Medications Pt 1 Flashcards
what are anticoagulants and what is it used for
heparin
enoxaparin
Warfarin
use to inhibit platelet clotting factor
used for:
- stroke
- heart failure
- heart valve disease
- coronary artery disease
- dysrhythmias, afib
- DVT
contraindications in anticoagulatns
coagulation disorder
peptic ulcer disease
malignancy
bleeding or recent trauma/surgery
pregnancy or lactating
used cautiously in those getting epidural analgesia
anticoagulants common side effects
bleeding fever heparin induced thrombocytosis anemia pain and bruising at the injection site
anticoagulants nursing consideration
treatment is effective when there is no emboli, stroke, MI
monitor for bleeding
- bleeding in urine
- dark tarry stools –> bleeding in stools
- decreased serum platelets and hct
wear a med bracelet
have bleeding precautions:
electric razor
soft toothbrush
let HCP know if: bleeding gums excessive bruising black, tarry stools bloody nose
ginger, gingko, garlic, ginseng, alfalfa, chamomile can interact with anticoagulants
vitamin C may prolong PT and vitamin E can increase Warfarin’s anticoagulation effect
you should consume foods high in Vitamin K:
green leafy vegetables
meats, fish, eggs, liver
if scheduled for a spinal or epidural procedure, you must check with HCP
Heparin antidote: protamine sulfate
Warfarin antidotes: Vit K, fresh frozen plasma
what are alpha 1 adrenergic blockers
Doxazosin
Tamsulosin
Prazosin
Terazosin
used alone or in combination
used to control blood pressure or treat symptoms associate with BPH
causes decreased blood pressure and the prostate and bladder neck to relax in BPH
alpha 1 adrenergic blockers contraindications
hypersensitivity to drugs within this class
if you are taking aninazolines
this could cross into breast milk and cause adverse effects in newborn
Doxazosin: should be used with caution in client’s with
- constipation
- Gi obstruction
- ileus
- liver impairement
Terazosin, Prazosin and Tamsulosin are contraindicated in clients:
- who have undergone cataract or galucoma surgery
- clients who has a history of angina, or orthostatis hypotension
alpha 1 adrenergic blockers common side effects
hypotension
dizziness
loss of muscle strength and energy
headache and edema
alpha 1 adrenergic blockers nursing considerations
before first dose, obtain:
- vitals
- HR
- fluid status
- weight
- BUN
- creatinine
administer first dose at bedtime because considered risk for falls
monitor: BP, pulse GI function liver function muscle strength fluid volume status
change positions slowly and consult with HCP before discontinuing
make lifestyle changes:
- management of weight
- increasing activity levels
- low sodium diet
what are ACE inhibitors and what is it used for
Captopril
Lisinopril
Enalapril
Ramipril
Captopril:
take on an empty stomach 1 hour before meals or 2 hours after meals
may be crushed
might experience loss of taste for 2-3 months so monitor nutritional intake
Lisionpril:
can take without regard to food
may be crushed
Enalapril:
cardio adverse reaction, especially when given parenterally
so monitor BP before and after
administered over 5 min
Ramipril:
can take without regard to food
can be mixed with juice, water, applesauce
used to control blood pressure
treat heart failure
prevent CVA, stroke
used as a kidney protect for those with diabetic nephropathy
ACE inhibitors contraindications
use with caution in clients with impaired renal function or renal artery stenosis
cross the placenta and causes severe fetal abnormalities and death
hypersensitivity reaction or those that use aliskiren
ACE inhibitors common side effects
persistent dry hacking cough hypotension rash hyperkalemia los of taste
rare: angioedema hepatotoxicity pancreatitis pancytopenia - lower than normal number of RBCs, WBCs, plts renal damage
ACE inhibitors nursing considerations
before first dose, assess if they have ever gotten ace inhibitor-induced angioedema (swelling of the face and tongue)
- if they have report to HCP immediately
baseline date:
- BP, pulse, rhythm, fluid, negative pregnancy test
- BUN, Cr, sodium and potassium
do not breastfeed and use barrier contraceptives if childbearing age
