![\"\"](\"https:\/\/d3tvd1u91rr79.cloudfront.net\/16dbb2be44090319f22bc925a436eded\/html\/bg1.png?Policy=eyJTdGF0ZW1lbnQiOlt7IlJlc291cmNlIjoiaHR0cHM6Ly9kM3R2ZDF1OTFycjc5LmNsb3VkZnJvbnQubmV0LzE2ZGJiMmJlNDQwOTAzMTlmMjJiYzkyNWE0MzZlZGVkL2h0bWwvKiIsIkNvbmRpdGlvbiI6eyJEYXRlTGVzc1RoYW4iOnsiQVdTOkVwb2NoVGltZSI6MTY5MDY1MTQxOH19fV19&Signature=DCiOA0yj5XEQCxLO5TD3gEsNJ44Q8wKnVtwqsQZs5BKePnHqzkAhMg97et3yPl98eJBQjbIkB7ytjKIh6Zz3HvFpwWTNPY4dw35yURUs~gdy3gvcYb-pj3nmam0O1IkRjQwgJ3E~MQLycDBkht3qPTup4GR~uSOoUEGbxpMD1tuO95YRRk2AURJgC1xt0SXx6WdImjpla~MyQBLqxPZZpxWp52STgrkOOXftgdgDbo98dkT6tGB7Mzk2lX3PdCnK5ilxklWjWonYla~vwWtPdyREOSjH-SIcmWNdm7tNBV5SJXJP4vmu6IBM6I6otKWOvEqgPFkSMrnJR7E9EV1wtQ__&Key-Pair-Id=APKAJ535ZH3ZAIIOADHQ\")
<\/p>\n\n\n\n<\/p>\n\n\n\n
1<\/p>\n\n\n\n
PHARMACOLOGY HESI REVIEW<\/p>\n\n\n\n
DRUGS AFFECTING THE NERVOUS SYSTEM<\/p>\n\n\n\n
ANTICONVULSANTS\/ANTISEIZURE MEDICATIONS<\/p>\n\n\n\n
Prototype :<\/p>\n\n\n\n
a. Hydantoins – phenytoin (Dilantin)<\/p>\n\n\n\n
b. Barbiturates – phenobarbital ( Luminal)<\/p>\n\n\n\n
Adverse effects :<\/p>\n\n\n\n
– sedation & drowsiness, gingival hyperplasia<\/p>\n\n\n\n
– diplopia, nystagmus, vertigo, dizziness<\/p>\n\n\n\n
– thrombocytopenia, aplastic anemia<\/p>\n\n\n\n
Nursing considerations :<\/p>\n\n\n\n
1. Advise female clients to use contraceptives.<\/p>\n\n\n\n
2. Inform clients taking phenytoin that harmless urine discoloration is common.<\/p>\n\n\n\n
3. Warn clients with diabetes that hydantoins may increase blood sugar level.<\/p>\n\n\n\n
4. Reassure that barbiturates are not addictive at a low dosage.<\/p>\n\n\n\n
5. Avoid taking alcohol with barbiturates.<\/p>\n\n\n\n
6. Administer IV phenytoin slowly to avoid cardiotoxicity.<\/p>\n\n\n\n
7. Avoid mixing other drugs in same syringe with phenytoin.<\/p>\n\n\n\n
ANTIPARKINSONIAN AGENTS<\/p>\n\n\n\n
Prototype :<\/p>\n\n\n\n
a. Anticholinergic agents – trihexyphenidyl (Artane), benztropine (Congentin)<\/p>\n\n\n\n
b. Dopaminergic agents – Levodopa, carbidopa-levodopa (Sinemet), amantidine (Symmetrel)<\/p>\n\n\n\n
Adverse effects of dopaminergic agents:<\/p>\n\n\n\n
a. levodopa\u2013nausea, vomiting, anorexia, orthostatic hypotension, dark-colored<\/p>\n\n\n\n
urine and sweat<\/p>\n\n\n\n
b. amantidine \u2013 ankle edema, constipation<\/p>\n\n\n\n
Nursing considerations:<\/p>\n\n\n\n
1. Give dopaminergic agents after meals to reduce GI symptoms.<\/p>\n\n\n\n
2. Reassure client that levodopa may cause harmless darkening of urine and sweat.<\/p>\n\n\n\n
3. Avoid taking Vit B6 (pyridoxine) because it reverses effects of levodopa.<\/p>\n\n\n\n
4. Change positions slowly to avoid orthostatic hypotension.<\/p>\n\n\n\n
5. Elevate leg to reduce ankle edema.<\/p>\n\n\n\n
DRUGS AFFECTING MENTAL FUNCTIONING<\/p>\n\n\n\n
SEDATIVES, HYPNOTICS, AND ANXIOLYTICS \u2013 induce sleep, sedate & calm clients<\/p>\n\n\n\n
Prototype:<\/p>\n\n\n\n
a. Benzodiazepines (end with \u2013epam)<\/p>\n\n\n\n
– diazepam (Valium), lorazepam (Ativan),<\/p>\n\n\n\n
alprazolam (Xanax), flurazepam (Dalmane)<\/p>\n\n\n\n
b. Barbiturates<\/p>\n\n\n\n
– phenobarbital,<\/p>\n\n\n\n
Adverse effects:<\/p>\n\n\n\n
– hangover-effect, dizziness, CNS depression<\/p>\n\n\n\n
– respiratory depression, drug-dependence<\/p>\n\n\n\n
![\"\"](\"https:\/\/d3tvd1u91rr79.cloudfront.net\/16dbb2be44090319f22bc925a436eded\/html\/bg2.png?Policy=eyJTdGF0ZW1lbnQiOlt7IlJlc291cmNlIjoiaHR0cHM6Ly9kM3R2ZDF1OTFycjc5LmNsb3VkZnJvbnQubmV0LzE2ZGJiMmJlNDQwOTAzMTlmMjJiYzkyNWE0MzZlZGVkL2h0bWwvKiIsIkNvbmRpdGlvbiI6eyJEYXRlTGVzc1RoYW4iOnsiQVdTOkVwb2NoVGltZSI6MTY5MDY1MTQxOH19fV19&Signature=DCiOA0yj5XEQCxLO5TD3gEsNJ44Q8wKnVtwqsQZs5BKePnHqzkAhMg97et3yPl98eJBQjbIkB7ytjKIh6Zz3HvFpwWTNPY4dw35yURUs~gdy3gvcYb-pj3nmam0O1IkRjQwgJ3E~MQLycDBkht3qPTup4GR~uSOoUEGbxpMD1tuO95YRRk2AURJgC1xt0SXx6WdImjpla~MyQBLqxPZZpxWp52STgrkOOXftgdgDbo98dkT6tGB7Mzk2lX3PdCnK5ilxklWjWonYla~vwWtPdyREOSjH-SIcmWNdm7tNBV5SJXJP4vmu6IBM6I6otKWOvEqgPFkSMrnJR7E9EV1wtQ__&Key-Pair-Id=APKAJ535ZH3ZAIIOADHQ\")
<\/p>\n\n\n\n
2<\/p>\n\n\n\n
Nursing considerations:<\/p>\n\n\n\n
1. Warn clients of injuries and falls.<\/p>\n\n\n\n
2. Brief period of confusion and excitement upon waking up is common with benzodiazepines.<\/p>\n\n\n\n
3. Warn clients not to discontinue medications abruptly without consulting a physician.<\/p>\n\n\n\n
4. Avoid alcohol while taking these drugs.<\/p>\n\n\n\n
6. Rotate and don\u2019t shake the ampoules of barbiturates. Don\u2019t mix with other drugs.<\/p>\n\n\n\n
7. Warn female clients that diazepam is associated with cleft lip.<\/p>\n\n\n\n
ANTIDEPRESSANTS AND MOOD DISORDER DRUGS<\/p>\n\n\n\n
Prototype:<\/p>\n\n\n\n
a. Tricyclic antidepressants – amitriptyline (Elavil), imipramine (Tofranil), desipramine<\/p>\n\n\n\n
b. MAOI (monoamine oxidase inhibitors) -phenelzine (Nardil), tranylcypromine (Pernate)<\/p>\n\n\n\n
c. Second-generation antidepressants – fluoxetine (Prozac)<\/p>\n\n\n\n
Adverse effects:<\/p>\n\n\n\n
– dry mouth, blurred vision, urine retention, constipation (anticholinergic effects)<\/p>\n\n\n\n
– orthostatic hypotension, insomnia<\/p>\n\n\n\n
– hypertensive crisis (MAO)<\/p>\n\n\n\n
Nursing considerations:<\/p>\n\n\n\n
1. Caution client to rise slowly to reduce the effects of orthostatic hypotension.<\/p>\n\n\n\n
2. Take antidepressant with food to enhance absorption<\/p>\n\n\n\n
3. Explain to client that full response may take several weeks (2 weeks)<\/p>\n\n\n\n
4. Assess client for constipation resulting from tricyclic antidepressant use.<\/p>\n\n\n\n
5. Client taking MAO inhibitors should avoid tyramine-rich foods to avoid hypertensive crisis.<\/p>\n\n\n\n
-aged cheese, sour cream, yogurt, beer, wine, chocolate, soy sauce and yeast<\/p>\n\n\n\n
6. Inform physician and withhold fluoxetine if client develop rashes.<\/p>\n\n\n\n
ANTIPSYCHOTIC DRUGS (Neuroleptics)<\/p>\n\n\n\n
Prototype:<\/p>\n\n\n\n
a. Phenothiazines<\/p>\n\n\n\n
– chlorpromazine (Thorazine),<\/p>\n\n\n\n
– thioridazine (Mellaril)<\/p>\n\n\n\n
b. Other Agents \u2013 olanzapine (Zyprexa) , haloperidol (Haldol)<\/p>\n\n\n\n
Mechanism of action:<\/p>\n\n\n\n
– block dopamine receptors in the limbic system, hypothalamus, and other regions of the brain.<\/p>\n\n\n\n
Adverse effects:<\/p>\n\n\n\n
– Extra pyramidal syndrome (or EPS) such as dystonia, pseudoparkinsonism, and an<\/p>\n\n\n\n
irreversible tardive dyskinesia as manifested by:<\/p>\n\n\n\n
a. lip smacking<\/p>\n\n\n\n
b. fine wormlike tongue movement<\/p>\n\n\n\n
c. involuntary movements of arms and leg<\/p>\n\n\n\n
– Neuroleptic malignant syndrome (NMS)<\/p>\n\n\n\n
a. fever, tachycardia, tachypnea, diaphoresis, cardiovascular collapse<\/p>\n\n\n\n
b. muscle rigidity, seizures.<\/p>\n\n\n\n
– Orthostatic hypotension<\/p>\n\n\n\n
Nursing considerations:<\/p>\n\n\n\n
1. Teach family members the signs of EPS and NMS, and report to physician immediately<\/p>\n\n\n\n
2. Normalization of symptoms may not occur for several weeks after beginning of therapy<\/p>\n\n\n\n
3. Watch out for orthostatic hypotension and photosensitivity with phenothiazine.<\/p>\n\n\n\n
6. Be sure that oral doses are swallowed, and not hoarded.<\/p>\n\n\n\n
![\"\"](\"https:\/\/d3tvd1u91rr79.cloudfront.net\/16dbb2be44090319f22bc925a436eded\/html\/bg3.png?Policy=eyJTdGF0ZW1lbnQiOlt7IlJlc291cmNlIjoiaHR0cHM6Ly9kM3R2ZDF1OTFycjc5LmNsb3VkZnJvbnQubmV0LzE2ZGJiMmJlNDQwOTAzMTlmMjJiYzkyNWE0MzZlZGVkL2h0bWwvKiIsIkNvbmRpdGlvbiI6eyJEYXRlTGVzc1RoYW4iOnsiQVdTOkVwb2NoVGltZSI6MTY5MDY1MTQxOH19fV19&Signature=DCiOA0yj5XEQCxLO5TD3gEsNJ44Q8wKnVtwqsQZs5BKePnHqzkAhMg97et3yPl98eJBQjbIkB7ytjKIh6Zz3HvFpwWTNPY4dw35yURUs~gdy3gvcYb-pj3nmam0O1IkRjQwgJ3E~MQLycDBkht3qPTup4GR~uSOoUEGbxpMD1tuO95YRRk2AURJgC1xt0SXx6WdImjpla~MyQBLqxPZZpxWp52STgrkOOXftgdgDbo98dkT6tGB7Mzk2lX3PdCnK5ilxklWjWonYla~vwWtPdyREOSjH-SIcmWNdm7tNBV5SJXJP4vmu6IBM6I6otKWOvEqgPFkSMrnJR7E9EV1wtQ__&Key-Pair-Id=APKAJ535ZH3ZAIIOADHQ\")
<\/p>\n\n\n\n
3<\/p>\n\n\n\n
DRUGS USED IN PAIN MANAGEMENT<\/p>\n\n\n\n
ANALGESICS<\/p>\n\n\n\n
Prototype:<\/p>\n\n\n\n
a. Narcotic analgesics<\/p>\n\n\n\n
– codeine, meperidine (Demerol), morphine<\/p>\n\n\n\n
b. Non \u2013 narcotic analgesics<\/p>\n\n\n\n
NSAIDs \u2013 aspirin (acetylsalicylic acid), ibuprofen (Motrin)<\/p>\n\n\n\n
paracetamol and acetaminophen (Tylenol)<\/p>\n\n\n\n
Mechanism of actions:<\/p>\n\n\n\n
a. Narcotic analgesics – alter pain perception by binding to opioid receptors in CNS.<\/p>\n\n\n\n
b. Non- narcotic analgesics – relieve pain and fever by inhibiting the prostaglandin pathway.<\/p>\n\n\n\n
Nursing considerations:<\/p>\n\n\n\n
1. Monitor respiratory depression & hypotension in clients taking narcotic analgesics.<\/p>\n\n\n\n
2. Injury and accident precautions in clients taking narcotic analgesic.<\/p>\n\n\n\n
3. Warn clients about possibility of dependency, and do not discontinue narcotics abruptly in<\/p>\n\n\n\n
narcotic-dependent clients.<\/p>\n\n\n\n
4. Naloxone is the antidote for narcotic overdose.<\/p>\n\n\n\n
5. Advice clients to take NSAIDs with food and monitor for bleeding complications.<\/p>\n\n\n\n
6. Aspirin is contraindicated in clients below 18 years old with flu-like symptoms.<\/p>\n\n\n\n
7. Monitor hearing loss in clients taking aspirin.<\/p>\n\n\n\n
DRUGS AFFECTING THE CARDIOVASCULAR SYSTEM<\/p>\n\n\n\n
ANTICOAGULANTS<\/p>\n\n\n\n
Prototype:<\/p>\n\n\n\n
– Heparin (SQ and IV)<\/p>\n\n\n\n
Warfarin (Orally)<\/p>\n\n\n\n
Mechanism of actions:<\/p>\n\n\n\n
a. Heparin<\/p>\n\n\n\n
– prevents thrombin from converting fibrinogen to fibrin.<\/p>\n\n\n\n
b. Warfarin<\/p>\n\n\n\n
– suppress coagulation by acting as an antagonist of vitamin K after 4-5 days.<\/p>\n\n\n\n
Indications:<\/p>\n\n\n\n
– thrombosis, pulmonary embolism, myocardial infarction<\/p>\n\n\n\n
Adverse effect:<\/p>\n\n\n\n
– bleeding<\/p>\n\n\n\n
Nursing considerations:<\/p>\n\n\n\n
1. HEPARIN sodium<\/p>\n\n\n\n
– test : PTT<\/p>\n\n\n\n
– antidote : (protamine sulfate)<\/p>\n\n\n\n
2. WARFARIN sodium (coumadin)<\/p>\n\n\n\n
– test : INR<\/p>\n\n\n\n
– reduce intake of green leafy vegetables.<\/p>\n\n\n\n
– antidote : Vitamin K ( Aquamephyton)<\/p>\n\n\n\n
ANTIPLATELET MEDICATIONS<\/p>\n\n\n\n
