Drug List Flashcards
(130 cards)
1
Q
name the first generation NSAIDs
A
- aspirin
- ibuprofen
- naproxen
- diclofenac/misoprostol
- ketorolac
2
Q
name commonalities among all first generation NSAIDs
A
- MOA: inhibit COX 1 & 2–>inhibit PG synthesis
- indication:
- inflammatory disorders (RA, OA, bursitis)
- mild-moderate pain
- suppress fever
- dysmenorrhea
- ADRxns:
- inc risk of GI bleed
- renal impairment
3
Q
Aspirin: Class
A
salicylates
4
Q
Aspirin: MOA
A
-
irreversible inhibitor of COX1 and COX2–>inhibits PG synthesis
- COX2: for inflammation, pain, fever
- COX1: for MI and stroke (b/c it inhibits platelet aggregation)
5
Q
Aspirin: Indications
A
- inflammation: RA, JRA, OA, rheumatic fever, tendinitis, bursitis
- mild-moderate pain (no tolerance or dependence like opioids)
- reduction of fever in adults
- dysmenorrhea
- suppression of platelet aggregation (by inhibiting COX1)
- so for prophylaxis of MI and stroke
- colorectal cancer prevention
6
Q
Aspirin: SE
A
- gastric distress
- nausea
- heartburn
7
Q
Aspirin: ADRxns
A
- GI bleeding, gastric ulceration, perforation
- bleeding inc b/c platelet aggregation is inhibited
- salicylism: tinnitus, sweating, headache
- renal impairment
- due to COX1 inhibition
- Reye’s Syndrome in children
- encephalopathy and fatty liver degeneration
- anaphylaxis and laryngeal edema
8
Q
Ibuprofen: Class
A
NSAID
9
Q
Ibuprofen: MOA
A
- reversible inhibitor of COX 1 and COX 2–>inhibit PG synthesis
10
Q
Ibuprofen: Indications
A
- fever
- mild to moderate pain
- inflammation: RA, OA
- dysmenorrhea: best NSAID for this
- closure of DA in infants
- **suppression of platelet aggregation is MUCH less than aspirin
11
Q
Ibuprofen: SE
A
- headache
- constipation
- dyspepsia
- nausea
- vomiting
12
Q
Ibuprofen: ADRxns
A
- gastric ulcers and GI bleeding (less than aspirin)
- renal impairment
- due to COX 1 inhibition
- Stevens Johnson Syndrome
- can cause scarring, blindness, death
- MI and Stroke
- b/c it causes little to no suppression of platelet aggregation, so inc risk of MI and stroke
- exfoliative dermatitis
- toxic epidermal necrolysis
- anaphylaxis
13
Q
Naproxen: Class
A
NSAID
14
Q
Naproxen: MOA
A
- reversible inhibitor of COX 1 (highly selective for COX 1–>inhibit PG synthesis
15
Q
Naproxen: Indications
A
- inflammation:
- RA, bursitis, tendinitis
- dysmenorrhea
- fever
- mild-moderate pain
16
Q
Naproxen: SE
A
- dizziness
- drowsiness
- headache
- constipation
- dyspepsia
- nausea
17
Q
Naproxen: ADRxns
A
- GI distress, bleed
- renal fcn impairment
- MI
- Stroke
- b/c it is a selective inhibitor of COX1, the risk for MI and stroke appears less with Naproxen than other traditional NSAIDs like ibuprofen and diclofenac
- drug induced hepatitis
- anaphylaxis
- Stevens Johnson Syndrome
18
Q
Diclofenac/Misoprostol: Class
A
NSAID/cytoprotective PG
19
Q
Diclofenac/Misoprostol: MOA
A
- reversible inhibitor of COX 1 and COX 2–>inhibit PG synthesis
- Misoprostol: PG analog that can protect against NSAID induced ulcers
20
Q
Diclofenac/Misoprostol: Indications
A
- RA, OA pts at high risk for NSAID induced gastric/duodenal ulcers
21
Q
Diclofenac/Misoprostol: SE
A
- diarrhea (misoprostol)
- abdominal pain
22
Q
Diclofenac/Misoprostol: ADRxns
A
- uterine contractions (misoprostol)–>miscarriage
- contraindicated during pregnancy, pts should be on contraception to prevent pregnancy
23
Q
Ketorolac: Class
A
NSAID
24
Q
Ketorolac: MOA
A
- reversible COX-1 and COX-2 inhibitor–>inhibits PG synthesis
25
Ketorolac: Indication
* pain (as good as morphine, opioids)
* use for acute, severe pain
* post op pain
* \*\*minimal anti-inflammatory effects
26
Ketorolac: SE
* drowsiness
27
Ketorolac: ADRxns
* ulcers, GI bleed, perforation
* renal impairment
* premature closure of DA
* suppress uterine contractions
* MI/Stroke
* b/c it causes little to no suppression of platelet aggregation, so inc risk of MI and stroke
* exfoliative dermatitis
* Stevens Johnson Syndrome
* Toxic Epidermal necrolysis
28
Ketorolac: what is important to remember?
