Meds Flashcards
ditiazem (Cardizem)
special uses
Calcium Channel Blocker
for A Fib, A Flutter and SVTs
in addition to Angina and HTN
same s/e, and N/I as other CCBs
Calcium Channel Blockers
Use: Angina HTN
Caution: use with Digoxin & BB
Contraindicated: HF, H Block or Brady
No grapefruit juice
S/E: Constipation, Peripheral edema, reflex Tachycardia
N/I: IV inject over 2-3min
Taper doses
Monitor HR and BP
Verapamil (Calan)
special uses
Calcium Channel Blocker
For A Fib, A Flutter and SVT
Captopril (Capoten)
special directions
ACE Inhibitor
Take 60 min before meals
ACE Inhibitors and ARBs
Antihypertensive, HF, MI, Diabetic Nephropathy
N/I-Monitor BP and K+ levels
S/E: -orthostatic hypotension
- avoid hot tubs, saunas
- *angioedema (adm. epi)
- avoid use in 2nd and 3rd trimerster
- *persistent dry cough
Metronidazole (Flagyl)
reduces intestinal bacteria
Neomycin (Oral)
reduces intestinal bacteria
spironolactone (Aldactone)
Diuretic Aldosterone antagonist decreases K+ excretion (hyperkalemia) increases Na+ excretion (hypernatremia) Steven Johnson syndrome Metabolic Acidoses
Lactulose (Chronulac)
hyperosmotic laxative/
ammonia de-toxicant (hepatic enceph)
Hypernatremia
Hypokalema
Alpha 2 Agonist Clonidine Guanfacine Methydopa reduces vascular resistance, HR, and BP
Use: Primary HTN - (may be used with other anti-HTN and diuretics) HTN crisis, severe cancer pain
do not use with: anticoagulations, hepatic failure, MAOI’s, lactation
S/E: Dry mouth
rebound HTN (don’t stop abruptly)
**Black/sore tongue
**leukopenia
N/I: CNS side effects
CBC, HR, BP
use at bedtime
notify if involuntary jerky movement,
prolonged dizziness, rash
Alpha Adrenergic Blockers
-osin
Block receptors
Use: Primary HTN
-increased risk of HTN and cyncope if
w/other anti-HTNs, BB or diuretics
-watch INSAIDs, may reduce effect of prazosin
S/E - dizziness/fainting
N/I:- monitor HR & BP
–take at bedtime to reduce s/e of
HypoTN
-not OTC meds unless dr approved
methyldopa (Aldomet)
special precautions
Alpha 2 Agonist
do not administer in IV line with
barbiturates or sulfonamides
Vancomycin
Toxic to Vessels
Red Man’s Syndrome is common (flushing/Upper body puritis)
Rapid Acting Insulin
Drug name
Onset
Peak
DurationDrug name: Lispro (Humalong)
Onset: <15 min
Peak: 0.5- 1 hr
Duration: 3-4 hr
Short Acting Insulin
Drug name
Onset
Peak
DurationDrug name: Regular (Humalin R)
Onset: 0.5- 1 hr
Peak: 2-3hr
Duration: 5-7hr
Intermediate Insulin
Drug name
Onset
Peak
DurationDrug name: NPH ( Humalin N)
Onset:1-2hr
Peak: 4-12hr
Duration: 18-24
Long Acting Insulin
Drug name
Onset
Peak
DurationDrug name: I glargine
Onset: 1hr
Peak: none
Duration: 10.5-24hr
Which Insulin can be given in IV form?
Regular
When mixing Regular insulin with NPH, in what order do you inject air and draw up the insulin?
