Medications Flashcards
(116 cards)
1
Q
Levophed (Norepinephrine)
A
Adrenergics - used for cardiac arrest, COPD
vasoconstrictor to increase blood pressure and cardiac output
- reflex bradycardia may occur with rise in BP
- pt should be attended at all times
- monitor urinary output
- infuse with dextrose not saline
- monitor blood pressure
- protect med from light
S/E: headache, palpitations, nervousness, epigastric distress, angina, hypertension tissue necrosis with extravasation
2
Q
Intropin (Dopamine)
A
Adrenergics - used for cardiac arrest, COPD
low dose - dilates renal and coronary arteries
high does - vasoconstrictor, increases myocardial oxygen consumption
monitor blood pressure, peripheral pulse, urinary output
headache early symptom of excess drug
S/E: increased ocular pressure, ectopic beats, nausea, tachycardia, chest pain, dyshrythmias
3
Q
Pyridium (phenazophyridine)
A
urinary tract analgesic
S/E: headache, vertigo
Nursing:
• Urinary tract analgesic
• Tell pt urine will be orange
4
Q
Furadantin (nitrofurantoin)
A
anti-infective
S/E: asthma attacks, diarrhea
Nursing:
• Anti-infective
• Give with food or milk
• Monitor pulmonary status
• Taken with cranberry juice – helps it to work
• Don’t eat alcoline foods – almond, coconut, milk, some veggies
5
Q
Heprin
A
Uses – pulmonary embolism, venous thrombosis, prophylaxis after acute MI
Action – blocks conversion of prothrombin to thrombin
S/E: heamturia, tissue irritaion
Nursing: • Monitor clotting time or partial thromboplastin time (PTT) • Normal 20-45 sec • Therapetic level 1.5-2.5 times control • Antagonist – protamine sulfate • Give SC or IV
6
Q
Coumadin (warfarin)
A
Uses- pulmonary embolism, venous thrombosis, phrphylaxis after acute MI
Action – interferes with synthesis of vitamin K-dependent clotting factors
S/E: hemorrhage, alopecia
Nursing:
• Monitor prothrombin test (PT)
• Normal 9-12
• Therapeutic level 1.5 times control
• Antagonist – vitamin K (Aquamephyton)
• Monitor for bleeding
• Give PO
• Avoid aspirin and NSAIDs
• Watch foods that have vitamin K (green veggies, pork, rice, some cheese, fish, milk)
• Vitamin C will decrease effectiveness of med
• Vitamin E will increase effectiveness of med
• Garlic gingko, and ginger will increase
7
Q
Dilatin
A
anticonvulsant
o if given too quickly can cause cardiac arrest
o turns urine pink
o can’t be mixed with any other med
8
Q
Mag sulfate
A
anticonvulsant
o commonly used in OB
o deep tendon reflexes must be evaluated
o respiratory arrest
9
Q
Lispro
A
rapid acting insulin
Onset – 15-20mins
Peak - 30 mins - 2.5 hrs
Duration – 3-6 hrs
pt should eat within 5-15 min after injection
10
Q
Aspart
A
rapid acting insulin
Onset – 10 - 20 mins
Peak - 1-3 hrs
Duration – 3 hrs
pt should eat within 5-15 min after injection
11
Q
Glulisine
A
rapid acting insulin
Onset – 10-15 mins
Peak - 1-1.5hrs
Duration – 3-5 hrs
pt should eat within 5-15 min after injection
12
Q
Regular/Humulin R insulin
A
Short acting
Onset – 30min-1hrs
Peak - 2-4 hrs (when worry about hypoglycemia)
Duration – 6-8 hrs
only regular insulin can be given IV
clear insulin - can be mixed with others
13
Q
Isophane
A
(NPH) Intermediate-acting insulin
Onset – 1- 2 hrs
Peak – 6-14 hrs
Duration – 16 hrs
14
Q
Insulin detemir
A
Intermediate-acting insulin
Onset – 1-2 hrs
Peak - 12-24
Duration – varies
15
Q
Humulin N
A
Intermediate-acting
Onset – 2 hrs
Peak – 6-12 hrs
Duration – 18-26 hrs
16
Q
Glargine (Lantus)
A
long acting insulin
Onset – 3-4 hrs
Peak – continuous (no peak)
Duration – 24hrs
cannot be mixed with other insulins
17
Q
Ultralente
A
Slow acting insulin
Onset – 4 hrs
Peak – 8-20 hrs
Duration – 24-36 hrs
18
Q
Humulin U
A
Slow acting insulin
Onset – 4 hrs
Peak – 8-20 hrs
Duration – 24-36 hrs
19
Q
Humulin 70/30
A
combination insulin
Onset – 30 mins
Peak – 2-12 hrs
Duration 24 hrs
20
Q
Epinephrine
A
Adrenergics - used for cardiac arrest, COPD
stimulates alpha and beta adrenergic receptors
- monitor BP
- ensure adequate hydration
- carefully aspirate syringe before IM and subQ doses
- always check strength
1: 100 inhalation
1: 1,000 SubQ or IM
S/E: nervousness, restlessness, dizziness, local necrosis of skin
21
Q
GlucaGen (glucagon)
A
Uses – hypoglycemia
Action – stimulates liver to change glycogen to glucose
S/E: hypotension, bronchospasm
Nursing:
• May repeat in 15 min
• Give carbohydrates orally to prevent secondary hypoglycemic reactions
22
Q
Lithium
A
– salt – dosages change all the time, blood drawn every 2-3 weeks, fluids are important 3000 ml/day, dehydration will cause severe response, evaluated every 2 weeks
given for manic phase of bipolar
23
Q
Tegretol
A
– mood stablizer given for bipolar, watch kidney and liver function
24
Q
Depakote
A
mood stablizer given over time for bipolar
25
Echinacea
Herbal
