Pharmacology Flashcards
Magnesium Sulfate
- *Indication** HTN, hypomagnesameia, preterm labor, torsade de pointes, asthma, anticonvulant with eclampsia
- *Action** magnesium plays a role in muscle excitability
- *Class** mineral/electrolytes
- *Nursing Considerations** caution with renal insufficiency, decreased respiratory rate, dysrthymias, hypotension, muscle weakness. Monitor EKG and repsiratory status. Monitor Mg levels. 2 practictioner check
Altepase
- Indication MI, Acute ischemis strok, occluded central lines
- Action converts plasminogen to plasmin, degrades fibrin in clots
- Class thrombolytic
- Nursing Considerations Intracranial hemorrhage, bleediing, anaphylaxis, HTN, neuro status
Calcium Acetate
Indication hypocalcemia, menopausal osteoporosis, hypokalemia,
Action maintains cell membranes, muscle contraction, nerve impulses, blood formation and coagulation
Class antacids, minerl/electrolyte replacement
Nursing cardiac arrest and arrhythmias, phlebitis at insertion, hypotension, bradycardia, hypercalcemia, dig toxicity, watch parathyroid hormone
Antidote for Benzodiazepines
Flumazenil
Vasopressin
- *Indication** MGMT of diabetes insipidius, Vt/VF, unresponsibe to initial shock, GI hemorrhage
- *Action** increases water permeability of the kidney collecting duct and distal convoluted tubule elading to water retention, also increases peripheral vascular resistance leading to increased BP
- *Class** antidiuretic hormone
- *Nursing Considerations** caution with HF, and CV disease, contraindicated in renal failure, hypersensitivity to pork. Monitor vitals. Monitor urine specific gravity & osmolality. Weight pt and assess for edema. Monitor electrolyte panel. DO NOT USE alcohol
Propanolol
- *Indication** hypertension, angina, arrthymias, cardiomyopathy, alcohol withdrawal, anziety
- *Action** blocks Beta 1 & 2
- *Class** antianginal, antiarrthymic, antihypertensive, headache suppressant, beta blocker
- *Nursing Considerations** pulmonary edema, contraindicated with CHF, cardiogenic shock, bradycardia, heart block. Masks symptoms associated with diabetes mellitus. Advise physician if difficulty breathing
Atenolol
- *Indication** hypertension, angina, prevention of MI
- *Action** blocks the stimulation of beta 1 receptors in the SNS w/ minimal effect on beta 2
- *Class** antianginal, antihypertensive, beta blocker
- *Nursing Considerations** monitor hemodynamic parameters, bradycardia, CHF, pulmonary edema, Masks symptoms associated with diabete mellitus, advise to change positions slowly to prevent orthostatic hypotension, instruct pt on how to take BP
Diphenoxylate/Atropine
Indication tx of diarrhea
Action inhibits GI motility via anticholinergic effects
Class antidiarrheal, anticholinergic
Nursing contraindicated with angle closure glaucoma, dehydration, r/t opioids watch patients allergic to opioids, SE- constipation, tachycardia, dizziness, ilues, monitor liver, do not double dose
Benzotropine
Indication Parkinson’s Disease
Action anticholinergic to reduce rigidity and tremors
Class antiparkinson, anticholinergic
Nursing arrthymias, hypotension, palpitations, tachycardia, constipation, dry mouth, assess extrapyramidal symptoms, good oral hygiene
Ketorolac (Toradol)
- *Indication** pain
- *Action** pain relif due to prostaglandin inhibition
- *Class** nonsteroidal antiinflammatory agent, non-opioid analgesics, pyrroziline carboxylic acid
- *Nursing Considerations** Steven Johnson Syndrome, anaphylaxis, drosiness, GI bleed, should not exceed 5 days of tx, increased bleeding risk with garlic, ginger and ginkgo, decrease HTN meds and diuretics
Norepinephrine
- *Indication** tx of severe hypotension and shock
- *Action** increase BP and COutput by stimulating alpha-adrenergic receptors in the blood vessels, demonstrates minor beta activity
- *Class** vasopressor
- *Nursing Considerations** monitor bp every couple minutes, can result in rebound hypotension due to tissue ischemia, monitor EKG and CVP if possible. Instruct pt to report headaches, dizziness, and chest pain
Epinephrine
Indication adrenalin, asthma, COPD exacerbations, allergic, cardiac arrest, anesthesia adjunct
Action both beta 1 and beta 2, alpha agonist properties. Bronchodilation, increases HR and BP
Class antiasthmatic, bronchodilator, vasopressor, adrenergic
Nursing angina, tachycardia, hytpertension, restlessness, nervouseness, hyperglycemia, MAOIs can lead to hypertensive crisis, do not use stimulants, hemodynamics, chest pain, adequate fluid intake, rinse after inhalation, beta blockers negate effects, increased blood sugar
Pancrelipase
- *Indication** pancreatic insufficiency, ductal obstruction
- *Action** replacement of pancreatic enzymes: lipase, amylase, protease
- *Class** digestive agent
- *Nursing Considerations** contraindicated in pig products, SOB, rash, assess nutritional status, monitor for steatorrhea, increase uric acid levels, take with meals
semide
diuretic
Hydrochlorothiazide
Indication hypertension, CHF, renal dysfunction, Cirrhosis, glucocorticoid therapy
Action selectively inhibits reuptake serotonin
Class anti hypertensive, diuretics, thiazide diuretic
Nursing dizziness, hypokalemia, hyponatremia, hypophosphatemia, hypomagnesemia, dehydration. hypokalemai can increase risk for dig toxicity. Monitor BP and I/Os. Monitor electrolyte levels. Take same time each day. How to take BP.
-tricin
antibiotics
Altorvastatin
- *Indication** high cholesterol
- *Action** lowers LDL, increase HDL, inhibits HMG-CoA reductase in liver and cholesterol formation
- *Class** lipid lowering agent
- *Nursing Considerations** contraindicated with liver disease,may cayse rhabdomyolysis, renal function, monitor cholesterol, report muscle weakness
Bismuth Subsalicylate
Indication diarrhea, heartburn, indigestion, H.pylori ulcer
Action stimulates absoprtion of f/e’s in intestinal wall, reduction of hypermotility of stomach and binds to toxins
Class antidiarrheal, antiulcer, adsorbant
Nursing contraindicated in aspirin, hypersensitivity, increase risk for impaction with geratric and pediatric patients, monitor liver profile, bismuth may intere fere with radiologic exams
What lab value is an increased risk for dig toxicity
hypokalemia
- Adol -aldol
ex: Tramadol
Analgesic
Indomethacin
Indication inflammaotry disorders when pts do not respond to other meds.
Action decrease pain and inflammation by inhibiting prostaglandin synthesis
Class antirheumatic, ductus arteriosis patency, nonsteroidal antiinflammatory agent
Nursing monitor hepatitis and GI bleed, dizziness, drowsiness and headache. Assess for anaphylactic reaction. Aspirin may decrease effectiveness. Monitor renal labs. Shake supension before administration. Pt should wear sunscreen and protective clothing to protect against photosensitivity.
