Medications Flashcards
What is the function of Corticosteroids?
Alter normal immune response and suppress inflammation. Produce anti-inflammatory, antiallergic, and anti-stress effects
What are the 6 main side effects of Corticosteroids?
- immunosuppression
- hyperglycemia (glucose intolerance)
- fluid and sodium retention
- hypokalemia
- hypocalcemia
- weight gain
What medications need to be tapered off gradually ?
- Steroids (prednisone)
- antihypertensives (captopril)
- antiseizure meds (phenytoin)
What antihypertensive medication should not be administered to a client with COPD or who is in an acute asthma attack ?
non-selective BB such as propranolol. It will block the beta receptor, causing further bronchoconstriction
What is the nurse’s best action to prevent lithium toxicity in a client?
Increase the client’s fluid intake and maintain sodium intake to prevent hyponatremia. (hyponatremia potentiates lithium toxicity)
To which client should the nurse administer lithium?
The client diagnosed with bipolar disorder
What medications are ototoxic?
- cisplatin
- furosemide (IV Push over 1-2 minutes)
- gentamicin
- vancomycin
What are the main side effects of antibiotics?
- Gastric irritation
- ototoxicity
- superinfection
- photosensitivity
- nephrotoxicity
How and when should Tetracyclines be taken?
Take with a full glass of water 1 hour before or 2 hours after meals.
Do NOT take with milk or antacids.
Do NOT crush the tablets
What is Benztropine?
anticholinergic medication that activates sympathetic nervous system. CONTRAINDICATED in glaucoma because it increases IOP
What are the side effects of atenolol?
Atenolol = selective BB
- bradycardia, heart failure, decreased exercise tolerance, gastric pain
What should the nurse assess for in children and adolescents taking medication for ADHD?
Assess for weight loss and nutritional status.
common side effect:
- loss of appetite, anorexia, growth suppression
What are some common medications given for treatment of ADHD?
Methylphenidate
Atomoxetine
What should the nurse educate the client taking Tamsulosin on?
To get up slowly because of orthostatic hypotension
medication to treat BPH
What lab value should the nurse monitor for the client on Ketolorac for severe pain?
Monitor serum creatinine because Ketolorac is a nephrotoxic NSAID
What are adverse reactions of isoniazid?
- hepatitis
- peripheral neuropathy
How should the nurse respond when the client asks how long he must take his medications for TB?
6-12 months
Non-infectious after 2-3 weeks or 3 negative sputum cultures
How does the nurse know that the atorvastatin is effective in the client with hyperlipidemia?
LDL levels < 139
What is an elevated triglyceride level?
Normal: < 150
Elevated: > 200
What is normal cholesterol level?
Normal: < 200
What is priority for the nurse to monitor for in a client taking SSRIs?
monitor for suicidal thoughts/behavior
What are some common SSRIs?
- fluoxetine
- setraline
- citalopram
- escitalopram
Medications that majorly interact with grapefruit juice
- verapamil
- simvastatin
- busprione
- carbamazepine
- cyclosporine
- INCREASES serum levels of medications
In which patients is verapamil contraindicated in?
Contraindicated in HF patients receiving digoxin
What are the side effects of Cisplatin?
tinnitus, hypokalemia, hypocalcemia, hypomagnesemia, nephrotoxicity
What should you teach the client to do after taking beclomethasone?
Rinse the mouth out with water after every treatment
What are the side effects of opiates?
cough suppression, facial flushing, urinary retention, constipation
Which meds take a few weeks to take effect
- BPH meds (tamsulosin)
- SSRIs
- ## antispychotics
What is Nimodipine?
Calcium Channel Blocker
used in hypertensive crisis or after strokes
When is the best time to take antacids?
after meals
Do not take antacids with other meds because they delay the absorption of the medications
What is a side effect of carbamazepine?
causes bone-marrow suppression
- low RBCs, WBCs, platelets
What is the therapeutic range for Phenytoin?
What are signs of toxicity?
normal range: 10-20 mcg/mL (dose given once a day)
long term side effects: acne, hirsutism, gingival hyperplasia
signs of toxicity: ataxia, slurred speech, nystagmus
other side effects:
- rash, increased suicidal tendencies, contraindicated in pregnancy
What nutritional deficiencies can phenytoin cause?