* duration of therapy by all routes should be no more than 5 days
29
what is considered a second generation NSAID?
* Celecoxib
30
Celecoxib: Class
NSAID
31
Celecoxib: MOA
* **COX 2 selective** inhibitor--\>inhibit PG synthesis
32
Celecoxib: Indications
* inflammation
* OA, RA, ankylosing spondylitis, juvenile idiopathic arthritis
* acute pain
* dysmenorrhea
* familial adenomatous polyposis which predisposes to colorectal cancer
33
Celecoxib: SE
* dyspepsia
* abdominal pain
34
Celecoxib: ADRxns
* possible gastric ulcers, but less likely
* MI, stroke
* contraindicated in pts who have heart dz
* renal impairment
* sulfonamide allergy
* premature closure of DA
* contraindicated in pregnancy
* exfoliative dermatitis
* Stevens Johnson Syndrome
* Toxic Epidermal Necrolysis
35
why are gastric ulcers less likely with Celecoxib?
* b/c it is only a selective inhibitor of COX2, COX1 is not inhibited, so there is no inhibition of platelet aggregation
36
why are MI, stroke ADRxns for Celecoxib?
* b/c the drug does not inhibit COX1, so there is no platelet aggregation
* b/c it does inhibit COX2, which causes increased vasoconstriction, so there is inc likelihood of vessel blockage once the process of thrombosis has begun
37
NSAIDs: general nursing implications
* take with food, milk, water to prevent GI upset
* do not crush or chew enteric coated or sustained release capsules
* DO NOT consume alcohol (problem is 3+/day)
* notify prescriber if GI irritation is severe or persistent
* avoid use to prevent vaccination associated fever/pain
* contraindicated if: hx of severe NSAID allergy, children w/ chickenpox or influenza
* Celecoxib: for those with sulfa allergy
* in pregnant women b/c may cause maternal anemia, premature closure of DA
* do not take with ACE inhibitors/ARBs: inc renal impairment risk
* do not take with glucocorticoids: b/c inc risk of GI bleed
* give PPI or H2RA if pt at high risk for bleeding
* discontinue before major surgery
* be careful if taking anticoagulants
38
Aspirin: specific nursing implications
* discard any that smells like vinegar
* can cause salicylism
* educate about S/S: tinnitus, sweating, headache, dizziness
* avoid aspirin in children due to risk of Reye's Syndrome
* use acetaminophen instead
* take about 2 hours _before_ another NSAID b/c otherwise, NSAID antagonizes anti-platelet effect of aspirin and decreases protection for MI/stroke
* aspirin toxicity is an emergency:
* tx: external cooling, fluids to correct dehydration/electrolyte loss, infusion of bicarb to reverse acidosis, ventilation
39
Prednisone: Class
glucocorticoids
40
Prednisone: MOA
* anti-inflammatory:
* inhibit synthesis of chemical mediators (PG, histamine, LT)
* reduce swelling, warmth, redness, pain
* suppress infiltration of phagocytes, so damage from lysosomal enzymes averted
* immunosuppressive
* proliferation of lymphocytes
41
Prednisone: Indication
* RA: reduce inflammation and pain
* SLE
* IBD: ulcerative colitis, Crohn's
* bursitis, tendinitis, OA
* allergic rxns: rhinitis, bee stings
* asthma
* skin dz
* neoplasms
* suppression of allografts
* prevention of respiratory distress syndrome in preterm infants
42
Prednisone: SE
* osteoporosis
* infection: especially Pneumocystic pneumonia
* glucose intolerance
* myopathy, muscle weakness
* fluid and electrolyte disturbance--\>HTN, edema
* growth delay (in children)
* psychological disturbances: insomnia, anxiety
* cataracts, glaucomas
43
Prednisone: ADRxns
* adrenal insuffiency
* psychological disturbances: hallucinations, suicide
* peptic ulcer dz
* b/c inhibits PG synthesis
* Cushing's
* moon face, buffalo hump, potbelly, hyperglycemia, osteoporosis, muscle wasting
* thromboembolism
44
Prednisone: Nursing Implications
* contraindicated for those with systemic fungal infections and receiving live virus vaccines
* **DO NOT drink with grapefruit juice**
* **avoid taking aspirin and acetaminophen with it**
