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Medications Flashcards

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1
Q

Levophed (Norepinephrine)

A

Adrenergics - used for cardiac arrest, COPD

vasoconstrictor to increase blood pressure and cardiac output

  • reflex bradycardia may occur with rise in BP
  • pt should be attended at all times
  • monitor urinary output
  • infuse with dextrose not saline
  • monitor blood pressure
  • protect med from light

S/E: headache, palpitations, nervousness, epigastric distress, angina, hypertension tissue necrosis with extravasation

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2
Q

Intropin (Dopamine)

A

Adrenergics - used for cardiac arrest, COPD

low dose - dilates renal and coronary arteries
high does - vasoconstrictor, increases myocardial oxygen consumption

monitor blood pressure, peripheral pulse, urinary output

headache early symptom of excess drug

S/E: increased ocular pressure, ectopic beats, nausea, tachycardia, chest pain, dyshrythmias

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3
Q

Pyridium (phenazophyridine)

A

urinary tract analgesic

S/E: headache, vertigo

Nursing:
• Urinary tract analgesic
• Tell pt urine will be orange

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4
Q

Furadantin (nitrofurantoin)

A

anti-infective

S/E: asthma attacks, diarrhea
Nursing:
• Anti-infective
• Give with food or milk
• Monitor pulmonary status
• Taken with cranberry juice – helps it to work
• Don’t eat alcoline foods – almond, coconut, milk, some veggies

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5
Q

Heprin

A

Uses – pulmonary embolism, venous thrombosis, prophylaxis after acute MI
Action – blocks conversion of prothrombin to thrombin

S/E: heamturia, tissue irritaion

Nursing:
•	Monitor clotting time or partial thromboplastin time (PTT)
•	Normal 20-45 sec 
•	Therapetic level 1.5-2.5 times control
•	Antagonist – protamine sulfate
•	Give SC or IV
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6
Q

Coumadin (warfarin)

A

Uses- pulmonary embolism, venous thrombosis, phrphylaxis after acute MI
Action – interferes with synthesis of vitamin K-dependent clotting factors

S/E: hemorrhage, alopecia

Nursing:
• Monitor prothrombin test (PT)
• Normal 9-12
• Therapeutic level 1.5 times control
• Antagonist – vitamin K (Aquamephyton)
• Monitor for bleeding
• Give PO
• Avoid aspirin and NSAIDs
• Watch foods that have vitamin K (green veggies, pork, rice, some cheese, fish, milk)
• Vitamin C will decrease effectiveness of med
• Vitamin E will increase effectiveness of med
• Garlic gingko, and ginger will increase

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7
Q

Dilatin

A

anticonvulsant
o if given too quickly can cause cardiac arrest
o turns urine pink
o can’t be mixed with any other med

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8
Q

Mag sulfate

A

anticonvulsant
o commonly used in OB
o deep tendon reflexes must be evaluated
o respiratory arrest

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9
Q

Lispro

A

rapid acting insulin
Onset – 15-20mins
Peak - 30 mins - 2.5 hrs
Duration – 3-6 hrs

pt should eat within 5-15 min after injection

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10
Q

Aspart

A

rapid acting insulin
Onset – 10 - 20 mins
Peak - 1-3 hrs
Duration – 3 hrs

pt should eat within 5-15 min after injection

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11
Q

Glulisine

A

rapid acting insulin
Onset – 10-15 mins
Peak - 1-1.5hrs
Duration – 3-5 hrs

pt should eat within 5-15 min after injection

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12
Q

Regular/Humulin R insulin

A

Short acting
Onset – 30min-1hrs
Peak - 2-4 hrs (when worry about hypoglycemia)
Duration – 6-8 hrs

only regular insulin can be given IV
clear insulin - can be mixed with others

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13
Q

Isophane

A

(NPH) Intermediate-acting insulin
Onset – 1- 2 hrs
Peak – 6-14 hrs
Duration – 16 hrs

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14
Q

Insulin detemir

A

Intermediate-acting insulin
Onset – 1-2 hrs
Peak - 12-24
Duration – varies

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15
Q

Humulin N

A

Intermediate-acting
Onset – 2 hrs
Peak – 6-12 hrs
Duration – 18-26 hrs

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16
Q

Glargine (Lantus)

A

long acting insulin
Onset – 3-4 hrs
Peak – continuous (no peak)
Duration – 24hrs

cannot be mixed with other insulins

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17
Q

Ultralente

A

Slow acting insulin
Onset – 4 hrs
Peak – 8-20 hrs
Duration – 24-36 hrs

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18
Q

Humulin U

A

Slow acting insulin
Onset – 4 hrs
Peak – 8-20 hrs
Duration – 24-36 hrs

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19
Q

Humulin 70/30

A

combination insulin
Onset – 30 mins
Peak – 2-12 hrs
Duration 24 hrs

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20
Q

Epinephrine

A

Adrenergics - used for cardiac arrest, COPD

stimulates alpha and beta adrenergic receptors

  • monitor BP
  • ensure adequate hydration
  • carefully aspirate syringe before IM and subQ doses
  • always check strength
    1: 100 inhalation
    1: 1,000 SubQ or IM

S/E: nervousness, restlessness, dizziness, local necrosis of skin

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21
Q

GlucaGen (glucagon)

A

Uses – hypoglycemia
Action – stimulates liver to change glycogen to glucose

S/E: hypotension, bronchospasm

Nursing:
• May repeat in 15 min
• Give carbohydrates orally to prevent secondary hypoglycemic reactions