change positions slowly
avoid potassium supplements
if pregnany, disconitnus ACE inhibitors
persistent cough doesn’t mean that they should stop taking ACe inhibitors
OTC meds, cough, cold and allergy meds may exacerbate hypertension
lifestyle changes:
- manage weight, increasing activity, changing unhealthy dietary habits
what are ARBs and what is it used for
“sartans”
losartan
valsartan hydrochlorothiazide
Valsartan
used to control blood pressure and treat heart failure
used with clisent who cannot tolerate ACE inhibitors
ARBs contraindications
hypersensitivity reaction
cross the placenta and cause severe fetal abnormalities
ARBs common side effects
headache dizziness syncope weakness back pain tooth pain abdominal discomfort sxs of upper respiratory infection
ARBs nursing considerations
obtain baseline data:
- BP, pulse, weight, resp status
- GI function, liver function
labs:
- BUN
- liver function tests
- creatinine
needs to have negative pregnancy test
do not breastfeed and discontinue if pregnant
make lifestyle changes:
- weight management
- increasing activities
- low sodium diet
Anti Alzheimer’s Dementia Agents and what is it used for
- anticholinesterase inhibitors:
- prevent the breakdown of acetylcholine
- metabolized in the liver and excreted in the urine and feces
- Donepezil
- Galantamine
- Rivastigmine - NMDA receptor antagonists:
- decreasing the effect of glutamine
- minimal metabolism, excreted in urine
- memantine hydrochloride
used to slow the progression of Alzheimer disease
anti-alzheimers dementia agents contraindications
used with caution in clients with a history of :
- asthma
- COPD
- bradycardia
- bladder obstruction
- ulcer disease
Galantamine and Rivastigmine: not used in clients with low body weight
anti-alzheimers dementia agents commons side effects
headache insomnia generalized pain dizziness anorexia diarrhea
NMDA additional effects: hypertension and cough
overdose of anticholinestera drugs can lead cholinergic crisis
- nausea
- hypotension
- diaphoresis
- bradycardia
- seizures
- cardiac arrest
- muscle weakness
- resp depression
antidote for cholinergic crisis: atropine sulfate given IV
anti-alzheimers dementia agents nursing consideration
baseline data
- cognitive function
- vitals
- medical history
- allergy or severe renal disease with anticholinesterase inhibitors
first dosage should be lowest possible, then gradually increase
Donepezil: no regard to food and should be taken at night
Galantamine and Rivastigmine: should be given with meals
teach sxs on overdose
aminoglycosides and what is it used for
“mycin’
amikacin
gentamycin
tobramycin
antibiotics
treat gram negative aerobic bacillus
poorly absorbed in the GI tract, but rapidly absorbed after injection
excreted unchagned in urine
crosses the placenta and enter breastmilk
aminioglycosides contrainidications
hypersensitivity renal or hepatic disease preexisitng hearing loss herpes myasthenia gravis
parkinsons
breastfeeding
if used in pregnancy, can cause congenital defects
aminoglycosides common side effects
BLACK BOX WARNING: nephrotoxicity and irreversible ototoxicity
others:
- anorexia
- nausea
- vomiting
- diarrhea
- pain at injection site
aminoglycosides nursing considerations
get baseline data:
- renal, auditory and hepatic function
given for short period of time
monitor for sxs:
- tinnitus, vertigo, worsening infection
report any changes in bowel patterns, discomfort, tinnitus, or perceived changes to hearing
cephalosporins and what is it used for
1st:
cephalexin
2nd gen:
cefuroxime
3rd gen:
cefidinir
4th gen:
cefepime
they are antibiotics
1st gen: narro spwcturm 4th gen: broad spectrum that is effective against: - respiratory tract infections -skin and soft tissue infections -urinary tract infections
excrete in urine
cephalosporins contraindications
anaphylactic reaction to penicillin
caution should be used when administering to clients with renal impairment or:
- history of GI ulcer disease
- history of penicillin allergy
cephalosporins common side effects