Air: NPH -> Regular
(Cloudy -> Clear)
Draw: Regular -> NPH
(Clear -> Cloudy)
Heparin
Class
Administration
Precautions
Labs
Antidote
Anticoagulant
Give IV or SubQ
Rotate injection sites
Avoid NSAID, Aspirin, Salicylate
Monitor PTT every 4-6hr
Norm- 16-40
Therapeutic 1.5-2.5 X normal
Alert if >100
PROTAMINE SULFATE
Warfarin (Cumadin)
Class
Administration
Precautions
Labs
Antidote
Anticoagulant
Oral
Avoid NSAID, Aspirin
Monitor INR every 4-6hr
Therapeutic 2-3
VITAMIN K
Dabigatran (pradaxa)
Class Administration Precautions
Anticoagulant
Oral
Avoid NSAID, Aspirin
Must discontinue Warfarin before starting
Discontinue 1-2 days before sx if possible
Thronbolytics
alteplase (Activase tPA) tenecteplase (TNKase) reteplase (Retavase)
When is use contraindicated
What is the time limit for tPA
Contraindicated for intracranial hemorrhage, active bleeding, aortic dissection, brain tumor of if they have had head trauma or CVA within the last 2 months
tPA within 4-6hr of onset of s/s
Adverse GI effects of antacids
Other meds should be taken 1hr before or after antacid
Aluminum hydroxide
constipation
hypophosphatemia
Magnesium hydroxide (milk of mag)
diarrhea
hypermagnesemia
renal impairment
Sodium Bicarbonate
Constipation
proton Pump Inhibitors
Take on empty stomach 30-60min before meal
Omeprazole (Prilosec)
May increase Digoxin level
Risk of infection, caution w/COPD
esomeprazole (Nexium)
Take on empty stomach 30-60min before meal
H2 receptor antagonists
Zantac
famotidine (Pepcid)
cimetidne ( Tagament)
may cause toxicity with warfarin, phenytonin, lidocaine
Tagament increases risk of infection, caution w/COPD
Mucosal Protectors
Sucrafate (Carafate)
Adheres to ulcer, protects up to 6hr
Give 1hr before meal
promethazine (Phenergan)
Side effects
Nursing interventions
Drowsy
Anticholinergic effects
EPS
Potentiates effect of narcotic
Monitor VS, toxic to vessels, can give IM in large muscle
metoclopramide (Reglan)
Side effects
Nursing interventions
Drowsy Anticholinergic effects EPS Tardive dyskanesia Restlessness
Teach about rapid GI emptying
Discontinue w/ signs of EPS
ondansterone (Zofran)
Side effects
Nursing interventions
Headace
EPS
Administer 30min prior to chemo and 1-2hr prior to radiation
Scopolamine (sea sickness ear sticker)
Side effects
Nursing interventions
Blurred vision
Sedation
Anticholinergic effect
Apply behind ear
Use lubrication eye drop
Don’t use with angle- closure glaucoma
Loop and Thiazide Diuretics
Loop Thiazide
Lasix Duril
Bumex Hydroduril
Hypovolemia Ototoxity Hypo K+ Hypo Na+ Hyperglycemia Digoxin toxicity (w/ Hypo K+) Lithium toxicity
Alpha- Adernergic Blockers for Urinary Retention
bethanechol (Urechiline)
bethanechol (Urechiline)
Helps bladder tone for urinary hesitation (strong start)
DON’T give IM or IV
Give on empty stomach
S/E excessive salivation and tearing
Alpha- Adernergic Blockers for Urinary Retention
tamsulosin (Flomax)
tamsulosin (Flomax)
Improves urine flow with BPH
Must rule out bladder cancer first
Take 30min after meal
Take same time each day
S/E decreased libidoAntibiotics
Aminiglycosides
Vancomycin
Gentimicin
Uses
S/E
labs
Therapeutic rangesSepticemia, Meningitis, pneumonia
high risk for ototoxity
nephrotoxicity
monitor Creatinine and BUN
Peak and Trough levels
Gentamicin therapeutic 4-12
Vancomycin 20-40
Antibiotic
Cephalosporins
Keflex
claforan
Uses
S/E
URI, UTI
Causes sensitivity with penicillins
monitor for C-Diff
Antibiotic
fluroquinolones
Cipro
Levaquin
Uses
S/E
Bronchitis, Chlamydia, gonorrhea, UTI, pneumonia, sinusitis
Caution with hepatic, renal, or seizure disorders
Antibiotic
Macrolides
Zthromax
Biaxin
Erythromycin
Uses
S/E
URI, sinusitis, whooping cough, chlamydia
Used if allergic to PCN
Give with meals
Antibiotic
Nitrofurantoin
macrodantin
Uses
S/E
UT
Broad spectrum
Urine will be brown
Don’t give with renal dysfunction
Antibiotic
Penicillins
Amoxil
Omnipen
Uses
S/E
Pnuemonia, septicemia, URI, endocarditic, rheumatic fever, GYN infection
hypersensitivity with possible anaphylaxis
Antibiotic
Sulfonamides
Bactrin
Septra
Uses
S/E
UT, bronchitis, otitis media
Drink 3L of water/day
Avoid sun exposure
Use back up contraceptives
Antibiotic
Tetracyclines
Vibramycin
Sumycin
Fungal, bacterial, protozoal, rickettsial, infection
Permanent tooth discoloration in children under 8
Drink 3L of water/day
Avoid sun exposure
Use back up contraceptives
Antifungal
Diflucan
Candiddisis
Refrigerate
monitor renal and hepatic function
increase risk for bleeding if on anticoagulant