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22
Q

Lithium

A

– salt – dosages change all the time, blood drawn every 2-3 weeks, fluids are important 3000 ml/day, dehydration will cause severe response, evaluated every 2 weeks

given for manic phase of bipolar

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23
Q

Tegretol

A

– mood stablizer given for bipolar, watch kidney and liver function

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24
Q

Depakote

A

mood stablizer given over time for bipolar

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25
Q

Echinacea

A

Herbal
Immunostimulant: prevent and treat colds/flu/UTI and wound healing

S/E: Allergic reaction, N/V, tingling of tongue

Nursing:
o Decreases effectiveness of immunosuppressant
o Avoid if allergic to ragweed or daisies

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26
Q

Garlic:

A

herbal
antimicrobial, antilipidemic, antithrombotic, antitumor, anti-inflammatory

S/E: flatulence, heartburn, irritation of mouth, esophagus, and stomach, allergic reaction

Nursing:
• May potentiate anticoagulant and antiplatelets, antihyperlipidemics, antihypertensives, antidiabetic
• May decrease oral contraception

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27
Q

Chondroitin:

A

herbal
Collagen synthesis

Dyspepsia, nausea, potentiate anticoagulants

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28
Q

Glucosamine:

A

herbal
Collagen synthesis

Dyspepsia, nausea

Impedes insulin secretion or increase insulin resistance

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29
Q

Capsium/Cayenne Pepper

A

Herbal
Analgesia, circulation, nerve pain, PVD

S/E: GI discomfort, burning pain in eyes nose mouth, bronchospasm

Nursing:
• May decrease effectiveness of antihypertensive
• Increase risk of cough with ACE inhibitors
• Potentiate antiplatelets
• Hypertensive crisis on MAOI
• Increase theophylline absorption

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30
Q

St John’s Wart

A

Herbal
Antidepressant, sedative, antiviral, antimicrobial

S/E: photosensitivity, fatigue, allergic reaction, restlessness

Nursing:
• Decreases effectiveness of digoxin, antineoplastics, antivirals, AIDS meds, antirejection meds, theophylline, Coumadin, oral contraceptives!!

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31
Q

Epinephrine (adrenaline)

A

Adrenergics - used for cardiac arrest, COPD

  • stimulates alpha and beta adrenergic receptors
  • monitor BP
  • aspirate before IM and SQ
  • check strength 1:100 (inhalation), 1:1,000 (SQ or IM)
  • ensure adequate hydration

S/E: nervousness, restlessness, dizziness, local necrosis of skin

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32
Q

Isoproterenol (Isuprel)

A

stimulates beata 1 and beta 2 adrenergic receptors
used for heart block, ventricular arrhythmias, and bradycardia
bronchodilatior used for asthma and bronchospasms

  • don’t give at hs - interrupts sleep patterns
  • monitor pulse, bp

S/E: headache, palpitations, tachycardia, BP changes, angina, bronchial asthma

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33
Q

Phenylephrine (Neo-Synephrine)

A

potent alpha 1 agonist
used to treat hypotension

S/E: palpitaitons, tachycardia, hypertension, dysrhythmias, angina, tissue necrosis with extravasation

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34
Q

Dobutamine hydrocholoride (Dobutrex)

A

stimulates beat 1 receptors

  • incompatible with alkaline solutions (Sodium Bicarb)
  • admin through central line or large peripheral vein
  • don’t infuse through line with other meds
  • monitor EKG, BP, I&O, serum potassium

S/E: hypertension, PVCs, Asthmatic episodes, headache

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35
Q

Milrione (Primacor)

A

positive inotropic agent
smooth muscle relaxant used to treat severe heart failure

S/E: dysrhythmia, throbocytopenia, jaundice

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36
Q

Sodium nitroprusside (Nitropress)

A

Dilates cardiac veins and arteries
decreases preload and afterload
increases myocardial perfusion

S/E: hypotension

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37
Q

Diphenhydramine Hcl

A

(Benedryl)
blocks affects of histamines in bronchioles, GI tract, and blood vessels

S/E: drowsiness, confusion, insomnia, headache, vertigo, photosensitivity

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38
Q

Chloradiazepoxide (Librium)

A

Benzodiazepine
CNS depressant
Uses - anxiety, sedation, alcohol withdrawal, seizures

  • may result in toxic build-up in the elderly
  • potential for addiction
  • can develop tolerance and cross-tolerance
  • smoking increases clearance of drug
  • alcohol increases CNS depression

S/E: lethargy, hangover, respiratory depression, hypotension

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39
Q

Diazepam (Valium)

A

Benzodiazepine
CNS depressant
Uses - anxiety, sedation, alcohol withdrawal, seizures

  • may result in toxic build-up in the elderly
  • potential for addiction
  • can develop tolerance and cross-tolerance
  • smoking increases clearance of drug
  • alcohol increases CNS depression

S/E: lethargy, hangover, respiratory depression, hypotension

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40
Q

Alprazolam

A

(Xanax) Benzodiazepine
CNS depressant

  • safer for elderly
  • don’t combine with alcohol or other depressants
  • check renal and hepatic function
  • don’t dc abruptly
  • teach addictive potential

S/E: drowsiness, light-headedness, hypotension, hepatic dysfunction, increased salivation, orthostatic hypotension, memory impairment and confusion

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41
Q

Clonazepam (Klonopin)

A

Benzodiazepine
CNS depressant

  • safer for elderly
  • don’t combine with alcohol or other depressants
  • check renal and hepatic function
  • don’t dc abruptly
  • teach addictive potential

S/E: drowsiness, light-headedness, hypotension, hepatic dysfunction, increased salivation, orthostatic hypotension, memory impairment and confusion

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42
Q

Lorazepam

A

(Ativan) Benzodiazepine
CNS depressant

  • safer for elderly
  • don’t combine with alcohol or other depressants
  • check renal and hepatic function
  • don’t dc abruptly
  • teach addictive potential

