Medications Flashcards
Fleet enema
Has a lot of sodium so makes you retain water in vascular space and can cause fluid volume excess
Also, has phosphorus in it so can use to decrease Ca (inverse relationship)
Alka-seltzer
Has a lot of sodium so makes you retain water in vascular space and can cause fluid volume excess
Aldosterone
Mineralocorticoid Steriod
when blood volume gets too low (from vomiting or hemorrhage) aldosterone can cause retention of Na AND water so blood volume increases
make you lose potassium
Vasopressin (Pitressin)
another name for antidiuretic hormone - may be used for ADH replacement in diabetes insipidus (not enough ADH)
Demopressin acetate (DDAVP)
may be used for antidiuretic hormone replacement in diabetes insipidus (not enough ADH)
Furosemide
(Lasix) Loop Diuretic
Watch lab work
Dehydration can occur
Electrolyte problems (loose K - so increase foods high in K)
will decrease preload
give IV push SLOWLY to prevent otoxicity and hypotension
given for pulmonary edema - diuresis and vasodilaties so traps more blood in arms and legs to reduce preload and afterload
Bumetanide
(Bumex) loop diuretic, given when Lasix doesn’t work
Watch lab work
Dehydration can occur
Electrolyte problems (loose K - so increase foods high in K)
will decrease preload
can give for pulmonary edema to provide rapid fluid removal
Hydrochlorothiazide
(Thiazide) (HCTZ) Diuretic Watch lab work Dehydration can occur Electrolyte problems (loose K - so increase foods high in K) will decrease preload
Spiralactone
(Aldactone) K sparing diuretic
makes you retain potassium
limit foods in K (salt substitutes)
will decrease preload
Calcium Gluconate
antidote for Mg toxicity
reverse respiratory depression and potential arrhythmias caused by mg toxicity
administered IVP very slowly (max rate 1.5-2 ml/min)*
Phospho Soda
Sodium phosphate
Use to decrease Ca because has inverse relationship with phosphorus
Calcitonin
decreases serum Ca
given to tx osteoporosis pts by making the bones stronger by driving Ca back into bones
Vitamin D
helps utilize Calcium
Sevelamer Hydrochloride
(Renagel) phosphate binder - bind to phsophorus to decrease and then can increase Calcium because of inverse relationship
Given for hypoparathyroidism = hypocalcemia = hyperphosphatemia
Calcium Acetate
(PhosLo) phosphate binder - bind to phsophorus to decrease and then can increase Calcium because of inverse relationship
Given for hypoparathyroidism = hypocalcemia = hyperphosphatemia
IV calcium
GIVE SLOWLY and make sure pt is on a heart monitor because it causes bradycardia - it acts like a sedative and can widen QRS complex
Given for hypoparathyroidism = hypocalcemia = hyperphosphatemia
Sodium polystyrene sulfate
(Kayexalate)
only give when documented case of hypokalemia
exchanges Na and K in GI tract
push fluids with so don’t become dehydrated
increases Na and decreases K (inverse relationship)
Albumin
holds onto fluid in the vascular space so increases vascular volume increases kidney perfusion increases bp increases cardiac output
Tetanus Toxoid
Active Immunity
takes 2-4 weeks to develop their own immunity
body has to take active role with the shot
makes body produce own antibodies
boosts body
Immune Globulin
think immediate protection!!
passive immunity - body lays there passively - not working for antibodies, just given them
injecting pt with antibodies!
