-emetics)
ondansetron
prochlorperazine
* Be sure hands are dry when handling oral disintegrating
tablets (ondansetron)
* Liquid not required for the oral soluble film (ondansetron)
* Select the form of the drug that is most appropriate for the
patient’s level of nausea (for example, a patient with severe
nausea may not be able to tolerate an oral tablet)
209
pt. ed--1:
(anti-emetics)
ondansetron
* Do not chew or swallow the oral film form of ondansetron
210
omeprazole class
(Proton Pump Inhibitor)
211
omeprazole (PPI) indications--4
* acid reflux
* duodenal ulcers
* erosive esophagitis
* gastric ulcers
212
omeprazole (PPI) contraindications--1
when used with rilpivirine
213
omeprazole (PPI) caution--2
* elderly patients
* vitamin B12 deficiency
214
omeprazole (PPI) side effects--4
* abdominal pain
* constipation
* diarrhea
* nausea
215
omeprazole (PPI) adverse effects--1
* hypomagnesemia
216
omeprazole (PPI) assess/monitor--3
* Resolution of acid reflux symptoms
* Serum magnesium levels
* Serum vitamin B12
217
omeprazole (PPI) admin--2
* Administer 30 minutes before meals for best effect
* Omeprazole capsules may be opened and sprinkled with 1 tbsp of puree — do not crush or chew
218
omeprazole (PPI) pt. ed --1
* Taking this medication for longer than a year can increase the
risk of some adverse effects
219
famotidine class
H2 histamine blocker
220
famotidine (H2 histamine blocker) indications--2
* indigestion
* acid reflux
221
famotidine (H2 histamine blocker) contraindications--1
hypersensitivity
222
famotidine (H2 histamine blocker) cautions--1
elderly patients
223
famotidine (H2 histamine blocker) side effects--3
* abdominal pain
* constipation
* diarrhea
224
famotidine (H2 histamine blocker) adverse effects--1
* arrhythmias
225
famotidine (H2 histamine blocker) assess/monitor--2
* Resolution of GI symptoms
* CBC assessment needed
226
famotidine (H2 histamine blocker) admin--1
* Administer 30 to 60 minutes before meals
227
famotidine (H2 histamine blocker) pt. ed --2
* Monitor for side effects
* Notify provider before starting new medications, as
H2 histamine blockers can interact with many drugs
228
class:
bisacodyl
docusate
lactulose
polyethylene glycol
sennosides
laxatives
229
indications (laxatives)--3:
bisacodyl
docusate
lactulose
polyethylene glycol
sennosides
* constipation
* bowel preparation for
GI procedure
* neurogenic bowel
230
contraindications (laxatives)--3:
bisacodyl
docusate
lactulose
polyethylene glycol
sennosides
* bowel obstruction
* appendicitis
* gastroenteritis
231
caution (laxatives)--2:
bisacodyl
docusate
lactulose
polyethylene glycol
sennosides
* extended use
* inflammatory bowel
disease
232
side effects (laxatives)--2:
bisacodyl
docusate
lactulose
polyethylene glycol
sennosides
* abdominal cramps
* diarrhea
233
adverse effects (laxatives)--1:
bisacodyl
docusate
lactulose
polyethylene glycol
sennosides
* electrolyte
imbalances
234
assess/monitor (laxatives)--2:
bisacodyl
docusate
lactulose
polyethylene glycol
sennosides
* Assess for abdominal distention, tenderness, and
presence of bowel sounds
* Assess color, consistency, and amount of last stool
235
admin (laxatives)--5:
bisacodyl
docusate
lactulose
polyethylene glycol
sennosides
* Hold for loose stools
* Understand route of administration for these medications
(may be PO, enema, or a suppository)
* Administer oral preparations with a full glass of water
* Avoid milk products or antacids within 1 hour of bisacodyl
* When mixed with some form of thickened water,
polyethylene glycol will become a thin liquid
236
pt. ed (laxatives)--3:
bisacodyl
docusate
lactulose
polyethylene glycol
sennosides
* Do not use for more than one week unless directed
by provider
* Report rectal bleeding
* Bowel movement should occur within 15 to 60 minutes after
a suppository, up to 12-24 hours after PO forms
237
class:
albuterol sulfate
short-acting bronchodilators
238
class:
salmeterol
ipratropium tiotropium
long-acting bronchodilators
239
indications (bronchodilators)--2:
albuterol sulfate
rescue med (abort attack) for
* asthma
* COPD
240