oral or vaginal candidiasis diarrhea abdominal cramping serum sickness-like reaction - fever - arthralgia colitis -inflammation of the inner lining fo the colon
cephalosporins nursing consideration
baseline data:
- renal
- resp status
- vitals
- skin assessment
monitor for candidiasis or any bowel changes
complete full regimen
report candidiasis and persisitent diarrhea
fuloroquinolones and what is it used for
“floxacin”
ciprofloxacin
levofloxacin
moxifloxacin
antibiotics used to treat gram negative and gram positive bacteria that infect the: - lower respiratory tract - soft and skin tissues - urianry tract - STDs
effective against anthrax inhalations
fluoroquinolones contraindications
history of reaction to quinolones
under 18 years of age
caution when giving to:
- daibetes
- renal impairment
- rheumatoid arthritis
- prolonged QT intervals
- myasthenia gravis
fluoroquinolones common side effects
Gi distress
confusion
crystalluria
- crystals in the urine
colitis
photosensitivity
burning of the eyes and crusty discharge
BLACK BOX WARNING: tendonitis and tendon rupture
fluoroquinolones nursing considerations
superinfections, colitis, diarrhea
baseline data:
- hypersenstivity reaction
- impaired renal function or liver function
- EKG to rule out prolonged QT interval
during and after first dose, monitor for reactions
oral cipro and floxacin should be administered with a glass of water one hour BEFORE or 2 hours AFTER meals, antacids or supplements
monitor for muscle weakness or tendon swelling, gastric upset or photosensitivity
maintain hydration
report diarrhea, bloody stools, muscle weakness or tendon swelling
macrolides and what is it used for
“mycin” these are also mycin so don’t get it mixed up with aminoglycosides
azithromycin
clarithromycin
erythromycin
azithromycin:
used as prophylaxis for endocarditis in dental work and pulmonary exacerbations in cystic fibrosis
clrithromycin:
used as prophylaxis for endocarditis before dental work and pertussis and lyme disease
antibiotics
metabolized in the liver and excreted in urine
macrolides contraindications
history of hepatic impairment realted to aithromycin use
using lovastatin, simvastatin, ergotamine
caution in clients that have renal or hepatic impairment, liver disease, myasthenia gravis, prolonged QT interval
aluminum or magensium antacids can decrease absorptions
if they take calcium channel blockers or other meds that prolong QT intervals
macrolides common side effects
nausea vomiting diarrhea topical use: dry skin IV: pain and redness at injection site
clarithromycin: headaches and altered taste
macrolides nursing considerations
baseline data:
- history of reaction
- impaired renal function or liver function
- EKG to rule prolonged QT interval
monitor for reaction
- azithro and clarithro = can take without regard to food
monitor for GI upset, bowel patterns, liver function and pruritus
report: diarrhea
avoid aluminum and mangesium antacids
complete full course
penicilline and what is it used for
“cillin”
amoxicillin
ampicillin
penicillin
used to prevent or treat strep, syphilis, lyme
penicillin contraindications
history of penicillin related or cephalosporin related hypersensitivity
caution when administering to:
- renal or hepatic impairment
- seizure disorder
- asthma
- hypersensitvity to cephalosporins
penicillin common side effects
allergic reactions
renal, hepatic or hematologic abnormalities
nausea vomiting diarrhea lethargy electrolyte imbalances
penicillin nursing considerations
baseline data:
- electrolytes
- integumentary and liver/kdiney function test
-verify that a client does not have pre-existing penicillin or cephalosporin allergy
report diarrhea, topical rash or ecchymosis
tetracyclines and what is it used for
“cycline”
doxycycline
minocycline
used to treat respiratory infections, skin infections, syphilis, chlamydia and UTI
prophlyaxis for malaria
antibiotics
tetracyclines contrainidications
sulfite-related hypersensitvity
pregnant
children less than 8 years old
- cause permanent discoloration of teeth
caution should be used in clients with:
- candidiasis
- renal or hepatic or hematologic impairment
tetracylines common side effect