Prototype: aspirin (ASA), Dipyridamole (Persantin), Clopidogrel (Plavix)<\/p>\n\n\n\n
Mechanism of action:<\/p>\n\n\n\n
– inhibit the aggregation of platelet thereby prolonging bleeding time.<\/p>\n\n\n\n
Indications:<\/p>\n\n\n\n
– used in the prophylaxis of long-term complication following M.I, coronary revascularization &<\/p>\n\n\n\n
thrombotic CVA<\/p>\n\n\n\n
![\"\"](\"https:\/\/d3tvd1u91rr79.cloudfront.net\/16dbb2be44090319f22bc925a436eded\/html\/bg4.png?Policy=eyJTdGF0ZW1lbnQiOlt7IlJlc291cmNlIjoiaHR0cHM6Ly9kM3R2ZDF1OTFycjc5LmNsb3VkZnJvbnQubmV0LzE2ZGJiMmJlNDQwOTAzMTlmMjJiYzkyNWE0MzZlZGVkL2h0bWwvKiIsIkNvbmRpdGlvbiI6eyJEYXRlTGVzc1RoYW4iOnsiQVdTOkVwb2NoVGltZSI6MTY5MDY1MTQxOH19fV19&Signature=DCiOA0yj5XEQCxLO5TD3gEsNJ44Q8wKnVtwqsQZs5BKePnHqzkAhMg97et3yPl98eJBQjbIkB7ytjKIh6Zz3HvFpwWTNPY4dw35yURUs~gdy3gvcYb-pj3nmam0O1IkRjQwgJ3E~MQLycDBkht3qPTup4GR~uSOoUEGbxpMD1tuO95YRRk2AURJgC1xt0SXx6WdImjpla~MyQBLqxPZZpxWp52STgrkOOXftgdgDbo98dkT6tGB7Mzk2lX3PdCnK5ilxklWjWonYla~vwWtPdyREOSjH-SIcmWNdm7tNBV5SJXJP4vmu6IBM6I6otKWOvEqgPFkSMrnJR7E9EV1wtQ__&Key-Pair-Id=APKAJ535ZH3ZAIIOADHQ\")
<\/p>\n\n\n\n
4<\/p>\n\n\n\n
Nursing considerations:<\/p>\n\n\n\n
– Monitor bleeding time ( NV = 1-9 mins)<\/p>\n\n\n\n
– Take the medication with food.<\/p>\n\n\n\n
CARDIAC GLYCOSIDES<\/p>\n\n\n\n
Prototype: digoxin (Lanoxin)<\/p>\n\n\n\n
Mechanism of actions:<\/p>\n\n\n\n
\uf0b7 increase intracellular calcium, which causes the heart muscle fibers to contract more<\/p>\n\n\n\n
efficiently, producing positive inotropic & negative chronotropic action.<\/p>\n\n\n\n
Indications:<\/p>\n\n\n\n
\uf0b7 use for CHF, atrial tachycardia and fibrillation<\/p>\n\n\n\n
Nursing considerations:<\/p>\n\n\n\n
– Monitor for toxicity as evidenced by:<\/p>\n\n\n\n
o nausea, vomiting, anorexia, halo vision, confusion, bradycardia and heart blocks<\/p>\n\n\n\n
– Do not administer if pulse is less than 60 bpm.<\/p>\n\n\n\n
– Should be caution in patient with hypothyroidism and hypokalemia.<\/p>\n\n\n\n
– Antidote : Digoxin Immune FAB<\/p>\n\n\n\n
NITRATES<\/p>\n\n\n\n
Prototype:<\/p>\n\n\n\n
– isosorbide dinitrate (Isordil)<\/p>\n\n\n\n
– nitroglycerine (Deponit, Nitrostat)<\/p>\n\n\n\n
Mechanism of action:<\/p>\n\n\n\n
– produce vasodilatation including coronary artery.<\/p>\n\n\n\n
Indications:<\/p>\n\n\n\n
– angina pectoris, MI, peripheral arterial occlusive disease.<\/p>\n\n\n\n
Adverse effects:<\/p>\n\n\n\n
– headache, orthostatic hypotension .<\/p>\n\n\n\n
Nursing Considerations:<\/p>\n\n\n\n
1. Transdermal patch<\/p>\n\n\n\n
– apply the patch to a hairless area using a new patch and different site each day<\/p>\n\n\n\n
– remove the patch, allowing 10-12 hours \u201cpatch free\u201d each day to prevent tolerance<\/p>\n\n\n\n
2. Sublingual medications :<\/p>\n\n\n\n
– note the BP before giving the medication.<\/p>\n\n\n\n
– offer sips of water before giving because dryness may inhibit absorption.<\/p>\n\n\n\n
– one tablet for pain and repeat every 5 mins.for a total of three doses; if not relieved after 10<\/p>\n\n\n\n
mins., seek medical help.<\/p>\n\n\n\n
– stinging or burning sensation indicates that the tablet is fresh<\/p>\n\n\n\n
– instruct patient not to swallow the pill<\/p>\n\n\n\n
– sustained release medications should be swallowed and not crushed<\/p>\n\n\n\n
– protect the pills from light<\/p>\n\n\n\n
ANTI \u2013 HYPERTENSIVES<\/p>\n\n\n\n
ANGIOTENSIN-CONVERTING ENZYME (ACE) INHIBITORS (DRUG NAMES END IN WITH \u201c-PRIL\u201d)<\/p>\n\n\n\n
Prototype :<\/p>\n\n\n\n
captopril (Capoten), enalapril (Vasotec), quinapril, lisinopril<\/p>\n\n\n\n
Mechanism of actions:<\/p>\n\n\n\n
– prevent peripheral vasoconstriction by blocking conversion of angiotensin I to angiotensin II<\/p>\n\n\n\n
decreasing peripheral resistance.<\/p>\n\n\n\n
Adverse effect :<\/p>\n\n\n\n
![\"\"](\"https:\/\/d3tvd1u91rr79.cloudfront.net\/16dbb2be44090319f22bc925a436eded\/html\/bg5.png?Policy=eyJTdGF0ZW1lbnQiOlt7IlJlc291cmNlIjoiaHR0cHM6Ly9kM3R2ZDF1OTFycjc5LmNsb3VkZnJvbnQubmV0LzE2ZGJiMmJlNDQwOTAzMTlmMjJiYzkyNWE0MzZlZGVkL2h0bWwvKiIsIkNvbmRpdGlvbiI6eyJEYXRlTGVzc1RoYW4iOnsiQVdTOkVwb2NoVGltZSI6MTY5MDY1MTQxOH19fV19&Signature=DCiOA0yj5XEQCxLO5TD3gEsNJ44Q8wKnVtwqsQZs5BKePnHqzkAhMg97et3yPl98eJBQjbIkB7ytjKIh6Zz3HvFpwWTNPY4dw35yURUs~gdy3gvcYb-pj3nmam0O1IkRjQwgJ3E~MQLycDBkht3qPTup4GR~uSOoUEGbxpMD1tuO95YRRk2AURJgC1xt0SXx6WdImjpla~MyQBLqxPZZpxWp52STgrkOOXftgdgDbo98dkT6tGB7Mzk2lX3PdCnK5ilxklWjWonYla~vwWtPdyREOSjH-SIcmWNdm7tNBV5SJXJP4vmu6IBM6I6otKWOvEqgPFkSMrnJR7E9EV1wtQ__&Key-Pair-Id=APKAJ535ZH3ZAIIOADHQ\")
<\/p>\n\n\n\n
5<\/p>\n\n\n\n
– hyperkalemia<\/p>\n\n\n\n
– induce chronic dry cough<\/p>\n\n\n\n
Nursing considerations :<\/p>\n\n\n\n
– not to discontinue medications because it can cause rebound hypertension.<\/p>\n\n\n\n
– avoid using K+ sparing diuretics.<\/p>\n\n\n\n
ADRENERGIC BLOCKING AGENTS<\/p>\n\n\n\n
Prototype: Beta blockers (drug names end with \u201c-olol\u201d)<\/p>\n\n\n\n
– atenolol (Tenormin), metoprolol (Lopressor),<\/p>\n\n\n\n
propanolol (Inderal), timolol ( Blocadren)<\/p>\n\n\n\n
Mechanism of actions :<\/p>\n\n\n\n
– compete with epinephrine in b-receptors in heart, pulmonary airways, peripheral<\/p>\n\n\n\n
circulation and CNS.<\/p>\n\n\n\n
Indications :<\/p>\n\n\n\n
– Raynaud\u2019s disease, hypertension, pheochromocytoma.<\/p>\n\n\n\n
– angina, arrhythmias, mitral valve prolapse, glaucoma<\/p>\n\n\n\n
Adverse effects :<\/p>\n\n\n\n
– orthostatic hypotension, bradycardia, CHF<\/p>\n\n\n\n
– depression, insomnia and vertigo<\/p>\n\n\n\n
– bronchospasm and dyspnea, nasal stuffiness, cold extremities<\/p>\n\n\n\n
Nursing considerations :<\/p>\n\n\n\n
1. Administer oral beta-blockers before meals and at a.m. if insomnia occurs.<\/p>\n\n\n\n
2. Check client\u2019s apical pulse rate before drug administration, refer if below 60 bpm.<\/p>\n\n\n\n
3. Change positions slowly to avoid orthostatic hypotension.<\/p>\n\n\n\n
4. Warn clients not to drive or operate dangerous machinery until he\/she has adjusted to<\/p>\n\n\n\n
medications.<\/p>\n\n\n\n
CALCIUM-CHANNEL BLOCKERS<\/p>\n\n\n\n
Prototype :<\/p>\n\n\n\n
– Nifedipine (calcibloc, adalat), Amlodipine (norvasc), Verapramil (Isoptin)<\/p>\n\n\n\n
Mechanism of action:<\/p>\n\n\n\n
– decrease cardiac contractility and the workload of the heart, thus decreasing the need for O2<\/p>\n\n\n\n
– it also promotes vasodilatation of the coronary and peripheral vessels.<\/p>\n\n\n\n
Indications:<\/p>\n\n\n\n
– hypertension, angina, arrhythmia<\/p>\n\n\n\n
Adverse effects:<\/p>\n\n\n\n
– bradycardia, hypotension, headache<\/p>\n\n\n\n
– reflex tachycardia, constipation<\/p>\n\n\n\n
Nursing considerations:<\/p>\n\n\n\n
– Administer between meals to enhance absorption.<\/p>\n\n\n\n
– Take client\u2019s pulse rate before each dose. Withhold if pulse is below 60 bpm.<\/p>\n\n\n\n
– Refer for signs of congestive heart failure.<\/p>\n\n\n\n
DIURETICS<\/p>\n\n\n\n
– usually given at morning<\/p>\n\n\n\n
Thiazides – hydrochlorothiazide<\/p>\n\n\n\n
– blocks Na and K reabsorption; reabsorb Ca<\/p>\n\n\n\n
– hypercalcemia<\/p>\n\n\n\n
Loop diuretics – furosemide (Lasix)<\/p>\n\n\n\n
– blocks Na, K, and Ca reabsorption<\/p>\n\n\n\n
– hypocalcemia<\/p>\n\n\n\n
![\"\"](\"https:\/\/d3tvd1u91rr79.cloudfront.net\/16dbb2be44090319f22bc925a436eded\/html\/bg6.png?Policy=eyJTdGF0ZW1lbnQiOlt7IlJlc291cmNlIjoiaHR0cHM6Ly9kM3R2ZDF1OTFycjc5LmNsb3VkZnJvbnQubmV0LzE2ZGJiMmJlNDQwOTAzMTlmMjJiYzkyNWE0MzZlZGVkL2h0bWwvKiIsIkNvbmRpdGlvbiI6eyJEYXRlTGVzc1RoYW4iOnsiQVdTOkVwb2NoVGltZSI6MTY5MDY1MTQxOH19fV19&Signature=DCiOA0yj5XEQCxLO5TD3gEsNJ44Q8wKnVtwqsQZs5BKePnHqzkAhMg97et3yPl98eJBQjbIkB7ytjKIh6Zz3HvFpwWTNPY4dw35yURUs~gdy3gvcYb-pj3nmam0O1IkRjQwgJ3E~MQLycDBkht3qPTup4GR~uSOoUEGbxpMD1tuO95YRRk2AURJgC1xt0SXx6WdImjpla~MyQBLqxPZZpxWp52STgrkOOXftgdgDbo98dkT6tGB7Mzk2lX3PdCnK5ilxklWjWonYla~vwWtPdyREOSjH-SIcmWNdm7tNBV5SJXJP4vmu6IBM6I6otKWOvEqgPFkSMrnJR7E9EV1wtQ__&Key-Pair-Id=APKAJ535ZH3ZAIIOADHQ\")
<\/p>\n\n\n\n
6<\/p>\n\n\n\n
Potassium sparing diuretics – Spironolactone (Aldactone)<\/p>\n\n\n\n
– excrete Na and water but it reabsorbs K<\/p>\n\n\n\n
– hyperkalemia<\/p>\n\n\n\n
RESPIRATORY MEDICATIONS<\/p>\n\n\n\n
BRONCHODILATORS<\/p>\n\n\n\n
Prototype :<\/p>\n\n\n\n
Symphatomimetic Xanthines<\/p>\n\n\n\n
– albuterol, salbutamol – aminophylline<\/p>\n\n\n\n
– isoproterenol, salmeterol – theophylline<\/p>\n\n\n\n
– terbutaline<\/p>\n\n\n\n
Mechanism of actions:<\/p>\n\n\n\n
– sympathomimetic (<\/p>\n\n\n\n
\uf062<\/p>\n\n\n\n
-receptor agonist) bronchodilators, dilate airways.<\/p>\n\n\n\n
– xanthine bronchodilators, stimulate CNS for respiration.<\/p>\n\n\n\n
Indications :<\/p>\n\n\n\n
-bronchospasm, asthma, bronchitis, COPD.<\/p>\n\n\n\n
Adverse effects :<\/p>\n\n\n\n
– palpitations and tachycardia<\/p>\n\n\n\n
– restlessness, nervousness, tremors<\/p>\n\n\n\n
– anorexia, nausea and vomiting, headache, dizziness.<\/p>\n\n\n\n
Nursing considerations:<\/p>\n\n\n\n
– Contraindicated in hyperthyroidism, cardiac dysrhythmia, or uncontrolled seizure disorder.<\/p>\n\n\n\n
– Should be used with caution in patients with HPN and narrow-angle glaucoma.<\/p>\n\n\n\n
GLUCOCORTICOIDS (Corticosteroids)<\/p>\n\n\n\n
Prototype:<\/p>\n\n\n\n
– prednisone<\/p>\n\n\n\n
Mechanism of actions :<\/p>\n\n\n\n
– act as anti-inflammatory agents and reduce edema of the airways, as well as<\/p>\n\n\n\n
pulmonary edema.<\/p>\n\n\n\n
Adverse effects :Cushing\u2019s syndrome, neutropenia. osteoporosis<\/p>\n\n\n\n
Nursing considerations :<\/p>\n\n\n\n
– Take drugs with food.<\/p>\n\n\n\n
– Eat foods high in potassium, low in sodium.<\/p>\n\n\n\n
– Instruct client to avoid individuals with RTI.<\/p>\n\n\n\n
– Instruct client not to stop medication abruptly it should be tapered to prevent adrenal<\/p>\n\n\n\n
insufficiency<\/p>\n\n\n\n
– Avoid taking NSAIDs while taking steroids.<\/p>\n\n\n\n
– Take inhaled bronchodilators first before taking inhaled steroids, and rinse mouth after using.<\/p>\n\n\n\n
ANTI-HISTAMINES (H-1 blockers)<\/p>\n\n\n\n
Prototype:<\/p>\n\n\n\n
– Loratidine (Claritin)<\/p>\n\n\n\n
– Brompheniramine (Dimetapp)<\/p>\n\n\n\n
– Diphenhydramine (Benadryl)<\/p>\n\n\n\n
Mechanism of action :<\/p>\n\n\n\n
