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Emergency Room Common Meds > Meds > Flashcards

Meds Flashcards

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1
Q

Morphine

A

Class: Opioid agonist

Use: Produces analgesia, respiratory depression,euphoria, sedation

Onset IV: <5 min
Peak IV: 20 min

Action: Acts on the mu receptors and to a lesser degree the kappa receptors

Adverse Effects: respiratory depression, constipation, orthostatic hypotension, urinary retention

Nursing Considerations: assess pain level on a regular basis

  • take baseline vital signs and monitor them periodically
  • double check opioid doses with another nurse prior to administering them
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2
Q

Ceftriaxone IV/IM (ROCEPHIN)

A

Class: Cephalosporin 3rd generation

Good for gram positive or some gram negative, *great CNS penetration (crosses blood brain barrier)

Action: destroy bacterial cell walls

Adverse Effects: -allergies, anaphylaxis
-may increase bleeding tendencies

Nursing Considerations:

  • given IM or IV
  • do NOT give to neonates due to bilirubin/albumin binding
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3
Q

Azithromycin IV/PO (ZITHROMAX)

A

Class: Macrolide antibiotic

inhibit microorganism growth *can cover “atypical” organisms

Action: inhibit protein synthesis of microorganisms
*(binds to the ribosome of the bacteria so it can’t do protein synthesis)

Adverse Effects:

  • GI discomfort
  • prolonged QT intervals (cardiac)

Nursing Considerations:
used for clients who have a penicillin allergy

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4
Q

Metronidazole IV/PO (FLAGYL)

A

Class: antiprotozoals antibiotic

Treatment of protozoal infections (intestinal amebiasis)

Action: nucleic acid synthesis inhibitor

Adverse Effects:

  • GI discomfort
  • metallic taste

Nursing Considerations:

  • severe reaction with alcohol!
  • use condoms if treating for STD and finish entire course of medication
  • drug interactions
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5
Q

Amoxicillin PO

A

Class: broad spec. antibiotic

Use: Treats infections due to gram positive and gram negative bacteria

Action: destroys cell walls of bacteria

Adverse Effects: allergies, diarrhea

Nursing Considerations:

  • take with meals
  • watch for interactions with oral contraceptive use
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6
Q

Amoxicillin/Clavulanic acid PO (AUGMENTIN)

A

Class: Broad-spectrum antibiotic

Use: Treats infections due to gram-positive and gram negative cocci (helps with amoxicillin resistance)

Action: destroys the cell wall of bacteria

Adverse Effects:

  • -allergies, anaphylaxis
  • diarrhea

Nursing Considerations:

  • take medication with meals,
  • report any signs of allergies right away,
  • complete entire course of therapy
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7
Q

Doxycycline IV/PO (VIBRAMYCIN)

A

Class: Tetracycline broad-spectrum antibiotic

Covers both gram pos and gram neg bacteria such as chlamydia

Action: inhibit protein synthesis of microorganisms

Adverse Effects:

  • GI discomfort
  • hepatotoxicity
  • photosensitivity (intense sunburn)

Nursing Considerations:
monitor for nausea, vomiting, diarrhea
-binds to cations; separate 2 hrs from any cation ingestion
wear sunscreen

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8
Q

Enoxaparin (LOVENOX) SC

A

Class: anticoagulant

Action: inactivates factor Xa

Adverse Effects:

  • bleeding
  • heparin induced thrombocytopenia

Nursing Considerations:

  • cautious in pts with renal dysfunction b/c of elimination
  • less protein binding

Onset: 3-5 hours
Duration: 12 hours

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9
Q

Aspirin PO/PR

A

Classification: Nonopioid Analgesics, anti platelet agent

Use: inflammation suppression, Analgesia for mild/moderate pain, fever reduction

Onset PO: about 30 min
Duration PO: 4-6 hours

Action: COX1 and COX2 inhibitor

Adverse effects and rxns: GI, Impaired kidney function (decreased urine output, increased BUN and creatinine levels), Salicylism (tinnitus, sweating, headache, dizziness, respiratory acidosis)

Nursing considerations:

  • Aspirin toxicity should be managed as a medical emergency, activated charcoal given to decrease absorption
  • Reverse acidosis and promote salicylate excretion with bicarbonate
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10
Q

Sulfamethoxazole/Trimethoprim PO/IV (BACTRIM or SEPTRA)

A

Class: Sulfonamide Antibiotic
effective against gram positive and gram negative

Action:

  • metabolism inhibitor (folate antagonist)
  • bacteriostatic

Adverse Effects:

  • hyperkalemia
  • thrombocytopenia, neutropenia, megaloblastic anemia
  • renal dysfunction; potassium sparing diuretic

Nursing Considerations:
drug interactions with Warfarin (increasing levels)!!!