photosensitivity anorexia GI upset diarrhea renal, hepatic or hematologic abnormalities increase in intracranial pressure
tetracyclines nursing consideration
baseline data:
- culture and sensitivity test
- NO tetracycline and sulfite reaction
perform central nervous assessment
verficiation of pregnancy status
evaluate renal and hepatic function
monitor renal function and bowel patterns
teach about barrier contraceptives because there is a decreased effectivness in oral contraceptives
wear protective clothing in direct sunlight
avoid taking with antacids or iron supplements
complete full course
nitrates and what is it used for
isosorbide nitrate
nitroglycerine
anti-anginal
used to prevent and treat angina pectoris
work by relaxing and dilating blood vessels which reduce cardiac workload
cross the placenta and enter breast milk
nitrates contraindications
taking sildenafil, vardenafil, tadalafil
-within 24-36 hours of taking a nitrate
severe anemia
cerebral trauma or cerebral hemorrhage
caution in clients with:
- hepatice or renal impairment
- hypotension or hypovolemia
nitrates common side effects
headache dizziness syncope nausea vomiting hypotension reflex tachycardia increased angina
nitrates nursing considerations
baseline data:
- BP
- HR
- history of taking ergot derivatives or sildenafil, vardenafil, tadalfil
monitor for sxs of worsening or unrelieve angina, hypotension or reflex tachycardia
may suffer from headache and can take common pain relievers to treat headache
change positions slowly
keep fresh supply of nitroglycerin on hand
store tablets in an airtight, dark glass bottle with a metal cap
- loses its potency approx 3 months later
if 3 sublingual tablets taken over a 15 min time period do not relieve chest pain, then go to the hospital because it might be MI
anticonvulsants / antiseizure and what is it used for
phenytoin - Dilantin phenobarbital clonazepam diazepam ethosuximide valproic acid carbamezapine gabapentin
control epileptic seizures and treat neuropathic pain
treat migraine hedaches and bipolar disorder
anticonvulsants/ antiseizure contraindications
can cause significant birth defects
should not be used in pregnancy or lactation
caution with clients with:
- cardiac dysrhythmias
- liver impairment
- renal impairment
anticonvulsants/ antiseiures common side effects
phenytoin and phenobarbital:
- CNS depression
- depression
- confusion
- constipation
- loss of libido
- ataxia
- urinary retention
- dry mouth
- severe liver toxicity
- bone marrow suppression
succinimides have fever incidences of side effects
phenytoin:
- severe liver toxicity
- nystagmus and diplopia
- rash and gingival hyperplasia
- hirsutism
phenobarbital:
- dependence
- respiratory depression
valproic acid:
- severe liver toxicity
- pancreatitis
- teratogenicity
clonzapem and diazepam:
- dependence
carbamezapine:
- myelosuppression
- fluid overload
- diplopia
- rash
anticonvulsants / antiseizure nursing considerations
baseline data:
- neuro assessment
- history of reactions
- pregnancy/lactation status
- liver and renal function tests
monitor for reactions, therapeutic plasma levels, liver function and level of consciousness
avoid alcohol and other CNS depressants to reduce risks of CNS depression
use barrier contraceptives
avoid activity that require alertness
wear med alert bracelet
tricyclic antidepressants and what is it used for
amitriptyline
doxepine
imipramine
nortriptyline
metabolize in the liver and excreted in the urine
relieve depression and help treat OCD enuresis
tricyclic antidepressants contraindications
history of myocardial infarction or current MAOI use
pregnancy or lactation
used with caution if:
- history of galucoma
- enlarged prostate
- cardiovascular problems
- history of seizures
- liver or renal impairement
BLACK BOX WARNING: increased suicidal ideation, esp in children and adolescents
tricclic antidepressants common side effects
sedation drowsiness hallucinations difficulty concentrating ataxia sexual dysfunction loss of libido orthostatis hypotension dry mouth constipation nausea urinary retention
TCAs should be avoided for 24 hours after myelography due to interaction with the dyes
