Medications Flashcards
ADRENERGICS (4)
NE - vasoconstrictor to ↑ BP
Epi - stim alpha & beta receptors
DA - vasoconstrictor to ↑ BP
Dobutamine - stim beta 1 to ↑ BP
Tx: cardiac arrest, hypovolemic shock, anaphylaxis
SE: tremors, dysrhythmia
NC: ↑BP, pulses, UO
ANTIANXIETY
BZD (4)
NON-BZD (1)
BZD: “-zepam, -zolam, -zalam”
Chlordiazepoxide - use alcohol withdrawal, sedation, seizures, anxiety; ∅ elderly
Alprazolam, Clonazepam, Lorazepam - SAFE in elderly
NON-BZD:
Buspirone - NO abuse potential, ∅ grapefruit
MoA: depress CNS
Use: anxiety, manic ep, panic attacks
SE: sedation, confusion, hepatic failure
NC:
- Taper off, Addiction/ OD, Monitor liver func
- ∅ alcohol, smoking, caffeine
- W/ FOOD or MILK
Chlordiazepoxide
(Librium)
BZD, CNS Depressant:
USE: alcohol withdrawal, sedation, seizures, anxiety
SE: drowsy, ↓ BP, resp depression, blurred vision, C/A, slurred speech, thrombocytopenia, polyuria (↑ UO),
NC: ∅ elderly (toxic build up)
ANTACIDS (2)
Al hydroxide, Mg hydroxide
MoA: neutralize gastric acid, ↑ pH, inactivate pepsin
Use: PUD, indigestion, reflex esophagitis
SE: C/D, acid rebound
NC:
- Interferes w/ absorption of Abx, Iron, INH, Oral contraceptives
- Bowel Addiction ∴ caution in long term use
- admin 1-2 hrs AFTER meals
- Metal Tox risk → check DTR
ANTIDYSRHYTHMICS (3)
Procainamide HCl, Quinidine, Lidocaine (Vtach)
MoA: ↓ excitability of heart
Use: myocardial irritability, Afib + Flutter, ↑HR, PVCs
SE: lightheaded. ↓BP, ↓HR urinary retention
NC: ambulate slowly
ANTIBIOTICS
General SE, NC
- *Allergic rxn** - common in 2nd exposure, mild-anaphylaxis
- *Superinfection** - kills abnorm + norm bacteria (sore throat, fever, fatigue)
- *Organ Tox** - LIVER (metabolize), KIDNEY (excrete)
Teaching:
- Culture & Sensitivity 1st (ensure kills bacteria)
- *- ↑ Fluids, Milk + Yogurt** (maintain norm intestinal flora)
AMINOGLYCOSIDES
“mycin” - gentamycin, neomycin, streptomycin, tobramycin
MoA: inhibit protein syn in gram-
Use: Pseudomonas, E.coli
SE: ototoxicity, A/N/V/D
NC:
- √ CN 8 (acoustic), √ Renal func
- Use 7-10 days
- ↑ Fluids
- √ Peak (1 hr post dose) & Trough (before hanging dose)
CEPHALOSPORINS
“cef-, ceph-“ - cefaclor, cefazolin, cephalexin
MoA: Inhibits bacterial cell wall syn
Use: Tonsillitis, Otittis media, Meningitis
SE: Bone Marrow Depression (√ labs), Rash
NC:
- Admin W/ FOOD (d/t GI upset)
- Cross allergy w/ PENICILLIN
- ∅ Alcohol - flushing, dizzy, HA
- Long term use: overgrowth of organisms (√ tongue)
SULFONAMIDES
