Week 4-7 Drug cards Flashcards
1
Q
What is Ibuprofen Class, Brand name, and Mechanism?
A
Class: NSAID
Brand name: Advil
Mechanism: Blocks arachidonate (cell membrane fluidity) by inhibiting COX-1 & COX 2
Inhibits prostaqlandin synthesis
* cell membrane phospholipids of dead cell (promotes inflammation)
2
Q
What are the therapeutic effects of Ibuprofen?
A
- Decreases pain
- Decreases fever
- Anti-inflammatory
*Don’t take w/ warfarin, they do same thing
- thinks kidneys
3
Q
What is administration for ibuprofen?
A
- PO: 200mg-400mg q4h (1200mg max)
- IV
assess pain before and after
take w/ food if upset stomach
stay hydrated
4
Q
Ibuprofen indications and contrainidcations?
A
Indications: pain of arthritis, dental, musculoskeletal, migraine, lower fever, mild-mod pain
Contrainidcations: 3rd trimester asthma, severe renal/hepatic disease, old age, allergy to NSAIDS/salicylate/sulfonamides
Contraind. peptic ulcer (GI Bleed), thrombotic events (stroke)
Drug-Drug interaction: corticosteriods increase risk of GI bleed
5
Q
Side effects of ibuprofen?
A
- Headache
- Anorexia
- GI bleed, perforation
CVS: Stroke
GI: pain, nausea, constipation, diarrhea
Hema: bleeding, (gums), platelet inhibition
SAFETY* if over dose, implement gastric lavage
6
Q
Nursing consideration for ibuprofen?
A
- Assess perioperative
- CABG pain (stroke); Cardiac status
- Assess for S&S of GI bleed, renal function, liver function
Report: sore throat, itch/rash, weight gain, swelling PV, vision change
7
Q
What is Aspirin class, brand name, & mechanism?
A
Class: NSAIDS
Brand name: Acetylsalicylic acid (ASA)
Mechanism: Supresses platelets clumping together by inhibiting COX, plateletes need COX to sunthesis TXA, which is 1 factor that makes platelets aggregate together*
***Also supress production of prostaglandins + thromboxanes is due to its irreversible inactivation of cycloxygenase (cox) enzymes
8
Q
What are the therapuetic effects of Aspirin?
A
- Decrease fever
- Decrease pain
- Decrease swelling
- Decrease blood clots (inhibits platelet aggregation 7-10 days -single dose)
**combo w/ antacids, pain reliver, cough + cold meds
9
Q
What is administration for aspirin?
A
- PO 300mg-650mg, 4-6 hours (400mg max per day)
- Rectal
- IV
10
Q
Aspirin indications and contrainidcations?
A
Indications: Stroke, myocardial infraction, reduces risk of clots
Contrainidcations: hypersensitivity, allergy to NSAIDS, Severe asthma, peptic ulcer disease
11
Q
Aspirin side effects?
A
- Risk of bleeding
- Stomach ulcers
- GI bleeding
12
Q
Nursing considerations for aspirin?
A
Before procedures that may cause bleeding (i.e. surgery) you want to assess
13
Q
what is Naproxen class, brand name & mechanism?
A
Class: NSAIDS
Brand name: Aleve, Maxidol, Nalgesin
Mechanisim: Blocks arachidonate binding to competitively inhibit both cyclooxygenase (COX) isoenzymes, COX-1 and COX-2
14
Q
What are the theraputic effects of naproxen?
A
- Decreases inflammation
- Decreases swelling
- Decreases stiffness
- Decreases joint pain
15
Q
What is the administration of Naproxen?
A
- PO 250mg-500mg BID (100 mg daily max)
Enteric coated is not reccomened for initial dose, does not release fast
16
Q
What is the inidcations and contraindications of naproxen?
