Neurosensory Drug List

Question 1

Atropine* ophthalmic

Answer 1

Trade Names: Atropine-1, Isopto Atropine

Classification: mydriatics

Common Use: amblyopia

Common side/adverse effects: watery or puffy eyes, mild burning/stinging or irritation in eyes, sensitivity to light

Nursing Interventions: Make sure pt does not have history of HTN or DM before administering. Monitor s/s of systemic toxicity ( tachycardia)

Teaching Points: Wear dark glasses to minimize photophobia.

Question 2

Tropicamide

Answer 2

Trade Names: Mydriacyl

Classification: Ophthalmic muscarinic antagonist

Common Use: dilate pupils for diagnostic procedures

Common side/adverse effects: tachycardia, flushing or redness of face, hallucinations, increased thirst or dryness of mouth

Nursing Interventions: Monitor vitals. Make sure tip of bottle does not touch the eye when administering.

Teaching Points: Protect eyes from bright light while pupils are still dilated.

Question 3

Ranibizumab

Answer 3

Trade Names: Lucentis

Classification: vascular endothelial growth factor A (VEGF-A) antagonists

Common Use: wet age-related macular degeneration

Common side/adverse effects: headache, dry or itchy eyes, teary eyes

Nursing Interventions: Discolored or cloudy solutions should not be used. Assess eyes for infection after injection.

Teaching Points: Immediately report any redness, pain, or sensitivity to light in eyes, or any visual changes.

Question 4

Betaxolol

Answer 4

Trade Names: Betoptic S, Betoptic

Classification: beta-blocker

Common Use: open-angle glaucoma

Common side/adverse effects: eye irritation, itchy or watery eyes, blurred vision, sensitivity to light

Nursing Interventions: Closely monitor pulse and BP in pts w/ severe heart disease. Monitor for therapeutic effectiveness.

Teaching Points: Wait at least 10 min before using other eye drop meds. Don’t use this med while wearing contact lenses. Don’t breastfeed while taking med.

Question 5

Mannitol

Black Box Warning

Answer 5

Trade Names: Aridol, Osmitrol

Classification: osmotic diuretic

Common Use: intraocular or intracranial pressure, cerebral edema

Common Side/Adverse Effects: dry mouth, thirst, blurred vision, fluid and electrolyte balance

Black Box Warning: May result in severe bronchospasm.

Nursing Interventions: Monitor I&O, serum electrolytes. Assess v/s, skin turgor, and mucous membranes. Monitor for s/s of hypernatremia and hyper or hypo kalemia

Teaching Points: Expect increase in urinary frequency. may cause dry mouth.

Question 6

Dexamethasone

Answer 6

Trade Name: Ozurdex, Maxidex, DexPak 6 Day

Classification: long-acting glucocorticoid; corticosteriod

Common use: for inflammation

Common Side/Adverse Effects: GI upset, vomiting, headache, insomnia, muscle wasting

Nursing Interventions: Monitor I&O, weight, serum glucose and serum electrolytes. Assess for signs of edema. Be alert to infection. Assess ability to sleep.

Teaching points: Don’t change dose/schedule or abruptly stop taking drug. Report any fever, sore throat, muscles aches, edema, sudden weight gain, and exposure to measles/chickenpox. Avoid alcohol and limit caffeine.

Question 7

Hypertonic saline solution

Answer 7

Classification: Mucolytics

Common Use: replenish fluid and electrolytes

Common side/adverse effects: fever, infections at the site of injection, hypervolemia, extravasation

Nursing Interventions: Monitor and assess for adverse effects, skin turgor, v/s, EKG.

Question 8

Gabapentin

Answer 8

Trade Name: Neurotin, Gralise, Horizant

Classification: anticonvulsant, antineuralgic

Common use: To reduce seizure activity and neuropathic pain

Common Side/Adverse Effects: Fatigue, drowsiness, dizziness, ataxia

Nursing Interventions: Seizure precautions. Monitor seizure duration/frequency, kidney function, weight. Monitor for s/s of depression, suicidal ideation, or unusual behavior.