“-azole, -azine” - acetyl sulfisoxazole, co trimoxazole, sulfasalazine
MoA: Antagonize folic acid syn
USE: Ulcerative collitis, Crohn’s, Otitis Media, UTI
SE: Peripheral neuropathy, Crystalluria, Photosensitivity, GI upset, Stomatitis, Allergic rxn (urticaria, rash)
NC:
- Admin W/ FOOD
- *- ↑ Fluids** d/t risk of crystals in urine
FLOUROQUINOLONES (1)
Ciprofloxin
Use: E.coli, Pseudomonas, Staph. aureus
SE: D (destroys norm flora), ↓ WBC, ↓ Hct, ↑ AST & ALT, Photosensitivity
NC:
- ↑ Fluids (3,000 mL/day), sunscreen
- 1 hr ac or 2 hr pc meal ∴ ∅ FOOD (slows absorption)
- ∅ Antacids, Iron
PENICILLIN
“-icillin” - amoxicillin, ampicillin, Augmentin
USE: Mod-severe inf, Syphillis, Lyme disease
SE: Stomatitis (breakdown of mouth & GI tract), D, allergic rxn
NC:
- 1-2 hrs AC or 2-3 hrs PC ∴ ∅ FOOD
- Cross allergy w/ Cephalosporins
- √ Creatinine Clearance - determine dose
GLYCOPEPTIDE (1)
Vancomycin
USE: MRSA, C. diff
SE: Thrombophlebitis, Abscess formation, Renal tox, Ototoxicity
NC:
- √ Renal func + Hearing
- “Red Man Syn” - ↓ BP, Flushed face + neck → Tx w/ Antihistamine
MACROLIDE (2)
“momma Clinda and baby needs Erythro”
Erythromycin, Clindamycin
USE: Acne, Acute inf, URI, allergy to PCN or Cephalosporin
SE: D, Confusion, Liver tox
NC:
- 1 hr ac or 2 hr pc ∴ ∅ FOOD
- Admin w/ WATER (∅ juice)
- *- ↑ Potency of Coumodin (Warfarin)** ∴ bleeding risk
TETRACYCLINE
“-cycline” - doxycycline, tetracycline
SE: Phototoxic rxn, glossitis
NC:
1 hr ac or 2 hrs pc ∴ ∅ FOOD
∅ Actacids, Milk, Protein
AVOID SUN!
NITROFURANTOIN
TX: UTI (antiinfective)
SE: asthma attacks (ABCs), D
NC:
- W/ FOOD or MILK, CRANBERRY JUICE (acidify urine)
- Monitor mulmonary status (SE asthma)
- ∅ Alkaline foods - almonds, coconut
PHENAZOPYRIDINE
TX: UTI Analgesic
SE: HA, vertigo
NE: orange urine
ANTIIMPOTENCE (3)
“-afil” - sildenafil (Viagra), vardenafil, tadalafil
MoA: cause erection
SA: HA, ↓ BP, priapism (painful erection)
CONTRA: Nitrates (hypotensive crisis, tx CAD, dilate BVs), Alpha Blockers (severe hypotension)
NC: ∅ Grapefruit, Erection 4+ hrs call HCP
ANTICHOLINERGIC EFFECTS
HOT as a hare = ↑ T
DRY as a bone = dry mouth, ↓ sweat
BLIND as a bad = mydriasis (dilated pupils)
RED as a cherry = flushed face
MAD as a hatter = delirium
Urinary retention
↓ BP, ↑ HR
ANTICHOLINERGICS (5)
bipas
Benztropine - tx Parkinson’s, taper off
Iproproprium - tx asthma [neb med]
Propanthekine - tx incontinence, PUD
Atropine sulfate - tx badycardia (↑ HR)
Scopolamine - tx motion sickness