Immunostimulant: prevent and treat colds/flu/UTI and wound healing
S/E: Allergic reaction, N/V, tingling of tongue
Nursing:
o Decreases effectiveness of immunosuppressant
o Avoid if allergic to ragweed or daisies
26
Garlic:
herbal
antimicrobial, antilipidemic, antithrombotic, antitumor, anti-inflammatory
S/E: flatulence, heartburn, irritation of mouth, esophagus, and stomach, allergic reaction
Nursing:
• May potentiate anticoagulant and antiplatelets, antihyperlipidemics, antihypertensives, antidiabetic
• May decrease oral contraception
27
Chondroitin:
herbal
Collagen synthesis
Dyspepsia, nausea, potentiate anticoagulants
28
Glucosamine:
herbal
Collagen synthesis
Dyspepsia, nausea
Impedes insulin secretion or increase insulin resistance
29
Capsium/Cayenne Pepper
Herbal
Analgesia, circulation, nerve pain, PVD
S/E: GI discomfort, burning pain in eyes nose mouth, bronchospasm
Nursing:
• May decrease effectiveness of antihypertensive
• Increase risk of cough with ACE inhibitors
• Potentiate antiplatelets
• Hypertensive crisis on MAOI
• Increase theophylline absorption
30
St John’s Wart
Herbal
Antidepressant, sedative, antiviral, antimicrobial
S/E: photosensitivity, fatigue, allergic reaction, restlessness
Nursing:
• Decreases effectiveness of digoxin, antineoplastics, antivirals, AIDS meds, antirejection meds, theophylline, Coumadin, oral contraceptives!!
31
Epinephrine (adrenaline)
Adrenergics - used for cardiac arrest, COPD
- stimulates alpha and beta adrenergic receptors
- monitor BP
- aspirate before IM and SQ
- check strength 1:100 (inhalation), 1:1,000 (SQ or IM)
- ensure adequate hydration
S/E: nervousness, restlessness, dizziness, local necrosis of skin
32
Isoproterenol (Isuprel)
stimulates beata 1 and beta 2 adrenergic receptors
used for heart block, ventricular arrhythmias, and bradycardia
bronchodilatior used for asthma and bronchospasms
- don't give at hs - interrupts sleep patterns
- monitor pulse, bp
S/E: headache, palpitations, tachycardia, BP changes, angina, bronchial asthma
33
Phenylephrine (Neo-Synephrine)
potent alpha 1 agonist
used to treat hypotension
S/E: palpitaitons, tachycardia, hypertension, dysrhythmias, angina, tissue necrosis with extravasation
34
Dobutamine hydrocholoride (Dobutrex)
stimulates beat 1 receptors
- incompatible with alkaline solutions (Sodium Bicarb)
- admin through central line or large peripheral vein
- don't infuse through line with other meds
- monitor EKG, BP, I&O, serum potassium
S/E: hypertension, PVCs, Asthmatic episodes, headache
35
Milrione (Primacor)
positive inotropic agent
smooth muscle relaxant used to treat severe heart failure
S/E: dysrhythmia, throbocytopenia, jaundice
36
Sodium nitroprusside (Nitropress)
Dilates cardiac veins and arteries
decreases preload and afterload
increases myocardial perfusion
S/E: hypotension
37
Diphenhydramine Hcl
(Benedryl)
blocks affects of histamines in bronchioles, GI tract, and blood vessels
S/E: drowsiness, confusion, insomnia, headache, vertigo, photosensitivity
38
Chloradiazepoxide (Librium)
Benzodiazepine
CNS depressant
Uses - anxiety, sedation, alcohol withdrawal, seizures
- may result in toxic build-up in the elderly
- potential for addiction
- can develop tolerance and cross-tolerance
- smoking increases clearance of drug
- alcohol increases CNS depression
S/E: lethargy, hangover, respiratory depression, hypotension
39
Diazepam (Valium)
Benzodiazepine
CNS depressant
Uses - anxiety, sedation, alcohol withdrawal, seizures
- may result in toxic build-up in the elderly
- potential for addiction
- can develop tolerance and cross-tolerance
- smoking increases clearance of drug
- alcohol increases CNS depression
S/E: lethargy, hangover, respiratory depression, hypotension
40
Alprazolam
(Xanax) Benzodiazepine
CNS depressant
- safer for elderly
- don't combine with alcohol or other depressants
- check renal and hepatic function
- don't dc abruptly
- teach addictive potential
S/E: drowsiness, light-headedness, hypotension, hepatic dysfunction, increased salivation, orthostatic hypotension, memory impairment and confusion
41
Clonazepam (Klonopin)
Benzodiazepine
CNS depressant
- safer for elderly
- don't combine with alcohol or other depressants
- check renal and hepatic function
- don't dc abruptly
- teach addictive potential
S/E: drowsiness, light-headedness, hypotension, hepatic dysfunction, increased salivation, orthostatic hypotension, memory impairment and confusion
42
Lorazepam
(Ativan) Benzodiazepine
CNS depressant
- safer for elderly
- don't combine with alcohol or other depressants
- check renal and hepatic function
- don't dc abruptly
- teach addictive potential
S/E: drowsiness, light-headedness, hypotension, hepatic dysfunction, increased salivation, orthostatic hypotension, memory impairment and confusion