-azosin
alpha blockers
Examples of selective beta 1s
MEAANe
- Metroprolol
- Exmolol
- Acebutolol
- Atenolol
- Nebivolol
Insulin Mixture
Humulin 70/30
- *Indication** hyperglycemia with diabetes type 1 and type 2, ketoacidosis
- *Action** stimulates uptake of glucose into muscle and fat cells, inhibits production of glucose in the livere, prevents breakdown of fat and protien
- Lispro Mix 15-30 min , pk 2-3 hr*
- Aspart Mix 15 min, 1-4 hr*
- NPH reg 30 min, 4-8 hours*
- *Class** lpancreatics, antidiabetics
- *Nursing Considerations** monitor body weight over time, may cause decreased inorganic phsophates, potassium and mag. Monitor B/S Q6, monitor A1C every 3-6 months
Enalapril
Indication hypertension, MGMT of CHF
Action iblock conversion of angiotensin I to angiotensin II, increases renin levels and decrease aldosterone, vasodilation
Class ACE inhibitor, antihypertensive
Nursing neutropenia, caution with potassium, watch diuretic therapy, admin 1 hour before meals, monitor BP, monitor weight and fluid status, monitor renal profile, monitor CBC
-olone
steroid
Diltiazem
Indication HTN, angina, SVT, Afib, Aflutter
Action inhibits calcium transport resulting in inhibition of excitation and contraction, leads to vasodilation and decreased bp
Class antianginals, antiarrhythmics, antihtn, Calcium Channel Blocker
Nursing contraindicated in 2nd and 3rd av block, dysrythmias, CHF, bradycardia, peripheral edema, ginigval hyperplasia, increases dig levels, no grapefruit juice, monitor EKG, ortho hypotension, monitor potassium, teach how to take BP
Trimethroprim/Sulfamethoxazole
- *Indication** bronchitis, UTI, diarrhea, pneumonia, multiple types of infection
- *Action** bacteriacidal by preventing metabolism of folic acid
- *Class** folat antagonist, antiinfective, antiprotozoal
- *Nursing Considerations** renal damage, steven johnson syndrome, agranulocytosis, aplastic anemia, phlebitis, drink 8-10 glasses of water
Omeprazole
- *Indication** GERD, ulcers, Zollinger syndrome, reduce risk of GI bleed in ill patients, heart burn
- *Action** prevents the transport of H ions into gastric lumen by binding to gastric parietal cells.
- *Class** antiulcer agent, ppi
- *Nursing Considerations** capsules should be swallowed whole, report black tarry stools
Drugs that alter electrolytes
- diuretics
- Thiazides- hold on to Ca & Uric Acid
- ACE- hyperkalemia
- Steroids- hypokalemia
Oxytocin
- *Indication** labor induction, postpartum bleeding
- *Action** stimulates uterine smooth muscle
- *Class** hormone, oxytocics
- *Nursing Considerations** ICH in fetus, asphyxia in fetus, may cause coma and seizures in mother. Monitor blood pressure, assess maternal electrolytes. Uterine Tetany
Cimetidine
Indication duodenal ulcers, CERG, heartburn, Zollinger Ellison syndrome, GI bleeding in crit patients
Action iinhibits action of histamine leading to inhibition of gastric acid secretion
Class H2 antagonist, antiulcer agent
Nursing increases serum levels of warfarin, respiratory infection, watch dysryhthmias, agranulocytosis, aplastic anemia, monitor CBC, increase fluid and fiber intake to decrease constipation
Insulin Rapid Acting
novolog, humalog, apidra,, aspart, lispro, glulisine
- *Indication** hyperglycemia with diabetes type 1 and type 2, ketoacidosis
- *Action** stimulates uptake of glucose into muscle and fat cells, inhibits production of glucose in the livere, prevents breakdown of fat and protien
IAspart 1-20 min , 1-3 hr
glulisine 15 min 1 hr
lispro 15 min 1-1.5 hr
- *Class** lpancreatics, antidiabetics
- *Nursing Considerations** monitor body weight over time, may cause decreased inorganic phsophates, potassium and mag. Monitor B/S Q6, monitor A1C every 3-6 months
Morphine
- *Indication** pain, pulmonary edemia, MI
- *Action** binds to opiate receptors in the CNS and alters perception of pain. Decreases cough reflex and GI motility
- *Class** opioid analgesic,
- *Nursing Considerations** hypotension, constipation, N/V, BP, pulse, RR. Caution with pt receiving MAOIs
Gabapentine
Indication seizures, peripheral neuropathy, neuropathic pain, prevention of migraines
Action exact method of action is unknown
Class anticonvulsant, mood stabilizer
Nursing suicidal thoughts, confusion, depression, drowsiness, ataxia, facial edema, HTN. Monitor pt closely for changes in behavior and dpression. Asses seizure activity, pain. Take as prescribed
-dil-
Vasodilator
Glucagon
Indication severe hypoglycemia, antidote for beta blockers and calcium channel blockers
Action stimulates production of glucose, relaxes GI tract
Class pancreatic, hormone
Nursing anaphylaxis, hypotensionn. Assess for hypoglycemia, neuro status. Monitor serum glucose. Teach pt signs of hypoglycemia
Lamotrigine
- *Indication** Seizures r/t epilepsy, bipolar
- *Action** inibits sodium transport in neurons
- *Class** anticonvulsant
- *Nursing Considerations** suicidal thoughts, dizziness, behavior changes, N/V, photosensitivity, rahs, Steven Johnsons, caution with oral contraceptiv, assess mental status,
Hydralazine
Indication Hypertension
Action arterial vasodilator
Class anti hypertensive, vasodilator
Nursing tachycardia, sodium retention, dysrthymias, angina. Use caution with MAOIs. Monitor BP. Instruct pt on how to take BP
Clindamycin
Indication skin infections, respiratory tract infections, septicemia, intraabdominal infections, osteomyelitis
Action inhibits protein synthesis
Class antiinfective
Nursing arrhthmias, pseudomemrbanous colitis, diarrhea, phlebitis, watch bowel function, cultrues prior to therapy, monitor liver function, monitor cbc
-pidem
hynotic/sedative
Drugs that are ototocxic?
- Loop diuretics
- Aminoglycoside Antibx (Gent)
- Aspirin
-pezil
acetycholinesterase inhibitor
anti-alzheimer agent
Metformin
- *Indication** mgmt of type II DM
- *Action** decreases glucose production inthe liver, decrease absorption, increases ellular insulin sensitivity
- *Class** antidiabetic, Biguanide
- *Nursing Considerations** do not use with renal dysfunction, metabolic acidosis. May cause diarrhea, N/V, lactic acidosis. D/C if acidotic.