MoA: pupil dilation, bronchodilation & ↓ secretions (dry mouth), ↓ GI motility
NC:
- 30 min ac or 2 hr pc ∴ EMPTY STOMACH
- ∅ glaucoma - pupil dilation ↓ ophthalamic fluid drainage
- ∅ paralyzed ileus, BPH
ANTICONVULSANTS (7)
GaP Diva CCaMP
Gabapentin
Phenytoin (Dilantin) - ∅ Pregnant pt, NEVER admin w/ another med
Divalproex - ∅ carbonated drinks
Clonazepam (BZD)
Carbamazepine - interferes w/ hormonal birth control
Mg sulfate - √ DTR
Phenobarbitol
MoA: ↓ flow of Ca + Na across neurons (CNS depressant)
USE: seizures
SE: resp depression, aplastic anemia, ataxia, gingival hypertrophy
NC:
- Taper off, Monitor I&O (urine pink, red), Drowsy
- ∅ MAOI (lower seizure threshold), Antipsychotics, Grapefruit, alcohol
- *- W/ FOOD**
- Cause Folate & Vita D deficiency (anemia) ∴ ↑ intake
- OKAY to continue before surgery (prevent seizures) – NOTIFY ANETHESIOLOGIST
MAO INHIBITORS (3)
TIP
Tranylcypromine, Isocarboxazid, Phenelzine sulfate
MoA: ↑ conc of NTs (NE, Epi, Serotonin)
USE: depression, chronic pain
SE: HTN crisis (tyramine foods, HA), Photosensitivity
NC:
- ∅ TYRAMINE (aged cheese, bologna, pepperoni, salami, banana, raisins, BEER, liver, yogurt)
- monitor OUTPUT (d/t urinary retention)
- Effective in 4 wks
- ∅ Alcohol, Cold meds
- ∅ SSRI (serotonin syndrome)
SSRI (3)
SParoFlu
Setraline HCl, Paroxetine, Fluoxetine
USE: depression, OCD, Bulemia
SE: anxiety, GI upset, Δ appetite & bowel func
NC:
- SUICIDE @ 2-3 wks
- Effective in 4 wks
- Admin in A.M.
- I&O (Δ appetite), Pink urine
- ∅ SSRI (serotonin syn), St. John’s Wort
TRICYCLICS (2)
I Am Dox
Imipramine, Amitriptyline, Doxepin HCl
MoA: inhibit reuptake of NE & Serotonin
USE: depression, sleep apnea
SE: sedation, anticholinergic effects, confusion, ↓ BP, urinary retention, photosensitivity
OD: excitability, tremors
NC:
- SUICIDE @ 2-3 wks
- Effective @ 1-3 wks, Full @ 6-9 wks
- *- Admin @ P.M.
- Wean off**slowly
- ∅ alcohol, sun
HETEROCYCLICS (2)
Bupropion, Trazadone
USE: depression, smoking cessation
SE:
Buproprion - agitation, insomnia (HYPER)
Trazadone - sedation, ↓ BP (HYPO)
NC: wean off slowly, ∅ alcohol, depress CNS
ANTIDIARRHEAL (4)
DIBO
Diphenoxylate/Atropine, Ioperamide, Bismuth subsalicylate (Pepto), Opium
MoA: ↓ peristalsis (absorbs water, gas, tox, nutrients in bowel), ↑ tone of sphincters
SE: C, fecal impaction, anticholinergic effects
NC:
- HOLD w/ abd pain [CONTRA]
- √ urinary retention (output)
- Admin 2 hr BEFORE or 3 hr AFTER other meds
- ↑ FLUIDS!
