Pharmacology Flashcards
(188 cards)
1
Q
Magnesium Sulfate
A
- *Indication** HTN, hypomagnesameia, preterm labor, torsade de pointes, asthma, anticonvulant with eclampsia
- *Action** magnesium plays a role in muscle excitability
- *Class** mineral/electrolytes
- *Nursing Considerations** caution with renal insufficiency, decreased respiratory rate, dysrthymias, hypotension, muscle weakness. Monitor EKG and repsiratory status. Monitor Mg levels. 2 practictioner check
2
Q
Altepase
A
- Indication MI, Acute ischemis strok, occluded central lines
- Action converts plasminogen to plasmin, degrades fibrin in clots
- Class thrombolytic
- Nursing Considerations Intracranial hemorrhage, bleediing, anaphylaxis, HTN, neuro status
3
Q
Calcium Acetate
A
Indication hypocalcemia, menopausal osteoporosis, hypokalemia,
Action maintains cell membranes, muscle contraction, nerve impulses, blood formation and coagulation
Class antacids, minerl/electrolyte replacement
Nursing cardiac arrest and arrhythmias, phlebitis at insertion, hypotension, bradycardia, hypercalcemia, dig toxicity, watch parathyroid hormone
4
Q
Antidote for Benzodiazepines
A
Flumazenil
5
Q
Vasopressin
A
- *Indication** MGMT of diabetes insipidius, Vt/VF, unresponsibe to initial shock, GI hemorrhage
- *Action** increases water permeability of the kidney collecting duct and distal convoluted tubule elading to water retention, also increases peripheral vascular resistance leading to increased BP
- *Class** antidiuretic hormone
- *Nursing Considerations** caution with HF, and CV disease, contraindicated in renal failure, hypersensitivity to pork. Monitor vitals. Monitor urine specific gravity & osmolality. Weight pt and assess for edema. Monitor electrolyte panel. DO NOT USE alcohol
6
Q
Propanolol
A
- *Indication** hypertension, angina, arrthymias, cardiomyopathy, alcohol withdrawal, anziety
- *Action** blocks Beta 1 & 2
- *Class** antianginal, antiarrthymic, antihypertensive, headache suppressant, beta blocker
- *Nursing Considerations** pulmonary edema, contraindicated with CHF, cardiogenic shock, bradycardia, heart block. Masks symptoms associated with diabetes mellitus. Advise physician if difficulty breathing
7
Q
Atenolol
A
- *Indication** hypertension, angina, prevention of MI
- *Action** blocks the stimulation of beta 1 receptors in the SNS w/ minimal effect on beta 2
- *Class** antianginal, antihypertensive, beta blocker
- *Nursing Considerations** monitor hemodynamic parameters, bradycardia, CHF, pulmonary edema, Masks symptoms associated with diabete mellitus, advise to change positions slowly to prevent orthostatic hypotension, instruct pt on how to take BP
8
Q
Diphenoxylate/Atropine
A
Indication tx of diarrhea
Action inhibits GI motility via anticholinergic effects
Class antidiarrheal, anticholinergic
Nursing contraindicated with angle closure glaucoma, dehydration, r/t opioids watch patients allergic to opioids, SE- constipation, tachycardia, dizziness, ilues, monitor liver, do not double dose
9
Q
Benzotropine
A
Indication Parkinson’s Disease
Action anticholinergic to reduce rigidity and tremors
Class antiparkinson, anticholinergic
Nursing arrthymias, hypotension, palpitations, tachycardia, constipation, dry mouth, assess extrapyramidal symptoms, good oral hygiene
10
Q
Ketorolac (Toradol)
A
- *Indication** pain
- *Action** pain relif due to prostaglandin inhibition
- *Class** nonsteroidal antiinflammatory agent, non-opioid analgesics, pyrroziline carboxylic acid
- *Nursing Considerations** Steven Johnson Syndrome, anaphylaxis, drosiness, GI bleed, should not exceed 5 days of tx, increased bleeding risk with garlic, ginger and ginkgo, decrease HTN meds and diuretics
11
Q
Norepinephrine
A
- *Indication** tx of severe hypotension and shock
- *Action** increase BP and COutput by stimulating alpha-adrenergic receptors in the blood vessels, demonstrates minor beta activity
- *Class** vasopressor
- *Nursing Considerations** monitor bp every couple minutes, can result in rebound hypotension due to tissue ischemia, monitor EKG and CVP if possible. Instruct pt to report headaches, dizziness, and chest pain
12
Q
Epinephrine
A
Indication adrenalin, asthma, COPD exacerbations, allergic, cardiac arrest, anesthesia adjunct
Action both beta 1 and beta 2, alpha agonist properties. Bronchodilation, increases HR and BP
Class antiasthmatic, bronchodilator, vasopressor, adrenergic
Nursing angina, tachycardia, hytpertension, restlessness, nervouseness, hyperglycemia, MAOIs can lead to hypertensive crisis, do not use stimulants, hemodynamics, chest pain, adequate fluid intake, rinse after inhalation, beta blockers negate effects, increased blood sugar
13
Q
Pancrelipase
A
- *Indication** pancreatic insufficiency, ductal obstruction
- *Action** replacement of pancreatic enzymes: lipase, amylase, protease
- *Class** digestive agent
- *Nursing Considerations** contraindicated in pig products, SOB, rash, assess nutritional status, monitor for steatorrhea, increase uric acid levels, take with meals
14
Q
semide
A
diuretic
15
Q
Hydrochlorothiazide
A
Indication hypertension, CHF, renal dysfunction, Cirrhosis, glucocorticoid therapy
Action selectively inhibits reuptake serotonin
Class anti hypertensive, diuretics, thiazide diuretic
Nursing dizziness, hypokalemia, hyponatremia, hypophosphatemia, hypomagnesemia, dehydration. hypokalemai can increase risk for dig toxicity. Monitor BP and I/Os. Monitor electrolyte levels. Take same time each day. How to take BP.