S/E: drowsiness, light-headedness, hypotension, hepatic dysfunction, increased salivation, orthostatic hypotension, memory impairment and confusion

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43
Q

Oxazepam (Serax)

A

Benzodiazepine
CNS depressant

  • safer for elderly
  • don’t combine with alcohol or other depressants
  • check renal and hepatic function
  • don’t dc abruptly
  • teach addictive potential

S/E: drowsiness, light-headedness, hypotension, hepatic dysfunction, increased salivation, orthostatic hypotension, memory impairment and confusion

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44
Q

Midazolam (Versed)

A

Benzodiazepine
CNS depressant

uses - preoperative sedation, conscious sedation for endoscopic procedures and diagnostic tests

S/E: retrograde amnesia, euphoria, hypotension, dysrhythmias, cardiac arrest, respiratory depression

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45
Q

Buspirone (Buspar)

A

Nonbenzo antianxiety agent

  • little sedation
  • requires 3 weeks to be effective
  • cannot be given as PRN med
  • particularly useful for generalized anxiety disorder
  • no abuse potential - used for pts with previous addiction
  • avoid alcohol and grapefruit juice
  • monitor for worsening depression/suicidal thoughts

S/E: light headedness, confusion, hypotension, palpitations

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46
Q

Hydroxyzine (Vistaril) (Atarax)

A

Nonbenzo antianxiety agent

  • produces no dependence, tolerance, or intoxication
  • can be used for anxiety relief for indefinite periods

S/E: Drowsiness, ataxia, Leukopenia, hypotension

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47
Q

Kava

A

Herbal - similar to benzodiazepines
suppresses emotional excitability and produces mild euphoria

  • do not take with CNS depressant
  • should not be taken by women or are pregnant, lactating, or children under 12

S/E: impaired thinking, judgement, motor reflexes, vision, decreased plasma proteins, thrombocytopenia, leukocytopenia, dyspnea, and pulmonary HTN

48
Q

Melatonin

A

Herbal
influences sleep-wake cycles (levels are high during sleep)
used for prevention and tx of jet lag and insomnia

  • use cautiously if given with benzo and CNS depressant
  • contraindicated in hepatic insufficiency, history of cerebrovascular disease, depression, and neurologic disorders

S/E: sedation, confusion, headache, and tachycardia

49
Q

Aluminum hydroxide gel (Amphojel)

A

Antacid - for peptic ulcer, indigestion (prevent or treat), reflex esophagitis

action - neutralize gastric acids

  • monitor bowel pattern
  • compounds contain sodium - make sure not on Na restricted diet
  • aluminum and magnesium antacid interfere with tetracycline absorption
  • encourage fluids
  • monitor for signs of phosphate deficiency - malaise, weakness, tremors, bone pain
  • shake well
  • careful use advised for kidney dysfunction

S/E: constipation that may lead to impaction, phosphate depletion

50
Q

Calcium carbonate (titralac)

A

Antacid - for peptic ulcer, indigestion (prevent or treat), reflex esophagitis

action - neutralize gastric acids

  • monitor bowel pattern
  • compounds contain sodium - make sure not on Na restricted diet
  • encourage fluids
  • monitor for signs of phosphate deficiency - malaise, weakness, tremors, bone pain
  • shake well
  • careful use advised for kidney dysfunction

S/E: constipation that may lead to impaction, phosphate depletion

51
Q

Aluminum hydroxide and magnesium trisilicate

A

Antacid - for peptic ulcer, indigestion (prevent or treat), reflex esophagitis

action - neutralize gastric acids

  • monitor bowel pattern
  • compounds contain sodium - make sure not on Na restricted diet
  • aluminum and magnesium antacid interfere with tetracycline absorption
  • encourage fluids
  • monitor for signs of phosphate deficiency - malaise, weakness, tremors, bone pain
  • shake well
  • careful use advised for kidney dysfunction

S/E: constipation that may lead to impaction, phosphate depletion

52
Q

Magnesium hydrodoxide

A

(Milk of Magnesia) Antacid - for peptic ulcer, indigestion (prevent or treat), reflex esophagitis

action - neutralize gastric acids

  • store at room temp with lid tight to prevent absorption of CO2
  • prolonged and frequent use of cathartic dose can lead to dependence
  • administer with caution to pt with renal disease

S/E: nausea, vomiting, diarrhea

53
Q

aluminum hydroxide and magnesium hydroxide

A

(Maalox) Antacid - for peptic ulcer, indigestion (prevent or treat), reflex esophagitis

action - neutralize gastric acids

  • encourage fluid intake
  • administer with caution to pts with renal disease

S/E: slight laxative effect

54
Q

Procainamide (Pronestyl)

A

Antidysrhythmic - Decrease myocardial irritability

  • monitor bp
  • monitor for widening of the PR, QRS, or QT intervals

S/E: hypotension, HF

55
Q

Disophramine (Norpace)

A

Antidysrhythmic - Decrease myocardial irritability

  • monitor bp
  • monitor for widening of the PR, QRS, or QT intervals

S/E: hypotension, HF

56
Q

Lidocaine (xylocaine)

A

Antidysrhythmic - Decrease myocardial irritability

  • monitor for CNS side effects
  • monitor BP and heart rate and cardiac rhythm

S/E: slurred speech, confusion, drowsiness, seizures, hypotension, bradycardia

57
Q

Mexiletine hydrochloride (Mexitil)

A

Antidysrhythmic - Decrease myocardial irritability

  • monitor for CNS side effects
  • monitor BP and heart rate and cardiac rhythm

S/E: slurred speech, confusion, drowsiness, seizures, hypotension, bradycardia

58
Q

Tocainide hydrochloride (Tonocard)