A
Indications: -osteoarthritis, rheumatoid arthritis and ankylosing spondylitis, mild to moderate pain, (sprains and strains)
Contrainidcations: CABG, pregnancy, breast feeding, renal & hepta impairment, GI bleeding, allergy to NSAIDS
*avoid taking with wairfin, antacids, anti coag. anti hypertens.
17
Q
Naproxen side effects?
A
- Heart burn
- constipation/diarrhea
- abdominal pain
- nausea
- headache
- GI bleed
-Thirst - lightheadedness/dizziness
18
Q
Nursing considerations for naproxen?
A
- Do not administer to breast feeding mothers
- Note renal or hepatic disfunction
19
Q
What is acetaminophen class, brand name and mechanism?
A
Class: Non-opiod analgesic + anti-pyretic
Brand name: Tyolenal, parcetamol, tembra
Mechanism: Lowers fever by directly acting on hypothalamic heat regulating center. Analgesic mechanism is through inhibitom of prostaglandis in the CNS, not an anti-inflammatory agent
20
Q
Acetaminophen therapuetic effects?
A
- Decreases fever
- Decreases pain
**think liver
21
Q
Acetaminophen administartion?
A
Po or PR, max dose per day 4000mg for adults, 3000mg for older adults
**assess pain prior and after admin
22
Q
Acetaminophen indications and contrainidcations?
A
Indication: treat of mild-mod pain, reduction in fever
Contraindications: allergy to acetaminophen, use cautiosly with impaired hepatic function, chronic alcholism
23
Q
Acetaminophen side effects?
A
- Hypersensitivity: rash, fever
- Hepatotoxicity
- Renaltoxicity
DO NOT exceed reccomended dose
if overdose, monitor serum levels, antidote: acetylcysteine
24
Q
What is the hydromorphone class, brand name, mechanism?
A
Class: Opiod analgesics (agonist increased efficacy)
Brand name: Dilaudid
Mechanism: inhibits pain transmission, increases pain threshhold, alters pain perception
Interacts w/ MU opiod receptors
25
Hydromorphone therapuetic effects?
- treat moderate-severe acute pain
| *treats severe chronic pain
26
Hydromorphone administration?
PO 2.5mg/ 10mg 4+ hours
| Give with food if stomach is upset
27
Hydromorphone indications and contrainidications?
Indications: mod-severe pain
Contrainidications: Resp. depression, GI obstruction (paralyticieus)
| ONLY given w/ benzodiazepines
28
Hydromorphone side effects?
- Seizures
- Drowsiness
- confusion
- headaches
- bradycardia
- nausea/vom.
- resp. depression
- pysch. consequences
| use naloxone for OD
29
Nursing considerations for hydromorphone?
asses resp. dysfunction, substance abuse, pain after 15-30 min
30
What is morphine class, brand name and mechanism?
Class: opiod analgesic (agonist w/ increased efficacy)
Brand name: arymo, avinza
Mechanism: binds to MU receptors in CNS depressing transmission
31
What are the therapuetic effects of morphine?
- Relieves pain
32
Morphine administration?
PO: 60min onset, 4-5hr duration
Subcut: 50-90min onset, 4-5hr duration
IM: 30-60min onset, 6-7hr duration
IV (perferred): 20min onset, 4-5 duration
Epidural: 15-60min onset, <24hrs duration
33
Morphine indications and contraindications?
Indications: moderate-severe pain
Contraindications: hypersensitivity, severe asthma, sleep apnea, morbid obesity, resp. insuff., increaed intracranial pressue
34
Morphine side effects?
CNS: sedation, euphoria
CVS: HypoT, palp, flushing
Resp: resp. depress., asthma, exacerbation
GI: Nausea, vomitting, constip., biliary tract spasm
GU: urinary retention
Integumentary: itichy, rash
| **No ceiling effect, subject to abuse, NALOXONE for OD
35
Morphine nursing considerations?
Assess for substance abuse, resp. depression
36
What is fentanyl class, brand name, mechanism?