16
Q
-tricin
A
antibiotics
17
Q
Altorvastatin
A
- *Indication** high cholesterol
- *Action** lowers LDL, increase HDL, inhibits HMG-CoA reductase in liver and cholesterol formation
- *Class** lipid lowering agent
- *Nursing Considerations** contraindicated with liver disease,may cayse rhabdomyolysis, renal function, monitor cholesterol, report muscle weakness
18
Q
Bismuth Subsalicylate
A
Indication diarrhea, heartburn, indigestion, H.pylori ulcer
Action stimulates absoprtion of f/e’s in intestinal wall, reduction of hypermotility of stomach and binds to toxins
Class antidiarrheal, antiulcer, adsorbant
Nursing contraindicated in aspirin, hypersensitivity, increase risk for impaction with geratric and pediatric patients, monitor liver profile, bismuth may intere fere with radiologic exams
19
Q
What lab value is an increased risk for dig toxicity
A
hypokalemia
20
Q
- Adol -aldol
ex: Tramadol
A
Analgesic
21
Q
Indomethacin
A
Indication inflammaotry disorders when pts do not respond to other meds.
Action decrease pain and inflammation by inhibiting prostaglandin synthesis
Class antirheumatic, ductus arteriosis patency, nonsteroidal antiinflammatory agent
Nursing monitor hepatitis and GI bleed, dizziness, drowsiness and headache. Assess for anaphylactic reaction. Aspirin may decrease effectiveness. Monitor renal labs. Shake supension before administration. Pt should wear sunscreen and protective clothing to protect against photosensitivity.
22
Q
-azosin
A
alpha blockers
23
Q
Examples of selective beta 1s
MEAANe
A
- Metroprolol
- Exmolol
- Acebutolol
- Atenolol
- Nebivolol
24
Q
Insulin Mixture
Humulin 70/30
A
- *Indication** hyperglycemia with diabetes type 1 and type 2, ketoacidosis
- *Action** stimulates uptake of glucose into muscle and fat cells, inhibits production of glucose in the livere, prevents breakdown of fat and protien
- Lispro Mix 15-30 min , pk 2-3 hr*
- Aspart Mix 15 min, 1-4 hr*
- NPH reg 30 min, 4-8 hours*
- *Class** lpancreatics, antidiabetics
- *Nursing Considerations** monitor body weight over time, may cause decreased inorganic phsophates, potassium and mag. Monitor B/S Q6, monitor A1C every 3-6 months
25
Enalapril
**Indication** hypertension, MGMT of CHF
**Action** iblock conversion of angiotensin I to angiotensin II, increases renin levels and decrease aldosterone, vasodilation
**Class** ACE inhibitor, antihypertensive
**Nursing** neutropenia, caution with potassium, watch diuretic therapy, admin 1 hour before meals, monitor BP, monitor weight and fluid status, monitor renal profile, monitor CBC
26
-olone
steroid
27
Diltiazem
**Indication** HTN, angina, SVT, Afib, Aflutter
**Action** inhibits calcium transport resulting in inhibition of excitation and contraction, leads to vasodilation and decreased bp
**Class** antianginals, antiarrhythmics, antihtn, Calcium Channel Blocker
**Nursing** contraindicated in 2nd and 3rd av block, dysrythmias, CHF, bradycardia, peripheral edema, ginigval hyperplasia, increases dig levels, no grapefruit juice, monitor EKG, ortho hypotension, monitor potassium, teach how to take BP
28
Trimethroprim/Sulfamethoxazole
* *Indication** bronchitis, UTI, diarrhea, pneumonia, multiple types of infection
* *Action** bacteriacidal by preventing metabolism of folic acid
* *Class** folat antagonist, antiinfective, antiprotozoal
* *Nursing Considerations** renal damage, steven johnson syndrome, agranulocytosis, aplastic anemia, phlebitis, drink 8-10 glasses of water
29
Omeprazole
* *Indication** GERD, ulcers, Zollinger syndrome, reduce risk of GI bleed in ill patients, heart burn
* *Action** prevents the transport of H ions into gastric lumen by binding to gastric parietal cells.
* *Class** antiulcer agent, ppi
* *Nursing Considerations** capsules should be swallowed whole, report black tarry stools
30
Drugs that alter electrolytes
* diuretics
* Thiazides- hold on to Ca & Uric Acid
* ACE- hyperkalemia
* Steroids- hypokalemia
31
Oxytocin
* *Indication** labor induction, postpartum bleeding
* *Action** stimulates uterine smooth muscle
* *Class** hormone, oxytocics
* *Nursing Considerations** ICH in fetus, asphyxia in fetus, may cause coma and seizures in mother. Monitor blood pressure, assess maternal electrolytes. Uterine Tetany
32
Cimetidine
**Indication** duodenal ulcers, CERG, heartburn, Zollinger Ellison syndrome, GI bleeding in crit patients
**Action** iinhibits action of histamine leading to inhibition of gastric acid secretion
**Class** H2 antagonist, antiulcer agent
**Nursing** increases serum levels of warfarin, respiratory infection, watch dysryhthmias, agranulocytosis, aplastic anemia, monitor CBC, increase fluid and fiber intake to decrease constipation
33
Insulin Rapid Acting
## Footnote
*novolog, humalog, apidra,, aspart, lispro, glulisine*
* *Indication** hyperglycemia with diabetes type 1 and type 2, ketoacidosis
* *Action** stimulates uptake of glucose into muscle and fat cells, inhibits production of glucose in the livere, prevents breakdown of fat and protien
IAspart 1-20 min , 1-3 hr
glulisine 15 min 1 hr
lispro 15 min 1-1.5 hr
* *Class** lpancreatics, antidiabetics
* *Nursing Considerations** monitor body weight over time, may cause decreased inorganic phsophates, potassium and mag. Monitor B/S Q6, monitor A1C every 3-6 months
34
Morphine
* *Indication** pain, pulmonary edemia, *MI*
* *Action** binds to opiate receptors in the CNS and alters perception of pain. Decreases cough reflex and GI motility
* *Class** opioid analgesic,
* *Nursing Considerations** hypotension, constipation, N/V, BP, pulse, RR. Caution with pt receiving MAOIs
35
Gabapentine
**Indication** seizures, peripheral neuropathy, neuropathic pain, prevention of migraines
**Action** exact method of action is unknown
**Class** anticonvulsant, mood stabilizer
**Nursing** suicidal thoughts, confusion, depression, drowsiness, ataxia, facial edema, HTN. Monitor pt closely for changes in behavior and dpression. Asses seizure activity, pain. Take as prescribed
36
