NCLEX recongition of meds Flashcards

Selective serotonin reuptake inhibitor
Terms Definitions
Norepinephrine (levophed)
vasoconstrictor,increase BP and CO
tx shock, cardiac arrest
Norepinephrine (levophed)
-reflex bradycardia
-monitor urinary output
-infuse with dextrose not saline
-monitor BP
Dopamine (Intropin)
high dose- vasoconstrictor
low dose- dilates renal and coranary arteries
Dopamine (Intropin)
headache early s/s of excess
Epinephrine (Adrenalin)
stimulates alpha and beta adrenergic receptors
Epinephrine (Adrenalin)
check dose!!!
Isoproterenol (Isuprel)
used for heart block, ventricular arrhythmias, and bradycardia
-bronchodilator, used for bronchospasms.
Isoproterenol (Isuprel)
Don't give at hs-interrupts sleep patterns
Phenylephrine (Neo-Synephrine)
potent alpha 1 agonist
tx hypotension
Phenylephrine (Neo-Synephrine)
s/e hypertension
Dobutamine hydrochloride (Dobutrex)
stimulates beta 1 receptors
Dobutamine hydrochloride (Dobutrex)
s/e hypertension
Don't infuse with other meds
not good w/ alkaline solutions
Milrinone (Primacor)
positive inotropic agent
relaxes smooth muscle
tx severe HF
Sodium nitroprusside (Nitropress)
dilates cardiac veins and arteries
decreases preload and afterload
increases myocardial perfussion
Diphenhydramine HCI (Benadryl)
blocks effects of histamine on brochioles, GI, and blood vessels
Diphenhydramine HCI (Benadryl)
s/e photosensitivity
Chlordiazepoxide (Librium)
antianxiety
Diazepam (Valium)
antianxiety
benzodiazepine
Alprazolam (Xanax)
antianxiety
benzodiazepine
Alprazolam (Xanax)
CNS depressant
short onset and duration
safer for elderly
don't DC abrubtly
Clonazepam (Klonopin)
antianxiety
benzodiazepine
Clonazepam (Klonopin)
CNS depressant
short onset and duration
safer for elderly
don't DC abrubtly
Lorazepam (Ativan)
antianxiety
benzodiazepine
Lorazepam (Ativan)
CNS depressant
short onset and duration
safer for elderly
don't DC abrubtly
Oxazepam (Serax)
antianxiety
benzodiazepine
Oxazepam (Serax)
CNS depressant
short onset and duration
safer for elderly
don't DC abrubtly
Midazalam (Versed)
antianxiety
benzodiazepine
Midazalam (Versed)
CNS drepressant
used for conscious sedation
Buspirone (BuSpar)
antianxiety
non- benzodiazepine
Buspirone (BuSpar)
no abuse potential
Hydroxyzline (Vistaril) (Atarax)
antianxiety
non- benzodiazepine
Hydroxyzline (Vistaril) (Atarax)
can be used long periods of time
produces no dependence
Kava
herbal antianxiety
Kava
not for pregnant woman
Melatonin
herbal antianxiety
Melatonin
influences sleep-wake cycles
priorty for all antianxiety meds
watch out for liver disfunction
aluminum hydroxide gel (amphojel)
antacid
aluminum hydroxide gel (amphojel)
contains sodium, check if pt is on sodium restriction
monitor for phosphate decrease: (fatigue, weakness, tremors, bone pain)
encourage fluids
renal precaution
Cacium carbonate (Titralac)
antacid
Cacium carbonate (Titralac)
contains sodium, check if pt is on sodium restriction
monitor for phosphate decrease: (fatigue, weakness, tremors, bone pain)
encourage fluids
renal precaution
Aluminum hydroxide and magnesium trisilicate
antacid
Aluminum hydroxide and magnesium trisilicate
contains sodium, check if pt is on sodium restriction
monitor for phosphate decrease: (fatigue, weakness, tremors, bone pain)
encourage fluids
renal precaution
Magnesium hyroxide (milk of magnesia)
antacid, saline agent. draws water from plasma to intestines
Magnesium hyroxide (milk of magnesia)
caution with Renal diseases
Aluminum hydroxide and magnesium hydroxide (Maalox)
antacid, with slight laxative effect
Aluminum hydroxide and magnesium hydroxide (Maalox)
caution with Renal diseases
encourage fluids
General info for antacids
s/e: acid rebound btwn doses
constipation, diarrhea
metabolic acidosis
General info for antacids
contains sodium!!
absorption of tetracyclines, quinolones, iron, phenothiazides reduce with antacids
Oral contraceptive and salicylates effectiveness decreases with antacid
gentamycin (Garamycin)
Antibiotics: aminoglycosides
tx gram negative: inhibits protein synthesis
gentamycin (Garamycin)
Nephrotoxic- check BUN, cre
Ototoxic-check 8th cranial nerve
Check peak (2hr after med given) and trough (prior to med)
Neomycin (Neobiotic)
Antibiotics: aminoglycosides
Nephrotoxic
Ototoxic
Neomycin (Neobiotic)
Opthalmic= remove infective excudate around eyes prior to administration.
Streptomycin
Antibiotics: aminoglycosides
Streptomycin
Nephrotoxic- check BUN, cre
Ototoxic-check 8th cranial nerve
Check peak (2hr after med given) and trough (prior to med)
Tobramycin (Tobrax)
Antibiotics: aminoglycosides
Tobramycin (Tobrax)
Nephrotoxic- check BUN, cre
Ototoxic-check 8th cranial nerve
Check peak (2hr after med given) and trough (prior to med)
Amikacin (Amikin)
antibiotic: aminoglycoside
Amikacin (Amikin)
Nephrotoxic- check BUN, cre
Ototoxic-check 8th cranial nerve
Check peak (2hr after med given) and trough (prior to med)
cephalexin (Keflex)
antibiotic: cephalosporins 1st gen
cephalexin (Keflex)
inhibits cell wall: bacterial
increases risk for bleeding! (have vit K around)
cross allergy with pencillins
cause false positive Coombs test
cefaclor (Ceclor)
antibiotic: cephalosporins 2nd gen
cefaclor (Ceclor)
inhibits cell wall: bacterial
increases risk for bleeding! (have vit K around)
cross allergy with pencillins
cause false positive Coombs test
ceftriaxone (Rocephin)
antibiotic: cephalosporins 3rd gen
ceftriaxone (Rocephin)
inhibits cell wall: bacterial
increases risk for bleeding! (have vit K around)
cross allergy with pencillins
cause false positive Coombs test
cefepime (Maxipime)
antibiotic: cephalosporins 4th gen
cefepime (Maxipime)
inhibits cell wall: bacterial
increases risk for bleeding! (have vit K around)
cross allergy with pencillins
cause false positive Coombs test
Ciprofloxacin (Cipro)
Antibiotic: fluorquinolones
Ciprofloxacin (Cipro)
interfers w/DNA of gram negative
do not give children under 18
avoid caffeine
watch renal and liver
do not give with antacid or irons
Levofloxacin (Levequin)
Antibiotic: fluorquinolones
Levofloxacin (Levequin)
interfers w/DNA of gram negative
do not give children under 18
avoid caffeine
watch renal and liver
do not give with antacid or irons
Norfloxacin (Noroxin)
Antibiotic: fluorquinolones
Norfloxacin (Noroxin)
interfers w/DNA of gram negative
do not give children under 18
avoid caffeine
watch renal and liver
do not give with antacid or irons
Vancomycin
antibiotic: glycopeptide
cell wall
Vancomycin
liver damage
nephrotoxic
ototoxic
can cause "red man syndrome"= give antihistamine
suprainfection: may cause sore throat, fever, etc
clindamycin HCI phosphate (Cleocin)
antibiotic: lycosamides
clindamycin HCI phosphate (Cleocin)
liver toxic
given for strep, staph
can cause colitis
give with full glass of water to prevent esophageal ulcers
Chlorpromazine Hydrochloride (Thorazine)
antipyschotic- traditional, low potency with high sedative effect, no potential for abuse.
Chlorpromazine Hydrochloride (Thorazine)
s/e: sun sensivity
hypotension.
Erythromycin (erythrocin)
Macrolide antibiotic
bacterostatic
Erythromycin (erythrocin)
hepatotoxic
renal problems too
take one hour before or 2-3 hours after meals with full glass of water
Azethromycin (Zithromax)
Macrolide antibiotic
bacterostatic
Azethromycin (Zithromax)
hepatotoxic
renal issues too
take one hour before or 2-3 hours after meals with full glass of water
Amoxicillin (amoxil)
antibiotic: penicillins
for gram positive bacteria
Amoxicillin (amoxil)
good mouth care/ Watch for change in tongue!
c/s prior to tx/ first dose
take one hour before or 2-3 hours after meals
check for hypersensitivity
renal and hepatic s/e
yogurt if diarrhea develops: watch for loose foul smelling stool
Ampicillin (Omnipen)
antibiotic: penicillins
for gram positive bacteria
Ampicillin (Omnipen)
good mouth care/ Watch for change in tongue!
c/s prior to tx/ first dose
take one hour before or 2-3 hours after meals
check for hypersensitivity
renal and hepatic s/e
Methicillin
antibiotic: penicillins
for gram positive bacteria
Methicillin
good mouth care/ Watch for change in tongue!
c/s prior to tx/ first dose
take one hour before or 2-3 hours after meals
check for hypersensitivity
renal and hepatic s/e
Nafcillin (Unipen)
antibiotic: penicillins
for gram positive bacteria
Nafcillin (Unipen)
good mouth care/ Watch for change in tongue!
c/s prior to tx/ first dose
take one hour before or 2-3 hours after meals
check for hypersensitivity
renal and hepatic s/e
Augmentin
antibiotic: penicillins
for gram positive bacteria
Augmentin
good mouth care/ Watch for change in tongue!
c/s prior to tx/ first dose
take one hour before or 2-3 hours after meals
check for hypersensitivity
renal and hepatic s/e
Sulfisoxazole (Gantrisin)
antibiotic: sulfonamides
bateriostatic
Sulfisoxazole (Gantrisin)
s/e: GI allergic rash, and urine crystals
-force fluids
-maintain alkaline urine
-avoid vit C= which acidifies urine
Sulfasalazine (Azulfidine)
antibiotic: sulfonamides
bateriostatic
Sulfasalazine (Azulfidine)
-photosensivity
-fluid intake at 3,000ml to avoid urine crystals
-s/e agranulocytosis
Trimethoprim/Sulfamethoxazole (Bactrim, Septra)
antibiotic: sulfonamides
bateriostatic
Trimethoprim/Sulfamethoxazole (Bactrim, Septra)
-s/e: hyoersensivity, blood dyscrasias
-3,000 ml fluids day= prevents crystal formation.
-get c/s before 1st dose
-NEVER give IM
-IV: give over slowly at 60-90 min.
Doxyycycline (Vibramycin)
antiobiotic: tetracyclines
bacteriostatic
Doxyycycline (Vibramycin)
photosensitivity
NO milk products or antacids
Use additional birth control
check tongue for Monillia infection
Note expiration date=becomes highly nephrotoxic
Do not take with meals
Minocycline (Minocin)
antiobiotic: tetracyclines
bacteriostatic
Minocycline (Minocin)
photosensitivity
NO milk products or antacids
Use additional birth control
check tongue for Monillia infection
Note expiration date=becomes highly nephrotoxic
Do not take with meals
Tetracycline (Panmycin)
antiobiotic: tetracyclines
bacteriostatic
Tetracycline (Panmycin)
photosensitivity
Do not give on pregnacy=will discolor primary teeth!!!
NO milk products or antacids
Use additional birth control
check tongue for "black hairy"
Note expiration date=becomes highly nephrotoxic
Do not take with meals
Nitrofurantoin (furadantin)
anti-infective: bacteria
GI med that fight UTI's
Nitrofurantoin (furadantin)
take with food or milk
avoid antacids
watch for resp issues
phenazopyridine (pyridium)
pain reliever for GI
spasmolytic
phenazopyridine (pyridium)
take with meals
will turn urine BRIGHT ORANGE
s/e : h/a, vertigo
Oxybutynin (Ditropan)
anticholinergics
used to reduce bladder spasms and tx urinary incontinence
Oxybutynin (Ditropan)
increase fluid and fiber
s/e:
Blurred vision
Dry mouth
Constipation
Urinary retention
Hyoscyamine (Anaspaz)
anticholinergics
used to reduce bladder spasms and tx urinary incontinence
Hyoscyamine (Anaspaz)
increase fluid and fiber
s/e:
Blurred vision
Dry mouth
Constipation
Urinary retention
Proppantheline (Pro-Banthine)
anticholinergics
-used to reduce bladder spasms
-tx urinary incontinence
-used for peptic ulcers tx
Proppantheline (Pro-Banthine)
-increase fluid and fiber
-Give night's dose, 2hr after last meal
-30min ac
-s/e:
Blurred vision
Dry mouth
Constipation
Urinary retention
Darifenacin (Enablex)
anticholinergics
used to reduce bladder spasms and tx urinary incontinence
Darifenacin (Enablex)
increase fluid and fiber
s/e:
Blurred vision
Dry mouth
Constipation
Urinary retention
Solifenacin (Vesicare)
anticholinergics
used to reduce bladder spasms and tx urinary incontinence
Solifenacin (Vesicare)
increase fluid and fiber
s/e:
Blurred vision
Dry mouth
Constipation
Urinary retention
Tolterodine (Detrol)
anticholinergics
used to reduce bladder spasms and tx urinary incontinence
Tolterodine (Detrol)
increase fluid and fiber
s/e:
Blurred vision
Dry mouth
Constipation
Urinary retention
Sildenafil (Viagra)
tx erectile disfunction
Sildenafil (Viagra)
-Never take with nitrates and alpha blockers= risk for severe hypotension.
-take 1 hr before sex
-Do not drink grapefruit juice
s/e: hypotension, priapism, h/a, flushing
Vardenafil (Levitra)
tx erectile disfunction
Vardenafil (Levitra)
-Never take with nitrates and alpha blockers= risk for severe hypotension.
-take 1 hr before sex
-Do not drink grapefruit juice
s/e: hypotension, priapism, h/a, flushing
Tadalafil (Cialis)
tx erectile disfunction
Tadalafil (Cialis)
-Never take with nitrates and alpha blockers= risk for severe hypotension.
-take 1 hr before sex
-Do not drink grapefruit juice
s/e: hypotension, priapism, h/a, flushing
Finasteride (Proscar, Propecia)
Testosterone inhibitors
Proscar: tx benign prostatic hyperplasia
Propecia: tx male hair loss
Finasteride (Proscar, Propecia)
s/e: decreased libido
impotence
breast tenderness
PregWoman: AVOID contact with crushed drug or pt's semen= will affect male fetus.
Action of anticholinergics
-competes with acetylcholine at receptor sites in autonomic nervous system
-causes: cycloplegia (relax ciliary muscles), mydriasis (dilation of pupils), brochodialtion, decreases broncho secretions, decreases GI motility and GI secretions.
-DO NOT give if pt has glaucoma!!!!
s/e:
Action of anticholinergics
Blurred vision
Dry mouth
Urinary retention
Heart Rate Changes (?)
Belladonna
anticholinergics
Atropine sulfate
anticholinergics, used for bradycardia
Atropine sulfate
check hx of: glaucoma, HTN, asthma
-give 30 min prior to meals
- make sure pt pees before giving
-expect increase HR and resp.rate
-avoid heat!!-persperation in decreased.
Iproproprium (Atrovent)
anticholinergics used for brochospasms and long term tx of asthma
Tiotropium (Spiriva)
anticholinergics used for brochospasms and long term tx of asthma
Tiotropium (Spiriva)
given in powder form
Iprotropium plus albuterol (Atrovent, DuoNeb)
anticholinergics used for brochospasms and long term tx of asthma
s/e?
Iprotropium plus albuterol (Atrovent, DuoNeb)
-increase fluids, bulk foods, and exercise
-taper before d/c
-orthostatic hypotension precautions
Benztropine (Cogentin)
anticholinergics: used for parkinson's disease
s/e?
Benztropine (Cogentin)
-increase fluids, bulk foods, and exercise
-taper before d/c
-orthostatic hypotension precautions
Trihexyphenydil (Artane)
anticholinergics: used for parkinson's disease
s/e?
Trihexyphenydil (Artane)
-increase fluids, bulk foods, and exercise
-taper before d/c
-orthostatic hypotension precautions
Scopolamine (Transderm-Scop)
anticholinergics: used for motion sickness
s/e?
Scopolamine (Transderm-Scop)
Do not use in acute angle glaucoma!
Enoxaparin (Lovenox)
anticoagulant
low weight heparin