indications (bronchodilators)--2:
salmeterol
ipratropium
tiotropium
prophylactic med for
* asthma
* COPD
241
contraindications
(bronchodilators)--1:
albuterol sulfate
ipratropium
tiotropium
salmeterol
hypersensitivity
242
cautions
(bronchodilators)--2:
albuterol sulfate
ipratropium
tiotropium
salmeterol
* cardiovascular disorders
* hyperthyroidism
243
side effects
(bronchodilators--4):
albuterol sulfate
ipratropium
tiotropium
salmeterol
* tachycardia
* nervousness
* restlessness
* palpitations
244
adverse effects
(bronchodilators)--1:
albuterol sulfate
ipratropium
tiotropium
salmeterol
* paradoxical
bronchospasm
245
assess/monitor
(bronchodilators)--4:
albuterol sulfate
ipratropium
tiotropium
salmeterol
* Respiratory status
* Pulse
*BP
* Amount, color, and character of sputum
246
admin
(bronchodilators):
albuterol sulfate
ipratropium
tiotropium
salmeterol
* Inhaled medications are typically given with metered-dose
inhalers (MDI) or nebulized
* Use a spacer for individuals who have difficulty coordinating
inhalation from an MDI
247
pt. ed
(bronchodilators):
albuterol sulfate
ipratropium
tiotropium
salmeterol
* Report to provider if needing to increase the frequency
for symptom relief
* Use proper technique for inhaler
* avoid caffeine
* report sputum changes
248
class:
beclomethasone
fluticasone
inhaled corticosteroids
249
(inhaled corticosteroids) indications--2
beclomethasone
fluticasone
* asthma
* COPD
250
(inhaled corticosteroids) contraindications--1
beclomethasone
fluticasone
* status asthmaticus or other
acute episodes of asthma
251
(inhaled corticosteroids) cautions--6
beclomethasone
fluticasone
* hypertension
* diabetes mellitus
* hepatic insufficiency
* renal insufficiency
* pregnancy
* untreated infection
252
(inhaled corticosteroids) side effects--3
beclomethasone
fluticasone
* oral candidiasis
(thrush)
* throat/nasal
irritation
* hoarseness
253
beclomethasone
fluticasone
(inhaled corticosteroids) adverse effects--2
* osteoporosis
* glaucoma
254
(inhaled corticosteroids) assess/monitor--1
beclomethasone
fluticasone
* Respiratory status
* thrush
* hyperglycemia
255
(inhaled corticosteroids) admin--2
beclomethasone
fluticasone
* Not a rescue medication — will not treat an acute
bronchospasm
* Prime inhaler before initial use only
256
(inhaled corticosteroids) pt. ed--2
beclomethasone
fluticasone
* Rinse mouth with water after inhaling the drug to
prevent oral thrush
* This medication may cause increased glucose levels
257
class:
methylprednisolone
prednisone
corticosteroids
258
indications (corticosteroids)--5:
methylprednisolone
prednisone
* allergic reactions
* adrenal insufficiency
* dermatologic conditions
* rheumatic conditions
* inflammatory processes or
diseases
259
contraindication (corticosteroids)--1:
methylprednisolone
prednisone
serious infection
260
caution (corticosteroids)--6:
methylprednisolone
prednisone
* hypertension
* diabetes mellitus
* hepatic insufficiency
* renal insufficiency
* pregnancy
* untreated infection
261
side effects (corticosteroids)--4:
methylprednisolone
prednisone
* depression
* hypertension
* GI disturbances
* bruising
262
adverse effects (corticosteroids)--3:
methylprednisolone
prednisone
* hyperglycemia
* fluid and electrolyte
imbalances
* adrenal insufficiency
263
assess/monitor (corticosteroids)--4:
methylprednisolone
prednisone
* Blood glucose levels
* Serum potassium and sodium levels
* WBC
* Signs of adrenal insufficiency (hypotension, weight loss,
weakness, nausea/vomiting, confusion, peripheral edema)
264
admin including routes (corticosteroids)--4:
methylprednisolone
prednisone
* Give oral medications with meals to avoid GI irritation in AM (avoid insomnia)
*prednisone is given PO
*methylprednisolone is given IV
* These drugs have many interactions
265
pt. ed (corticosteroids)--2:
methylprednisolone
prednisone
* Do not discontinue abruptly
*rinse mouth after taking
266
class:
allopurinol
colchicine
uric acid reducer
267
indication (uric acid reducer) --1:
allopurinol
colchicine
gout
268
contraindication (uric acid reducer) --1:
allopurinol
colchicine
