Neurosensory Drug List Flashcards
Atropine* ophthalmic
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.
Tropicamide
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.
Ranibizumab
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.
Betaxolol
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.
Mannitol
Black Box Warning
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.
Dexamethasone
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.
Hypertonic saline solution
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.
Gabapentin
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.
Pregabalin
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.
Baclofen
BBA
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.
Gliadel wafer (trade name)
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.
Temozolomide
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.
Cimetidine
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.
Pantoprazole
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.
Pentobarbital
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.
Enoxaparin
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.
Norepinephrine
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.
Phenylephrine
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.
Heparin
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.
Atropine
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.
Sildenafil
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.
