Top ALS Meds Flashcards

1
Q

metoprolol (Lopresor)

A

Classification: Beta Blocker, Antihypertensive
Mechanism of Action: Blocks Beta 1 receptors decreasing BP and HR
Normal recommended adult dose: 25-100 mg/day PO, two divided doses
Side effects: Erectile Dysfunction, fatigue, weakness, blurred vision
Nursing considerations: Monitor BP, Pulse and EKG, Daily weights, HF

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2
Q

lisinopril

A

Classification: Ace inhibitor, antihypertensive
Mechanism of Action: Block conversion of angiotensin 1 to angiotensin to preventing vasoconstriction; increase plasma renin levels and decrease aldosterone levels
Normal recommended adult dose: 10 mg/day, up to 20-40 mg/day
Side effects: Hypotension, dizziness, cough, edema
Nursing considerations: Monitor Pulse, BP, angioedema, daily weight, BUN, Creatinine, Potassium, Sodium

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3
Q

amlodipine

A

Classification: Calcium Channel Blockers, Antihypertensive
Mechanism of Action: INhibits transport of calcium into myocardial and vascular smooth muscle, inhibiting contraction
Normal recommended adult dose: 5-10 mg/day
Side effects: Peripheral Edema, dizziness, nausea, flushing, hypotension
Nursing considerations: Monitor Pulse, BP, daily weight, angina

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4
Q

enoxaparin (Lovenox)

A

Classification: Antithrombotics, Anticoagulants
Mechanism of Action: Inhibits effects on antithrombin on Factor Xa and thrombin, preventing clots
Normal recommended adult dose: 1 mg/kg BID
Side effects: bleeding, anemia
Nursing considerations: Monitor for bleeding or hemorrhage, CBC, Platelets, increase AST, ALT levels, watch for occult blood

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5
Q

furosemide (Lasix)

A

Classification: Loop Diuretic
Mechanism of Action: Inhibits reabsorption of sodium and chloride from the loop of Henle and distal tubule of the kidney
Normal recommended adult dose: 20-80 mg/day
Side effects: Dehydration, hypocalcemia, hypochloremia, hypovolemia, hyponatremia, hypomagnesemia, metabolic acidosis, aplastic anemia, stevens johnson syndrome
Nursing considerations: Monitor fluids, electrolytes, daily weight, edema, lung sounds, skin turgor, mucous membranes, BP and Pulse before administering, monitor for rash

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6
Q

diltiazem (Tiazac XR)

A

Classification: Calcium Channel Blockers, Antianginal, Antiarrhythmic
Mechanism of Action: Inhibits transport of calcium into myocardial and vascular smooth muscle cells, resulting in vasodilation, decreasing BP
Normal recommended adult dose: 30-100 mg/3-4x day; 180-240 mg/day XR
Side effects: Peripheral edema, bradycardia, arrhythmias, HF
Nursing considerations: Monitor BP/Pulse before giving, daily weight, assess for rash associated with Stevens Johnson Syndrome, Monitor EKG for arrhythmias.

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7
Q

Docusate Sodium

A

Classification: Stool Softeners
Mechanism of Action: Draws water into stool, softening it. May also bring electrolytes and water into the colon.
Normal recommended adult dose: 240 mg/day
Side effects: Cramps, diarrhea
Nursing considerations: Not a stimulant laxative, administered with water/juice but may be given on an empty stomach for rapid results.

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8
Q

Ondansetron(Zofran)

A

Classification: Five ht3 antagonists, Antiemetic
Mechanism of Action: Blocks effects of serotonin at 5HT3 receptor sites in the CNS
Normal recommended adult dose: 8-24 mg/8hr
Side effects: Constipation, diarrhea, headache serotonin syndrome, stevens johnson syndrome, toxic epidermal necrolysis
Nursing considerations: Assess for N/V, bowel sounds, distention before administering, monitor for serotonin syndrome, monitor for rash, may cause increased bilirubin, AST and ALT

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9
Q

ketorolac (Toradol)

A

Classification: Non-opioid analgesic
Mechanism of Action: Inhibits prostaglandin synthesis, antipyretic and antiinflammatory properties
Normal recommended adult dose: PO 20 mg initially, followed by 10mg/4-6hr
Side effects: GI bleeding, drowsiness, HF, Heart Attack, Stroke, rash, asthma
Nursing considerations: Assess for rash, monitor BP, assess pain before and after administration, may increase AST and ALT, prolonged bleeding time for 24-48 hrs, may increase BUN, Creatinine and K+