43
Oxazepam (Serax)
Benzodiazepine
CNS depressant
- safer for elderly
- don't combine with alcohol or other depressants
- check renal and hepatic function
- don't dc abruptly
- teach addictive potential
S/E: drowsiness, light-headedness, hypotension, hepatic dysfunction, increased salivation, orthostatic hypotension, memory impairment and confusion
44
Midazolam (Versed)
Benzodiazepine
CNS depressant
uses - preoperative sedation, conscious sedation for endoscopic procedures and diagnostic tests
S/E: retrograde amnesia, euphoria, hypotension, dysrhythmias, cardiac arrest, respiratory depression
45
Buspirone (Buspar)
Nonbenzo antianxiety agent
- little sedation
- requires 3 weeks to be effective
- cannot be given as PRN med
- particularly useful for generalized anxiety disorder
- no abuse potential - used for pts with previous addiction
- avoid alcohol and grapefruit juice
- monitor for worsening depression/suicidal thoughts
S/E: light headedness, confusion, hypotension, palpitations
46
Hydroxyzine (Vistaril) (Atarax)
Nonbenzo antianxiety agent
- produces no dependence, tolerance, or intoxication
- can be used for anxiety relief for indefinite periods
S/E: Drowsiness, ataxia, Leukopenia, hypotension
47
Kava
Herbal - similar to benzodiazepines
suppresses emotional excitability and produces mild euphoria
- do not take with CNS depressant
- should not be taken by women or are pregnant, lactating, or children under 12
S/E: impaired thinking, judgement, motor reflexes, vision, decreased plasma proteins, thrombocytopenia, leukocytopenia, dyspnea, and pulmonary HTN
48
Melatonin
Herbal
influences sleep-wake cycles (levels are high during sleep)
used for prevention and tx of jet lag and insomnia
- use cautiously if given with benzo and CNS depressant
- contraindicated in hepatic insufficiency, history of cerebrovascular disease, depression, and neurologic disorders
S/E: sedation, confusion, headache, and tachycardia
49
Aluminum hydroxide gel (Amphojel)
Antacid - for peptic ulcer, indigestion (prevent or treat), reflex esophagitis
action - neutralize gastric acids
- monitor bowel pattern
- compounds contain sodium - make sure not on Na restricted diet
- aluminum and magnesium antacid interfere with tetracycline absorption
- encourage fluids
- monitor for signs of phosphate deficiency - malaise, weakness, tremors, bone pain
- shake well
- careful use advised for kidney dysfunction
S/E: constipation that may lead to impaction, phosphate depletion
50
Calcium carbonate (titralac)
Antacid - for peptic ulcer, indigestion (prevent or treat), reflex esophagitis
action - neutralize gastric acids
- monitor bowel pattern
- compounds contain sodium - make sure not on Na restricted diet
- encourage fluids
- monitor for signs of phosphate deficiency - malaise, weakness, tremors, bone pain
- shake well
- careful use advised for kidney dysfunction
S/E: constipation that may lead to impaction, phosphate depletion
51
Aluminum hydroxide and magnesium trisilicate
Antacid - for peptic ulcer, indigestion (prevent or treat), reflex esophagitis
action - neutralize gastric acids
- monitor bowel pattern
- compounds contain sodium - make sure not on Na restricted diet
- aluminum and magnesium antacid interfere with tetracycline absorption
- encourage fluids
- monitor for signs of phosphate deficiency - malaise, weakness, tremors, bone pain
- shake well
- careful use advised for kidney dysfunction
S/E: constipation that may lead to impaction, phosphate depletion
52
Magnesium hydrodoxide
(Milk of Magnesia) Antacid - for peptic ulcer, indigestion (prevent or treat), reflex esophagitis
action - neutralize gastric acids
- store at room temp with lid tight to prevent absorption of CO2
- prolonged and frequent use of cathartic dose can lead to dependence
- administer with caution to pt with renal disease
S/E: nausea, vomiting, diarrhea
53
aluminum hydroxide and magnesium hydroxide
(Maalox) Antacid - for peptic ulcer, indigestion (prevent or treat), reflex esophagitis
action - neutralize gastric acids
- encourage fluid intake
- administer with caution to pts with renal disease
S/E: slight laxative effect
54
Procainamide (Pronestyl)
Antidysrhythmic - Decrease myocardial irritability
- monitor bp
- monitor for widening of the PR, QRS, or QT intervals
S/E: hypotension, HF
55
Disophramine (Norpace)
Antidysrhythmic - Decrease myocardial irritability
- monitor bp
- monitor for widening of the PR, QRS, or QT intervals
S/E: hypotension, HF
56
Lidocaine (xylocaine)
Antidysrhythmic - Decrease myocardial irritability
- monitor for CNS side effects
- monitor BP and heart rate and cardiac rhythm
S/E: slurred speech, confusion, drowsiness, seizures, hypotension, bradycardia
57
Mexiletine hydrochloride (Mexitil)