– decrease nasopharyngeal secretions and decrease nasal itching by blockinghistamine in<\/p>\n\n\n\n
H1-receptor.<\/p>\n\n\n\n
Indications :<\/p>\n\n\n\n
– common colds, rhinitis, nausea and<\/p>\n\n\n\n
vomiting, urticaria, allergies and as sleep aid. Document continues below<\/p>\n\n\n\n
Discover more from:<\/strong><\/p>\n\n\n\n Adult health (nur 3240)<\/a><\/strong>(nur 3240)<\/p>\n\n\n\n 24 documentsGo to course<\/p>\n\n\n\n 7<\/p>\n\n\n\n Nursing Considerations :<\/p>\n\n\n\n – Administer with food and drink.<\/p>\n\n\n\n – Precautions in handling machinery and driving while taking these drugs.<\/p>\n\n\n\n – Ice chips or candy for dry mouth<\/p>\n\n\n\n DECONGESTANTS<\/p>\n\n\n\n – pseudoephedrine (Sudafed) \u2013 adrenergic (sympathomimetic) agent<\/p>\n\n\n\n – Caution : do not use with clients with HPN<\/p>\n\n\n\n DRUGS AFFECTING GASTROINTESTINAL SYSTEM<\/p>\n\n\n\n ANTI-ULCER DRUGS<\/p>\n\n\n\n ANTACIDS<\/p>\n\n\n\n Prototype :<\/p>\n\n\n\n – aluminum\/magnesium compounds (Maalox)<\/p>\n\n\n\n – sodium bicarbonate (Alka-Seltzer)<\/p>\n\n\n\n – calcium carbonate (Tums)<\/p>\n\n\n\n – magnesium hydroxide (Milk of Magnesia).<\/p>\n\n\n\n Mechanism of actions :<\/p>\n\n\n\n – neutralize the stomach acidity.<\/p>\n\n\n\n Adverse effects:<\/p>\n\n\n\n – metabolic alkalosis, stone formation<\/p>\n\n\n\n – electrolyte imbalance<\/p>\n\n\n\n – diarrhea (magnesium), constipation (aluminum).<\/p>\n\n\n\n Nursing considerations:<\/p>\n\n\n\n – Give 1 hr after meals.<\/p>\n\n\n\n – Avoid giving medications within 1-2 hrs of antacid administration (decreases absorption).<\/p>\n\n\n\n – Take fluids to flush after intake of antacid suspensions.<\/p>\n\n\n\n – Monitor for changes of bowel patterns.<\/p>\n\n\n\n HISTAMINE-2 BLOCKERS (END WITH \u2013IDINE)<\/p>\n\n\n\n Prototype:<\/p>\n\n\n\n – cimetidine (Tagamet), ranitidine (Zantac),<\/p>\n\n\n\n famotidine (Pepcid), nizatidine (Axid).<\/p>\n\n\n\n Mechanism of action:<\/p>\n\n\n\n – blocks H2 receptors in the stomach, reducing acid secretions.<\/p>\n\n\n\n Nursing considerations:<\/p>\n\n\n\n – Given before or with meals<\/p>\n\n\n\n – Avoid giving other drugs with cimetidine<\/p>\n\n\n\n – Gynecomastia may develop with chronic use of cimetidine.<\/p>\n\n\n\n PROTON \u2013 PUMP INHIBITORS (PPI) (END WITH \u2013AZOLE)<\/p>\n\n\n\n Prototype :<\/p>\n\n\n\n – omeprazole (Losec), Lansoprazole (Lanz), pantoprazole (Pantoloc).<\/p>\n\n\n\n Mechanism of action :<\/p>\n\n\n\n – inhibit the proton H+ to combine with Cl- toform hydrochloric acid.<\/p>\n\n\n\n Nursing considerations :<\/p>\n\n\n\n – Given before meals preferably at morning.<\/p>\n\n\n\n MUCOSAL BARRIERS<\/p>\n\n\n\n Prototype :<\/p>\n\n\n\n – sucralfate (Carafate), misoprostol (Cytotec).<\/p>\n\n\n\n 8<\/p>\n\n\n\n Mechanism of action:<\/p>\n\n\n\n – coats the mucosa to prevent ulcerations.<\/p>\n\n\n\n Nursing consideration:<\/p>\n\n\n\n – Given before meals.<\/p>\n\n\n\n – Misoprostol is contraindicated for pregnants.<\/p>\n\n\n\n – Sucralfate cause constipation.<\/p>\n\n\n\n ANTII-EMETICS (ANTI-VOMITING)<\/p>\n\n\n\n – Dimenhydrinate (Gravol) \u2013 an anticholinergic; used also for motion sickness<\/p>\n\n\n\n – Diphenhydramine (Benadryl) \u2013 an antihistamie<\/p>\n\n\n\n – Metoclopramide (Reglan) \u2013 dopamine antagonist<\/p>\n\n\n\n o Not available in Canada; EPS side effects<\/p>\n\n\n\n ANTI-DIARRHEAL AGENTS<\/p>\n\n\n\n Prototype :<\/p>\n\n\n\n – diphenoxylate (Lomotil), loperamide (Imodium), kaolin\/pectin mixture (Kaopectate).<\/p>\n\n\n\n Mechanism of actions :<\/p>\n\n\n\n – decrease stomach motility and peristalsis.<\/p>\n\n\n\n Nursing considerations :<\/p>\n\n\n\n – Monitor for rebound constipation.<\/p>\n\n\n\n – Be cautious taking if with infectious diarrhea.<\/p>\n\n\n\n – Monitor atropine toxicity with diphenoxylate.<\/p>\n\n\n\n – Clay, white or pale stool is common with kaopectate.<\/p>\n\n\n\n LAXATIVES<\/p>\n\n\n\n a. Osmotic : lactulose (Duphalac), Na biphosphate (Fleet enema) & magnesium salt (Milk of<\/p>\n\n\n\n Magnesia)<\/p>\n\n\n\n – retain fluid and distend intestine<\/p>\n\n\n\n b. Fecal softeners : ducosate (Dialose)<\/p>\n\n\n\n – emulsify fecal fat and water<\/p>\n\n\n\n c. Stimulant : bisacodyl (Dulcolax) & senna (X-prep)<\/p>\n\n\n\n – irritates intestinal mucosa and stimulates intestinal smooth muscles<\/p>\n\n\n\n d. bulk-forming laxative (Metamucil)<\/p>\n\n\n\n – increase fecal bulk and water content<\/p>\n\n\n\n e. Emollient\/Lubricant : mineral oil<\/p>\n\n\n\n – lubricates & prevent colon absorption<\/p>\n\n\n\n DRUGS AFFECTING THE ENDOCRINE SYSTEM<\/p>\n\n\n\n THYROID AGENTS<\/p>\n\n\n\n Prototype:<\/p>\n\n\n\n \uf0b7 Synthroid (levothyroxine)<\/p>\n\n\n\n Mechanism of action:<\/p>\n\n\n\n – function as natural or synthetic hormones.<\/p>\n\n\n\n Nursing considerations:<\/p>\n\n\n\n – Taken in the morning.<\/p>\n\n\n\n -Caution with coronary artery disease.<\/p>\n\n\n\n -Monitor for signs of hyperthyroidism and refer for decreasing the dose.<\/p>\n\n\n\n ANTIDIABETICS<\/p>\n\n\n\n ORAL HYPOGLYCEMIC AGENTS (OHA)<\/p>\n\n\n\n 1. Sulfonylureas<\/p>\n\n\n\n 9<\/p>\n\n\n\n \uf0b7 stimulate insulin secretions and increase tissue sensitivity to insulin.<\/p>\n\n\n\n \uf0b7 First Generation: Chlorpropamide (Diabenase) – disulfiram precautions<\/p>\n\n\n\n \uf0b7 Second Generation: Glypizide, Glymepiride<\/p>\n\n\n\n 2. Biguanides<\/p>\n\n\n\n \uf0b7 facilitates insulin action on the peripheral receptor site<\/p>\n\n\n\n \uf0b7 Metformin and Glucophage (Glucovance) – side effect is lactic acidosis<\/p>\n\n\n\n 3. Alpha-glucosidase inhibitors<\/p>\n\n\n\n \uf0b7 delay carbohydrate absorption in the intestinal system<\/p>\n\n\n\n \uf0b7 Acarbose (Precose) \u2013 side effect is diarrhea<\/p>\n\n\n\n 4. Thiazolinidine<\/p>\n\n\n\n \uf0b7 increase tissue sensitivity of insulin; e.g Rosiglitazone (Avandia) \u2013 already discontinued<\/p>\n\n\n\n Nursing considerations:<\/p>\n\n\n\n – Effective only for type II DM<\/p>\n\n\n\n – Contraindicated to pregnant & breastfeeding.<\/p>\n\n\n\n – Given before meals<\/p>\n\n\n\n – Monitor for signs of hypoglycemia.<\/p>\n\n\n\n Insulin<\/p>\n\n\n\n Type of Insulin<\/p>\n\n\n\n & Brand<\/p>\n\n\n\n Names<\/p>\n\n\n\n Onset<\/p>\n\n\n\n Peak<\/p>\n\n\n\n Duration<\/p>\n\n\n\n Role in Blood Sugar<\/p>\n\n\n\n Management<\/p>\n\n\n\n Rapid-Acting<\/p>\n\n\n\n Humalog or<\/p>\n\n\n\n lispro<\/p>\n\n\n\n 15-30 min.<\/p>\n\n\n\n 30-90 min<\/p>\n\n\n\n 3-5 hours<\/p>\n\n\n\n Rapid-acting insulin<\/p>\n\n\n\n covers insulin needs<\/p>\n\n\n\n for meals eaten at the<\/p>\n\n\n\n same time as the<\/p>\n\n\n\n injection. This type of<\/p>\n\n\n\n insulin is used with<\/p>\n\n\n\n longer-acting insulin.<\/p>\n\n\n\n Novolog or<\/p>\n\n\n\n aspart<\/p>\n\n\n\n 10-20 min.<\/p>\n\n\n\n 40-50 min.<\/p>\n\n\n\n 3-5 hours<\/p>\n\n\n\n Apidra or<\/p>\n\n\n\n glulisine<\/p>\n\n\n\n 20-30 min.<\/p>\n\n\n\n 30-90 min.<\/p>\n\n\n\n 1-2\u00bd hours<\/p>\n\n\n\n Short-Acting<\/p>\n\n\n\n Regular (R)<\/p>\n\n\n\n humulin or<\/p>\n\n\n\n novolin<\/p>\n\n\n\n 30 min. -1 hour<\/p>\n\n\n\n 2-5 hours<\/p>\n\n\n\n 5-8 hours<\/p>\n\n\n\n Short-acting insulin<\/p>\n\n\n\n covers insulin needs<\/p>\n\n\n\n for meals eaten within<\/p>\n\n\n\n 30-60 minutes<\/p>\n\n\n\n Velosulin (for<\/p>\n\n\n\n use in the<\/p>\n\n\n\n insulin pump)<\/p>\n\n\n\n 30 min.-1 hour<\/p>\n\n\n\n 2-3 hours<\/p>\n\n\n\n 2-3 hours<\/p>\n\n\n\n Intermediate-Acting<\/p>\n\n\n\n NPH (N)<\/p>\n\n\n\n 1-2 hours<\/p>\n\n\n\n 4-12 hours<\/p>\n\n\n\n 18-24 hours<\/p>\n\n\n\n Intermediate-acting<\/p>\n\n\n\n insulin covers insulin<\/p>\n\n\n\n needs for about half<\/p>\n\n\n\n the day or overnight.<\/p>\n\n\n\n This type of insulin is<\/p>\n\n\n\n often combined with<\/p>\n\n\n\n rapid- or short-acting<\/p>\n\n\n\n insulin.<\/p>\n\n\n\n Lente (L)<\/p>\n\n\n\n 1-2\u00bd hours<\/p>\n\n\n\n 3-10 hours<\/p>\n\n\n\n 18-24 hours<\/p>\n\n\n\n 10<\/p>\n\n\n\n Long-Acting<\/p>\n\n\n\n Ultralente (U)<\/p>\n\n\n\n 30 min.-3<\/p>\n\n\n\n hours<\/p>\n\n\n\n 10-20 hours<\/p>\n\n\n\n 20-36 hours<\/p>\n\n\n\n Long-acting insulin<\/p>\n\n\n\n covers insulin needs<\/p>\n\n\n\n for about one full day.<\/p>\n\n\n\n This type of insulin is<\/p>\n\n\n\n often combined, when<\/p>\n\n\n\n needed, with rapid- or<\/p>\n\n\n\n short-acting insulin.<\/p>\n\n\n\n * Cannot mix these<\/p>\n\n\n\n with other insulins in<\/p>\n\n\n\n the same vial. Have to<\/p>\n\n\n\n give two separate<\/p>\n\n\n\n injections.<\/p>\n\n\n\n Lantus<\/p>\n\n\n\n (Glargine)<\/p>\n\n\n\n 1-1\u00bd hour<\/p>\n\n\n\n No peak time;<\/p>\n\n\n\n insulin is<\/p>\n\n\n\n delivered at a<\/p>\n\n\n\n steady level<\/p>\n\n\n\n 20-24 hours<\/p>\n\n\n\n Levemir or<\/p>\n\n\n\n detemir<\/p>\n\n\n\n 1-2 hours<\/p>\n\n\n\n 6-8 hours<\/p>\n\n\n\n Up to 24 hours<\/p>\n\n\n\n Pre-Mixed*<\/p>\n\n\n\n Humulin 70\/30<\/p>\n\n\n\n 30 min.<\/p>\n\n\n\n 2-4 hours<\/p>\n\n\n\n 14-24 hours<\/p>\n\n\n\n These products are<\/p>\n\n\n\n generally taken twice<\/p>\n\n\n\n a day before<\/p>\n\n\n\n mealtime.<\/p>\n\n\n\n Novolin 70\/30<\/p>\n\n\n\n 30 min.<\/p>\n\n\n\n 2-12 hours<\/p>\n\n\n\n Up to 24 hours<\/p>\n\n\n\n Novolog 70\/30<\/p>\n\n\n\n 10-20 min.<\/p>\n\n\n\n 1-4 hours<\/p>\n\n\n\n Up to 24 hours<\/p>\n\n\n\n Humulin 50\/50<\/p>\n\n\n\n 30 min.<\/p>\n\n\n\n 2-5 hours<\/p>\n\n\n\n 18-24 hours<\/p>\n\n\n\n Humalog mix<\/p>\n\n\n\n 75\/25<\/p>\n\n\n\n 15 min.<\/p>\n\n\n\n 30 min.-2\u00bd<\/p>\n\n\n\n hours<\/p>\n\n\n\n 16-20 hours<\/p>\n\n\n\n *Premixed insulins are a combination of specific proportions of intermediate-acting and short-<\/p>\n\n\n\n acting insulin in one bottle or insulin pen (the numbers following the brand name indicate the<\/p>\n\n\n\n percentage of each type of insulin).<\/p>\n\n\n\n Nursing considerations:<\/p>\n\n\n\n – Usually given before meals.<\/p>\n\n\n\n – Roll the bottle in palm of hands, don\u2019t shake.<\/p>\n\n\n\n – Inject amount of air that is equal to each dose into the bottle- short acting last (clear).<\/p>\n\n\n\n – Aspirate short acting first, then long or intermediate (cloudy).<\/p>\n\n\n\n – Alcohol is recommended for cleansing bottle but not with skin.