A

Antidysrhythmic - Decrease myocardial irritability

  • monitor for CNS side effects
  • monitor BP and heart rate and cardiac rhythm

S/E: slurred speech, confusion, drowsiness, seizures, hypotension, bradycardia

59
Q

Flecainide (Tambocor)

A

Antidysrhythmic - Decrease myocardial irritability

  • monitor for increasing dysrhythmias
  • monitor heart rate and blood pressure
  • monitor for CNS effects

S/E: bradycardia, hypotension, dysrhytmias
CNS: anxiety, insomnia, confusion, seizures

60
Q

propafenone hydrochloride (Rythmol)

A

Antidysrhythmic - Decrease myocardial irritability

  • monitor for increasing dysrhythmias
  • monitor heart rate and blood pressure
  • monitor for CNS effects

S/E: bradycardia, hypotension, dysrhytmias
CNS: anxiety, insomnia, confusion, seizures

61
Q

Propanolol (Inderal)

A

Antidysrhythmic - Decrease myocardial irritability

  • monitor apical heart rate, cardiac rhythm and blood pressure
  • assess for SOB and wheezing
  • assess for fatigue, sleep disturbances
  • assess apical pulse 1 min before administration

S/E: bradycardia, hypotension, bronchospasm, increase in HF, fatigue and sleep disturbances

62
Q

Acebutolol (Sectral)

A

Antidysrhythmic - Decrease myocardial irritability

  • monitor apical heart rate, cardiac rhythm and blood pressure
  • assess for SOB and wheezing
  • assess for fatigue, sleep disturbances
  • assess apical pulse 1 min before administration

S/E: bradycardia, hypotension, bronchospasm, increase in HF, fatigue and sleep disturbances

63
Q

Esmolol hydrochloride (Brevibloc)

A

Antidysrhythmic - Decrease myocardial irritability

  • monitor apical heart rate, cardiac rhythm and blood pressure
  • assess for SOB and wheezing
  • assess for fatigue, sleep disturbances
  • assess apical pulse 1 min before administration

S/E: bradycardia, hypotension, bronchospasm, increase in HF, fatigue and sleep disturbances

64
Q

Sotalol hydrochloride (Betapace)

A

Antidysrhythmic - Decrease myocardial irritability

  • monitor apical heart rate, cardiac rhythm and blood pressure
  • assess for SOB and wheezing
  • assess for fatigue, sleep disturbances
  • assess apical pulse 1 min before administration

S/E: bradycardia, hypotension, bronchospasm, increase in HF, fatigue and sleep disturbances

65
Q

Amiodarone hydrochloride (Cordarone)

A

Antidysrhythmic - Decrease myocardial irritability

  • continuous monitoring of cardiac rhythm during IV administration
  • monitor QT interval during IV administration
  • monitor heart rate, blood pressure during initiation of therapy
  • instruct client to wear sunglasses and sunscreen

S/E: hypotension, bradycardia and atrioventricular block, muscle weakness, tremors, photosensitivity and photophobia, liver toxicity

66
Q

Ibutilide fumarate (Corvert)

A

Antidysrhythmic - Decrease myocardial irritability

  • continuous monitoring of cardiac rhythm during IV administration
  • monitor QT interval during IV administration
  • monitor heart rate, blood pressure during initiation of therapy
  • instruct client to wear sunglasses and sunscreen

S/E: hypotension, bradycardia and atrioventricular block, muscle weakness, tremors, photosensitivity and photophobia, liver toxicity

67
Q

Dofetilide (Tikosyn)

A

Antidysrhythmic - Decrease myocardial irritability

  • continuous monitoring of cardiac rhythm during IV administration
  • monitor QT interval during IV administration
  • monitor heart rate, blood pressure during initiation of therapy
  • instruct client to wear sunglasses and sunscreen

S/E: hypotension, bradycardia and atrioventricular block, muscle weakness, tremors, photosensitivity and photophobia, liver toxicity

68
Q

Verapamil (Calan)

A

Antidysrhythmic - Decrease myocardial irritability

  • monitor apical heart rate and blood pressure
  • instruct clients about orthostatic precautions
  • instruct pts to repoart signs of HF to MD

S/E: bradycardia, hypotension, dizziness, orthostatic hypotension, HF

69
Q

Ditiazem hydrochloride (Cardizem)

A

Antidysrhythmic - Decrease myocardial irritability

  • monitor apical heart rate and blood pressure
  • instruct clients about orthostatic precautions
  • instruct pts to repoart signs of HF to MD

S/E: bradycardia, hypotension, dizziness, orthostatic hypotension, HF

70
Q

Gentamicin (Garamycin)

A

Aminoglycosides - antibiotic

Uses – Pseudomonas, E. coli
Action – inhibits protein synthesis in gram-negative bacteria

S/E: ototoxicity (ears), anorexia, nausea, vomiting, diarrhea, nephrotoxic (kidneys)

Nursing:
• Check 8th cranial nerve (hearing)
• Check renal function (BUN, urinary output 1200 ml per day)
• Take 7-10 days – until med complete

71
Q

Neomycin

A

Aminoglycosides - antibiotic

Uses – Pseudomonas, E. coli
Action – inhibits protein synthesis in gram-negative bacteria

S/E: ototoxicity (ears), anorexia, nausea, vomiting, diarrhea, nephrotoxic (kidneys)

Nursing:
• Check 8th cranial nerve (hearing)
• Check renal function (BUN, urinary output 1200 ml per day)
• Take 7-10 days – until med complete