Antidysrhythmic - Decrease myocardial irritability
- monitor for CNS side effects
- monitor BP and heart rate and cardiac rhythm
S/E: slurred speech, confusion, drowsiness, seizures, hypotension, bradycardia
58
Tocainide hydrochloride (Tonocard)
Antidysrhythmic - Decrease myocardial irritability
- monitor for CNS side effects
- monitor BP and heart rate and cardiac rhythm
S/E: slurred speech, confusion, drowsiness, seizures, hypotension, bradycardia
59
Flecainide (Tambocor)
Antidysrhythmic - Decrease myocardial irritability
- monitor for increasing dysrhythmias
- monitor heart rate and blood pressure
- monitor for CNS effects
S/E: bradycardia, hypotension, dysrhytmias
CNS: anxiety, insomnia, confusion, seizures
60
propafenone hydrochloride (Rythmol)
Antidysrhythmic - Decrease myocardial irritability
- monitor for increasing dysrhythmias
- monitor heart rate and blood pressure
- monitor for CNS effects
S/E: bradycardia, hypotension, dysrhytmias
CNS: anxiety, insomnia, confusion, seizures
61
Propanolol (Inderal)
Antidysrhythmic - Decrease myocardial irritability
- monitor apical heart rate, cardiac rhythm and blood pressure
- assess for SOB and wheezing
- assess for fatigue, sleep disturbances
- assess apical pulse 1 min before administration
S/E: bradycardia, hypotension, bronchospasm, increase in HF, fatigue and sleep disturbances
62
Acebutolol (Sectral)
Antidysrhythmic - Decrease myocardial irritability
- monitor apical heart rate, cardiac rhythm and blood pressure
- assess for SOB and wheezing
- assess for fatigue, sleep disturbances
- assess apical pulse 1 min before administration
S/E: bradycardia, hypotension, bronchospasm, increase in HF, fatigue and sleep disturbances
63
Esmolol hydrochloride (Brevibloc)
Antidysrhythmic - Decrease myocardial irritability
- monitor apical heart rate, cardiac rhythm and blood pressure
- assess for SOB and wheezing
- assess for fatigue, sleep disturbances
- assess apical pulse 1 min before administration
S/E: bradycardia, hypotension, bronchospasm, increase in HF, fatigue and sleep disturbances
64
Sotalol hydrochloride (Betapace)
Antidysrhythmic - Decrease myocardial irritability
- monitor apical heart rate, cardiac rhythm and blood pressure
- assess for SOB and wheezing
- assess for fatigue, sleep disturbances
- assess apical pulse 1 min before administration
S/E: bradycardia, hypotension, bronchospasm, increase in HF, fatigue and sleep disturbances
65
Amiodarone hydrochloride (Cordarone)
Antidysrhythmic - Decrease myocardial irritability
- continuous monitoring of cardiac rhythm during IV administration
- monitor QT interval during IV administration
- monitor heart rate, blood pressure during initiation of therapy
- instruct client to wear sunglasses and sunscreen
S/E: hypotension, bradycardia and atrioventricular block, muscle weakness, tremors, photosensitivity and photophobia, liver toxicity
66
Ibutilide fumarate (Corvert)
Antidysrhythmic - Decrease myocardial irritability
- continuous monitoring of cardiac rhythm during IV administration
- monitor QT interval during IV administration
- monitor heart rate, blood pressure during initiation of therapy
- instruct client to wear sunglasses and sunscreen
S/E: hypotension, bradycardia and atrioventricular block, muscle weakness, tremors, photosensitivity and photophobia, liver toxicity
67
Dofetilide (Tikosyn)
Antidysrhythmic - Decrease myocardial irritability
- continuous monitoring of cardiac rhythm during IV administration
- monitor QT interval during IV administration
- monitor heart rate, blood pressure during initiation of therapy
- instruct client to wear sunglasses and sunscreen
S/E: hypotension, bradycardia and atrioventricular block, muscle weakness, tremors, photosensitivity and photophobia, liver toxicity
68
Verapamil (Calan)
Antidysrhythmic - Decrease myocardial irritability
- monitor apical heart rate and blood pressure
- instruct clients about orthostatic precautions
- instruct pts to repoart signs of HF to MD
S/E: bradycardia, hypotension, dizziness, orthostatic hypotension, HF
69
Ditiazem hydrochloride (Cardizem)
Antidysrhythmic - Decrease myocardial irritability
- monitor apical heart rate and blood pressure
- instruct clients about orthostatic precautions
- instruct pts to repoart signs of HF to MD
S/E: bradycardia, hypotension, dizziness, orthostatic hypotension, HF
70
Gentamicin (Garamycin)
Aminoglycosides - antibiotic
Uses – Pseudomonas, E. coli
Action – inhibits protein synthesis in gram-negative bacteria
S/E: ototoxicity (ears), anorexia, nausea, vomiting, diarrhea, nephrotoxic (kidneys)
Nursing:
• Check 8th cranial nerve (hearing)
• Check renal function (BUN, urinary output 1200 ml per day)
• Take 7-10 days – until med complete
71
Neomycin
Aminoglycosides - antibiotic
