NCLEX Common Meds Flashcards
What classes of drugs are used as antihypertensives?
ACE inhibitors, beta blockers, calcium channel blockers, and vasodilators
What are indications for ACE inhibitors? Contraindications? Side effects? Nursing considerations? Nursing education? Examples?
HTN, heart failure
pregnancy, hx of angioedema
cough, hypotension, angioedema, acute renal failure
monitor: BP, renal/liver function, electrolytes, signs of angioedema
change position slowly to prevent orthostatic hypotension
“pril”: captopril, enalapril, lisinopril
What are indications for beta blockers? Contraindications? Side effects? Nursing considerations? Nursing education? Examples?
HTN, HF, angina pectoris
decompensated HF, severe bradycardia, 2nd or 3rd degree heart block
bradycardia, hypotension, dizziness, fatigue, hypoglycemia
monitor: BP, HR
given IV
change position slowly, monitor blood glucose (signs of hypoglycemia may be hidden)
“olol”: atenolol, metoprolol, propranolol
What are indications for calcium channel blockers? Contraindications? Side effects? Nursing considerations? Nursing education? Examples?
HTN, stable angina
symptomatic hypotension, heart blocks
edema, abdominal pain, nausea, fatigue, cardiac arrhythmia
monitor:BP, HR, peripheral edema, liver/kidney function, electrolytes
administered IV
change position slowly to prevent orthostatic changes
amlodipine, diltiazem, nifedipine, verapamil
What are indications for vasodilators? Contraindications? Side effects? Nursing considerations? Nursing education? Examples?
HTN, angina pectoris
CAD, mitral valve disease, cardiomyopathies, NO should not be used for patients with increased ICP
diarrhea, loss of appetite, n/v, headache, dizziness, hypotension
monitor: BP, HR, presence/resolution of angina
nitrate patches must be taken off at night and reapplied in AM, can take NO 3x/5 min
hydralazine, isosorbide, nitroglycerine
What drug classes are used for antiarrhythmia?
class III anti-arrhythmic and digitalis
What are indications for class III anti-arrhythmic? Contraindications? Side effects? Nursing considerations? Nursing education? Examples?
ventricular arrhythmia, afib/flutter
heart blocks, long QT syndrome, severe bradycardia
dizziness, lightheadedness, fatigue, bradycardia, hypotension, SOB
monitor: HR, QT interval, signs of pulmonary toxicity (crackles, decreased lung sounds, pleuritic chest pain), signs of neurotoxicity (ataxia, muscle weakness, tingling, tremors), signs of thyroid dysfunction, liver and thyroid labs
do not discontinue abruptly
amiodarone, dofetilide, sotalol
What are indications for digitalis? Contraindications? Side effects? Nursing considerations? Nursing education? Examples?
afib, HF, ventricular rate control
ventricular fibrillation
fatigue, bradycardia, anorexia, n/v
monitor: HR, electrolytes, serum digoxin level, renal function
signs of toxicity: ab pain, confusion, weakness, anorexia, n/v, bradycardia, visual changes - blurred vision, green/yellow color disturbances
digoxin
What are common drug classes of antihyperlipidemics?
statins
What are indications for statins? Contraindications? Side effects? Nursing considerations? Nursing education? Examples?
hyperlipidemia
acute liver disease, pregnancy, breastfeeding
diarrhea, abdominal pain, constipation, muscle or joint pain, nasopharyngitis
monitor: lipid panel, liver function, serum creatine kinase, presence of muscle pain
simvistatin should be taken in PN, avoid alcohol
“statin”: atorvastatin, lovastatin, rosuvastatin, simvastatin
What are common drug classes used as diuretics?
loop diuretics, potassium sparing diuretics, thiazides
What are indications for loop diuretics? Contraindications? Side effects? Nursing considerations? Nursing education? Examples?
edema associated with HF, RF, and cirrhosis of liver
anuria
electrolyte imbalances, hypotension, severe electrolyte imbalances could result in cardiac arrhythmias
change position slowly
monitor: BP, signs of hypokalemia, serum sodium and magnesium, urine output and kidney function
furosemide, budesonide, torsemide
What are indications for potassium sparing diuretics? Contraindications? Side effects? Nursing considerations? Nursing education? Examples?