-dil-
Vaso**dil**ator
37
Glucagon
**Indication** severe hypoglycemia, **antidote for beta blockers and calcium channel blockers**
**Action** stimulates production of glucose, relaxes GI tract
**Class** pancreatic, hormone
**Nursing** anaphylaxis, hypotensionn. Assess for hypoglycemia, neuro status. Monitor serum glucose. Teach pt signs of hypoglycemia
38
Lamotrigine
* *Indication** Seizures r/t epilepsy, bipolar
* *Action** inibits sodium transport in neurons
* *Class** anticonvulsant
* *Nursing Considerations** suicidal thoughts, dizziness, behavior changes, N/V, photosensitivity, rahs, Steven Johnsons, caution with oral contraceptiv, assess mental status,
39
Hydralazine
**Indication** Hypertension
**Action** arterial vasodilator
**Class** anti hypertensive, vasodilator
**Nursing** tachycardia, sodium retention, dysrthymias, angina. Use caution with MAOIs. Monitor BP. Instruct pt on how to take BP
40
Clindamycin
**Indication** skin infections, respiratory tract infections, septicemia, intraabdominal infections, osteomyelitis
**Action** inhibits protein synthesis
**Class** antiinfective
**Nursing** arrhthmias, pseudomemrbanous colitis, diarrhea, phlebitis, watch bowel function, cultrues prior to therapy, monitor liver function, monitor cbc
41
-pidem
hynotic/sedative
42
Drugs that are ototocxic?
* Loop diuretics
* Aminoglycoside Antibx (Gent)
* Aspirin
43
-pezil
acetycholinesterase inhibitor
anti-alzheimer agent
44
Metformin
* *Indication** mgmt of type II DM
* *Action** decreases glucose production inthe liver, decrease absorption, increases ellular insulin sensitivity
* *Class** antidiabetic, Biguanide
* *Nursing Considerations** do not use with renal dysfunction, metabolic acidosis. May cause diarrhea, N/V, lactic acidosis. D/C if acidotic.
45
Paroxetine
* *Indication** major depressive disorder, OCD, anxiety, PTSD
* *Action** blocks reuptake of CNS
* *Class** antianxiety agent, antidepressant, SSRI
* *Nursing Considerations** neurleptic malignant syndrome, decrease effectiveness of digozin, increase bleeding with warfarin, suicidal thoughts
46
-thiazide
diuretics
47
-pamil
vasodilator
48
-pril
ACE inhibitor
49
Iron Antidote
Deferoxamine
50
Antidote for tylenol
acetycysteine
51
Buproprion
**Indication** depression, smoking cessation, ADHD
**Class** antidepressant, smoking deterrents, aminoketones
**Nursing** seizures, suicidal thoughts, do not take w/ MAOI, renal/liver impairment, assess mental status, avoid alcohol
52
Alendronate
* *Indication** osteoporosis
* *Action** linhibits osteoclast activity leading to inhibition of resorption of bone
* *Class** bone resorption inhibitor, biphophnates
* *Nursing Considerations** *take first thing in the morning* *w/ water 30 min _prior to eating_*, assess calcium, may cause muscle pain
53
-mycin
antibiotic
54
Nystatin
* *Indication** Candidiasis (thrush)
* *Action** causes leakge of funcal cell contents
* *Class** antifungal
* *Nursing Considerations** diarrhea, N/V, caution with dentures, assess mucus membranes
55
Ibuprofen
**Indication** mild to moderate pain, inflammatory states
**Action** decreases pain and inflammation by inhibiting rostaglandins
**Class** antypyretic, antirheumatics, nonopioid analgesic
**Nursing** GI bleeding, hepatitis, Stevens Johnson Syndrome. Monitor for headache N/V, constipation. Therapy should be D/Ced after first sign of rash. Monitor renal and liver labs. Avoid alcohol
56
Cephalexin (Keflex)
**Indication** skin infections, pneumonia, UTI, otitis media
**Action** bactericidal
**Class** antiinfective, cephalosporin 1st generation
**Nursing** contraindication with penacillin allergy, seizures, pseudomembranous colitis, diarrhea, phlebitis at iv site, anaphalaxis, obtain cultures prior to therapy, monitor bowel function, may lead to super infection, may cause elevated liver enzymes
57
Propolol
* *Indication** anaesthia, induction, sedation
* *Action** hypnotic, produces amnesia
* *Class** general anesthetic
* *Nursing Considerations** caution with CVD, lipid disorder, increased ICP, apnea bradycardai, hypotension. Burnign pain at insertion site. Can turn urine green, assess respiraotry status and hemodynamic. Maintain patent airway. Assess level of sedation
58
What lab value is an increased risk for lithium toxicity
hyponatremia
59
Metoprolol
* *Indication** HTN, angina, prevention of MI, heart failure management. Migrain prophylaxis
* *Action** blocks the stimulation of beta1, receptors in the SNS does not effect beta 2,
* *Class** antianginal, antihypertensive, beta blocker
* *Nursing Considerations** monitor hemodynamics, may lead to bradycardia, pulmonary edema, assess I&Os and monitor signs of CHF
60
Haloperidol
**Indication** schisophrenia, mania, aggressive and agitated
**Action** alters effect of dopamine
**Class** antipsychotic, butryrophenones
**Nursing** EPS, caution in QT prolongation. seizures, constipation, dry mouth, agranulosytosis. Assess for hallucinations, Monitor hemodynamics, monitor neurleptic malignant syndrome. CBC with differential
61
Amiodipine
Indication HTN, Angina
Action blocks transport of calcium into muscle cells inhibiting excitation and contraction
Class antiHTN, CA channel blocker
Nursing Considerations gingival hyperplasia, grapefruit juice may increase drug level, BP and pulse prior to therapy, monitor I/Os, assess signs of CHF, teach patient how to take BP
62
Beta 1 affects
heart
63
Famotidine (Pepcid)
**Indication** short term active ulcer, GERD, heartburn, indigestion, prevetion of GI bleed, over use of NSAIDS
**Action** blocks action of histamine located in gastric pareital cells, inhibits gastric acid secretion
**Class** antiulcer agent, H2 antagonist
**Nursing** dysrthmias, agranulocytosis, aplastic anemias, asses ab pain and occult blood, monitor CBC, instruct pt to increase fluid and fiber intake to prevent constipation
64