s/e?
Enoxaparin (Lovenox)
less allergic than heparin
SQ, never given IV or IM
does not require lab test monitoring
heparin
anticoagulant
-blocks conversion of fibrinogen to fibrin
- used for preventative and tx of thromboembolic disorders.
heparin
-Monitor PTT: 1.5 to 2.5 x the control(~20-45)= highest is 112.5 & lowest is 30.
Monitor platlet count
IV: use pump, duration 2-6 hours
NEVER IM
SQ: duration 8-12
s/e:
hemorrhage, anemia, thrombocytpenia (Low-platlets), fever
heparin antidote
protamine sulfate w/in 30 min
Warfarin (Coumadin)
anticoagulant
-interferes with liver synthesis of vit K-dependent clotting factors
-used for pulm. emboli, DVT, MI, atrial dysrhymmias, valve replacements
Warfarin (Coumadin)
Monitor PT: 1.5 to 2.5 x the control(~9-12)= highest is 30 & lowest is 13.5.
INR at 2-3
duration: 3-5 days
Avoid venous stasis
Avoid foods high in Vit k: greens, pork, yogurt, cheese, fish
s/e: hemorrhage, diarrhea, rash, fever
Warfarin (Coumadin) antidote
vit K, whole blood, or plasma
Lepirudin (Refludan)
anticoagulant
tx heparin induced thrombocytopenia (low platelets)
Also, d/c heparin
dipyridamole (Persantine)
anticoagulant
keeps the platelets in your blood from coagulating (clotting) around new valve

given adjunct coumadin post op vlave replacement and adjunct to aspirin to reduce repeat stroke or TIA
anticoagulant: should avoid what
1.procedures?
2. meds?
3. herbs
4. vitamins
1. NO IM's!! risk for cuts, injuries
2. ASA-containing products and NSAIDs, Plavix
3. a. Ginkgo, Ginger, Garlic?
b. Anise, chamomile?
c. Ginseng and alfalfa?
d. black haw?
4. a.Vit C
b. Vit E
anticoagulant: should avoid what
1.procedures?
2. meds?
3. herbs
4. vitamins
a. Ginkgo, Ginger, Garlic increases bleeding with Coumadin
b. Anise, chamomile=interfers with action
c. Ginseng and alfalfa decrease action
d. black haw increases
4. a Vit c decreases warfarin's effect
b. Vit E increases warfarin's effect
General info about all anticonvulsants?
-decreases flow of calcium and sodium across neuronal membranes
-s/e?
-tolerance develops
-Don't d/c abrubtly
-caution use with MAO's= lowers siezure threshold
General info about all anticonvulsants?
s/e:
Cardio depression
resp depression
aplastic anemia (bone marrow does not produce sufficient new cells to replenish blood cells)
agranulocytosis (failure of the bone marrow to make enough
white blood cells=low WBC)
Clonazepam (Klonopin)
benzodiazepine
anticonvulsant
Clonazepam (Klonopin)
don't d/c abrubtly
Diazepam (Valium)
benzodiazepine
anticonvulsant
-long term withdrawal s/s?
Diazepam (Valium)
-IV push- not exceed 2mg/min
-increases CNS depression with alcohol
-s/s of withdrawal: vomiting, sweating, cramps, tremors, convulsions.
Fosphenytoin (Cerebyx)
anticonvulsant
used for tonic clonic, status epilepticus
Fosphenytoin (Cerebyx)
highly protein bound
-Contact HCP if rash develops!
levetiracetam (Keppra)
anticonvulsant
levetiracetam (Keppra)
s/e: suicidal ideation
pheytoin sodium (Dilantin)
anticonvulsant
s/e: ?
pheytoin sodium (Dilantin)
s/e: gingival hypertrophy, GI upset, nystagmus (involuntary eye movement), hirsutism, lethargy
-take with water or meals=reduces GI upset
-Red/brown or pink discoloration of seat and urine occurs
-IV admin can cause cardiac arrest
-NEVER mix tubinwith other drugs or dextrose
-Increase Vit D and exposure to sun
phenobarbital (Luminal)
anticonvulsant
-Barbiturate, long-acting, Sedative and hypnotic
-early toxicity s/s?
phenobarbital (Luminal)
-early s/s of toxicity= nystagmus
-if IV= watch VS!
-folic acid supplements need to be taken for long term use
primidone (Mysoline)
anticonvulsant
primidone (Mysoline)
theuraputic responcse may take up to 2 weeks
-shake supension well
Magnesium sulfate
anticonvulsant
also used for:
-tx eclampsia/ hypertension on pregnancy
-magnesium deficiency in pts with hypocalcemia or on TPN (s/s of hypomag are: tetany, positive Chvostek and Trousseau signs, convulsions,generalized weakness, anorexia, hypokalemia hypocalcemia)
-uterine tetany as a myometrial relaxant.
-
Magnesium sulfate
Monitor I&O
prior to dose, check reflexes (knee jerks)!!
VS monitored, especially if on TPN
Valproic acid (Depakote)
anticonvulsant
Valproic acid (Depakote)
-good for use in young children
-Do not take with carbonated beverage
-take with food
-Monitor platelets, bleeding time, and liver function
Carbamazepine (Tegretol)
-anticonvulsant &trigeminal neuralgia
-also tx bipolar disorder (mood stabilzer)
s/e: myelsuppression (low RBC production), ataxia-(failure of muscular coordination)
Carbamazepine (Tegretol)
-photosensivitiy
-take with meals
-Monitor CBC's and I&O's
-supervise ambulation
Ethosuximide (Zarontin)
anticonvulsant
Ethosuximide (Zarontin)
monitor weight weekly
monitor behavioral changes
Gabapentin (Neurontin)
anticonvulsant-
also used to tx posttherpetic neuralgia
Gabapentin (Neurontin)
monitor weight weekly
monitor behavioral changes
Lamotrigine (Lamictal)
anticonvulsant
Lamotrigine (Lamictal)
-take divided doses with meals or just afterward to decrease adverse effects.
-life-threatening rash wen given with valproic acid
Topiramate (Topamax)
anticonvulsant
Topiramate (Topamax)
-adjunct therapy for intractable partial seizures
-increased risk for renal calculi
-STOP drug immediately if eye problems occur-could lead to permanent damage!
Phenezline sulfate (Nardil)
Antidepressants: Monoamine oxidase inhibitors
Phenezline sulfate (Nardil)
Do not take with SSRI's
-d/c 10 days before general anesthesia
-lowers seizure threshold
-can cause urinary retention
-avoid caffine, antihistamines, amphetamines
-takes 3-4 wks to work
-avoid tricyclics until 3wks after stopping MAOs
-s/e: HTN crisis taken with foods containing tyramine or OTC drugs, photosensitivity, weight gain, sexual disfunction, ortho hypotension.
General info for Monoamine oxidase inhibitors (MAO's)
1. action?
2. s/e?
3. herbal precautions?
1. interferes with monoamine oxidase, allowing for increased neurotransmitters (epi, norepi, serotonin)
2. HTN crisis taken with foods containing tyramine or OTC drugs, photosensitivity, weight gain, sexual disfunction, ortho hypotension.
3. ginseng= potentiates MAO
ma huang or ephedra= avoid with MAO
brewer's yeast w/MAO= increases BP
General info for Monoamine oxidase inhibitors (MAO's)
1. action?
2. s/e?
3. herbal precautions?
-Not 1st line drug
-Do not take with SSRI's
-d/c 10 days before general anesthesia
-lowers seizure threshold
-can cause urinary retention
-avoid caffine, antihistamines, amphetamines
-takes 3-4 wks to work
-avoid tricyclics until 3wks after stopping MAOs
Food which contain tyramine
aged cheese, bologna, pepperoni, salami, figs, bananas, raisins, beer, red wine.
s/s of hypertensive crisis:
h/a, sweating, palpitations, stiff neck, intracranial hemorrhage
isocarboxazid (Marplan)
Antidepressants: Monoamine oxidase inhibitors
isocarboxazid (Marplan)
Do not take with SSRI's
-d/c 10 days before general anesthesia
-lowers seizure threshold
-can cause urinary retention
-avoid caffine, antihistamines, amphetamines
-takes 3-4 wks to work
-avoid tricyclics until 3wks after stopping MAOs
-s/e: HTN crisis taken with foods containing tyramine or OTC drugs, photosensitivity, weight gain, sexual disfunction, ortho hypotension.
tranylcypromine (Parnate)
Antidepressants: Monoamine oxidase inhibitors
tranylcypromine (Parnate)
Do not take with SSRI's
-d/c 10 days before general anesthesia
-lowers seizure threshold
-can cause urinary retention
-avoid caffine, antihistamines, amphetamines
-takes 3-4 wks to work
-avoid tricyclics until 3wks after stopping MAOs
-s/e: HTN crisis taken with foods containing tyramine or OTC drugs, photosensitivity, weight gain, sexual disfunction, ortho hypotension.
General info for SSRI's (Selective Serotonin Reuptake inhibitors
1. actions?
2. s/e?
1. inhibits CNS uptake of serotonin, acts like a stimulant.
2. s/e: h/a, nervousness, insomnia, anxiety, tremor, dry mouth, GI upset, taste changes, rash, URI, painful menstrations, sexual disfunction, weight loss, palpations, bradycardia