ANTIEMETICS (5)
TriP MOM
Trimethobenzamide HCl - inject IM gluts
Prochlorperazine
Metoclopramide - ↓ residual/ aspiration in tube feedings
Ondansetron
Meclizine - ∅ glaucoma
MoA: ↑ GI motility, Block DA, effects in chemoreceptor trigger zone (vomiting zone)
SE: sedation, anticholinergic effects
NC:
- use BEFORE chemo/ radiation
- use w/ viral infection - Risk of Reye’s syn (pt <21 yo, toxic encephalopathy)
- ∅ GI bleeding/ hemorrage
- ∅ pregnant
ANTIFUNGAL (3)
MAN
Metronidazole
Amphotericin B “amphoterrible” - HYPOkalemia (muscle pain), seizures
Nystatin
USE: Candidiasis (oral yeast inf), Oral thrush, histoplasmosis
SE: hepatotox, thrombocytopenia (↑ bleeding, ↓ PLT), leukopenia (↓ WBC, infection risk), pruritis
NC:
- W/ FOOD (↓ GI upset)
- Monitor liver func, PLT, WBC
- Oral hygiene
ANTIGOUT (3)
CAP
Colchicine - acute phase of gout tx
Allopurinol
Probenecid - chronic tx of gout, ↑ MoA of ciprofloxin
MoA: ↓ uric acid production & resorption
USE: gout, uric acid stones
SE: aplastic anemia, agranulocytosis (↓ WBC, inf risk), renal calculi, GI upset
NC:
- Monitor kidney stones (↑ FLUIDS)
- W/ FOOD, MILK, ANTACIDS
ANTIHISTAMINE (3)
Chlorpheniramine maleate, Diphenhydramine (Benadryl), Promethazine (antiemetic)
USE: allergic rhinitis, allergic rxn to blood
SE: drowsy, dry mouth, photosensitivity, bronchospasm, anticholinergic
NC:
- **W/ FOOD
- ∅ alcohol**
- √ RR
- sunscreen, mouth care
ANTILIPEMIC (3 types)
- *Bile Acid Sequestrants** - Cholestyramine, Folic acid
- *Statins** - Lovostatin, Pravastatin, Atorvastatin
- *Nicotinic acid** - Niacin
MoA: inhibit cholesterol & tryglyceride syn (↓ cholesterol & LDLs)
SE:
BAS - C, rash, ↓ fat soluble vitas
Statins - myopathy
Nicotinic - flushing, hyperglycemia, gout
NC:
- Admin @ NIGHT, W/ FOOD (∅ grapefruit)
- GOOD w/ diet, exercise, ∅ smoking
- GOOD w/ herbals: flaxseed, garlic, green tea, soy
- ∅ other meds ∴ Admin 1 hr before or 4 hrs after
ACE INHIBITORS
Angiotensin Converting Enzyme Inhibitor
“-pril” - Catopril, Enalpril, Lisinopril
** A for Artery ** - SYSTEMIC VASODILATION
MoA: blocks ACE in lungs from converting Angio I → Angio II (vasoconstrictor)
USE: HTN, CHF
SE: ↑ HR, MI, Proteinuria, Cough
NC:
- ∅ FOOD - 1 hr ac or 2 hr pc
- small, freq meals
- Δ positions slowly
- OK w/ Thiazide DIuretics
- NO dmg to kidneys
β BLOCKERS
“-olol” - Atenolol, Propanolol, Metoprolol
** B for Beat ** SLOWS HEART BEAT (↓HR)
MoA: blocks β receptors to ↓ excitability of heart
USE: HTN, Angina, SVT
SE: Bronchospasm (√ airway), ↑ or ↓ HR, gastric pain
NC:
- MASKS s/sx of Shock & Hypoglycemia (∅ DM)
- w/ FOOD
- Taper off slowly
Ca CHANNEL BLOCKERS
“-dipine” - Nifedipine, Amlodipine, Verapamil
** C for Cardiac **
MoA: slows impulse conduction, ↓ contractility, ↓ HR
USE: HTN, Angina
SE: ↓HR, Dizzy, Angioedema, Renal fail
NC:
- √ Edema (facial swelling, SOB)
- SR Tablets ∅ chew or break
ANGIOTENSIN II RECEPTOR BLOCKERS (ARBs)
“-sartan” - Candesartan, Lorsartan
MoA: blocks vasoconstriction & aldosterone of Angio II
USE: HTN
SE: dizzy, GI upset, angioedema
NC:
- √ Edema (facial swelling, SOB)
α1 BLOCKERS
“-zosin” - Doxazosin, Prazosin, Terazosin
MoA: block α1 receptors in BVs ∴ cause vasodilation
USE: HTN, BPH, Raynaud’s disease
SE: reflex tachycardia, nasal congestion
NC:
- Admin 1st dose @ NIGHT (cause fainting)
- Δ positions slowly
- Monitor BUN, WT, edema
DIRECT-ACTING VASODILATORS (2)
Hydralazine
Minoxidil - ↑ hair growth
MoA: relax smooth muscles to cause vasodilation
SE: ↑HR ∴ use w/ β Blocker
NC: √ HR - HOLD HR< 60
CENTRALLY ACTING
α-ADRENDERGIC
Clonidine, Methyldopa
MoA: stim α receptors in medulla (CNS) to ↓ SNS action of heart (↓ force, contractility, CO)
USE: HTN
SE: drowsy, sedation
NC: taper off slowly
BIPOLAR AGENTS (3) LCD
Lithium - target blood lvl 1-1.5
Carbamazepine - liver func tests
Divalproex (Depakote) - anticonvulsant, ∅ carbonated drinks
MoA: ↓ catecholamine release & ↑ NE + Sero reuptake
USE: manic ep, MOOD STABILIZERS
SE: GI upset, tremors, polydipsia, polyuria
Lithium Tox
[EARLY] Fine tremors, N/V/D, drowsy, muscle weakness
[LATE] Ataxia, confusion, seizures
NC:
- Monitor drug lvls (Lithium!!)
