med comp Flashcards
latanoprost ophthalmic solution (Xalatan)
eye drop - indication: increased IOP with ocular HTN or open-angle glaucoma
C: hypersensitivity & intraocular inflammation
SE: dry eye, itching, rash, lid discomfort
AE: angina, blurred vision, eye pain, back pain
NC: don’t give while the patient is wearing contacts, don’t exceed recommended amount
PT: inform patients of the risk of eye color changing in the treated eye, inform the patient that darkening or eyelid may occur, tell pt t remove contacts before instilling solution, and wait 15 mins before inserting them back
CYANOCOBALAMIN
IM - I: vitamin B12 deficiency & pernicious anemia
C: hypersensitivity
SE: diarrhea, headache, itching, swelling of the body
AE: anaphylaxis, HF, pulmonary edema, hypokalemia
NC: assess the patient for signs of vitamin B12 deficiency before and periodically during therapy
PT: foods high in B12 (meat, eggs, seafood), encourage patients to comply with the diet recommendation, emphasize the importance of follow-up exams and evaluate progress
PANTOPRAZOLE (protonix)
IV - I: Gerd
C: hypersensitivity
SE: diarrhea, headache, flatulence
AE: C.Diff, bone fractures, lupus erythmetosis
NC: assess routinely for epicanthic pain and abdominal pain
PT: take as directed, finish therapy even if feeling better, notify HCP if fever and diarrhea develops
NITROGLYCERIN PATCH
Topical - I: long-term prophylactic
management of angina pectoris
C: hypersensitivity, increase intracranial pressure, severe anemia
SE: nausea, vomiting, dizziness, headache
AE: hypotension, tachycardia, contact dermatitis
NC: assess location, duration,
intensity & precipitating factors of anginal pain, monitor BP & pulse before & after administering
PT: Take the drug exactly as directed, even if feeling better, change positions slowly to minimize orthostatic hypotension, avoid drinking alcohol, notify a healthcare professionals if dry mouth or blurred vision occurs
POTASSIUM CHLORIDE
Oral - I: potassium depletion
C: hyperkalemia, severe renal impairment, untreated Addison’s disease
SE: nausea, vomiting, diarrhea, flatulence
AE: arrhythmias, GI ulceration, paresthesia (pins & needles)
NC: Assess S/S of hypokalemia
PT: Take medication as the directed, correct method of administration, encourage compliance with recommended diet
ONDANSETRON (Zofran)
Oral - I: prevent nausea & vomiting associated with chemo or radiation
C: hypersensitivity, use with apomorphine
SE: diarrhea, constipation, headache, dizziness
AE: Serontonin syndrome, stevens-johnson syndrome
NC: monitor S/S for serotonin syndrome (mental status changes) assess for rash periodically
PT: Take medication as directed, call a healthcare professional immediately if you have irregular heartbeat, serotonin syndrome, involuntary eyes/face/limbs movement
LEVOTHYROXINE (synthroid)
Oral - I: thyroid supplement of hypothyroidism, euthyroid goiters
C: hypersensitivity, MI, hyperthyroidism
SE: vomiting, diarrhea, sweating, headache
AE: insomnia, tachycardia, arrhythmias, angina pectoris
NC: assess apical pulse & BP periodically throughout therapy, assess for tachyarrhythmias & chest pain, monitor thyroid function prior to and during therapy
PT: Take the medication at the same time each day, explain that this is a lifelong therapy
GABAPENTIN (Neurotonin)
Oral - I: partial seizures, postherpetic neuralgia
C: hypersensitivity
SE: dizziness, drowsiness, confusion, depression
AE: hypersensitivity reactions, suicidal thoughts
NC: monitor patients taking or starting AEDs for changes in behavior (depression, suicidal thoughts), If ordered to stop, gradually stop drug >1 week to minimize the risk of seizures.