Folate and vitamin D deficiencies
eat milk, green leafy veggies, oranges, cantaloupe
What is clozapine?
atypical antipsychotic for schizophrenia
can cause bone marrow suppression and agranulocytosis - REPORT sore throat or fever
*report WBCs weekly for first 6 months
What are side effects of Metoclopramide?
restlessness, drowsiness, dizziness, insomnia, headache, EPS
When should you take oral corticosteroids?
Take in the AM before 9
Take with meals because they have ulcerogenic properties
What is methotrexate?
immunosuppressive and chemotherapy drug
- monitor for low platelet levels
- NO fresh flowers/plants
- use electric razors
Uses for diphenhydramine
- allergy rhinitis
- parkinson’s - to decrease muscle tremors
- insomnia
- motion sickness
What is gingko?
anti-platelet agent and CNS stimulant
Don’t give w/ NSAIDs - risk for bleeding
What is gabapentin?
How many times a day is it given?
- treats neuropathic pain
- given in 3 divided doses
In what order should insulin be drawn up when mixing short-acting and intermediate-acting?
Draw up the clear, short-acting FIRST
and then draw up cloudy, intermediate-acting
What medication should not be administered with phosphodiesterase inhibitors?
Do not administer w/ NGT - can cause fatal drop in blood pressure
What are the adverse effects of aspirin overdose?
tinnitus and GI upset
What is the onset and peak of short-acting insulin?
onset: 30-60 minutes
peak: 2-3 hours
What are adverse effects of metformin?
- nephrotoxicity
- impairs vitamin B12 absorption
- use w/ caution in pregnancy
What is the action of morphine in an acute MI?
- decreases preload and afterload
- causes vasodilation and pooling of blood in extremities
- relieves anxiety
How should Levothyroxine be taken?
take in the morning on empty stomach 30 minutes before breakfast
Symptoms of levothyroxine overdose
tachycardia, chest pain, restlessness, nervousness, and insomnia
What immunosuppression drug is used after organ transplant ?
cyclosporine - lifelong anti-rejection drug
- take the same time every day
What is disulfiram?
antabuse - alcoholism medication
- can take at night to minimize sedative effects
- DO NOT take with any OTC cough medications
- avoid any contact with alcohol (even paint or wood fumes)
What medications are contraindicated with St. Johns Wort ?
- digoxin
- warfarin
- hydromorphone
- citalopram
- nifedipine
- simvastatin
Purpose of epoetin
biologic response modifier
- stimulates RBC production for anemia, CKD, chemotherapy
what is the most common side effect of trimethoprim-sulfamethoxazole
urticaria
What is the action of thiazide diuretics
inhibits absorption of sodium and water
What electrolyte imbalance potentiates digoxin toxicity?
Hypokalemia - don’t give digoxin with furosemide or licorice because both also lower K+
What are foods high in potassium?
broccoli, spinach, potatoes, bananas, cantaloupe, oranges, strawberries
how to minimize side effects after Dtap immunization?
administer antipyretics
what lab values need to be monitored after acetaminophen overdose?
AST and ALT levels from hepatic toxicity
*toxicity manifests ~1-3 days after ingestion
what is the maximum daily dose of acetaminophen?
4 grams/day
how does calcium affect iron absorption?
it decreases iron absorption
- iron should be taken separately from other foods and medications
How should NSAIDS be taken?
taken with meals because they cause GI distress
How should ABX be taken?
generally on an empty stomach, but can be taken with meals if gastric irritation
Pain unrelieved by medication is a sign of acute ______.
compartment syndrome
- perform neurovascular assessment!
It is most important for the nurse performing CPR to maintain ______ on client’s chest through heel of the nurse’s hands.
Return of client’s pulse should be checked _____.
vertical pressure
After every minute
what is the action of furosemide?
excretes sodium, water, and potassium
what is the action of spironolactone ?
promotes water and sodium excretion
retains potassium
- monitor for hyperkalemia
- don’t give with ACE inhibitors
Blood TSH levels will _____ when taking levothyroxine.