Class: opiod analgesic (pure agonist-high efficacy)
Brand name: Fentanyal (duragesic)
Mechanism: Binds to opiod receptors in CNS and alters the perception of and response to painful stimulis while producing generalized CNS depression
37
What are therapeutic effects of fentanyl?
- Treatment of moderate to severe pain
- supression of respiratory distress
38
Fentanyl administration?
PO: Immediate release (IR) and Sustained Release (SR)
IV, SC, IM, PR, epidural, transdermal
Used in all ages: if nausea take w/ food
| Caution: pregnant, breastfeeding, liver/renal impariemnt, elderly
39
Fentanyl inidcations and contraindications?
Indications: relief of mod to severe acute+chronic pain, analgesic during anesthesia, cancer pain + pain at end of life NO CEILING EFFECT
Contrainidcations: Acute pancreatitis, renal/liver impairement, resp depression, paralytic ileus, acute/severe bronchial asthma or COPD, severe head injury, acute alcoholism
40
Fentanyl side effects?
- CNS depression
- Resp. depression
- Dizziness, delirium, sedation
- Urinary retention + nausea
- POTENTIALLY FATAL
41
Fentanyl safety precautions
Potentially fatal due to: resp depression, bradycardia, hypotension, cardiac arrest, deepening coma, analphylactic reactions
Safety: assess + monitor vitals, resp and LOC, naloxone = reversal, consider bowels as fent is risk for constipation
42
Fentanyl nursing considerations?
Assess allergies, S&S of resp + CNS depression, GI obstruction, head injury
DO NOT perform hazardous activities
NO OTHER CNS DEPRESSANTS
DO NOT cut, crush, chew controlled release
Dilute+admin IV slowly (rapid IV risks hypotension + resp. depression)
43
Naloxene hydrochloride class, brand name, mechanism?
Class: opiod antagonist
Brand name: Naloxone, Narcan
Mechanism: Attaches to opiod receptors + reverses + blocks effects of opiods
44
Naloxone administration?
IV
IM + Subcut
MAX : 10mg (0.4-2mg every 2-3 min until 10mg)
45
Naloxone indications and contrainidcations?
Indications: reversal of opiods overdose
Contrainidications: hypersensitivity, do not abrupt reversal
46
Naloxone therapeutic effects?
Reverses opiod overdose
47
Side effects of naloxone?
- Tachycardia
- Fibrillation
- hypo+HTN
- nausea/vomitting
| Safety: start low+slow for reversal
48
Nursing considerations for naloxone?
assess with drawl symptoms+resp. dsyfunction
49
Gabapentin class, brand name, and mechanism?
Class: Anticonvulsant
Brand name:
Mechanism: calms overreactive nerve signals, binds to part of Ca channel in nerve cells, reduce release of excitatory nt
50
Gabapentin administration?
PO, can be given with or without food
51
Gabapentin indications and contrainidications?
Inidcations: nerve pain after shingles, neurpathic pain, restless leg syndrome
Contraindications: severe renal impairment, caution w/ CNS depresseants
52
Gabapentin therapuetic effects?
- Prevents seizures
- Pain relieve
53
Gabapentin side effects?
- Drowsiness
- Dizzy
- Fatigue
- Ataxia
- Dry mouth
- Peripheral edema
- Weight gain
54
Nursing consideration for Gabapentin?
- Avoid alcohol
- Other CNS depressants
- Do not drive
- Do not discontinue abruptly
55
Cannabis class, brand name, mechanism?
Class: Pyschoactive substance, analgesic
Brand name: Sativia or indica
Mechanism: THC binds to cannabinoid receptors (CB1 & CB2) in the central nervous system (CNS), producing psychoactive effects (euphoria, relaxation, altered perception). Providing potential anti-inflammatory, analgesic, and anxiolytic effects without intoxication.
56
Cannabis administraion?
Smoked, Vapourized, Ingested
57
Cannabis indications and contrainidications?