edema associated with liver failure, HF, or HTN
addison disease, hyperkalemia
gynecomastia, diarrhea, n/v, somnolence
monitor: BP, urine output and edema, potassium, renal function
avoid potassium supplements, take with food
spironalactone
What are indications for thiazides? Contraindications? Side effects? Nursing considerations? Nursing education? Examples?
edema, HTN
anuria
photosensitivity, hyperglycemia, diarrhea, loss of appetite, n/v, dizziness
monitor: BP, daily weight, edema, electrolytes
“thiazide”: chlorothiazide, hydrochlorothiazide, chlorthialidone, metolazone
What class of drugs are used for anticoagulant/antiplatelets?
warfarin, direct-acting oral anti-coagulants (DOACs), heparin, anti-platelet drugs
What are indications for warfarin? Contraindications? Side effects? Nursing considerations? Nursing education? Examples?
prevention of blood clots, PE, VTE
hemorrhage, recent or potential surgery or other procedure
minor bleeding or prolonged bleeding time, GI bleeding
monitor: INR, signs of bleeding
vitamin K is the antidote
avoid large amounts of foods containing vitamin K (leafy greens)
warfarin
What are indications for direct-acting oral anti-coagulants (DOACs)? Contraindications? Side effects? Nursing considerations? Nursing education? Examples?
prevent of blood clots, DVT, PE
active bleeding
minor bleeding or prolonged bleeding time, GI bleeding
monitor: bleeding
do not d/c abruptly
apixaban, dabigatran, rivaroxaban
What are indications for heparin? Contraindications? Side effects? Nursing considerations? Nursing education? Examples?
afib, DIC, VTE (prophylaxis or treat), venous catheter occlusion, warfarin bridging
severe thrombocytopenia, uncontrolled active bleeding
thrombocytopenia, increased liver amino-transferase, HIT, anemia, thrombocytopenia, bleeding
monitor: bleeding, platelets, INR, hgb, hematocrit, liver function
do not remove air bubble from prefilled enoxaparin syringes, protamine sulfate is antidote for heparin, heparin is IV or SQ, enoxaparin is SQ
heparin, enoxaparin
What are indications for anti-platelet class drugs? Contraindications? Side effects? Nursing considerations? Nursing education? Examples?
acute MI, CVA, prevention of thrombosis after percutaneous coronary intervention (PCI), PAD
active bleeding
rash, diarrhea, minor bleeding, agranulocytosis, GI bleeding, intracranial hemorrhage
monitor: signs of bleeding
do not take with NSAIDs or additional aspirin, do not d/c abruptly
aspirin, clopidogrel, prasugrel, ticagrelor
What are the drug classes used as analgesics?
non-opioids, NSAIDs, opioids, muscle relaxants
What are indications for non-opioids? Contraindications? Side effects? Nursing considerations? Nursing education? Examples?
pain, fever
severe hepatic disease
n/v, constipation, liver failure, stevens-johnson syndrome
monitor: liver function, pain, fever
do not take with alcohol
acetaminophen
What are indications for NSAIDs? Contraindications? Side effects? Nursing considerations? Nursing education? Examples?
pain, fever, inflammation
hx of adverse reaction, CABG, 20-30wk of gestation
headache, constipation, n/v, GI bleeding
monitor: pain, fever, liver function, renal function, signs of bleeding
give PO with food, do not drink alcohol or smoke, do not take with other NSAIDs (inc. aspirin)
celecoxib, ibuprophen, indomethacin, ketorolac, naproxen
What are indications for opioids? Contraindications? Side effects? Nursing considerations? Nursing education? Examples?
acute/chronic pain, air hunger/ SOB
respiratory depression, known or suspected GI obstruction
confusion, sedation, hypotension, constipation, nausea, respiraotry depression, dependence/withdrawal
monitor: BP, HR, RR, LOC, pain, sedation level, bowel function, respiratory depression
give with stool softeners and laxatives
do not d/c abruptly
codeine, fentanyl, hydromorphone, morphine, oxycodone, codeine/acetaminophen, hydrocodone/acetaminophen, oxycodone/acetaminophen
What are indications for muscle relaxants? Contraindications? Side effects? Nursing considerations? Nursing education? Examples?