hypersensitivity
269
caution (uric acid reducer) --2:
allopurinol
colchicine
* hepatic insufficiency
* renal insufficiency
270
side effects (uric acid reducer) --2:
allopurinol
colchicine
* rash
* GI disturbances
271
adverse effects (uric acid reducer) --2:
allopurinol
colchicine
* hepatic failure
* renal failure
272
assess/monitor (uric acid reducer) --4:
allopurinol
colchicine
* Serum uric acid levels
* Liver function
* Renal function
* Joint swelling/joint pain
273
admin (uric acid reducer) --1:
allopurinol
colchicine
* Administer after a meal to reduce gastric irritation
274
pt. ed (uric acid reducer) --1:
allopurinol
colchicine
Increase fluid during therapy to reduce the risk of
kidney stones
275
vancomycin class
broad spectrum antibiotic
276
vancomycin (broad spectrum antibiotic) indication--1
bacterial infections where
the infectious agent has
not been identified
277
vancomycin (broad spectrum antibiotic) contraindication--1
hypersensitivity
278
vancomycin (broad spectrum antibiotic) cautions--2
* hepatic impairment
* renal impairment
279
vancomycin (broad spectrum antibiotic) side effects--2
* GI: diarrhea, nausea,
vomiting
* photosensitivity
280
vancomycin (broad spectrum antibiotic) adverse effect--6
* rash
* hives
* anaphylaxis
* C. diificile colitis
* nephrotoxicity
* ototoxicity
281
vancomycin (broad spectrum antibiotic) assess/monitor--6
* Signs/symptoms of worsening infection
* CBC
* Renal function
* Liver function
* Bleeding (some antibiotics can interact with anticoagulants)
* Signs of antibiotic-associated diarrhea
282
vancomycin (broad spectrum antibiotic) admin--5
* Obtain blood and specimen cultures before administering
the first dose
* Most broad-spectrum antibiotics are administered
intravenously or intramuscularly
* Drug may need to be reconstituted before administration
* Check for compatibility with fluids or other medications
if given intravenously
* Vancomycin is a vesicant — monitor IV site frequently;
do not give through a midline catheter
283
vancomycin (broad spectrum antibiotic) pt. ed--4
* Do not take antidiarrheal while on this medication unless
directed by healthcare provider
* Antibiotics may decrease the effectiveness of birth control —
use backup contraception while taking
* Take oral antibiotics with a full glass of water
* Some drugs may interact with alcohol — avoid it during
antibiotic therapy
284
cephalexin class
antibiotics: cephalosporins
285
cephalexin (antibiotics: cephalosporins) indication--1
bacterial infection, especially if mild allergy to penicillin
286
cephalexin (antibiotics: cephalosporins) contraindication--1
* hypersensitivity
287
cephalexin (antibiotics: cephalosporins) caution--5
* renal impairment
* hepatic impairment
* pregnancy
* for patients receiving
other nephrotoxic drugs
(additive effect)
* neuromuscular disease
288
cephalexin (antibiotics: cephalosporins) MOA--1
-disrupts bacterial cell wall, killing the bacterial cell; works best if bacterial cells are growing/dividing
289
cephalexin (antibiotics: cephalosporins) side effects--2
* diarrhea, nausea,
vomiting
* photosensitivity
290
cephalexin (antibiotics: cephalosporins) adverse effects--6
* rash
* hives
* anaphylaxis
* C. diificile colitis
* nephrotoxicity
* ototoxicity
291
cephalexin (antibiotics: cephalosporins) assess/monitor--6
* Signs/symptoms of worsening infection
* CBC
* Renal function
* Liver function
* Bleeding (some antibiotics can interact with anticoagulants)
* Signs of antibiotic-associated diarrhea
292
cephalexin (antibiotics: cephalosporins) admin--
* If indicated, obtain blood and specimen cultures
before administering the first dose
* Antibiotics can be administered in many forms —
PO, IV, IM, or topically
* Unless contraindicated, oral medications are generally
better tolerated with food
* Antacids can decrease absorption — do not give together
* Do not give tetracyclines with dairy products
293
cephalexin (antibiotics: cephalosporins) pt. ed--4
* Do not take antidiarrheal while on this medication unless directed by healthcare provider
