Anticonvulsants
- Dilantin
- Phenobarbital
- Depakote
- Tegretol
- Klonopin
- prevention of seizures (CNS depressant)
- decreases Ca+ and Na+ flow across neuronal membranes
S/E
- respiratory depression
- aplastic anemia
- gingival hypertrophy
- ataxia, drowsiness
NSG:
- Do not D/C abrubtly
- Monitor I/O
- caution w medsthat lower threshhold (MAOI, antidpressants)
- take with food
- urine may be pink/brown
- Dilantin: IV admin too quick will cause cardiac arrest, turns urine pink, do not mix with any other med
- Mg sulfate: asses deep tendon reflexes, respiratory arrest potential
- Depakote: no carbonated beverages
MAOI’s
- Nardil
- Parnate
- Marplan
two-syllable
Anti-depressant
- lower incidence of sedation and anti-cholinergic side effects
- avoid foods with tyramine
- may result in hypertensive crisis
- cannot use with any other MAOI, cyclic, Demerol, CNS depressants, anesthestics, many antihypertensives
- photosensitivity
- take 4 weeks
- do not take w cold meds, stimulants
Food containing tyramine:
- aged cheese, aged meats, liver, wine
- fava beans, tofu, herring
- overripe fruit, avocado, bananas
- sauerkraut, tap beer, yogurt, peanuts
Hypertensive crisis
- severe headache, palpitations
- diaphoretic, stiff neck
- potenital for intercranial hemmorhage
SSRI’s
- Prozac
- Paxil
- Zoloft
- Celexa
- Lexapro
- Luvox
Anti-depressant
- depression
- OCD
- bulimia
Side effects:
- anxiety, agaitiation, akathisia
- nausea, insomnia
- GI upset, appetite change, wt gain
- urinary retention, bowel function change
Nsg:
- sucide precautions (ask yes/no questions)
- takes 4 weeks
- take in am
Tricyclics
- Elavil
- Tofranil
- Norpramin
- -ine (generics)
Antidepressant
- depression
- sleep apnea
Side efffects:
- wt gain, sexual dysfunction
- sedation, confusion
- anticholinergic effects
- postural hypotension, tachycardia
Nsg:
- monitor for suicide
- 2-6 weeks to work
- take before sleep
- monitor VS
- use sunscreen
- if stopped abruptly: headaches, vertigo, rapid wt change
Heterocyclics
- Wellbutrin
- Trazadone
Uses:
- depression
- smoking cessation
Side effects:
- wellbutrin: agitation
- trazadone: sedation
Nsg:
- avoid alchohol
- avoid CNS depressants
- wean off slowly
Rapid acting insulin
- Novolog
- Apidra
- Humalog
- Onset: 15 min
- Peak: 30-90 min
- duration 3-5 hrs
Short acting insulin
- Humulin R (generic: regular)
- Novolin R
Short acting
- regular, humulin R
- novolin R
- onset: 30-60 min
- peak: 2-4 hrs
- duration: 5-8 hrs
- sub-q
- regular: only insulin that can be given IV
Intermediate Insulin
- Humulin N (generic: NPH)
- Novolin N
Intermediate acting
- NPH, Humulin N
- Novolin N
- Onset 2 hrs
- Peak: 6-12 hrs
- Duration: 12-16
Long acting insulin
- Levemir
- Lantus
- Onset: 1 hr
- Peakless
- 20-26 hrs
Pre-mixed NPH (70/30)
Combo of intermediate and short acting (regular)
- 70% NPH
- 30% regular
- onset: 30-60 min
- peak: varies 2-12 hrs
- duration 10-16 hrs
Oral hypoglycemics
- Acarbose
- Glyset
Action:
-slows carbohydraate absorption/digestion
Contra:
- intestinal disease due to increased flatulence
Oral DM Meds
Metformin
Uses:
- reduces gluconeogenisis
- increases uptake of glucose by muscles
NSG:
- W/hold 48 hr prior/post test with contrast
Contra:
- severe infection
- shock
- hypoxic conditions
Oral hypoglycemic:
Januvia
Action:
- Promotes release of insulin
- Lowers glucagon secretions