Paroxetine
- *Indication** major depressive disorder, OCD, anxiety, PTSD
- *Action** blocks reuptake of CNS
- *Class** antianxiety agent, antidepressant, SSRI
- *Nursing Considerations** neurleptic malignant syndrome, decrease effectiveness of digozin, increase bleeding with warfarin, suicidal thoughts
-thiazide
diuretics
-pamil
vasodilator
-pril
ACE inhibitor
Iron Antidote
Deferoxamine
Antidote for tylenol
acetycysteine
Buproprion
Indication depression, smoking cessation, ADHD
Class antidepressant, smoking deterrents, aminoketones
Nursing seizures, suicidal thoughts, do not take w/ MAOI, renal/liver impairment, assess mental status, avoid alcohol
Alendronate
- *Indication** osteoporosis
- *Action** linhibits osteoclast activity leading to inhibition of resorption of bone
- *Class** bone resorption inhibitor, biphophnates
- *Nursing Considerations** take first thing in the morning w/ water 30 min prior to eating, assess calcium, may cause muscle pain
-mycin
antibiotic
Nystatin
- *Indication** Candidiasis (thrush)
- *Action** causes leakge of funcal cell contents
- *Class** antifungal
- *Nursing Considerations** diarrhea, N/V, caution with dentures, assess mucus membranes
Ibuprofen
Indication mild to moderate pain, inflammatory states
Action decreases pain and inflammation by inhibiting rostaglandins
Class antypyretic, antirheumatics, nonopioid analgesic
Nursing GI bleeding, hepatitis, Stevens Johnson Syndrome. Monitor for headache N/V, constipation. Therapy should be D/Ced after first sign of rash. Monitor renal and liver labs. Avoid alcohol
Cephalexin (Keflex)
Indication skin infections, pneumonia, UTI, otitis media
Action bactericidal
Class antiinfective, cephalosporin 1st generation
Nursing contraindication with penacillin allergy, seizures, pseudomembranous colitis, diarrhea, phlebitis at iv site, anaphalaxis, obtain cultures prior to therapy, monitor bowel function, may lead to super infection, may cause elevated liver enzymes
Propolol
- *Indication** anaesthia, induction, sedation
- *Action** hypnotic, produces amnesia
- *Class** general anesthetic
- *Nursing Considerations** caution with CVD, lipid disorder, increased ICP, apnea bradycardai, hypotension. Burnign pain at insertion site. Can turn urine green, assess respiraotry status and hemodynamic. Maintain patent airway. Assess level of sedation
What lab value is an increased risk for lithium toxicity
hyponatremia
Metoprolol
- *Indication** HTN, angina, prevention of MI, heart failure management. Migrain prophylaxis
- *Action** blocks the stimulation of beta1, receptors in the SNS does not effect beta 2,
- *Class** antianginal, antihypertensive, beta blocker
- *Nursing Considerations** monitor hemodynamics, may lead to bradycardia, pulmonary edema, assess I&Os and monitor signs of CHF
Haloperidol
Indication schisophrenia, mania, aggressive and agitated
Action alters effect of dopamine
Class antipsychotic, butryrophenones
Nursing EPS, caution in QT prolongation. seizures, constipation, dry mouth, agranulosytosis. Assess for hallucinations, Monitor hemodynamics, monitor neurleptic malignant syndrome. CBC with differential
Amiodipine
Indication HTN, Angina
Action blocks transport of calcium into muscle cells inhibiting excitation and contraction
Class antiHTN, CA channel blocker
Nursing Considerations gingival hyperplasia, grapefruit juice may increase drug level, BP and pulse prior to therapy, monitor I/Os, assess signs of CHF, teach patient how to take BP
Beta 1 affects
heart
Famotidine (Pepcid)
Indication short term active ulcer, GERD, heartburn, indigestion, prevetion of GI bleed, over use of NSAIDS
Action blocks action of histamine located in gastric pareital cells, inhibits gastric acid secretion
Class antiulcer agent, H2 antagonist
Nursing dysrthmias, agranulocytosis, aplastic anemias, asses ab pain and occult blood, monitor CBC, instruct pt to increase fluid and fiber intake to prevent constipation
prazole
antiulcer agent
Captopril
Indication hypertension
Action block angiotensin I to angiotensin II, Increases renin levels and decreases aldosterone. Vasodilation
Class ACE inhibitor, antihtn
Nursing neurtopenia, watch potassium, watch diuretics, 1 hr before meals, watch weight and fluid status, renal profile, monitor CBC
Tetracycline
- *Indication** tx of infection, gonorrhea syphilis with penicillin alercy, chornic bronchitis
- *Action** bacteriostatic by inhibiting protein synthesis
- *Class** antiinfective
- *Nursing Considerations** caution with liver impairment. pseudomembranous colitis, diarrhea, N/V, photsensitivity. Increase effects of warfarin.
Chlorpromazine
Indication second line tx for schizo, N/V, pre-op sedation, acute intermittent prphyria, headache, bipolar
Action anticholinergic activity, alters effects of dopamine in CNS
Class phenothiazine, antisychotic, antiemetic
Nursing neuroliptic malignant syndrome, sedation, tardive dyskinesia, hyoptension, agranulocytosis, asses mental status prior to tx, monitor BP, monitor CBC and liver function, do not skip dose
Divalproex
Indication seizures, manic episodes, prevention of headache
Action increases the level of GABA in CNS
Class anticonvulsant, vascular headache suppressants
Nursing suicidal thoughts, agitation, dizziness, insomnia, hepatotoxicity, pancreatitis, increase risk for bleeding w/ Warfarin, caution with MAOIs, monitor liver function
Sertraline
- *Indication** major depressive disorder, OCD, anxiety
- *Action** inhibits uptake of serotonin,
- *Class** antidepressant, SSRI
- *Nursing Considerations** dont use with MAOIs, neurolyptic malignant syndrome, suicidal thoughts, dry mouth, tremors, takes 1-4 weeks for therapy to be effective
Acetaminophen
- *Indication** pain, fever
- *Action** inhibits synthesis of prostaglandins
- *Class** lipid lowering agent
- *Nursing Considerations** do not exceed 4 g per day to limit risk for liver, renal and cardiac damage, OD can lead to hepatotoxicity, increase risk for bleeding w/ warfarin, alter blood glucose measurements
Glipizide
Indication type 2 diabetes mellitus
Action stimulate release and sensitivity to insulin to lower blood glucose
Class anti-diabetic, sulfonylureas
Nursing aplastic anemias, hypoglycemia, photosensitivity, dizziness, drowiness, headache, diarrhea. Monitor CBC, assess for allergy to sulfonamides. Beta blockers may creat signs of hypoglycemia. Instruct patient on how to check blood sugars. Carry source of sugar in case of hypoglycemia
Dexamethasone
Indication cerebral edema, assess for cushing’s dissease
Action suppress inflammation and normal immune response. Used in inflammatory states
Class antiasthmatics, corticosteroids,
Nursing watch liver, avoid in untreated infections, may cause CNS alteration, peptic ulcers, cushings, weight gin, osteoporosis, decrease wound healing, elevated blood sugars, watch lipid and cholesterol
Spironolactone
- *Indication** potassium loss, hypertension, edema CHF
- *Action** inhibits sodium reabsorption while sparing potassium and hydrogen
- *Class** diuretic
- *Nursing Considerations** contraindicated with hyperkalemia, monitor I/O, BP, potassium and renal panel
Diazepam
Indication anxiety, pre-op sedation, conscious sedation, tx of seixures, insomnia, mgmt of alcohol withdrawal
Action depress the CNS
Class benzodiazepine, antianxiety, anticonvulsant, skeletal muscle relaxant
Nursing ccontraindicated in hepatic dysfunction, wathc renal impairment, dizziness, drowsiness, lethargy, hypotension, physical dependence, tolerance, caution with alcohol use
Cardiopa/Levodopa
Indication parkinson’s disease
Action levodopa converts to dopamine and works as a neurotransmitter and carbidopa prevents destruction of levodopa