Indications: Chronic pain, cancer patient, Nausea/vomiting due to chemo, epilepsy, MS
Contraindications: Pregnancy, Breast feeding, history of pychosis, CVS impairment
58
Cannabis side effects?
Euphoria, relaxation, impaired coordination
Dry mouth, red eyes, increased appetite
Drowsiness, dizziness, cognitive impairment
Anxiety, paranoia (high THC doses)
59
Nursing considerations for cannabis?
No alcohol or other drugs
do not drive
60
Lorazepam class, brand name and mechanism?
Class: Benzodiazepines
Brand name: Ativan
Mechanism: depresses CNS activity as it potentiates the inhibitory effects of endogenous GABA
| INTERMEDIATE ACTING
61
Lorazepam administration?
Route: PO
Dose: 2-4mg/h
| Route + Frequency: SL = 1Hr, IV = 5-10 mins
## Footnote
Half-life = 10-20 hrs
62
Lorazepam theraputic effects?
decreases anxiety, promotes sleep, treats active seizures
63
Lorazepam indications and contraindications?
Indications: Anxiety, sedation, seizures
Contraindications: Allergy to benzos, additive with other CNS depressents (alcohol, opiods), use cautiously with patients with impaired respiratory status
| Use for short term therapy, used long term can cause dependency
64
Lorazepam side effects?
CNS depression, hypotension, constipation
| Withdrawl: headache, nausea, vomiting, muscles, pain, weakness, seizures
65
Lorazepam nursing considerations?
Assess hx and physical conditions, educate about the additive effects with other CNS depressents, do not discontinue abruptly after long-term use, if overdose flumazenil is the antidote
66
Diazepam class, brand name and mechanism?
Class: Benzodiazepine
Brand Name: valium
Mechanism: depresses CNS, affects hypothalamic, thalamic and limbic systems of the brain, potentiates the inhibitory effects of endogenous GABA
67
Diazepam administartion?
Given orally, rectally or IV
Route: PO
IV Dose: 0.5-2mg/h
| Half life 100h
68
Diazepam therapeutic effects?
- Reduces anxiety
- Reduces seizures
- induces sleep
| Long acting
69
Diazepam indications and contraindications?
Indications: Treatment or prevention on axniety symptoms or disorders, used in treatment of seizures, sleep disordes, muscle spasms, alcohol withdrawl
Contraindications: additive w/ other CNS depressents, may reduce liver metabolism, may cause interactions with other drugs or food
Enzyme inducers: reduce effect of benzo by speeding up breakdown
Enzyme inhibitors: can increase effect of benzo by delaying breakdown
70
Diazepam side effects?
- CNS depression
- Hypotension
Withdrawl: insomnia, anxiety, agitation, tremor, tachycardia, anorexia
Less REM sleep suppression
Does NOT increase metabolism of other drugs
| Antidote: Flumazenil
71
Nursing considerations for diazepam?
Assess HX and physical condition, educate about additive effect w/ other CNS depressents, caution effect may be increased with grapefruit intake, antibiotics, oral contraceptives, effects may decrease with St Johns Wart
72
Midazolam class, brand name, and mechanism?
Class: Benzodiazepine
Brand name: Versed
Mechanism: Depress CNS activity as it potentiates the inhibitory effects on GABA
73
Midazolam administration?
Route: IV
Dose 1.5-5mg/min
half-life 1-4hrs
| Short acting
74
Midazolam indications and contrainidcations?
Indications: Anxiety, sedation
Contraindications: Do not give to babies, careful with IV admin, resp. depression. CO administration w/ other CNS depressents, allergies, epidural use
75
Midazolam side effects?
- CNS depression
- hypotension
- nausea/vomiting
- amnesia
- withdrawl slowly
76
Midazolam nursing considerations?
Educate about additive CNS depressents
Flumazenil antidote
77
Prednisone Class, brandname and mechanism?