- W/ FOOD + FLUIDS
ALKYLATING AGENTS (4)
BCycloChlorCis
Busulfan, Chlorambucil, Cisplatin, Cyclophospamide
CHEMO: interfere w/ rapidly reproducing DNA [good + bad] in hair, mucous membrane, blood (WBC, RBC)
USE: leukemia, myeloma
SE: hetapatotox, bone marrow suppression (↓ WBC, PLT, RBC), N/V, Alopecia, Stomatitis, Ototox, confusion, tremors
NC:
- √ Hematopoietic func
- ↑ Fluids, Oral hygiene
ANTIMETABOLITES (4)
these Metabolite Clones can Fool 5 People
Cytarabine, Fluororacil 5, Pemetrexid, Methotrxate
CHEMO: resembles norm metabolites ∴ “fool cells” to stop cell division; inhibit DNA polymerase
USE: ALL, colon, breast, pancreatic cancer
SE: N/V, Bone marrow suppression, Alopecia, oral ulceration
NC: SAME
ANTITUMOR ABX
B Do Da
Bleomycin, Doxorubicin, Dactinomycin
CHEMO - interferes w/ DNA & RNA syn
SE: bone marrow suppression, alopecia, stomatitis
NC: Admin antiemetic BEFORE
HORMONAL (3)
Tamoxifen - antiestrogen; bind @ estrogen receptors on malignant cells
Leuprolide - progestin; cause tumor cell regression
Testolactone - androgen; palliative care in advanced breast cancer
USE: breast cancer, testicular cancer
SE: leukopenia (↓ WBC), bone pain (d/t ↓ estrogen), hypercacemia
NC: √ CBC, Ca
VINCA ALKALOIDS
“Vin-“ - Vinblastine, Vincristine
CHEMO - interferes w/ cell division [good + bad]
USE: cancers
SE: bone marrow suppression, stomatitis, alopecia, ↓ DTR
NC:
- Antiemetic before chemo
- √ DTR
- √ IV for Extravasation @ site (check patency)
ANTIPARKINSON
BBAPT LC
Bromocriptine mesylate, Benztropine mesylate, Amantadine, Pergolide, Trihexyphenidyl (√ IOP)
Levodopa (precursor to DA)
Carbidopa-Levodopa - ∅ MAO I
MoA: converts into dopamine, stim postsynaptic DA receptors
SE: dizzy, ataxia, confusion, hemolytic anemia
NC:
- √ urinary retention
- ANTIDOTE: Vita B6 (large doses reverses effects)
- ∅ Alcohol
- w/ FOOD
HEPARIN
MoA: blocks conversion of PT → Thrombin to stop clotting, ↑ bleeding
USE: Pulmonary embolis, DVT, Acute MI
ROUTE: SubQ, IV
SE: Hematuria, Hemmorrhage, Tissue irritation
NC:
- ANTIDOTE: PROTAMINE SULFATE (call HCP 1st)
- ∅ ASA, NSAIDS - ↑ bleeding
- Monitor PTT (clotting time) → NORM (25-35 sec), THERA (35-85 sec, 1.5-2.5X) - LOW (not bleeding enough), OVER (bleeding too much
COUMADIN
(Warfarin)
MoA: ↓ syn of vita K clotting factors
USE: Pulmonary embolism, DVT< Acute MI
ROUTE: PO
SE: Hemmorrhage, Alopecia
NC:
- ANTIDOTE: VITAMIN K (Aquamephyton)
- START 4-5 days before D/C Heparin
- PEAK @ 3-5 days
- ∅ ASA, NSAIDs, Vita K foods, Vita C (↓ E), Vita E (↑ E)