<\/p>\n\n\n\n – Pinch skin, avoid I.M, don\u2019t aspirate.<\/p>\n\n\n\n – Rotate the injection site an inch a part.<\/p>\n\n\n\n – Prefilled syringes are stored vertically, needle-up.<\/p>\n\n\n\n – May increase dose during illnesses.<\/p>\n\n\n\n – Used bottles stored in room temperature, unused bottle stored in refrigerator.<\/p>\n\n\n\n – Monitor for acute hypoglycemia; treat with:<\/p>\n\n\n\n a. 3-4 commercially prepared glucose tablet<\/p>\n\n\n\n b. 4-6 ounce of fruit juice or regular soda<\/p>\n\n\n\n c. 2-3 teaspoons of honey<\/p>\n\n\n\n d. Glucagon 1 gm SQ or IM<\/p>\n\n\n\n e. D50-50 IV.<\/p>\n\n\n\n DRUGS FOR TREATING INFECTION<\/p>\n\n\n\n ANTIBACTERIAL AGENTS<\/p>\n\n\n\n 1. Cell wall inhibitors<\/p>\n\n\n\n a. penicillins – pen G, amoxicillin, cloxacillin<\/p>\n\n\n\n b. cephalosphorins – cephalexin, cefaclor<\/p>\n\n\n\n c. glycopeptide \u2013 vancomycin<\/p>\n\n\n\n 2. Protein synthesis inhibitors<\/p>\n\n\n\n a. aminoglycosides – amikacin, gentamycin<\/p>\n\n\n\n b. macrolide \u2013 erythromycin<\/p>\n\n\n\n 11<\/p>\n\n\n\n c. tetracycline\u2019s<\/p>\n\n\n\n 3. Antimetabolites – blocks folic acid synthesis<\/p>\n\n\n\n a. Sulfonamides \u2013 cotrimoxazole<\/p>\n\n\n\n 4. DNA synthesis inhibitors<\/p>\n\n\n\n a. quinolones – ciprofloxacin, norfloxacin<\/p>\n\n\n\n b. metronidazole (Flagyl)<\/p>\n\n\n\n Adverse effects :<\/p>\n\n\n\n 1. Aminoglycoside – nephrotoxicity & ototoxicity<\/p>\n\n\n\n 2. Sulfonamides – Steven-Johnson\u2019s syndrome, photosensitivity Quinolones – insomnia<\/p>\n\n\n\n 3. Tetracyclines – bone problems<\/p>\n\n\n\n 4. Erythromycin – hepatitis<\/p>\n\n\n\n Nursing considerations:<\/p>\n\n\n\n 1. Collect appropriate specimen for C & S before starting antibiotics.<\/p>\n\n\n\n 2. Check client\u2019s history of allergies.<\/p>\n\n\n\n 3. Monitor adverse effects: ALL antibiotics can cause nausea, vomiting & diarrhea<\/p>\n\n\n\n DRUGS with MULTIPLE USES<\/p>\n\n\n\n CHOLINERGIC BLOCKING AGENTS (Parasympatholytics, Anticholinergics)<\/p>\n\n\n\n Prototype: atropine<\/p>\n\n\n\n Mechanism of actions:<\/p>\n\n\n\n – block the binding of acetylcholine in the receptors of parasympathetic nerves.<\/p>\n\n\n\n Indications:<\/p>\n\n\n\n – use preoperatively to dry up secretions.<\/p>\n\n\n\n – treat spasticity of GI or urinary tract.<\/p>\n\n\n\n – use for treatment of bradycardia, asthma, parkinsonism.<\/p>\n\n\n\n – use for antidote in organophosphate poisoning (insecticide)<\/p>\n\n\n\n Adverse effects:<\/p>\n\n\n\n – dry mouth , dilatation of pupils, tachycardia<\/p>\n\n\n\n – urinary retention, ileus, heat stroke<\/p>\n\n\n\n Nursing considerations:<\/p>\n\n\n\n 1. Keep clients in cool environment.<\/p>\n\n\n\n 2. Watch out for signs of heatstroke and dehydration.<\/p>\n\n\n\n 3. Encourage clients to increase fluid intake and use of sugarless gum\/candy for dry mouth.<\/p>\n\n\n\n 4. For GI spasticity, administer 30 minutes before meals and at bedtime.<\/p>\n\n\n\n ADRENERGIC AGENTS (Sympathomimetics)<\/p>\n\n\n\n Prototype:<\/p>\n\n\n\n – epinephrine, phenylephrine,<\/p>\n\n\n\n terbutaline, albuterol, isoproterenol.<\/p>\n\n\n\n Mechanism of actions:<\/p>\n\n\n\n – stimulate alpha and beta adrenergic receptor directly or trigger the release of catecholamines<\/p>\n\n\n\n indirectly causing sympathetic effects.<\/p>\n\n\n\n Indications:<\/p>\n\n\n\n – cardiopulmonary arrest, hypotension<\/p>\n\n\n\n – COPD and asthma, nasal congestions<\/p>\n\n\n\n – allergic reaction, anaphylactic shock<\/p>\n\n\n\n Adverse effects:<\/p>\n\n\n\n – restlessness, insomnia, tremors, nausea<\/p>\n\n\n\n – palpitations, angina, tachycardia, HPN<\/p>\n\n\n\n 12<\/p>\n\n\n\n Nursing considerations:<\/p>\n\n\n\n 1. Contraindicated in clients w\/ hyperthyroidism, pheochromocytoma & cardiovascular disease.<\/p>\n\n\n\n 2. Monitor vital signs and advice precautions<\/p>\n\n\n\n MISCELLANEOUS DRUGS<\/p>\n\n\n\n ANTI-GOUT<\/p>\n\n\n\n – Acute attacks : phenylbutazone (an NSAID), colchicine<\/p>\n\n\n\n – Maintenance : allopurinol<\/p>\n\n\n\n 13<\/p>\n\n\n\n *These lists are not extensive but should help<\/p>\n\n\n\n Drugs and their Antidotes<\/p>\n\n\n\n 1. Digoxin \u2013 Digibind<\/p>\n\n\n\n 2. Heparin\/Lovenox – Protamine Sulfate<\/p>\n\n\n\n 3. Morphine sulfate – Naloxone Hydrochloride<\/p>\n\n\n\n 4. Warfarin\/Coumadin- Vitamin K<\/p>\n\n\n\n 5. Acetaminophen – Acetylcycteine<\/p>\n\n\n\n 6. Benzodiazepine – Flumazenil<\/p>\n\n\n\n 7. Penicillin \u2013 Epinephrine<\/p>\n\n\n\n 8. Anticholinergic poisoning – Physostigmine<\/p>\n\n\n\n Drug Classification (Drugs \u201cEndings\u201d and their Classification)<\/p>\n\n\n\n -caine<\/p>\n\n\n\n Local Anesthetics<\/p>\n\n\n\n -dine<\/p>\n\n\n\n H2 Blockers (Anti-Ulcers)<\/p>\n\n\n\n -ide<\/p>\n\n\n\n Oral Hypoglycemics<\/p>\n\n\n\n -micin<\/p>\n\n\n\n Antibiotics<\/p>\n\n\n\n -mide<\/p>\n\n\n\n Diuretics<\/p>\n\n\n\n -zide<\/p>\n\n\n\n Diuretics<\/p>\n\n\n\n -olol<\/p>\n\n\n\n Beta Blockers<\/p>\n\n\n\n -pam<\/p>\n\n\n\n Anti-Anxiety Agents<\/p>\n\n\n\n -sone<\/p>\n\n\n\n Steroids<\/p>\n\n\n\n -vir<\/p>\n\n\n\n Antivirals<\/p>\n\n\n\n -cillin<\/p>\n\n\n\n Antibiotics<\/p>\n\n\n\n -done<\/p>\n\n\n\n Opioid Analgesics<\/p>\n\n\n\n -lam<\/p>\n\n\n\n Anti-Anxiety Agents<\/p>\n\n\n\n -mycin<\/p>\n\n\n\n Antibiotics<\/p>\n\n\n\n -nium<\/p>\n\n\n\n Neuromuscular Blocking Agents<\/p>\n\n\n\n -oxacin<\/p>\n\n\n\n Antibiotics<\/p>\n\n\n\n -pril<\/p>\n\n\n\n ACE Inhibitors<\/p>\n\n\n\n -statin<\/p>\n\n\n\n Anti-hyperlipidemics<\/p>\n\n\n\n What is the indication for metoclopramide\/reglan? Side effects of metoclopramide\/reglan Notify MD if what occurs when using metoclopramide\/reglan What is the indication xenical (orlistat, Alli) SE of xenical (orlistat or alli) Nursing implications for a pt on xenical (orlistat or alli) What can decrease side effects of xenical (orlistat or alli) Which type of fluids need plenty of water? Why do you need plenty of fluids when taking bulk forming laxatives Laxative use assessment With laxative use the nurse should Laxative use and result in what is ondansetron (zofran) What is ondansetron (zofran)used for? Who should you use caution with when giving ondansetron\/zofran? Drugs for ulcerative colitis and crohns How do 5 aminosalicylates; (mesalamie, sulfasalazine) work? Side effects of 5 aminosalicylates; (mesalamie, sulfasalazine) Which drug can cause colitis\/c.diff What kind of infection is c.diff What is azithromycin\/zithromax? What does azithromycin\/zithromax treat? How much azithromycin\/zithromax is usually required? If a female pt has trichomonas (any STI) and is asymptomatic does the male need to be tested? azithromycin\/zithromax can cause what? What is nitrofurantoin\/cipro used for? nitrofurantoin\/cipro side effect nitrofurantoin\/cipro nursing considerations Drug of choice for treating c.diff? When is metronidazole\/flagyl to be taken? What should be avoided when taking metronidazole\/flagyl and why? aminoglycosides examples how are aminoglycosides ,(-mycin, -micin), administered? what is an adverse effect of aminoglycosides (-mycin, -micin) what labs need to be evaluated when given aminoglycosides (-mycin, -micin)? DOC for MRSA what is MRSA implications for giving vancomycin risks when using vancomycin SE of vancomycin how long should IV vancomycin infuse? what is trimethoprim\/sulfamethoxazole? what is trimethoprim\/sulfamethoxazole known for? nursing implications for trimethoprim\/sulfamethoxazole penicillins have a _ to _<\/em><\/strong> nursing considerations for penicillins what can a nurse treat penicillin anaphylaxis with? nursing considerations for antibiotics what is ribavirin(copegus) indicated for? ribavirin(copegus) SE what is ticarcillin\/clavulanic acid (timentin)? nursing considerations for ticarcillin\/clavulanic acid (timentin) what is the indicated use for rifampin? rifampin SE what labs need to be monitored with rifampin? what is the indicated use for isoniazid (INH) what does isoniazid (INH) interact with? what should be used with isoniazid (INH)? flu vaccine SE what is the indicated use for fluconazole (diflucan)? what labs should be monitored with fluconazole (diflucan)? what is antifunal terbinafine (lamisil) used to treat? nursing considerations for terbinafine (lamisil) how do you know if an antibiotic is effective? nursing considerations for antidepressants. what is the indicated use for benztropine\/cogentin? what is benztropine\/cogentin? SE of benztropine\/cogentin how does levodopa-carbidopa (sinemet) work? what does levodopa-carbidopa (sinemet) treat? S\/S of levodopa-carbidopa (sinemet) toxicity what foods should a pt on levodopa-carbidopa (sinemet) avoid? what is lithium (lithobid, lithotabs) indicated for? what kind of therapeutic index does lithium have? lithium (lithobid, lithotabs) levels initial lithium therapy levels maintenance lithium levels when should lithium levels be drawn? how often during maintenance therapy should lithium levels be checked? normal sodium level how does an increased sodium level effect serum lithium levels? early S\/S of lithium toxicity what happens with lithium toxicity? nursing considerations for lithium haloperidol\/haldol produces what? what are EPS what is the extrapyramidal system? early reaction of haloperidol(haldol). late haloperidol(haldol) symptoms what is tardive dyskinesia characterized by? earliest manifestation of TD what may result with TD what may be used to treat EPS? selective serotonin reuptake inhibitors assessment when using selective serotonin reuptake inhibitors (prozac, zoloft, paxil) selective serotonin reuptake inhibitors (prozac, zoloft, paxil) nursing considerations what is olanzapine\/zyprexa? what is it used to treat? common side effects of zyprexa examples of opioids what is clonazepam\/klonopin? what does it treat? SE of clonazepam\/klonopin antidote for benzodiazepines DOC for treating alcoholic delirium tremens (DTs) what is lorazepam (ativan) used for? lorazepam (ativan) nursing considerations what is penytoin\/dilantin used for? therapeutic plasma levels plasma levels above 