* should be taken with food to prevent gastritis
* **do not stop abruptly**
* inform pts about early signs of infection: fever, sore throat
* educate pt about S/S of fluid retention (weight gain, swelling of extremities) and hypokalemia (muscle weakness, irregular pulse, cramping)
* notify doc if vision becomes cloudy, blurred
* notify doc if black, tarry stool
* notify pt about possible psychologic rxns
* watch for signs of compression fractures and fractures of other bones
* take w/ Ca and vitamin D to prevent osteoporosis
* also should have bone scans
* evaluate growth of children
* pt should receive eye exams
* watch for signs of hyperglycemia
* watch for thinning of the skin, especially in older pts
45
Diphenhydramine: Class
Antihistamines
46
Diphenhydramine: MOA
* H1 Receptor Antagonist
47
Diphenhydramine: Indications
* sneezing
* rhinorrhea
* nasal itching
* allergic rhinitis
48
Diphenhydramine: SE
* sedation
* anticholinergic effects: dry mouth, constipation, urinary hesitancy, blurred vision (b/c of pupil paralysis), HTN, tachycardia
* anorexia
49
Diphenhydramine: Nursing Implications
* does not work against common cold
* more effective if taken prophylactically, before symptoms begin
* should be administered on regular basis throughout allergy season
* have to be careful when giving to older adults, b/c it may inc risk of falls
50
name the H2 Receptor Antagonists
* cimetidine
* ranitidine
* famotidine
51
name commonalities among H2 Receptor Antagonists
* MOA: suppression of gastric acid from parietal cells
* indication: gastric and duodenal ulcers
52
Cimetidine: Class
* H2 Receptor Antagonist
53
Cimetidine: MOA
* when H2 receptors are activated, then gastric acid secretion is promoted
* so cimetidine acts by reducing volume of gastric juice and its hydrogen ion concentration, suppresses acid secretion
54
Cimetidine: Indications
* gastric and duodenal ulcers
* GERD
* Zollinger Ellison Syndrome (hypersecretory syndromes)
* aspiration pneuomonitis: aspiration of gastric acid
* occurs in surgery b/c anesthesia suppresses glottal reflex so the gastric acid goes to lungs
* OTC: heartburn, acid indigestion, sour stomach
55
Cimetidine: SE
* antiandrogenic effects: gynecomastia, reduced libido, impotence
* CNS effects: confusion, hallucinations, CNS depression (lethargy), CNS stimulation (restlessness, seizures)
* pneumonia: when acidity is dec, bacterial colonization inc
56
Ranitidine: differences from cimetidine
* more potent
* fewer ADRxns
* fewer drug rxns
57
Ranitidine: Class
H2 Receptor Antagonists
58
Ranitidine: MOA
* H2 receptor blocker that suppresses secretion of gastric acid from parietal cells
59
Ranitidine: Indications
* short term tx of gastric/duodenal ulcers
* prophylaxis of recurrent duodenal ulcers
* tx of ZE Syndrome: better than cimetidine
* tx of GERD
60
Ranitidine: SE
* rare CNS effects: b/c penetrates BBB poorly
* \*\*no antiandrogenic effects b/c does not bind to androgen Rs
61
Famotidine: Class
H2 Receptor Antagonists
62
Famotidine: MOA
* binds to H2 R and blocks it, so suppresses secretion of gastric acid
63
Famotidine: Indications
* tx and prevention of duodenal ulcers
* tx of gastric ulcers
* GERD
* ZE Syndrome (hypersecretory states)
* OTC: heartburn, acid indigestion, sour stomach
64
Famotidine: SE
* elevation of gastric pH may inc risk of pneumonia
* \*\*no antiandrogenic effects b/c does not bind to androgen Rs
65
H2 Receptor Antagonists: Nursing Implications
* may be taken w/o regard to meals
* make sure pt knows the dosing schedule
* avoid cigarettes and aspirin/NSAIDs
* advise pt to stop drinking b/c drinking exacerbates ulcer symptoms
* tell pts 5-6 small meals may be preferable to 3 larger meals
* educate pt about signs of GI bleed: black/tarry stools, coffee ground vomitus
* inform pt about S/S of respiratory infection, notify provider if these occur
* for PUD, need dx with visualization of ulcer and test for H. pylori
