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NCLEX > NCLEX Common Meds > Flashcards

NCLEX Common Meds Flashcards

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1
Q

What classes of drugs are used as antihypertensives?

A

ACE inhibitors, beta blockers, calcium channel blockers, and vasodilators

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2
Q

What are indications for ACE inhibitors? Contraindications? Side effects? Nursing considerations? Nursing education? Examples?

A

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

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3
Q

What are indications for beta blockers? Contraindications? Side effects? Nursing considerations? Nursing education? Examples?

A

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

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4
Q

What are indications for calcium channel blockers? Contraindications? Side effects? Nursing considerations? Nursing education? Examples?

A

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

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5
Q

What are indications for vasodilators? Contraindications? Side effects? Nursing considerations? Nursing education? Examples?

A

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

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6
Q

What drug classes are used for antiarrhythmia?

A

class III anti-arrhythmic and digitalis

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7
Q

What are indications for class III anti-arrhythmic? Contraindications? Side effects? Nursing considerations? Nursing education? Examples?

A

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

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8
Q

What are indications for digitalis? Contraindications? Side effects? Nursing considerations? Nursing education? Examples?

A

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

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9
Q

What are common drug classes of antihyperlipidemics?

A

statins

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10
Q

What are indications for statins? Contraindications? Side effects? Nursing considerations? Nursing education? Examples?

A

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

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11
Q

What are common drug classes used as diuretics?

A

loop diuretics, potassium sparing diuretics, thiazides

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12
Q

What are indications for loop diuretics? Contraindications? Side effects? Nursing considerations? Nursing education? Examples?

A

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

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13
Q

What are indications for potassium sparing diuretics? Contraindications? Side effects? Nursing considerations? Nursing education? Examples?

A

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

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14
Q

What are indications for thiazides? Contraindications? Side effects? Nursing considerations? Nursing education? Examples?

A

edema, HTN

anuria

photosensitivity, hyperglycemia, diarrhea, loss of appetite, n/v, dizziness

monitor: BP, daily weight, edema, electrolytes

“thiazide”: chlorothiazide, hydrochlorothiazide, chlorthialidone, metolazone

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15
Q

What class of drugs are used for anticoagulant/antiplatelets?

A

warfarin, direct-acting oral anti-coagulants (DOACs), heparin, anti-platelet drugs

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16
Q

What are indications for warfarin? Contraindications? Side effects? Nursing considerations? Nursing education? Examples?

A

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

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17
Q

What are indications for direct-acting oral anti-coagulants (DOACs)? Contraindications? Side effects? Nursing considerations? Nursing education? Examples?

A

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

18
Q

What are indications for heparin? Contraindications? Side effects? Nursing considerations? Nursing education? Examples?

A

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

19
Q

What are indications for anti-platelet class drugs? Contraindications? Side effects? Nursing considerations? Nursing education? Examples?

A

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

20
Q

What are the drug classes used as analgesics?

A

non-opioids, NSAIDs, opioids, muscle relaxants

21
Q

What are indications for non-opioids? Contraindications? Side effects? Nursing considerations? Nursing education? Examples?

A

pain, fever

severe hepatic disease

n/v, constipation, liver failure, stevens-johnson syndrome

monitor: liver function, pain, fever

do not take with alcohol

acetaminophen

22
Q

What are indications for NSAIDs? Contraindications? Side effects? Nursing considerations? Nursing education? Examples?

A

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

23
Q

What are indications for opioids? Contraindications? Side effects? Nursing considerations? Nursing education? Examples?

A

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

24
Q

What are indications for muscle relaxants? Contraindications? Side effects? Nursing considerations? Nursing education? Examples?

A

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

25
Q

What drug classes are used for anxiolytics and mood stabalizers?

A

anxiolytics, SSRI

26
Q

What are indications for anxiolytic class drugs? Contraindications? Side effects? Nursing considerations? Nursing education? Examples?

A

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

27
Q

What are indications for SSRIs? Contraindications? Side effects? Nursing considerations? Nursing education? Examples?

A

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

28
Q

What are indications for anti-epiletpics? Contraindications? Side effects? Nursing considerations? Nursing education? Examples?

A

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

29
Q

What are indications for anti-parkinson drugs? Contraindications? Side effects? Nursing considerations? Nursing education? Examples?

A

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

30
Q

What are indications for anti-psychotics? Contraindications? Side effects? Nursing considerations? Nursing education? Examples?

A

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

31
Q

What are indications for antiemetics? Contraindications? Side effects? Nursing considerations? Nursing education? Examples?

A

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

32
Q

What are indications for PPIs? Contraindications? Side effects? Nursing considerations? Nursing education? Examples?

A

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

33
Q

What are indications for H2 histamine blockers? Contraindications? Side effects? Nursing considerations? Nursing education? Examples?

A

indigestion, acid reflux

hypersensitivity

ab pain, constipation, diarrhea, arrhythmia

monitor: CBC, GI symptoms

administer 30 to 60 min before meals

cimetidine, famotidine, ranitidine

34
Q

What are indications for laxatives? Contraindications? Side effects? Nursing considerations? Nursing education? Examples?

A

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

35
Q

What are indications for bronchodilator? Contraindications? Side effects? Nursing considerations? Nursing education? Examples?

A

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

36
Q

What are indications for inhaled corticosteroids? Contraindications? Side effects? Nursing considerations? Nursing education? Examples?

A

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

37
Q

What are classes of anti-inflammatory drugs?

A

corticosteroids, uric acid reducers

38
Q

What are indications for corticosteroids? Contraindications? Side effects? Nursing considerations? Nursing education? Examples?

A

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

39
Q

What are indications for uric acid reducers? Contraindications? Side effects? Nursing considerations? Nursing education? Examples?

A

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

40
Q

What are indications for broad spectrum antibiotics? Contraindications? Side effects? Nursing considerations? Nursing education? Examples?

A

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

41
Q

What are the classifications of antibiotics? Nursing considerations? Examples?

A

“Antibiotics Can Terminate Protein Synthesis For Microbial Cells Like Germs”

Aminoglycosides: nephrotoxic and ototoxic; gentamycin, “micin” “Mycin”: gentamycin, streptomycin, tobramycin

Carbapenems: “penem”:ertapenem, meropenem

NCLEX (4 decks)

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