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11
Q

Furosemide IV/PO

A

Class: Loop Diuretic

Action: inhibit sodium, potassium, and chloride reabsorption in the loop of henle in the kidney to decrease water retention

Duration: 2 hours

AE: hypokalemia, hypotension, dehydration
*good for pt with kidney disease

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12
Q

Metoprolol PO/IV (LOPRESSOR)

A

Class: Beta Adrenergic Blocker

Onset: 20 min IV, 1-2 hr PO
Duration 3-6 hr PO, 5-8 hr IV

Action:

  • decreases cardiac output
  • suppresses reflex tachycardia caused by vasodilators
  • reduces release of renin (in kidneys, reduces the RAAS system input)
  • lowers HR
  • long term use reduces peripheral vascular resistance

Adverse Reactions:
bradycardia, heart block, bronchoconstriction

Nursing Considerations:
monitor heart rate
-watch for patients with asthma, COPD

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13
Q

Magnesium Sulfate IV

A

Class: IV electrolyte replacement therapy, antidyssrhythmics

helps treat hypomagnesemia, preeclampsia (by depressing the CNS) and eclampsia, migraines, status asthmatics
Slows rate of SA node impulse formation in myocardium and prolongs conduction time

Nursing Considerations:

  • use w caution in renal dysfunction
  • monitor pts cardiac and neuromuscular status

Give over 15 min for asthma, 1 hour for electrolyte replacement

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14
Q

Potassium Chloride IV

A

Class: electrolyte replacement
Helps reverse hypokalemia

Adverse Effects:
PO: GI effects- nausea, vomiting, diarrhea, abdominal discomfort, esophagitis (should give w food
and lots of water)

IV: can cause local irritation and pain

Nursing Considerations:

  • watch serum potassium levels, monitor for signs and sx of hyperkalemia
  • watch IV site
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15
Q

Calcium Chloride IV

A

Class: electrolyte replacement
more elemental calcium than gluconate
1 g of chloride= 3 g of gluconate

Helps with calcium replacement and also hyperkalemia

Adverse Effects:

  • more caustic to the vasculature than gluconate
  • should be administered centrally (central not periph line)

Nursing Considerations:
-hyperkalemia- 10-30 min, 1g/hr

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16
Q

Calcium Gluconate IV

A

Class: electrolyte replacement
Helps with calcium replacement

Nursing Considerations:

  • peripheral administration
  • hyperkalemia- 10-30 min, 1g/hr
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17
Q

Dextrose 50% IV

A

Class: electrolyte replacement; concentrated dextrose
“ATP pump booster”
Helps treat hyperkalemia

Action:
Treatment of diabetes and hyperkalemia, essential for cellular uptake of glucose
*cells can grab the glucose and the pumps can work to rid the K from ECF back to the ICF

Nursing Considerations:
Monitor BG

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18
Q

Insulin (Regular) IV/SC

A

Class: Class: electrolyte replacement; concentrated dextrose
“ATP pump booster”
Helps treat hyperkalemia

Action:
Treatment of diabetes and hyperkalemia, essential for cellular uptake of glucose
*cells can grab the glucose and the pumps can work to rid the K from ECF back to the ICF

Adverse Effects:
can accumulate in renal dysfunction

Nursing Considerations:
Monitor BG

19
Q

Amitriptyline

A

Class: Tricyclic antidepressant

Action: Blocks neuronal reuptake of NE and serotonin

AE: orthostatic hypotension, sedation, anticholinergic effect, cardiac toxicity, seizures

20
Q

Heparin

A

Class: anticoagulant

Action: inactivates thrombin & factor Xa

Adverse Effects:

  • bleeding
  • heparin-induced thrombocytopenia

Nursing Considerations:
unpredictable bioavailability, short half life, monitor labs aPTT

21
Q

Labetalol (IV)

A

Class: Combination Beta & Alpha Blocker hypertensive agent

Action:

  • decreases cardiac output
  • suppress reflex tachycardia caused by vasodilators
  • reduces release of renin
  • long term use reduces peripheral vascular resistance

Adverse Reactions:
-bradycardia, heart block, bronchoconstriction

Nursing Considerations:

  • monitor heart rate
  • watch for patients with asthma, COPD
22
Q

Nitroglycerin

A

Class: Organic nitrate

Action: Dilates veins and decreases venous return (preload) which decreases oxygen demand

AE: drug interactions; phosphodiesterase Type 5 inhibitors

  • tolerance can occur rapidly (1 day)
  • related to depletion of sulfahydryl groups
23
Q

Clopidogrel

A

Class: Antiplatelet agent

Action: PG2 Y12 receptor antagonist (antiplatelet agent); prevents ADP stimulated platelet aggregation

AE: -irreversible antiplatelet effect
-bleeding, TTP, drug interactions with proton pump inhibitors

*pro-drug

24
Q

Atropine

A

Class: Muscarinic antagonist

Action: Blocks Ach binding to muscarinic receptor
-used to treat symptomatic bradycardia, decrease secretions, use to dilate pupils

AE: tachycardia, drying, constipation

25
Q

Alteplase

A

Class: Fibrinolytic agent

Action: Tissue plasminogen activator (used for STEMI, stroke, PE, restore patency to catheters)

Clot buster

26
Q

Lidocaine

A

Class IB sodium channel blocker

Action: Slows cardiac conduction velocity via blockade; decrease electrical conduction, increase rate of repol, decrease automaticity

AE: short term use for ventricular dysthythmias
-AE: CNS- drowsines, AMS, paresthesias, seizures, hypotension, CV collapse

*first pass effect when given orally

27
Q

Amiodarone

A

Class III; prolong action potential and prolong refractory period

Action: prolongs the action potential and refractory period due to K channel blockade
-used for atrial and ventricular dysrhythmias

AE: pulmonary fibrosis, cardiac sinus bradycardia, decreased contractility, hepatotoxicity, ophthalmic, dermatologic
oral and IV; CP450 DRUG INTERACTIONS!