give if don’t know when had last tetanus and not knowing if they have current antibodies to boost
Mannitol
osmotic diuretic
decreases cerebral edema and intracranial pressure
Only one given to flush out kidneys when see brown or red urine in burn pt
- can crystalize if gets too cold
- don’t refrigerate
- use inline filter
- observe for clarity before administering
magnesium carbonate
(Mylanta)
given to prevent a stress ulcer or curling’s ulcer (stress ulcer from burns)
Prantoprazole
(Prontonix) proton pump inhibitor
given to prevent a stress ulcer or curling’s ulcer (stress ulcer from burns)
given for pancreatitis
decreases acid secretions
Famotidine
(Pepcid) H2 antagonist
given to prevent a stress ulcer or curling’s ulcer (stress ulcer from burns)
can be given during dialysis because not filtered through kidneys
given for pancreatitis
given for peptic ulcer
aluminum hydroxide gel
(Amphogel) Antacid
Magnesium hydroxide
(Milk of Magnesium) Antacid
ranitidine
(Zantac) H2 antagonist
given for pancreatitis
given for peptic ulcer
nixatidine
(Axid) H2 antagonist
esomeprazole
(Nexium) proton pump inhibitor
decreases acid secretions
given for peptic ulcer
sutilanis
(Travase) enzymatic drug - eats dead tissue (debridement)
Don’t use on face - can leave scar
Don’t use if pregnant
Don’t use over large nerves
Don’t use if area is open to a body cavity - cant eat organs
collagenase
(Santyl) enzymatic drug - eats dead tissue (debridement)
Don’t use on face - can leave scar
Don’t use if pregnant
Don’t use over large nerves
Don’t use if area is open to a body cavity - cant eat organs
silver sulfadiazine
(silvadene) for burns
soothing, apply directly, if it rubs off apply more, can lower the WBC, can cause a rash
mafenide acetate
(Sulfamylon) for burns
can cause acid base problems, stings, if it rubs off apply more
silver nitrate
for burns
keep dressings wet, can cause electrolyte problems
povidone-iodine
(Betadine) for burns
stings, stains, allergies, acid base problems
Mycin drugs
worry about ototxicity and nephrotoxicity *
so watch the pts BUN, creatitine for increases and watch if pt complains of hearing los
Always make sure _________ before you start antibiotics
the cultures were collected
doxorubicin
(Adriamycin) chemotherapy
used for uterine, breast, and stomach cancer
cisplatin
(Platinol-AQ) chemotherapy
used for uterine and stomach cancer
medroxyprogesterone
(Depo-Provera) estrogen inhibitor
Used for uterine cancer
tamoxifen
(Nolvadex/Soltamox) estrogen inhibitor
Used for uterine and breast cancer
paclitaxel
(Taxol) chemotherapy
used for breast cancer
leuprolide
(Lupron) estrogen synthesis inhibitors
puts pt into a type of menopause
good for breast cancer because breast tumors are estrogen dependent
goserelin
(Zoladex) estrogen synthesis inhibitors
puts pt into a type of menopause
good for breast cancer because breast tumors are estrogen dependent
belladonna and opium suppository
(B&O suppository)
given for bladder spasms
oxybutynin
(Ditropan)
given for bladder spasms
docusate
(Colace) stool softener used to avoid straining
leuprolide
(Lupron) decreases testosterone
fluorouracil
(5-FU) chemotherapy
used for stomach cancer
mutamycin
(Mitomycin-C) chemotherapy
used for stomach cancer
Calcitonin
or Calcimar
decreases serum Ca+ levels by taking calcium out of the blood and pushing it back into the bone
good for osteoporosis
Amiodarone
(Cordarone) antiarrhythmic drug
used when V fib and pulseless v tach are resistant to treatment
also for fast arrythmias
can cause hypotension that can lead to further arrhythmias!
contains high levels of iodine and may affect thyroid function - so may sure discontinued 1 week prior to thyroid scan
propylthiouracil
(PTU) anti-thyroid
stops thyroid from making thyroid hormone
used preopp to stun the thyroid
methimazole
(Tapazole) anti-thyroid
stops thyroid from making thyroid hormone
used preopp to stun the thyroid
(SSKI)
potassium iodine - iodine compund
decreases size and vascularity of the thyroid gland (all endocrine glands VERY VASCULAR)
so given preopp to decrease risk of bleeding
Drink through straw - stains teeth
(Lugol’s solution)
strong iodine solution - iodine compund
decreases size and vascularity of the thyroid gland (all endocrine glands VERY VASCULAR)
so given preopp to decrease risk of bleeding
Drink through straw - stains teeth
Do not give beta blockers to who?**
asthmatic or diabetic!
Because can mask the s/s of hyperglycemia
Can trigger an asthma attack
propranolol
(Inderal) beta blocker - block release of epi and norepi to decrease HR and BP
decreases myocardial contractility so decreases CO, so decreases workload of the heart
Also, DECREASES ANXIETY - why given to hyperthyroid pts
can possibly decrease HR and BP too much
make sure to check bp and pulse first!
radioactive iodine
given for hyperthyroidism
destroys thyroid cells so now less thyroid hormone so pt becomes hypothyroid
Must follow radioactive precautions
Must rule out pregnancy first
Watch for thyroid storm(thyrotoxicosis and thyrotoxic crisis) - hyperthyroid x100 - could be a rebound effect post-radioactive iodine**
radioactive precautions with radioactive iodine
stay away from babies for 24 hours
don’t kiss anyone for 24 hours
Levothyroxine
(Synthroid)
given for hypothyroidism
increases energy, HR, and BP
thuroglobulin
(Proloid)
given for hypothyroidism
increases energy, HR, and BP
liothryonine
(Cystomel)
given for hypothyroidism
increases energy, HR, and BP
Glucocorticoids***
adrenal cortex steriods
- change your mood - insomnia, depressed, psychotic
- alter defense mechanism - immunosuppressed
- breakdown fats and proteins - children won’t grow regularly
- inhibit insulin - hyperglycemia, do blood glucose monitoring frequently
Fludrocortisone
(Florinef) Mineralocorticoid - Aldosterone
Makes you retain Na and Water
Given for Addison’s disease
DAILY WEIGHTS are very important (keep the weight within 2-3lbs of their normal weight)
If pt on Fludrocortisone (Florinef) and gains 7 lbs over night what do you do with the next dose?