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10
Q

Metformin

A

Classification: Biguanide, Antidiabetic
Mechanism of Action: Decreases hepatic glucose production and intestinal glucose absorption, increases sensitivity to insulin
Normal recommended adult dose: 500 mg/BID mac 2000 mg/day in 3 divided doses
Side effects: Lactic acidosis, bloating, diarrhea, N/V
Nursing considerations: Monitor for hypoglycemia when taken with sulfonylureas, assess renal function before and during therapy, monitor folic acid and b12 in LT therapy

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11
Q

Morphine Sulfate

A

Classification: Opioid Agonists, Opioid analgesics
Mechanism of Action: Binds to opiate receptors in CNS
Normal recommended adult dose: PO 30 mg/3-4hr; IV 4-10mg/3-4hr
Side effects: Hypotension, constipation, N/V, sedation, confusion, dependance, respiratory depression.
Nursing considerations: Pain assessments, boluses for breakthrough pain, assess LOC, BP Pulse and RR before/after administration, monitor for abuse, may cause OD

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12
Q

Methylprednisolone (SOLU-Medrol)

A

Classification: Corticosteroids, antiinflammatory steroids, immunosuppressants
Mechanism of Action: Suppresses inflammation and normal immune response,
Normal recommended adult dose: PO 160 mg/day for 7 days, then 64 mg/every other day for 1 mo.
Side effects: HTN, acne, decreased wound healing, fragility, petechiae, hirsutism, ecchymosis, adrenal suppression, peptic ulcers, anorexia, N/V, muscle wasting, osteoporosis, depression, euphoria, cushingoid appearance
Nursing considerations: Monitor daily weight, BG, electrolytes, may suppress allergy testing, monitor for adrenal insufficiency

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13
Q

Allopurinol

A

Classification: Xanthine Oxidase Inhibitors, Antigout agents
Mechanism of Action: Inhibits the production of uric acid by inhibiting the action of xanthine oxidase
Normal recommended adult dose: 100 mg/day initially, 100-200 mg/2-3x daily maintenance dose
Side effects: Hypersensitivity, rash.
Nursing considerations: I&O, daily weight, S/S of DRESS, may cause hypoglycemia in those taking antidiabetics, monitor renal and liver function tests.

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14
Q

Fluticasone & Salmeterol (Advair)

A

Classification: Corticosteroids, Anti-inflammatories; Adrenergics, Bronchodilators
Mechanism of Action: Locally acting anti-inflammatory; Produces accumulation of cAMP at beta 2 receptors causing bronchodilation
Normal recommended adult dose: 88 mcg/BID max 880 mcg/day; 50 mcg BID
Side effects: Headache, hypersensitivity
Nursing considerations: Monitor for adrenal insufficiency, Monitor lung sounds, pulse, BP before administering, may increase BG

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15
Q

tamsulosin (Flomax)

A

Classification: Peripherally acting antiadrenergics
Mechanism of Action: Decreases contractions in smooth muscle by binding to alpha 1 receptors decreasing urinary urgency/nocturia
Normal recommended adult dose: 0.4mg/day
Side effects: Dizziness, headache
Nursing considerations: Take after a meal, daily weight.

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16
Q

insulin lispro (HumaLOG)

A

Classification: Hormone
Mechanism of Action: Stimulates glucose uptake in skeletal muscle/fat, inhibits hepatic glucose production to control hyperglycemia
Normal recommended adult dose: 0.5-1.2 units/kg/day
Onset: <15mins
Peak: 1-2hr
Duration: 3-4hrs
Side effects: Hypoglycemia, hypersensitivity
Nursing considerations: Assess blood glucose, HA1C, K+ levels, give when tray is in front of patient(rapid acting)

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17
Q

insulin aspart (NovoLOG)

A

Classification: Hormone
Mechanism of Action: Stimulates glucose uptake, inhibits hepatic glucose production
Normal recommended adult dose: 0.5-1 unit/kg/day
Onset: <15 mins
Peak: 1-2 hr
Duration: 3-4 hr
Side effects: Hypoglycemia, anaphylaxis
Nursing considerations: Assess blood glucose, hypoglycemia