* Antibiotics may decrease the effectiveness of birth control — use backup contraception while taking
* Take oral antibiotics with a full glass of water
* Some drugs may interact with alcohol — avoid it during antibiotic therapy
294
amoxicillin class
antibiotics: penicillins
295
amoxicillin (antibiotics: penicillins) indication--1
bacterial infection (broad spectrum)
296
amoxicillin (antibiotics: penicillins) contraindication--1
hypersensitivity
297
amoxicillin (antibiotics: penicillins) cautions--5
* renal impairment (reduce dose)
* hepatic impairment
* pregnancy
* for patients receiving
other nephrotoxic drugs
(additive effect)
* neuromuscular disease
298
amoxicillin (antibiotics: penicillins) MOA
-disrupts bacteria cell walls
-disrupts bacterial cell replication
299
amoxicillin (antibiotics: penicillins) side effects--2
* diarrhea, nausea,
vomiting
* photosensitivity
300
amoxicillin (antibiotics: penicillins) adverse effects--6
* rash
* hives
* anaphylaxis
* C. diificile colitis
* nephrotoxicity
* ototoxicity
301
amoxicillin allergy--
-allergic reaction treated with epinephrine
-skin test to check for allergy
-allergic reaction my be immediate (2-30 min), accelerated (1-72 hrs.), or delayed (days, weeks)
302
amoxicillin (antibiotics: penicillins) assess/monitor--6
* Signs/symptoms of worsening infection
* CBC
* Renal function
* Liver function
* Bleeding (some antibiotics can interact with
anticoagulants)
* Signs of antibiotic-associated diarrhea
303
amoxicillin (antibiotics: penicillins) admin--5
* If indicated, obtain blood and specimen cultures
before administering the first dose
* Antibiotics can be administered in many forms —
PO, IV, IM, or topically
* Unless contraindicated, oral medications are generally
better tolerated with food
* Antacids can decrease absorption — do not give together
* Do not give tetracyclines with dairy products
304
amoxicillin (antibiotics: penicillins) pt. ed--4
* Do not take antidiarrheal while on this medication
unless directed by healthcare provider
* Antibiotics may decrease the effectiveness of birth
control — use backup contraception while taking
* Take oral antibiotics with a full glass of water
* Some drugs may interact with alcohol — avoid it during
antibiotic therapy
305
class:
sulfamethoxazole /trimethoprim
antibiotics: sulfonamides
306
sulfamethoxazole /trimethoprim (antibiotics: sulfonamides) indications--1
systemic bacterial infection (esp. UTI); bacteriostatic: weakens bacteria so that host's body can kill the infection
307
sulfamethoxazole /trimethoprim (antibiotics: sulfonamides) contraindications--2
* hypersensitivity
* sulfonamides are
contraindicated in
children under 2
308
sulfamethoxazole /trimethoprim (antibiotics: sulfonamides) caution--5
* renal impairment
* hepatic impairment
* pregnancy
* for patients receiving
other nephrotoxic drugs
(additive effect)
* neuromuscular disease
309
sulfamethoxazole /trimethoprim (antibiotics: sulfonamides) MOA--2
-disrupts folate production in bacterial cells; folate is essential to bacterial cell reproduction, and humans do not produce folate
-bacteriostatic: weakens bacteria so that host's body can kill the infection
310
sulfamethoxazole /trimethoprim (antibiotics: sulfonamides) side effects--2
* diarrhea, nausea,
vomiting
* photosensitivity
311
sulfamethoxazole /trimethoprim (antibiotics: sulfonamides) adverse effects--6
* rash
* hives
* anaphylaxis
* C. diificile colitis
* nephrotoxicity
* ototoxicity
*Stephens Johnson Syndrome
312
sulfamethoxazole /trimethoprim (antibiotics: sulfonamides) assess/monitor--6
* Signs/symptoms of worsening infection
* CBC
* Renal function
* Liver function
* Bleeding (some antibiotics can interact with
anticoagulants)
* Signs of antibiotic-associated diarrhea
313
sulfamethoxazole /trimethoprim (antibiotics: sulfonamides) admin--5
* If indicated, obtain blood and specimen cultures
before administering the first dose
* Antibiotics can be administered in many forms —
PO, IV, IM, or topically
* Unless contraindicated, oral medications are generally
better tolerated with food
* Antacids can decrease absorption — do not give together