20mcg\/ml side effects of phenytoin\/dilantin carbamazepine\/tegretol serum level avoid which drink when taking carbamazepine\/tegretol topiramate may _<\/em> effects of phenytoin what is lioresal\/baclofen? lioresal\/baclofen pt teaching how is lioresal\/baclofen given? SE of lioresal\/baclofen adderall generic name adderall time of dosage How is adderal XR given? how does adderall XR work what does adderall treat> what does ergotamine and dihydroergotamine treat? how does ergotamine and dihydroergotamine work? what is sumatriptan\/imitrex? what is sumatriptan\/imitrex used for? sumatriptan\/imitrex contraindications what is methylphenidate\/ritalin when should methylphenidate\/ritalin be taken? methylphenidate\/ritalin schedule what can echinacea produce? echinacea can have an effect on who should avoid using echinacea? what is gingko bioba used for? gingko bioba may increase the risk of what? what is st john’s wort which drugs can st john’s wort interact with? what is glucosamine and chondroitin used for? meg vitamin C dosage indications of use for Meg vitamin C excess doses of meg vitamin C can lead to foods high in ascorbic acid what can happen if meg vitamin c is abruptly withdrawn? vitamin A foods vitamin A deficiency what happens when a pt ODs on vitamin D normal Ca levels what is calcitonin (mitacalcin) calcitonin (mitacalcin) pt teaching what is calcium acetate (phoslo) and calcium carbonate (tums) used for? when does calcium acetate (phoslo) and calcium carbonate (tums) show desired effects? phosphate normal levels what is epoetin alfa (epogen, procrit) used for? what does epoetin alfa (epogen, procrit) do? what levels need to be assessed with epoetin alfa (epogen, procrit) epoetin alfa (epogen, procrit) pt teaching what is risedronate (actonel), alendronate (fosamax) used for? risedronate (actonel), alendronate (fosamax) pt teaching why should a pt remain upright for 30 mins after receiving risedronate (actonel), alendronate (fosamax) ibandronate (boniva) pt teaching SE of biphosphonates biphosphonates interactions how far apart should biphosphonates and calcium supplements\/antacids be spaced? what is pilocarpine (isopto, pilocar)? how does pilocarpine (isopto, pilocar) work? side effects of pilocarpine (isopto, pilocar)? miotics cause pupil _ making pts be at risk for _<\/strong> what is bethanechol (urecholine) used to treat? how does bethanechol (urecholine) work? what is edrophonium (tensilon) who is edrophonium (tensilon) used for? how do you know is edrophonium (tensilon) is effective? what is pyridostigmine (mestinon) and neostigmine (prostigmine) used for how does pyridostigmine (mestinon) and neostigmine (prostigmine) work? how do we know pyridostigmine (mestinon) and neostigmine (prostigmine) is effective? what is physostigmine (antilirium) and rivastigmine (exelon) used to treat? anticholinergic saying anticholinergics and also treat transderm scopolamine (transderm-scop) use atropine is a __<\/em> oxybutynin (ditropan) and tolterodine (detrol) indications for use oxybutynin SE anticholinergic SE what does an androgen block treat SE of androgen blockers what premise should you work on when giving androgen blockers why are estrogens prescribed for men with prostate cancer SE of estrogen therapy in men SE of estrogen therapy in women estrogen hormone replacement therapy (HRT) treats estrogen hormone replacement therapy SE drugs for erective dysfunctions drugs for erective dysfunction are contraindicated with osymetholone, oxandrolone, nandrolone how does anabolic steroids (osymetholone, oxandrolone and nandrolone) work? SE of anabolic steroids glucocorticoids (steroid drugs) decrease the __<\/em> what is cyclosporine (gengraf, neoral, sandimmune) what is the indicated use for cyclosporine (gengraf, neoral, sandimmune) cyclosporine (gengraf, neoral, sandimmune) can cause _ and __<\/strong> what should be avoided with cyclosporine (gengraf, neoral, sandimmune) what is the indicated use for interferons avonex betaseron SE of interfon medications when should interfons be taken to relieve SE of interferons iron (fe\/ ferrous sulfate) nursing considerations when should antacids or milk products be taken with iron? after taking iron the pt should how is IM iron given vitamin C __<\/em> absorption of iron why would filgrastim(neupogen) be prescribed? how do we know filgrastim(neupogen) is effective? when should filgrastim(neupogen) be given? SE of filgrastim(neupogen) what is bioavailability? different forms and routes of same drug have _<\/em> bioavailability directions for taking medications on an empty stomach directions for taking medications after a meal when are peak and trough levels drawn when should peak level be drawn? when should trough levels be drawn? elevated trough level signifies which drugs need peak and trough levels assessed what is succinylcholine (anectine) and why is it used? SE of succinylcholine (anectine) succinylcholine (anectine) has an added NMB action when added with what needs to be assessed with succinylcholine (anectine) what is isotretinoin (accutane) used for? SE of isotretinoin (accutane?) calculate IV mL\/hr on infusion device calculate IV drip rates Assess the 6 rights of medication administration:<\/p>\n\n\n\n Medication Administration: techniques of administration:<\/p>\n\n\n\n Magnesium Sulfate: Antidote Cholinergic Medications (Myesthenic Bradycardia): Antidote Methotrexate: Antidote Generic Name: Acetaminophen (Tylenol): Medication category, purpose, side effects, and nursing considerations Generic Name: Codeine: Medication category, purpose, side effects, and nursing considerations Generic Name: Diclofenac (Voltaren): Medication category, purpose, side effects, and nursing considerations Digoxin’s Therapeutic Range: Generic Name: Digoxin (Lanoxin): Medication category, purpose, side effects, and nursing considerations Generic Name: Heparin: Medication category, purpose, side effects, and nursing considerations Generic Name: Lisinopril (Prinvil, Zestril): Medication category, purpose, side effects, and nursing considerations Signs of Digitalis toxicity:<\/p>\n\n\n\n Generic Name: Omeprazole (Prilosec): Medication category, purpose, side effects, and nursing considerations Generic Name: Phenytoin (Dilantin): Medication category, purpose, side effects, and nursing considerations<\/p>\n\n\n\n Generic Name: Propanolol (Inderal): Medication category, purpose, side effects, and nursing considerations<\/p>\n\n\n\n Generic Name: Spironolactone (Aldactone): Medication category, purpose, side effects, and nursing considerations<\/p>\n\n\n\n Generic Name: Tamoxifen: Medication category, purpose, side effects, and nursing considerations<\/p>\n\n\n\n Generic Name: Vancomycin (Vancocin): Medication category, purpose, side effects, and nursing considerations<\/p>\n\n\n\n Generic Name: Warfarin (Coumadin): Medication category, purpose, side effects, and nursing considerations<\/p>\n\n\n\n Generic Name: Ranitidine (Zantac): Medication category, purpose, side effects, and nursing considerations<\/p>\n\n\n\n Generic Name: Risedronate (Actonel): Medication category, purpose, side effects, and nursing considerations<\/p>\n\n\n\n Commonalities in Medication Classification Names: Androgens: Most names end with -terone (e.g., testosterone). Most names end with -pril (e.g., enalapril). Most names end in -pressin (e.g., desmopressin). Many end with -statin (e.g., atorvastatin). Most contain vir (e.g., acyclovir). Although this class includes medications such as alprazolam and chlordiazepoxide, most names such as diazepam end in -pam. (Another tip for identifying a benzodiazepine: The name includes a vowel-z-vowel combination.) Most names end with -lol (e.g., atenolol). Most names end in -pine (e.g., amiodipine); exceptions include diltiazem and verapamil. Most names end in -mide (e.g., dorzolamide). These medications are used to treat glaucoma. Most names contain -est (e.g., estradiol or conjugated estrogen). Most names end in -sone (e.g., prednisone<\/p>\n\n\n\n Histamine H2 receptor antagonists Most names contain nitr (e.g., nitroglycerin). Most names contain pancre (e.g., pancrealipase). Most names end in -zole (e.g., lansoprazole). Most names include sulf (e.g., sulfasalazine). Most names end in -ide (e.g., glipizide). These medications are used to treat diabetes mellitus.<\/p>\n\n\n\n Most names end in -zide (e.g., hydrochlorothiazide). Most names include -ase (e.g., alteplase).<\/p>\n\n\n\n Most names contain thy (e.g., levothyroxine).<\/p>\n\n\n\n Most names end in -line (e.g., theophylline). Lithium’s therapeutic index Signs of lithium toxicity Atypical (second-generation) antipsychotic medications (eg, risperidone [Risperdal], quetiapine [Seroquel], olanzapine [Zyprexa]) are used in the treatment of schizophrenia, bipolar disorder, and other mental health disorders. The nurse should teach clients and caregivers about potential side effects of antipsychotic medications. Key teaching points include: -Fever and muscle rigidity may indicate neuroleptic malignant syndrome, a potentially fatal condition requiring emergent intervention .<\/p>\n\n\n\n -Clients may experience anticholinergic effects (eg, dry mouth, constipation).<\/p>\n\n\n\n -Clients should change positions slowly to prevent orthostatic hypotension<\/p>\n\n\n\n -Sedating effects (eg, drowsiness, hypersomnia [excessive sleeping]) are common.