Watch out for???
General info for SSRI's (Selective Serotonin Reuptake inhibitors
1. actions?
2. s/e?
-Take in AM= reduces insomnia
-Suicide precautions
-Take 4 wks to work
-Monitor weight
-Mouth care
-Do NOT give with MAO=risk for serotonin syndrome
-increase effect of digoxin, coumadin, valium
-Monitor for thrombocytopenia, leukopenia, anemia
Fluoxetine (Prozac)
SSRI
Fluoxetine (Prozac)
h/a, nervousness, insomnia, anxiety, tremor, dry mouth, GI upset, taste changes, rash, URI, painful menstrations, sexual disfunction, weight loss, palpations, bradycardia

-Take in AM= reduces insomnia
-Suicide precautions
-Take 4 wks to work
-Monitor weight
-Mouth care
-Do NOT give with MAO=risk for serotonin syndrome
-increase effect of digoxin, coumadin, valium
-Monitor for thrombocytopenia, leukopenia, anemia
Paroxetine (Paxil)
antidepressant: SSRI

s/e?
Paroxetine (Paxil)
s/e: palpitations, bradycardia n/v, diarrhea or constipation, increased or decreased appetite, urinary retention
-Take in am= reduces insomnia
-takes 4 wks to work
-potentiates the effect of digoxin, coumadin, valium
-don't give with MAO's= serotonin syndrome
-good mouth care
Sertraline hydrochloride (Zoloft)
antidepressant: SSRI

s/e?
Sertraline hydrochloride (Zoloft)
s/e: palpitations, bradycardia n/v, diarrhea or constipation, increased or decreased appetite, urinary retention
-Take in am= reduces insomnia
-takes 4 wks to work
-potentiates the effect of digoxin, coumadin, valium
-don't give with MAO's= serotonin syndrome
-good mouth care
Citalopram (Celexa)
antidepressant: SSRI

s/e?
Citalopram (Celexa)
s/e: palpitations, bradycardia n/v, diarrhea or constipation, increased or decreased appetite, urinary retention
-Take in am= reduces insomnia
-takes 4 wks to work
-potentiates the effect of digoxin, coumadin, valium
-don't give with MAO's= serotonin syndrome
-good mouth care
Venlafaxine (Effexor)
antidepressant: SSRI

s/e?
Venlafaxine (Effexor)
s/e: palpitations, bradycardia n/v, diarrhea or constipation, increased or decreased appetite, urinary retention
-Take in am= reduces insomnia
-takes 4 wks to work
-potentiates the effect of digoxin, coumadin, valium
-don't give with MAO's= serotonin syndrome
-good mouth care
s/s of serotonin syndrome?
* Agitation
* fast heart beat
* Diarrhea
* Heavy sweating not due to activity
* Fever
* Mental status changes such as confusion or hypomania
* Muscle spasms (myoclonus)
* Overactive reflexes (hyperreflexia)
* Shivering
* Tremor
* Uncoordinated movements (ataxia)

=happens cause too much serotonin
General info about antidepressants: tricyclics
1. action?
2. s/e?
1. inhibits presynaptic uptake of norepinephrine and serotonin: anticholinergic action at CNS.
2. s/e= sedation, anticholinergic effects (dry mouth, blured vision, constipation, urinary retention), confusion
Photosensitivity
Orthostatic hypotension
Bone marrow depression

nursing care?
General info about antidepressants: tricyclics
1. action?
2. s/e?
take 2-6 wks to work
suicide risk 10-14 days later
given at night to promote sleep and decrease s/e in day
ortho hypo precaution
Do not stop abrubtly
avoid sun, sunscreen
avoid sedation things=alcohol, OTC, etc.
increase fluids
use sugarless candy for dry mouth
Amitriptyline hydrochloride (Elavil)
antidepressants: tricyclics
s/e= sedation, anticholinergic effects (dry mouth, blured vision, constipation, urinary retention), confusion
Photosensitivity
Orthostatic hypotension
Bone marrow depression
Amitriptyline hydrochloride (Elavil)
take 2-6 wks to work
suicide risk 10-14 days later
given at night to promote sleep and decrease s/e in day
ortho hypo precaution
Do not stop abrubtly
avoid sun, sunscreen
avoid sedation things=alcohol, OTC, etc.
increase fluids
use sugarless candy for dry mouth
Imipramine (Tofranil)
antidepressants: tricyclics
s/e= sedation, anticholinergic effects (dry mouth, blured vision, constipation, urinary retention), confusion
Photosensitivity
Orthostatic hypotension
Bone marrow depression
Imipramine (Tofranil)
take 2-6 wks to work
suicide risk 10-14 days later
given at night to promote sleep and decrease s/e in day
ortho hypo precaution
Do not stop abrubtly
avoid sun, sunscreen
avoid sedation things=alcohol, OTC, etc.
increase fluids
use sugarless candy for dry mouth
Desipramine hydrochloride (Norpramin)
antidepressants: tricyclics
s/e= sedation, anticholinergic effects (dry mouth, blured vision, constipation, urinary retention), confusion
Photosensitivity
Orthostatic hypotension
Bone marrow depression
Desipramine hydrochloride (Norpramin)
take 2-6 wks to work
suicide risk 10-14 days later
given at night to promote sleep and decrease s/e in day
ortho hypo precaution
Do not stop abrubtly
avoid sun, sunscreen
avoid sedation things=alcohol, OTC, etc.
increase fluids
use sugarless candy for dry mouth
Doxepin (Sinequan)
antidepressants: tricyclics
s/e= sedation, anticholinergic effects (dry mouth, blured vision, constipation, urinary retention), confusion
Photosensitivity
Orthostatic hypotension
Bone marrow depression
Doxepin (Sinequan)
take 2-6 wks to work
suicide risk 10-14 days later
given at night to promote sleep and decrease s/e in day
ortho hypo precaution
Do not stop abrubtly
avoid sun, sunscreen
avoid sedation things=alcohol, OTC, etc.
increase fluids
use sugarless candy for dry mouth
Nortriptyline (Pamelor)
antidepressants: tricyclics
s/e= sedation, anticholinergic effects (dry mouth, blured vision, constipation, urinary retention), confusion
Photosensitivity
Orthostatic hypotension
Bone marrow depression
Nortriptyline (Pamelor)
take 2-6 wks to work
suicide risk 10-14 days later
given at night to promote sleep and decrease s/e in day
ortho hypo precaution
Do not stop abrubtly
avoid sun, sunscreen
avoid sedation things=alcohol, OTC, etc.
increase fluids
use sugarless candy for dry mouth
General info about antidepressants: Heterocyclics
used for depression & smoking cessation
action: does not inhibit MAO, has some anticholinergic effects, alters effects of serotonin on CNS
s/e?
General info about antidepressants: Heterocyclics
s/e= dry mouth, nausea,
may require gradual reduction before d/c
avoid other sedative meds up to 1 wk after end of therapy.
Bupropion (Wellbutrin, Zyban)
antidepressants: Heterocyclics

s/e?
Bupropion (Wellbutrin, Zyban)
s/e= dry mouth, nausea, insomnia, agitiation
Trazodone (Desyrel)
antidepressants: Heterocyclics

s/e?
Trazodone (Desyrel)
s/e= dry mouth, nausea, sedation, orthostatic hypotension
St. John's Wart
herbal antidepressant

1. s/e?
2. nursing consideration?
St. John's Wart
s/e= diziness, hypertension, allergic reaction, phototoxicity

nursing= Avoid with MAOI (2 wks seperartion)
interacts with SSRIs
d/c 1-2 wks before surgery
-avoid alcohol
-avoid sun
Lispro (Humalog)
rapid acting insulin
onset?
time of adverse reaction?
when given?
Lispro (Humalog)
onset= 5-15min
time of adverse reaction= midmorning(trembling, weakness)
when given=?
Aspart (Novolog)
rapid acting insulin
onset?
time of adverse reaction?
when given?
Aspart (Novolog)
onset= 5-15min
time of adverse reaction= midmorning(trembling, weakness)
when given=?
Regular (Humulin R, Novolin R, Iletin II R)
short acting insulin
onset?
time of adverse reaction?
when given?
Regular (Humulin R, Novolin R, Iletin II R)
onset= 30-60min
time of adverse reaction=midmorning, midafternoon: weakness, fatigue
when given=20-30 min before meals
-Clear solution, can be given with other insulins
-ONLY insulin in IV form!!!
Isophane (NPH)
Intermediate acting insulin
onset?
time of adverse reaction?
when given?
Isophane (NPH)
onset= 2-4 hrs
time of adverse reaction=early evening: weakness, fatigue
when given= can be given after meals
-White and cloudy
Lente
Intermediate acting insulin
onset?
time of adverse reaction?
when given?
Lente
onset= 2-4 hrs
time of adverse reaction=early evening: weakness, fatigue
when given= can be given after meals
-White and cloudy
Ultralente
Long acting insulin
onset?
time of adverse reaction?
when given?
Ultralente
onset= 6-8 hr
time of adverse reaction= early morning: headache, confusion
when given: used to control fasting blood glucose levels
Glargine (Lantus)
Very long acting
onset?
time of adverse reaction?
when given?
Glargine (Lantus)
onset= 1hr
time of adverse reaction=?
when given=at bedtime
-maintains blood glucose levels regardless of meals
-Cannot me mixed with other insulins!!!
herbs that increase blood glucose?
bee pollen
ginkgo biloba
glucosamine
herbs that decrease blood glucose?
basil
bay leaf
chromium
echinacea
garlic
ginseng
Glimepiride (Amaryl)
oral hypogylcemic agents:
Sulfonylureas
Glimepiride (Amaryl)
-pt has some pancreas beta cell function: stimulates release of insulin
-take with food if GI upset
Gliipizide (Glucotrol)
oral hypogylcemic agents:
Sulfonylureas
Gliipizide (Glucotrol)
-pt has some pancreas beta cell function: stimulates release of insulin
-take with food if GI upset
Glyburide (Micronase)
oral hypogylcemic agents:
Sulfonylureas
Glyburide (Micronase)
-pt has some pancreas beta cell function: stimulates release of insulin
-take with food if GI upset
Metformin (Glucophage)
oral hypogylcemic agents:
Biguanides
Metformin (Glucophage)
-no effect on beta cells: decreases glucose production by liver
-not given if renal impairment
-Don't give with alpha glucosidase inhibitors
Acarbose (Precose)
oral hypogylcemic agents:
alpha glucosidase inhibitors
Acarbose (Precose)
-delays digestion of carbs
-must take immediately before meal
Miglitol (Glyset)
oral hypogylcemic agents:
alpha glucosidase inhibitors
Miglitol (Glyset)
-delays digestion of carbs
-must take immediately before meal
Rosiglitazone (Avandia)
oral hypogylcemic agents:
thaizolidinediones
Rosiglitazone (Avandia)
-decreases insulin resisitance and inhibits gluconeogenesis
-may restart ovulation in perimenopause
-Need liver function tests: hard on liver!!
Pioglitazone (Actos)
oral hypogylcemic agents:
thaizolidinediones
Pioglitazone (Actos)
-decreases insulin resisitance and inhibits gluconeogenesis
-may restart ovulation in perimenopause
-Need liver function tests: hard on liver!!
Repaglinide (Prandin)
oral hypogylcemic agents:
meglitinides
Repaglinide (Prandin)
-increases pancreatic insulin release
- med should NOT be taken if skipped meal!!!
General info about about oral hypogylcemic agents
s/e?
nursing considerations?
General info about about oral hypogylcemic agents
s/e= anorexia, nausea, diarrhea, allergic skin reactions, hypoglycemia
nursing consid=
take before breakfast
monitor serum glucose
avoid alcohol
teach about dx
good skin care
Glucagon
med that reverses hypoglycemia