Teaching points: Do not abruptly stop taking drug. Avoid tasks that require mental alertness, and alcohol. Carry and identification card/bracelet to indicate seizure disorder or anticonvulsant therapy.

Question 9

Pregabalin

Answer 9

Trade Name: Lyrica

Classification: Anticonvulsant, antineuralgic, Schedule V analgesic

Common use: adjunct therapy for partial-onset seizures; neuropathic pain.

Common Side/Adverse Effects: dizziness, drowsiness, ataxia, peripheral edema

Nursing Interventions: Seizure precautions. Assess for improvement of pain. Assess for signs of peripheral edema.

Teaching points: Don’t abruptly stop taking drug- increases risk of seizure frequency. Avoid tasks that require mental alertness, and alcohol. Carry and identification card/bracelet to indicate seizure disorder or anticonvulsant therapy.

Question 10

Baclofen

BBA

Answer 10

Trade Name: Gablofen, Lioresal

Classification: skeletal muscle relaxer; antispastic, analgesic (for trigeminal neuralgia)

Common use: muscle spasms

Common Side/Adverse Effects: transient drowsiness, asthenia, dizziness, n&v

Black Box Warning: Abrupt withdrawal of intrathecal form may result in severe hyperpyrexia, obtundation, rebound/exaggerated spasticity, muscle rigidity, leasing to organ failure and possibly death.

Nursing Interventions: Monitor BMP, LFT, blood counts. Assess for contradicting reaction. Watch for drowsiness, dizziness, and ataxia. Assist w ambulation.

Teaching points: Avoid tasks that require mental alertness. Dont abruptly stop taking med, may cause muscle rigidity, rebound spasticity, fever, and altered mental status. Avoid alcohol.

Question 11

Gliadel wafer (trade name)

Answer 11

Generic Name: Carmustine

Classification: Alkylating antineoplastic agent

Common Use: brain tumors, Hodgkin’s disease, multiple myeloma, non-Hodgkin’s lymphoma

Common side/adverse effects: constipation, stomach/abdominal/back pain, n&v

Nursing Interventions: Monitor renal/hepatic func tests. Monitor for hematologic toxicity and pulmonary toxicity. Monitor for s/s of anemia.

Teaching Points: Maintain adequate hydration. Don’t get immunization’s w/o HCP approval. Report any vomiting, chills, fever, unusual bleeding/bruising.

Question 12

Temozolomide

Answer 12

Trade Names: Temodar

Classification: antineoplactic

Common Use: brain cancer

Common side/adverse effects: myelosuppression, n&v, headache, fatigue

Nursing Interventions: Obtain CBC on 22nd day of therapy. Monitor for hematologic toxicity, Monitor for symptoms of anemia.

Teaching Points: Take on an empty stomach to reduce n&v. Report any fever, sore throat, unusual bruising/bleeding. Avoid crowds.

Question 13

Cimetidine

Answer 13

Trade Names: Tagamet HB 200

Classification: antacid, antihistamine, antiulcer, gastric acid secretion inhibitor

Common Use: stomach ulcers

Common side/adverse effects: headache, diarrhea, drowsiness, nausea

Nursing Interventions: Assess for GI bleeding. Monitor for mental status changes in elderly/severely ill/impaired renal

Teaching Points: Report any blood in vomit/stool. Avoid tasks that require alertness. Avoid smoking and excessive intake of caffeine.

Question 14

Pantoprazole

Answer 14

Trade name: Protonix

Classification: Proton pump inhibitor

Common use: GERD, severe erosive esophagitis

Side/adverse effects: Pancreatitis, pseudomembranous colitis, anaphylaxis

Nursing considerations: Assess bowel sounds q8h, monitor pain in abdomen, swelling, anorexia. Hepatic studies, skin reaction. Monitor electrolyte imbalances

Teaching points: Report GI symptoms. Hyperglycemia may occur in diabetics. Avoid alcohol, NSAID, salicylates (may cause GI irritation). Notify provider of pregnancy or if breastfeeding.