<\/p>\n\n\n\n -Symptoms are evaluated on an individual basis, and most minor symptoms can be managed with a decrease in dosage or change in medication. The health care provider may prescribe medications to treat EPS (eg, benzodiazepines, diphenhydramine<\/p>\n\n\n\n Generic Name: Magnesium Sulfate: Medication category, purpose, side effects, and nursing considerations Generic Name: Nifedipine, Medication category, purpose, side effects, and nursing considerations Generic Name: Betamethasone and Dexamethasone: Medication category, purpose, side effects, and nursing considerations Generic Name: Hydromorphone hydrochloride and Meperidine hydrochloride, Fentanyl and Sufentanil, & Butorphanol tartrate and Nalbuphine, Medication category: Opioid Analgesics, purpose, side effects, and nursing considerations Generic Name: Misoprostol & Dinoprostone Medication category, purpose, side effects, and nursing considerations Generic Name: Oxytocin Medication category, purpose, side effects, and nursing considerations Generic Name: Methylergonovine maleate Medication category, purpose, side effects, and nursing considerations Medications Used to Manage Post-partum Hemorrhage: 1 PHARMACOLOGY HESI REVIEW DRUGS AFFECTING THE NERVOUS SYSTEM ANTICONVULSANTS\/ANTISEIZURE MEDICATIONS Prototype : a. Hydantoins – phenytoin (Dilantin) b. Barbiturates – phenobarbital ( Luminal) Adverse effects : – sedation & drowsiness, gingival hyperplasia – diplopia, nystagmus, vertigo, dizziness – thrombocytopenia, aplastic anemia Nursing considerations : 1. Advise female clients to use contraceptives. 2. Inform clients […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[],"tags":[],"class_list":["post-110966","post","type-post","status-publish","format-standard","hentry"],"_links":{"self":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/posts\/110966","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/comments?post=110966"}],"version-history":[{"count":0,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/posts\/110966\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/media?parent=110966"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/categories?post=110966"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/tags?post=110966"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}\n
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<\/p>\n\n\n\n![\"\"](\"https:\/\/d3tvd1u91rr79.cloudfront.net\/16dbb2be44090319f22bc925a436eded\/html\/bgd.png?Policy=eyJTdGF0ZW1lbnQiOlt7IlJlc291cmNlIjoiaHR0cHM6Ly9kM3R2ZDF1OTFycjc5LmNsb3VkZnJvbnQubmV0LzE2ZGJiMmJlNDQwOTAzMTlmMjJiYzkyNWE0MzZlZGVkL2h0bWwvKiIsIkNvbmRpdGlvbiI6eyJEYXRlTGVzc1RoYW4iOnsiQVdTOkVwb2NoVGltZSI6MTY5MDY1MTQxOH19fV19&Signature=DCiOA0yj5XEQCxLO5TD3gEsNJ44Q8wKnVtwqsQZs5BKePnHqzkAhMg97et3yPl98eJBQjbIkB7ytjKIh6Zz3HvFpwWTNPY4dw35yURUs~gdy3gvcYb-pj3nmam0O1IkRjQwgJ3E~MQLycDBkht3qPTup4GR~uSOoUEGbxpMD1tuO95YRRk2AURJgC1xt0SXx6WdImjpla~MyQBLqxPZZpxWp52STgrkOOXftgdgDbo98dkT6tGB7Mzk2lX3PdCnK5ilxklWjWonYla~vwWtPdyREOSjH-SIcmWNdm7tNBV5SJXJP4vmu6IBM6I6otKWOvEqgPFkSMrnJR7E9EV1wtQ__&Key-Pair-Id=APKAJ535ZH3ZAIIOADHQ\")
<\/p>\n\n\n\n
Prevention of chemotherapy-induced emesis and diabetic gastroparesis<\/p>\n\n\n\n
Drowsiness, EPS such as tremors<\/p>\n\n\n\n
Tremors<\/p>\n\n\n\n
For PTs with BMI of 30+; LT weight control<\/p>\n\n\n\n
Oily stool and flatulence<\/p>\n\n\n\n
Ask pt to describe dietary intake since SE are increased if greater than 30% of fat is in diet.<\/p>\n\n\n\n
Fiber laxatives like Metamucil help decrease SE by binding to the fat.<\/p>\n\n\n\n
Bulk forming laxatives<\/p>\n\n\n\n
Because they can produce esophageal and or intestinal obstruction<\/p>\n\n\n\n
Last BM and characteristics, abdominal pain, fever and obstruction. Assess dietary and fluid intake.<\/p>\n\n\n\n
Encourage fluids, fiber and exercise as tolerated\/indicated<\/p>\n\n\n\n
Lack of bowel tone which can lead to dependency<\/p>\n\n\n\n
antiemetic<\/p>\n\n\n\n
Prevention of N\/V associated with chemotherapy and radiation therapy.<\/p>\n\n\n\n
PTs with liver failure<\/p>\n\n\n\n
5 aminosalicylates; mesalamie, sulfasalazine.<\/p>\n\n\n\n
They decrease GI inflammation<\/p>\n\n\n\n
Nausea, rash, arthralgia, hematological disorders<\/p>\n\n\n\n
Linezolid\/zyvox<\/p>\n\n\n\n
Suprainfection<\/p>\n\n\n\n
An antibiotic<\/p>\n\n\n\n
STDs such as: gonorrhea and chlamydia<\/p>\n\n\n\n
One dose of 1g or 2g.<\/p>\n\n\n\n
Yes!<\/p>\n\n\n\n
Hepatotoxicity- elevated liver enzymes<\/p>\n\n\n\n
An antibiotic for UTI<\/p>\n\n\n\n
Hepatotoxicity, skin reactions, neuropathy<\/p>\n\n\n\n
Give with milk or meals check LFTs. Watch for numbness or tingling of extremities this can be an irreversible peripheral neuropathy<\/p>\n\n\n\n
Metronidazole\/flagyl<\/p>\n\n\n\n
With food and around the clock<\/p>\n\n\n\n
Alcohol; can cause a disulfiram-like reaction<\/p>\n\n\n\n
gentamicin(garamycin), neomycin, tobramycin(nebcin)<\/p>\n\n\n\n
given IV for several days<\/p>\n\n\n\n
decreased hearing\/ototoxicity and nephrotoxicity<\/p>\n\n\n\n
BUN and creatinine<\/p>\n\n\n\n
vancomycin<\/p>\n\n\n\n
severe staph infections that have become resistant to most antibiotics<\/p>\n\n\n\n
acute care requires frequent monitoring og serum drug level for dose adjustment. peak and trough schedule. trough is drawn just prior to next dose.<\/p>\n\n\n\n
nephrotoxicity and ototoxicity<\/p>\n\n\n\n
thrombophlebitis, red man syndrome if infused too rapidly: flushing or rash of upper body, dyspnea, itching, hypotension- can be lethal<\/p>\n\n\n\n
greater than 60 minutes<\/p>\n\n\n\n
it is a sulfonamide for treatment of UTI. combination increases efficacy and inhibits metabolism of folic acid at two different points<\/p>\n\n\n\n
sulfa allergy<\/p>\n\n\n\n
assess for rash due to potential for stevens johnson syndrome<\/p>\n\n\n\n
cross-sensitivity; cephalosporins. they are structurally similar.<\/p>\n\n\n\n
observe respiratory status for first 30 minutes when administering for the first time. watch for anaphylaxis if allergic to one or the other may have cross sensitivity<\/p>\n\n\n\n
epinephrine<\/p>\n\n\n\n
do not take for viral illnesses. take entire prescription as ordered. don’t take if not needed as it can produce resistance.<\/p>\n\n\n\n
antiviral for treatment of hepatitis C that has failed other treatment<\/p>\n\n\n\n
hemolytic anemia<\/p>\n\n\n\n
broad spectrum\/extended spectrum penicillins<\/p>\n\n\n\n
do not administer in same infusion with aminoglycosides<\/p>\n\n\n\n
antitubercular for treatment of TB<\/p>\n\n\n\n
turns: body fluids; tears, saliva, urine, soft contacts red\/orange\/brown. (ADVISE PT THIS IS NORMAL). Teratogenic- may decrease effectiveness of oral contraceptives; advise to use nonhormonal form of conception throughout therapy. Hepatotoxicity<\/p>\n\n\n\n
LFTs<\/p>\n\n\n\n
TB<\/p>\n\n\n\n
foods containing tyramine; can produce life-threatening hypertensive crisis.<\/p>\n\n\n\n
2nd form of birth control<\/p>\n\n\n\n
for anyone 6 months and older every season; soreness, redness and swelling at site of injections, low grade fever, aches.<\/p>\n\n\n\n
antifungal for vaginal candidiasis<\/p>\n\n\n\n
many antifungals can cause liver injury monitor LFTs<\/p>\n\n\n\n
superficial dermatologic infections (athlete’s foot) and onychomycosis (nail fungus).<\/p>\n\n\n\n
avoid alcohol, monitor LFTs, report: nausea, upper stomach pain, itching, loss of appetite, dark urine, clay-colored stools and jaundice<\/p>\n\n\n\n
decrease in WBC, decrease in fever, better cultures, pt feels better<\/p>\n\n\n\n
can cause addiction, pts experience withdrawal symptoms. ALWAYS GET MEDICATION HISTORY SINCE MANY DRUGS CAN INTERACT WITH ANTIDEPRESSANTS<\/p>\n\n\n\n
parkinson’s disease and treatment of extrapyramidal symptoms (EPS) AKA parkinsonism<\/p>\n\n\n\n
anticholinergic<\/p>\n\n\n\n
blurry vision, urinary retention<\/p>\n\n\n\n
stimulates dopamine production or increases sensitivity of dopamine receptors<\/p>\n\n\n\n
parkinson’s<\/p>\n\n\n\n
involuntary muscle twitching, facial grimacing, spasmodic eye winking, exaggerated protrusion of the tongue. NOTIFY PRESCRIBER.<\/p>\n\n\n\n
high protein meals! can impair effects!<\/p>\n\n\n\n
to treat pts with bipolar disorder.<\/p>\n\n\n\n
low\/narrow; toxicity can occur at blood levels only slightly greater than therapeutic levels monitoring lithium is mandatory<\/p>\n\n\n\n
below 1.5 mEq\/L; anything greater causes toxicity<\/p>\n\n\n\n
0.8-1.4 mEq\/L<\/p>\n\n\n\n
0.5-1.5 mEq\/L<\/p>\n\n\n\n
in the morning 12 hours after evening dose<\/p>\n\n\n\n
every 3-6 months<\/p>\n\n\n\n
136-145 mEq\/L<\/p>\n\n\n\n
increase in sodium causes increase in renal excretion which will lower serum lithium levels<\/p>\n\n\n\n
D\/N\/V, drowsiness, muscle weakness.<\/p>\n\n\n\n
life-threatening dysrhythmia, coma, convulsions, and death<\/p>\n\n\n\n
keep salt consistent in diet; no diuretic<\/p>\n\n\n\n
severe extrapyramidal symptoms (EPS) or reactions including tardive dyskinesia<\/p>\n\n\n\n
movement disorders resulting from effects of anypsychotic drugs on the extrapyramidal motor system.<\/p>\n\n\n\n
same neuronal network whose malfunction is responsible for movement disorders of parkinson’s disease.<\/p>\n\n\n\n
acute dystonia, parkinsonism, akathisia\/constantly moving\/tapping the foot<\/p>\n\n\n\n
tardive dyskinesia- the most troubling EPS<\/p>\n\n\n\n
involuntary choreoathetoid (twisting writing wormlike) movements of the tongue and face. pts may present lip-smacking movements and their tongues may flick out in a fly-catching motion.<\/p>\n\n\n\n
slow worm-like movement of the tongue<\/p>\n\n\n\n
malnutrition and weight loss; movements can interfere with chewing, swallowing and speaking<\/p>\n\n\n\n
benztropine(cogentin) and diphenhydramine (benadryl)<\/p>\n\n\n\n
prozac, zoloft, paxil<\/p>\n\n\n\n
neuromuscular and GI symptoms<\/p>\n\n\n\n
may take 4-6 weeks to see therapeutic effects. take meds as prescribed. carefully monitor pt for self-harm or suicide. obtain list of all other meds<\/p>\n\n\n\n
antipsychotic medication that affects chemicals in the brain. it is used to treat symptoms of psychotic conditions such as schizophrenia and bipolar disorder (manic depression) in adults and children who are at least 13 years old. can be used with other antipsychotics or antidepressants<\/p>\n\n\n\n
asthenia, dizziness, drowsiness, extrapyramidal reactions, hyperkinesia, akinesia, cogwheel rigidity, drug-induced parkinson’s disease, dyspepsia, mask-like face, xerostomia, abnormal gait, back pain, constipation, fever, orthostatic hypotension, weight gain, myoclonus and personality disorder<\/p>\n\n\n\n
barbiturates (barbital), benzodiazepines (lam\/pam), antiepileptics (AEDs), skeletal muscle relaxants<\/p>\n\n\n\n
anticonvulsant, benzodiazepine to treat panic disorder<\/p>\n\n\n\n