-give SQ or IM
-onet 8-10min lasts 12-27 min
-may repeat in 15 min if needed
Glucagon
-give carbs asap orally to prevent secondary hypoglycemic reactions
-IV must be given of pt fails to respond
Bismuth subsalicyalte
(Pepto-bismol, kaopectate)
antidiarreheal

s/e: darkening of stools and tongue
Bismuth subsalicyalte
(Pepto-bismol, kaopectate)
-give 2-3 hours before or after other meds
-encourage fluids
-call MD if not resolved
-don't give more than 2 days if kids <3 yrs or fever present
-monitor for salicylate toxciity
-Avoid use before x-ray- radiopaque
Diphenoxylate hydrochloride and atropine sulfate (Lomotil)
antidiarreheal
Diphenoxylate hydrochloride and atropine sulfate (Lomotil)
-onset in 45-60 min
Iopermide (Imodium)
antidiarreheal
Iopermide (Imodium)
-monitor kids for CNS effects
Optium alkaloids (Paregoric)
antidiarreheal
Optium alkaloids (Paregoric)
-d/c as soon as stool controlled, has narcotic dependece.
General info about antidiarrheals
-don't give if ab pain of unknown origin present
-has anticholingeric effects- watch for urinary retention
-watch out for constipation
Trimethobenzamide HCI (Tigan)
antiemetic
Trimethobenzamide HCI (Tigan)
-Give deep IM
Prochlorperizine dimaleate (Compazine)
antiemetic
Prochlorperizine dimaleate (Compazine)
=check CBC and liver function
-protect from sun
-s/e: ortho hypo
diplopia
photosensitivty
Odansetron (Zofran)
antiemetic
Odansetron (Zofran)
-give 30 min prior to chemo
-s/e: h/a, sedation, tansient elevations of liver enzymes
Thiethyperazine maleate (Torecan)
antiemetic
Thiethyperazine maleate (Torecan)
-give deep IM
-stay in bed for 1 hour after given
-protect from sun
-s/e: photosensitive
trasient leukopenia
extrapyramidal s/s
ortho hypo
anticholinergic effects
Metoclopramide (Reglan)
antiemetic
Metoclopramide (Reglan)
-monitor BP
-avoid driving
-take before meals
-used with tube feeding to reduce aspiration
-give 30 min prior to chemo
-s/e: extrampyramindal effects
dystonic reaction
restlessness
anixety
drowsiness
Meclizine (Antivert, Bonine)
antiemetic
Meclizine (Antivert, Bonine)
-Do not give with GLAUCOMA
-avoid driving
-s/e: anticholingeric
excitiation, restlessness
Dimenhydrinate (Dramamine)
antiemetic
Dimenhydrinate (Dramamine)
-avoid driving
-s/e: drowsiness, hypotension, blirred vision
Promethazine (Phenergan)
antiemetic
Promethazine (Phenergan)
-used for motion sickness
-take 1/2 to 1 hour prior to traveling
-avoid driving, alcohol, CNS depressants
-s/e: anticholnergic
Droperidol (Inapsine)
antiemetic
Droperidol (Inapsine)
-observe extrampyramidal s/s: dystonia, extended neck, flexed arms, tremor, restlessness, hyperactivity, anxiety= which can be reversed with anticholnergics.
General info about anitemetics
-blocks dopamine, increase GI motility
-s/e: anticholinergic, drowsiness, sedation
-if used for viral infectionmay cause Reye's syndrome in pts <21 yrs
-ginger often given, watch out for bleeding
Amphotericin B (Fungizone)
antifungal
nickname "amphoterrible"
s/e:?
-meticulous care and observation of injection site!!
Amphotericin B (Fungizone)
s/e: GI upset
hypokalemia
CNS disturbances in vision, hearing
peripheral neuritis
seizures
Renal, hepatic, cardiac, blood abnormalities
-report febrile reaction or any changes in nervous!!!
Nystatin (Mycostatin)
antifungal

s/e?
Nystatin (Mycostatin)
s/e: mild GI distress, hypersensitivity

-d/c if any reddness, swelling, or irritation.
-good oral, vaginal, skin hygiene!
Flucanozal (Diflucan)
antifungal
Flucanozal (Diflucan)
-give after hemodialysis
-drug excreted unchnged by kidneys, dose reduced if creatinine clearance is affected by renal failure!
General info about antifungals
-used for fungal infections: candidiasis, oral thrush, histoplasmosis
-s/e?
-nurse action?
General info about antifungals
-s/e= hepatotoxic
thrombocytopenia
leukopenia
pruritis
-give with food
small meals
check hepatic function!
take full course of therapy!
colchicine (Colsalide)
antigout
also: anaglesic, anti-inflammatory
-used for acute gout with use of NSAIDs
colchicine (Colsalide)
s/e: GI upset, angranulocytosis, peripheral neuritis
-check CBC
-check I&O
-give with meals
Probenecid (Benemid)
antigout
-used for chronic gout
-reduces uric acid
Probenecid (Benemid)
s/e: nausea, constipation, skin rash
-check BUN, renal function tests
-encourage fluids
-give with milk, food, antacids
**alkaline urine helps prevent renal stones
Allopurinol (Zyloprim)
antigout
-block formation of uric acid
Allopurinol (Zyloprim)
-check CBC, renal function tests
-encourage fluids
-give with meals
**alkaline urine helps prevent renal stones
**AVOID ASA because it inactivates drug!
general info about antigout meds
-decrease uric acid production and reabsorbtion
s/e?
nursing action?
general info about antigout meds
s/e: aplastic anemia
agranulocytosis
renal calculi
GI irritation
nursing action: monitor for renal calculi!!
Chlorpheniramine maleate (Chlor-Trimeton)
antihistamine
Chlorpheniramine maleate (Chlor-Trimeton)
-take before onset of s/s
-s/e: drowsiness, dry mouth
Diphenhydramine HCI (Benadryl)
antihistamine
Diphenhydramine HCI (Benadryl)
-avoid alcohol
-give with food
-use sunscreen
-s/e: drowsiness, dry mouth, nausea, photosensitive
Promethazine HCI
(Phenergan)
antihistamine
Promethazine HCI
(Phenergan)
-give with food
-use sunscreen
-s/e: drowsiness, dry mouth, photosensitive, agranulocytosis
-prior to giving IV, check for patency of vein=extravasation will cause necrosis
Loratadine (Claritin)
antihistamine
Loratadine (Claritin)
-reduce dose or give every other day for pts with renal or liver disfunction
-s/e: drowsiness
Cetirizine (Zyrtec)
antihistamine
Cetirizine (Zyrtec)
-reduce dose or give every other day for pts with renal or liver disfunction
-s/e: drowsiness
Fexofenadine (Allegra)
antihistamine
Fexofenadine (Allegra)
-reduce dose or give every other day for pts with renal or liver disfunction
-s/e: drowsiness
General info about antihistamines
-blocks the effects of histamine at H1 receptor sites, anticholinergic, antipruritic effects

-give with food
-good skin care
-give candy for mouth
-avoid driving, etc, alcohol
General info about antihistamines
s/e;
drowsiness/sedation
depression
nightmares
bronchospasm
alopecia
dry mouth
Clolestryramine (Questran)
Antilipemic
bile acid sequestrants
-increase bile acid in feces, decreases cholesterol
Clolestryramine (Questran)
-give 1 hour before or 4-6 hour after other meds to avoid blocking absorbtion.
-report constipation ASAP!!
s/e:
ab pain, bloating, fat-soluble vit deficiency, rash, constipation
Colestipol (Colestid)
Antilipemic
bile acid sequestrants
-increase bile acid in feces, decreases cholesterol
Colestipol (Colestid)
-give 1 hour before or 4-6 hour after other meds to avoid blocking absorbtion.
-report constipation ASAP!!
s/e:
ab pain, bloating, fat-soluble vit deficiency, rash, constipation
Lovostatin (Mevacor)
antilipemic
HMG-CoA reductase inhibitors (statins)
-decrease LDL levels, cause peripheral vasodilation
Lovostatin (Mevacor)
-take with food
-call MD if muscle pain especially with fever and/or malaise
-take at night
-caution with pt with liver problems
s/e: myopathy, increased liver enzyme levels
Pravastatin (Pravachol)
antilipemic
HMG-CoA reductase inhibitors (statins)
-decrease LDL levels, cause peripheral vasodilation
Pravastatin (Pravachol)
-take with food
-call MD if muscle pain especially with fever and/or malaise
-take at night
-caution with pt with liver problems
s/e: myopathy, increased liver enzyme levels
Simvastatin (Zocor)
antilipemic
HMG-CoA reductase inhibitors (statins)
-decrease LDL levels, cause peripheral vasodilation
Simvastatin (Zocor)
-take with food
-call MD if muscle pain especially with fever and/or malaise
-take at night
-caution with pt with liver problems
s/e: myopathy, increased liver enzyme levels
Atorvastatin (Lipitor)
antilipemic
HMG-CoA reductase inhibitors (statins)
-decrease LDL levels, cause peripheral vasodilation
Atorvastatin (Lipitor)
-take with food
-call MD if muscle pain especially with fever and/or malaise
-take at night
-caution with pt with liver problems
s/e: myopathy, increased liver enzyme levels
Fluvastatin (Lescol)
antilipemic
HMG-CoA reductase inhibitors (statins)
-decrease LDL levels, cause peripheral vasodilation
Fluvastatin (Lescol)
-take with food
-call MD if muscle pain especially with fever and/or malaise
-take at night
-caution with pt with liver problems
s/e: myopathy, increased liver enzyme levels
Rosuvastatin (Crestor)
antilipemic
HMG-CoA reductase inhibitors (statins)
-decrease LDL levels, cause peripheral vasodilation
Rosuvastatin (Crestor)
-take with food
-call MD if muscle pain especially with fever and/or malaise
-take at night
-caution with pt with liver problems
s/e: myopathy, increased liver enzyme levels
Niacin (Niacor, Niaspan)
antilipemic
Nicotonic acid
-decreases total cholesterol, LDL, triglycerides, increases HDL
Niacin (Niacor, Niaspan)
-flushing will occur, reduces after 2wk
-s/e:
flushing, hyperglycemia, gout, upper GI distress, liver damage
-avoid alcohol!!
Fenofibrate (Tricor)
antilipemic
folic acid derivatives
decreases total cholesterol, VLDL, triglycerides
Fenofibrate (Tricor)
-give before meals
-call MD if muscle pain occurs!!!
-s/e: ab pain, increased risk fo gall bladder dx, myalgia, swollen joints
Gemfibrozil (Lopid)
antilipemic
folic acid derivatives
decreases total cholesterol, VLDL, triglycerides
Gemfibrozil (Lopid)
-give before meals
-call MD if muscle pain occurs!!!
-s/e: ab pain, increased risk fo gall bladder dx, myalgia, swollen joints
herbs used to tx high cholesterol:
flax seed: decreases absorbtion of other meds
garlic: increases bleeding, increases hypoglycemic effects of insulin
green tea: has stimulant effect
soy
general info about antilipemics
inhibits cholesterol and triglycerides synthesis, decreases serum cholesterol and LDL