prazole
antiulcer agent
65
Captopril
**Indication** hypertension
**Action** block angiotensin I to angiotensin II, Increases renin levels and decreases aldosterone. Vasodilation
**Class** ACE inhibitor, antihtn
**Nursing** neurtopenia, watch potassium, watch diuretics, 1 hr before meals, watch weight and fluid status, renal profile, monitor CBC
66
Tetracycline
* *Indication** tx of infection, gonorrhea syphilis with penicillin alercy, chornic bronchitis
* *Action** bacteriostatic by inhibiting protein synthesis
* *Class** antiinfective
* *Nursing Considerations** caution with liver impairment. pseudomembranous colitis, diarrhea, N/V, photsensitivity. Increase effects of warfarin.
67
Chlorpromazine
**Indication** second line tx for schizo, N/V, pre-op sedation, acute intermittent prphyria, headache, bipolar
**Action** anticholinergic activity, alters effects of dopamine in CNS
**Class** phenothiazine, antisychotic, antiemetic
**Nursing** neuroliptic malignant syndrome, sedation, tardive dyskinesia, hyoptension, agranulocytosis, asses mental status prior to tx, monitor BP, monitor CBC and liver function, do not skip dose
68
Divalproex
**Indication** seizures, manic episodes, prevention of headache
**Action** increases the level of GABA in CNS
**Class** anticonvulsant, vascular headache suppressants
**Nursing** suicidal thoughts, agitation, dizziness, insomnia, hepatotoxicity, pancreatitis, increase risk for bleeding w/ Warfarin, caution with MAOIs, monitor liver function
69
Sertraline
* *Indication** major depressive disorder, OCD, anxiety
* *Action** inhibits uptake of serotonin,
* *Class** antidepressant, SSRI
* *Nursing Considerations** dont use with MAOIs, neurolyptic malignant syndrome, suicidal thoughts, dry mouth, tremors, takes 1-4 weeks for therapy to be effective
70
Acetaminophen
* *Indication** pain, fever
* *Action** inhibits synthesis of prostaglandins
* *Class** lipid lowering agent
* *Nursing Considerations** do not exceed 4 g per day to limit risk for liver, renal and cardiac damage, OD can lead to hepatotoxicity, increase risk for bleeding w/ warfarin, alter blood glucose measurements
71
Glipizide
**Indication** type 2 diabetes mellitus
**Action** stimulate release and sensitivity to insulin to lower blood glucose
**Class** anti-diabetic, sulfonylureas
**Nursing** aplastic anemias, hypoglycemia, photosensitivity, dizziness, drowiness, headache, diarrhea. Monitor CBC, assess for allergy to sulfonamides. Beta blockers may creat signs of hypoglycemia. Instruct patient on how to check blood sugars. Carry source of sugar in case of hypoglycemia
72
Dexamethasone
**Indication** cerebral edema, assess for cushing's dissease
**Action** suppress inflammation and normal immune response. Used in inflammatory states
**Class** antiasthmatics, corticosteroids,
**Nursing** watch liver, avoid in untreated infections, may cause CNS alteration, peptic ulcers, cushings, weight gin, osteoporosis, decrease wound healing, elevated blood sugars, watch lipid and cholesterol
73
Spironolactone
* *Indication** potassium loss, hypertension, edema CHF
* *Action** inhibits sodium reabsorption while sparing potassium and hydrogen
* *Class** diuretic
* *Nursing Considerations** contraindicated with hyperkalemia, monitor I/O, BP, potassium and renal panel
74
Diazepam
**Indication** anxiety, pre-op sedation, conscious sedation, tx of seixures, insomnia, mgmt of alcohol withdrawal
**Action** depress the CNS
**Class** benzodiazepine, antianxiety, anticonvulsant, skeletal muscle relaxant
**Nursing** ccontraindicated in hepatic dysfunction, wathc renal impairment, dizziness, drowsiness, lethargy, hypotension, physical dependence, tolerance, caution with alcohol use
75
Cardiopa/Levodopa
**Indication** parkinson's disease
**Action** levodopa converts to dopamine and works as a neurotransmitter and carbidopa prevents destruction of levodopa
**Class** dopamine agonist, antiparkinson agent
**Nursing** orthostatic hypotension, dark urine, takes weeks to effect, no MAOIs, no with glaucoma/melanoma
76
Heparin Antidote
Protamine Sulfate
77
Streptokinase
* *Indication** pulmonary embolism, DVT, occluded lines, arterial thrombus
* *Action** converts plasminogen to plasmin which degenerates fiibrin clots
* *Class** thrombolytic, plaminogen activator
* *Nursing Considerations** contraindicated with active bleeding, hypersensitivity, bronchospasm, ICH, hypotension,. Begin therapy as soon as possible, Monitor VS continuously. Avoid invasive procedures
78
Phenytoin
* *Indication** tonic clonic seizures, dysrthymia, neuropathic pain
* *Action** interferes with ion transport, shortens action adn decreases automaticity
* *Class** antidysrthmia, anticonvulsant, hydanotin
* *Nursing Considerations** ataxia, suicidal thoughts, EPS, hypotension, tachy cardia, gingival hyperplasia, enteral feedings may decrease absorption, monitor for hypersensitivity, assess seizures, therapeutic level is 1-20 mcg/ml
79
Procainamide
* *Indication** ventricular and atrial dysthrythmias, PAC, PVC, Vtach, post cardioversion
* *Action** decreases excitibility and slows conduction velocity
* *Class** antidysrthmia
* *Nursing Considerations** ventricular dyrhythmias, seizures, aysystole, heart block. widening of QRS complex. hypotensions must be supine. can cause drug induced lupus syndrome
80
Lorazepam
* *Indication** anxiety, sedation
* *Action** general CNS depression
* *Class** anesthetic, antianxiety, sedative hypnotic, bonzo
* *Nursing Considerations** caution with COPD and sleep apnea, avoid alcohol use, antidote is *Flumazenil*, may cause cardiac arrest, bradycardia, hypotension, administer slowly and dilute to decrease complications
81
Levetiracetam
## Footnote
*Keppra*
* *Indication** seizures
* *Action** decreases everity and incidence of seizures
* *Class** anticonvulsant