72
Q

Sreptomycin

A

Aminoglycosides - antibiotic

Uses – Pseudomonas, E. coli
Action – inhibits protein synthesis in gram-negative bacteria

S/E: ototoxicity (ears), anorexia, nausea, vomiting, diarrhea, nephrotoxic (kidneys)

Nursing:
• Check 8th cranial nerve (hearing)
• Check renal function (BUN, urinary output 1200 ml per day)
• Take 7-10 days – until med complete

73
Q

Tobramycin (Tobrex)

A

Aminoglycosides - antibiotic

Uses – Pseudomonas, E. coli
Action – inhibits protein synthesis in gram-negative bacteria

S/E: ototoxicity (ears), anorexia, nausea, vomiting, diarrhea, nephrotoxic (kidneys)

Nursing:
• Check 8th cranial nerve (hearing)
• Check renal function (BUN, urinary output 1200 ml per day)
• Take 7-10 days – until med complete

74
Q

Amikacin (Amikin)

A

Aminoglycosides - antibiotic

Uses – Pseudomonas, E. coli
Action – inhibits protein synthesis in gram-negative bacteria

S/E: ototoxicity (ears), anorexia, nausea, vomiting, diarrhea, nephrotoxic (kidneys)

Nursing:
• Check 8th cranial nerve (hearing)
• Check renal function (BUN, urinary output 1200 ml per day)
• Take 7-10 days – until med complete

75
Q

Ceclor (Cefaclor),

A

Cephalosporin - antibiotic

Uses – tonsillitis, otitis media, peri-operative prophylaxis, meningitis, respiratory tract infections, UTIs
Action – inhibits synthesis of bacterial cell wall

S/E: bone marrow depression, super-infections, rash, increased risk of bleeding, abdominal pain

Nursing:
• Take with food – cause GI upset
• Cross allergy with PCN
• Avoid alcohol – can cause flushing, dizziness, and muscle aches
• Obtain C&S before first dose
• May give false positive for protienuria or glucose in urine

76
Q

Ancef (cefazolin)

A

Cephalosporin - antibiotic

Uses – tonsillitis, otitis media, peri-operative prophylaxis, meningitis, respiratory tract infections, UTIs
Action – inhibits synthesis of bacterial cell wall

S/E: bone marrow depression, super-infections, rash, increased risk of bleeding, abdominal pain

Nursing:
• Take with food – cause GI upset
• Cross allergy with PCN
• Avoid alcohol – can cause flushing, dizziness, and muscle aches
• Obtain C&S before first dose
• May give false positive for protienuria or glucose in urine

77
Q

Keflex (chephalexin)

A

Cephalosporin - antibiotic

Uses – tonsillitis, otitis media, peri-operative prophylaxis, meningitis, respiratory tract infections, UTIs
Action – inhibits synthesis of bacterial cell wall

S/E: bone marrow depression, super-infections, rash, increased risk of bleeding, abdominal pain

Nursing:
• Take with food – cause GI upset
• Cross allergy with PCN
• Avoid alcohol – can cause flushing, dizziness, and muscle aches
• Obtain C&S before first dose
• May give false positive for protienuria or glucose in urine

78
Q

Ceftriaxone (Rocephin)

A

Cephalosporin - antibiotic

Uses – tonsillitis, otitis media, peri-operative prophylaxis, meningitis, respiratory tract infections, UTIs
Action – inhibits synthesis of bacterial cell wall

S/E: bone marrow depression, super-infections, rash, increased risk of bleeding, abdominal pain

Nursing:
• Take with food – cause GI upset
• Cross allergy with PCN
• Avoid alcohol – can cause flushing, dizziness, and muscle aches
• Obtain C&S before first dose
• May give false positive for protienuria or glucose in urine

79
Q

Mefoxin (cefoxitin)

A

Cephalosporin - antibiotic

Uses – tonsillitis, otitis media, peri-operative prophylaxis, meningitis, respiratory tract infections, UTIs
Action – inhibits synthesis of bacterial cell wall

S/E: bone marrow depression, super-infections, rash, increased risk of bleeding, abdominal pain

Nursing:
• Take with food – cause GI upset
• Cross allergy with PCN
• Avoid alcohol – can cause flushing, dizziness, and muscle aches
• Obtain C&S before first dose
• May give false positive for protienuria or glucose in urine

80
Q

Cefepime (Maxipime)

A

Cephalosporin - antibiotic

Uses – tonsillitis, otitis media, peri-operative prophylaxis, meningitis, respiratory tract infections, UTIs
Action – inhibits synthesis of bacterial cell wall

S/E: bone marrow depression, super-infections, rash, increased risk of bleeding, abdominal pain

Nursing:
• Take with food – cause GI upset
• Cross allergy with PCN
• Avoid alcohol – can cause flushing, dizziness, and muscle aches
• Obtain C&S before first dose
• May give false positive for protienuria or glucose in urine

81
Q

Levofloxacin (Levequin)

A

Fluroroquinolones - antibiotic

Uses – E. coli, pseudomonas, S. aureaus
Action – interferes with DNA replication in gram-negative bacteria

S/E: diarrhea, decreased WBC and hematocrit, elevated liver enzymes (AST, ALT), elevated alkaline phosphate, elevated BUN, rash, photosensitivity, Achilles tendon rupture

Nursing:
• C&S before starting
• Encourage fluids 3000 ml per day
• Take 1 h ac or 2 h pc – not taken with food – will slow absorption
• Do not take with antacids or iron absorption

82
Q

Ciprofloxacin (Cipro)

A

Fluroroquinolones - antibiotic

Uses – E. coli, pseudomonas, S. aureaus
Action – interferes with DNA replication in gram-negative bacteria