Class dopamine agonist, antiparkinson agent
Nursing orthostatic hypotension, dark urine, takes weeks to effect, no MAOIs, no with glaucoma/melanoma
Heparin Antidote
Protamine Sulfate
Streptokinase
- *Indication** pulmonary embolism, DVT, occluded lines, arterial thrombus
- *Action** converts plasminogen to plasmin which degenerates fiibrin clots
- *Class** thrombolytic, plaminogen activator
- *Nursing Considerations** contraindicated with active bleeding, hypersensitivity, bronchospasm, ICH, hypotension,. Begin therapy as soon as possible, Monitor VS continuously. Avoid invasive procedures
Phenytoin
- *Indication** tonic clonic seizures, dysrthymia, neuropathic pain
- *Action** interferes with ion transport, shortens action adn decreases automaticity
- *Class** antidysrthmia, anticonvulsant, hydanotin
- *Nursing Considerations** ataxia, suicidal thoughts, EPS, hypotension, tachy cardia, gingival hyperplasia, enteral feedings may decrease absorption, monitor for hypersensitivity, assess seizures, therapeutic level is 1-20 mcg/ml
Procainamide
- *Indication** ventricular and atrial dysthrythmias, PAC, PVC, Vtach, post cardioversion
- *Action** decreases excitibility and slows conduction velocity
- *Class** antidysrthmia
- *Nursing Considerations** ventricular dyrhythmias, seizures, aysystole, heart block. widening of QRS complex. hypotensions must be supine. can cause drug induced lupus syndrome
Lorazepam
- *Indication** anxiety, sedation
- *Action** general CNS depression
- *Class** anesthetic, antianxiety, sedative hypnotic, bonzo
- *Nursing Considerations** caution with COPD and sleep apnea, avoid alcohol use, antidote is Flumazenil, may cause cardiac arrest, bradycardia, hypotension, administer slowly and dilute to decrease complications
Levetiracetam
Keppra
- *Indication** seizures
- *Action** decreases everity and incidence of seizures
- *Class** anticonvulsant
- *Nursing Considerations** suicidal thoughts, dizziness, weakness. Alters RBC, WBC and liver function. Somnolence. Infuse over 15 min
Phenazopyridine
- *Indication** urological pain
- *Action** analgesia to Urinary tract mucosa
- *Class** non opioid analgesic
- *Nursing Considerations** urine will turn red orange. headache, vertigo, heaptic toxicity, monitor renal function
Amoxicillin
- *Indication** skin ifections, respiratory infections, sinusitis, endocarditis prophylaxis, lime disease
- *Action** linhibits synthesis of bacterial cell wall leadting to cell death
- *Class** antiinfective, antiulcer, aminopenicillins
- *Nursing Considerations** contraindicated w/ penicillin allergy, seizures, rash anaphylaxis, excreted by kidneys-monitor renal albs, monitor pt for diarrhea, bloddy stool should be reported immediately
Aspirin
- *Indication** rheumatoid arthritis, osteoarthritis, ischemic stroke and MI prophylaxis
- *Action** inhibits production of prstaglandins which leads to rreductiono fever and inflammation, decreases platelet aggregation leading to a decrease in ischemic diseases
- *Class** antipyretic, non opioid analgesic, salicylates
- *Nursing Considerations** bleeding, chronic alcohol use, Steven Johnson syndrome, laryngeal edema, anaphylaxis, increass risk for bleeding with warfarin, heparin, and clopdiogrel, increased risk for GI bleeding w. NSAID, liver function tests
Loperamide (Imodium)
- *Indication** Acute diarrhea, decrease drainage post ileostomy
- *Action** inhibits peristalsis, reduces volumje of feces wwhil increasing the bulk and viscoscituy
- *Class** antidiarrheal
- *Nursing Considerations** can lead to constipation, asses bowel function, assess fluid and elctrolyte levels
Terbutaline
- *Indication** asthma, COPD, preterm leabor
- *Action** prdouces bronchodilation
- *Nursing Considerations** nervousness, restlessness, tremors, assess respiratory status. monitor for hypoglycemia, may cause decreased potassium level.
Naproxen
- *Indication** pain dimennorhea, fever, inflammation
- *Action** inhibits prostaglandins
- *Class** NSAID, antipyretic
- *Nursing Considerations** GI bleeding, increase risk for stroke and MI, Steven Johnson Syndrome, should remain upright 30 min after administration
- arone
ex: Amiodarone
antiarrhythmic
Cefaclor
Indication tx of respiratory tract infections, skin infections, otitis media
Action bacteriacidal, binds to bacterial cell wall causing cell death
Class cephalosporin 2nd generation, anti-infective
Nursing contraindicated cephalosporin and penicillin allergies, may lead to seizures, pseudomembranous colitis, diarrhea, phlebitis at iv site, anaphalzis, assess infection and allergies, obtain cultures prior to therapy, monitor bowel function, can lead to super infection
Promethazine
- *Indication** allergic reactions, N/V, sedation
- *Action** blocks the effects of histamine, antiemetic effect. anticholinergic, CNS depression
- *Class** antiemetic, antihistamine, sedative, phenothiazine
- *Nursing Considerations** IV administration can cause tissue damage, hypertension impaired liver function. Neuroleptic malignant syndrome, confusion, sedation
-conazole
systemic antifungal
-sartan
ARBs
-Zoin
Alpha adrenergic blocker
Vancomycin
- *Indication** life threatening infection
- *Action** bacetericidal, antiinfective
- *Class** antianginal, antihypertensive, beta blocker
- *Nursing Considerations** ototoxicity, N/V, nephrotoxicity, anaphylaxis, red man syndrome,. Monitor BP
Clopidogrel (plavix)
Indication atherosclerotic events, MI, CVA, PVD, acute coronary syndrome
Action inhibits platelet aggregration
Class antiplatelet, platelet aggregation inhibitor
Nursing GI bleed, neutropenia, hypercholesterolemia, increase risk for bleeding, monitor CBS and platelet count, discontinue 5-7 days before surgery
Why are statins administered in the evening
because cholesterol synthesis increases at night
Digoxin
Indication CHF, Afib, Aflutter
Action ipositive inotropic effect, increases force of Myocardial contraction, prolongs refractiory period, decrease conduction through SA and AV nodes. Increases CO and slow Rate
Class antiarrhythmic, inotropics, digitalis glycosides
Nursing contraindicated with uncontrolled ventricular arrhthmias, hypokalemia increase risk for toxicity, hypercalcemia increase risk for toxic, caution with diuretic, watch for bradycardia, toxciity= vision changes, yellow green vision, montior pulse rate for 1 full minute
-perone
antianxiety agent
Sucralfate
- *Indication** GI ulcers, GI injury prevention form high dose aspirin, NSAID tx
- *Action** reacts with gastric acid to form a paste that dheres to ulcer
- *Class** antiulcer, GI protectant
- *Nursing Considerations** caution in renal failure, concurrent use of antacids may decrease the effect of sucralfate. Administer 30 min before or after. Adminsiter on empty stomch 1 hour before meals
Digoxin antidote
digiband
Butorphanol
Indication severe pain, labor pain, sedation
Action alters perception and response to pain by biding to opiate receptors in the CNS
Class opioid analgesic, agonists
Nursing caution with MAOIs, may cause confusion, hallucination, sedation, Monitor CNS depression, assess BP, pulse and respirations, aminister slowly through IV line
Verapamil
- *Indication**hypertension, angina, SVT, migrain
- *Action** prevents tranport of calcium, leading to decreased contraction, decreases SA and AV node conduction
- *Class** antianginal, antiarrthymic, antihtn, vascular headache. CA blocker
- *Nursing Considerations** dont use with 2nd 3rd degree block. can cause anxiety, confusion, cough, dypsnea, CHF, bradycardia, hypotension, elevated liver enzymes, Steven’s Johnson sydrome. Hyperglycemia, gingival hyperplasia. grapefruit can increase effects. Can increase levels of diozin. assess angina.