-nursing consid?
general info about antilipemics
-meds should be used wit diet teaching, physical activity, stop smoking
-monitor lipids every 6 wk suntil normal, then every 4-6 months
Captopril (Capoten)
antihypertensives- tx of HTN, CHF
ACE inhibitors (Angiotensin converting enzyme)
-blocks ACE in lungs from converting angio1 to angio2 (powerful vasoconstrictor): decreasing BP, decreasing aldosterone secretion, causing sodium and fluid loss
Captopril (Capoten)
-report SWELLING of FACE, lightheadedness asap!
-give 1 hour before or 2 hours after meals
-small, frequent meals
-frequent mouth care
-change postions slowly
-can be used with thiazide diuretics
-s/e: dizziness, ortho hypo
Enalapril (Vasotec)
antihypertensives- tx of HTN, CHF
ACE inhibitors (Angiotensin converting enzyme)
-blocks ACE in lungs from converting angio1 to angio2 (powerful vasoconstrictor): decreasing BP, decreasing aldosterone secretion, causing sodium and fluid loss
Enalapril (Vasotec)
-report SWELLING of FACE, lightheadedness asap!
-give 1 hour before or 2 hours after meals
-small, frequent meals
-frequent mouth care
-change postions slowly
-can be used with thiazide diuretics
-s/e: dizziness, ortho hypo
Lisinopril (Zestril, Prinivil)
antihypertensives- tx of HTN, CHF
ACE inhibitors (Angiotensin converting enzyme)
-blocks ACE in lungs from converting angio1 to angio2 (powerful vasoconstrictor): decreasing BP, decreasing aldosterone secretion, causing sodium and fluid loss
Lisinopril (Zestril, Prinivil)
--report SWELLING of FACE, lightheadedness asap!
-give 1 hour before or 2 hours after meals
-small, frequent meals
-frequent mouth care
-change postions slowly
-can be used with thiazide diuretics
-s/e: dizziness, ortho hypo
Benazepril (Lotensin)
antihypertensives- tx of HTN, CHF
ACE inhibitors (Angiotensin converting enzyme)
-blocks ACE in lungs from converting angio1 to angio2 (powerful vasoconstrictor): decreasing BP, decreasing aldosterone secretion, causing sodium and fluid loss
Benazepril (Lotensin)
-give 1 hour before or 2 hours after meals
-small, frequent meals
-frequent mouth care
-change postions slowly
-can be used with thiazide diuretics
-s/e: ortho hypo, tachycardia, MI, proteinuria, rash, persistant dry non-productive cough, peripheral edema
Fosinopril (Monopril)
antihypertensives- tx of HTN, CHF
ACE inhibitors (Angiotensin converting enzyme)
-blocks ACE in lungs from converting angio1 to angio2 (powerful vasoconstrictor): decreasing BP, decreasing aldosterone secretion, causing sodium and fluid loss
Fosinopril (Monopril)
-give 1 hour before or 2 hours after meals
-small, frequent meals
-frequent mouth care
-change postions slowly
-can be used with thiazide diuretics
-s/e: ortho hypo, tachycardia, MI, proteinuria, rash, persistant dry non-productive cough, peripheral edema
Quinapril (Accupril)
antihypertensives- tx of HTN, CHF
ACE inhibitors (Angiotensin converting enzyme)
-blocks ACE in lungs from converting angio1 to angio2 (powerful vasoconstrictor): decreasing BP, decreasing aldosterone secretion, causing sodium and fluid loss
Quinapril (Accupril)
-give 1 hour before or 2 hours after meals
-small, frequent meals
-frequent mouth care
-change postions slowly
-can be used with thiazide diuretics
-s/e: ortho hypo, tachycardia, MI, proteinuria, rash, persistant dry non-productive cough, peripheral edema
Ramipril (Altace)
antihypertensives- tx of HTN, CHF
ACE inhibitors (Angiotensin converting enzyme)
-blocks ACE in lungs from converting angio1 to angio2 (powerful vasoconstrictor): decreasing BP, decreasing aldosterone secretion, causing sodium and fluid loss
Ramipril (Altace)
-give 1 hour before or 2 hours after meals
-small, frequent meals
-frequent mouth care
-change postions slowly
-can be used with thiazide diuretics
-s/e: ortho hypo, tachycardia, MI, proteinuria, rash, persistant dry non-productive cough, peripheral edema
Atenolol (Tenormin)
antihypertensive: Beta-Adrenergic Blocker
-decreases excitabilty of heart, reduces cardiac workload and O2 consumption, decreases release of renin, lowers BP
-s/e?
Atenolol (Tenormin)
-do not d/c abrubtly
-take with meals
-for DM pts: blocks normal s/s of hypoglycemia: monitor blood gluocose
-check APICAL pulse, <60 hold drug and call MD
-s/e: bradycardia, hypotension, brochospasm
Nadolol (Corgard)
antihypertensive: Beta-Adrenergic Blocker
-decreases excitabilty of heart, reduces cardiac workload and O2 consumption, decreases release of renin, lowers BP
Nadolol (Corgard)
-do not d/c abrubtly
-take with meals
-for DM pts: blocks normal s/s of hypoglycemia: monitor blood gluocose
-teach pt to check pulse before each dose
-check APICAL pulse before giving: <60 hold
-s/e: bradycardia, hypotension, HF
Propranolol (Inderal)
antihypertensive: Beta-Adrenergic Blocker
-decreases excitabilty of heart, reduces cardiac workload and O2 consumption, decreases release of renin, lowers BP
Propranolol (Inderal)
-do not d/c abrubtly
-take with meals
-for DM pts: blocks normal s/s of hypoglycemia: monitor blood gluocose
-teach pt to check pulse before each dose
-s/e: hypotension, brochospasm, bradycardia, depression, weakness
Metoprolol (Lopressor)
antihypertensive: Beta-Adrenergic Blocker
-decreases excitabilty of heart, reduces cardiac workload and O2 consumption, decreases release of renin, lowers BP
Metoprolol (Lopressor)
-do not d/c abrubtly
-take with meals
-for DM pts: blocks normal s/s of hypoglycemia: monitor blood gluocose
-teach pt to check pulse before each dose
-check APICAL pulse before giving: <60 hold
-s/e: bradycardia, hypotension, HF, depression
Acebutolol (Sectral)
antihypertensive: Beta-Adrenergic Blocker
-decreases excitabilty of heart, reduces cardiac workload and O2 consumption, decreases release of renin, lowers BP
Acebutolol (Sectral)
-do not d/c abrubtly
-take with meals
-for DM pts: blocks normal s/s of hypoglycemia: monitor blood gluocose
Carvedilol (Coreg)
antihypertensive: Beta-Adrenergic Blocker
-decreases excitabilty of heart, reduces cardiac workload and O2 consumption, decreases release of renin, lowers BP
Carvedilol (Coreg)
-do not d/c abrubtly
-take with meals
-for DM pts: blocks normal s/s of hypoglycemia: monitor blood gluocose
Pindolol (Visken)
antihypertensive: Beta-Adrenergic Blocker
-decreases excitabilty of heart, reduces cardiac workload and O2 consumption, decreases release of renin, lowers BP
Pindolol (Visken)
-do not d/c abrubtly
-take with meals
-for DM pts: blocks normal s/s of hypoglycemia: monitor blood gluocose
Nifedipine (Procardia)
antihypertensive: Calcium Channel Blocker
-reduces workload of left ventricle
-coronary vasodilator
Nifedipine (Procardia)
-Monitor BP
-assist with ambulation at start of therapy.
-contact MD if BP <90/60
s/e: hypotension
dizziness
GI distress
Liver disfunction
jitteriness
Verapamil (Calan)
antihypertensive: Calcium Channel Blocker
-reduces workload of left ventricle
-coronary vasodilator
Verapamil (Calan)
-avoid grapefruit juice
-Monitor BP
-assist with ambulation at start of therapy.
-contact MD if BP <90/60
s/e: hypotension
dizziness
GI distress
Liver disfunction
jitteriness
Diltiazem (Cardizem)
antihypertensive: Calcium Channel Blocker
-reduces workload of left ventricle
-coronary vasodilator
Diltiazem (Cardizem)
-Monitor BP
-assist with ambulation at start of therapy.
-contact MD if BP <90/60
s/e: hypotension
dizziness
GI distress
Liver disfunction
jitteriness
Amlodipine (Norvasc)
antihypertensive: Calcium Channel Blocker
Amlodipine (Norvasc)
-Monitor BP
-assist with ambulation at start of therapy.
-contact MD if BP <90/60
s/e: hypotension
dizziness
angina
Liver disfunction
AV block
bradycardia
perpheral edema
Felodipine (Plendil)
antihypertensive: Calcium Channel Blocker
Felodipine (Plendil)
-Monitor BP
-assist with ambulation at start of therapy.
-contact MD if BP <90/60
s/e: hypotension
dizziness
angina
Liver disfunction
AV block
bradycardia
perpheral edema
general info about antihypertensive: Calcium Channel Blocker
1. action?
-slows impulse conduction, depresses myocardial contractility, dilation of cornary arteries, decreases cardiac workload and energy consumption, increases O2 of myocardial cells
general info about antihypertensive: Calcium Channel Blocker
1. action?
-don't give for heart block
-monitor for signs of HF
--contact MD if BP <90/60
-assist with ambulation at start of therapy.
Candesartan (Atacand)
antihypertensive: Angiotensin II Receptor Antagonists: (ACE blockers/ ARB)
Candesartan (Atacand)
s/e: angioedema, renal failure, ortho hypo
-instruct client about postion changes
-monitor for edema
-tell pt to call MD if edema occurs
Eprosartan (Teveten)
antihypertensive: Angiotensin II Receptor Antagonists: (ACE blockers/ ARB)
Eprosartan (Teveten)
s/e: angioedema, renal failure, ortho hypo
-instruct client about postion changes
-monitor for edema
-tell pt to call MD if edema occurs
Irbesartan (Avapro)
antihypertensive: Angiotensin II Receptor Antagonists: (ACE blockers/ ARB)
Irbesartan (Avapro)
s/e: angioedema, renal failure, ortho hypo
-instruct client about postion changes
-monitor for edema
-tell pt to call MD if edema occurs
Losartan (Cozaar)
antihypertensive: Angiotensin II Receptor Antagonists: (ACE blockers/ ARB)
Losartan (Cozaar)
s/e: angioedema, renal failure, ortho hypo
-instruct client about postion changes
-monitor for edema
-tell pt to call MD if edema occurs
Valsartan (Diovan)
antihypertensive: Angiotensin II Receptor Antagonists: (ACE blockers/ ARB)
Valsartan (Diovan)
s/e: angioedema, renal failure, ortho hypo
-instruct client about postion changes
-monitor for edema
-tell pt to call MD if edema occurs
Doxazosin (Cardura)
antihypertensive: Alpha 1-adrenergic blocker
s/e: ortho hypo
reflex tachycardia
nasal congestion
impotence
Doxazosin (Cardura)
-give 1st dose at bedtime
-change positions slowly- b/c ortho hypo s/e
-Monitor BP, weight, BUN/creat edema
Prazosin (Minipress)
antihypertensive: Alpha 1-adrenergic blocker

antihypertensive: Alpha 1-adrenergic blocker
s/e: ortho hypo
reflex tachycardia
nasal congestion
impotence
Prazosin (Minipress)
-give 1st dose at bedtime
-change positions slowly- b/c ortho hypo s/e
-Monitor BP, weight, BUN/creat edema
Terazosin (Hytrin)
antihypertensive: Alpha 1-adrenergic blocker