decrease or hold it
If pt on Fludrocortisone (Florinef) and loses 7 lbs over night what do you do with the next dose?
increase it
If pt on Fludrocortisone (Florinef) and has edema and increase in BP, what should you do?
Or if bp is going down?
Hold the dose and call MD
increase the dose if decreasing bp
Will oral hypoglycemia agents work for type I diabetes?
No
have to have insulin
glipizide
(Glucotrol) oral anti-diabetics
stimulate the pancreas to make insulin
metformin
(Glucophage) oral anti-diabetics
stimulate the pancreas to make insulin
HOLD 48 hours after heart cath** - worried about kidneys - reacts with contrast dye!
pioglitazone
(Actos) oral anti-diabetics
stimulate the pancreas to make insulin
sitagliptin
(Januvia) oral anti-diabetics
stimulate the pancreas to make insulin
Regular dose of insulin
0.4-1.0 units/kg/day
Never give rapid acting insulin without
food at bedside
Only type of insulin can be given IV
regular
Basal/bolus method of insulin is
combination of long acting (Lantus) with rapid actiong (Novalog)
Lantus
long acting insulin, clear
Humalog, Lispro, Novalog
Rapid acting insulin
Novalin N, Humalin N
NPH insulin, cloudy
Humilin R
regular insulin, clear
When have order for regular and NPH insulin which one draw up first
regular
clear to cloudy
type of insulin for infusion pumps
rapid acting
provides a continuous (basal) dosing and on demand (bolus) dosing
D50W given
IV push when hypoglycemic
glucagon
(GlucaGen) IM given when no IV access and pt is hypoglycemic
anxiolytics
used for anxiety for short term use
Meds used for OCD
SSRIs or TCAs (tricyclic antidepressants)
anxiolytics can be given
every two hours
used for detox
chlordiazepoxide
(Librium) anxiolytic
used for outpatient detox
detox protocol
thiamine injections, multivatimins, and mg
atropine
(Atreza)
given with ECT to dry up secretions
Succinylcholine chloride
(Anectine)
given with ECT to relax muscles
nitroglycerin
(Nitrostat) sublingual
causes venous and arterial dilution so decreases preload and afterload - so decrease workload of heart and decrease demand of O2
take one every 5 mins x3
pt will get a headache (don’t call MD - expected)
keep in dark glass bottle
Don’t leave because could drop bp and it not come back up
given for pulmonary edema - to decrease afterload to increase CO
metoprolol
(Lopressor/Toprol) beta blocker - block release of epi and norepi to decrease HR and BP
decreases myocardial contractility so decreases CO, so decreases workload of the heart
can possibly decrease HR and BP too much
make sure to check bp and pulse first!
atenolol
(Tenormin) beta blocker - block release of epi and norepi to decrease HR and BP
decreases myocardial contractility so decreases CO, so decreases workload of the heart
can possibly decrease HR and BP too much
make sure to check bp and pulse first!
Carvedilol
(Coreg) beta blocker - block release of epi and norepi to decrease HR and BP
decreases myocardial contractility so decreases CO, so decreases workload of the heart
can possibly decrease HR and BP too much
make sure to check bp and pulse first!
nifedipine
(Procardia XL) Calcium Channel Blocker
given for prevention of angina
decrease bp by causes vasodilation of the arterial system (dilate coronary arteries!)
decrease after and increase O2 to heart muscle
verapmil
(Calan) Calcium Channel Blocker
given for prevention of angina
decrease bp by causes vasodilation of the arterial system (dilate coronary arteries!)
decrease after and increase O2 to heart muscle
almodipine
(Norvasc) Calcium Channel Blocker
given for prevention of angina
decrease bp by causes vasodilation of the arterial system (dilate coronary arteries!)
decrease after and increase O2 to heart muscle
diltiazem
(Cardizem) Calcium Channel Blocker
given for prevention of angina
decrease bp by causes vasodilation of the arterial system (dilate coronary arteries!)