PT: Take drug exactly as directed and don’t exceed recommended amount, May cause drowsiness; avoid driving, call doctor if thoughts of suicide, depressions
anxiety occur
FUROSEMIDE (Lasix)
Oral - I: edema (heart failure, renal disease), hypertension
C: hypersensitivity, cross-sensitivity with thiazides & sulfonamides, hepatic coma
SE: nausea, vomiting, diarrhea, dehydration
AE: Stevens-Johnson syndrome (skin disorder), agranulocytosis aplastic anemia (no RBC production)
NC: monitor vital signs with long-term use, stop if oliguria (low urine) occurs, monitor glucose levels in diabetic patients
PT: Take the drug exactly as directed and don’t exceed recommended amount, change positions to reduce orthostatic hypotension, call doctor if gained >3lbs in 1 day
FERROUS SULFATE (Iron)
Oral - I: iron deficiency anemia
C: hypersensitivity, hemochromatosis (iron
overload), hemosiderosis (iron overload w/o tissue damage)
SE: nausea, vomiting, constipation, dark stools
AE: GI bleeding, syncope
NC: GI upset may be related to dose, monitor Hb level, hematocrit, & reticulocyte count during therapy
PT: explain the purpose of iron
therapy, advise patient that stools may be dark green/black, follow a diet high in iron
FAMOTIDINE (Pepcid/Zantac)
Oral - I: heartburn, acid indigestion, sour stomach, management of GERD
C: hypersensitivity, phenylketonuria (birth
defect; build up in the body)
SE: nausea, diarrhea, drowsiness, dizziness
AE: arrhythmias agranulocytosis (severe
DOCUSATE SODIUM (Colace)
oral - I: constipation, prevention of opioid
induced constipation
C: hypersensitivity, abdominal pain, nausea, vomiting associated with fever
SE: nausea, vomiting, diarrhea, abdominal cramps
AE: electrolyte imbalance, urinary discoloration, rash
NC: before administering, determine if patient has adequate fluid intake, exercise & diet
PT: laxative should be used for short-term therapy, use other forms of bowel regulation (>fluid intake), for cardiac patients, avoid straining during BM
ATORVASTATIN CALCIUM (Lipitor)
Oral - I: management of high
cholesterol, prevent coronary heart disease
C: hypersensitivity, active liver disease
SE: nausea, diarrhea, constipation, flatus, heartburn
AE: chest pain, peripheral edema, amnesia, insomnia, memory loss
NC: obtain baseline lipid profile before treatment, obtain diet history and fat consumption
PT: Take drug exactly as directed and don’t exceed
recommended amount., medication should be used
along with diet restrictions, contact doctor if unexplained muscle pain/ tenderness/weakness occurs
ALPRAZOLAM (Xanax)
Oral - I: generalized anxiety
disorder (GAD), panic disorder, anxiety associated w/ depression
C: hypersensitivity, cross-sensitivity with other
benzodiazepines, pre-existing CNS depression, severe uncontrolled pain
SE: nausea, vomiting, diarrhea, constipation, dizziness
AE: blurred vision, tinnitus, chest pain, confusion
NC: monitor patient also taking opioid for S/S of respiratory depression, give the smallest effective dose to prevent ataxia
PT: Take the drug exactly as directed and don’t exceed recommended amount, avoid drinking alcohol, May cause drowsiness, avoid driving, avoid drinking grapefruit juice during therapy
IPRATROPIUM (Atrovent)
Inhaled - I: reversible airway obstruction due to COPD & asthma
C: hypersensitivity, avoid during acute bronchospasm
SE: nausea, cough, rash, headache, dizziness
AE: blurred vision, hypotension, palpitations, epistaxis (nosebleed), allergic reactions
NC: assess respiratory status before administering and the peak of medication.
PT: Instruct patient of proper use of the inhaler and to take as directed, advise the parent to rinse mouth after using the inhaler and have food oral hygiene, caution patient not to exceed 12 doses within 24hr.