* Do not give tetracyclines with dairy products
314
sulfamethoxazole /trimethoprim (antibiotics: sulfonamides) pt. ed--4
* Do not take antidiarrheal while on this medication
unless directed by healthcare provider
* Antibiotics may decrease the effectiveness of birth
control — use backup contraception while taking
* Take oral antibiotics with a full glass of water
* Some drugs may interact with alcohol — avoid it during
antibiotic therapy
315
tetracycline class
tetracyclines
316
tetracycline (tetracyclines) indication
* bacterial infections
where the infectious
agent has not been
identified
317
tetracycline (tetracyclines) contraindications--2
* hypersensitivity
* tetracyclines are
contraindicated for
children under 9
*
318
tetracycline (tetracyclines) cautions
* renal impairment
* hepatic impairment
* pregnancy
* for patients receiving
other nephrotoxic drugs
(additive effect)
* neuromuscular disease
319
tetracycline (tetracyclines) MOA
bacteriostatic action via inhibition of protein synthesis
320
tetracycline (tetracyclines) side effects
* diarrhea, nausea,
vomiting
* photosensitivity
*stains teeth
321
tetracycline (tetracyclines) adverse effects
* rash
* hives
* anaphylaxis
* C. diificile colitis
* nephrotoxicity
* ototoxicity
322
tetracycline (tetracyclines) assess/monitor
* Signs/symptoms of worsening infection
* CBC
* Renal function
* Liver function
* Bleeding (some antibiotics can interact with
anticoagulants)
* Signs of antibiotic-associated diarrhea
323
tetracycline (tetracyclines)
admin--
* If indicated, obtain blood and specimen cultures
before administering the first dose
* Antibiotics can be administered in many forms —
PO, IV, IM, or topically
* Unless contraindicated, oral medications are generally
better tolerated with food
* Antacids can decrease absorption — do not give together
* Do not give tetracyclines with dairy products
324
tetracycline (tetracyclines)
pt. ed--4
* Do not take antidiarrheal while on this medication
unless directed by healthcare provider
* Antibiotics may decrease the effectiveness of birth
control — use backup contraception while taking
* Take oral antibiotics with a full glass of water
* Some drugs may interact with alcohol — avoid it during
antibiotic therapy
*may discolor teeth
*causes photosensitivity: stay out of sun; sunscreen
325
gentamycin class
aminoglycosides
326
gentamycin (aminoglycosides) indication--
bacterial infection by aerobic gram-negative bacilli
327
gentamycin (aminoglycosides) contraindication--1
hypersensitivity
328
gentamycin (aminoglycosides) caution--5
* renal impairment
* hepatic impairment
* pregnancy
* for patients receiving
other nephrotoxic drugs
(additive effect)
* neuromuscular disease
329
gentamycin (aminoglycosides) MOA--
bactericidal action via inhibtion of bacterial protein synthesis
330
gentamycin (aminoglycosides) side effects--
* diarrhea, nausea,
vomiting
* photosensitivity
331
gentamycin (aminoglycosides) adverse effects--
* rash
* hives
* anaphylaxis
* C. diificile colitis
* nephrotoxicity
* ototoxicity
332
gentamycin (aminoglycosides) assess/monitor--
* Signs/symptoms of worsening infection
* CBC
* Renal function
* Liver function
* Bleeding (some antibiotics can interact with
anticoagulants)
* Signs of antibiotic-associated diarrhea
333
gentamycin (aminoglycosides) admin--
* If indicated, obtain blood and specimen cultures
before administering the first dose
* Antibiotics can be administered in many forms —
PO, IV, IM, or topically
* Unless contraindicated, oral medications are generally
better tolerated with food
* Antacids can decrease absorption — do not give together
* Do not give tetracyclines with dairy products
334
gentamycin (aminoglycosides) pt. ed--
* Do not take antidiarrheal while on this medication
unless directed by healthcare provider
* Antibiotics may decrease the effectiveness of birth
control — use backup contraception while taking
* Take oral antibiotics with a full glass of water
* Some drugs may interact with alcohol — avoid it during
antibiotic therapy
335
azithromycin class