Antidote for Magnesium Sulfate
Calcium Gluconate
Amitryptiline
- *Indication** depression, anxiety, insomnia
- *Action** increases effect of serotonin and norepinephrine in the CNS, exhibits antichoinergic effects
- *Class** Antidepressant, tricyclic
- *Nursing Considerations** contraindicated in MI, heart failure, glaucoma, risk for suicidal ideation, arrthythmias, hypotension EKG, alter BG levels, lethargy, do not use with MAOIs, take exactly as instructed, orthostatic hypotension, photosensitivity, may turn urine blue/green
tidine
H2 blocker
-terol
bronchodilator
Cortisone
Indication adrenal insufficiency, Addison’s Disease
Action suppress inflammation and normal immune response. Adrenal glands exrete steroid, cortisol, blood sugars, metabolism of fat, protein and carbohydrates. decreasing bone formation
Class antiasthmatic, corticosteroids
Nursing watch liver, avoid untreated infections, CNS alteration, peptic ulcers, Cushings, Weight, gain, osteoporosis, decrease wound healing
Ranitidine
- *Indication** duodenal ulcers, GERD, heartburn esophagitis, GI bleed
- *Action** inhibits action of histamine in gastric pareital cells, decreases gastric acid secretion
- *Class** antiulcer agent, H2 blocker
- *Nursing Considerations** dysrthmias, agranulocytosis, aplastic anemia, confusion. Ab pain, monitor for blood in stool. monitor CBC
Pantoprazole
- *Indication** GERD, heartburn
- *Action** decreases accumulation of acid in the stomach
- *Class** antiulcer agent, ppi
- *Nursing Considerations** hyperglycemia, abdominal pain, decreases absroption of certain drugs, may increase bleeding with warfarin, assess for occult blood.
Albuterol
Indication bronchodilator prevent airway obstruction in asthma and COPD
Action binds to Beta 2 adrenergic receptors in the airway leading to relaxation of smooth muscles in the airways
Class bronchodilator/adrenergic
Nursing Considerations may decrease effectiveness of beta blockers, caution w heart disase, diabetes, galucoma, seizure disorder, bronchospasms, chest pain, palpitations, decrease digoxin levels
Ondansetron
- *Indication** Nausea and vomiting
- *Action** blocks effects of serotonin on vagal nerve and CNS
- *Class** antiemetic, 5-HT3 antagonist
- *Nursing Considerations** headache, constipation, diaarrhea, dry mouth. EPS symptoms, monitor liver function tests. Administer slowly over 2-5 minutes
Nifedipine
- *Indication** HTN, angina, migranes, CHF
- *Action** blocks calcium transport, inhibits contraction causing sytemic vasodilation
- *Class** antianginal, antihypertensive, CA blocker
- *Nursing Considerations** no grapefruit juice, dysrthymias, elevated liver function tests, gingival hyperplasia, monitor BP and pulse
Hydrocodone/Acetominiphen (Norco)
Indication moderate to severe pain
Action alters perception and reaction to pain by binding to opiate receptors in the CNS. Suppresses the cough reflex.
Class opioid analgesic, allergy, cold and cough remedy.
Nursing hypotension, monitor hemodynamics and respirations. May increase ICP. Narcan is the antidote for OD. Do not exceed 4g of acetominophen per day
-vir, vir-
antiviral
Nitroprusside
- *Indication** hypertensive criss, cardiogenic shock
- *Action** peripheral vasodilation of arteries andv eins decreasing preload and afterload
- *Class** vasodilator, antihypertensive
- *Nursing Considerations** monitor HR, BP, EKG continuously. Cyanide toxciity. Sympathomimetics may decrease effectiveness, PAOP monitoring may help with MI and CHF
Carbamazepine
Indication seizure, DM neruopathy, pain associated with trigeminal neuralgia
Action affects sodium channels in neurons leading to decreased synaptic transmission
Class anticonvulsant
Nursing interferes with oral contraceptives, do not use with MAOIs, suicidal thoughts, Steven Johnson syndrom, agranylocytosis, aplastic anemia, thrombocytopenia, No grapefruit juice, monitor CBC and platelets, monitor blood levels
Ferrous Sulfate
Indication prevention of iron deficiency anemia
Action iron is needed for hemoglobin, myoglobin and enzymes. It is transported to organs where it becomes part of iron stores
Class anti-anemic, iron supplement
Nursing seizures, hypotension, constipation, epigastric pain, diarrhea, skin staining, anaphylaxis. Asses nutrtional status, bowel function. Monitor hemoglobin, hematocrin. May cause eleved liver enzymes. Should take on an empty stomach to increase absorptio (vit c helps). Use z-track for IM injections.
Lithium
- *Indication** mania
- *Action** alters cation transport and neurotransmitter reuptake
- *Class** mood stabilizer
- *Nursing Considerations** do not administer with NSAIDS, monitor drug blood levels frequently. May cause seizures dyrthymias, EKG changes, fatiuge, confusion, nausea, anorexia, hypothyroidism tremors. ACE inhibitors may increase serum levels. Instruct patient to maintain adequate fluid intake. Therapeutic level 0.5-1.5 mEq/L
Fentanyl (Sublimaze)
Indication supplement to general anethseia, continuous IV infusion for purpose of analgesia
Action binds to opiate receptors in the CNS altering perception of pain, producing CNS depression
Class opioid analgesic
Nursing watch for ICP, head trauma and adrenal insufficiency. Avoid MAOIs. Can cause apnea, laryngospasm, decreased respiration, bradycardia, hypotension. Do not consume grapfruit juice. Monitor hemodynamics. Assess pain scale
Isoniazide
INH
- *Indication** tuberculosis
- *Action** inhibits synthesis of mycobacterial cell wall
- *Class** antitubercular
- *Nursing Considerations** jaundice, peripheral neropathy, seizures, hepatitis, avoid tyramine, monitor liver function
-aril
Antiviral
Heparin
Indication venous trhomboembolism, prophylaxis and tx. Low dose used to ensure patency of IV catheters
Action increases the inhibitory effect of antithrombin on factor Xa
Class anticoagulant, antithrombotic
Nursing monitor signs of bleeding, platelet count, hyperkalemia, pt report signs of bleeding
Montelukast
- *Indication** prevent asthma, manage seasonal allergies, prevent exercise induced bronchoconstriction
- *Action** disrupts the effects of leukotrienes which effect airway edema.