S/E: diarrhea, decreased WBC and hematocrit, elevated liver enzymes (AST, ALT), elevated alkaline phosphate, elevated BUN, rash, photosensitivity, Achilles tendon rupture

Nursing:
• C&S before starting
• Encourage fluids 3000 ml per day
• Take 1 h ac or 2 h pc – not taken with food – will slow absorption
• Do not take with antacids or iron absorption

83
Q

Norfloxacin (Noroxin)

A

Fluroroquinolones - antibiotic

Uses – E. coli, pseudomonas, S. aureaus
Action – interferes with DNA replication in gram-negative bacteria

S/E: diarrhea, decreased WBC and hematocrit, elevated liver enzymes (AST, ALT), elevated alkaline phosphate, elevated BUN, rash, photosensitivity, Achilles tendon rupture

Nursing:
• C&S before starting
• Encourage fluids 3000 ml per day
• Take 1 h ac or 2 h pc – not taken with food – will slow absorption
• Do not take with antacids or iron absorption

84
Q

Vancomycin

A

glycopeptides - antibiotic

binds to bacterial cell wall, stopping its synthesis

treatment of resistant staph infections, pseudomembranous enterocolitis due to c diff infections

S/E: thrombophlebitis, abscess formation, nephrotoxicity, ototoxicity

Nursing:

  • Monitor renal function and hearing
  • poor absorption orally; administer IV
  • avoid extravastation during therapy; it may cause necrosis
  • give antihistamine if “red man syndrome” - decreased blood pressure, flushing of face and neck
  • contact MD if s/s of superinfection - sore throat, fever, fatigue
85
Q

Clindamycin (Cleocin)

A

antibiotic - lincosamide

both bacteriostatic and bactericidal, suppresses protein synthesis by preventing peptide bond formation

S/E: diarrhea, rash, liver toxicity

nursing:

  • admin PO with full glass of water to prevent esophageal ulcers
  • monitor for persistent vomiting, diarrhea, fever, or abdominal pain, superinfections
86
Q

Erthromycin (Erythrocin)

A

Macrolide antibiotic

blinds to cell membrane and causes changes in protein function

uses - acute infections, acne, skin infections, URIs, prophylaxis before dental procedures for pts allergic to PCN

S/E: abdominal cramps, diarrhea, confusion, uncontrollable emotions, hepatotoxicity, superinfection

nursing:

  • take oral med 1 h before or 2-3 hrs after meals with full glass of water
  • take around the clock to maximize effectiveness
  • monitor liver function
  • take full coarse
87
Q

Azithromycin (Zithromax)

A

Macrolide antibiotic

blinds to cell membrane and causes changes in protein function

uses - acute infections, acne, skin infections, URIs, prophylaxis before dental procedures for pts allergic to PCN

S/E: abdominal cramps, diarrhea, confusion, uncontrollable emotions, hepatotoxicity, superinfection

nursing:

  • take oral med 1 h before or 2-3 hrs after meals with full glass of water
  • take around the clock to maximize effectiveness
  • monitor liver function
  • take full coarse
88
Q

Amoxicillin (Amoxil)

A

antibiotic - penicillins

Uses – moderate to severe infections, syphilis, gonococcus infections, Lyme disease,
Action – inhibits synthesis of cell wall

S/E: stomatitis (breakdown in the mouth and along GI tract), diarrhea, allergic reactions, renal and hepatic changes

Nursing:

  • Check for hypersensitivity - multiple exposures cause reaction
  • Give 1-2 h ac or 2-3 h pc
  • Cross allergy with cephalosporins
  • Watch renal and hepatic labs
  • culture and sensitivity before tx
  • good mouth care
89
Q

Ampicillin (Omnipen)

A

antibiotic - penicillins

Uses – moderate to severe infections, syphilis, gonococcus infections, Lyme disease,
Action – inhibits synthesis of cell wall

S/E: stomatitis (breakdown in the mouth and along GI tract), diarrhea, allergic reactions, renal and hepatic changes

Nursing:

  • Check for hypersensitivity - multiple exposures cause reaction
  • Give 1-2 h ac or 2-3 h pc
  • Cross allergy with cephalosporins
  • Watch renal and hepatic labs
  • culture and sensitivity before tx
  • good mouth care
90
Q

Methicillin

A

antibiotic - penicillins

Uses – moderate to severe infections, syphilis, gonococcus infections, Lyme disease,
Action – inhibits synthesis of cell wall

S/E: stomatitis (breakdown in the mouth and along GI tract), diarrhea, allergic reactions, renal and hepatic changes

Nursing:

  • Check for hypersensitivity - multiple exposures cause reaction
  • Give 1-2 h ac or 2-3 h pc
  • Cross allergy with cephalosporins
  • Watch renal and hepatic labs
  • culture and sensitivity before tx
  • good mouth care
91
Q

Nafcillin (Unipen)

A

antibiotic - penicillins

Uses – moderate to severe infections, syphilis, gonococcus infections, Lyme disease,
Action – inhibits synthesis of cell wall

S/E: stomatitis (breakdown in the mouth and along GI tract), diarrhea, allergic reactions, renal and hepatic changes

Nursing:

  • Check for hypersensitivity - multiple exposures cause reaction
  • Give 1-2 h ac or 2-3 h pc
  • Cross allergy with cephalosporins
  • Watch renal and hepatic labs
  • culture and sensitivity before tx
  • good mouth care
92
Q

Penicillin G or V

A

antibiotic - penicillins

Uses – moderate to severe infections, syphilis, gonococcus infections, Lyme disease,
Action – inhibits synthesis of cell wall

S/E: stomatitis (breakdown in the mouth and along GI tract), diarrhea, allergic reactions, renal and hepatic changes