- Monitor PT: NORM (9-12 sec), THERA (13-18, 1.5X)
- Monitor bleeding (venapuncture sites, urine
AVOID IN ANTICOAG THERAPY (4 Gs)
Ginkgo, Ginger, Garlic, Ginsing
↑ BLEEDING RISK
ANTIPLATELETS (6)
ASA (Salicylates), ADP Antagonists, Clopidogrel, Dipyradamole, Abciximab, Glycoprotein IIb & IIIa Antagonists
MoA: interfere w/ PLT aggregation (↓ clotting)
USE: DVT, pulmonary embolism, CVA prevention
SE: hemorrhage (bleeding!), thrombocytopenia, hematuria, hemoptysis (cough blood)
NC:
- √ Bleeding (urine, teeth, stool)
- w/ FOOD or MILK (d/t GI upset)
- ∅ GGGG
ANTIPSYCHOTICS
(3 categories)
HIGH POT: Halperidol, Fluphenazine [LOW sedation]
MED POT: Perphenazine
LOW POT: Chlorpromazine [HIGH sedation]
MoA: blocks DA in basal ganglia
USE: acute & chronic psychosis
ROUTE: inject deep IM
SE: ↓ BP, NMS (neuroleptic malignant syn), photosensitivity
- *akathisia** (motor restlessness)
- *dyskinesia** (abnorm vol mvmts)
- *dystonia** (spasms: EARLY (tight jaw, stiff neck, swollen tongue), LATE (swollen airway))
- *parkinsonism** (shuffled gait, rigid muscles, ↑ salivation, tremors, mask-like expression)
- *tardive dyskinesia** (invol mvmts: chew, suching, tongue thrusts)
NC:
- Lowers seizure threshod
- ∅ Alcohol, Breastfeeding
- Slows child growth
- urinary retention
ATYPICAL ANTIPSYCH (4)
CRaZy Q
Risperidone, Quetiapine, Ziprasidone, Clozapine
MoA: interferes w/ binding of DA in brain
SE: ↓ BP, Bone marrow suppression, Agranulocytosis (LIFE THREATENING)
Extrapyramidal - pseudoparkinsonism, dystonia, akinesia, tardive dyskinesia, swollen airway
Dystonia - EARLY (tight jaw, stiff neck, swollen tongue), LATE (swollen airway)
Anticholinergic - blurry vision, dry mouth, nasal congestion, C, urinary retention
NC:
- Δ positions slowly; sunscreen
- ∅ breastfeeding, alcohol, SUN, extremes in heat/cold
- √ RBC, WBC, PLT
ANTIPYRETIC (2)
AA
Acetaminophen (Tylenol), ASA (Salicylate)
MoA: antiprostaglandin activity in hypothalamus (control T) to ↓ fever, cause vasodilation, antiinflamm
SE: GI irritation, liver dysfunc
NC:
- √ Liver Funcs (ACT, AST)
- ∅ ASA < 21 yo d/t Reye’s Syn
- ∅ ASA in bleeding disorders
ANTITHYROID (3)
MRiKi
Methimazole, Potassium Iodine, Radioactive Iodine
** Iodine = Antagonist of Thyroid **
MoA: ↓ vascularity (shrinks) thyroid
USE: Hyperthyroidism
SE: leukopenia (inf.), rash, thrombocytopenia (bleeding)
NC: may cause burning in mouth
THYROID REPLACEMENT (2)
LL
Levothyroxoid, Liothyronine
MoA: ↑ metabolic rate of body
USE: Hypothyroidism
SE: nervousness, ↑ HR, Wt loss
NC:
- √ Wt, Pulse, BP
- Admin in A.M.