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18
Q

insulin regular (Entuzity)

A

Classification: Hormone
Mechanism of Action: Stimulate glucose uptake, inhibits, hepatic glucose production
Normal recommended adult dose: 0.5-1 unit/kg/day
Onset: 30-60 mins
Peak: 2-4hr
Duration: 5-7 hr
Side effects: Hypoglycemia
Nursing considerations: Monitor weight, BG, hypoglycemia, only one that can be given IV

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19
Q

insulin glargine

A

Classification: Hormone
Mechanism of Action: Stimulates glucose uptake, inhibits hepatic glucose production
Normal recommended adult dose: ⅓ of total daily insulin given
Onset: 3-4hr
Peak: None
Duration: 24hr
Side effects: Hypoglycemia
Nursing considerations: Long lasting insulin

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20
Q

heparin (sub Q)

A

Classification: Anticoagulants
Mechanism of Action: Inhibits antithrombin to effect on thrombin and factor Xa, prevents conversion of prothrombin to thrombin in low doses, high doses neutralize thrombin which prevents conversion of fibrinogen to fibrin
Normal recommended adult dose: 5,000-10,000 units/ 4-6 hr
Side effects: Anemia, bleeding, HIT
Nursing considerations: Monitor for bleeding and hemorrhage, platelets, may increase ALT/AST

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21
Q

warfarin

A

Classification: Coumarins, Anticoagulants
Mechanism of Action: Interferes with hepatic synthesis of vit K dependant clotting factors (2, 7, 9, 10)
Normal recommended adult dose: 2-5 mg/day for 2-4 days then adjust based on INR
Side effects: Bleeding, calciphylaxis
Nursing considerations: Monitor for bleeding and hemorrhage, PT, INR

22
Q

Albuterol & Ipratropium

A

Classification: Adrenergics, Bronchodilators; Anticholinergics, Bronchodilators
Mechanism of Action: Binds to beta 2 receptors in smooth muscle; inhibits cholinergic receptors in bronchial smooth muscle causing bronchodilation
Normal recommended adult dose: 100mcg-20mcg inhalation as needed
Side effects: Chest pain, nervousness, restlessness, tremors, palpitations, bronchospasm
Nursing considerations: Assess lung sounds, pulse, BP, RR before administration, observe for wheezing, may decrease potassium levels

23
Q

sertraline (Zoloft)

A

Classification: SSRIs, Antidepressants
Mechanism of Action: Inhibits neuronal uptake of serotonin in CNS
Normal recommended adult dose: 50 mg/day; 200 mg/day max
Side effects: Increased sweating, diarrhea, dry mouth, nausea, tremors, dizziness, suicidal thoughts, fatigue, headache, insomnia, serotonin syndrome
Nursing considerations: Monitor for suicidal ideation, serotonin syndrome, appetite, may cause hyperglycemia

24
Q

oxycodone (Supeudol)

A

Classification: Opioid agonists, Opioid analgesics
Mechanism of Action: Binds to opiate receptors in the CNS
Normal recommended adult dose: 5-10 mg/3-4 hr PRN
Side effects: Constipation, confusion, sedation, respiratory depression, dependance, dry mouth, sweating
Nursing considerations: Pain assessments, Assess BP, pulse, RR before/after administration, monitor for dependance, may cause OD