tricyclic antidepressants nursing considerations
baseline data
- reaction to TCAs
- BP
- pulse
- orientation
- affect
- BM patterns
monitor for adverse effects, suicial ideation and reactions to side effects
report any suicidal ideation
avoid alcohol and other CNS depressants
take at night
could take up to 4-8 weeks to seeeffectiveness
SSRIs and what is it used for
citalopram escitalopram fluoxetine paroxetine sertraline
antidepressants
treat moderate to severe depression and chronic fatigue symptoms
treat premenstrual dysorder:
- OCD
- panic disorder
- PTSD
- GAD
SSRIs contraindications
allergy to SSRIs
taking any type of MAOI
SSRIs common side effects
weight gain of 10 pounds or more
sodium level changes
loss of libido
sexual dysfunction
BLACK BOX WARNING: increased risk of suicidal ideation or attempts in children and adolescents
SSRIs nursing considerations
monitor for reactions, sodium changes and weight gain
report any suicidal ideation or homicidal ideation
- therapeutic effects may take up to 4 weeks of use
avoid alcohol
sertraline = drug of choice for treating depression in elderly
fluoxetine= better choice for children
citalopram, escitalopram, fluoxetine and sertraline
- increase the effects of digoxin, warfarin and diazepam
Sulfonylureas and what is it used for
1st gen:
chlorpropamine
2nd gen:
glimepiride
glipizide
glyburide
antidiabetics
to improve insulin availability for type 2 diabetes
decreases blood sugar levels
sulfonylureas contraindications
clients with:
- severe infection
- pregnancy
- lactation or severe renal impariment or liver impairment
should not be used with type 1 diabetes
hypersensitivity reaction
sulfonylureas common side effects
hypoglycemia related to the intended therapeutic action Gi upset headache dizziness nausea vomiting diarrhea
sulfonylureas nursing considerations
baseline assessment:
- blood sugar
- symptoms of nausea, vomiting, anorexia
teach about dietary habits
exercise
avoiding alcohol
should be used in conjunction with diet and exercise
metformin and what is it used for
treatment of type of diabetes
contraindicated during pregnancy, lactation, renal impairment or with pancreatic disease
metformin common side effects
headache weakness dizziness drowsiness agitation nausea vomiting diarrhea lactiac acidosis flatulence
metformin nursing considerations
typically taken 2 per day with food
can be crushed as long as they are not extended release
be aware of signs of lactic acidosis:
- hyperventilation
- fatigue, chillls
- sleepiness
acarbose and what is it used for
treat type 2 diabetes
dont use if client has a history of sulfonamide allergy
acarbose common side effects
abdominal pain
diarrhea
flatulence
rash
pioglitazone and what is it used for
treat type 2 diabetes
contraindicated in pregnancy, lactation, renal impairments or those with pancreatic disease
pioglitazone common side effects
cold symptoms headache sinusitis resp infection muscle pain tooth disorder
take med at saem time every day
need to have liver enzymes checked and have regular eye exams for macular edema
ma increase the risk of bone fractures and can exacerbate heart failure
stiglaptin and what is it used for
treat type 2 diabetes
contraindicated in pregnancy, lactation, renal impairment and those with pancreatic disease
stiglaptin common side effects
pancreatitis kidney problems upper respiratory infections headaches rhinitis sore throat
take immediately before meals
contact if you experience:
- pancreatitis
- persistent abdominal pain with or without vomiting
antidiarrheals and what is it used for
bismuth subsalicylate
loperamide
diiphenoxylate-atropine
antidiarrheals contraindications
experience bowel obstructions:
- leus
- megacolon
- abdominal distention
clients with PKU
caution with someone with hepatic impairmeent
pregnant or lactating
antidiarrheals common side effect
dark tint of the tongue or stool
- dont confuse this with black and tarry stools
antidiarrheals nursing considerations
baseline data:
- abdominal assessment
- history of bowel movement patterns
monitor for slowing or decrease in bowel movement
monitor for constipation or GI discomfort