macrolides
336
azithromycin (macrolide) indication
* bacterial infections
where the infectious
agent has not been
identified
337
azithromycin (macrolide) contraindication
* hypersensitivity
338
azithromycin (macrolide) caution
* renal impairment
* hepatic impairment
* pregnancy
* for patients receiving
other nephrotoxic drugs
(additive effect)
* neuromuscular disease
339
azithromycin (macrolide) MOA
disrupts bacterial protein synthesis
340
azithromycin (macrolide) side effects
* diarrhea, nausea,
vomiting
* photosensitivity
341
azithromycin (macrolide) adverse effects—6
* rash
* hives
* anaphylaxis
* C. diificile colitis
* nephrotoxicity
* ototoxicity
342
azithromycin (macrolide) assess/monitor—6
* Signs/symptoms of worsening infection
* CBC
* Renal function
* Liver function
* Bleeding (some antibiotics can interact with anticoagulants)
* Signs of antibiotic-associated diarrhea
343
azithromycin (macrolide) admin
* If indicated, obtain blood and specimen cultures
before administering the first dose
* Antibiotics can be administered in many forms —
PO, IV, IM, or topically
* Unless contraindicated, oral medications are generally
better tolerated with food
* Antacids can decrease absorption — do not give together
* Do not give tetracyclines with dairy products
344
azithromycin (macrolide) pt. ed
* Do not take antidiarrheal while on this medication
unless directed by healthcare provider
* Antibiotics may decrease the effectiveness of birth
control — use backup contraception while taking
* Take oral antibiotics with a full glass of water
* Some drugs may interact with alcohol — avoid it during
antibiotic therapy
345
ciprofloxacin class
fluoroquinolones
346
ciprofloxacin (fluoroquinolones) indication--1
* bacterial infections
where the infectious
agent has not been
identified
347
ciprofloxacin (fluoroquinolones) contraindication
* hypersensitivity
348
ciprofloxacin (fluoroquinolones) caution
* renal impairment
* hepatic impairment
* pregnancy
* for patients receiving
other nephrotoxic drugs
(additive effect)
* neuromuscular disease
349
ciprofloxacin (fluoroquinolones) MOA
350
ciprofloxacin (fluoroquinolones) side effects
* diarrhea, nausea,
vomiting
* photosensitivity
351
ciprofloxacin (fluoroquinolones) adverse effects
* rash
* hives
* anaphylaxis
* C. dificile colitis
* nephrotoxicity
* ototoxicity
352
ciprofloxacin (fluoroquinolones) assess/monitor—6
* Signs/symptoms of worsening infection
* CBC
* Renal function
* Liver function
* Bleeding (some antibiotics can interact with anticoagulants)
* Signs of antibiotic-associated diarrhea
353
ciprofloxacin (fluoroquinolones) admin—4
* If indicated, obtain blood and specimen cultures before administering the first dose
* Antibiotics can be administered in many forms — PO, IV, IM, or topically
* Unless contraindicated, oral medications are generally better tolerated with food
* Antacids can decrease absorption — do not give together
354
ciprofloxacin (fluoroquinolones) pt. ed
* Do not take antidiarrheal while on this medication
unless directed by healthcare provider
* Antibiotics may decrease the effectiveness of birth
control — use backup contraception while taking
* Take oral antibiotics with a full glass of water
* Some drugs may interact with alcohol — avoid it during
antibiotic therapy
355
class:
fluconazole
nystatin
anti-fungals
356
indication:
nystatin
(anti-fungals)
fungal infection (skin or systemic)
357
contraindication:
fluconazole
nystatin
(anti-fungals)
* most systemic antifungals
are contraindicated during
pregnancy
358
caution:
fluconazole
nystatin
(anti-fungals)
* hepatic impairment
* renal dysfunction
359
MOA:
fluconazole
nystatin
(anti-fungals)
disrupts fungal cell membranes (sterols, which humans do not have)
360
side effects:
fluconazole
nystatin
(anti-fungals)—4
* headache
* rash (fluconazole: Stevens Johnson Syndrome)
* GI disturbances
* abdominal, joint, or
muscle pain
361
adverse effects:
fluconazole
nystatin
(anti-fungals)
* hepatic toxicity
362
assess/monitor:
fluconazole
nystatin
(anti-fungals)
* Signs/symptoms of worsening infection