25
omeprazole (Losec)
Classification: Proton Pump Inhibitors, Antiulcer agents Mechanism of Action: Binds to enzymes in presence of gastric acid preventing hydrogen atoms from entering the gastric lumen, resulting in less acid in the stomach Normal recommended adult dose: 20 mg/day Side effects: C-diff, abdominal pain, hypersensitivity Nursing considerations: Monitor bowel function, assess for pain and occult blood, may increase AST/ALT
26
diphenhydramine (Benadryl)
Classification: Antihistamines Mechanism of Action: Antagonizes effects of histamine at H1 receptor sites Normal recommended adult dose: 25-50 mg/4-6hr; 300 mg/day max Side effects: Anorexia, dry mouth, dizziness, drowsiness Nursing considerations: Assess sleep, may decrease skin response to allergy tests, discontinue 4 days before testing
27
potassium chloride (Micro-K)
Classification: Mineral and electrolyte supplements Mechanism of Action: Maintain acid-base balance, isotonicity and electrolyte balance in the cells Normal recommended adult dose: 40-100 mEq/day in divided doses Side effects: Arrhythmias, abdominal pain, diarrhea, flatulence, N/V Nursing considerations: Assess for hypokalemia, monitor serum potassium
28
glipizide (Glucotrol)
Classification: Sulfonylureas, Antidiabetics Mechanism of Action: Stimulate pancreatic insulin release, increase sensitivity to insulin Normal recommended adult dose: 2.5-40 mg/day Side effects: Photosensitivity, hypoglycemia, aplastic anemia Nursing considerations: Monitor for hypoglycemia, monitor CBC, may increase AST, LDH, BUN, Creatinine, Monitor BG and HA1C
29
Culturelle (Lactobacillus)
Classification: Probiotic Mechanism of Action: Produces lactic acid preventing survival of harmful bacteria in the GI tract Normal recommended adult dose: 15 billion cell/day Side effects: Bloating, gas, yeast infections, nausea Nursing considerations: Assess for yeast infections, not to be used in people with weak immune systems or short-gut syndrome
30
vancomycin (Vancocin)
Classification: Anti Infectives Mechanism of Action: Binds to bacterial cell wall, resulting in cell death Normal recommended adult dose: IV 500 mg/6hr; max 4 g/day Side effects: Rash, nephrotoxicity, phlebitis, pain, hypersensitivity Nursing considerations: Assess S/S of infection, obtain cultures, monitor IV site, monitor BP, daily weight, Monitor for anaphylaxis, may decrease BUN
31
levofloxacin
Classification: Fluroquinolones, Anti-infectives Mechanism of Action: Inhibits bacterial DNA synthesis by inhibiting DNA gyrase enzymes Normal recommended adult dose: IV 500-750 mg/day for 7-14 days Side effects: Elevated ICP, seizures, suicidal thoughts, aortic aneurysm, torases de pointes, stevens johnson syndrome, hepatotoxicity, C-Diff, Nausea, hypersensitivity, phlebitis Nursing considerations: Assess for infection, cultures, monitor bowels, assess for rash, assess for anaphylaxis, monitor for suicidal thoughts
32
acetylsalicylic acid (Aspirin/ASA)
Classification: Salicylates, Antiplatelets, nonopioid analgesics Mechanism of Action: Inhibits production of prostaglandins, decreases platelet aggregation Normal recommended adult dose: 81-325 mg/4-6 hr; 4 g/day max Side effects: GI bleeding, dyspepsia, epigastric distress, nausea, hypersensitivity Nursing considerations: Monitor for DRESS, assess pain, assess for hypersensitivity, monitor hepatic function, prolongs bleeding time for 4-7 days and can cause prolonged prothrombin time in large doses, monitor hematocrit in prolonged high doses.
33
clopidogrel (Plavix)
Classification: Platelet aggregation inhibitors, Antiplatelet agents Mechanism of Action: Inhibits platelet aggregation by inhibiting binding of ATP to platelet receptors Normal recommended adult dose: 75 mg/day Side effects: Rash, GI Bleeding, Neutropenia, hypersensitivity, stevens johnson syndrome Nursing considerations: monitor bleeding time, CBC with differential and platelet count, may increase bilirubin, hepatic enzymes, cholesterol, and uric acid
34
hydrochlorothiazide (Urozide)
Classification: Thiazide Diuretics, Antihypertensives Mechanism of Action: Increases excretion of Na and Water by inhibiting sodium reabsorption in the distal tubule, lowering BP Normal recommended adult dose: 12.5-100 mg.day in 1-2 doses; 200 mg/day max(50 mg/day max for HTN) Side effects: Skin cancer, stevens johnson syndrome, hypokalemia, pancreatitis Nursing considerations: Monitor BP, Daily weight, assess for edema, assess for rash, monitor electrolytes, BIN, BG, Creatinine and uric acid levels