* inform pt that _cimetidine_ can cause anti-androgenic effects (gynecomastia, dec libido, ED) but reverses after drug withdrawal
* also can cause CNS effects--notify provider of this
66
Cyclosporine: Class
* immunosuppressants--calcineurin inhibitors
67
Cyclosporine--MOA
* binds to a protein, cyclophilin, to inhibit calcineurin which is needed to synthesize IL-2
* w/o IL-2, proliferation of B cells and cytolytic T cells is suppressed
68
Cyclosporine--Indications
* to prevent rejection of allogenic kidney, liver, and heart
* dispense with prednisone
* psoriasis
* RA
69
Cyclosporine: SE
* HTN
* tremor
* hirsutism
* leukopenia
* gynecomastia
* sinusitus
70
Cyclosporine--ADRxns
* nephrotoxicity
* infection
* hepatotoxicity
* lymphomas
* anaphylaxis
* seizures
* posterior reversible encephalopathy syndrome
* progressive multifocal leukoencephalopathy
* \*\*interaction w/ grapefruit juice--inhibits cyclosporine metabolism--\>inc risk for toxicity
71
Cyclosporine--Nursing Implications
* avoid if pregnant, inoculated with live virus vaccine, chickenpox, herpes zoster
* dispense oral liquid using specially calibrated pipette
* mix well with diluent and drink immediately
* refill container with diluent and drink to ensure ingestion of entire dose
* can mix with apple juice or OJ to improve taste
* DO NOT drink grapefruit juice
* inform pt about needing periodic tests for kidney fcn (BUN, creatinine) and liver fcn (bilirubin, LFTs)
* if creatinine level inc too high in the blood, then this is sign that the kidneys are failing
* inform pt about early signs of infection: fever, sore throat
* inform pt about possible increase growth in hair, but that this is reversible
* do not breast feed
* women of child-bearing age should be using mechanical contraception
72
Tacrolimus vs. Cyclosporine
* tacrolimus is somewhat more effective than cyclosporine but more chance of toxicity
73
Tacrolimus--Class
immunosuppressants--calcineurin inhibitor
74
Tacrolimus--MOA
* binds to protein (FKBP-12) which then inhibits calcineurin, so IL-2 and IFN gamma are suppressed--\>inhibits proliferation of B cells and cytotoxic T cells
75
Tacrolimus--indications
* to prevent allogenic organ rejection of liver, kidney, and heart transplants
* administer with glucocorticoids
76
Tacrolimus--SE
* GI effects: diarrhea, nausea, vomiting
* HTN
* hyperkalemia
* hyperglycemia
* hirsutism
* paresthesia
77
Tacrolimus--ADRxns
* nephrotoxicity
* neurotoxicity: headache, tremor, insomnia
* anaphylaxis (if did IV administration)
* infection
* lymphomas
* posterior reversible encephalopathy syndrome (PRES)
* seizures
* \*\*metabolized by CYP3A4, and grapefruit juice inhibits this enzyme, so if drink grapefruit juice, then there will be inc circulating levels of tacrolimus
78
name the immunosuppressant--cytotoxic medications
* azathioprine
* mycophenolate
79
name the commonalities among the immunosuppresant cytotoxic drugs
* MOA: suppress immune response by killing B and T cells undergoing proliferation
* SE:
* bone marrow suppression
* GI distress
* reduced fertility
* alopecia
80
Azathioprine--Class
immunosuppressants: cytotoxic drugs
81
Azathioprine--MOA
* suppresses immune response by inhibiting proliferation of B and T cells
* **nonspecific**: toxic to all proliferating cells
82
Azathioprine--Indications
* used with cyclosporine and glucocorticoids to suppress transplant rejection
* severe refractory RA in non pregnant adults
* autoimmune dz
83
Azathioprine--SE
* GI distress: nausea, vomiting
* alopecia
* reduced fertility
* anemia
84
Azathioprine--ADRxns
* bone marrow suppression--\>neutropenia and thrombocytopenia
* pancreatitis
* blood dyscrasias
* neoplasms
* progressive multifocal leukoencephalopathy
* malignancy
* serum sickness
85
Azathioprine--Nursing Implications
* take CBC of pt for baseline before use
* avoid during pregnancy
86
Mycophenolate--Class
Immunosuppressants--cytotoxic drugs
87
Mycophenolate--MOA
* **selective** inhibitor of B and T cell proliferation