* Renal function
* Hepatic function
363
admin:
nystatin
(anti-fungals)
* Systemic antifungals interact with many drugs
* Understand the route of administration (topical or PO)
364
admin:
fluconazole
(anti-fungals)
* Systemic antifungals interact with many drugs
* Understand the route of administration (PO or IV)
365
pt. ed:
fluconazole
nystatin
(anti-fungals)
* Complete the full course of therapy
* Avoid intercourse while being treated for vaginal
yeast infection
* treatment is often prolonged, may cause toxicity
366
diphenhydramine class
antihistamine
367
diphenhydramine (antihistamine) indication
* allergic reactions
* insomnia
* motion sickness
368
diphenhydramine (antihistamine) contraindication
* newborns
* nursing mothers
369
diphenhydramine (antihistamine) caution
* elderly patients
370
diphenhydramine (antihistamine) MOA
blocks histamine receptors and acetylcholine receptors
371
diphenhydramine (antihistamine) side effects
* drowsiness
* dry mouth
* dizziness
372
diphenhydramine (antihistamine) adverse effects
* anaphylaxis
373
diphenhydramine (antihistamine) assess/monitor
* Signs/symptoms of worsening allergic reaction
* Improvement of symptoms
374
diphenhydramine (antihistamine) admin
* May be administered intravenously, intramuscularly,
topically, or orally
* Do not push IV Benadryl fast — no more than
25 mg per minute
375
diphenhydramine (antihistamine) pt. ed
* Young children may experience paradoxical excitement
* Avoid occlusive dressings directly on skin where topical
cream has been applied
* Avoid alcohol or other CNS depressants
376
class:
magnesium sulfate
potassium chloride
electrolytes
377
magnesium sulfate
potassium chloride (electrolytes) indication--1
* electrolyte imbalances:
hypomagnesemia,
hypokalemia
378
magnesium sulfate
potassium chloride (electrolytes) contraindication-1 each
* hypermagnesemia,
hyperkalemia,
379
magnesium sulfate
potassium chloride (electrolytes) MOA
replaces depleted electrolytes
380
magnesium sulfate
potassium chloride (electrolytes) side effects--1
GI distress (n/v/d)
381
magnesium sulfate
potassium chloride (electrolytes) adverse effects--1
* cardiac arrhythmias
382
magnesium sulfate
potassium chloride (electrolytes) assess/monitor--3
* Serum electrolytes
* Worsening signs of hypokalemia (weakness, fatigue,
increased PVCs on cardiac monitor
* Signs of hyperkalemia (bradycardia, fatigue, muscle
weakness, confusion, peaked T-waves on cardiac monitor)
383
magnesium sulfate
potassium chloride (electrolytes) admin--3
* Administer PO potassium with meals
* Do not crush extended-release tablets
* IV potassium can be mixed with lidocaine by the
pharmacy to reduce vascular irritation
384
magnesium sulfate
potassium chloride (electrolytes) pt. ed--1
* Avoid potassium-containing salt substitutes, high potassium foods, and potassium sparing diuretics
385
levothyroxine class
hormone
386
levothyroxine (hormone) indication
hypothyroidism
387
levothyroxine (hormone) contraindication--1
hyperthyroidism
388
levothyroxine (hormone) caution
* cardiovascular disease
* adrenal insufficiency
* diabetes
* pernicious anemia
389
levothyroxine (hormone) MOA
replaces thyroid hormone
390
levothyroxine (hormone) side effects
* palpitations
* diarrhea
* anxiety
391
levothyroxine (hormone) adverse effects
* hyperthyroidism —
typically only when
given in large doses
392
levothyroxine (hormone) assess/monitor
* Assess apical pulse and BP prior to giving periodically
* Thyroid function tests (T3-T4-TSH)
393
levothyroxine (hormone) admin--3
* Give on an empty stomach in the morning (at least one hour
before a meal and other medications)
* Hold enteral feedings for one hour before and after
giving medication
* Do not give within four hours of antacids, iron, or
calcium supplements
394
levothyroxine (hormone) pt. ed--2
* Symptom improvement may not be noticeable for several weeks
* Do not discontinue the drug abruptly
395
normal potassium range
3.5 - 5.0
396
normal sodium range
136 - 145
397
normal calcium range
9 - 10.5
398
chloride range
98-106
399
normal fasting glucose range
74-100
400