Uses – Pseudomonas, E. coli
Action – inhibits protein synthesis in gram-negative bacteria
S/E: ototoxicity (ears), anorexia, nausea, vomiting, diarrhea, nephrotoxic (kidneys)
Nursing:
• Check 8th cranial nerve (hearing)
• Check renal function (BUN, urinary output 1200 ml per day)
• Take 7-10 days – until med complete
72
Sreptomycin
Aminoglycosides - antibiotic
Uses – Pseudomonas, E. coli
Action – inhibits protein synthesis in gram-negative bacteria
S/E: ototoxicity (ears), anorexia, nausea, vomiting, diarrhea, nephrotoxic (kidneys)
Nursing:
• Check 8th cranial nerve (hearing)
• Check renal function (BUN, urinary output 1200 ml per day)
• Take 7-10 days – until med complete
73
Tobramycin (Tobrex)
Aminoglycosides - antibiotic
Uses – Pseudomonas, E. coli
Action – inhibits protein synthesis in gram-negative bacteria
S/E: ototoxicity (ears), anorexia, nausea, vomiting, diarrhea, nephrotoxic (kidneys)
Nursing:
• Check 8th cranial nerve (hearing)
• Check renal function (BUN, urinary output 1200 ml per day)
• Take 7-10 days – until med complete
74
Amikacin (Amikin)
Aminoglycosides - antibiotic
Uses – Pseudomonas, E. coli
Action – inhibits protein synthesis in gram-negative bacteria
S/E: ototoxicity (ears), anorexia, nausea, vomiting, diarrhea, nephrotoxic (kidneys)
Nursing:
• Check 8th cranial nerve (hearing)
• Check renal function (BUN, urinary output 1200 ml per day)
• Take 7-10 days – until med complete
75
Ceclor (Cefaclor),
Cephalosporin - antibiotic
Uses – tonsillitis, otitis media, peri-operative prophylaxis, meningitis, respiratory tract infections, UTIs
Action – inhibits synthesis of bacterial cell wall
S/E: bone marrow depression, super-infections, rash, increased risk of bleeding, abdominal pain
Nursing:
• Take with food – cause GI upset
• Cross allergy with PCN
• Avoid alcohol – can cause flushing, dizziness, and muscle aches
• Obtain C&S before first dose
• May give false positive for protienuria or glucose in urine
76
Ancef (cefazolin)
Cephalosporin - antibiotic
Uses – tonsillitis, otitis media, peri-operative prophylaxis, meningitis, respiratory tract infections, UTIs
Action – inhibits synthesis of bacterial cell wall
S/E: bone marrow depression, super-infections, rash, increased risk of bleeding, abdominal pain
Nursing:
• Take with food – cause GI upset
• Cross allergy with PCN
• Avoid alcohol – can cause flushing, dizziness, and muscle aches
• Obtain C&S before first dose
• May give false positive for protienuria or glucose in urine
77
Keflex (chephalexin)
Cephalosporin - antibiotic
Uses – tonsillitis, otitis media, peri-operative prophylaxis, meningitis, respiratory tract infections, UTIs
Action – inhibits synthesis of bacterial cell wall
S/E: bone marrow depression, super-infections, rash, increased risk of bleeding, abdominal pain
Nursing:
• Take with food – cause GI upset
• Cross allergy with PCN
• Avoid alcohol – can cause flushing, dizziness, and muscle aches
• Obtain C&S before first dose
• May give false positive for protienuria or glucose in urine
78
Ceftriaxone (Rocephin)
Cephalosporin - antibiotic
Uses – tonsillitis, otitis media, peri-operative prophylaxis, meningitis, respiratory tract infections, UTIs
Action – inhibits synthesis of bacterial cell wall
S/E: bone marrow depression, super-infections, rash, increased risk of bleeding, abdominal pain
Nursing:
• Take with food – cause GI upset
• Cross allergy with PCN
• Avoid alcohol – can cause flushing, dizziness, and muscle aches
• Obtain C&S before first dose
• May give false positive for protienuria or glucose in urine
79
Mefoxin (cefoxitin)
Cephalosporin - antibiotic
Uses – tonsillitis, otitis media, peri-operative prophylaxis, meningitis, respiratory tract infections, UTIs
Action – inhibits synthesis of bacterial cell wall
S/E: bone marrow depression, super-infections, rash, increased risk of bleeding, abdominal pain
Nursing:
• Take with food – cause GI upset
• Cross allergy with PCN
• Avoid alcohol – can cause flushing, dizziness, and muscle aches
• Obtain C&S before first dose
• May give false positive for protienuria or glucose in urine
80
Cefepime (Maxipime)
Cephalosporin - antibiotic
Uses – tonsillitis, otitis media, peri-operative prophylaxis, meningitis, respiratory tract infections, UTIs
Action – inhibits synthesis of bacterial cell wall
S/E: bone marrow depression, super-infections, rash, increased risk of bleeding, abdominal pain
Nursing:
• Take with food – cause GI upset
• Cross allergy with PCN
• Avoid alcohol – can cause flushing, dizziness, and muscle aches
• Obtain C&S before first dose
• May give false positive for protienuria or glucose in urine
81
Levofloxacin (Levequin)
Fluroroquinolones - antibiotic
Uses – E. coli, pseudomonas, S. aureaus
Action – interferes with DNA replication in gram-negative bacteria
