class: lipid-lowering agent

1.

2.Atorvastatin (Lipitor)

*class*: lipid-lowering agent

*Indication*: management of high cholesterol (hypercho-

lesterolemia), primary prevention of cardiovascular dis- ease

*Action*: lowers total cholesterol as well as LDL while

slightly increasing HDL. Inhibits HMG-CoA reductase which plays a role in the liver in cholesterol formation *Nursing Considerations*

• contraindicated in active liver disease
• may cause rhabdomyolysis
• monitor serum cholesterol
• monitor liver function tests, renal function

3.Acetaminophen (Tylenol)

*class*: antipyretic, non-opioid analgesic

*Indication*: pain, fever

*Action*: inhibit the synthesis of prostaglandins which

play a role in transmission of pain signals and fever re- sponse

*Nursing Considerations*:

• do not exceed 4g of acetaminophen per day
• overdose will lead to hepatotoxicity
• **Acetadote**is the antidote for overdose
• may increase risk for bleed with warfarin therapy

4.Acyclovir (Zovi- rax)

*class*: antiviral, purine analogues

*Indication*:genital herpes, herpes zoster, chicken pox

*Action*: interferes with viral DNA synthesis

*Nursing Considerations*:

• may cause seizures, renal failure, Stevens-Johnson syn-

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140 Must Know NCLEX Meds

Alteplase (t-PA) *class*: thrombolytics

*Indication*: MI, acute ischemic stroke, occluded central

lines

*Action*: converts plasminogen to plasmin which de-

grades the fibrin found

*Nursing Considerations*:

• contraindicated in active bleeding

-monitor for anaphylaxis

• use caution with uncontrolled hypertension

140 Must Know NCLEX MedsStudy online at https://quizlet.com/_1la8stdrome, thrombotic thrombocytopenic purpura syndrome, diarrhea, dizziness, nausea- monitor renal function- assess lesions- instruct patient to use proper protection during sexual intercourse5.Albuterol (Proventil)*class*: bronchodilator ,adrenergic*Indication*:bronchodilator used to prevent airway ob-struction in asthma and COPD*Action*: binds to Beta2 adrenergic receptors in the air-way leading to relaxation of the smooth muscles in the airways*Nursing Considerations*:- may decrease the effectiveness of Beta Blockers-use caution with: heart disease, diabetes, glaucoma, seizure disorder- overuse of inhalers can lead to bronchospasm- monitor for chest pain and palpitations- can decrease digoxin levels6.Alendronate (Fosamax)*class*: bone resorption inhibitor, biphosphnates*Indication*: osteoporosis (aging, menopause, corticos-teroid induced)*Action*: inhibits osteoclast activity leading to inhibition of resorption of bone*Nursing Considerations*:- take first thing in the morning with full glass of water 30 min prior to eating- assess serum calcium and vitamin D- may lead to muscle pain7.Alprazolam (Xanax)*class*: benzodiazepine, anti-anxiety agent*Indication*:anxiety, panic disorder, manage symptoms of PMS, insomnia, mania, psychosis*Action*: works in CNS to produce anxiolytic effect caus-ing CNS depression.*Nursing Considerations*:- may cause CNS depression, drowsiness, lethargy2 / 52

140 Must Know NCLEX MedsStudy online at https://quizlet.com/_1la8st- may lead to physical dependence- assess anxiety and mental status- *Flumazenil* is the antidote for overdose- Grapefruit juice may increase blood levels8.Amiodarone (Cordarone)*class*: Antiarrhythmic class III, Potassium channel block-er*Indication*: ventricular arrhythmias, SVT, ACLS protocol for v-fib and vTACH*Action*: prolongs action potential, inhibits adrenergic stimulation, slows rate, decreases peripheral vascular re-sistance causing vasodilation*Nursing Considerations*:- may lead to ARDS, pulmonary toxicity, CHF, bradycar-dia, hypotension- increases risk for QT prolongation- increases digoxin levels- increases activity of warfarin- monitor EKG - assess for signs and symptoms of ARDS- monitor liver function test- check dosage with another RN- avoid drinking grapefruit juice9.Amitryptiline (Elavil)*class*: tricyclic antidepressant*Indication*: depression, anxiety, insomnia*Action*: increases effect of serotonin and norepinephrine in the CNS, exhibits anticholinergic effects*Nursing Considerations*:- contraindicated in MI, heart failure, QT prolongation, glaucoma- may increase risk for suicidal ideation- may cause arrhythmias, hypotension, EKG changes- may cause alterations in blood glucose levels- may lead to general sedation and lethargy- do not use within 2 weeks of MAOIs- monitor for orthostatic hypotension- may lead to photosensitivity, instruct patient to use sun-3 / 52

140 Must Know NCLEX MedsStudy online at https://quizlet.com/_1la8stscreen- may turn urine blue/green color10.Amlodipine (Nor-vasc)*class*: Ca channel blocker, antihypertensive*Indication*: hypertension, angina*Action*: blocks transport of calcium into muscle cells inhibiting excitation and contraction*Nursing Considerations*:- may cause gingival hyperplasia- grapefruit juice may increase drug level- monitor blood pressure and pulse - monitor intake and output- assess for signs of CHF- assess characteristics of angina- instruct patient of interventions for hypertension and how to take BP11.Amoxicillin (Moxatag)*class*: anti-infectives, antiulcer agent, aminopenicillins*Indication*: skin infections, respiratory infections, sinusi-tis, endocarditis prophylaxis, lime disease*Action*: Inhibits synthesis of bacterial cell wall leading to cell death.*Nursing Considerations*:- Contraindicated with penicillin allergy- may cause seizures- assess for rash, anaphylaxis- excreted by kidneys - monitor renal labs- monitor patient for diarrhea - bloody stool should be reported immediately12.Ampicillin (Principen)*class*: aminopenicillin, anti-infective*Indication*: skin infections, soft tissue infections, oti-tis media, sinusitis, respiratory infections, GU infections, meningitis, septicemia*Action*: bactericidal, broader spectrum than penicillin, binds to cell wall leading to bacterial cell death*Nursing Considerations*:- contraindicated in penicillin allergy, use caution in renal insufficiency4 / 52