FLUTICASONE PROPIONATE (flonase/flovent)
Inhaled - I: chronic asthma
C: hypersensitivity
SE: nausea, vomiting, diarrhea, headache, dizziness
AE: conjunctivitis, epistaxis (nosebleed), pharyngitis, laryngitis
NC: observe the patient carefully for evidence of systemic corticosteroid effects, monitor patient, especially post-op, during period of stress or severe asthma attack
PT: Take drug exactly as directed and don’t exceed recommended amount, Call the doctor if the medication doesn’t improve asthma episodes, Advise patient to report all adverse reactions
ALBUTEROL
inhaler - I: asthma & COPD, prevention of exercise-induced bronchospasm
C: hypersensitivity
SE: nausea, vomiting, nervousness, restlessness, tremor
AE: paradoxical bronchospasm
(wheezing), chest pain, palpitations, angina, arrhythmias
NC: observe for (wheezing), withhold and notify healthcare professional immediately if it occurs, assess lung sounds, pulse, BP before and during the peak of medications, monitor pulmonary function tests before initiating therapy & periodically during therapy
PT: Take drug exactly as directed and don’t exceed recommended amount, Contact healthcare professional immediately if SOB is not relieved by medication, inform patient that it may cause an unusual or bad taste, avoid smoking and other respiratory irritants
VANCOMYCIN
IV - I: infections
C: hypersensitivity
SE: nausea, vomiting, rash
AE: hypotension, anaphylaxis, nephrotoxicity
NC: assess for infection at beginning & throughout therapy, obtain a specimen for culture & sensitivity before therapy, Monitor BP throughout IV infusion
PT: report signs of hypersensitivity, tinnitus,
vertigo, or hearing loss, notify health care professional if no improvement is seen in a few days
PIPERACILLIN/TAZOBACTAM
IV - I: infections
C: hypersensitivity
SE: nausea, vomiting, diarrhea, rash
AE: seizures, C. Diff associated diarrhea, anaphylaxis
NC: assess for infection at beginning & throughout therapy, obtain specimen for culture & sensitivity before therapy, monitor bowel function, assess for rash periodically during therapy
PT: report signs of superinfection and allergy, notify health care professional if fever and diarrhea develop especially if diarrhea contains blood, mucus, or pus.
DOXYCYCLINE
IV - I: infections
C: hypersensitivity
SE: nausea, vomiting, diarrhea, rash
AE: C. Diff associated diarrhea, pancreatitis, hepatotoxicity
NC: assess for infection at beginning & throughout therapy, obtain specimens for culture & sensitivity before therapy, monitor bowel function, assess for rash periodically during therapy
PT: take medication as directed, finish therapy even if feeling better, notify health care professional if fever and diarrhea develop especially if diarrhea contains blood, mucus, or pus.
CIPROFLOXACIN
IV - I: Infections
C: hypersensitivity, Hx myasthenia gravis
(muscle weakness)
SE: nausea, diarrhea, rash
AE: seizures, C. Diff associated diarrhea, anaphylaxis, suicidal thoughts
NC: assess for infection at beginning & throughout therapy, obtain a specimen for culture& sensitivity before therapy
PT: take medication as directed, finish therapy even if feeling better, notify health care professional if fever and diarrhea develop especially if diarrhea contains blood, mucus, or pus.
CEFTRIAXONE
IV - I: infections
C: hypersensitivity
SE: diarrhea, rash
AE: seizures, C. Diff associated diarrhea, anaphylaxis
NC: assess for infection at the beginning & throughout therapy, obtain specimens for culture & sensitivity before therapy
PT: report signs of superinfection and allergy, notify health care professional if fever and diarrhea develop especially if diarrhea contains blood, mucus, or pus.
BACITRACIN
Topical - I: localized infections due to
susceptible organisms
C: hypersensitivity, renal impairment
SE: nausea, vomiting, rash, itching
AE: pseudomembranous colitis, renal failure
NC: assess lesions prior to and periodically during therapy
PT: Take drug exactly as directed, caution to notify healthcare professionals if fever and diarrhea occur, especially if it contains blood, pus, mucus.