- Class** allergy, cold, cough remedis, bronchodilator. Leukotriene antagonist*
- *Nursing Considerations** assess respiratory status, liver function, does not treat acute asthma
Olanzapine
- *Indication** schizophrenia, mania, depression, anorexia nervosa, N/V, r/t chemo
- *Action** antagonizes dopamine and serotnin
- *Class** antipsychotic, mood stabiilizer, thienbenzodiazioines
- *Nursing Considerations** do not use while breastfeeding, neurlyptic malignant syndrome, seizures, suicidial thoughts, inosmonia, tardive dyskinesia, aggranulocytosis, constipation, tremors, assess mental status, hemodynamics, Blood sugars, intake and output. liver function tests
hydropmorphone/Dilaudid
Indication moderate to severe pain
Action alters perception and reaction to pain by binding to opiate receptors in the CNS. Suppresses the cough reflex.
Class opioid analgesic, allergy cold and cough remedy, antitussive
Nursing assess BP, respirations and pulse before and druing admin. CNS depression. Narcan is the antidote for OD. Caution with MAOIs. May be used as an antitussive. Dilue with NS prior to administration and to administer slowly to decrease CNS depression
Metronidazole
(Flagyl)
- *Indication** intra-abdominal infections, gynecoligical infections, septicemia, endocarditis, amebic liver abscess, peptic ulcer
- *Action** inhibits dna and protein synthesis in bacteria
- *Class** anti-infective, antiprotoxoals, antiulcer
- *Nursing Considerations** obtain cultures before therapy, monitor neruologic status, monitor intake and outpus and daily weights. May alter liver enzymes
Furosemide (Lasix)
Indication edema, hypertension
Action prevention reabsorption of sodium and chloride in kidneys, increase excretion of water, sodium, chloride, magnesium and potassium
Class diuretic, loop
Nursing caution with liver disease. Can cause hypotension, dry mouth, excessive urination, dehydration, electrolyte, metabolic alkalosis. Hypokalemia may lead to increase risk of digoxin toxicity. Monitor renal panel. Caution with antihypertensives. Causes arthritic symptoms. Do not take wih aminoglycosides due to ototoxicity.
Insulin Long Acting
Detemir, Glargine, Levemir, Lantus
- *Indication** hyperglycemia with diabetes type 1 and type 2, ketoacidosis
- *Action** stimulates uptake of glucose into muscle and fat cells, inhibits production of glucose in the livere, prevents breakdown of fat and protien
Detemir onset 3-4 hr, Peak 3-14hr
Glargine 3-4,, no peak
- *Class** lpancreatics, antidiabetics
- *Nursing Considerations** monitor body weight over time, may cause decreased inorganic phsophates, potassium and mag. Monitor B/S Q6, monitor A1C every 3-6 months
Propylthiouracil (PTU)
- *Indication** HYPERthyroidism
- *Action** inhibits thyroid hormones
- *Class** antithyroid agent
- *Nursing Considerations** hepatoxicity, N/V, agranulocytosis, WBC and liver function tests, weight patient frequently, lekopenia, jaundice. Take with meals
What drugs may lead to agranulocytosis
- Hyperthyroid drugs
- Propylthiorucil
- Methimazole
- Clozapine- 2nd gen antipsychotic
Guaifenesin (Robitussin)
Indication cough suppression
Action decreases viscosity of and mobilizes secretions
Class allergy, cold, cough remedy, expectorant
Nursing avoid OTC meds, assess lung sounds. Adequate fluid intake
Coumadin Antidote
Vitamin K
Epoetin
Indication anemia
Action stimulates erythropoesis,
Class anti-anemic, hormones
Nursing contraindicated in albumin sensitivity, seizures, CHF, MI, CVA, HTN, monitor BP, assess dialysis shunts, monitor bleeding times, seizure precautions, do not shake vial
Warfarin
- *Indication** venous thrombosis, pumonary embolism, afib, myocardial infarction
- *Action** disrupts liver synthesis of Vitamin K dependent clotting
- *Class** anticoagulatn, coumarins
- *Nursing Considerations** contraindicated with bleeding, severe hypertension. Azole and anitfungals increase effects. Obtain full hx of supplements and herbsl. Large amounts of Vit K may antagonize effects of warfarin. Therapeutic level PT 1.3-1.5, INR 2.5-3.5/ No alcohol. Monitor bleeding times
What drugs can lead to bleeding
- NSAIDS
- Anticoagulatns
- Thrombolytics
- Aspirin
Lactulose
- *Indication** Constipation, portal systemic encephalopathy
- *Action** draws water into the stool and softens stool, inhibits ammonia passing into the colon
- *Class** osmotic laxative
- *Nursing Considerations** caution with DIabetes, may cause cramps ab distention and hyperglyciema, mental status, ammonial levels , avg 2-3 bowel movement per day
Losartan (Cozaar)
- *Indication** HTN, DM neuropathy, CHF
- *Action** inhibits vasoconstrictive properties of angiotensin II
- *Class** angiotensin I receptor antagonist
- *Nursing Considerations** hypotension, tachycardia, angioedema, hyperkalemia. May increase digoxin levels. Asses BP and Heart rate. Assess fluids. Monitor dail weights with CHF. Monitor renal and liver.
Calcium Carbonate
Indication severe pain, labor pain, sedation
Action alters perception and response to pain by biding to opiate receptors in the CNS
Class opioid analgesic, agonists
Nursing caution with MAOIs, may cause confusion, hallucination, sedation, Monitor CNS depression, assess BP, pulse and respirations, aminister slowly through IV line
Gentamicin
Indication Tx of gram negative infection when penicillin is ineffective
Action sinhibits bacterial protein sysnthesis
Class aminoglycoside, anti=infective
Nursing causes tinnitus hearing loss, do not administer with penicillin. Caution in renal impairment. Assess for infection. Obtain cultures prior to therapy. Monitor liver function tests. Monitor blood levels of drug
Celecoxib
Indication Osteoarthritis, rheumatoid arthritis, acute pain
Action decrease pain and inflammation by inhibiting synthesis of prostaglandins
Class antirrheumatics/NSAID
Nursing watch cardiovascular disease, increase risk for MI, CVA, thrombosis, GI bleeding, steven johnson synddrome, dermatitis, notify provider for new onset of abdominal pain or black stool
Alprazolam
- *Indication** anxiety, panic disorder, PMS, insomnia, mania, psychosis
- *Action** CNS anxiolytic effect, CNS depression
- *Class** anti anxiety agent, benzo
- *Nursing Considerations** caution w/ sleep apnea, renal dysfunction, hepatic dysfunction, drowsiness, lethargy, physical dependence, tolerance effect, flumazenil is the antidote, grapefruit juice may increase blood levels
Levofloxacin
- *Indication** UTI, gonorrhea, respiratory infection, bronchitis, pneumonia, skin and bone infection
- *Action** inhibits DNA synthesis in bacteria. Antiinfective
- *Class** fluoroquinolone
- *Nursing Considerations** contraindicated in allergies. May cause QT prolongation, avoid use with other drugs that can cause QT prolongation. Seizures, dyrthymias, pseudomembranous colitis, anaphylaxis, Steven Johnson. Decreased of phenytoin. Monitor renal panel. Asses for infection, obtain cultures prior to therapy, monitor liver function tests.