- ↑ action of Warfarin & Antidepressants
- ↓ action of Insulin (need ↑ dose) & Digoxin
DIURETICS
General USE, SE, NC
USE: HF, HTN, renal disease, diabetes, ↓ osteoporosis
SE: dizzy, dry mouth, ↓ BP, Leukopenia (↓WBC), polyuria (↑ UO), photosensitivity, ↓ Na
NC:
- W/ FOOD, MILK in A.M.
- ↑ K FOODS
- ∅ Licorice, Aloe (↓ K)
- Do NOT admin @ Night
THIAZIDE DIURETICS
“-thiazide” - Hydrochlorothiazide, Chlorothiazide
MoA: inhibit reabsorption of Na + Cl in DRT
SE: ↓ K + Na, ↑ Glucose, blurry vision, ↓ BP
NC:
- **√ K lvls, I&O, BUN/ Cr
- W/ FOODS**
- ↑ K Foods, Fluids
- ∅ Gingko (↑ BP)
Potassium Sparing (1)
Spironolactone
MoA: Blocks effect of Aldosterone on renal tubes ∴ cause LOSS of Na + H2O, RETENTION of K
SE: ↑ K, ↓ Na, Hepatic/ Renal dmg, TInnitus
NC: W/ FOOD, ∅ K foods
LOOP DIURETICS
F&E
Furosemide, Ethacrynic acid
MoA: inhibit reabsorption of Na + Cl
SE: ↓ K + Na, ↓ BP, ↑ Glucose, GI upset
NC:
- ADMIN IV in Emergency!
- √ muscle weakness
- W/ FOOD
OSMOTIC DIURETIC (1)
Mannitol
MoA: pulls fluids from tissues d/t hypertonic effect
SE: dry mouth, thirst
NC: crystalizes @ room T ∴ ALWAYS use filter needle
DIGOXIN
MoA: ↑ Force of myocardia contration, ↓ HR
USE: L side HF
SE: ↓ HR, ↑ HR (rebound tachy), A/N/V, Halo vision (halos around dark objects), Dysrhythmias
NC:
- √ DIGOTIN TOX (risk w/ hypokalemia), K lvl
- ↑ K Foods!
- IV Push @ least 5 min - √ extravasation
ANTI TB (5)
PERIS
Pyrazinamide - ↑ uric acid (gout)
Ethambutol - √ Vision (optic neuritis, ↓ visual acuity)
Rifampin - orange urine/tears/saliva, W/ FOOD
Isoniazid - peripheral neuopathy (tingling), ∅ FOOD
Streptomycin (Aminoglycoside) - ototox (√ hearing)
USE: TB
SE: Hepatitis, Jaundice, Optic neuritis,Seizures, Peripheral neuritis
NC:
- ACTIVE TB: cover mouth & nose when coughing, wear mask in crowds until 3 negative sputum collections
- Airborne Precautions: N95 mask
- Admin Vita B6 (prevent peripheral neuropathy, dizziness, ataxia)
SUCRALFATE
MoA: Cytoprotective; forms barrier around surface of ulcer
USE: Duodenal ulcer
SE: C, dizzy (vertigo), gas
NC:
- Admin 1 hr BEFORE meals (∅ FOOD)
- Admin 2 hrs BEFORE or AFTER meds
- ∅ Antacids, H2 blockers
Bisacodyl
Stimulant Laxative: nerve stimulation cause irritation on GI wall ∴ stim peristalsis and evacuation
USE: C, Dependence
NC:
- ∅ MILK, ANTACIDS
- CONTRA: abd pain, N/V, fever
- Chronic use cause HYPOkalemia
Docusate
STOOL SOFTENER: soften fecal mass
SE: abd cramps, D
NC:
- CONTRA: abd pain, N/V, fever, Atonic bowel, N/V, GI pain
- Chronic Use cause HYPOkalemia, Laxative dependency, Bowel dmg, F&E imbalance