HEPARIN
SQ - I: thromboembolic disorders (venous thromboembolism, pulmonary emboli, Afib, etc)
C: hypersensitivity, uncontrolled bleeding, Hx heparin-induced thrombocytopenia, open wounds
SE: fever, anemia, rash, pain at the injection site
AE: bleeding, heparin-induced
thrombocytopenia (HIT), alopecia, osteoporosis
NC: assess for signs of bleeding & hemorrhage, monitory for hypersensitivity reactions, assess the patient for additional or increased thrombosis
PT: advise patient to report any symptoms of unusual bleeding or bruising immediately, instruct the patient not to take medications containing aspirin or NSAIDs while on therapy, caution patient to avoid IM injections and activities leading to injury, Use a soft toothbrush & electric razor during therapy
ENOXAPARIN
SQ - I: prevention of venous
thromboembolism (VTE),
DVT, and PE
C: hypersensitivity
SE: nausea, vomiting, dizziness, headache
AE: bleeding, anemia, alopecia edema
NC: assess for signs of bleeding & hemorrhage, assess the patient for evidence of additional or increase thrombosis, monitory patients hypersensitivity reaction
PT: instruct patient to correct
technique for self-injection, care, and disposal, advise patient to report any symptoms of unusual bleeding or bruising, dizziness, itching, rash, advise patient not to take aspirin, naproxen, or ibuprofen without talking to a doctor
HYDROCORTISONE CREAM
topical - I: inflammation & pruritus (itching) from allergic/ immunologic skin problems
C: hypersensitivity, untreated bacterial or viral
infections
SE: dryness, irritation, burning
AE: edema, adrenal suppression, secondary infection
NC: assess affected skin before and daily during therapy, note degree of inflammation & pruritus
PT: Take the drug exactly as directed, instruct patient on correct technique of medication administration, inform health care professional if symptoms return or worsen.
PREDNISONE (deltasone)
oral - I: inflammation, immunosuppression, an endocrine disorder
C: active untreated infections
SE: nausea, vomiting, acne, depression
AE: peptic ulceration, thromboembolism, hypertension
NC: assess for signs of adrenal
insufficiency before and periodically during therapy, monitor intake/output ratios & daily weights, observe for peripheral edema
PT: Take medication as directed, Do not stop taking
suddenly or adrenal insufficiency may occur, contact a healthcare professional if severe abdominal pain or tarry stools occur
LORATADINE
oral - I: seasonal allergies, hives
C: hypersensitivity
SE: drowsiness, confusion, dry mouth
AE: blurred vision, GI upset
NC: assess allergy symptoms, assess lung sounds & bronchial secretions
PT: Take the drug exactly as
directed, May cause drowsiness; avoid driving, avoid drinking alcohol
DIPHENHYDRAMINE (benadryl)
Oral - I: relief of allergic symptoms, mild nighttime sedation, prevents motion sickness
C: hypersensitivity, acute asthma attacks, known alcohol intolerance
SE: nausea, drowsiness, dizziness
AE: tinnitus, blurred vision, hypotension, dysuria
NC: this drug has multiple uses, determine why it was
ordered and assess symptoms, for anaphylaxis: assess urticaria and patient airway, for insomnia: assess sleep patterns, for motion sickness, assess nausea, vomiting, bowel sounds
PT: Take drug exactly as directed and don’t exceed recommended amount, May cause drowsiness; avoid driving, May cause dry mouth; frequent oral rinses each sleep hygiene techniques (dark-quiet room, limit daytime naps)
Insulin (levemir - long lasting & novalog - short lasting)
SQ - I: diabetes
C: hypersensitivity, hypoglycemia
SE: swelling, pruritus (itching)
AE: hypoglycemia, hypersensitivity reactions
NC: assess periodically for symptoms of hypoglycemia and hyperglycemia, monitor body weight periodically
PT: instruct on the proper technique of administration, explain that this medication controls hyperglycemia and is long term therapy, emphasize the importance of compliance with nutritional guidelines and regular exercise as directed