antihypertensive: Alpha 1-adrenergic blocker
s/e: ortho hypo
reflex tachycardia
nasal congestion
impotence
Terazosin (Hytrin)
-give 1st dose at bedtime
-change positions slowly- b/c ortho hypo s/e
-Monitor BP, weight, BUN/creat edema
Clonidine (Catapres)
antihypertensive: Centrally acting Alpha-adrenergics
-stimulates alpha receptors in medulla, decreasing rate of force of contraction, decreasing cardiac output.
-s/e?
Clonidine (Catapres)
s/e: drowsiness, dizziness, dry mouth, h/a, dermatitis, severe rebound hypertension.
-Don't d/c abruptly
-apply patch to non-hairy area!!
Methyldopa (Aldomet)
antihypertensive: Centrally acting Alpha-adrenergics
-stimulates alpha receptors in medulla, decreasing rate of force of contraction, decreasing cardiac output.
Methyldopa (Aldomet)
s/e: drowsiness, dizziness, bradycardia, hemolytic anemia, fever, ortho hypo.
-monitor CBC
-monitor liver function
-take at hs to min drowsiness
-change postions slowly
Hydralazine (Apresoline)
antihypertensives: direct acting vasodilators
-relaxes smooth muscle in vessels=lowers peripheral resistance
Hydralazine (Apresoline)
-give with meals
-observe mental status
-check for weight gain, edema
s/e: lupus erythematous-like syndrome,
h/a, palpitations, edema, tachycardia
Minoxidil
antihypertensives: direct acting vasodilators
-relaxes smooth muscle in vessels=lowers peripheral resistance
Minoxidil
-teach pt to check pulse
-check APICAL pulse before giving
-monitor weight gain, I&O
-s/e: tachycardia, angina pectoris, edema, increase in body hair.
herbs that interact with antihypertensive drugs:
Ma-huang (ephedra) = decreases effect of med, increases HTN with beta blockers
Black cohosh=increases hypo effects
Goldenseal=counteracts effects
Lithium
med for bi-polar disorder
-controls manic episodes
-normal target level: 1-1.5mEq/L
-s/s of toxicity?
Lithium
-increase fluids 2,500-3,000 ml/day
-check serum 2-3x wk at start, then monthly while on maintenance. test/draw in AM!
-takes 1-2 wks to work
-s/s of toxicity: vomiting, diarrhea, drowsiness, muscular weakness, ataxia
Carbamazepine (Tegretol)
med for bi-polar disorder
-mood stabilzer
-used for seizures and trigeminal neuralgia
Carbamazepine (Tegretol)
-obtain baseline urinaylsis, BUN, liver function, CBC
-shake oral susp
-NG tube=mix with equal amounts of NS or D5, then flush
-take with food
-drowsiness appears in 3-4days
s/e: vertigo, ataxia, CHF, aplastic anemia
Divalproex sodium (Depakote)
med for bi-polar disorder
-mood stabilzer
-used for siezures
Divalproex sodium (Depakote)
-monitor liver function, platelet count at starting med and during
-monitor blood levels
-take with food
-teach client about s/s of liver disfuntion: fever, malaise
-s/e: toxic hepatitis, thrombocytopenia, pancreatitis, sedation
General info about bipolar meds
action?
s/s severe toxcitiy?
s/e?
action=reduces catecholamines released into synapse and increases uptake of norepineephrine, serotonin
s/s toxicity=exagerated reflexes, seizures, coma
s/e: GI upset, tremors, polydipsia, polyuria
Busulfan (Myleran)
antineoplastic agent: alkylating agent
-interfers with rapidly producing DNA
Busulfan (Myleran)
-s/e: bone marrow supression
-Check CBC
-causes stomatitis- requires extra fluids to flush system
Chlorambucil (Leukeran)
antineoplastic agent: alkylating agent
-interfers with rapidly producing DNA
Chlorambucil (Leukeran)
-monitor for infection
-avoid IM when platelets are low
s/e: n/v, bone marrow suppresion, sterilty
-encourage fluids
Cisplatin platinol -AQ
antineoplastic agent: alkylating agent
-interfers with rapidly producing DNA
Cisplatin platinol -AQ
-encourage fluids
-check hematopoietic function weekly.
Cyclophosphamide (Cytoxan)
antineoplastic agent: alkylating agent
-interfers with rapidly producing DNA
Cyclophosphamide (Cytoxan)
-monitor for infection
-give antiemetics
-report hematuria
-force fluids
-se: alopecia, bone marrow suppresion, hemorrhagic cystitis, dermatitis, hyperclamia, hypoglycemia, amenorrhea.
Cytarabine (ARA-C)
antineoplastic agent
antimetabolites- "fool cells"-so cell division is halted.
s/e: n/v, hemo abnormalities, rash, weight loss
Cytarabine (ARA-C)
-force fluids, good oral care
Fluorouracil (5-FU)
antineoplastic agent
antimetabolites- "fool cells"-so cell division is halted.
s/e: n/v, diarrhea, bone marrow suppression, GI ulceration, alopecia, liver disfunction, stomatitis
Fluorouracil (5-FU)
-monitor for infection
-avoid extravasation
Pemetrexed (Alimta)
antineoplastic agent
antimetabolites- "fool cells"-so cell division is halted.
s/e: n/v, diarrhea, bone marrow suppression, GI ulceration, alopecia, liver disfunction, stomatitis
Mercaptopurine (6-MP)
antineoplastic agent
antimetabolites- "fool cells"-so cell division is halted.
s/e: n/v, diarrhea, bone marrow suppression, alopecia, liver disfunction, ab bleeding
Mercaptopurine (6-MP)
-check liver!
Methotrexate (MTX)
antineoplastic agent
antimetabolites- "fool cells"-so cell division is halted.
s/e: n/v, bloody diarrhea, bone marrow suppression, GI ulceration, alopecia, liver disfunction, stomatitis
Methotrexate (MTX)
-good mouth care, avoid alcohol
-monitor live and renal function
hydroxyurea (Hydrea)
antineoplastic agent
antimetabolites- "fool cells"-so cell division is halted.
s/e: n/v, diarrhea, bone marrow suppression, GI ulceration, liver disfunction, rash
hydroxyurea (Hydrea)
-teach ot to report toxic GI s/s ASAP
Bleomycin (Blenoxane)
antineoplastic agent:
antitumor antibiotics- interfers with DNA and RNA synthesis
Bleomycin (Blenoxane)
-monitor for septicemic reactions
-monitor for s/s of extravasation at injection sites
Dactinomycin (Actinomycin D)
antineoplastic agent:
antitumor antibiotics- interfers with DNA and RNA synthesis
Dactinomycin (Actinomycin D)
-monitor for septicemic reactions
-monitor for s/s of extravasation at injection sites
Doxorubicin (Adriamycin)
antineoplastic agent:
antitumor antibiotics- interfers with DNA and RNA synthesis
Doxorubicin (Adriamycin)
-monitor for septicemic reactions
-monitor for s/s of extravasation at injection sites
Tamoxifen (Nolvadex)
antineoplastic agent: hormonal agents
used in breast cancer
-antiestrogen= competes with estrogen to bind to estrogene receptor sites on malignant cells
Tamoxifen (Nolvadex)
-causes transient fall in WBC or platelets, hypercalcemia, bone pain
-monitor serum Calcium
-check CBC
Leuprolide (Lupron)
antineoplastic agent: hormonal agents
used in breast cancer
-progestin=causes tumor cell regression by unknown mechanisms
Testolactone (Teslac)
antineoplastic agent: hormonal agents
-androgen= used for palliation in advanced breast cancer
Vinblastine (Velban)
antineoplastic agent: vinca alkaloids
-interfers with cell division
Vinblastine (Velban)
s/e: n/v, loss of reflexes, bone marrow depression
-Avoid IV inflitration and extravasation
-IV can cause bronchospasm
-give antiemtic prior
-Zyloprim given to help excrete uric acid
Vincristine (Oncovin)
antineoplastic agent: vinca alkaloids
-interfers with cell division
Vincristine (Oncovin)
s/e: n/v, loss of reflexes, bone marrow depression
-Avoid IV inflitration and extravasation
-check reflexes
-give antiemtic prior
-Zyloprim given to help excrete uric acid
General info about antineoplastic agents
1. bone marrow suppression
2. n/v
3. altered immune response
4. impaired oral mucosa, stomatis
5. Fatigue
General info about antineoplastic agents
1. monitor bleeding, avoid IM, avoid rectal temp
2. small frequent meals, antiemtics
3. handwashing, timely reports in changes in VS indicating infection
4. oral hygiene
5. encourage rest
Trihexyphenidyl (Artane)
antiparkinson med
-blocks acetocholine at cerebral synaptic sites
Trihexyphenidyl (Artane)
-monitor Intraocular pressure, don't give with glaucoma
-assist with ambulation
-give with food
-avoid OTC meds, foods with vit B6, alcohol
Benztropine mesylate (Cogentin)
antiparkinson med
-supresses tremor of parkinison
Benztropine mesylate (Cogentin)
-monitor Intraocular pressure, don't give with glaucoma
-assist with ambulation
-give with food
-avoid OTC meds, foods with vit B6, alcohol
Levodopa (l-dopa)
antiparkinson med
-precursor of dopamine
Levodopa (l-dopa)
-monitor Intraocular pressure, don't give with glaucoma
-assist with ambulation
-give with food
-avoid OTC meds, foods with vit B6, alcohol
bromocriptine mesylate (Parodel)
antiparkinson med
bromocriptine mesylate (Parodel)
-monitor Intraocular pressure, don't give with glaucoma
-assist with ambulation
-give with food
-avoid OTC meds, foods with vit B6, alcohol
Pergolide (Permax)
antiparkinson med
Pergolide (Permax)
-monitor Intraocular pressure, don't give with glaucoma
-assist with ambulation
-give with food
-avoid OTC meds, foods with vit B6, alcohol
Carbidopa-Levodopa (Sinemet)
antiparkinson med
Carbidopa-Levodopa (Sinemet)
-don't use with MAO inhibitors
-monitor Intraocular pressure, don't give with glaucoma
-assist with ambulation
-give with food
-avoid OTC meds, foods with vit B6, alcohol
Amantadine (Symmetrel)
antiparkinson med
Amantadine (Symmetrel)
-monitor Intraocular pressure, don't give with glaucoma
-assist with ambulation
-give with food
-avoid OTC meds, foods with vit B6, alcohol
-don't give if epilepsy, arterioscerosis
general info about anti-parkinson meds
s/e: ataxia, confusion, psychosis, hemolytic anemia, n/v, ortho hypo, anticholingeric effects
general info about anti-parkinson meds
-monitor urinary retention
-avoid vit B6, alcohol, OTC drugs
-avoid glaucoma pts
Adenosine diphosphate (ADP) receptors antagonists
antiplatelets
Adenosine diphosphate (ADP) receptors antagonists
-s/e gi upset, hemorrhage
-watch out for bruises, bloddy or black stools
-inform dentist, careful brushing
-elderly higher risk for OTOTOXICITY
-contact HCP prior to OTC use
-avoid garlic, gingko, ginger.
Ticlodipine (Ticlid)
antiplatelets
Ticlodipine (Ticlid)
-s/e gi upset, hemorrhage
-watch out for bruises, bloddy or black stools
-inform dentist, careful brushing
-elderly higher risk for OTOTOXICITY
-contact HCP prior to OTC use
-avoid garlic, gingko, ginger.
Copidrogel (Plavix)
antiplatelets
Copidrogel (Plavix)
-s/e gi upset, hemorrhage
-watch out for bruises, bloddy or black stools
-inform dentist, careful brushing
-elderly higher risk for OTOTOXICITY
-contact HCP prior to OTC use
-avoid garlic, gingko, ginger.
Glycoprotein IIb and IIIa receptor antagonists
antiplatelets
Glycoprotein IIb and IIIa receptor antagonists
-s/e gi upset, hemorrhage
-watch out for bruises, bloddy or black stools
-inform dentist, careful brushing
-elderly higher risk for OTOTOXICITY
-contact HCP prior to OTC use
-avoid garlic, gingko, ginger.
Eptifibatide (Integrilin)
antiplatelets
Eptifibatide (Integrilin)
-s/e gi upset, hemorrhage
-watch out for bruises, bloddy or black stools
-inform dentist, careful brushing
-elderly higher risk for OTOTOXICITY
-contact HCP prior to OTC use
-avoid garlic, gingko, ginger.
Abciximab (ReoPro)
antiplatelets
Abciximab (ReoPro)
-s/e gi upset, hemorrhage
-watch out for bruises, bloddy or black stools
-inform dentist, careful brushing
-elderly higher risk for OTOTOXICITY
-contact HCP prior to OTC use
-avoid garlic, gingko, ginger.
Salicylates (Aspirin) (ASA)
antiplatelets
Salicylates (Aspirin) (ASA)
-s/e gi upset, hemorrhage
-watch out for bruises, bloddy or black stools
-inform dentist, careful brushing
-elderly higher risk for OTOTOXICITY
-contact HCP prior to OTC use
-avoid garlic, gingko, ginger.
Haloperidol (Haldol)
antipsychotic
traditional
Haloperidol (Haldol)
high incidence for extrapymidal effects
Fluphenazine (Prolixin)
antipsychotic
traditional
Perphenazine (Trilafon)
antipsychotic
traditional
Perphenazine (Trilafon)
-can help control severe vomiting
Chlorpromazine (Thorazine)
antipsychotic
traditional
Chlorpromazine (Thorazine)
-no risk for abuse
-photoensitive
Risperidone (Risperdal)
antipsychotic
atypical
Risperidone (Risperdal)
-1st line drug b/c low EPS, and low anticholinergic effects
Quetiapine (Seroquel)
antipsychotic
atypical
Quetiapine (Seroquel)
-1st line drug b/c low EPS, and low anticholinergic effects
Ziprasidone (Geodon)
antipsychotic
atypical
Ziprasidone (Geodon)
-low risk for weight gain
Aripiprazole (Abilify)
antipsychotic
atypical
Clozapine (Clorzaril)
antipsychotic
atypical
Olanzapine (Zyprexa)
antipsychotic
atypical
nursing considerations with anitpsychotic meds?
1. be aware that med lowers seizure theshold
2. slows growth rate in children
3. avoid alcohol
4. monitor GI motility and urinary retention
5. with antiHTN/nitrates, can cause hypoTN.
6. elderly higher risk for dehydration
7. avoid sun exposure
8. takes 4-6 wks to work
9. encourage fluid intake
10. may cause false positive preg. tests
11.DO NOT mix with caffeine or apple juice
12. Use 60ml dilution for every 5ml of med.
Akathisia
-motor restlessness, inability to sit or stand still, foot tap, pace
-extrapyramidal s/e of antipsychotics
Dyskinesia
abnormal voluntary movements
s/e of antipyschotics
extrapyramidal
Acute dystonic reaction
1. early s/s
2. late s/s?
=abnormal muscle tone
s/e of antipyschotics: extrapyramidal
1. early s/s= tightening of jaw. stiff neck, swollen tongue
2. swollen airway, oculogyric crisis= is reversible.
parkinson syndrome/ psuedoparkinsonism
s/e of antipyschotics
extrapyramidal
=shuffling gait, rigid muscles, excessive salvation, tremors, mask-like face, motor retardation
parkinson syndrome/ psuedoparkinsonism
med mgmt: give benzotropine (Cogentin)
or trihexyphenidyl (Artane)
Tardive dyskinesia
s/e of antipyschotics
extrapyramidal
=involuntary movements of mouth, tongue, trunk, extremities, chewing motions, sucking, tongue thrusting. May be irreversible!
Neuroleptic malignant syndrome
s/e of antipyschotics
seriuos!!, not reversible
s/s: ridigty, fever, sweating, autonomic dysfunction(dsyrthymias, fluctuations in BP), confusion, seizures, coma
1. -what nurse does?
Neuroleptic malignant syndrome
1. Immediately D/C antipsychotic!
control hyperthermia, hydration, give Dantroline (muscle relaxant for the rigidity) Bromocriptine used for CNS toxicity
Atropine psychosis
s/e of antipyschotics
s/s: 1. "Red as a beet" skin hot to touch w/out fever
2. "Dry as a bone" dehydration
3. "Mad as hatter"- AMS