35
fluoxetine (Prozac)
Classification: SSRIs, Antidepressants Mechanism of Action: Selectively inhibits the reuptake of serotonin in the CNS Normal recommended adult dose: 10-50 mg/day; max 80 mg/day Side effects: Torsades de pointes, increased sweating, pruritus, diarrhea, tremors, seizures, suicidal thoughts, anxiety drowsiness, headache, insomnia, nervousness, serotonin syndrome Nursing considerations: Monitor for mood changes, suicidal thoughts, monitor appetite, serotonin syndrome, monitor CBC with differential, may increase ALT, BUN, may cause hypoglycemia in those with diabetes
36
tramadol (Trideral)
Classification: Centrally acting opioid analgesics Mechanism of Action: Binds to opioid receptors, inhibits reuptake of serotonin and norepinephrine in the CNS Normal recommended adult dose: 50-100 mg/4-6hr; 400 mg/day max Side effects: Constipation, Nausea, Seizures, dizziness, headache, somnolence, respiratory depression Nursing considerations: Schedule 4 controlled substance, Assess pain, Monitor BP, RR before/after administration, assess bowel function, monitor for dependance
37
hydrocodone (Vicodin)
Classification: Opioid agonists nonopioid analgesic combinations, Opioid analgesics Mechanism of Action: Binds to opiate receptors in the CNS, suppress the cough reflex via central action Normal recommended adult dose: 2.5-10 mg/3-6 hr PRN Side effects: Hypotension, constipation, dyspepsia, nausea, confusion, dizziness, sedation, respiratory depression, dependance Nursing considerations: Assess BP, pulse, RR before/after administration, monitor for dependance, monitor for respiratory depression, pain assessments, may cause OD
38
lorazepam (Ativan)
Classification: Benzodiazepines, Anti Anxiety agents, sedatives/hypnotics Mechanism of Action: Depressed the CNS by potentiating GABA Normal recommended adult dose: 1-3 mg/2-3x daily; max 10 mg/day Side effects: Dizziness, drowsiness, respiratory depression, dependence, lethargy Nursing considerations: Assess for risk of abuse or dependance
39
piperacillin/tazobactam (Zosyn)
Classification: Extended spectrum penicillins, Anti infectives Mechanism of Action: Binds to cell wall membrane causing cell death; inhibits beta-lactamase, and enzyme that can destroy penicillins Normal recommended adult dose: 4.5 g/6hr IV Side effects: SJS, Rash, C-Diff, Pain, Phlebitis, seizures, hypersensitivity Nursing considerations: Assess for infection, cultures, observe for anaphylaxis, monitor bowel function, assess skin, monitor for DRESS, CBC
40
nitroglycerin (Nitroject)
Classification: Nitrates, Antianginals Mechanism of Action: Increases coronary blood flow by dilating coronary arteries, produces vasodilation, decreases left ventricular diastolic pressure and preload, reduces myocardial oxygen consumption Normal recommended adult dose: 0.3-0/6 mg may repeat every 5 mins for 2 additional doses in acute anginal attack Side effects: Hypotension, tachycardia, dizziness, headache Nursing considerations: Pain assessment, monitor BP and Pulse before administration, sit down next to phone during administration
41
nystatin (Nyaderm)
Classification: Antifungals Mechanism of Action: Affects permeability of fungal cell wall, allowing lysis Normal recommended adult dose: Apply cream, ointment or powder 2-3 times daily until healing is complete, PO 400,000-600,000 units/4x daily as suspension Side effects: Burning, itching, redness; PO nausea, diarrhea, pain, vomiting Nursing considerations: Assess skin and mucous membranes before application
42
ibuprofen (Motrin, Advil)
Classification: NSAIDs, nonopioid analgesics Mechanism of Action: Inhibits prostaglandin synthesis Normal recommended adult dose: 200-800 mg/4-6hr; 3200 mg/day max Side effects: HF, MI, Stroke, Stevens Johnson Syndrome, GI Bleeding, Hepatitis, constipation, dyspepsia, nausea, vomiting, headache, hypersensitivity, renal failure Nursing considerations: Assess for GI Bleeding, Rash, Monitor for DRESS, assess pain, BUN, Creatinine, CBC and liver test should be evaluated in long term therapy
43
Polyethylene glycol (MiraLax)
