N212 Exam 2 Medications Flashcards
Decadron (Dexamethasone)
A synthetic corticosteroid that reduces inflammation and suppresses immune response.
Common side effects:
Sick - Easier to get sick
Sad - Causes depression
Sex - Decreases libido
Salt - Retains more, causes weight gain
Sugar - Raises blood sugar
Nursing considerations:
- Assess for infections before starting
- Monitor blood glucose levels
- Taper dosage slowly to avoid withdrawal symptoms
Solumedrol (Methylprednisolone)
A corticosteroid that reduces inflammation and immune system activity. Usually administered intravenously.
Common side effects:
Sick - Easier to get sick
Sad - Causes depression
Sex - Decreases libido
Salt - Retains more, causes weight gain
Sugar - Raises blood sugar
Nursing considerations:
- Monitor for signs of infection
- Watch for signs of fluid retention
- Monitor glucose levels, especially in diabetics
Prednisone
Most commonly used oral glucocorticoid for anti-inflammatory or immunosuppressant purposes. Also used to treat exacerbations of chronic respiratory illnesses.
Common side effects:
Sick - Easier to get sick
Sad - Causes depression
Sex - Decreases libido
Salt - Retains more, causes weight gain
Sugar - Raises blood sugar
Nursing considerations:
- Monitor blood sugar
- Taper off gradually
- Teach patients about infection risk
- Monitor for mood changes
Tylenol (Acetaminophen)
Used for pain relief (analgesic) and fever reduction (antipyretic).
**Contraindications: **
* Known drug allergies
* Severe liver disease
* Chronic alcohol use
**Side effects/adverse effects: **
* Hepatotoxicity (liver damage caused by drugs, chemicals, alcohol, or infections)
* Skin disorders
* Nausea
* Vomiting
NSAIDs
Nonsteroidal antiinflammatory drugs (NSAIDs): A large and chemically diverse group of drugs that possess analgesic, antiinflammatory, and antipyretic (fever-reducing) activity. (ibuprofen, aspirin)
Generic: ibuprofen; Brand: Advil; Class: NSAIDs
Indication
- Treats mild-moderate pain (can help with bone cancer, chronic back pain)
- Antipyretic
- Anti-inflammatory conditions (rheumatoid arthritis, osteoarthritis, acute gout )
Side effects/adverse effects:
- GI irritation (ulcers)
- Kidney damage (renal failure)
- Bleeding risk
- Cardiovascular: Noncardiogenic pulmonary edema, increased risk of myocardial infarction and stroke
- Gastrointestinal: Dyspepsia, heartburn, epigastric distress, nausea, vomiting, anorexia, abdominal pain, gastrointestinal bleeding, mucosal lesions (erosions or ulcerations)
- Hematologic: Altered hemostasis due to effects on platelet function
- Hepatic: Acute reversible hepatotoxicity
- Renal: Reduced creatinine clearance, acute tubular necrosis with renal failure
- Other: Skin eruptions, sensitivity reactions, tinnitus, hearing loss
Contraindication:
- Drug allergies
- Patients at risk for bleeding
- Vit. K deficiency
- Peptic ulcer
Action
Inhibits prostaglandin synthesis
Interaction:
- Alcohol: Additive effect, increased GI bleeding
- Anticoagulants: Platelet inhibition, hypoprothrombinemia, increased bleeding tendencies
- Aspirin and other salicylates with other NSAIDs: Reduced NSAID absorption, additive gastrointestinal toxicities, increased GI toxicity with no therapeutic advantage
- Bisphosphonates: Additive GI toxicities, increased gastrointestinal bleeding risk
- Corticosteroids and other ulcerogenic drugs: Additive toxicities, increased ulcerogenic effects
- Cyclosporine: Inhibition of renal prostaglandin synthesis, increased nephrotoxic effects of cyclosporine, renal failure
- Diuretics and ACE inhibitors: Inhibition of prostaglandin synthesis, reduced hypotensive and diuretic effects
- Lithium: Increased lithium absorption and concentrations
Protein-bound drugs: Competition for binding, more pronounced drug actions - Uricosurics: Antagonism, decreased uric acid excretion
- Herbals (feverfew, garlic, ginger, ginkgo): Interference with platelet function, increased bleeding risk
Nursing Considerations:
- Monitor for signs of GI distress
- Use with caution in renal impairment
- Take with food to reduce GI irritation
Aspirin
Generic: aspirin; Class: NSAIDS
PO: Onset: 5-30min; Peak 1-3hr; Duration: 3-6hr
Indication:
- Inflammatory disorders, including Rheumatoid arthritis and Osteoarthritis
- Mild to moderate pain
- Fever
- Prophylaxis of transient ischemic attacks and MI.