- Slows gastric emptying
Nsg:
- use caution w/ renal impariment
- lower dose
Oral hypoglycemic:
- Prandin
- Starlix
Action:
- supreses gluconeogenesis in liver
- increases muscle uptake/use of glucose
Nsg:
Do not mix with NPH insulin due to angina
Oral hypoglycemic:
Sulfonylreas
- glipizide
- glyburide
Action:
Promotes release of insulin from pancreas
Nsg:
Very high risk of hypoglycemia in disorders w/:
- renal
- hepatic
- adrenal
Sulfonylreas: Highest risk of hypoglycemia
Oral hypoglycemics:
Actos
Avandia
Action:
Decrease insulin resistance
Nsg:
High risk of CHF due to fluid retention
SIde effects of hypoglyvemic oral agents
- hypoglycemia
- allergic skin reactions
- GI upset
- hypotension
- bronchospasm
Nsg:
- take before breakfast
- moniotr BG levels
- no alchohol
Increase effectiveness of meds: may casue hypoglycemia:
- aspirin
- sulfanomides
- alcohol
- oral BC pills
- MAOI’s
:
Treating hypoglycemia
- glucagon
may repeat in 15 min
give carbs orally to prevent secondaty hypoglycemic reactions
Antidiarrheals
- Kaopectate
- Lomotil
- Imodium
- slows paristalsis
- increases tone of sphincter
S/E:
- constipation
- antichoiilnergic s/e
Nsg:
- do not use with abdominal pain
- monitor urinary retention
- give 2 before or 3 h after other meds
- encourage fluids
Antiemtics
- phenergan
- reglan
- zofran
- tigan
- marinol
- increase GI motiltiy, reduces vomiting
S/E:
- sedation
- anticholinergic s/e
Nsg:
- before chemo
- may cause Rye’s syndrome when used in conjunction with viral infections
Antifungals
- fungizone (Amphotericin B)
- mycostatin
- impairs cell membrane
Uses:
- candidiasis
- oral thrush
- histoplasmosis
S/E:
- heptotoxicity
- thrombocytopenia: bleeding risk
- leuokopenia: infection risk
- pruitis
Nsg:
- give with food
- monitor LFT’s
- oral care
Antigout Meds
- allopurinol
- colchine (acute phases only)
- probenacid (increases action of Cipro) (chronic)
-decreases production and resorption of uric acid
S/E:
- agranulocytosis
- GI upset
- renal calculi
Nsg:
- monitor for renal calculi
- give w milk/food, anatacids
- -encourage fluids
Antihistamines
- chlor-trimeton
- benadryl
- phenergan
- loratadine
- allergic rhinitis
- blood alergies
S/E:
- drowsiness
- anticholinergic se
- photsnesitvity
- -w/ food
- use sunscreen
- assess respiration
- mouth care
antihyperlipidemic meds
-lower cholesterol
- Lipitor (stain)
- Prstor (statin)
- Questran (ocks absorptif cholesterol_
- elevated LDL
- cardiovasular disease
- statins inhibit sythesis of chlesterol
S/E:
- constipation
- fat-soluble vitamin deficinecy
- take 30 min ac or take at hs
- adminsiter 1hr before meds
- or 4-6 hrs after meds
-
DO NOT COMBINE W OTHER MEDS
*
K+ increasing meds
K-BANK
- K+ sparing diuretic
- beta blockers
- ace inhibitors
- NSAID’s
- K supplements
Anti-hypertensives
ACE inhibitors:
(pril/ all hctz)
- benazepril
- lisinopril
- quinapril
- enalapril
- A= arteries
- effect arteries in body by blocking vasoconstricttion
- blocks ACE in lungs
vasodilators
- HTN
- CHF
S/E:
- GI upset
- orto hypotension
- dizziness
- lethargy at firt, goes away
- change position slowly
Nsg:
-give 1 hr ac of 3 hr pc
Beta blockers
(olol)
- atenolol
- nadolol
- propranolol
B=Beats (heart)
- slows heart rate
- decreases oxygen consumption
- used for HTN, angina SVT (supraventriculartachycardia)
S/E:
- slows HR
- hypotension