S/E: diarrhea, decreased WBC and hematocrit, elevated liver enzymes (AST, ALT), elevated alkaline phosphate, elevated BUN, rash, photosensitivity, Achilles tendon rupture
Nursing:
• C&S before starting
• Encourage fluids 3000 ml per day
• Take 1 h ac or 2 h pc – not taken with food – will slow absorption
• Do not take with antacids or iron absorption
82
Ciprofloxacin (Cipro)
Fluroroquinolones - antibiotic
Uses – E. coli, pseudomonas, S. aureaus
Action – interferes with DNA replication in gram-negative bacteria
S/E: diarrhea, decreased WBC and hematocrit, elevated liver enzymes (AST, ALT), elevated alkaline phosphate, elevated BUN, rash, photosensitivity, Achilles tendon rupture
Nursing:
• C&S before starting
• Encourage fluids 3000 ml per day
• Take 1 h ac or 2 h pc – not taken with food – will slow absorption
• Do not take with antacids or iron absorption
83
Norfloxacin (Noroxin)
Fluroroquinolones - antibiotic
Uses – E. coli, pseudomonas, S. aureaus
Action – interferes with DNA replication in gram-negative bacteria
S/E: diarrhea, decreased WBC and hematocrit, elevated liver enzymes (AST, ALT), elevated alkaline phosphate, elevated BUN, rash, photosensitivity, Achilles tendon rupture
Nursing:
• C&S before starting
• Encourage fluids 3000 ml per day
• Take 1 h ac or 2 h pc – not taken with food – will slow absorption
• Do not take with antacids or iron absorption
84
Vancomycin
glycopeptides - antibiotic
binds to bacterial cell wall, stopping its synthesis
treatment of resistant staph infections, pseudomembranous enterocolitis due to c diff infections
S/E: thrombophlebitis, abscess formation, nephrotoxicity, ototoxicity
Nursing:
- Monitor renal function and hearing
- poor absorption orally; administer IV
- avoid extravastation during therapy; it may cause necrosis
- give antihistamine if "red man syndrome" - decreased blood pressure, flushing of face and neck
- contact MD if s/s of superinfection - sore throat, fever, fatigue
85
Clindamycin (Cleocin)
antibiotic - lincosamide
both bacteriostatic and bactericidal, suppresses protein synthesis by preventing peptide bond formation
S/E: diarrhea, rash, liver toxicity
nursing:
- admin PO with full glass of water to prevent esophageal ulcers
- monitor for persistent vomiting, diarrhea, fever, or abdominal pain, superinfections
86
Erthromycin (Erythrocin)
Macrolide antibiotic
blinds to cell membrane and causes changes in protein function
uses - acute infections, acne, skin infections, URIs, prophylaxis before dental procedures for pts allergic to PCN
S/E: abdominal cramps, diarrhea, confusion, uncontrollable emotions, hepatotoxicity, superinfection
nursing:
- take oral med 1 h before or 2-3 hrs after meals with full glass of water
- take around the clock to maximize effectiveness
- monitor liver function
- take full coarse
87
Azithromycin (Zithromax)
Macrolide antibiotic
blinds to cell membrane and causes changes in protein function
uses - acute infections, acne, skin infections, URIs, prophylaxis before dental procedures for pts allergic to PCN
S/E: abdominal cramps, diarrhea, confusion, uncontrollable emotions, hepatotoxicity, superinfection
nursing:
- take oral med 1 h before or 2-3 hrs after meals with full glass of water
- take around the clock to maximize effectiveness
- monitor liver function
- take full coarse
88
Amoxicillin (Amoxil)
antibiotic - penicillins
Uses – moderate to severe infections, syphilis, gonococcus infections, Lyme disease,
Action – inhibits synthesis of cell wall
S/E: stomatitis (breakdown in the mouth and along GI tract), diarrhea, allergic reactions, renal and hepatic changes
Nursing:
- Check for hypersensitivity - multiple exposures cause reaction
- Give 1-2 h ac or 2-3 h pc
- Cross allergy with cephalosporins
- Watch renal and hepatic labs
- culture and sensitivity before tx
- good mouth care
89
Ampicillin (Omnipen)
antibiotic - penicillins
Uses – moderate to severe infections, syphilis, gonococcus infections, Lyme disease,
Action – inhibits synthesis of cell wall
S/E: stomatitis (breakdown in the mouth and along GI tract), diarrhea, allergic reactions, renal and hepatic changes
Nursing:
- Check for hypersensitivity - multiple exposures cause reaction
- Give 1-2 h ac or 2-3 h pc
- Cross allergy with cephalosporins
- Watch renal and hepatic labs
- culture and sensitivity before tx
- good mouth care
90
Methicillin
antibiotic - penicillins
Uses – moderate to severe infections, syphilis, gonococcus infections, Lyme disease,
Action – inhibits synthesis of cell wall
S/E: stomatitis (breakdown in the mouth and along GI tract), diarrhea, allergic reactions, renal and hepatic changes
Nursing:
- Check for hypersensitivity - multiple exposures cause reaction
- Give 1-2 h ac or 2-3 h pc
- Cross allergy with cephalosporins