METFORMIN
oral - I: type 2 diabetes
C: hypersensitivity, diabetic ketoacidosis, severe renal impairment
SE: nausea, vomiting, diarrhea, bloating
AE: lactic acidosis
NC: observe S/S of hypoglycemic reactions, patients with severe renal impairment is >risk for lactic acidosis
PT: Take the medication at the
same time each day, drug helps control hyperglycemia and is usually long term therapy, follow prescribed diet and exercise
GUAIFENESIN (Mucinex)
oral - I: coughs caused by upper respiratory tract infections
C: hypersensitivity, intolerance to alcohol
SE: nausea, vomiting, diarrhea
AE: urticaria, stomach pain
NC: monitor cough type & frequency
PT: instruct to cough effectively, May cause drowsiness; avoid driving
DEXTROMETHORPHAN - delsym
oral - I: coughs caused by upper respiratory tract infections, chronic nonproductive coughs
C: hypersensitivity, chronic productive coughs, taking MAO inhibitors or SSRIs
SE: nausea, vomiting
AE: stomach pain, sedation
NC: monitor cough type and frequency
PT: Take the drug exactly as directed and don’t exceed recommended amount, instruct patient to cough effectively, avoid drinking alcohol, call doctor if cough lasts >1week
TIMOLOL
eye drop - I: hypertension, prevention of MI, prevent migraine headaches
C: Uncompensated HF, pulmonary edema, cardiogenic shock, bradycardia or heart attack
SE: nausea, constipation, fatigue, weakness, ED
AE: Arrhythmias, bradycardia, HF, pulmonary edema, anaphylaxis
NC: monitor intake/output ratios & daily weight, assess
patient routinely for evidence of fluid overload
PT: Take drug as directed, at the same time each day, even if they’re feeling better, Teach patient and family how to check pulse daily and BP biweekly, Call healthcare professional immediately if slow pulse, difficulty breathing, wheezing, May cause drowsiness; avoid driving
METOPROLOL (lopressor)
oral - I: hypertension, angina pectoralis (small chest pain)
C: HF, Pulmonary edema, bradycardia
SE: nausea, vomiting, diarrhea, fatigue
AE: HF, Pulmonary edema, bradycardia
NC: monitor BP, ECG & pulse throughout therapy, monitor intake/output & daily weight
PT: call a healthcare professional if slow pulse, difficult breathing, wheezing, dizziness occurs
LOSARTAN (cozaar)
oral - I: hypertension
C: hypersensitivity, bilateral renal artery stenosis
SE: nausea, diarrhea, dizziness, fatigue
AE: chest pain, angioedema, hypotension, hypoglycemia
NC: assess the patient for signs of angioedema, assess
BP & pulse throughout therapy
PT: call a healthcare professional immediately if swelling of faces eyes, lips occur, May cause drowsiness;
avoid driving, change positions slowly to reduce orthostatic hypotension
LISINOPRIL
oral - I: hypertension, heart failure
C: hypersensitivity, history of angioedema with previous use of ACE inhibitors
SE: nausea, vomiting, diarrhea, cough
AE: hypotension, impaired renal function
NC: monitor BP & pulse periodically throughout
therapy, assess the patient for signs of angioedema
PT: Take the medication at the same time each day even if feeling well, call the doctor if rash, sore throat, fever occur, change positions slowly to reduce orthostatic hypotension
HYDROCHLOROTHIAZIDE
oral - I: mild to moderate hypertension edema (heart failure, renal dysfunction)
C: hypersensitivity, intolerance to tartrazine, anuria
SE: nausea, vomiting, dizziness, drowsiness
AE: Stevens-Johnson
syndrome (skin disorder), hypotension, pancreatitis
NC: monitor BP, intake/output, daily weight, assess for skin rash, frequently during therapy
PT: Take the medication at the same time each day, motor weight biweekly; call the doctor if significant changes, change positions slowly to minimize orthostatic hypotension
AMLODIPINE (norvasc)
Oral - I: hypertension, angina pectoris, vasospastic angina
C: hypersensitivity, systolic BP <90mmHg
SE: nausea, dizziness, fatigue, flushing