HgA1C normal rang
4-5.7%
401
kidney labs--3
BUN 10-20
creatinine 0.5-1.2
GFR > 90
402
liver labs
AST 0-35
ALT 4-36
ALP 30-120
PT 11-12.5
total protein 6.3-7.9
bilirubin 0.3-1.0
403
class:
Doxazosin
Tamsulosin
alpha blockers
404
Doxazosin
(alpha blockers) indication
*essential hypertension
* BPH
* Raynaud's
405
Tamsulosin
(alpha blockers)
indication
BPH
406
Doxazosin
Tamsulosin
(alpha blockers) contraindication
*taking with sidenafil or other hypotensive meds
407
Doxazosin
Tamsulosin
(alpha blockers)
MOA
* Doxazosin only: decreases BP by causing vasodilation
* Both decrease the contraction of smooth muscles in prostatic capsule and smooth bladder
408
Doxazosin
Tamsulosin
(alpha blockers)
side effects—6
* reflex tachycardia
* ejaculatory problems
* dizziness
* headache
* rhinitis
* orthostatic hypotension
409
Doxazosin
Tamsulosin
(alpha blockers)
assess/monitor
*BP
* electrolytes
410
Doxazosin
Tamsulosin
(alpha blockers)
admin
* give PO daily at bedtime
* if for HTN, combined with diuretic because promotes renal retention of sodium, water
411
Doxazosin
Tamsulosin
(alpha blockers)
pt. ed
* don't drive when first taking (first dose effect)
* take at bedtime
412
finasteride class
5-alpha-reductase inhibitor
413
finasteride (5-alpha-reductase inhibitor)
indications--2
* BPH
* male pattern baldness
414
finasteride (5-alpha-reductase inhibitor)
contraindications
* pregnancy
* hypersensitivity
415
finasteride (5-alpha-reductase inhibitor)
side effects
* ED
* gynecomastia
* decrease PSA 50%
416
finasteride (5-alpha-reductase inhibitor)
adverse effects --3
* teratogenic
* severe myopathy
* increased cancer risk
417
finasteride (5-alpha-reductase inhibitor)
assess/monitor--2
* assess prostate by digital exam
* signs of BPH (urination)
418
finasteride (5-alpha-reductase inhibitor)
admin--1
female nurses should wear gloves to admin
419
finasteride (5-alpha-reductase inhibitor)
pt. ed
* effect may take 6 months
* take with or w/out food
* risks: ED, increased prostate cancer risk
420
oxybutynin class
anticholinergic
421
oxybutynin (anticholinergic)
indication--5
* urinary frequency
* urinary urgency
* nocturia
* urge incontinence
* over-active bladder
422
oxybutynin (anticholinergic)
side effects--6
* dry mouth
* nausea
* urinary retention
* constipation
* dizziness
* drowsiness
423
oxybutynin (anticholinergic)
assess/monitor--2
* I/O
* effects on symptoms treated
424
oxybutynin (anticholinergic)
pt. ed--3
* avoid alcohol
* good / frequent oral hygiene for dry mouth
* take IR tabs on empty stomach
* XL tabs taken regardless of food
425
phenazopyridine class
urinary analgesic
426
phenazopyridine (urinary analgesic)
indication
* given to treat pain with antibiotic to treat UTI
427
phenazopyridine (urinary analgesic)
side effects
* bright orange urine
428
phenazopyridine (urinary analgesic)
assess/monitor
* urinary fx before and during tx
429
sucralfate class
mucosal barrier fortifier
430
sucralfate indication
coats gut to prevent ulcers
431
sucralfate side effects
* constipation
* nausea
* dry mouth
432
sucralfate admin
* given 4x day on empty stomach 1 hr before meal and before bedtime
* give at least 2 hours after other meds; antacids may interfere with so space out admin
433
misoprostol
* highly teratogenic
* diarrhea at higher doses
* h/a
* abdominal pain
* vaginal bleeding
434
misoprostol admin
* given 4xday
* antacids may reduce absorption
435
misoprostol indication
prevent ulcers
436
pepto bismol class
salicylate
437
pepto bismol risk of long term use
neurologic injury
438
hypothyroidism symptoms
* fatigue
* weight gain,
* sensitivity to cold
* constipation
* dry skin
* muscle weakness
* joint pain
* depression
* slowed heart rate
* thinning hair
* irregular menstrual periods
* fertility problems
439
hyperthyroidism symptoms
* weight loss despite an increased appetite
* nervousness
* anxiety
* hand tremors
* irregular heartbeat
* increased sweating
* sensitivity to heat
* changes in menstrual cycles
* frequent bowel movements
* fatigue
* muscle weakness
* insomnia
* eye problems like bulging eyes or vision changes
440