drowsiness, CNS depression, dizziness, nightmares, dry mouth, constipation, weight gain, withdrawal phenomenon and hang over effect<\/p>\n\n\n\n
flumazenil\/romazicon<\/p>\n\n\n\n
lorazepam (ativan)<\/p>\n\n\n\n
anxiety and withdrawal symptoms<\/p>\n\n\n\n
after IV administration keep patient supine for 8 hours and observe closely<\/p>\n\n\n\n
to treat seizures<\/p>\n\n\n\n
10-20 mcg\/ml<\/p>\n\n\n\n
toxicity; nystagmus (back and forth movements of the eyes), ataxia (staggering gait), diplopia (double vision) and cognitive impairment- suicidal thoughts. EPS<\/p>\n\n\n\n
gingival hyperplasia- teach good oral hygiene including flassing and gum massage. measles-like rash, hirsutism, stevens johnsons or toxic epidermal necrolysis (TEN) especially in pts of asian decent with genetic mutation HLA-B*1502.<\/p>\n\n\n\n
4-12 mcg\/ml<\/p>\n\n\n\n
grapefruit juice<\/p>\n\n\n\n
increase<\/p>\n\n\n\n
a muscle relaxant and CNS depressant<\/p>\n\n\n\n
move carefully and slowly when rising\/walking; assess LOC<\/p>\n\n\n\n
intrathecally with baclofen pump; use test dose 1st<\/p>\n\n\n\n
CNS depression, drowsiness, dizziness and hypotension<\/p>\n\n\n\n
amphetamine\/dextroamphetamine mixture<\/p>\n\n\n\n
once in the morning and then 5 hours later. DO NOT GIVE AT BEDTIME<\/p>\n\n\n\n
once daily in the morning. DO NOT GIVE AT BEDTIME<\/p>\n\n\n\n
half dose is released immediately and the remainder 4 hours later<\/p>\n\n\n\n
ADHD<\/p>\n\n\n\n
vascular headaches including migraine with or without aura, cluster headaches<\/p>\n\n\n\n
by producing vasoconstriction of dilated blood vessels<\/p>\n\n\n\n
serotonin receptor agonist; a triptan<\/p>\n\n\n\n
relief of migraine headaches<\/p>\n\n\n\n
do not take within 24 hours of ergot alkaloids;(can cause coronary vasospasms) CVA<\/p>\n\n\n\n
stimulant that can produce insomnia DO NOT TAKE AT BEDTIME<\/p>\n\n\n\n
best if taken on an empty stomach 30-45 minutes before eating; DO NOT TAKE AT BEDTIME<\/p>\n\n\n\n
schedule II drug<\/p>\n\n\n\n
topical agent; dermatitis\/skin rash<\/p>\n\n\n\n
the immune systems. it increases the number of white blood cells which fight infection<\/p>\n\n\n\n
pts with autoimmune diseases (lupus, multiple sclerosis and collagen disorders) since it has a nonspecific stimulatory effect which can worsen symptoms of the disease<\/p>\n\n\n\n
mental alertness and improved memory<\/p>\n\n\n\n
bleeding with:
anticoagulants warfarin, heparin.
antiplatelets (aspirin, clopidogrel) and
NSAIDs<\/p>\n\n\n\n
herb for depression and anxiety<\/p>\n\n\n\n
immunosuppressant drugs for patients with kidney transplants<\/p>\n\n\n\n
osteoarthritis<\/p>\n\n\n\n
1000 mg or more daily<\/p>\n\n\n\n
ascorbic acid deficiency<\/p>\n\n\n\n
diarrhea and urinary stone formation<\/p>\n\n\n\n
citrus fruits, tomatoes, strawberries, cantaloupe and raw peppers<\/p>\n\n\n\n
rebound deficiency<\/p>\n\n\n\n
yellow, orange and leafy veggies<\/p>\n\n\n\n
night blidness\/visual changes<\/p>\n\n\n\n
increases serum calcium levels; excess vitamin D intake leads to excessive calcium absorption<\/p>\n\n\n\n
8.4-10.5 mg\/dl<\/p>\n\n\n\n
nasal spray to decrease bone loss from osteoporosis<\/p>\n\n\n\n
instruct pt to alternate nostrils each day when administering the nasal spray to decrease rhinitis<\/p>\n\n\n\n
management of hypocalcemia and hypophosphatemia in pts on chronic renal dialysis or pts with moderate to severe insufficiency with secondary hyperparathyroidism<\/p>\n\n\n\n
decrease in phosphorus and increase in calcium levels<\/p>\n\n\n\n
2.7-4.5 mg\/dl<\/p>\n\n\n\n
patients with chronic kidney disease (CKD)<\/p>\n\n\n\n
increase RBC production; treats anemia in pts with ESRD (CKD) or from HIV or chemotherapy<\/p>\n\n\n\n
iron and H&H; monitor for signs of bleeding or clotting such as with a DVT<\/p>\n\n\n\n
have a diet high in iron<\/p>\n\n\n\n
bisphosphonate (bone resorption inhibitor)> used for treatment of postmenopausal and corticosteroid-induced osteoporosis.<\/p>\n\n\n\n
take first thing in the morning with 8oz of water at least 30 minutes prior to other medications, food or beverages. remain upright for 30 minutes following doses.<\/p>\n\n\n\n
to facilitate passage to stomach and minimize risk of esophageal irritation (heartburn)<\/p>\n\n\n\n
take first thing in the morning with 8oz of water at least 60 minutes prior to other medications, food or beverages. remain upright for 60 minutes following doses.<\/p>\n\n\n\n
HA, GI upset, risk of esophageal burns if med becomes lodged in esophague, osteonecrosis or the jaw<\/p>\n\n\n\n
calcium supplements and antacids; can infere with absorption<\/p>\n\n\n\n
1-2 hours<\/p>\n\n\n\n
a topical muscarinic agonist for glaucoma<\/p>\n\n\n\n
produces miosis (constriction of the pupil) and contraction of the ciliary muscle<\/p>\n\n\n\n
decreased visual acuity, local irritation, eye pain, brow ache, bradycardia, bronchospasm, hypotension, urinary urgency, diarrhea, hypersalivation, sweating<\/p>\n\n\n\n
constriction (reduces night vision making driving at night dangerous), injury<\/p>\n\n\n\n
urinary retention in postop and postpartum pts<\/p>\n\n\n\n
relaxes the trigone and sphincter muscles and increases voiding pressure by contraction the detrusor muscle which composes the bladder wall<\/p>\n\n\n\n
an anticholinesterase that enhances effects of acetylcholine at the skeletal muscle receptors. has cholinergic effects!<\/p>\n\n\n\n
pts with myasthenia gravis<\/p>\n\n\n\n
improvement in pt muscle strength: opening eyes, improved swallowing, etc<\/p>\n\n\n\n
myasthenia gravis<\/p>\n\n\n\n
inhibits action of cholinesterase (cholinergic drugs)<\/p>\n\n\n\n
improvement in eye opening, improved ease of swallowing<\/p>\n\n\n\n
alzheimer’s and parkinson’s they are cholinergic medications<\/p>\n\n\n\n
dry as bone, red as a beet, mad as a hatter, hot as a hare<\/p>\n\n\n\n
bradycardia<\/p>\n\n\n\n
anticholinergic for motion sickness. dries secretions and reduces nausea postoperatively<\/p>\n\n\n\n
anticholinergic<\/p>\n\n\n\n
urinary tract antispasmodics; treats over active bladder<\/p>\n\n\n\n
constipation, dry mouth, urinary retention, mydriasis, tachycardia, HA, insomnia, angina, overheating<\/p>\n\n\n\n
constipation, dry mouth, urinary retention, mydriasis, tachycardia, HA, insomnia, angina, overheating<\/p>\n\n\n\n
prostrate and testicular cancer (Lupron)<\/p>\n\n\n\n
decreased libido and gynecomastia<\/p>\n\n\n\n
that tumors arising from tissue influenced by the hormones estrogen and progesterone\/androgen show regression (tumors shrink) when treat with a drug that produces the opposite hormonal effect\/enviroment<\/p>\n\n\n\n
estrogens act on the pituitary to suppress secretion of luteinizing hormone which in turn decreases testicular androgen secretion<\/p>\n\n\n\n
feminization; gynecomastia and impotence.<\/p>\n\n\n\n
decreased libido and breast tenderness<\/p>\n\n\n\n
postmenopausal symptoms<\/p>\n\n\n\n
nausea, thromboembolic events, photosensitivity, chloasma (brown spots on face, neck and cheeks)<\/p>\n\n\n\n
sildenafil (viagra), tadalafil (cialis) and vardenafil (levitra)<\/p>\n\n\n\n
nitrates\/nitroglycerin (potent vasodilator), isosorbide dinitrate (isordil) and isosorbide mononitrate (imdur)<\/p>\n\n\n\n
anabolic steroids<\/p>\n\n\n\n
stimulates growth and development of male sex organs and secondary sex characteristics. stimulates production of erythropoietin by the kidney<\/p>\n\n\n\n
administration of exogenous androgens inhibits the release of endogenous androgens which suppresses sperm production leading to infertility as well as shrinking of the testicles and gynecomastia<\/p>\n\n\n\n
immune system; the pt is at risk of infection<\/p>\n\n\n\n
immunosuppressant drugs<\/p>\n\n\n\n
prevention of organ rejection (kidney, liver, heart transplants)<\/p>\n\n\n\n
nephrotoxicity and posttransplant diabetes mellitus.<\/p>\n\n\n\n
grapefruit juice<\/p>\n\n\n\n
multiple sclerosis and other autoimmune disorders; makes flares happen less often. may also slow down how quickly symptoms get worse and help people have less physical disability.<\/p>\n\n\n\n
interferon; given once a week IM. pt who start taking it in early stages of MS may be able to go longer before any physical disabilities begin or get worse<\/p>\n\n\n\n
interferon; subq injection every other day.<\/p>\n\n\n\n
flu-like symptoms (fatigue, chills, fever, muscle aches and sweating) during first week of treatment<\/p>\n\n\n\n
at bedtime to prevent symptoms from slowing you down<\/p>\n\n\n\n
take acetaminophen or ibuprofen before each injection during the 24 hours after it was administered. swelling, redness and pain at injection site. if the site gets hard, call your doctor and do not give shot at that site. Sadness, anxiety, irritability, guilt, trouble concentrating, confusion, hard time sleeping or eating. Notify MD.<\/p>\n\n\n\n
dilute oral liquid dosage and sip through a straw to avoid discoloration of teeth. take supplements with meals or food to decrease GI upset.<\/p>\n\n\n\n
1-2 hours before or after oral dosage forms of iron<\/p>\n\n\n\n
remains upright for 30 minutes to help minimize esophageal irritation<\/p>\n\n\n\n
Z-track method<\/p>\n\n\n\n
enhances<\/p>\n\n\n\n
to increase the WBC in neutropenic pts<\/p>\n\n\n\n
WBC increase from 2500-5500 mm<\/p>\n\n\n\n
before infection occurs<\/p>\n\n\n\n
fever, muscle aches, bone pain, and flushing; give nonopioid or opioid analgesic. SE stops when med is D\/C<\/p>\n\n\n\n
the rate at which the drug is available in the body<\/p>\n\n\n\n
different<\/p>\n\n\n\n
1 hour before or 2 hours after eating<\/p>\n\n\n\n
30-60 minutes after eating<\/p>\n\n\n\n
initially then every 5-7 days<\/p>\n\n\n\n
30 minutes after IV infusion<\/p>\n\n\n\n
immediately before (less than 30 minutes) the next dose<\/p>\n\n\n\n
toxicity<\/p>\n\n\n\n
vancomycin and aminoglycosides<\/p>\n\n\n\n
depolarizing neuromuscular blocker; used during therapy<\/p>\n\n\n\n
ventricular tachycardia\/dysrhythmias<\/p>\n\n\n\n
vancomycin<\/p>\n\n\n\n
respiratory status<\/p>\n\n\n\n
treatment of several nodulocystic acne<\/p>\n\n\n\n
severe photosensitivity (avoid the sun hoe) and teratogenesis (pregnancy category X)<\/p>\n\n\n\n