AE: peripheral edema, angina, bradycardia, hypotension
NC: monitor BP & pulse before therapy and periodically during therapy, monitor intake & output ratios and daily weight monitor signs for heart failure
PT: Take the drug exactly as directed and don’t exceed recommended amount., teach the patient how to monitor pulse, Contact a healthcare professional if HR <50bpm, May cause drowsiness; avoid driving
LIDOCAINE PATCH
topical - I: pain due to post-op neuralgia
C: hypersensitivity, third-degree heart block, Wolf-Parkinson-White syndrome
SE: nausea, vomiting, confusion, drowsiness
AE: seizure, cardiac arrest
NC: monitor ECG continuously, BP & Respiratory status frequently during administration, monitor for pain intensity periodically during therapy
PT: May cause drowsiness; avoid driving, explain the purpose of lidocaine to the patient, avoid contact with water since the patch may not stick
FENTANYL PATCH
topical - I: moderate to severe chronic pain
C: hypersensitivity, acute, mild, intermittent, or post-op pain, respiratory depression, acute or severe bronchial asthma
SE: nausea, vomiting, constipation, confusion, sedation
AE: apnea, respiratory depression, bradycardia, hypotension, adrenal insufficiency
NC: assess BP, pulse, RR before and periodically during administration, assess risk for opioid addiction use, or misuse prior to administration, assess bowel function routinely
PT: instruct how and when to ask for and take pain medication.Instruct correct method for application and disposal of patch • avoid grapefruit juice
OXYCODONE
oral - I: moderate to severe pain
C: hypersensitivity, respiratory depression, acute or severe bronchial asthma
SE: nausea, vomiting, constipation, confusion, sedation
AE: respiratory depression, orthostatic hypotension, blurred vision
NC: Assess BP, pulse, & RR before and periodically
during administration, assess risk for opioid addiction , abuse, or misuse before administration.
PT: Instruct patient on how & when to ask for and take pain meds, advise patient that this drug is known to abuse potential, protect from theft, May cause drowsiness; avoid driving
IBUPROFEN
oral - I: pain, inflammation, reduce fever
C: hypersensitivity, active GI bleeding or ulcer disease, severe HF
SE: nausea, vomiting, constipation, abdominal discomfort
AE: HF, MI, stroke, GI bleeding
NC: assess pain before and 1-2 hr after administering, assess for S/S GI bleeding, assess for skin rashes
PT: Take drug exactly as directed and don’t exceed recommended amount, May cause drowsiness; avoid driving, avoid drinking alcohol
ACETYLSALICYLIC ACID
ASA) (aspirin
oral - I: Mild pain, Fever, inflammatory disorders, prophylaxis for heart attack
C: hypersensitivity to aspirin, cross-sensitivity with other
NSAIDs, bleeding disorders
SE: nausea, vomiting, dyspepsia (indigestion), epigastric distress, abdominal pain
AE: GI Bleeding, Hypersensitivity reactions
(anaphylaxis), tinnitus
NC: For inflammatory conditions give scheduled doses, monitor patient for hypersensitivity reactions, Monitor salicylate level; severe toxic effects levels >400mcg/mL
PC: Take with food or glass of water to reduce GI
reactions and sit upright for 15-30 minutes, avoid the previous hypersensitivity use of alcohol, Consult doctor is tinnitus occurs, consult a doctor if a fever lasts >3days
ACETAMINOPHEN
oral - I: Mild pain, fever
C: previous hypersensitivity severe hepatic impairment/
active liver disease
SE: nausea, vomiting, diarrhea, constipation, anxiety
AE: hepatotoxicity, renal failure, cardiac damage, toxic epidermal necrosis, rash
NC: Many OTC and prescriptions products contain acetaminophen; be aware when calculating total daily dose, reduce total daily dose & increase dosing intervals for patients with hepatic or renal impairment
PT: Take drug exactly as directed and don’t exceed recommended amount, consult doctor if fever lasts >3day, stop use and consult
doctor if a rash occurs