-what does nurse do....
Atropine psychosis
-reduce med or d/c med
-stay with pt while confused for safety
Major s/e effects of antipsychotics (8)
1. extrapyramidal (5)
2. Anticholinergic
3. sedative
4, hypotensive- ortho hypo
5. phototoxic
6. neuroleptic malignant syndrome
7. atropine psychosis
8. discolors urine pink to red brown.
tylenol (Acetaminophen)
antipyretic
antiinflammatory
antiprostaglandin activity in hypothalamus reduces fever, causes peripheral vasodilation
Salicylates (asiprin, ASA)
antipyretic
antiinflammatory
antiprostaglandin activity in hypothalamus reduces fever, causes peripheral vasodilation
Salicylates (asiprin, ASA)
-DO NOT under 21 ys =risk for Reye's syndrome
-give with milk, food, water
-don't give if pt has bleeding disorder
Methimazole (Tapazole)
antithyroid
tx hyperthyroidism, thyrotoxic crisis
-ihibits synthesis of thyroid hormone
Methimazole (Tapazole)
-check CBC
-check hepatic function
-give with meals
-Report fever, sore throat to MD
Propylthiouracil (PTU)
antithyroid
tx hyperthyroidism, thyrotoxic crisis
-ihibits synthesis of thyroid hormone
Propylthiouracil (PTU)
-check CBC
-check hepatic function
-give with meals
-Report fever, sore throat to MD
Lugol's iodine solution
antithyroid
tx hyperthyroidism, thyrotoxic crisis
-used 2 wks prior to surgery= decreases vasularity, decreases hormone release
-only effective for short period of time
Lugol's iodine solution
-stains teeth
-dilute in water, juice
-give after meals
Potassium iodine (SSKI)
antithyroid
tx hyperthyroidism, thyrotoxic crisis
-used 2 wks prior to surgery= decreases vasularity, decreases hormone release
Potassium iodine (SSKI)
-stains teeth
-dilute in water, juice
-give after meals
how is sodium effect lithium
lithium a med for bi-polar manic phase
-alkali metal salt acts like sodium ions in the body; excretion of lithium depends on normal sodium levels; sodium reduction causes marked lithium retention, leading to toxicity
bacterial meningitis vs. viral meningitis?
what precautions?
bacterial is worse. Has cloudy CSF, and high WBC
-viral is less severe, clear CSF, and normal high WBC's
-droplet precautions
Miller-abbott tube
function?
what is it used to tx?
Miller-Abbott tube provides for intestinal decompression; intestinal tube is often used for treatment of paralytic ileus.
-tube would be placed in an area of reduced peristalsis and would slowly work past an obstruction
Levin or Salem Sump
function?
-Prevents fluid and gas accumulation in the stomach
-decompresses the stomach
PKU
what does it test?
When should it be done?
genetic disorder caused by a deficiency in liver enzyme phenylalanine hydroxylase. Body cannot metabolize the essential amino acid phenylalanine. This allows phenyl acid to accumulate in the blood. If not recognized, resultant high levels of phenyl ketone in the brain cause mental retardation.
THINK: protein
2. BEST time to test is after the infant has ingested enough protein (i.e. breast milk) to test the infant’s blood. NO LATER THAN 7 days
Zidovudine (AZT)
antivirals
Levothyroxine (Synthroid, Levothroid)
thyroid replacement med. Tx hypothyroidism
Levothyroxine (Synthroid, Levothroid)
report chest pain, SOB, palpations to MD. Withold if pulse is >100
Liothyronine sodium (Cytomel)
thyroid replacement med. Tx hypothyroidism
Liothyronine sodium (Cytomel)
take same time everyday. Take in AM. Withhold if pulse is >100
General info about thyroid replacement meds
tx hypothyroidism. Enhances anticoagulants (prolongs PTT). Decreases action of insulin, & digitalis. Monitor weight (>2lbs wk=bad). Avoid OTC drugs
Isoniazid (INH)
antiTB- 1st line agents
Isoniazid (INH)
liver toxic. Check for s/s of hepatitis. Works in 2-3wks.
Ethambutol (EMB)
antiTB- 1st line agents
Ethambutol (EMB)
a
Rifampin (RIF, Rifadin)
antiTB- 1st line agents
Rifampin (RIF, Rifadin)
a
Streptomycin
antiTB- 1st line agents
Streptomycin
a
Para-amino salicyclic acid (PAS)
ant-TB- 2nd line agents
Para-amino salicyclic acid (PAS)
a
Pyrazinamide (PZA)
ant-TB- 2nd line agents
Pyrazinamide (PZA)
a
Dextromethoorphan hydromide (Benylin DM, Pertussis ES, Vicks formula 44)
anttussive/expectorant
Dextromethoorphan hydromide (Benylin DM, Pertussis ES, Vicks formula 44)
a
Guaifensin (Robitussin)
anttussive/expectorant
Guaifensin (Robitussin)
a
Acyclovir (Zovirax)
antivirals
Acyclovir (Zovirax)
a
Ribavarin (Virazole)
antivirals
Ribavarin (Virazole)
a
Zidovudine (AZT)
antivirals
Zidovudine (AZT)
a
Zalcitabine (HIVID)
antivirals
Zalcitabine (HIVID)
a
Didanosine (Videx)
antivirals
Didanosine (Videx)
a
Famiciclovir (Famvir)
antivirals
Famiciclovir (Famvir)
a
Ganciclovir (Cytonvene)
antivirals
Ganciclovir (Cytonvene)
a
Amantadine (Symmetrel)/Rimantadine (Flumadine)
antivirals
Amantadine (Symmetrel)/Rimantadine (Flumadine)
a
Oseltamivir (Tamiflu)
antivirals
Oseltamivir (Tamiflu)
a
Zanamivir (Relenza)
antivirals
Zanamivir (Relenza)
a
Methylphidate (Ritalin)
Attention deficit, hyperactivity disorder med
Methylphidate (Ritalin)
a
Dextroamphetamine sulfate (Dexedrine)
Attention deficit, hyperactivity disorder med
Dextroamphetamine sulfate (Dexedrine)
a
Alendronate (Fosamax)
Bone-reabsorbtion inhibitors (Biophosphonates)
Alendronate (Fosamax)
a
Risedronate (Actonel)
Bone-reabsorbtion inhibitors (Biophosphonates)
Risedronate (Actonel)
a
Ibandronate (Boniva)
Bone-reabsorbtion inhibitors (Biophosphonates)
Ibandronate (Boniva)
a
Aminophyline (Truphylline)
Bronchodilators/leukotriene-receptor blockers
Aminophyline (Truphylline)
a
Terbutaline sulfate (Brethaire)
Bronchodilators/leukotriene-receptor blockers
Terbutaline sulfate (Brethaire)
a
Ipatropium bromide (Atrovent)
Bronchodilators/leukotriene-receptor blockers
Ipatropium bromide (Atrovent)
a
Tiotropium (Spiriva)
Bronchodilators/leukotriene-receptor blockers
Tiotropium (Spiriva)
a
Albuterol (Proventil)
Bronchodilators/leukotriene-receptor blockers
Albuterol (Proventil)
a
Salmeterol (Serevent)
Bronchodilators/leukotriene-receptor blockers
Salmeterol (Serevent)
a
Epinephrine (Adrenline, Primatene mist)
Bronchodilators/leukotriene-receptor blockers
Epinephrine (Adrenline, Primatene mist)
a
Montelukast sodium (Singulair)
Bronchodilators/leukotriene-receptor blockers
Montelukast sodium (Singulair)
a
Zafirlukast (Accolade)
Bronchodilators/leukotriene-receptor blockers
Zafirlukast (Accolade)
a
Zileuton (Zyflo)
Bronchodilators/leukotriene-receptor blockers
Zileuton (Zyflo)
a
Acetylcysteine (Mucomyst)
Bronchodilators/xanthines
Acetylcysteine (Mucomyst)
a
Cromolyn sodium (Intal)
Bronchodilators/xanthines
Cromolyn sodium (Intal)
a
Salmeterol (Serevent)
Bronchodilators/xanthines
Salmeterol (Serevent)
a
Montelukast sodium (Singulair)
Bronchodilators/xanthines
Montelukast sodium (Singulair)
a
Acetazolamide (Diamox)
Carbonic anhydrase
Acetazolamide (Diamox)
a
Digoxin (Lanoxin)
cardiac glycosides
Digoxin (Lanoxin)
a
Sucralfate (Carafate)
cytoprotective agent
Sucralfate (Carafate)
a
Hydochlorothiazide (Hydrodiuril)
Thiazide diuretic
Hydochlorothiazide (Hydrodiuril)
a
Chlorothiazide (Diuril)
Thiazide diuretic
Chlorothiazide (Diuril)
a
Spironalactone (Aldactone)
poatassium sparing diuretic
Spironalactone (Aldactone)
a
Furosemide (Lasix)
loop diuretic
Furosemide (Lasix)
a
Ethacrynic acid (Edeecrin)
loop diuretic
Ethacrynic acid (Edeecrin)
a
Bumetamide (Bumex)
loop diuretic
Bumetamide (Bumex)
a
Mannitol
osmotic diuretic
Mannitol
a
Chlorthalidone (Hygroton, Thalitone)
diuretic
Chlorthalidone (Hygroton, Thalitone)
a
Calcium carbonate (Os-CAL)
electrolytes and replacement solutions
Calcium carbonate (Os-CAL)
a
Calcium chloride
electrolytes and replacement solutions
Calcium chloride
a
Magnesium Chloride (Slow Mag)
electrolytes and replacement solutions
Magnesium Chloride (Slow Mag)
a
Potassium chloride (K-Dur, slow-K, Micro-k)
electrolytes and replacement solutions
Potassium chloride (K-Dur, slow-K, Micro-k)
a
Potassium gluconate (Kaon liquid)
electrolytes and replacement solutions
Potassium gluconate (Kaon liquid)
a
sodium chloride
electrolytes and replacement solutions
sodium chloride
a
ferrous sulfate (Feosol)
iron preparations
ferrous sulfate (Feosol)
a
Iron dextran (Imferon)
iron preparations
Iron dextran (Imferon)
a
Calcium
mineral
Calcium
a
Vitamin D (ergocalciferol)
mineral
Vitamin D (ergocalciferol)
a
Sodium Fluoride
mineral
Sodium Fluoride
a
Potassium (K-Lor)
mineral
Potassium (K-Lor)
a
Methlcellulose (Tearisol)
eye meds
Methlcellulose (Tearisol)
a
Polyvinyl alcohol (liquifilm tears)
eye meds
Polyvinyl alcohol (liquifilm tears)
a
Tetrahydrozoline (visine, murine plus)
eye meds
Tetrahydrozoline (visine, murine plus)
a
Timolol maleate (Timoptic)
eye meds
Timolol maleate (Timoptic)
a
Levobunolol (Betagan)
eye meds
Levobunolol (Betagan)
a
Proparacaine HCI (Alcaine)
eye meds
Proparacaine HCI (Alcaine)
a
Tetracaine HCI, cocaine (Pontocaine)
eye meds
Tetracaine HCI, cocaine (Pontocaine)
a
Gentamycin (Garamycin)
eye meds
Gentamycin (Garamycin)