Nursing:

  • Check for hypersensitivity - multiple exposures cause reaction
  • Give 1-2 h ac or 2-3 h pc
  • Cross allergy with cephalosporins
  • Watch renal and hepatic labs
  • culture and sensitivity before tx
  • good mouth care
93
Q

Sulfisoxazole (Gantrisin)

A

Sulfonamide - antibiotic

Uses – ulcerative colitis, Crohn’s disease, otitis media, UTIs, conjunctivitis, meningitis, RA
Action – antagonize essential component of folic acid synthesis

S/E: peripheral neuropathy, crystalluria, photosensitivity, GI upset, stomatitis

Nursing:
• Take on empty stomach with full glass of water
• Encourage fluids – bc of crystal formation 3000 ml/day
• Good mouth care
• Antacids will interfere

94
Q

Sulfasalazine (Azulfidine)

A

Sulfonamide - antibiotic

Uses – ulcerative colitis, Crohn’s disease, otitis media, UTIs, conjunctivitis, meningitis, RA
Action – antagonize essential component of folic acid synthesis

S/E: peripheral neuropathy, crystalluria, photosensitivity, GI upset, stomatitis

Nursing:
• Take on empty stomach with full glass of water
• Encourage fluids – bc of crystal formation 3000 ml/day
• Good mouth care
• Antacids will interfere

95
Q

Trimethoprim/Sulfamethoxazole (Bactrim, Septra)

A

Sulfonamide - antibiotic

Uses – ulcerative colitis, Crohn’s disease, otitis media, UTIs, conjunctivitis, meningitis, RA
Action – antagonize essential component of folic acid synthesis

S/E: peripheral neuropathy, crystalluria, photosensitivity, GI upset, stomatitis

Nursing:
• Take on empty stomach with full glass of water
• Encourage fluids – bc of crystal formation 3000 ml/day
• Good mouth care
• Antacids will interfere

96
Q

Doxycycline (Vibramycin)

A

Tetracycline - Antibiotic

Uses – infections, acne, prophylaxis for ophthalmia neonatorum (given to every baby when born to prevent infection)
Treatment of: syphilis, chlamydia, gonorrhea, malaria prophylaxis, chronic periodnitits, anthrax, H. pylori, Lyme disease
Action – inhibits protein syntheis

S/E: discoloration of primary teeth if taken by mom during pregnancy, glossitis, rash, phototoxic reactions, glossitis, diarrhea, superinfection

Nursing:
• Take 1 h ac or 2-3 h pc
• Do not take with antacid, milk, iron – decrease absorption
• Note expiration date – if taken beyond expiration is toxic
• Monitor renal function
• Avoid sunlight - Sunblock!
- topical applications may stain clothing
- use contraceptive method in addiction to oral contraceptives

97
Q

Minocycline (Minocin)

A

Tetracycline - Antibiotic

Uses – infections, acne, prophylaxis for ophthalmia neonatorum (given to every baby when born to prevent infection)
Treatment of: syphilis, chlamydia, gonorrhea, malaria prophylaxis, chronic periodnitits, anthrax, H. pylori, Lyme disease
Action – inhibits protein syntheis

S/E: discoloration of primary teeth if taken by mom during pregnancy, glossitis, rash, phototoxic reactions, glossitis, diarrhea, superinfection

Nursing:
• Take 1 h ac or 2-3 h pc
• Do not take with antacid, milk, iron – decrease absorption
• Note expiration date – if taken beyond expiration is toxic
• Monitor renal function
• Avoid sunlight - Sunblock!
- topical applications may stain clothing
- use contraceptive method in addiction to oral contraceptives

98
Q

Tetracycline Hcl (Panmycin)

A

Tetracycline - Antibiotic

Uses – infections, acne, prophylaxis for ophthalmia neonatorum (given to every baby when born to prevent infection)
Treatment of: syphilis, chlamydia, gonorrhea, malaria prophylaxis, chronic periodnitits, anthrax, H. pylori, Lyme disease
Action – inhibits protein syntheis

S/E: discoloration of primary teeth if taken by mom during pregnancy, glossitis, rash, phototoxic reactions, glossitis, diarrhea, superinfection

Nursing:
• Take 1 h ac or 2-3 h pc
• Do not take with antacid, milk, iron – decrease absorption
• Note expiration date – if taken beyond expiration is toxic
• Monitor renal function
• Avoid sunlight - Sunblock!
- topical applications may stain clothing
- use contraceptive method in addiction to oral contraceptives

99
Q

Bacitracin ointment

A

Topical Antibacterial

S/E: nephrotoxicity, ototoxicity

Nursing: overgrowth of nonsusceptible organisms can occur

100
Q

Neosporin Cream

A

Topical Antibacterial

S/E: nephrotoxicity, ototoxicity

Nursing: allergic dermatitis may occur

101
Q

Providone- Iodine solution

A

(Betadine) Topical Antibacterial

S/E: Irritation

Nursing:

  • Don’t use around eyes
  • May stain skin
  • Don’t use full strength on mucous membranes
102
Q

Silver sulfadiazine cream (Silvadene)

A

Topical Antibacterial

S/E: neutropenia, burning

Nursing: use cautiously if sensitive to sulfonamides

103
Q

Tolnaftate cream (Tinactin)

A

Topical Antibacterial

S/E: irritation

Nursing:

  • use small amount of medication
  • use medication for duration prescribed
104
Q

Nystatin Cream (Myocstatin)

A

Topical Antibacterial

S/E: contact dermatitis

Nursing: Do not use occlusive dressing

105
Q

Nitrofurantoin (Furadantin)