* *Nursing Considerations** suicidal thoughts, dizziness, weakness. Alters RBC, WBC and liver function. Somnolence. Infuse over 15 min
82
Phenazopyridine
* *Indication** urological pain
* *Action** analgesia to Urinary tract mucosa
* *Class** non opioid analgesic
* *Nursing Considerations** urine will turn red orange. headache, vertigo, heaptic toxicity, monitor renal function
83
Amoxicillin
* *Indication** skin ifections, respiratory infections, sinusitis, endocarditis prophylaxis, lime disease
* *Action** linhibits synthesis of bacterial cell wall leadting to cell death
* *Class** antiinfective, antiulcer, aminopenicillins
* *Nursing Considerations** contraindicated w/ penicillin allergy, seizures, rash anaphylaxis, excreted by kidneys-monitor renal albs, monitor pt for diarrhea, bloddy stool should be reported immediately
84
Aspirin
* *Indication** rheumatoid arthritis, osteoarthritis, ischemic stroke and MI prophylaxis
* *Action** inhibits production of prstaglandins which leads to rreductiono fever and inflammation, decreases platelet aggregation leading to a decrease in ischemic diseases
* *Class** antipyretic, non opioid analgesic, salicylates
* *Nursing Considerations** bleeding, chronic alcohol use, Steven Johnson syndrome, laryngeal edema, anaphylaxis, increass risk for bleeding with warfarin, heparin, and clopdiogrel, increased risk for GI bleeding w. NSAID, liver function tests
85
Loperamide (Imodium)
* *Indication** Acute diarrhea, decrease drainage post ileostomy
* *Action** inhibits peristalsis, reduces volumje of feces wwhil increasing the bulk and viscoscituy
* *Class** antidiarrheal
* *Nursing Considerations** can lead to constipation, asses bowel function, assess fluid and elctrolyte levels
86
Terbutaline
* *Indication** asthma, COPD, preterm leabor
* *Action** prdouces bronchodilation
* *Nursing Considerations** nervousness, restlessness, tremors, assess respiratory status. monitor for hypoglycemia, may cause decreased potassium level.
87
Naproxen
* *Indication** pain dimennorhea, fever, inflammation
* *Action** inhibits prostaglandins
* *Class** NSAID, antipyretic
* *Nursing Considerations** GI bleeding, increase risk for stroke and MI, Steven Johnson Syndrome, should remain _upright 30 min after administration_
88
- arone
ex: Amiod**arone**
antiarrhythmic
89
Cefaclor
**Indication** tx of respiratory tract infections, skin infections, otitis media
**Action** bacteriacidal, binds to bacterial cell wall causing cell death
**Class** cephalosporin 2nd generation, anti-infective
**Nursing** contraindicated cephalosporin and penicillin allergies, may lead to seizures, pseudomembranous colitis, diarrhea, phlebitis at iv site, anaphalzis, assess infection and allergies, obtain cultures prior to therapy, monitor bowel function, can lead to super infection
90
Promethazine
* *Indication** allergic reactions, N/V, sedation
* *Action** blocks the effects of histamine, antiemetic effect. anticholinergic, CNS depression
* *Class** antiemetic, antihistamine, sedative, phenothiazine
* *Nursing Considerations** IV administration can cause tissue damage, hypertension impaired liver function. Neuroleptic malignant syndrome, confusion, sedation
91
-conazole
systemic antifungal
92
-sartan
ARBs
93
-Zoin
Alpha adrenergic blocker
94
Vancomycin
* *Indication** life threatening infection
* *Action** bacetericidal, antiinfective
* *Class** antianginal, antihypertensive, beta blocker
* *Nursing Considerations** ototoxicity, N/V, nephrotoxicity, anaphylaxis, red man syndrome,. Monitor BP
95
Clopidogrel (plavix)
**Indication** atherosclerotic events, MI, CVA, PVD, acute coronary syndrome
**Action** inhibits platelet aggregration
**Class** antiplatelet, platelet aggregation inhibitor
**Nursing** GI bleed, neutropenia, hypercholesterolemia, increase risk for bleeding, monitor CBS and platelet count, discontinue 5-7 days before surgery
96
Why are statins administered in the evening
because cholesterol synthesis increases at night
97
Digoxin
**Indication** CHF, Afib, Aflutter
**Action** ipositive inotropic effect, increases force of Myocardial contraction, prolongs refractiory period, decrease conduction through SA and AV nodes. Increases CO and slow Rate
**Class** antiarrhythmic, inotropics, digitalis glycosides
**Nursing** contraindicated with uncontrolled ventricular arrhthmias, hypokalemia increase risk for toxicity, hypercalcemia increase risk for toxic, caution with diuretic, watch for bradycardia, toxciity= vision changes, yellow green vision, montior pulse rate for 1 full minute
98
-perone
antianxiety agent
99
Sucralfate
* *Indication** GI ulcers, GI injury prevention form high dose aspirin, NSAID tx
* *Action** reacts with gastric acid to form a paste that dheres to ulcer
* *Class** antiulcer, GI protectant
* *Nursing Considerations** caution in renal failure, concurrent use of antacids may decrease the effect of sucralfate. Administer 30 min before or after. *Adminsiter on empty stomch 1 hour before meals*
100
Digoxin antidote
digiband
101
Butorphanol
**Indication** severe pain, labor pain, sedation
**Action** alters perception and response to pain by biding to opiate receptors in the CNS
**Class** opioid analgesic, agonists
**Nursing** caution with MAOIs, may cause confusion, hallucination, sedation, Monitor CNS depression, assess BP, pulse and respirations, aminister slowly through IV line
102
Verapamil
* *Indication**hypertension, angina, SVT, migrain
* *Action** prevents tranport of calcium, leading to decreased contraction, decreases SA and AV node conduction
* *Class** antianginal, antiarrthymic, antihtn, vascular headache. CA blocker
* *Nursing Considerations** dont use with 2nd 3rd degree block. can cause anxiety, confusion, cough, dypsnea, CHF, bradycardia, hypotension, elevated liver enzymes, Steven's Johnson sydrome. Hyperglycemia, gingival hyperplasia. grapefruit can increase effects. Can increase levels of diozin. assess angina.