a
Tobramycin (Tobrex)
eye meds
Tobramycin (Tobrex)
a
Prednisolone acetate (Ocu-pred)
eye meds
Prednisolone acetate (Ocu-pred)
a
Idoxuridine (Herplex, Stoxil)
eye meds
Idoxuridine (Herplex, Stoxil)
a
Dipivefrin HCI (Propine)
eye meds
Dipivefrin HCI (Propine)
a
Flurbiprofen (Ocufen)
eye meds
Flurbiprofen (Ocufen)
a
Cortisone acetate
glucocorticoids
Cortisone acetate
a
Hydrocortisone (Solu-Cortef)
glucocorticoids
Hydrocortisone (Solu-Cortef)
a
Dexamethasone (Decadron)
glucocorticoids
Dexamethasone (Decadron)
a
Methylprednisolone (Solu-Medrol)
glucocorticoids
Methylprednisolone (Solu-Medrol)
a
Prednisone (Deltrasone)
glucocorticoids
Prednisone (Deltrasone)
a
Beclomethasone
glucocorticoids
Beclomethasone
a
Betamethasone
glucocorticoids
Betamethasone
a
Budesonide (Pulmicort)
glucocorticoids
Budesonide (Pulmicort)
a
Montelukast sodium (Singulair)
leukotriene-receptor blockers
Montelukast sodium (Singulair)
a
Zafirlukast (Accolate)
leukotriene-receptor blockers
Zafirlukast (Accolate)
a
Zileuton (Zyflo)
leukotriene-receptor blockers
Zileuton (Zyflo)
a
Fludrocortisone acetate (Florinef)
mineralocorticoids
Fludrocortisone acetate (Florinef)
a
Deferoxamine mesylate (Desferal mesylate)
heavy metal antagonists
Deferoxamine mesylate (Desferal mesylate)
a
Dimercaprol (BAL in oil)
heavy metal antagonists
Dimercaprol (BAL in oil)
a
Edetate calcium disodium (EDTA) (Calcium disodium, Versenate)
heavy metal antagonists
Edetate calcium disodium (EDTA) (Calcium disodium, Versenate)
a
Cyclosporine (Sandimmune)
immunosupressants
Cyclosporine (Sandimmune)
a
Cascara
laxative and stool softeners
Cascara
a
Bisacodyl (Dulcolax)
laxative and stool softeners
Bisacodyl (Dulcolax)
a
Phenolphthalein (Feen-A-Mint)
laxative and stool softeners
Phenolphthalein (Feen-A-Mint)
a
Mineral Oil
laxative and stool softeners
Mineral Oil
a
Docusate (Colace)
laxative and stool softeners
Docusate (Colace)
a
Milk of magnesia
laxative and stool softeners
Milk of magnesia
a
Psyllium hydrophillic mucilliod (Metamucil)
laxative and stool softeners
Psyllium hydrophillic mucilliod (Metamucil)
a
Polyethylene glycol and electrolytes (Colyte)
laxative and stool softeners
Polyethylene glycol and electrolytes (Colyte)
a
Pilocarpine (Isopto-Carpine, Pilocar)
miotic eye med (for open angle glaucoma)
Pilocarpine (Isopto-Carpine, Pilocar)
a
Carachol (Carbacel)
miotic eye med (for open angle glaucoma)
Carachol (Carbacel)
a
Edrophonium (Tensilon)
musculoskeletal meds (for Myathenia gravis)
Edrophonium (Tensilon)
a
Neostigmine (Prostigmin)
musculoskeletal meds (for Myathenia gravis)
Neostigmine (Prostigmin)
a
Pyridostigmine bromide (Mestinon)
musculoskeletal meds (for Myathenia gravis)
Pyridostigmine bromide (Mestinon)
a
Alendronate sodiumm (Fosamax)
musculoskeletal meds (for osteoporosis, Paget's)
Alendronate sodiumm (Fosamax)
a
Glucosamine
musculoskeletal meds (antirheumatic)
Glucosamine
a
Atropine sulfate (Isopto-Atropine)
mydriatic and cyclopegic eye med
Atropine sulfate (Isopto-Atropine)
a
Cyclopentolate (Cyclogyl)
mydriatic and cyclopegic eye med
Cyclopentolate (Cyclogyl)
a
Morohine Sulfate
narcotic (opioid anagesics)
Morohine Sulfate
a
Codeine
narcotic (opioid anagesics)
Codeine
a
Methadone (Dolophine)
narcotic (opioid anagesics)
Methadone (Dolophine)
a
Propoxyphene (Darvon)
narcotic (opioid anagesics)
Propoxyphene (Darvon)
a
Merperidine (Demerol)
narcotic (opioid anagesics)
Merperidine (Demerol)
a
Hydromorphine (Dilaudid)
narcotic (opioid anagesics)
Hydromorphine (Dilaudid)
a
Oxycodone (Percodan)
narcotic (opioid anagesics)
Oxycodone (Percodan)
a
Hydrocodone/Acetaminophen (Vicodin)
narcotic (opioid anagesics)
Hydrocodone/Acetaminophen (Vicodin)
a
Nitroglycerin (Nitro-Bid, Nitrostat, Transderm-Nitro0
nitrates/ antianginals
Nitroglycerin (Nitro-Bid, Nitrostat, Transderm-Nitro0
a
Isosorbide (Isordil, Sorbitrate)
nitrates/ antianginals
Isosorbide (Isordil, Sorbitrate)
a
Ibuprofen (Motrin)
NSAID
Ibuprofen (Motrin)
a
Indomethacin (Indocin)
NSAID
Indomethacin (Indocin)
a
Naproxen (Anaprox, Naprosyn)
NSAID
Naproxen (Anaprox, Naprosyn)
a
Celecoxib (Celebrex)
NSAID
Celecoxib (Celebrex)
a
Ketorolac (Toradol)
NSAID
Ketorolac (Toradol)
a
Calcitonin (Calcimar)
med for Paget's disease
Calcitonin (Calcimar)
a
Etidronate disodium (EHDP)
med for Paget's disease
Etidronate disodium (EHDP)
a
Mithramycin (Mitharcin)
med for Paget's disease
Mithramycin (Mitharcin)
a
Reteplase (Retavase)
thrombolytic med used to tx MI's/stroke w/in 6(?) hrs after s/s
Reteplase (Retavase)
a
Alteplase (Activase)
thrombolytic med used to tx MI's/stroke w/in 6(?) hrs after s/s
Alteplase (Activase)
a
Tissue plasminogen activator (t-PA)
thrombolytic med used to tx MI's/stroke w/in 6(?) hrs after s/s
Tissue plasminogen activator (t-PA)
a
Anistreplase (Eminase)
thrombolytic med used to tx MI's/stroke w/in 6(?) hrs after s/s
Anistreplase (Eminase)
a
Streptokinase (Streptase SK)
thrombolytic med used to tx MI's/stroke w/in 6(?) hrs after s/s
Streptokinase (Streptase SK)
a
Cimetide (Tagamet)
ulcer med- H2 antagonist
Cimetide (Tagamet)
a
Ranitidine (Zantac)
ulcer med- H2 antagonist
Ranitidine (Zantac)
a
Sucralfate (Carafate)
ulcer med- H2 antagonist
Sucralfate (Carafate)
a
Famotidine (Pepcid)
ulcer med- H2 antagonist
Famotidine (Pepcid)
a
Nizatidine (Axid)
ulcer med- H2 antagonist
Nizatidine (Axid)
a
Omeprazole (Prilosec)
ulcer med- antisecretory agent
Omeprazole (Prilosec)
a
Lansoprazole (Prevacid)
ulcer med- antisecretory agent
Lansoprazole (Prevacid)
a
Rabeprazole (AcipHex)
ulcer med- antisecretory agent
Rabeprazole (AcipHex)
a
Esomeprazole (Nexium)
ulcer med- antisecretory agent
Esomeprazole (Nexium)
a
Pantoprazole (Protonix)
ulcer med- antisecretory agent
Pantoprazole (Protonix)
a
Misoprostol (Cytotec)
ulcer med- prostagladin analogs
Misoprostol (Cytotec)
a
Cyanocobalamin (Vit B12)
vitamin
Cyanocobalamin (Vit B12)
a
Folic acid (Fovite)
vitamin
Folic acid (Fovite)
a
Ethinyl, Estradiol, Norgestrel (Ovral)
women health med- contraceptive
Ethinyl, Estradiol, Norgestrel (Ovral)
a
Levonorgestrel (Norplant)
women health med-contraceptive
Levonorgestrel (Norplant)
a
Estradiol (Estrace)
estrogen
Estradiol (Estrace)
a
Estrogens conjugated (Premarin)
women health med-estrogen
Estrogens conjugated (Premarin)
a
Medroxyprogestrone acetate (Provera, Depo-Provera)
women health med-progestins
Medroxyprogestrone acetate (Provera, Depo-Provera)
a
Terazosin (Hytrin)
men's health med-for prostatic hypperplasia, decrease in urinary urgency
Terazosin (Hytrin)
a
Tamsulosin (Flomax)
men's health med-for prostatic hypperplasia, decrease in urinary urgency
Tamsulosin (Flomax)
a
Finasteride (Proscar)
men's health med-for prostatic hypperplasia, slows prostatic growth
Finasteride (Proscar)
a
Dutasteride (Avodart)
men's health med-for prostatic hypperplasia, slows prostatic growth
Dutasteride (Avodart)
a
Sildenafil (Viagra)
anti-impotence agent
Sildenafil (Viagra)
a
Vardenafil (Levitra)
anti-impotence agent
Vardenafil (Levitra)
a
Tadalafil (Cialis)
anti-impotence agent
Tadalafil (Cialis)
a
Saw palmetto
herbal urinary antiseptic tx prostatic begnin hyerplasia
Saw palmetto
a
Echinacea
used for colds, wound healing, UTI
Echinacea
a
Garlic
reduces cholesterol, decrease BP. (increase anticogaulants effects
Garlic
a
Ginseng
increase stamina, stimulant to immune and nervous system
Ginseng
a
Evening primrose oil
anti-inflammatory, sedative. Used for premenstral and menopausal problems
Evening primrose oil
a
Chondroitin
used for arthitis cause it’s a cartilage systhesis
Chondroitin
a
Glucosamine
used for arthitis cause it’s a cartilage systhesis
Glucosamine
a
Capsicum/Cayenne Pepper
anagelsia, improves blood circulation, used for arthritis, boel probs, nerve pain, PVD, used as personal defense spray
Capsicum/Cayenne Pepper
a
Feverfew
anagelsia. Used for migraines, fever and menstral probs
Feverfew
a
Flaxseed
laxative, anticholesterol
Flaxseed
a
Ginger
antiemtic, antioxidant, digestive aid, and antiinflammatory
Ginger
a
Licorice
soothes expectorant, antiinflammatory. Used for coughs, colds, stomach pains, ulcers
Licorice
a
Saw plametto
mild diuretic, used for BPH, increasing sexual vigor, cyctitis
Saw plametto
a
Chamomile
sedative, hypnotic, antiinflammatory. Used for stress, anxiety, GI disorders
Chamomile
a
Kava
sedative, anti-axiety, insomnia
Kava
a
Melatonin
hormone form pineal gland. Used for insomnia.
Melatonin
a
St.John's Wort
antidepressant, sedative, antimicrobial. Used for depression, sleep disorders, promotes healing
St.John's Wort
a
Valerian
sedative. Used for insommnia, restlessness, anxiety
Valerian
a
Gingko
enhances cerbral and peripheral blood flow, antidepressant. Used for dementia, veritgo, depression, and sexual dysfunction
Gingko
a
Hawthorn
antianginal, antiarrhythmic, vasodialotor. Used for mild HF, HTN
Hawthorn
a
Eucalyptus
decongestant, antiinflammatory, antimicrobial.
Eucalyptus
a
/ 888
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