Action:
- Produce analgesia and reduce inflammation and fever by inhibiting the production of prostaglandins
- Decreases platelet aggregation
Side effects/adverse effects:
- Abdominal pain
- GI Bleeding
- Nausea
- Epigastric distress
Contraindication:
- Drug allergy
- Bleeding disorders or thrombocytopenia
- History of GI bleeding or ulcer disease (use cautiously)
Interaction:
- Increase risk of bleeding with warfarin, heparin
- Can increase activity of penicillin
- Increased bleeding risk with chamomile, ginger, garlic, and ginkgo.
Opioids
(SI)
What does it do
- Treats severe pain
- Blocks receptors in brain that sense pain
Common Side effects
- Constipation
- Drowsiness
- Euphoria
- Monitor respiratory rate
Last bm ?
PRN laxatives
Nursing Consideration
- Watch for signs of overdose (respirations <12/min)
- Constipation prevention (e.g., stool softeners) check vitals
Oxycodone
Generic: oxycodone; Brand: Oxycontin; Class: Opioid, synthetic
Schedule II Drug; Black box warning
Indication:
Relief of moderate to severe pain
Side effects/adverse effects:
- Cardiovascular: Hypotension, flushing, bradycardia
- Central nervous system: Sedation, disorientation, euphoria, lightheadedness, dysphoria
- Gastrointestinal: Nausea, vomiting, constipation, biliary tract spasm
- Genitourinary: Urinary retention
- Integumentary: Itching, rash, wheal formation
- Respiratory: Respiratory depression, possible asthma aggravation
Action
Binds to opiate receptors in the CNS
Alters the perception of and response to painful stimuli, while producing generalized CNS depression
Contraindication:
- Drug allergy
- Significant respiratory depression
- Paralytic ileus
- Acute or severe bronchial asthma
- Renal impairment
Interaction:
Co-administration of opioids with alcohol, antihistamines, barbiturates, benzodiazepines, phenothiazine, and other CNS depressants can result in additive respiratory depressant effects.
Nursing Considerations:
- Assess BP, HR, and respiratory rate before and periodically during administration
- Monitor for signs of GI distress
- Use with caution in renal impairment
- Take with food to reduce GI irritation
Morphine (Sulfate)
Generic: morphine; Class: Opiate analgesic; opium alkaloid
Schedule II
Indication
Severe pain, high abuse potential
Side effects/adverse effects:
- Cardiovascular: Hypotension, flushing, bradycardia
- Central nervous system: Sedation, disorientation, euphoria, lightheadedness, dysphoria
- Gastrointestinal: Nausea, vomiting, constipation, biliary tract spasm
- Genitourinary: Urinary retention
- Integumentary: Itching, rash, wheal formation
- Respiratory: Respiratory depression, possible asthma aggravation
Action
Binds to opiate receptors in the CNS. Alters perception of and response to painful stimuli while producing generalized CNS depression
Interactions:
Using other CNS depressants + other opioids can cause profound sedation, respiratory depression, coma and death
Contraindication:
- Drug allergy
- Renal impairment
- Significant respiratory depression
- Acute or severe bronchial asthma
- Paralytic ileus
Hydrocodone
Generic: hydrocodone; Brand: Norco, Vicodin, Anexsia; Class: opioid analgesics
Indication:
- Cough suppressant
- Severe pain
Action:
Binds to opiate receptors in the CNS. Alters perception of and response to painful stimuli while producing generalized CNS depression
–Suppress the cough reflux via a direct central action–
Side effects/adverse effects:
- Hypotension
- Sedation, confusion, dizziness, unusual dreams, euphora
- Respiratory depression (hyperventilation)
- Constipation
Interaction:
Other drugs that can cause drowsiness or breathing problems can risk serious side effects if taken with hydrocodone.
Contraindication:
- Drug allergy
- Renal impairment
- Significant respiratory depression
- Acute or severe bronchial asthma
- Paralytic ileus
glipizide (Glucotrol)
Generic: glipizide; Brand: Glucotrol; Class: sulfonylureas (Second-gen.)