103
Antidote for Magnesium Sulfate
Calcium Gluconate
104
Amitryptiline
* *Indication** depression, anxiety, insomnia
* *Action** increases effect of serotonin and norepinephrine in the CNS, exhibits antichoinergic effects
* *Class** Antidepressant, tricyclic
* *Nursing Considerations** contraindicated in MI, heart failure, glaucoma, risk for suicidal ideation, arrthythmias, hypotension EKG, alter BG levels, lethargy, *do not use with MAOIs*, take exactly as instructed, orthostatic hypotension, photosensitivity, may turn urine blue/green
105
tidine
H2 blocker
106
-terol
bronchodilator
107
Cortisone
**Indication** adrenal insufficiency, Addison's Disease
**Action** suppress inflammation and normal immune response. Adrenal glands exrete steroid, cortisol, blood sugars, metabolism of fat, protein and carbohydrates. decreasing bone formation
**Class** antiasthmatic, corticosteroids
**Nursing** watch liver, avoid untreated infections, CNS alteration, peptic ulcers, Cushings, Weight, gain, osteoporosis, decrease wound healing
108
Ranitidine
* *Indication** duodenal ulcers, GERD, heartburn esophagitis, GI bleed
* *Action** inhibits action of histamine in gastric pareital cells, decreases gastric acid secretion
* *Class** antiulcer agent, H2 blocker
* *Nursing Considerations** dysrthmias, agranulocytosis, aplastic anemia, confusion. Ab pain, monitor for blood in stool. monitor CBC
109
Pantoprazole
* *Indication** GERD, heartburn
* *Action** decreases accumulation of acid in the stomach
* *Class** antiulcer agent, ppi
* *Nursing Considerations** hyperglycemia, abdominal pain, decreases absroption of certain drugs, may increase bleeding with warfarin, assess for occult blood.
110
Albuterol
Indication bronchodilator prevent airway obstruction in asthma and COPD
Action binds to Beta 2 adrenergic receptors in the airway leading to relaxation of smooth muscles in the airways
Class bronchodilator/adrenergic
Nursing Considerations may decrease effectiveness of *beta blockers*, caution w heart disase, diabetes, galucoma, seizure disorder, bronchospasms, chest pain, palpitations, decrease *digoxin* levels
111
Ondansetron
* *Indication** Nausea and vomiting
* *Action** blocks effects of serotonin on vagal nerve and CNS
* *Class** antiemetic, 5-HT3 antagonist
* *Nursing Considerations** headache, constipation, diaarrhea, dry mouth. EPS symptoms, monitor liver function tests. Administer slowly over 2-5 minutes
112
Nifedipine
* *Indication** HTN, angina, migranes, CHF
* *Action** blocks calcium transport, inhibits contraction causing sytemic vasodilation
* *Class** antianginal, antihypertensive, CA blocker
* *Nursing Considerations** no grapefruit juice, dysrthymias, elevated liver function tests, gingival hyperplasia, monitor BP and pulse
113
Hydrocodone/Acetominiphen (Norco)
**Indication** moderate to severe pain
**Action** alters perception and reaction to pain by binding to opiate receptors in the CNS. Suppresses the cough reflex.
**Class** opioid analgesic, allergy, cold and cough remedy.
**Nursing** hypotension, monitor hemodynamics and respirations. May increase ICP. Narcan is the antidote for OD. Do not exceed 4g of acetominophen per day
114
-vir, vir-
antiviral
115
Nitroprusside
* *Indication** hypertensive criss, cardiogenic shock
* *Action** peripheral vasodilation of arteries andv eins decreasing preload and afterload
* *Class** vasodilator, antihypertensive
* *Nursing Considerations** monitor HR, BP, EKG continuously. Cyanide toxciity. Sympathomimetics may decrease effectiveness, PAOP monitoring may help with MI and CHF
116
Carbamazepine
**Indication** seizure, DM neruopathy, pain associated with trigeminal neuralgia
**Action** affects sodium channels in neurons leading to decreased synaptic transmission
**Class** anticonvulsant
**Nursing** interferes with oral contraceptives, do not use with MAOIs, suicidal thoughts, Steven Johnson syndrom, agranylocytosis, aplastic anemia, thrombocytopenia, No grapefruit juice, monitor CBC and platelets, monitor blood levels
117
Ferrous Sulfate
**Indication** prevention of iron deficiency anemia
**Action** iron is needed for hemoglobin, myoglobin and enzymes. It is transported to organs where it becomes part of iron stores
**Class** anti-anemic, iron supplement
**Nursing** seizures, hypotension, constipation, epigastric pain, diarrhea, skin staining, anaphylaxis. Asses nutrtional status, bowel function. Monitor hemoglobin, hematocrin. May cause eleved liver enzymes. Should take on an *empty stomach* to increase absorptio (vit c helps). Use z-track for IM injections.