Milk of Magnesia
OSMOTIC/ SALINE AGENT: HYPERtonic ∴ draws water INTO intestines causing soften stool & ↑ peristalsis
SE: ↑ Mg, dehydration, D
NC:
- CONTRA: abd pain, N/V, fever
- Chronic use cause HYPOkalemia, dehydration, Laxative dependence
Psyllium Hydrophilic Mucilloid
BULK FORMING: absorbs water in stool to ↑ bulk, and stim peristalsis
** SAFEST ** (even w/ routine admin)
SE: obstruction of GI tract
NC:
- Admin w/ FULL GLASS WATER
NITOGLYCERIN
NITRATE/ ANTIANGINAL: relax smooth muscle, ↓ BP, ↓ myocardia O2 consumption
USE: Angina, HTN, CHF r/t MI
SE: ↓BP, ↑ HR, HA, flushing, dizzy
NC:
- sublingual dose may repeat Q5min x 3 doses
- CHECK BP
- ∅ Alcohol
NSAIDs (5)
NIICK
Naproxen, Ibuprofen, Indomethacin
Celecoxib - COX2 inhibitor, avoid in sulfonamide allergy
Ketorolac
MoA: inhibit PG (prostaglandins)
USE: Pain, Fever, Arthritis, dysmenorrhea
SE: HA, dizzy, bleeding, GI upset (N/V/D/C), Fluid & Na retention
NC:
- W/ FOOD
- CONTRA: ASA, NSAID allergies
- √ GI bleeding - dark stools
- monitor liver func
H2 ANTAGONISTS
“-tidine”- Cimetidine (↑ confusion in elderly), Ranitidine
USE: ULCERS
SE: D, confusion, dizzy, HA
NC:
- Admin @ Bedtime (suppress nocturnal acid production), W/ MEALS
- ∅ Antacids within 1 hr of dose
- ∅ alcohol, smoking, ASA, caffiene (↑ stomach acid)
BRONCHODILATORS (9)
I AM A CAT (who) Eats Salmon
Aminophylline - ∅ coffee, tea, cola
Terbutaline - short β agonist
Ipratropium bromide [MDI] - anticholinergic
Albuterol - short β agonist
Epinephrine
Salmeterol - long β agonist, dry powder, NOT for acute bronchospasms/ exacerbations
Montelukast - asthma therapy, ∅ Theophylline
Acetylcysteine [NEB] - mucolytic, cough (clear airway) before admin
Cromolyn sodium - mast cell stabilizer, prevent asthma attacks & allergy rxn
USE: asthma, bronchospasm (COPD), bronchitis, emphysema
SE: ↑ HR, seizures, tremors, pulmonary edema, anticholinergic effects (bronchodilation)
NC: aggrevate diabetes (cause HYPERglycemia)
ANTISECRETORY AGENTS
“-prazole” - Omeprazole, Lansoprazole, Pantoprazole
USE: ULCERS
SE: D, dizzy
NC:
- Admin @ Bedtime (suppress nocturnal acid production)
- May sprinkle on food or mix w/ fluid for NG tube
- ∅ alcohol, smoking, ASA, caffiene (↑ stomach acid)
Misoprostol
PG ANALOG: prevent ULCERS caused by NSAIDs (which are PG inhibitors)
SE: abd pain, D, miscarriage
NC: ∅ alcohol, smoking, ASA, caffiene (↑ stomach acid)
∅ GRAPEFRUIT
CCB “-dipine”
Antiimpotence “-afil”
SSRI - Fluoxitine, Sertraline
Caffiene
Carbamazepine (Anticonvulsant)
Buspirone (Antianxiety)
Midazolam (Antianxiety)