muscle spasms
arrhythmias, when using MAOIs, CHF, heart blocks, hyperthyroidism
dizziness, fatigue, somnolence, dry mouth, constipation, cardiac dysrhythmias, liver impairment
monitor: presence and reduction of pain, muscle stiffness, increased risk of sedation and weakness in the elderly
give ER at approx the same time each day, intended for short term use
cyclobenzaprine, methocarbamol
What drug classes are used for anxiolytics and mood stabalizers?
anxiolytics, SSRI
What are indications for anxiolytic class drugs? Contraindications? Side effects? Nursing considerations? Nursing education? Examples?
anxiety, status epilepticus
acute narrow-angle glaucoma, respiratory insufficiency
dizziness, drowsiness, lethargy, delirium
monitor: LOC, sedation, presence of anxiety, resolution of seizure (if for status epilepticus)
do not d/c abruptly
“pam”: clonazepam, diazepam, lorazepam, alprazolam
What are indications for SSRIs? Contraindications? Side effects? Nursing considerations? Nursing education? Examples?
major depressive disorder, panic disorders, PTSD
MOAIs
constipation, diarrhea, indigestion, nausea, dizzines, headache, insomnia, reduced libido, suicidal thoughts, serotonin syndrome
monitor: mood and affect, sodium, suicidal ideology, weight gain
may take several weeks for therapeutic effect, do not use alcohol, avoid abrupt d/c
citalopram, escitalopram, fluoxetine, paroxetine, sertraline
What are indications for anti-epiletpics? Contraindications? Side effects? Nursing considerations? Nursing education? Examples?
seizures, neuropathic pain
caution with pregnancy
drowsiness, ataxia, weakness, GI disturbance, hypotension
monitor: seizure activity, serum drug levels, pain reduction (w/ gabapentin)
use PPE when handling medication, do not d/c abruptly, avoid antacids (risk of decreased absorption) and alcohol (risk of drug serum level changes)
carbamazepine, gabapentin, levetiracetam, phenytonin
What are indications for anti-parkinson drugs? Contraindications? Side effects? Nursing considerations? Nursing education? Examples?
parkinson’s
narrow-angle glaucoma, hx of melanoma
vitamin B6 deficiency, nausea, confusion, dizziness, dyskinesia, depression, hallucinations, suicidal thoughts, melanoma
monitor: parkinson’s s/s, kidney/liver labs, adverse rxn during dosage adjustment period
take with food to minimize GI upset, administer consistently at scheduled times, PO may discolor saliva, sweat or urine to dark red, brown, or black, high-fat/protein-calorie meals may delay absorption, avoid sudden d/c of med
carbidopa, carbidopa/levodpa
What are indications for anti-psychotics? Contraindications? Side effects? Nursing considerations? Nursing education? Examples?
agitation, restlessness, hallucinations, bipolar disorder, schizophrenia
caution with prolonged QT interval and elderly
constipation, dry mouth, blurred vision, extrapyramidal s/e, increased cholesterol, increased liver enzymes, suicidal thoughs and behavor, prolonged QT interval, drug induced lukopenia or neutropenia
monitor: mood and mental status, presence of s/e
give with food to minimize GI irritation, change positions slowly, do not d/c abrutply, avoid alcohol
haloperidol, olanzapine, quetiapine, risperidone
What are indications for antiemetics? Contraindications? Side effects? Nursing considerations? Nursing education? Examples?
n/v
apomorphine, prochlorperazine is c/i for children
constipation, diarrhea, headache, fatigue, prolonged QT interval, torsades de pointes, serotonin syndrome
monitor: n/v, prolonged QT, extrapyramidal s/e (w/ prochlorperazine)
do not chew or swallow oral film form of ondansetrol
ondansetron, prochlorperazine, promethazine
What are indications for PPIs? Contraindications? Side effects? Nursing considerations? Nursing education? Examples?