Class: Corticosteriods
Brandname:
Mechanism: Decrease inflammation by supressing immune responses (inhibit macrophage accumulation, reduce capillary permeability)
78
Therapeutic effects of prednisone?
Less likely to see immediate effects!
Active inflammation: Reduced inflammation (if lungs- reduced bronchial inflammation = improved work of breath, reduced wheezing, reduced mucus production
For treatment of endocrine disorder: reduce active disease
79
Prednisone administration?
Short term use: higher dose noted
Long term use: lower dose noted
do not stop admin abruptly
give with or immediatly after meals
take in AM, avoid evening doses
80
Prednisone indications vs contraindications?
Indications: used systemically + locally in a wide variety of chronic diseases however reversed for acute or severe exacerbations unresponsive to conventional therapy, severe allergic reactions, endocrine disorders, respiratory disorders
contraindications: Hypersensitivity, active untreated infections, avoid chronic use, drug to drug interactions with NSAIDS/ASA (GI side effects increased)
81
Prednisone side effects?
CVS: fluid retention
Skin: Long term use - bruising, thin skin, acne, decreased wound healing
Endo: adrenal insufficieny
GI: peptic ulcer
MSK: long term use- osteoporosis
PYSCH: mood disturbances (roid rage)
Labs: hyperglycemia
longterm use - cushings
82
Nursing considerations for prednisone?
Assess areas of concern depending on indication for use (resp system vs endo system)
Assess for adrenal insufficiency (hypotension, weight loss, confusion)
monitor daily weights, BP or signs of fluid retention
monitor labs: sodium, potassium, glucose
watch for signs of infection
83
Hydrochlorothiazide Class, brand name and mechanism?
Class: Thiazide
Brandname:
Mechanism: Inhibits sodium reabsorption in distal tubules causing increased excretion of sodium and water as well as potassium
| 2 mechanism
## Footnote
Reduction of blood volume and reduction in arterial resistance
84
Hydrochlorothiazide administration?
Administer early in day to avoid nocturia
onset: abt 2hrs
85
Hydrochlorothiazide therapeutic effects?
- Reduce blood pressue
- Reduce edema
86
Hydrochlorothiazide indications and contraindications?
Indications: HTN, edema, general volume overload
Contraindications: hypersensitivity, anuria (kidneys dont produce urine), renal impairment
| First line for hypertension
87
Hydrochlorothiazide side effects?
- electrolyte imbalance
- hypokalemia (low potassium)
- hyponatremia (low sodium)
- hypotension
88
Nursing considerations for hydrochlorothiazide?
- asses reason for diuretic (edema, HTN) prior to and after administration
- monitor effectiveness - urine output
- monitor daily weight (fluid)
- monitor labs (sodium, potassium, creatinine)
89
Loop diuretic class, brand name and mechanism?
Class: Loop diuretic
Brandname: Furosemide
Mechanism: Inhibiting sodium potassium pump in the ascending loop of henle, decreasing reabsorption of sodium and water
90
Loop diuretic administartion?
Increase consumption of potassium rich foods
Take in AM or if BID early in the afternoon to avoid interupting sleep
Can be given PO or IV
PO: effect in 60 min and diuresis lasts for 8 hours
IV: effect in 5 min and lasts 2 hours
91
Loop diuretic indications vs contraindications?
Indications: Treatment of edema, management of mild-mod HTN, acute pulmonary edema, renal impairment, hyperkalemia
Contraindications: hypersensitivity, anura or renal failure, poor fluid and electolyte imbalance:
## Footnote
not routinely used for HTN however help for those who need greater diuresis that can be achieved with thiazides, and those with low glomerular filtration rate
92
Therapeutic effects of Loop diuretic?
- Decreased edema
- Lower BP
- stable or improved potassium levels
93
Side effects of Loop diuretic?
CNS: dizziness, syncope
CVS: hypotension, tachycardia
ENT: otoxicity, hypokalemia, renal failure
94
Nursing considerations for loop diuretic?