Indication
Given for type 2 diabetes to control blood sugar (lowers)
Action
Lowers blood sugar via stimulating pancreatic islet cells to cause more insulin secretion
Side effects/adverse effects:
- Hypoglycemia
- Abdominal pain
- Nausea, vomiting
- Anemia
- GI Bleeding
- Pyrosis (heartburn)
Contraindication
- Hypoglycemia
- Allergic to sulfonamide antibiotics (cross-allergy)
- **Diabetic ketoacidosis - a life-threatening complication of diabetes that occurs when the body produces too many ketones too quickly because there is not enough insulin being produced
- NOT contraindicated with patients with severe renal failure
Interactions
- Beta-blockers, garlic, ginger, ginseng, sulfonamide antibiotics, fluconazole, and cimetidine; Enhanced effects = Increased Hypoglycemia
- Carbamazepine, rifampin, phenytoin, and phenobarbital; Increases metabolism = Decrease effectiveness
Nursing Considerations:
This is a PO tablet given for type 2 diabetes, it is an extended-release tablet, so don’t give it to someone with dangerously low blood sugar. Must administer 30 min before a meal
- PO, Extended-release onset is 1 hr
- Works best given 30 min before meals
Regular Insulin
Brand: Humulin R, Novolin R; Class: Short-acting insulin
Route: IV, SQ *Only regular insulin can be given intravenously
Clear, colorless solution
Indication:
* Managing blood glucose levels in patients with diabetes mellitus (DM) type 1 and type 2.
* Used during acute hyperglycemia
* Diabetic ketoacidosis (route = IV)
Side effects/adverse effects:
* Hypokalemia
* Hypoglycemia
* Edema
* Lipodystrophy (hardening/scarring of tissue at injection site)
Contraindications:
* Drug allergy
* Hypoglycemia
Nursing considerations:
* Take 30 minutes before eating
* Rotate injection sites
* Monitor blood sugar
NPH Insulin
Brand name: Novolin N, Humulin N;
Group: Intermediate-acting insulin
Route: SQ
Slower onset and longer duration of action than regular insulin, but not as long as the long-acting insulins
*Cloudy solution
*Duration of action: 10-18 hours
Indication:
* Manage blood glucose levels in patients with diabetes mellitus (DM) type 1 and type 2 over a longer period
* Combined with regular insulin to reduce number of insulin injections per day
Side effects/adverse effects:
* Hypoglycemia
* Hypokalemia
* Lipodystrophy (hardening/scarring of tissue at injection site)
Contraindication:
* Hypersensitivity
* Hypoglycemia
Nursing considerations:
* Monitor blood sugar
* Rotate injection sites
Lantus
Insulin glargine
Long acting insulin
*Clear, colorless solution
Action
Binds to insulin receptors to lower blood glucose levels
*Duration of action: 24 hours
Indications:
* Help control blood glucose levels in invidivuals with Diabetes Mellitus (Type I and Type II)
* Provides constant level of insulin in the body, enhancing safety
Side effects/adverse effects:
* Hypoglycemia
* Weight gain
* Lipodystrophy
* Edema
* Hypokalemia
**Contraindication: **
* Hypersensitivity
* Hypoglycemia
Nursing considerations:
* Monitor blood glucose levels
* Rotate injection sites
* Do not mix with other insulins, separate injections are required.
glucagon
Glucagon is a hormone that increases blood sugar in emergency scenarios
Generic: glucagon; Brand: Glucagen; Class: diagnostic hormonal agents; systemic hormonal agents
Administer route: IV, IM, SUBQ, and Intranasal
Indication:
- Acute management of severe hypoglycemia.
- Anaphylaxis
- Beta-blocker overdose (toxicity)
Action:
Glucagon activates hepatic glucagon receptors; Promoting glycogen breakdown in the liver
- Releases glucose and increases blood glucose within minutes
Relaxes smooth muscles in the GI tract
Side effects/adverse effects:
- Abdominal pain
- Anaphylactic shock
- Hyperglycemia
- Hypotension
Contraindication:
- Glucagonoma
- Insulinoma
- Pheochromocytoma
Interactions:
- Patients on concurrent beta-blocker therapy may have a greater increase in heart rate and BP
Nursing Considerations:
Just know that this is an emergency medication for dangerously low blood sugar. Most commonly given emergency IM if a person is unconscious, however, if the person is awake, there are also PO options.
