Medications Flashcards
for the final
Uses: chronic hypocalcemia, osteoporosis, Paget’s disease, Osteomalacia, rickets, pregnancy, rapid child growth
SE: weakness, anorexia, confusion, kidney stones, increased urination, dehydration
Contraindications: patients with ventricular fibrillation, metastatic bone cancer, renal calculi or hypercalcemia
Nursing Considerations: give orally w meals or within 1 hr. of meals
calcium salts - calcium supplements
Uses: prevent and treat osteoporosis, decrease bone resorption and increase bone mass and density by through estrogen receptor, prevents vertebral fractures
Education: give with or without food
Contraindications: pregnant women and breastfeeding
SE: hot flashes, leg cramps, weight gain
Raloxifene (Evista)
SERMs
MOA: inhibits cell synthesis (DNA & RNA)
photosensitivity, n/v, less toxic antifungal, largest & most versatile
systematic & superficial
PEDS: topical is best
Older: renal/hepatic function, drug-drug
Azoles
MOA: enhance action of GABA in the CNS
Uses: insomnia, anxiety, seizures, muscle spasms, alcohol withdrawal, panic, induction of anesthesia
Contraindications: CNS depression, respiratory depression, physical dependence, anterograde amnesia and sleep related behaviors, pregnancy/breastfeeding, HX of substance abuse, elderly, sleep apnea
Interactions: CNS depressant DO NOT use with alcohol, barbiturates and opioids
Education: taper dose when stopping, take with meals, take 15-20 minutes before bedtime, limit use to 7-10 days
Diazepam or ending in pam
Benzodiazepines
MOA: enhance action of GABA in CNS. results in prolonged sleep duration
Uses: short term management of insomnia
SE: daytime sleepiness, lightheadedness, and HA
Contraindications: pregnancy/breastfeeding, neonatal, elderly, sleep related complex behaviors
Nursing Administrations: oral and SL
zolpidem
Non- benzodiazepines
MOA: activation of melatonin receptors
Uses: chronic insomnia management
SE: sleepiness, dizziness, fatigue, hormonal effects
Contraindications: pregnancy/breastfeeding, liver disease, depression, apnea and COPD
Education: take 40 minutes before bed, take on empty stomach, avoid high fat foods, avoid driving/operating heavy machinery
Ramelteon
melatonin agonist
MOA: reduce gastric acid by inhibiting hydrogen/potassium ATPase- this reduces gastric acid secretion
SE: nausea, vomiting, diarrhea, headache
Education: take 30 minutes prior to primary daily meal, may take a few days for symptoms to resolve, increase calcium and vitamin D, man drug-drug interactions
SE/AE: fractures, hypomagnesemia, pneumonia
Contraindications: pregnancy
omeprazole, pantoprazole (prazole)
Proton pump inhibitors
MOA: neutralize HCI and reduce pepsin activity
SE/AE: below…
Sodium bicarbonate: hypernatremia, water retention, metabolic alkalosis, acid rebound
Calcium carbonate: acid rebound (rebound heartburn), hypercalcemia, Burnett syndrome
Magnesium hydroxide: diarrhea
Aluminum hydroxide: constipation
Education: do not take with other medications, take as directed or rebound heartburn can occur, some clients with kidney disease need to avoid anything with magnesium, substances with calcium can cause constipation or cause kidney stones
Antacids OTC
Uses: glaucoma, ocular hypertension
MOA: reduces intraocular pressure by decreasing production of aqueous humor
SE: eye discomfort, burning, stinging with administration, blurry vision, miosis, bronchoconstriction.. bradycardia, AV heart block, heart failure
Education: proper administration, hold pressure for 1 full minute to prevent drug from absorbing systemically
Nursing considerations: monitor clients BP and pulse for changes
carteolol, levobunolol, timolol (…olol)
Beta adrenergic blockers
Uses: inflammatory disorders, suppress histamine release
MOA: inhibit the biosynthesis of prostaglandins
Education: they can mask infections, potential for infections to grow rapidly and remain undetected, an active infection is contraindicated for corticosteroid therapy
SE/AE: suppression of the normal functions of the adrenal glands, hyperglycemia, mood changes, cataracts, peptic ulcers, electrolyte imbalances and osteoporosis, Cushing Syndrome
Treatment: short term for acute disease, long term.. doses are kept low, alternate day therapy
cortisone, dexamethasone, prednisone (…sone)
corticosteroids
MOA: inhibition of COX 1 and COX 2
Uses: moderate pain, fever, inflammation