Question 15

Pentobarbital

Answer 15

Trade Names: Nembutal

Classification: Sedative/Hypnotics; Barbiturates

Common Use: epilepsy, seizures, anxiety, insomnia

Common side/adverse effects: HoTN, dizziness, CNS depression, confusion

Nursing Interventions: Closely monitor vital signs after administration. Put on fall precautions.

Teaching Points: Avoid activities that require alertness. Change positions slowly. Do not take if pregnant.

Question 16

Enoxaparin

Answer 16

Trade Names: Lovenox

Classification: antithrombotics, low molecular weight heparins; anticoagulant

Common Use: Prevention of DVT, pulmonary embolism, ischemia complications fr unstable angina, MI, STEMI

Common Side/Adverse Effects: Immune-mediated thrombocytopenia, bleeding episodes

Nursing Interventions: Antidote is protamine sulfate. Monitor CBC esp platelet count. Monitor for bleeding.

Teaching points: Don’t take OTC meds esp aspirin w/o consulting HCP. Report unusual bleeding or bruising.

Question 17

Norepinephrine

Answer 17

Trade Names: Levophed

Classification: vasopressor

Common Use: shock, severe HoTN, heart failure

Common side/adverse effects: anxiety, bradycardia, palpitations

Black Box Warning: Extravasation may produce severe tissue necrosis, sloughing.

Nursing Interventions: Assess EKG, and BP continuously. Assess for extravasation on IV site. Monitor I&O. Don’t leave pt during IV infusion.

Question 18

Phenylephrine

Answer 18

Trade Names: Preparation H, Sudafed PE, Suphedrine PE

Classification: decongestant, vasopressor

Common Use: nasal congestion, SVT, HoTN, dilate pupils

Common side/adverse effects: mild CNS stimulation, rebound nasal congestion, dry nasal mucosa, tachycardia

Black Box Warning: IV use should be administered by adequately trained individuals familiar w/ its use.

Nursing Interventions: Monitor BP, hr. Monitor central venous pressure.

Teaching Points: Discontinue med if adverse reactions occur. Don’t use for nasal decongestion for longer than 3 days. Discon if insomnia, dizziness, weakness, tremor, palpitation occur.

Question 19

Heparin

Answer 19

Trade Names: Hep-lock

Classification: Antithrombotics; anticoagulants

Common Use: Prevent DVT, pulmonary emboli, and emboli fr Afib. STEMI, NSTEMI, unstable angina.

Common Side/Adverse Effects: Bruising or bleeding easily, burning or itching on feet, major hemorrhage

Nursing Interventions: Bleeding precautions. Monitor PPT and aPTT (should be 1.5-2.5 times normal). Monitor/assess urine and stool for occult blood or hematuria. IV 30 min w/in admission.

Teaching points: Use electric razor and a soft toothbrush to prevent bleeding. Blow nose gently. Inform dentist and other physicians of heparin therapy.

Question 20

Atropine

Answer 20

Trade Names: Lomotil

Classification: antidysrhythmic, antispasmodic, anticholinergic

Common Use: bradycardia; preop to inhibit secretions

Common side/adverse effects: dry mouth/nose/throat, constipation, possibly tachycardia

Nursing Interventions: Monitor changes in NP, pulse, and temp. Monitor I&O. Assess skin turgor and mucous membranes for hydration status.

Teaching Points: For preop use, expect warm flushing or feeling to occur.

Question 21

Sildenafil

Answer 21

Trade Names: Viagra, Revatio

Classification: erectile dysfunction agents, vasodilators

Common Use: Pulmonary arterial HTN (PAH), erectile dysfunction

Common Side/Adverse Effects: headache, heartburn, muscle aches, sensitivity to light, flushing

Nursing Interventions: Monitor cardiovascular status. Monitor diet (high fat meals can slow absorption)

Teaching points: Never take drug with nitrates. Report painful urination, dizziness, rash, loss of vision.