clear liquid diet, or bland diet until diarrhea is resolved
report any blatoign, fever, or bloody stool
can cause Reye syndrome in children
dont give bismuth subsalicylate to children or teens
use of OTC antidiarrehals could mask a more serious condition
antidysrhythmics and what is it used for
class 1: sodium channel blocks:
- quinidine
- procacainamide
- lidocaine
- flecainide
- propafenone
class 2:beta blockers:
- brevibloc
- propanolol
class 3: potassium channel blockers:
- amiodarone
- ibutilide
class 4:calcium channel blockers:
- Diltiazem
- Verapamil
others:
- adenosine
- digoxin
antidysrhythmics contraindications
not clients with cradycardia
caution when giving to : bronchila asthma due to bronchospasms
antidysrhythmics common side effects
class 1 and 3= prolonged QT intervals which leads to torsades de pointe
bradycardia
hypotension
ECG changes
antidysrhythmics nursing considerations
conitnuous EKG monitoroing
change positions slowly and report any palpitations, shortness of breath, dependent edema
antiemetics and what is it used for
meclizine metoclopramide prochlorperazine promethazine ondansetron
used to manage nausea and vomiting
antiemetics contraindications
pregnancy or lactation
receiving chemotherapy
injectable dolsetron should NO LONGER be used to prevent chemotherapy induced nausea and vomiting
antiemetics common side effects
metoclopramide: restlessness lasstiude headache sleeplessness dry mouth anxiety
prochlorperazine: orthostatic hypotension blurred vision dry eyes dry mouth constipation photosensitivity
promethazine: constipation urianry retention dry mouth hyperglycemia
antiemetics nursing considerations
baseline data monitor side effects refrain from acitvities that require alertness avoid alcohol and CNS depressants change positions slowly monitor bowel patterns
metoclopramide:
- used with tube feedings
- take 30-60 minutes before meals and medical procuedures
- IV administration should be injected slowly over 1-2 minutes or infused over 15 min
- monitor for tardiv dyskinesia
Prochlorperazine:
- monitor for development of neuroleptic malignant syndrome
- erythrocyte and liver functions tests should be tested
- inject slowly, deep into gluteal muscles
- remain lying down for 30 minutes
- if taken PO, then take it with food
- wear sunscreen or protective clothing to prevent photosensitivity reactions
antihistamines and what is it used for
1st gen:
hydroxyzine
diphenhydramine
2nd gen:
cetirizine Hcl
fexofenadine
loratidine
used to treat allergic reactions
antihistamine contraindications
pregnant or lactating
caution if history of liver impairment or renal impariemnt
or cardiac dysrhythmias
antihistamine common side effects
!st gen:
drowsiness and sedation
2nd gen:
sedation
dry mucous membranes
antihistamine nursing considerations
baseline data
monitor for dizziness, drowsiness and dry mucous membranes
avoid activities that require mental alertness
avoid alcohol and other CNS depressants
maintain adequate hydration
-may benefit from hard candy to alleviate dry mouth
antineoplastics and what is it used for
methotrexate
tamoxifen
treat various solid tumors, lymphomas and leukemias
antineoplastic common side effects
nausea vomiting diarrhea altered taste alopecia ulcerative stomatitis bone marrow suspension increased uric acid
tamoxifen linked to irreversible visual changes and temporary vaginal bleeding
antineoplastic nursing considerations
assess bone marrow suppression, renal or liver impairment
pregnancy or lactation
methotrexate will terminate pergnancy and stimulate abortion
limit exposure to these meds
avoid peopel with contagious infections
avoid med that could thin their blood
methotrexate can lead to pulmonary toxicity
- dry, unproductive cough
tamoxifen linked to irreversible changes in vision
- instruct to notify HCP if they notice changes in visual acuits
vaginal bleeding, pruritus or hot flashes = reversible after the med is discontinued
antiparkinsonism agents and what is it used for
carbidopa and levodopa
rasagiline
levodopa
relieve manifesation of PArkinson’s disease
antiparkinsonism agents contraindications
have angle closure glaucoma