- Watch renal and hepatic labs
- culture and sensitivity before tx
- good mouth care
91
Nafcillin (Unipen)
antibiotic - penicillins
Uses – moderate to severe infections, syphilis, gonococcus infections, Lyme disease,
Action – inhibits synthesis of cell wall
S/E: stomatitis (breakdown in the mouth and along GI tract), diarrhea, allergic reactions, renal and hepatic changes
Nursing:
- Check for hypersensitivity - multiple exposures cause reaction
- Give 1-2 h ac or 2-3 h pc
- Cross allergy with cephalosporins
- Watch renal and hepatic labs
- culture and sensitivity before tx
- good mouth care
92
Penicillin G or V
antibiotic - penicillins
Uses – moderate to severe infections, syphilis, gonococcus infections, Lyme disease,
Action – inhibits synthesis of cell wall
S/E: stomatitis (breakdown in the mouth and along GI tract), diarrhea, allergic reactions, renal and hepatic changes
Nursing:
- Check for hypersensitivity - multiple exposures cause reaction
- Give 1-2 h ac or 2-3 h pc
- Cross allergy with cephalosporins
- Watch renal and hepatic labs
- culture and sensitivity before tx
- good mouth care
93
Sulfisoxazole (Gantrisin)
Sulfonamide - antibiotic
Uses – ulcerative colitis, Crohn’s disease, otitis media, UTIs, conjunctivitis, meningitis, RA
Action – antagonize essential component of folic acid synthesis
S/E: peripheral neuropathy, crystalluria, photosensitivity, GI upset, stomatitis
Nursing:
• Take on empty stomach with full glass of water
• Encourage fluids – bc of crystal formation 3000 ml/day
• Good mouth care
• Antacids will interfere
94
Sulfasalazine (Azulfidine)
Sulfonamide - antibiotic
Uses – ulcerative colitis, Crohn’s disease, otitis media, UTIs, conjunctivitis, meningitis, RA
Action – antagonize essential component of folic acid synthesis
S/E: peripheral neuropathy, crystalluria, photosensitivity, GI upset, stomatitis
Nursing:
• Take on empty stomach with full glass of water
• Encourage fluids – bc of crystal formation 3000 ml/day
• Good mouth care
• Antacids will interfere
95
Trimethoprim/Sulfamethoxazole (Bactrim, Septra)
Sulfonamide - antibiotic
Uses – ulcerative colitis, Crohn’s disease, otitis media, UTIs, conjunctivitis, meningitis, RA
Action – antagonize essential component of folic acid synthesis
S/E: peripheral neuropathy, crystalluria, photosensitivity, GI upset, stomatitis
Nursing:
• Take on empty stomach with full glass of water
• Encourage fluids – bc of crystal formation 3000 ml/day
• Good mouth care
• Antacids will interfere
96
Doxycycline (Vibramycin)
Tetracycline - Antibiotic
Uses – infections, acne, prophylaxis for ophthalmia neonatorum (given to every baby when born to prevent infection)
Treatment of: syphilis, chlamydia, gonorrhea, malaria prophylaxis, chronic periodnitits, anthrax, H. pylori, Lyme disease
Action – inhibits protein syntheis
S/E: discoloration of primary teeth if taken by mom during pregnancy, glossitis, rash, phototoxic reactions, glossitis, diarrhea, superinfection
Nursing:
• Take 1 h ac or 2-3 h pc
• Do not take with antacid, milk, iron – decrease absorption
• Note expiration date – if taken beyond expiration is toxic
• Monitor renal function
• Avoid sunlight - Sunblock!
- topical applications may stain clothing
- use contraceptive method in addiction to oral contraceptives
97
Minocycline (Minocin)
Tetracycline - Antibiotic
Uses – infections, acne, prophylaxis for ophthalmia neonatorum (given to every baby when born to prevent infection)
Treatment of: syphilis, chlamydia, gonorrhea, malaria prophylaxis, chronic periodnitits, anthrax, H. pylori, Lyme disease
Action – inhibits protein syntheis
S/E: discoloration of primary teeth if taken by mom during pregnancy, glossitis, rash, phototoxic reactions, glossitis, diarrhea, superinfection
Nursing:
• Take 1 h ac or 2-3 h pc
• Do not take with antacid, milk, iron – decrease absorption
• Note expiration date – if taken beyond expiration is toxic
• Monitor renal function
• Avoid sunlight - Sunblock!
- topical applications may stain clothing
- use contraceptive method in addiction to oral contraceptives
98
Tetracycline Hcl (Panmycin)
Tetracycline - Antibiotic
Uses – infections, acne, prophylaxis for ophthalmia neonatorum (given to every baby when born to prevent infection)
Treatment of: syphilis, chlamydia, gonorrhea, malaria prophylaxis, chronic periodnitits, anthrax, H. pylori, Lyme disease
Action – inhibits protein syntheis
S/E: discoloration of primary teeth if taken by mom during pregnancy, glossitis, rash, phototoxic reactions, glossitis, diarrhea, superinfection
Nursing:
• Take 1 h ac or 2-3 h pc
• Do not take with antacid, milk, iron – decrease absorption
• Note expiration date – if taken beyond expiration is toxic
• Monitor renal function
• Avoid sunlight - Sunblock!