Salmeterol
- *Indication** reversible airway obstruction, exercise induced asthma
- *Action** bronchodilation through stimualtion of beta 2 adrenergic receptor
- *Class** bronchodilator, adrenergic
- *Nursing Considerations** avoid excessive use, headache, palpitations, tachycardia ab pain, paradoxical bronchospasm. decrease effectiveness of betablockers. Assess respiratory status. May increase glucose levels
Dopamine
Indication improve blood pressure, cardiac output and urine output
Action small dose result in renal vasodilation, medium cardiac stimulation by acting on beta 1 receptors, large dose stimulate alpha receptors leading to vasoconstriction increase SVR
Class inotropic, vasopresser
Nursing cmonitor BP, HR, EKG, CVP, PAOP, titrate to obtain appropriate BP, irritation may occur at IV site, beta blockers may counteract therapeutic effects
Iodine
- *Indication** thyroidectomy, thyrotoxic crisis, radiation exposure
- *Action** inhibits release of thyroid hormones
- *Class** antithyroid agent
- *Nursing Considerations** GI bleed, diarrhea, hypothyroidism, goiter, monitor for hypersensitivity
Quetiapine
- *Indication** schizophrenia, depressive disorder, mania
- *Action** dopamine and serotonin antagonist
- *Class** antipsychotic, mood stabilizer
- *Nursing Considerations** neuroleptic malignant seziures, dizziness, palpitations, weight gain, anorexia, dont use with CNS depressants. Weight frequently, Monitor liver function test and CBC, may increase cholesterol
Bisocodyl
Indication constipation, bowel regimen
Action stimulates peristalsis leads to fluid accumulation in the colon
Class laxative, stimulant laxative
Nursing hypokalemia, ab pain, use caution w/ milk, abdominal distention & bowel function, drink 1500-2000 ml/day during therapy, monitor F&E, take as ordered
Ampicillin
- *Indication** skin infections, soft tissue infections, otitis media, sinusitis, respiratory infection, GU infections, meningitis, septicemia
- *Action** bactericidal, broader spectrum than penicillins, binds to cell wall leading to bacterial cell death
- *Class** antiinfective
- *Nursing Considerations** super infection fury overgrowth on tongue, vaginal itching, loose and foul smelling stool, pt should not use with oral contracetive, liver function, can cause seizures, diarrhea, anaphylaxes super infection
Methadone
- *Indication** withdrawal symptoms, pain
- *Action** binds to opiate receptors in the CNS and alters perception of pain while producing a general depression of the CNS. Decrease in the cough reflex and GI motility
- *Class** opioid analgesic
- *Nursing Consideration** caution with MAOIs may cause QT prolongation, hypotension, respiratory depression, dependence, confusion, sedation. Assess pain, vital signs, bowel function. May increase pancreatic enzyme levels. Assess withdrawal symptoms
What drogs are nephrotoxic?
- cyclosporine
- Aminoglycoside Antibiotics (Gentamycin)
- NSAIDS
- Antiviral agnes such as Acyclovir
-sporin
immunosuppresants
Midazolam
- *Indication** Sedation, conscious sedation, anesthesia, status epilepticus
- *Action** CNS depressant, mediated by GABA
- *Class** Benzo, antianziety, sedative
- *Nursing Considerations** assess level of sedation 2-6 hours following. Monitor BP, Pulse, Respirs, IV administratiaon, Antidote is Flumazenil
Beta 2 means
2 lungs- constrict bronchi lead to increase in blood glucose concentration
Nalpuphine
- *Indication** pain, analgesia during labor, sedation before surgery, supplement of balance anesthesia
- *Action** alters perception and response to pain, causes CNS depression
- *Class** opioid analgesic
- *Nursing Considerations** caution with head trauma, dizziness, headache, N/V, respiraotry depression. Do not use with MAOIs, assess pain, hemodynamics, can elevate pancreatic enzymes. NARCAN antidote
Amiodarone
- *Indication** ventricular arrthythmias, SVT, ACLS V-fib, Vtach
- *Action** prolongs action potential, inhibits adrenergic stimulation, decreases peripheral vascular resistance causing vasodilation
- *Class** Antiarrthymic Class III, Potassium channel blocker
- *Nursing Considerations** can cause ARDS, pulmonary toxicity, CHF, bradycardia, hypotension, increases dig levels, increases activity of warfarin, 2 RN check, monitor pulse daily and pt report abnormaility, avoid drinking grapefruit juice
Erythromycin
Indication in place of peniccillin, upper and lower respiratory tract infections, otitis media, skin infections, pertussis, syphilis, rheumatic fever
Action suppress bacterial protein synthesis, bacteriostatic
Class antiinfective, macrolide
Nursing QT prolongation, ventricular arrhythmias, diarrhea, liver function
What drugs are hepatotoxic?
- INH
- Acetominophen
- Statins
- Valproic Acid
- Antifungal Agents- “Azoles”
What does a scheduled I drug mean
very addictive (heroin, LSD)
Fluticasone (Flovent)
Indication prophylactic asthma treatmt
Action local anti-inflammatory
Class corticosteroid, inhalation, anti-asthmatic
Nursing watch for untreated infectios and suppressed immune function. Can cause headaches, insomnia, bronchospasm, nasal congestion, adrenal suppression. Monitor respiratory status, may lead to decreased bone density. Bronchodilators should be used BEFORE corticosteroids. Stop smoking
Acyclovir
- *Indication** genital herpes, herpes zoster, chicken pox
- *Action** interferes w/ viral DNA synthesis
- *Class** antiviral, purine analogues
- *Nursing Considerations** seizures, renal failure, Steven Johnson syndrome, thrombotic pprpura syndrome, diarrhea, dizziness, nausea, renal panel during administration, assess lesions, use proper protection druing sexual intercourse
-cef
cephlosporin
Rifampin
- *Indication** TB
- *Action** inhibits RNA synthesis
- *Class** antitubercular, rifamycin
- *Nursing Considerations** can turn body fluids red. N/V, confusion. Assess lung sounds and sputum, evaluate renal and liver tests, instruct patient not to skip or double dose
Escitalopram (Lexapro)
Indication major depressive disorder, anxiety, PTSD, social phobia
Action selectively inhibits reuptake serotonin
Class antidepressant, SSRI
Nursing contraindicated wtih MAOI, citallrpan use, may cause suididal thoughts, insomnia, diarrhea, nausea, serotonin syndrome, QT prolongation, sexual dysfunction, 406 weeks for full affect to take place
Insulin (Short Acting)
- *Indication** hyperglycemia with diabetes type 1 and type 2, ketoacidosis
- *Action** stimulates uptake of glucose into muscle and fat cells, inhibits production of glucose in the livere, prevents breakdown of fat and protien
- IV onset 1-2 hr, Peak 4-12 hr*
- *Class** lpancreatics, antidiabetics
- *Nursing Considerations** monitor body weight over time, may cause decreased inorganic phsophates, potassium and mag. Monitor B/S Q6, monitor A1C every 3-6 months
Methlergonovine
- *Indication** postpartum hemorrhage
- *Action** stimulates uterine muscles causing uterine contraction
- *Class** oxytocic, ergot alkaloids
- *Nursing Considerations** can cause hypertension, cramps, N/V, dyspnea. Monitor BP, HR and uterine response. Assess caclium levels
Diphemhydramine (Benadryl)
Indication allergy, anaphylaxis, sedation, motion sickness, antitussive
Action antagonizes effects of histamine, CNS depression
Class allergy, cold and cough, antihistamine, antitussive
Nursing drowsiness, anorexia, dry mouth, nausea, chest tightness, thick secreations, hypotension, blurred vision, headache, anticholinergic effects, monitor cough and lung sounds, avoid otc meds.