- bronchospasm (B=broncospasm)
Nsg:
- may masks signs of shock/hypoglycemia (caution w DM)
- take with food
- don not stop abruptly
- not as effective with blacks
Antihypertensive
Ca+ channel blockers
(ipines)
- procardia (nifedipine)
- calan
- cardizem
- norvasc (amlodipine)
- slows movement of Ca+ into smooth muscle
- aterial dialtion
- decreased BP
Uses:
- angina
- HTN
- interstitial cystitis
- Afib,flutter, SVT (Calan/Cardizem only)
S/E:
- ortho hypotension
- renal failure
- angioedema
- peripheral edema
- constipation
Contra:
- caution w digoxin and beta blockers
- heart failure, block, brady
- no grapefruit
- do not open/crush, etc
Antihypertensives
Angiotensin receptor blockers (ARBs)
(sartan)
- losartan
- valsartan
- irbesartan
- blocks vasocontriction and aldosterone effects
- vasodilator
Uses:
- HTN
- heart failure
- MI
- diabetic neurapthy
- stroke prevention
S/E:
- hypotension
- dizziness
- GI distress
- do not chew, break open SR’s
Antihypertensives
Alpha1 adrenergic blockers
(zosin)
- doxazosin
- prazosin
- peripheral vasodilation
- lowers B/P
Uses:
- primary HTN
- BPH (doxazosin)
S/E:
- reflex tachycardia
- orthostatic hypotension/snycope
- nasal congestion
Nsg:
- 1st dose hs to avoid fainting
- renal: monitor BUN, weight, edema
Antihypertensives
Centrally acting Alpha-2 agonists
- clonidine
- guanfacine
- methyldopa
- reduce peripheral vascular resistance
- reduce HR and BP
Uses:
- HTN
- hypertensive crisis
- severe cancer pain
S/E:
- ortho hypotension
- sedation
- dry mouth
- leukopenia
- black/sore tongue
Nsg:
- take at hs
- do not stop abruptly
- monitor for fluid retention
- may be used with other anti-HTH meds
- contra: MAOI’s, anticoags, hepatic failure
- do not use during lactation
Antihypertensives
Direct acting vasodilators
- apresoline
- minoxidil
- relaxes smooth msucle peripherally
- HTN
S/E:
- tachycarida
- used with beta blockers
- increase in body hair
- check pulse for brady
Bipolar meds
- lithium
- tegretol
- depakote (anti-convuslant)
reduces catecholamine relaese
Uses:
- manic episodes
- GI upset
- polydipsia/polyuria
- with meals
- tremors
Lithium (salt)
- frequent doasge change
- range: 1.0-2.0
- blood drawn q2-3 wekks
- encourage fluids (3000 mL)
- monitor Na levels, kidneys
- NSAIDS/aspirin increase levels
Tegretol/Depakote
mood stabilizer
given over entire cascde (manic/depressive)
kidney functions (BUN/LFTS)
Antineoplastics
- work on rapidly producing cells
- hair
- mucous membranes
- blood
Chemo Meds
Alkylating agents
busulfan
cyclophosphamide
uses:
- leukemia
- multiple myleoma
S/E:
- hepatoxicity
- bone marrow supresssion
- neutropenia/leukopenia/thromboctopneia
- bleeding, ecchymossis, epitaxis
- N&V, stomatitis,anorexia, diarrhea
- alopecia, infertiltiy
Nsg:
- WBC count
- limit visitors
- force fluids
- mouth/skin care
Chemo Meds
Antimetabolites
- 5-FU (flourouracil)
- methotrexate
- acute lymphatic leukemia
- cancer of colon
- breast
- pancreas
S/E:
- N&V (stimulates vomiting center)
- oral ulceration
- bone marrow suppression
- alopecia
Nsg:
- monitor hematopoietic function
- mouth care
- body image changes
- infection risk
- SOB
- air hunger
- bleeding
Chemo Meds
Antitumor antibiotics
- Adriamycin
- Bleomycin
- Actinomycin D
All cancers
S/E:
- bone marrow suppression
- alopecia
- antiemitic meds prophylaxis
- O2 consumpotion (not eneogh RBC’s to carry O2)