A

anti-infective

S/E: asthma attacks, diarrhea, N/V

Nursing:
• Give with food or milk
• Monitor pulmonary status
• Taken with cranberry juice – helps it to work
• Don’t eat alcoline foods – almond, coconut, milk, some veggies

106
Q

Phenazophyridine (Pyridium)

A

– urinary tract analgesic

S/E: headache, vertigo

Nursing:
• Tell pt urine will be orange
- Take with meals

107
Q

Oxybutynin (Ditropan)

A

Anticholinergic

used to reduce bladder spasms and treat urinary incontinence

Uses – ophthalmic exam, motion sickness, pre-operative (to reduce GI and bladder motility)
Action – dilates pupils, causes bronchodilation and decreased secretions, decreases mobility and GI secretions

S/E: blurred vision, dry mouth, urinary retention, change in heart rate, drowsiness, constipation

  • Nursing
    • monitor output (1500 ml normal)
    • contraindicated with glaucoma (will interfere with fluid drainage)
    • give 30 min ac, hs, or 2 h pc
    • not used with paralytic illeus – don’t want to slow down more, BPH – enlarged prostate and don’t want to slow down bladder
  • increased fluids and fiber in diet
  • older adults require higher dose and have greater incidence of side effects
108
Q

Propantheline (Pro-Banthine)

A

Anticholinergic

used to reduce bladder spasms and treat urinary incontinence

Uses – ophthalmic exam, motion sickness, pre-operative (to reduce GI and bladder motility)
Action – dilates pupils, causes bronchodilation and decreased secretions, decreases mobility and GI secretions

S/E: blurred vision, dry mouth, urinary retention, change in heart rate, drowsiness, constipation

  • Nursing
    • monitor output (1500 ml normal)
    • contraindicated with glaucoma (will interfere with fluid drainage)
    • give 30 min ac, hs, or 2 h pc
    • not used with paralytic illeus – don’t want to slow down more, BPH – enlarged prostate and don’t want to slow down bladder
  • increased fluids and fiber in diet
109
Q

Darifenacin (Enablex)

A

Anticholinergic

used to reduce bladder spasms and treat urinary incontinence

Uses – ophthalmic exam, motion sickness, pre-operative (to reduce GI and bladder motility)
Action – dilates pupils, causes bronchodilation and decreased secretions, decreases mobility and GI secretions

S/E: blurred vision, dry mouth, urinary retention, change in heart rate, drowsiness, constipation

  • Nursing
    • monitor output (1500 ml normal)
    • contraindicated with glaucoma (will interfere with fluid drainage)
    • give 30 min ac, hs, or 2 h pc
    • not used with paralytic illeus – don’t want to slow down more, BPH – enlarged prostate and don’t want to slow down bladder
  • increased fluids and fiber in diet
110
Q

Solifenacin (VESIcare)

A

Anticholinergic

used to reduce bladder spasms and treat urinary incontinence

Uses – ophthalmic exam, motion sickness, pre-operative (to reduce GI and bladder motility)
Action – dilates pupils, causes bronchodilation and decreased secretions, decreases mobility and GI secretions

S/E: blurred vision, dry mouth, urinary retention, change in heart rate, drowsiness, constipation

  • Nursing
    • monitor output (1500 ml normal)
    • contraindicated with glaucoma (will interfere with fluid drainage)
    • give 30 min ac, hs, or 2 h pc
    • not used with paralytic illeus – don’t want to slow down more, BPH – enlarged prostate and don’t want to slow down bladder
  • increased fluids and fiber in diet
111
Q

Tolterodine (Detrol)

A

Anticholinergic

used to reduce bladder spasms and treat urinary incontinence

Uses – ophthalmic exam, motion sickness, pre-operative (to reduce GI and bladder motility)
Action – dilates pupils, causes bronchodilation and decreased secretions, decreases mobility and GI secretions

S/E: blurred vision, dry mouth, urinary retention, change in heart rate, drowsiness, constipation

  • Nursing
    • monitor output (1500 ml normal)
    • contraindicated with glaucoma (will interfere with fluid drainage)
    • give 30 min ac, hs, or 2 h pc
    • not used with paralytic illeus – don’t want to slow down more, BPH – enlarged prostate and don’t want to slow down bladder
  • increased fluids and fiber in diet
112
Q

Sildenafil

A

(Viagra) Anti-impotence

S/E: headache, hypotension, priapism

Contraindications: nitrates, alpha blockers - will cause fatal hypotension

Nursing:
• Can not take with grapefruit juice
• Call PCP if erection lasting longer than 4 hrs
- take 1 hr before sexual activity

113
Q

Vardenafil (Levitra)

A

Anti-impotence

S/E: headache, hypotension, priapism

Contraindications: nitrates, alpha blockers - will cause fatal hypotension

Nursing:
• Can not take with grapefruit juice
• Call PCP if erection lasting longer than 4 hrs
- take 1 hr before sexual activity

114
Q

Tadalfil (Cialis)

A

Anti-impotence

S/E: headache, hypotension, priapism

Contraindications: nitrates, alpha blockers - will cause fatal hypotension

Nursing:
• Can not take with grapefruit juice
• Call PCP if erection lasting longer than 4 hrs
- take 1 hr before sexual activity

115
Q

Finasteride (Proscar)

A

Testosterone inhibitor

tx of BPH

S/E: decreased libido, impotence, breast tenderness

  • pregnant women should avoid contact with crushed drug or pt’s semen - may adversely affect male fetus
116
Q

Propecia

A

Testosterone inhibitor
tx of male hair loss

S/E: decreased libido, impotence, breast tenderness

  • pregnant women should avoid contact with crushed drug or pt’s semen - may adversely affect male fetus

NCLEX!!! (7 decks)

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