Enoxaparin
Indication prevention of VTE, DVT, and PE
Action iprevents thrombus formation by potentiating the inhibitory effect of antithrombin on factor Xa
Class anticoagulant, antighrombotic
Nursing contraindicated in pork hypersensitivity, onitor signs of bleeding, admin in SUBQ tissues, do not eject air bubble prior to injection, do not aspirate or massage site
-azepam
Antianxiety
-pressin
vasoconstrictor
Nal-
narcotic agonist/antagonist
Cyclosporine
Indication prevent rejection in transplantation, treatment of RA, MGMT of ulcerative colitits
Action inhibits normal immune response,
Class apolypeptides,immunosuppresants, antirheumatics (DMARD)
Nursing cseizures, tremors HTN, hepatoxicity, diarrhea, N/V, gingival hyperplasia, increase immune suppression, avoid grapefruit juice, renal panel, liver enzymes, lifelong therapy required for transplant patients, teach how to take bp
Fluoxetine (Prozac)
Indication depressive disorder, PCD, bulimia, panic, bipolar, ADHD, DM neuropathy, obesity
Action inhibits reuptake of serotonin,
Class antidepressant, SSRI
Nursing contraindicated wtih MAOI, citallrpan use, may cause suididal thoughts, insomnia, diarrhea, nausea, serotonin syndrome, QT prolongation, monitor nutrition, good oral hygiene. 4-6 weeks for full affect to take place
Mannitol
- *Indication** increased ICP, oliguric renal failure, edema introcular pressure
- *Action** reeabsorption of water and electrolytes by increasing osmotic pressure excreted by the kidneys
- *Nursing Considerations** phlebitis at IV site. Dehydration, F/E imbalance. Monitor neuro status
Barb
Barbituric Acid derivatives
Meperidine
- *Indication** moderate to severe pain, sedation
- *Action** binds to opiate receptors in the CNS and alters perception of pain, while producing a general depression of the CNS
- *Class** opioid Analgesic
- *Nursing Considerations** altered mentation, hypotension, constipation, N/V. Assess BP, pulse and respriatory rate. Use caution if matient is receiving MAOIs. Narca is the antidote. Can cause seizures. May increase pancreatic enzyme levels. Assess bowel function
ACE Inhibitor consideration
- *Indication** hypertension, CHF
- *Action** block convfersion of angiotensin I to angiotensin II, increases renin levels and decreases aldosterone leading to vasodilation
- *Nursing Considerations** caution with potasssium supplements and potassium sparing diuretics. Caution with diuretic therapy, Administire 1 hour before meals, Monitor BP often. Monitor weight and fluid status. Monitor renal profile. Monitor liver function tests
Potassium antidote
insulin, NaHCO3, Kayexalate, Albuterol
Opioids antidote
naloxone
Codeine
Indication mgmt of pain, diarrhea, cough suppressant
Action binds to opiate receptors in the CNS and alters perception of pain while producing genereal depression of CNS. Decreases cough reflex and GI motility
Class allergy, cold, cough remedy, antitussive, opioid analgesic, opioid agonist
Nursing alteration in mentation, hypotension, constipation, N/V, asses vitals before admin, caution with MAOIs
Methylphenidate
(ritalin)
- *Indication** ADHD, narcolepsy
- *Action** improves attention span
- *Class** CNS stimulatn,
- *Nursing Considerations** sudden death, hypertension, plapitations, anorexia, hyperactivity, insomnia. decreased effects of warfarin and phenytoin. Do not use with MAOIs. Do not consume caffeniated beverages. Monitor for dependence
Metoclopramide
(Reglan)
- *Indication** prevention of N/V hiccups, migrains, gastric stasis
- *Action accelerates gastric emptying by stimulating motility**
- *Class** anti-emetic
- *Nursing Considerations** do not use with GI obstruction. Can cay extrapyramidal reaction, Neurolyptic malignant syndrome, Tardive dyskinesia, dysrithymias, BP alterations, hematologic alteration, facila movements, sedation. Can decrease effects of levodopa. Monitor liver function
-Alol
combined alpha and beta blockers
Atropine
- *Indication** decreases oral and respiratory secretions, treats sinus bradycardia and heart block, treatment of brochospasm
- *Action** anticholinergic inhibits the effects of PNS, acetycholine. Increases HR, bronchodilation decreased GI and respiratory secretions
- *Class** antiarrthmic, anticholinergic, antimuscarinic
- *Nursing Considerations** avoid acute hemorrhage, tachycardia, and angle closure glaucoma, monitor tachycardia and palpitations, may cause urinary retention, constipation
Dobutamine
Indication short term mgmt of heart failure
Action positive inotropic effects, little effect on heart rate. Stimulates beta receptors in the heart
Class inotropic, adrenergic
Nursing hemodynapics, hypertension, increase HR, PVCs, skin reactions, beta blockers may negate therapeutic effects, montior CO, watch peripheral pulses, do not confuse with dopamine
Insulite (Intermediate Acting)
NPH, Humulin N, Novolin N
- *Indication** hyperglycemia with diabetes type 1 and type 2, ketoacidosis
- *Action** stimulates uptake of glucose into muscle and fat cells, inhibits production of glucose in the livere, prevents breakdown of fat and protien
IV onset 10-30min, Peak 15-30min
- subQ 30-60 min, peak 2-4 hours*
- *Class** lpancreatics, antidiabetics
- *Nursing Considerations** monitor body weight over time, may cause decreased inorganic phsophates, potassium and mag. Monitor B/S Q6, monitor A1C every 3-6 months
Levothyroxine
- *Indication** thyroid hormone replacement in hypothyroidism
- *Action** replaces thyroid hormone increasing metabolism, promotes gluconeogensis, stimulates protein synthesis, restores normal hormone balance ans uppresses thyroid cancer
- *Class** thyroid prep, hormone
- *Nursing Considerations** assess pulse, monior dyrthymias, chest pain, monitor TSH levels, OD is presents as hyperthyroidsm, start with low doses and increase as indicated, therapy is lifelong. Take directly after breast feeding, increases the effects of warfarin.
Azithromycin
- *Indication** URI, chronic bronchitis, lower respiratory infections, otitis media, skin infections, STIs, prevention of bacterial endocarditis, tx of CF
- *Action** inhibits bacterial protein synthesis
- *Class** atypical myobacterium antiinfective, macrolide
- *Nursing Considerations** pseydomembranous colitis, pain, diarrhea, nausea, Stevens Johnson Syndrome, Angioedema, increase risks for warafin toxicity, anaphylaxis, notify physician for diarrhea or blood in the stool, take meds exactly as prescribed.
Methylpredinosone
- *Indication** inflammation, allergy, autoimune disorders, prevent organ rejection
- *Action** isuppress inflammation and normal immune response. Increase B/S, immune suppression, metabolism of fat, protein and carbohydrates. Decrease Bone formation
- *Class** antiasthmatics, corticosteroids
- *Nursing Considerations** monitor liver profile, avoid active untreated infections. CNS alterations. Peptic ulcers. Cushings. Weight gain, osteoporosis, Decrease wound healing. Elevate blood sugars. Increase cholesterol and lipid values.