* mycophenolate is converted to mycophenolic acid (MPA)--\>inhibits inosine monophosphase dehydrogenase (which is required to synthesize purines)--\>inhibits B and T cell proliferation
88
Mycophenolate--indications
* to prevent rejection of allogenic heart, liver, kidney
* administered with cyclosporine and glucocorticoids
89
Mycophenolate--SE
* GI distress: diarrhea, vomiting
* alopecia
* reduced fertility
* paresthesia
* anxiety
* dizziness
90
Mycophenolate--ADRxns
* bone marrow suppression--\>**severe** neutropenia, thrombocytopenia
* sepsis: cytomegalovirus viremia
* pure red cell aplasia
* neoplasms
* infection
* progressive multifocal leukoencephalopathy (PML)
* GI bleed
91
Mycophenolate--Nursing Implications
* avoid during pregnancy
* do pregnancy test before medication administration
* women should use 2 reliable forms of contraception
* CBC should be done before administration
92
Interferon Beta 1A--Class
Immunomodulators--Multiple Sclerosis
93
Interferon Beta 1A--MOA
* inhibits migration of pro-inflammatory leukocytes across BBB, so prevents them from reaching CNS
* suppresses helper T cell activity
94
Interferon Beta 1A--Indications
* relapsing MS
* decreases freq of attacks, reduces size and number of MRI lesions, delays progression of disability
* secondary progressive MS
95
Interferon Beta 1A--SE
* flu like rxns--headache, fever, chills, malaise, muscle aches, stiffness
* will diminish
* minimized by: starting low dose and titrating up, giving analgesic/antipyretic med (NSAID)
* injection site rxns--pain, erythema, rash, itching
* can minimize by: rotating injection site, apply ice, apply warm compress
* help with itching with oral diphenhydramine or topical hydrocortisone
* depression
* neutralizing Abs
96
Interferon Beta 1A--ADRxns
* hepatoxicity
* myelosuppression--suppress bone marrow fcn--\>dec production of all blood cell types
* drug interactions--w/ any drug that suppresses bone marrow or causes liver injury
97
Interferon Beta 1A--Nursing Implications
* obtain baseline liver fcn and CBC
* also check throughout therapy
* don't use in those who abuse alcohol or have liver dz
* instruct pt to store drug in fridge, teach to self inject, advise them to rotate injection site
* if flu like rxn, pt can take analgesic-antipyretic med
* if injection rxn:
* can minimize by: rotating injection site, apply ice, apply warm compress
* help with itching with oral diphenhydramine or topical hydrocortisone
* don't use hydrocortisone continuously b/c skin damage may occur
98
Cimetidine: ADRxns
* arrhythmias
* agranulocytosis
* aplastic anemia
99
Ranitidine: ADRxns
* arrhythmias
* agranulocytosis
* aplastic anemia
100
Famotidine: ADRxns
* arrhythmias
* agranulocytosis
* aplastic anemia
101
Misoprostol--Class
PG E1 analog, anti-ulcer drug
102
Misoprostol--MOA
* prevents NSAID induced ulcers by acting as a replacement for endogenous PG
* PGs protect stomach by suppressing secretion of gastric acids and promotes secretion of bicarbonate and protective mucous
103
Misoprostol--Indications
* prevention of gastric ulcers caused by long term therapy with NSAIDs
* w/ mifepristone, can induce medical termination of pregnancy
104
Misoprostol--SE
* dose related diarrhea
* abdominal pain
* spotting
* dysmenorrhea
105
Misoprostol--ADRxns
* miscarriage
106
Misoprostol--Nursing Implications
* women of child bearing age must:
* be able to comply with birth control
* be given oral/written warnings about the dangers
* have a negative serum pregnancy test result w/in 2 weeks before beginning therapy
* begin therapy only on 2nd or 3rd day of next normal menstrual cycle
107
Metoprolol--Class
2nd generation beta blockers
108
Metoprolol--MOA
* selective blockade of beta 1 receptors in the heart
* usually does not block beta 2
109
Metoprolol--Indications
* HTN
* angina pectoris
* heart failure
* MI
110
Metoprolol--SE
* fatigue
* weakness
* erectile dysfunction
111