mL divided by minutes times 60<\/p>\n\n\n\n
ml to be infused x drop factor divided by minutes<\/p>\n\n\n\n\n
\n
Calcium Gluconate<\/p>\n\n\n\n
\u2022Atropine<\/p>\n\n\n\n
Leucorvorin<\/p>\n\n\n\n
Generic Name: Acetaminophen (Tylenol):
Medication Category: Analgesics, Nonopioid Analgesics
Purpose:<\/p>\n\n\n\n\n
Side Effects:<\/li>\n\n\n\n
Nursing Considerations:<\/li>\n\n\n\n
Generic Name: Codeine
Medication Category: Analgesics, Opioid Analgesics
Purpose: Treatment of moderate to severe pain, nonproductive cough
Side Effects:<\/p>\n\n\n\n\n
Nursing Considerations:<\/li>\n\n\n\n
Generic Name: Diclofenac (Voltaren)
Medication Category: Musculoskeletal Medications, Nonsalicylate NSAIDS, Antirheumatics
Purpose: Used in arthritic conditions, dysmenorrhea
Side Effects:<\/p>\n\n\n\n\n
Nursing Considerations<\/li>\n\n\n\n
0.5-2 mg<\/p>\n\n\n\n
Generic Name: Digoxin (Lanoxin)
Medication Category: Cardiovascular Medications, Digitalis Glycosides
Purpose: Used in treatment of CHF; atrial fibrillation\/flutter, or tachycardia<\/p>\n\n\n\n\n
Side Effects:<\/li>\n\n\n\n
Nursing Considerations:<\/li>\n\n\n\n
Generic Name: Heparin
Medication Category: Anticoagulants
Purpose: Prophylaxis and treatment of thromboembolic disorders in very low doses (10-100 units) to maintain patency of IV catheters (heparin flush)
Side Effects:<\/p>\n\n\n\n\n
Nursing Considerations:<\/li>\n\n\n\n
Generic Name: Lisinopril (Prinivil, Zestril)
Medication Category: Cardiovascular Medications, ACE Inhibitors
Purpose: Treatment of mild to moderate hypertension, systolic CHF, acute MI
Side Effects:<\/p>\n\n\n\n\n
Nursing Considerations:<\/li>\n\n\n\n\n
Generic Name: Omeprazole (Prilosec)
Medication Category: Gastrointestinal Medications, Antisecretory
Purpose: Treatment of active duodenal ulcers
Side Effects:<\/p>\n\n\n\n\n
Nursing Considerations:<\/li>\n\n\n\n\n
\n
\n
Generic Name: Aldactone
Medication Category: Cardiovascular Medications: Potassium Sparing\/Combination Diuretics
Purpose: Used in treatment of edema and hypertension, primary hyperaldosteronism
Side Effects:<\/li>\n\n\n\n
Nursing Considerations:<\/li>\n\n\n\n\n
\n
\n
\n
\n
Androgens<\/p>\n\n\n\n
Angiotensin-converting enzyme (ACE) inhibitors<\/p>\n\n\n\n
Antidiuretic hormones:<\/p>\n\n\n\n
Antilipemic medications:<\/p>\n\n\n\n
\u2022Antiviral medications<\/p>\n\n\n\n
\u2022Benzodiazepines<\/p>\n\n\n\n
\u2022Beta-adrenergic blockers:<\/p>\n\n\n\n
\u2022Calcium channel blockers<\/p>\n\n\n\n
\u2022Carbonic anhydrase inhibitors:<\/p>\n\n\n\n
\u2022Estrogens:<\/p>\n\n\n\n\n
Most names end in -dine (e.g., cimetidine).<\/p>\n\n\n\n
\u2022Nitrates<\/p>\n\n\n\n
\u2022Pancreatic enzyme replacements<\/p>\n\n\n\n
\u2022Proton pump inhibitors<\/p>\n\n\n\n
\u2022Sulfonamides<\/p>\n\n\n\n\n
\u2022Thiazide diuretics<\/p>\n\n\n\n\n
\n
\u2022Xanthine bronchodilators<\/p>\n\n\n\n
0.6-1.2 MEQ\/L<\/p>\n\n\n\n
Nausea, vomiting, ataxia, and tremors<\/p>\n\n\n\n
-Extrapyramidal symptoms (EPS) include akathisia (restlessness, fidgeting) and Parkinsonism (tremors, shuffling gait)
-These specific symptoms are important to watch for, as EPS is easily mistaken for agitation or negative schizophrenic symptoms.<\/p>\n\n\n\n
Generic Name: Magnesium Sulfate
Medication category:
-CNS depressant
Purpose:
-Stopping preterm labor to prevent pre term birth.
-Preventing and controlling seizures in preeclamptic and eclamptic clients.
Side effects:
-Maternal: Depressed respirations, depressed DTRs. hypotension, extreme muscle weakness, flushing, decreased urine output, pulmonary edema, serum magnesium levels > 7.5 mEq\/L
-Newborn: Hypotonia and sleepiness
Nursing considerations:
-Magnesium sulfate can cause respiratory depression, depressed reflexes, flushing, hypotension, extreme muscle weakness, decreased urine output, pulmonary edema, and elevated serum magnesium levels.
-Continuous IV infusion increases the risk of magnesium toxicity in the newborn
-IV administration should not be used for 2 hours preceding birth.
-Magnesium sulfate may be prescribed for the first 12 to 24 hours postpartum if it is used for preeclampsia
-High doses can cause loss of deep tendon reflexes, heart block, respiratory paralysis, and cardiac arrest.
-The medication is contraindicated in clients with heart block, myocardial damage, or kidney failure
-The medication is used with caution in clients with kidney impairment<\/p>\n\n\n\n
Generic Name: Nifedipine
Medication category:
-Calcium Channel Blocker
Purpose:
-Relaxes smooth muscles, including the uterus, by blocking calcium entry; in some healthcare agencies, this may be the first-line agent to halt preterm labor contractions
Side effects:
-Maternal: Tachycardia, hypotension, dizziness, headache, nervousness, facial flushing, fatigue, nausea
-Newborn: Hypotension
Nursing considerations:
-Follow agency protocol for administration
-Use with magnesium sulfate is avoided because severe hypotension can occur
-Monitor for adverse effects<\/p>\n\n\n\n
Generic Name: Betamethasone & Dexamethasone
Medication category:
-Corticosteroids
Purpose:
-Corticosteroids that increase the production of surfactant to accelerate fetal lung maturity and reduce the incidence or severity of respiratory distress syndrome
-For a client in preterm labor between 28 and 32 weeks gestation whose labor can be inhibited for 48 hours without jeopardizing the mother or fetus
Side effects:
-May decrease the mother’s resistance to infection
-Pulmonary edema secondary to sodium and fluid retention can occur.
-Elevated blood glucose levels can occur in a client with diabetes mellitus
Nursing considerations:
-Monitor maternal vital signs and lung sounds, and for edema
-Monitor mother for signs of infection
-Monitor white blood cell count
-Monitor blood glucose levels
-Administer by deep intramuscular injection<\/p>\n\n\n\n
Generic Name (s):
-Hydromorphone hydrochloride and Meperidine hydrochloride, Fentanyl and Sufentanil, & Butorphanol tartrate and Nalbuphine,
Medication category:
-Opioid Analgesics
Purpose:
-Used to relieve moderate to severe pain associated with labor
Side effects:
-Regular use of opioids during pregnancy may produce withdrawal symptoms in the newborn (irritability, excessive crying, tremors, hyperactive reflexes, fever, vomiting, diarrhea, yawning, sneezing, and seizures
Nursing Considerations:
-Monitor vital signs, particularly respiratory status; if respirations are 12 breaths\/minute or less, withhold the medication and contact the HCP.
-Monitor the fetal heart rate and characteristics of uterine contractions
-Monitor for blood pressure changes (hypotension); maintain the client in recumbent position (elevate the hip with a wedge pillow or other device).
-Record the level of pain relief
-Monitor the bladder for distension and retention
-Have the antidote naloxone readily accessible, especially if delivery is expected to occur during peak medication absorption time.<\/p>\n\n\n\n
Generic Name: Misoprostol & Dinoprostone
Medication category:
-Prostoglandins
Purpose:
-Preinduction cervical ripening (ripening of the cervix before the induction of labor when the bishop score is <4 -Induction of labor -Induction of abortion (abortifacient agent) Side effects: -GI effects, including diarrhea, nausea, vomiting, and stomach cramps -Fever, chills, flushing, headache, and hypotension -Uterine tachysystole (>12 uterine contractions in 20 minutes without an alteration in the fetal heart rate pattern
-Hyperstimulation of the uterus
-Fetal passage of Meconium
Nursing considerations:
-Monitor maternal vital signs, fetal heart rate pattern, adverse effects, and status of pregnancy, including indications for cervical ripening or induction of labor, and the Bishop score.
-Have the client void before administration of medication and then have her maintain a supine with lateral tilt or side-lying position for 30 to 60 minutes (gel) up to 2 hours (insert) after administration
-Treatment is discontinued when the Bishop score is 8 or more (cervix ripens) or an effective contraction pattern is established (3 or more contractions in a 10-minute period); in addition, signs of adverse effects indicate that treatment needs to be discontinued
-Follow agency protocol for the induction of labor if cervical ripening has occured and labor has not begun; oxytocin can be initiated if needed 6-12 hours after discontinuation of prostaglandin therapy<\/p>\n\n\n\n
Generic Name: Oxytocin
Medication category:
-Oxytocics (Uterine Stimulants)
Purpose:
-Induces or augments labor
-Controls postpartum bleeding
-Manages an incomplete abortion
Side effects:
-Allergies
-Dysrythymias
-Changes in BP
-Uterine Rupture
-Water Intoxication
Nursing considerations:
-Monitor Maternal VS\/15 minutes
-Monitor frequency, duration, and force of contractions and resting uterine tone\/15 min
-Monitor Fetal HR \/15 min
-Administered most commonly by IV Infusion via an infusion monitoring device
-Carefully monitor the dose being administered; do not leave the client unattended while the oxytocin is infusing<\/p>\n\n\n\n
Generic Name: Methylergonovine maleate
Medication category: Ergot Alkaloid
Purpose:
-Post-partum hemorrhage
-Post-abortal hemorrhage resulting from atony or involution
Side effects:
-Nausea
-Uterine Cramping
-Bradycardia
-Dysrhythymias
-Myocardial infarction
-Severe hypertension
Nursing considerations:
-Monitor maternal VS
-Monitor BP closesly; the medication causes vasoconstriction which causes an increase in BP, if noted withold the med and notify the HCP
-Monitor uterine contractions (frequency, strength, and duration)
-Assess for chest pain, h\/a, SOB, itching, pale or cold hands or feet, nausea, diarrhea, and dizziness
-Assess the extremeties for color, warm, movement or pain
-Assess vaginal bleeding
-Notify HCP–Chest pain or other adverse effects
-Administer analgesics as prescribed; they may be required because the medication produces painful uterine contractions.<\/p>\n\n\n\n
-Methylergonovine
-Oxytocin
-Prostaglandine: Carboprost tromethamine<\/p>\n","protected":false},"excerpt":{"rendered":"