118
Lithium
* *Indication** mania
* *Action** alters cation transport and neurotransmitter reuptake
* *Class** mood stabilizer
* *Nursing Considerations** do not administer with NSAIDS, monitor drug blood levels frequently. May cause seizures dyrthymias, EKG changes, fatiuge, confusion, nausea, anorexia, hypothyroidism tremors. ACE inhibitors may increase serum levels. Instruct patient to maintain adequate fluid intake. Therapeutic level 0.5-1.5 mEq/L
119
Fentanyl (Sublimaze)
**Indication** supplement to general anethseia, continuous IV infusion for purpose of analgesia
**Action** binds to opiate receptors in the CNS altering perception of pain, producing CNS depression
**Class** opioid analgesic
**Nursing** watch for ICP, head trauma and adrenal insufficiency. Avoid MAOIs. Can cause apnea, laryngospasm, decreased respiration, bradycardia, hypotension. Do not consume grapfruit juice. Monitor hemodynamics. Assess pain scale
120
Isoniazide
INH
* *Indication** tuberculosis
* *Action** inhibits synthesis of mycobacterial cell wall
* *Class** antitubercular
* *Nursing Considerations** jaundice, peripheral neropathy, seizures, hepatitis, avoid _tyramine_, monitor liver function
121
-aril
Antiviral
122
Heparin
**Indication** venous trhomboembolism, prophylaxis and tx. Low dose used to ensure patency of IV catheters
**Action** increases the inhibitory effect of antithrombin on factor Xa
**Class** anticoagulant, antithrombotic
**Nursing** monitor signs of bleeding, platelet count, hyperkalemia, pt report signs of bleeding
123
Montelukast
* *Indication** prevent asthma, manage seasonal allergies, prevent exercise induced bronchoconstriction
* *Action** disrupts the effects of leukotrienes which effect airway edema.
* *Class** allergy, cold, cough remedis, broncho*dilator. Leukotriene antagonist*
* *Nursing Considerations** assess respiratory status, liver function, does not treat acute asthma
124
Olanzapine
* *Indication** schizophrenia, mania, depression, anorexia nervosa, N/V, r/t chemo
* *Action** antagonizes dopamine and serotnin
* *Class** antipsychotic, mood stabiilizer, thienbenzodiazioines
* *Nursing Considerations** do not use while breastfeeding, neurlyptic malignant syndrome, seizures, suicidial thoughts, inosmonia, tardive dyskinesia, aggranulocytosis, constipation, tremors, assess mental status, hemodynamics, Blood sugars, intake and output. liver function tests
125
hydropmorphone/Dilaudid
**Indication** moderate to severe pain
**Action** alters perception and reaction to pain by binding to opiate receptors in the CNS. Suppresses the cough reflex.
**Class** opioid analgesic, allergy cold and cough remedy, antitussive
**Nursing** assess BP, respirations and pulse before and druing admin. CNS depression. Narcan is the antidote for OD. Caution with MAOIs. May be used as an antitussive. Dilue with NS prior to administration and to administer slowly to decrease CNS depression
126
Metronidazole
| (Flagyl)
* *Indication** intra-abdominal infections, gynecoligical infections, septicemia, endocarditis, amebic liver abscess, peptic ulcer
* *Action** inhibits dna and protein synthesis in bacteria
* *Class** anti-infective, antiprotoxoals, antiulcer
* *Nursing Considerations** obtain cultures before therapy, monitor neruologic status, monitor intake and outpus and daily weights. May alter liver enzymes
127
Furosemide (Lasix)
**Indication** edema, hypertension
**Action** prevention reabsorption of sodium and chloride in kidneys, increase excretion of water, sodium, chloride, magnesium and potassium
**Class** diuretic, loop
**Nursing** caution with liver disease. Can cause hypotension, dry mouth, excessive urination, dehydration, electrolyte, metabolic alkalosis. Hypokalemia may lead to increase risk of digoxin toxicity. Monitor renal panel. Caution with antihypertensives. Causes arthritic symptoms. Do not take wih aminoglycosides due to ototoxicity.