acid reflux, duodenal ulcers, erosive esophagitis, gastric ulcers
rilpivirine
ab pain, constipation, diarrhea, nausea, hypomagnesia
monitor: serum magnesium and vitamin B12
administer 30 min before meals, do not take for prolonged periods
“azole”: omeprazole, pantoprazole
What are indications for H2 histamine blockers? Contraindications? Side effects? Nursing considerations? Nursing education? Examples?
indigestion, acid reflux
hypersensitivity
ab pain, constipation, diarrhea, arrhythmia
monitor: CBC, GI symptoms
administer 30 to 60 min before meals
cimetidine, famotidine, ranitidine
What are indications for laxatives? Contraindications? Side effects? Nursing considerations? Nursing education? Examples?
constipation, bowel prep, neurogenic bowel
bowel obstruction, appendicitis, gastroenterititis
ab cramps, diarrhea, electolyte imbalances
monitor: ab distention, tenderness, and presence of bowel sounds, last stool’s color, consistency, and amount
hold for loose stools, avoid milk products or antacids w/i 1 hr of bisacodyl, do not use for more than 1 wk, report rectal bleeding, BM should occur within 15 to 60 min after suppos and up to 12 to 24 hr of PO
bisacodyl, docusate, lactulose, polyethylene glycol, sennoside
What are indications for bronchodilator? Contraindications? Side effects? Nursing considerations? Nursing education? Examples?
asthma, COPD
hypersensitivity
tachycardia, nervousness, restlessness, palpations, paradoxical bronchospasm
monitor: respiratory status, pulse, BP, sputum amount, color, and character
educate on proper technique
short acting: albuterol sulfate, ipratopium bromide, levalbuterol, tiotropium, albuterol/ipratropium bromide
long acting: formoterol, salmeterol
What are indications for inhaled corticosteroids? Contraindications? Side effects? Nursing considerations? Nursing education? Examples?
asthma, COPD
status asthmaticus or other acute episode of asthma
oral candidiasis, throat/nasal irrtation, hoarseness, osteoporosis, glaucoma
monitor: respiratory status
not a rescue medication, rinse mouth afterwards, may increase glucose levels
beclomethasone, budesonide, fluticasone, mometasone, budesonide/formoterol
What are classes of anti-inflammatory drugs?
corticosteroids, uric acid reducers
What are indications for corticosteroids? Contraindications? Side effects? Nursing considerations? Nursing education? Examples?
allergic rxn, adrenal insufficiency, dermatologic conditions, rhematic conditions, inflammatory process or diseases
serious infection
depression, HTN, GI disturbances, bruising, hyperglycemia, fluid and electrolyte imbalances, adrenal insufficiency
monitor: BG levels, potassium and sodium, WBC, signs of adrenal insuffiviency (hypotension, weight loss, weakness, n/v, confusion, peripheral edema)
give with meals to avoid GI irritation, do not d/c abruptly
cortisone, dexamethasone, hydrocortisone, methylprednisolone, prenisone
What are indications for uric acid reducers? Contraindications? Side effects? Nursing considerations? Nursing education? Examples?
gout
hypersensitivity
rash, GI disturbances, hepatic failure, renal failure
monitor: serum uric acid levels, liver function, renal function, joint swelling/joint pain
administer after a meal, increase fluid intake to reduce risk of kidney stones
allopurinol, colchicine
What are indications for broad spectrum antibiotics? Contraindications? Side effects? Nursing considerations? Nursing education? Examples?
bacterial infections where the infectious agent has not been identified
hypersensitivity
diarrhea, n/v, photosensitivity, rash, hives, anaphylaxis, c.diff, nephrotoxicity, ototoxicity
monitor: s/s of worsening infection, CBC, renal function, liver function, bleeding, signs of antibiotic-associated diarrhea
can decrease effectiveness of birth control, vancomycin is a vesicant and shouldn’t be given through a midline
ceftriaxone, clindamycin, maropenem, piperacillin-tazobactum, vancomycin
What are the classifications of antibiotics? Nursing considerations? Examples?
“Antibiotics Can Terminate Protein Synthesis For Microbial Cells Like Germs”
Aminoglycosides: nephrotoxic and ototoxic; gentamycin, “micin” “Mycin”: gentamycin, streptomycin, tobramycin
Carbapenems: “penem”:ertapenem, meropenem