- topical applications may stain clothing
- use contraceptive method in addiction to oral contraceptives
99
Bacitracin ointment
Topical Antibacterial
S/E: nephrotoxicity, ototoxicity
Nursing: overgrowth of nonsusceptible organisms can occur
100
Neosporin Cream
Topical Antibacterial
S/E: nephrotoxicity, ototoxicity
Nursing: allergic dermatitis may occur
101
Providone- Iodine solution
(Betadine) Topical Antibacterial
S/E: Irritation
Nursing:
- Don't use around eyes
- May stain skin
- Don't use full strength on mucous membranes
102
Silver sulfadiazine cream (Silvadene)
Topical Antibacterial
S/E: neutropenia, burning
Nursing: use cautiously if sensitive to sulfonamides
103
Tolnaftate cream (Tinactin)
Topical Antibacterial
S/E: irritation
Nursing:
- use small amount of medication
- use medication for duration prescribed
104
Nystatin Cream (Myocstatin)
Topical Antibacterial
S/E: contact dermatitis
Nursing: Do not use occlusive dressing
105
Nitrofurantoin (Furadantin)
anti-infective
S/E: asthma attacks, diarrhea, N/V
Nursing:
• Give with food or milk
• Monitor pulmonary status
• Taken with cranberry juice – helps it to work
• Don’t eat alcoline foods – almond, coconut, milk, some veggies
106
Phenazophyridine (Pyridium)
– urinary tract analgesic
S/E: headache, vertigo
Nursing:
• Tell pt urine will be orange
- Take with meals
107
Oxybutynin (Ditropan)
Anticholinergic
used to reduce bladder spasms and treat urinary incontinence
Uses – ophthalmic exam, motion sickness, pre-operative (to reduce GI and bladder motility)
Action – dilates pupils, causes bronchodilation and decreased secretions, decreases mobility and GI secretions
S/E: blurred vision, dry mouth, urinary retention, change in heart rate, drowsiness, constipation
- Nursing
• monitor output (1500 ml normal)
• contraindicated with glaucoma (will interfere with fluid drainage)
• give 30 min ac, hs, or 2 h pc
• not used with paralytic illeus – don’t want to slow down more, BPH – enlarged prostate and don’t want to slow down bladder
- increased fluids and fiber in diet
- older adults require higher dose and have greater incidence of side effects
108
Propantheline (Pro-Banthine)
Anticholinergic
used to reduce bladder spasms and treat urinary incontinence
Uses – ophthalmic exam, motion sickness, pre-operative (to reduce GI and bladder motility)
Action – dilates pupils, causes bronchodilation and decreased secretions, decreases mobility and GI secretions
S/E: blurred vision, dry mouth, urinary retention, change in heart rate, drowsiness, constipation
- Nursing
• monitor output (1500 ml normal)
• contraindicated with glaucoma (will interfere with fluid drainage)
• give 30 min ac, hs, or 2 h pc
• not used with paralytic illeus – don’t want to slow down more, BPH – enlarged prostate and don’t want to slow down bladder
- increased fluids and fiber in diet
109
Darifenacin (Enablex)
Anticholinergic
used to reduce bladder spasms and treat urinary incontinence
Uses – ophthalmic exam, motion sickness, pre-operative (to reduce GI and bladder motility)
Action – dilates pupils, causes bronchodilation and decreased secretions, decreases mobility and GI secretions
S/E: blurred vision, dry mouth, urinary retention, change in heart rate, drowsiness, constipation
- Nursing
• monitor output (1500 ml normal)
• contraindicated with glaucoma (will interfere with fluid drainage)
• give 30 min ac, hs, or 2 h pc
• not used with paralytic illeus – don’t want to slow down more, BPH – enlarged prostate and don’t want to slow down bladder
- increased fluids and fiber in diet
110
Solifenacin (VESIcare)
Anticholinergic
used to reduce bladder spasms and treat urinary incontinence
Uses – ophthalmic exam, motion sickness, pre-operative (to reduce GI and bladder motility)
Action – dilates pupils, causes bronchodilation and decreased secretions, decreases mobility and GI secretions
S/E: blurred vision, dry mouth, urinary retention, change in heart rate, drowsiness, constipation
- Nursing
• monitor output (1500 ml normal)
• contraindicated with glaucoma (will interfere with fluid drainage)
• give 30 min ac, hs, or 2 h pc
• not used with paralytic illeus – don’t want to slow down more, BPH – enlarged prostate and don’t want to slow down bladder
- increased fluids and fiber in diet
111
Tolterodine (Detrol)
Anticholinergic
used to reduce bladder spasms and treat urinary incontinence
Uses – ophthalmic exam, motion sickness, pre-operative (to reduce GI and bladder motility)
Action – dilates pupils, causes bronchodilation and decreased secretions, decreases mobility and GI secretions
S/E: blurred vision, dry mouth, urinary retention, change in heart rate, drowsiness, constipation
- Nursing
• monitor output (1500 ml normal)
• contraindicated with glaucoma (will interfere with fluid drainage)
• give 30 min ac, hs, or 2 h pc
• not used with paralytic illeus – don’t want to slow down more, BPH – enlarged prostate and don’t want to slow down bladder
- increased fluids and fiber in diet
112
Sildenafil
(Viagra) Anti-impotence
S/E: headache, hypotension, priapism
Contraindications: nitrates, alpha blockers - will cause fatal hypotension
Nursing:
• Can not take with grapefruit juice
• Call PCP if erection lasting longer than 4 hrs
- take 1 hr before sexual activity
113
Vardenafil (Levitra)
Anti-impotence
S/E: headache, hypotension, priapism
Contraindications: nitrates, alpha blockers - will cause fatal hypotension
Nursing:
• Can not take with grapefruit juice
• Call PCP if erection lasting longer than 4 hrs
- take 1 hr before sexual activity
114
Tadalfil (Cialis)
Anti-impotence
S/E: headache, hypotension, priapism
Contraindications: nitrates, alpha blockers - will cause fatal hypotension
Nursing:
• Can not take with grapefruit juice
• Call PCP if erection lasting longer than 4 hrs
- take 1 hr before sexual activity
115
Finasteride (Proscar)
Testosterone inhibitor
tx of BPH
S/E: decreased libido, impotence, breast tenderness
- pregnant women should avoid contact with crushed drug or pt's semen - may adversely affect male fetus
116
Propecia
Testosterone inhibitor
tx of male hair loss
S/E: decreased libido, impotence, breast tenderness
- pregnant women should avoid contact with crushed drug or pt's semen - may adversely affect male fetus