DECREASE with medication effectiveness
replaces T4 only
Metformin should be taken _____.
with meals
Metformin: use and side effects
oral hypoglycemia agent - helps tissues respond to insulin and increase glucose uptake
2 common side effects: bitter, metallic taste and abdominal cramps
ACE-inhibitors cause _____ retention.
potassium retention
- avoid foods high in K+
- take on empty stomach
- don’t double up on doses
- can cause orthostatic hypotension
garlic can potentiate ______ effects
hypoglycemic effects
adverse effects of Theophylline:
tachycardia, hypotension, N/V
imipramine
use and side effects
tricyclic antidepressant medication
- sore throat, fever, increased fatigue, vomiting, diarrhea
what is a common side effect of gabapentin?
fatigue
When are statins most effective?
At night when cholesterol synthesis is highest
interventions for patients on chemotherapy agents:
- administer anti-emetics
- offer high cal, high fat meals to prevent weight loss
- cleanse mouth before and after meals to prevent stomatitis
- increase fluid intake to prevent cystitis
- encourage moderate exercise to help manage fatigue
What is given to reduce ammonia formation in the intestines?
lactulose
- frequently given in cirrhosis
what are early and severe adverse effects of lithium?
early:
- N/V, slurred speech, muscle weakness
severe:
- coarse hand tremors and ataxia
What should NOT be taken with clopidogrel?
ginger, gingko, and garlic
What are contraindications to Benzotropine?
contraindicated in glaucoma because it will increase IOP
it’s an anticholinergic med - also causes urinary retention and dry mouth
for patient on heparin
aPTT should be ____ x the normal range
what is the antidote for heparin?
1.5 x (46-70 seconds)
protamine sulfate
naproxen
NSAID
- take with food, milk, or antacid to decrease GI upset
- no alcohol
- watch for signs of GI bleeding
clonidine transdermal patch
antihypertensive medication
alpha 1 agonist
replace patch every 7 days
what 2 drugs can cause a problem for clients with asthma
NSAIDs and non-selective BB - bronchospasms
what should you administer to someone with signs of EPS?
benztropine
trihexphenidyl
common NSAIDs
aspirin ketolorac meloxicam naproxen sulindac ibuprofen indomethacin celecoxib
oseltamivir
treatment for influenza
- take as soon as symptoms appear
- can open capsules and mix with flavoring
- take with foods cuz it can cause stomach upset
- still take annual flu shots
- no contraindication for egg allergy
amitriptyline hydrochloride
tricyclic antidepressant
- takes 3-4 weeks to reach therapeutic levels
what are side effects of amitriptyline hydrochloride?
blurred vision dry mouth diaphoresis postural hypotension urinary retention increased appetite
*AVOID tyramines and wear sunblock
phenazopyridine
UTI analgesic
watch for yellow discoloration of skin or sclera - indicates accumulation of med due to kidney injury
what is the peak and onset of NPH?
Onset: 2-4 hours
Peak: 6-12 hours
Sulfasalazine
treats IBD
- increase fluid intake to prevent crystallization
- orange-red urine is normal
- take with foods or after meals
normal therapeutic range for digoxin?
0.5 -2
half life - 36 hours
Terbutaline
tocolytic and bronchodilator
administered to DELAY preterm labor
withhold if pregnant mother has high HR
Hydralazine
vasodilator for HTN
- watch for anorexia and orthostatic hypotension
- avoid taking with OTC meds
Procainamide
anti-dysrhythmic
watch for hypotension and bradycardia
aminophylline
xanthine bronchodilator
main side effects: palpitations and nervousness
what are toxic effects of aminophylline?
N/V confusion headache flushing seizures
what is a possible life-threatening reaction with clozapine?
Risk of agranulocytosis - monitor WBCs weekly for the 1st 6 months
D/C drug if WBC below 2000
clients on warfarin should avoid what ?
dark leafy greens because they’re high in vitamin K
Verapamil is contraindicated i n which patients?
patients with HF and those on digoxin
Carbamazepine interferes with what drugs?
hormonal contraceptives
serum levels increase when taken with grapefruit juice
what is a common side effects of Rantidine?
mild diarrhea
acne-like rash
fluticasone
inhaled glucocorticoid and anti-inflammatory
used on regular basis
rinse and gargle after use to decrease risk of candida infection
butorphanol tartrate
opioid analgesic
side effects - sedation, diplopia, blurred vision
Monitor vital signs!!