Education: take with food, 8 oz of water or milk, duration of 4-6 hours, onset 30-60 minutes
Alerts: asthma or allergy to aspirin can exhibit a hypersensitivity reaction to ibuprofen, caution in pregnancy, can increase risk for miscarriage, use in late pregnancy should be avoided due to NSAIDS can cause premature closure of the fatal ductus arteriosus
SE/AE: nausea, heartburn, epigastric pain and dizziness, BLACK BOX WARNING: increased risk for serious thrombotic events, MI and stroke
advil or motrin
ibuprofen or ibuprofen like drugs
MOA: binds to both COX-1 and COX-2 enzymes, changing their structures and preventing them from forming inflammatory prostaglandins
Contraindications: large doses that are needed to suppress sever inflammation results in AE on digestive system
SE/AE: epigastric pain, heartburn, bleeding due to ulceration, ototoxicity, nephrotoxicity
Risk factors: history of peptic ulcers, age greater than 60 y/o, use of anticoagulants or corticosteroids, helicobacter pylori infection, smoking, use of alcohol, potential for bleeding
Alternative formations: buffered, enteric coated
Aspirin
salicylates
MOA: inhibiting the synthesis of prostaglandins
Uses: block inflammation
Contraindications: first line of drugs mild to moderate inflammation such as aspirin and ibuprofen, analgesic, antipyretic and anti-inflammatory properties
SE/AE: bleeding, gastric acid, reduced kidney function
NSAIDs
MOA: relaxes eye muscle to prevent accommodation, dilates
Education: Allows healthcare provider to perform certain procedures (like cataract surgery)
SE: blurry vision, loss of vision
cycloplegics
MOA: pupil widens to allow healthcare provider to view inner structures of the eye
SE: causes blurred vision, light sensitivity, photophobia
Education: avoid driving until effects wear off
mydriatic
MOA: cell wall synthesis inhibitor
Uses: bacteriostatic and bactericidal (depending on drug and dosage)
SE/AE: rash, pruritus, diarrhea, anaphylaxis angioedema and cardiac arrest
Nursing considerations: one of the safest classes of antibiotics
amoxicillin, piperacillin (end in icillin)
Penicillin’s
– cefazolin, cephalexin, (end in cef. Or ceph.)
MOA: cell wall synthesis inhibitor
Uses: bactericidal
SE/AE: Gi complaints, allergic reaction, rash, fever, anaphylaxis, nephrotoxicity
Nursing considerations: contraindicated for patients who have experienced an allergic reaction to penicillin
Cephalosporins
MOA: inhibit protein synthesis
Uses: bacteriostatic – slow microbial growth
SE/AE: hepatotoxicity, teeth decolorization, if expired nephrotoxicity, hepatotoxicity, photosensitivity
Education: do not drink milk or take iron supplements, do not use them during pregnancy, avoid direct sunlight, not for children under 8 y/o
Doxycycline, minocycline (end in cycline)
Tetracyclines
MOA: inhibit DNA synthesis
Uses: bactericidal
SE/AE: anaphylaxis, photosensitivity, hepatotoxicity, peripheral neuropathy, tendinitis, tendon rupture
Education: affect cartilage development.. do not use in children under 18, avoid taking during pregnancy/breastfeeding, CNS effects
Ciprofloxacin, levofloxacin (ends in either floxacin or oxacin)
Fluoroquinolones
MOA: cell wall synthesis inhibitor
Uses: bactericidal
SE/AE: anaphylaxis, nephrotoxicity, ototoxicity, red man syndrome
Nursing Considerations: peak and trough levels must be drawn after 3 doses
vancomycin
Glycopeptides
Uses: prevention and treatment of osteoporosis (women and men)
SE: flatulence, metallic taste, abdominal pain, dyspepsia, arthralgia, myalgia, HA and rash
Contraindicated: patients with abnormalities of the esophagus
Education: fractures may occur if the drug is taken for more than 3 months, should not be used during pregnancy unless the benefits justify the potential risks to fetus, take on an empty stomach with plain water, at least 30 minutes before eating or drinking, remain upright position for at least 30 minutes after taking, can cause osteonecrosis of the jaw, jaw pain, swelling, loosening of teeth
Alondronate (Fosamax)
Bisphosphonates
Uses: promotes intestinal absorption of calcium and elevates serum levels of calcium
Administration: protect capsules from light and heat
SE/AE: hypercalcemia, confusion, increased urination, dysrhythmias, dehydration, and weight loss
S/S of excess vitamin D: anorexia, excessive thirst, confusion, kidney stones, bone fractures
Calcitriol
Vitamin D