Classification: Osmotics, Laxatives Mechanism of Action: Draws water into the lumen of the GI tract Normal recommended adult dose: 17g(1 TBS) in 8oz of water daily, use up to 2 weeks Side effects: Cramping, pain, flatulence Nursing considerations: Assess bowel sounds, distention, pain, assess stool produced, assess usual bowel patterns
44
scopolamine
Classification: Anticholinergics, Antiemetics Mechanism of Action: Inhibits muscarinic activity of acetylcholine, corrects imbalance of acetylcholine and norepinephrine in the CNS Normal recommended adult dose: Apply 1 patch 4hr prior to travel and every 3 days PRN Side effects: Tachycardia, blurred vision, dry mouth, urinary hesitancy, drowsiness, decreased sweating Nursing considerations: Assess for anticholinergic symptoms (“Can’t see, can’t spit, can’t pee, can’t shit”)
45
spironolactone
Classification: Potassium Sparing Diuretics Mechanism of Action: Loss of Sod. Bicarb and Ca while sparing K and Hydrogen ions by antagonizing aldosterone, inhibits testosterone secretion and androgen binding to their receptors Normal recommended adult dose: 25100 mg/day Side effects: Hyperkalemia, dizziness, muscle cramps, DRESS, hypersensitivity Nursing considerations: Daily weight, BP, ECG’s, Monitor for hyperkalemia
46
valsartan (Diovan)
Classification: Angiotensin 2 receptor antagonists, Antihypertensives Mechanism of Action: Blocks the vasoconstrictor and aldosterone secreting effects of angiotensin 2, including vascular smooth muscle and adrenal glands Normal recommended adult dose: 80 or 160 mg/day; max 320 mg Side effects: Dizziness, edema, diarrhea, angioedema Nursing considerations: Monitor BP, monitor for angioedema, daily weight
47
hydromorphone (Dilaudid)
Classification: Opioid agonist, Opioid analgesics Mechanism of Action: Binds to opioid receptors in the CNS Normal recommended adult dose: PO 4-8 mg/3-4hr Side effects: Hypotension, Constipation, confusion, sedation, respiratory depression, dependance Nursing considerations: Assess BP, pulse, RR before/after administration, monitor for respiratory depression, monitor for dependence, pain assessment, may cause OD
48
simvastatin
Classification: hmg coa reductase inhibitors (statin), Lipid-lowering agents Mechanism of Action: Inhibits HMG-CoA reductase, an enzyme partly responsible for the synthesis of cholesterol Normal recommended adult dose: 5-40 mg/day in the evening Side effects: Rash, abdominal cramps, constipation, diarrhea, flatus, heartburn, rhabdomyolysis, hypersensitivity Nursing considerations: Night med, Obtain diet history, evaluate cholesterol and triglyceride levels before/during therapy
49
levothyroxine (Eltroxin)
Classification: Hormones Mechanism of Action: Synthetic form of thyroxine (T4), replacement thyroid hormones Normal recommended adult dose: 1.6 mcg/day Side effects: Headache, diarrhea, hyperthyroidism, arrhythmias, tachycardia Nursing considerations: Apical Pulse and BP prior to administration, monitor height, weight and motor development in children
50
cephalexin (Keflex)
Classification: First Generation Cephalosporins, Anti Infectives Mechanism of Action: Binds to bacterial cell membrane, causing cell death Normal recommended adult dose: 200-500 mg/6hr; max 4 g/day Side effects: Diarrhea, seizures in high doses, ,C-Diff, Nursing considerations: Assess for S/S of infection, cultures, observe for anaphylaxis, monitor bowel function, may increase AST, ALT, Bilirubin, LDH, BUN, Creatinine
51
metronidazole (Flagyl)
Classification: Anti Infectives, antiulcer agents Mechanism of Action: Disrupts DNA and protein synthesis in susceptible organisms Normal recommended adult dose: 7.5 mg/kg/6hr; max 4 g/day Side effects: Stevens Johnson Syndrome, abdominal pain, anorexia, nausea, seizures, dizziness, headache, aseptic meningitis, Nursing considerations: Assess for infection, cultures, monitor neuro status, daily weight, assess for rash (SJS)
52
acetaminophen (Tylenol)
Classification: Antipyretic, nonopioid analgesic Mechanism of Action: Inhibits prostaglandin synthesis Normal recommended adult dose: 325-650 mg/6hr; max 3000 mg/day or 2000 mg/day in those with hepatic or renal impairment Side effects: Hepatotoxicity, SJS, renal failure Nursing considerations: Hepatotoxicity risk, assess for rash, assess pain, assess fever, watch for increased bilirubin, LDH, AST, ALT and prothrombin time may indicate hepatotoxicity, acetylcysteine is the antidote for OD