- Assess reason for diuretic prior to and after admin
- monitor effectiveness- urine output
- monitor daily weights
- monitor labs: sodium, potassium, creatinine
95
Potassium sparing class, brand name and mechanism?
Class: Potassium-sparing diuretics, aldosterone antagonist
Brand name: Spironolactone
Mechanism: Inhibits water and sodium reabsorption in the kidney while saving potassium
| modest increase in urine prodcution, decrease in potassium excretion
96
Potassium sparing indications and contraindications?
Indications: used with other diuretics to treat edema or hypertension, counteract potassium loss caused by other diuretics, off lable use: acne and hormone therapy for trans females
Contraindications: hypersensitivity, anuria, acute renal insufficiency, hyperkalemia, addisons disease
97
Potassium sparing theraputic effects?
- Stable or improved potassium levels
- decreased edema
- lower BP
98
Potassium sparing side effects?
- Electrolyte imbalances, hyperkalemia, hyponatremia
- Renal dysfunction
- CVS: dizziness, hypotension
- Gynecomastia
99
Nursing considerations for potassium sparing diuretics?
- Assess areas of edema prior to, before and after administration
- monitor urine output and daily weights
- monitor BP before and after
- monitor labs: hyperkalemia, creatinine
100
Calcium channel blockers class, brand name and mechanism?
Class: Calcium channel blockers
Brand name: amlodipine
Mechanism: inhibits calcium ion from entering the channels prodcuing a relaxation of coronary vascular smooth muscle and coronary vasodialation
| Dialation of aterioles, cause reflex tachycardia
101
Calcium channel blockers administration?
Onset: ~24-48HRS
Slow onset
102
Calcium channel blocker therapeutic effects?
- Reduced BP
103
Calcium channel blockers indications and contraindications?
Indications: HTN, Angina, off label: raynauds
Contraindications: Hypersensitivity, peripheral edema
104
Nursing considerations for calcium channel blockers?
Assess BP prior to administration
105
Adrenergic inhibitor class, brandname and mechanism?
Class: beta adrenergic blocker
Brand name: metoprolol
Mechanism: selective inhibitor of beta 1 adrenergic receptors
**Blocks beta 1 receptors in heart, high doses impact beta 2 receptors in lungs
Blocks beta 1 receptors in kidenys-reduced renin
Reduces vascular resistance**
106
Adrenergic inhibitor administration?
PO onset 1-2hrs
107
Adrenergic inhibitor indications and contrainidcations?
Indications: Angina, myocardial infractions, heart failure, HTN (not first line), off label: A fib migraines
Contraindications: hypersensitivity, second or third degree heart block
108
Therapeutic effects of adrenergic inhibitors?
**- Reduces HR**
- Reduces BP
- Reduces force of contraction
109
Adrenergic inhibitor side effects?
- bradycardia
- hypotension
- bronchospasm
- hypoglycemia
110
Nursing considerations for adrenergic inhibitors?
- Assess HR and BP prior to admin
- Assess glucose
111
Angiotensin inhibitor class, name brand and mechanism?
Class: Angiotensin converting enzyme inhibitor
Name brane: captopril
Mechanism: competitive inhibitor of angitensin converting enzyme; prevents conversion of angiotensin 1 to angiotensin 2 which reduces vasoconstriction and aldosterone secretion
112
113
Angiotensin inhibitor administartion?
Onset: 15 min
less effective in african americans
114
Therapeutic effects of angiotensin inhibitors?
Reduces BP
115
Angiotensin inhibitor indications and contraindications?
Indications: MI/acute coronary syndrome, heart failure, HTN
Contraindications: Hypersensitivty, hypotension, renal impairment
116
Angiotensin inhibitor side effects?
Acute kidney injury, angioedema, cough, hyperkalemia, hypotension
117
Nursing considerations for angiotensin inhibitors?
Monitor BP before and after, monitor blood work: potassium, creatinine