Antimalarials
Plaquinil
Quinine
Rheumatoid arthritis
Lupus
Prevent malarial attacks
Antituberculars
Isoniazid (INH)
Rifampin
Prevention and treatment of TB
Latent TB 6-9mo
Active TB up to 24mo
Antiretrovirals
Zovirax
Valtrex
AZT
Genital herpes, HIV, Shingles
increase fluid intake
Start with first onset of s/s
Zovirax: Give on empty stomach
Valtrex: Give with meal
Biophosphonates
Boniva
Reclast
Actonel
osteoporosis
Hyperglycemia r/t malignancy
Contraindicated while lactating
Contraindicated with esophageal strictures
absorption effected with calcium, orange juice, antacids, caffeine
Give in morning on empty stomach w/8oz water and sit up for 30 min
Disease Modifying Antirheumatic Drugs
DMARDS
Methotrexate
Plaquenil
Embrel
Remicade
Humira
slow joint degeneration and progression of rheumatoid arthritis
Methorexate- contraindicated in pregnancy, renal or liver failure, alcoholism
increases risk for infection, bone marrow suppression, GI ulceration
3-6wk to be therapeutic
Antigout medications
Allopurinol
Colchicine
Avoid foods high in purines
Allopurinol - inhibits uric acid production
Colchicine- prevent leukocytes from invading joints
Anti anxiety medications alprazolam (Xanax) buspirone (BuSpar) chlordiazepoxide (Librium) diazepam (Valium) lorazepam (Ativan)
Increase GABA to reduce anxiety
GAD
Insomnia
alcohol withdrawal
S/E
CNS depression, paradoxical response, withdrawal
Caution BuSpar and Valium w/ liver disease and substance abuse
Antidepressant
SSRI
Cymbalta
Prozac
Lexapro
Luvox
Pexeva
ZoloftInhibits serotonin reuptake
Must avoid ETHO
Monitor for serotonin syndrome (agitation, confusion, hallucination) in first 72hr
Weight gain, Sexual dysfunction, drowsiness, fatigue
Antidepressant
Tricyclic
Elavil
Anafranil
Sinequan
TofranilDon’t administer with MAOI
Don’t administer w/ St. Johns wart
Avoid ETHO
Not for client w/ seizure disorder
Anticholinergic
Sedation
Toxicity
Decreased seizure threshold
Antidepressant
MAOI
Marplan
Pranate
NardilAvoid foods w/ Tyramine
contraindicated with SSRI’s Tricyclics, HF, CVA, renal insufficiency
CNS stimulant
Orthostatic hypotension
Hypertensive Crisis
Bipolar Medications
Lithium
MOnitor Na+ levels
NSAID’s and asprin increase Lithium levels
therapeutic 0.4-1.0 mEq/L
Antiphychotic Medications
Conventional
Thorazine
Halodol
Atypical
Abilify
Zyprexa
Geodon
Bock dopamine, acetylcholine, histamine and epinephrine in the brain
Schizophrenia, manic bipolar, tourett’s, Dementia
Contraindicated with severe depression, PD, severe hypotention
S/E
Extrapyramidal effect, Tardive dyskinesia, Neuroleptic Malignant Syndrome, Seizures
Bipolar Medications
Lithium
MOnitor Na+ levels
NSAID’s and asprin increase Lithium levels
therapeutic 0.4-1.0 mEq/L
Antiphychotic Medications
Bock dopamine, acetylcholine, histamine and epinephrine in the brain
Schizophrenia, manic bipolar, tourett’s, Dementia
Contraindicated with severe depression, PD, severe hypotention
S/E
Extrapyramidal effect, Tardive dyskinesia, Neuroleptic Malignant Syndrome, Seizures
Vasopressin
desmopressin DDAV
Vasoconstrictor (ADH)
Diabetes Insipidus
Cardiac Arrest
Monitor for hyponatremia
I&O
urine specific gravity
BP
Instruct on use of DDAV, for bedwetting
Methimazol (Tapazol)
action
use
s/e
teaching
inhibits synthesis of Thyroid Hormone
Use: Thyroid Storm, hyperthyroidism
S/E: Agranulocytosis -
Thrombocytopenia (platelets)
Administer with food
No Iodine in diet
increase fluids to 3L day
Antihistamines
monitor for
urinary retention
Caution use if:
glaucoma, PUD, urinary retention,
anticholinergic effect
dry mouth, drowsiness
hypokalemia
Bronchodilators
use
s/e
toxicity s/s
Use: Asthma
s/e: tachycardia nervousness monitor for signs of toxicity therapeutic levels 10-20 no ETOH = toxicity
Toxicity: seizures
give diazepam
Beta Blockers will _______ the effect of bronchodilators
decrease
MAOI’s will _______ the effect of bronchodilators
increase
Antilipidemic
Contraindicated with liver disease
Multiple drug interactions
Take in evening (production increased)
no grapefruit juice
Monitor liver and renal fx
Low fat - high fiber diet
Amnioderone is incompatible with ________
heparin
Amnioderone
S/E
Bradycardia
cardiogenic shock
Adenosine Use
SVT’s
push fast follow with N/S push fast
ensure safety for client, reassure them and keep them focused on you tell them what is about to happen
Beta Blockers
S/E Bradycardia
Nasal stuffiness
Bronchospasm
Do not give is Systolic is <50
monitor for hypoglycemia