linked to melanoma in clients with skin lesions
caution when clients have: cardiac conditions, asthma, psychiatric disorders
antiparkinsonism common side effects
agitation dry mouth urinary retention cardiac dysrhythmias abnormal breathing patterns headache malaise confusion ataxia
antiparkinsonsim nursing considerations
monitor hepatic and renal function, CBC AST ALT bilirubin alkaline phosphataste LDH
not effective with neural deterioration
antiplatelet and what is it used for
aspirin
clopidogrel
dipyridamole
crosses into the breastmilk
antiplatelet contraindiciations
history of bleeding disorder
active bleeding disorder
recent surgery
history of stroke
antiplatelet commone side effects
bleeding bruising headaches weakness GI upset skin rash
antiplatelet nursing considerations
baseline assessment
monitor for bleeding
bleeding precautions are necessary
make sure not to use when going into surgery
use with caution if dizziness occurs while ambulating
antipsychotics and what is it used for
typical:
haloperidol
chlorpromazine
atypical:
clozapine
risperidone
ziprasidone
treat acute and chronic psychosis
used for:
- tourettes
- substance abuse
- stuttering
- OCD
- PTSD
- depression
- bipolar disorder
- personality disorders
antipsychotics contraindications
those with CNS depression cardiac dysrhythmias blood dystocia Parkinsons elderly dementia
caution if:
- benign prostate enlargement
- glaucoma
- peptic ulcer disease
- bowel obstruction
lowers seizure thershold
should NOT be given within 24-48 hours of myelography due to neuron interaction with dye
BLACK BOX WARNING:
increase the risk of death for elderly people with dementia-related psychosis
antipsychotics common side effects
drowsiness sedation vertigo headache visual disturbances
Haloperidol, Zipradisone, Risperidone = linked to tardive dyskinesia
- repetitive jerky movements
cog-wheel rigidity drooling shuffling gait dystonia akathisia muscle rigidity
neuroleptic malignant syndrome:
- muscle rigidity
- altered mental condition
- decreased level of consciousness
antipsychotics nursing considerations
baseline data:
BP, neuro status, history of reaction
cardiac dysrhythmias, resp status
seizure disorder, glaucoma, recent myelography
monitor for pseudoparkinsonism symptoms
avoid alcohol and other CNS depressntans
protect from sun exposure and change positions slowly
antitubercular and what is it used for
isoniazid
rifampin
pyrazinamie
used to treat TB
prophylaxis for people who live with someone who was diagnosed with tB
antituberculer contraindications
history of reaction
severely impaired renal or liver function
antitubercular common side effects
CNS: dizziness headache drowsiness hallucinations peripheral neuropathy
GI: anorexia nausea vomiting abdominal pain
body secretion may become orange and could stain their clothes and contact lens
- not an indication to stop treatment
antitubercular nursing considerations
assess baseline liver, kidney and reaction
monitor for reaction
avoid alcohol and must have monthly liver tests
reinforce teaching about liver impairment - yellow eyes and skin nausea, vomiting - anorexia - dark urine - unusual tiredness or weakness
if client cannot tolerate med or infection is not responding, then do second-line drug
must take med for 6 months or longer, making adherence a real problem
antiulcer meds and what is it used for
proton pump inhibitors:
lansoprazole
omeprazole
H2 receptor blockers:
cimetidine
famotidine
antacids:
sodium bicarbonate
GI protectant:
sucralfate
used to treat and prevent peptic ulcer disease and gastric hypersecretion
manage symptoms of GERD
treat recurrent gastric and duodenal ulcers caused by Helicobacter pylori
antiulcer contraindications
pregnancy or lactation
hepatic or renal impariment
antacids
antiulcer common side effects
headaches nausea vomiting diarrhea constipation flatulence
cimetidine: confusion and cardiac dysrhythmias
- often associated with impaired absorption and slowed metabolism of other medications
timing of med and food is important
with antacids = acid rebound is a concern because it produces more acid
antiulcer nursing considerations