side effects of risperidone
- weight gain
- avoid extreme temperatures
- photosensitivity
- orthostatic hypotension
- causes sleep disturbances
what foods should you take with cephalexin?
yogurt and acidophilus milk
helps maintain normal intestinal flora which can be altered from this med
sucralfate
antacid that decreases bonding to GI mucosa
don’t give antacids within 30 minutes of each other
*BEST on an empty stomach
side effects of albuterol
nervousness
restlessness
palpitations
usually diminishes after 1 week or longer
metronidazole
- take with meals
- don’t drink alcohol
- metallic taste expected
tyramine foods
red wine organ meat yogurt aged-cheese bananas yeast avocados beer
*cream cheese is ok
pentamidine isethionate
antiprotozoal agent to tx Pneumocystitis PNA - common in AIDS clients
therapeutic response would be decreased crackles and dyspnea
urine output will _____ with levothryoxine
INCREASE
increased metabolic processes –> better glomerular filtration
can enteric coated tablets be broken?
no
tetracyclines should not be given within 1 hour of _____ because of _______.
clients should take _____ methods of contraceptives during use.
Do not take ____ within 1-3 hours of taking oral tetracyclines.
bedtime; esophageal irritation
nonhormonal (condoms)
antacid
probenecid
uric acid reducer - prevents reoccurrence of gouty arthritis
colchicine
treats acute gout attacks
- don’t give with atorvastatin
acyclovir
used to treat herpes
side effects: N//V
given 5 x a day
don’t apply anything on lesions
what lab results should be monitored for client taking clopidogrel
anti-platelet med
Hemoglobin and hematocrit
daily iron needs
pregnant: 30mg/day
12-13 F: 8mg/day
14-18 F: 15mg/day
12-13 M: 8 mg/day
14-18 M: 11 mg/day
permethrin
treatment of lice
- leave cream in for 10 min and rinse out
- only use 1x/week
- wash linens in hot water and dryer
- check all family members
- makes itching stop by killing lice and nits
- can cause erythema
glargine
given at same time everyday usually at night
onset: 3-4 hours
lasts for 24 hours
should not be mixed with any other insulin in a syringe
signs of digoxin toxicity
Halos, N/V, confusion, headache
normal range: 0.5-2.0
how should cyclosporine oral solution be stored?
tightly closed container protected from light
Fluphenazine decanoate
treats psychotic disorders
given IM or SQ every 1-6 weeks
onset: 24-96 hours
clients that need B12 supplementation
pernicious anemia
strict vegan diet
takes metformin
gastrectomy
chlorpromazine
antipsychotic
- dry mouth, leukopenia, pink urine
- takes at least 6 weeks to take effect
- no alcohol
- avoid driving until dose stabilized
what is commonly given to treat H. Pylori
antibiotics :
- clarithromycin
- amoxicillin
- tetracycline
- metronidazole
nystatin
antifungal agent in oral suspension
swish around mouth and swallow
ethacrynic acid
loop diuretic
- orthostatic hypotension
- take with meals to minimize GI upset
- increase K+ rich foods
chlordiazepoxide
antianxiety med
watch for lethargy and ensure safety!
statins
take at night use contraception NOT during pregnancy monitor liver function - blood work optimal cholesterol <200
trifluoperazine
antipsychotic medication
no breastfeeding
dry eyes, weight gain, EPS, urinary retention
hydralazine
take with food
talk to HCP about OTC meds
orthostatic hypotension
report any anorexia
carbidopa-levodopa
parkinson’s medication
take with low-protein to decrease GI upset
orthostatic hypotension
twitching eyelid - early sign of overdose
check with HCP with OTC meds and multivitamins - can reverse actions
ciprofloxacin
increase fluids - prevent crystalluria no mulitvitamin within 6 hrs dont take with milk or yogurt avoid sun avoid caffeine - increases caffeine effects
side effects of estrogen
changes in libido
change in weight
dry eyes
no smoking
medication treatment for multiple sclerosis
adrenocorticotropic hormone
cyclophosphamide - alopecia
chloral hydrate
sedative
can cause paradoxical excitation in children - closely monitor them