decrease after and increase O2 to heart muscle
acetylsalicylic acid
(aspirin) antiplatelet
can be given for angina
not for pain but to keep the platelets from sticking together so blood keeps flowing and more O2
can give after fibrinolytic
can give to high risk pts when stented to keep artery open and those in cath lab
mucomyst
(Acetylcysteine)
can be given before cardiac cath to protect the kidneys especially if they have kidney problems
Lidocaine
given to prevent 2nd episode of v fib
toxicity = neuro changes
streptokinase
(streptase) fibrinolytic
dissolve the clot that is blocking blood flow to the heart muscle that decreases the size of MI
worry about allergies with this one! !
should be administered within 6-8 hours
major complication: bleeding! - so bleeding precautions
give peripheral IV
follow up with an antiplatelet
alteplase
(t-PA) fibrinolytic
dissolve the clot that is blocking blood flow to the heart muscle that decreases the size of MI
should be administered within 6-8 hours
major complication: bleeding! - so bleeding precautions
give peripheral IV
follow up with an antiplatelet
tenecteplase
(TNKase) fibrinolytic
one time push
dissolve the clot that is blocking blood flow to the heart muscle that decreases the size of MI
should be administered within 6-8 hours
major complication: bleeding! - so bleeding precautions
give peripheral IV
follow up with an antiplatelet
reteplase
(Retavase) fibrinolytic
dissolve the clot that is blocking blood flow to the heart muscle that decreases the size of MI
should be administered within 6-8 hours
major complication: bleeding! - so bleeding precautions
give peripheral IV
follow up with an antiplatelet
clopidogrel
(Plavix) antiplatelet
given after fibrinolytic
can give to high risk pts when stented to keep artery open and those in cath lab
abciximab
(ReoPro IV) antiplatelet
given after fibrinolytic
can give to high risk pts when stented to keep artery open and those in cath lab
eptifibatide
(Integrilin IV) antiplatelet
can give to high risk pts when stented to keep artery open and those in cath lab
nesiritide
(Natrecor)
vasodilates veins and arteries and has diuretic effect
can give for pulmonary edema
stop 2 hours prior to drawing BNP for HF
will give false high!!
ACE inhibitors
drug of choice for HF, also used for HTN
suppress renin angiotension system (prevent angiontension I to II)
results in dilation and increased SV
s/e: dry, cough, laryngeal swelling
block aldosterone - so decrease Na and water and risk for hyperkalemia
ARBS
block angiontension II receptors and cause decrease in arterial resistance and decreased BP and increase CO
block aldosterone - so decrease Na and water and risk for hyperkalemia, hypotension, renal dysfunction
used for HTN and HF
Digitalsis
(Lanoxin)
makes contraction stronger
slows HR - so more time to fill ventricles
increases CO - how know it works
increases kidney perfusion
before admin check - apical pulse!
all electrolytes MUST be normal!** especially K - k and dig bind to same thing so if hypokalemic then more dig binds and becomes toxic
s/s of dig toxicity
early: anorexia, N/V
late: arrhythmia and vision changes - see halos yellow/green
hydrocholorothiazide/triameterene
(Dyazide) diuretic
will decrease preload
morphine
(morphien sulfate)
given for MI
also can give for pulmonary edema to vasodilate and decrease preload and afterload
enalapril
(Vasotec) Ace Inhibitor
drug of choice for HF, also used for HTN
suppress renin angiotension system (prevent angiontension I to II)
results in dilation and increased SV
s/e: dry, cough, laryngeal swelling
block aldosterone - so decrease Na and water and risk for hyperkalemia
fosinopril
(Monopril) Ace Inhibitor
drug of choice for HF, also used for HTN
suppress renin angiotension system (prevent angiontension I to II)
results in dilation and increased SV
s/e: dry, cough, laryngeal swelling
block aldosterone - so decrease Na and water and risk for hyperkalemia
captopril
(Capoten) Ace Inhibitor
drug of choice for HF, also used for HTN
suppress renin angiotension system (prevent angiontension I to II)
results in dilation and increased SV
s/e: dry, cough, laryngeal swelling
block aldosterone - so decrease Na and water and risk for hyperkalemia
valsartan
(Diovan) ARBs
block angiontension II receptors and cause decrease in arterial resistance and decreased BP and increase CO