baseline assessment:
- electrolytes
- bowel assessment
- renal function tests
- liver function tests
if severe liver impairment
- nizatidine is often used since it is not metabolized in liver
change positions slowly
maintain adequate hydration
continued and prolonged use of these meds may mask severe condition
antivirals and what is it used for
acyclovir
oseltamivir phosphate
valacyclovir HCl
manage to treat viral infections like: HIV herpes cytomegalovirus viral pneumonia measles, mumps influenza
antivirals contraindications
caution in clients with renal impairment
oseltamivir = NOT used during pregnancy or lactation
Zanamivir = NOT recommended for clients with asthma or COPD due to risk of serious and fatal bronchospasms
- those who are allergic to milk proteins or lactose should not use this drug
antiviral common side effects
with all of them: headache dizziness nausea vomiting
acyclovir:
peripheral neuopathy
thrombocytopenia purpura
liver damage
oseltamivir phosphate: fatigue couhg othostatic hypotneison insomnia urinary retention
valacyclovir HCL:
diarrhea
abdominal cramps
rash and fatigue
antiviral nursing considerations
works best when started with 2 days after client becomes sick
- will not CURE the disease
baseline data:
- reaction
- pregnancy status
- renal function
monitor adverse effects
increase fluid intake
if for viral sexual transmited: then avoid sex while lesions are visible, not opne, but VISIBLE
benzodiazepines and what is it used for
alprazolam
chlordiazepoxide
diazepam
lorazepam
used to treat anxiety disorder, panic disorder, preoperative anxiety and alcohol withdrawal
benzodiazepines contraindications
pregnancy psychosis narrow angle glaucoma coma acute alcohol intoxification shock
caution when given to clients of adnvaced age and impaired renal or liver function
lowest possible dose you could give
benzodiazepines common side effects
drowsiness light-headedness lethargy hypotension GI upset dry mouth constipation hypotension resp distress dysrhythmias palpitation cardiac arrest confusion
abruptyl discontinuing these meds will cause withdrawal syndrome
- nausea
- headahce
- night tremors
benzodiazepines nursing considerations
adequate liver and renal function
pregnant
vitals
elderly increased risk for falls
better for intermittent or short-term
can have tolerance and develop addition
-symptoms of depression or suicidal behavior may worsen
avoid acitivites that require mental alertness
if at home, meds should be kept ina s afe place away from children and adolescents
beta adrenergic blockers and what is it used for
beta 1 selective:
atenolol
metoprolol succinate
meotprolo tartrate
nonselective beta blockers:
propanolol HCl
long term treatment of hypertneion, dysrhythmias
angina
can also treat galucoma,
prevent infarction and prevent migraine headaches
beta adrenergic blockers contraindications
bradycardia
pregnancy or lactating
diabetes or thyroid disease
caution when given to clients with hisotry of chronic illness
caution with client that suffer from resp illness and heart failure
beta adrenergic blockers common side effects
metoprolol succinate/tartrate: bradycardia palpitations nausea vomiting diarrhea hypotension heart failure depression insomnia dizziness and confusion
propanolol HCl: headache weakness hypotension bronchospasm bradycardia insomnia depression
beta adrenergic nursing consideration
hx of reaction pulse resp assessment vital signs of heart failure
contact HCP before discontinuing med
= abrupt withdrawal can cause severe exacerbation of angina, heart attacks, or sudden death
teach how to accurately assess and monitor heart rate using radial pulse - different than apical pulse
- if below 50 then don’t take med and contact HCP
metoprolol succinate/tartrate:
check clients apical pulse
- if its less than 60/min, nurse should hold med and contact HCP
- should not use OTC meds unless told by HCP
- report dyspnea to provider
propanolol Hcl:
check apical pulse
- if less than 60 then hold
- should take with full glass of water at same time each day
- med should not be opened, chewed or crushed
- dont use an antacid that contains aluminum