Metoprolol--ADRxns
* bradycardia
* heart failure (if use incautiously)
* pulmonary edema
* reduced cardiac output
* AV heart block
* rebound cardiac excitement (w/ abrupt withdrawal)
112
Metoprolol--Nursing Implications
* contraindicated in those with sinus bradycardia, AV block greater than 1st degree
* use carefully in heart failure pts
* safer than propranolol in pts with asthma and severe allergic rxns b/c only minimally binds to beta 2
* safer in diabetics than propranolol
* but will mask common signs of hypoglycemia so need to watch for other signs like hunger, fatigue, and poor concentration
* do not stop abruptly
* pts should know about early signs of heart failure: shortness of breath, night coughs, swelling of extremities
113
Metoclopramide--Class
Prokinetic drugs: inc tone and motility of GI tract
114
Metoclopramide--Indications
* used for chemotherapy induced vomiting and chronic constipation
* **NOT A LAXATIVE**
* PO:
* diabetic gastroparesis
* suppression of GERD
* IV:
* suppression of post op nausea and vomiting
* suppression of CINV
* facilitation of small bowel intubation
* facilitation of radiologic exam of GI tract
115
Metoclopramide--SE
* diarrhea
* sedation
116
Metoclopramide--ADRxns
* tardive dyskinesia: repetitive involuntary movements of the arms, legs, facial muscles
* especially in older adults
* so tx should be as short as possible
117
Metoclopramide--Nursing Implications
* tx should be as short as possible to prevent tardive dyskinesia
* contraindicated in pts with GI obstruction, perforation, or hemorrhage
118
Magnesium Sulfate--Class
Tocolytic drug
119
Magnesium Sulfate--MOA
* inhibits release of acetylcholine at neuromuscular junction both in uterus and skeletal M
* smooth muscle relaxer
120
Magnesium Sulfate--Indication
* suppression of preterm labor by suppressing contractions
* prevention and tx of seizures associated with eclampsia and pre-eclampsia
121
Magnesium Sulfate--SE
* transient hypoTN
* flushing
* headache
* dizziness
* lethargy
* dry mouth
* feeling of warmth
122
Magnesium Sulfate--ADRxns
* hypothermia
* paralytic ileus
* pulmonary edema
* in infants:
* infant mortality: if used in high doses b/c drug readily crosses placenta
* hypotonia (muscle weakness)
* may last 3-4 days and may need mechanical ventilation during this time
* sleepiness
123
Magnesium Sulfate--Nursing Implications
* low dose may offer benefit of neuroprotection (from cerebral palsy)
* high dose can cause inc risk of infant mortality
* if get pulmonary edema, need to discontinue immediately and give diuretic to accelerate magnesium excretion
* contraindicated in pts with myasthenia gravis, renal failure, hypocalcemia
124
Acetaminophen--Class
analgesic, antipyretic
125
How is acetaminophen different from aspirin?
* acetaminophen is not an anti-inflammatory or anti-rheumatic
* could be b/c it only inhibits COX in CNS while aspirin does it in CNS and PNS
* does not suppress platelet aggregation, cause GI ulcers, or lead to renal impairment
126
Acetaminophen--indication
* fever
* mild to moderate pain
* in children with chickenpox/flu
127
Acetaminophen--MOA
* inhibit COX (but only in CNS)--\>inhibit PG synthesis
128
Acetaminophen--SE
* HTN (if more than 500 mg/day)
* asthma
129
Acetaminophen--ADRs
* liver injury (if overdose)
* anaphylaxis
* Stevens Johnson Syndrome
* acute generalized exanthematous pustulosis (AGEP)
* toxic epidermal necrolysis
130
Acetaminophen--nursing implications
* if drink alcohol regularly, consume no more than 2000 mg/day (same for those with liver damage)
* should not drink 3+/day
* may inhibit warfarin metabolism--\>inc risk of bleeding
* monitor if taking warfarin and more than 1 g of acetaminophen/day
* monitor BP
* inform pts about S/S of anaphylaxis: trouble breathing and swelling of face, mouth, throat
* consume no more than 4000 mg/day (total)
* if undernourished, consume no more than 3000 mg/day total
* antidote is acetylcysteine