block aldosterone - so decrease Na and water and risk for hyperkalemia, hypotension, renal dysfunction
used for HTN and HF
losartan
(Cozaar) ARBs
block angiontension II receptors and cause decrease in arterial resistance and decreased BP and increase CO
block aldosterone - so decrease Na and water and risk for hyperkalemia, hypotension, renal dysfunction
used for HTN and HF
irbesartan
(Avapro) ARBs
block angiontension II receptors and cause decrease in arterial resistance and decreased BP and increase CO
block aldosterone - so decrease Na and water and risk for hyperkalemia, hypotension, renal dysfunction
used for HTN and HF
heparin sodium
anticoagulant
warfarin
(coumadin) anticoagulant
limit green leafy veggies to 3 times a week (contain vit k - anticlotting) and foods high in potassium
enoxaparin
(lovenox) anticoagulant
dabigatran etexilate
(Pradaxa) anticoagulant
lisinopril
(zestril)
will decrease bp
ampicillim
(polycillin)
ketorolac
(Toradol)
given for kidney stones
ondansetron
(Zofran) - tx nausea
given for kidney stones
hydromorphine
(Dilaudid)
given for kidney stones
fentanyl patches
(duragesic)
benztropine
(Cogentin) anticholinergic
given for pancreatitis
diphenoxylate/atropine
(Lonox) anticholinergic
given for pancreatitis
acetaminophen
(Tylenol)
never give to liver pt
acetylcysteine
(Mucomyst)
give to liver pt instead of tylenol
lactulose
decreases serum ammonia so used in liver pts
octreotide
(Sandostatin)
lowers portal hypertension (high bp in liver)
internal organ specific vasoconstrictor
liquid or tablet antacids for peptic ulcers
liquid to coat stomach
omeprazole
(Prilosec) proton pump inhibitor
decreases acid secretions
given for peptic ulcer
lansoprazole
(Prevacid) proton pump inhibitor
decreases acid secretions
given for peptic ulcer
clarithromycin
(Biaxin) antibiotic
given for peptic ulcer
amoxicillin
(Amoxil) antibiotic
given for peptic ulcer
tetracycline
(Panmycin) antibiotic
given for peptic ulcer
metronidazole
(flagyl) antibiotic
given for peptic ulcer
sucralfate
(carafate)
forms barrier over wound so acid can’t get into ulcer
polyethylene glycol
(go-LYTELY)
given for colonoscopy
citalopram
(Celxa)
SSRI
antidepressant
gabapentin
antiseizure
zolpidem
(ambiem)
hypnotic
diuretics will interact with
ace inhibitors
may promote significant diuresis; first dose of ACE inhibitors increases risk of “first dose” phenomenon due to vasodilation; combination of vasodilation and diuresis increases risk of orthostatic hypotension
be careful with beta blockers with
asthmatics - will cause bronchospasms
diabetes - will decrease blood sugar
Methylphenidate
Ritalin
Aldactone
K sparing diuretic
Ketorolac
Toradol
NO grapefruit
antianxiety, ace inhibitors, anticonvulsants
Buspirone
antianxiety
Verapmil
Ace inhibitor
carbamazepine
(tegretol) anticonvulsant
monitor urinary and liver function, CBC, platelet and reticulocyte counts;
never discontinue suddenly
side effects include dizziness, vertigo, fatigue, ataxia, worsening of seizures, confusion, headache, syncope, heart failure, arrhythmias, urinary frequency and retention
If pt on Carbamazepine is going to sx don’t discontinue, notify anesthetist because amount of anesthetic may need to be reduced because client is on anticonvulsant
gingko, garlic, and ginger will
increase bleeding
ziprasidone
antipsychotic
if allergy to penicillin then allergy
to cephalosporins
cefaclor
if allergy to aspirin then allergy to
NSAIDS
naproxen
prednisone adverse effects
glucocorticoids
decrease bone density ( Ca and vit D)
hyperglycemia and glyxosuria
hypokalemia and hypernatremia
increase the risk of cataracts and glaucoma
Glucocorticoids cause sodium and water retention
hydrochlorothiazide
diuretic
lasartin
ace inhibitor
quinapril
ace inhibitor
with ace inhibitors avoid
potassium
disculfiram
(Antabuse)
avoid any form of alcohol including over the counter cough and cold medications
chlorpromazine
(Thorazine)
antipsychotic/antiemetic
Prochlorperazine
(Compazine)
antiemetic used to control nausea and vomiting, anxiety;
Hydralazine hydrochloride
(Apresoline)
fast acting antihypertensive; relaxes smooth muscle; side effects include headache, angina, tachycardia, palpitations, sodium retention, anorexia, lupus erythematosus-like syndrome (sore throat, fever, muscle-joint aches, rash)
Diazepam
(Valium)
tx of seizures
loperamide
antidiarrheal
with statin drugs should avoid
being pregnant
urokinase
used to break down a clot in an IV if need to keep IV