28
Q

Prednisone

A

Class: Corticosteroid

Action: Interrupt inflammatory process via: -inhibit synthesis of mediators (i.e. prostaglandins, leuks, histamines)

  • suppress infiltration of phagocytes
  • suppress proliferation of lymphocytes

AE: adrenal insufficiency (you will be overly stressed, so you will lack the stress response once you actually get stressed), osteoporosis, infection, glucose intolerance, myopathy, fluid and electrolyte abnormalities, growth retardation, psychological disturbances, cataracts and glaucoma, peptic ulcer disease

  • do not take NSAIDs with this or anticoagulants
  • do not stop abruptly, watch for thrush
29
Q

Methylprednisone (IV)

A

Class: Corticosteroid

Action: Interrupt inflammatory process via: -inhibit synthesis of mediators (i.e. prostaglandins, leuks, histamines)

  • suppress infiltration of phagocytes
  • suppress proliferation of lymphocytes

AE: adrenal insufficiency (you will be overly stressed, so you will lack the stress response once you actually get stressed), osteoporosis, infection, glucose intolerance, myopathy, fluid and electrolyte abnormalities, growth retardation, psychological disturbances, cataracts and glaucoma, peptic ulcer disease
*same precautions as prednison

30
Q

Naloxone

A

Class: opioid antagonist

Action: complete or partial reversal of opioid depression (including resp depression)

AE: tachycardia, pt will experience pain again because the pain meds wore off

31
Q

Ondansetron

A

Zofran! v effective for chemo induced vomiting
Class: serotonin antagonist

Action: Blocks 5HT3 receptors in CTZ & afferent vagal neurons in the upper GI tract

AE: QTC prolongation, HA, dizziness, lightheadedness

32
Q

Promethazine (Phenergan)

A

Phenergan
Class: phenothiazin

Action: Blocks dopamine receptors in CTZ

AE: respiratory depression, sedation, local tissue injury w extravasation, EPS

33
Q

Metoclopramide PO/IV (REGLAN)

A

Reglan

Class: Prokinetic/Dopamine Antagonists

Action: Controls N/V by blocking dopamine and serotonin receptors

  • augments action of acetylcholine, which increases GI motility
  • good for gastroparesis

AE: contraindicated in clinical w GI perforation, bleeding or obstruction, can cause diarrhea and tardive dyskinesia (EPS)

34
Q

Lactulose PO/PR

A

Class: Osmotic laxative; -semisynthetic disaccharide
(galactose and fructose)

Action: Metabolized by colonic bacteria to lactic, formic, and acetic acids

  • also used for hepatic encephalopathy
  • acids exert mild osmotic action
  • effect in 1-3 days

AE: sig flatulence and cramping

35
Q

Diphenhydramine PO/IV (Benadryl)

A

Class: First Generation Antihistamine
use for allergic runs, sleep, motion sickness, common cold

Action: antihistamine; H1 blocker

AE: sedation, more readily crosses BBB, dry mouth, constipation, CNS, dizziness, incoordination, confusion, fatigue, CNS stimulation, resp depression, severe local tissue injury

*injectable, oral, topical
Adult dose= 6.25-50 mg IV/PO Q4/6 hrs PRN

36
Q

Epinephrine IV/IM

A

Class: Sympathomimetic (Adrenergic agent)

Action: increases BP, HR, air movement via stimulating B1, B2, alpha receptors (alpha stimulates periphery, B1 heart, B2 lungs)

AE: HTN, dysrhythmias, angina, necrosis, hyperglycemia (activates beta receptors), 1:1000, 1:10,000, wheezing, SOB

SYRINGE OF EPI ONLY GOES INTO A PATIENTS IV IF THEY ARE DEAD. IM or SQ if they are alive (1:1000)

37
Q

Acetaminophen

A

Class: non opioid analgesic

Action: reduction of pain and fever

AE: hepatotoxicity, hypersensitivity

38
Q

Ibuprofen

A

Class: non opioid analgesic
NSAID

Action: reduction of pain and fever

AE: ulcerations

39
Q

Ketorolac (TORADOL)

A

Class: non-opioid analgesic

Action:

AE:

40
Q

Oxycodone/Acetaminophen (PERCOCET)

A

Class: opioid analgesic

Action:

AE:

41
Q

Fentanyl

A

Class: opioid analgesic

Action:

AE:

42
Q

Hydromorphone (DILAUDID)

A

Class: opioid analgesic

Action: pain relief for about an hour

AE:

43
Q

Tramadol (ULTRAM)

A

Class: opioid analgesic

Action:

AE:

Emergency Room Common Meds (1 decks)

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