128
Insulin Long Acting
Detemir, Glargine, Levemir, Lantus
* *Indication** hyperglycemia with diabetes type 1 and type 2, ketoacidosis
* *Action** stimulates uptake of glucose into muscle and fat cells, inhibits production of glucose in the livere, prevents breakdown of fat and protien
Detemir onset 3-4 hr, Peak 3-14hr
Glargine 3-4,, no peak
* *Class** lpancreatics, antidiabetics
* *Nursing Considerations** monitor body weight over time, may cause decreased inorganic phsophates, potassium and mag. Monitor B/S Q6, monitor A1C every 3-6 months
129
Propylthiouracil (PTU)
* *Indication** HYPERthyroidism
* *Action** inhibits thyroid hormones
* *Class** antithyroid agent
* *Nursing Considerations** hepatoxicity, N/V, agranulocytosis, WBC and liver function tests, weight patient frequently, lekopenia, jaundice. Take with meals
130
What drugs may lead to agranulocytosis
* Hyperthyroid drugs
* *Propylthiorucil*
* *Methimazole*
* Clozapine- 2nd gen antipsychotic
131
Guaifenesin (Robitussin)
**Indication** cough suppression
**Action** decreases viscosity of and mobilizes secretions
**Class** allergy, cold, cough remedy, expectorant
**Nursing** avoid OTC meds, assess lung sounds. Adequate fluid intake
132
Coumadin Antidote
Vitamin K
133
Epoetin
**Indication** anemia
**Action** stimulates erythropoesis,
**Class** anti-anemic, hormones
**Nursing** contraindicated in albumin sensitivity, seizures, CHF, MI, CVA, HTN, monitor BP, assess dialysis shunts, monitor bleeding times, seizure precautions, do not shake vial
134
Warfarin
* *Indication** venous thrombosis, pumonary embolism, afib, myocardial infarction
* *Action** disrupts liver synthesis of Vitamin K dependent clotting
* *Class** anticoagulatn, coumarins
* *Nursing Considerations** contraindicated with bleeding, severe hypertension. Azole and anitfungals increase effects. Obtain full hx of supplements and herbsl. Large amounts of Vit K may antagonize effects of warfarin. Therapeutic level PT 1.3-1.5, INR 2.5-3.5/ No alcohol. Monitor bleeding times
135
What drugs can lead to bleeding
* NSAIDS
* Anticoagulatns
* Thrombolytics
* Aspirin
136
Lactulose
* *Indication** Constipation, portal systemic encephalopathy
* *Action** draws water into the stool and softens stool, inhibits ammonia passing into the colon
* *Class** osmotic laxative
* *Nursing Considerations** caution with DIabetes, may cause cramps ab distention and hyperglyciema, mental status, ammonial levels , avg 2-3 bowel movement per day
137
Losartan (Cozaar)
* *Indication** HTN, DM neuropathy, CHF
* *Action** inhibits vasoconstrictive properties of angiotensin II
* *Class** angiotensin I receptor antagonist
* *Nursing Considerations** hypotension, tachycardia, angioedema, hyperkalemia. May increase digoxin levels. Asses BP and Heart rate. Assess fluids. Monitor dail weights with CHF. Monitor renal and liver.
138
Calcium Carbonate
**Indication** severe pain, labor pain, sedation
**Action** alters perception and response to pain by biding to opiate receptors in the CNS
**Class** opioid analgesic, agonists
**Nursing** caution with MAOIs, may cause confusion, hallucination, sedation, Monitor CNS depression, assess BP, pulse and respirations, aminister slowly through IV line
139
Gentamicin
**Indication** Tx of gram negative infection when penicillin is ineffective
**Action** sinhibits bacterial protein sysnthesis
**Class** aminoglycoside, anti=infective
**Nursing** causes tinnitus hearing loss, do not administer with penicillin. Caution in renal impairment. Assess for infection. Obtain cultures prior to therapy. Monitor liver function tests. Monitor blood levels of drug
140
Celecoxib
**Indication** Osteoarthritis, rheumatoid arthritis, acute pain
**Action** decrease pain and inflammation by inhibiting synthesis of prostaglandins
**Class** antirrheumatics/NSAID
**Nursing** watch cardiovascular disease, increase risk for MI, CVA, thrombosis, GI bleeding, steven johnson synddrome, dermatitis, notify provider for new onset of abdominal pain or black stool
141
Alprazolam
* *Indication** anxiety, panic disorder, PMS, insomnia, mania, psychosis
* *Action** CNS anxiolytic effect, CNS depression
* *Class** anti anxiety agent, benzo
* *Nursing Considerations** caution w/ sleep apnea, renal dysfunction, hepatic dysfunction, drowsiness, lethargy, physical dependence, tolerance effect, *flumazenil* is the antidote, grapefruit juice may increase blood levels
142
Levofloxacin
* *Indication** UTI, gonorrhea, respiratory infection, bronchitis, pneumonia, skin and bone infection
* *Action** inhibits DNA synthesis in bacteria. Antiinfective
* *Class** fluoroquinolone
* *Nursing Considerations** contraindicated in allergies. May cause QT prolongation, avoid use with other drugs that can cause QT prolongation. Seizures, dyrthymias, pseudomembranous colitis, anaphylaxis, Steven Johnson. Decreased of phenytoin. Monitor renal panel. Asses for infection, obtain cultures prior to therapy, monitor liver function tests.
143
Salmeterol
* *Indication** reversible airway obstruction, exercise induced asthma
* *Action** bronchodilation through stimualtion of beta 2 adrenergic receptor
* *Class** bronchodilator, adrenergic
* *Nursing Considerations** avoid excessive use, headache, palpitations, tachycardia ab pain, paradoxical bronchospasm. decrease effectiveness of betablockers. Assess respiratory status. May increase glucose levels
144
Dopamine
**Indication** improve blood pressure, cardiac output and urine output
**Action** small dose result in renal vasodilation, medium cardiac stimulation by acting on beta 1 receptors, large dose stimulate alpha receptors leading to vasoconstriction increase SVR
**Class** inotropic, vasopresser
**Nursing** cmonitor BP, HR, EKG, CVP, PAOP, titrate to obtain appropriate BP, irritation may occur at IV site, beta blockers may counteract therapeutic effects
145
Iodine
* *Indication** thyroidectomy, thyrotoxic crisis, radiation exposure
* *Action** inhibits release of thyroid hormones
* *Class** antithyroid agent
* *Nursing Considerations** GI bleed, diarrhea, **hypo**thyroidism, goiter, monitor for hypersensitivity
146
Quetiapine
* *Indication** schizophrenia, depressive disorder, mania
* *Action** dopamine and serotonin antagonist
* *Class** antipsychotic, mood stabilizer
* *Nursing Considerations** neuroleptic malignant seziures, dizziness, palpitations, weight gain, anorexia, dont use with CNS depressants. Weight frequently, Monitor liver function test and CBC, may increase cholesterol
147
Bisocodyl
**Indication** constipation, bowel regimen
**Action** stimulates peristalsis leads to fluid accumulation in the colon
**Class** laxative, stimulant laxative
**Nursing** hypokalemia, ab pain, use caution w/ milk, abdominal distention & bowel function, drink 1500-2000 ml/day during therapy, monitor F&E, take as ordered
148
Ampicillin
* *Indication** skin infections, soft tissue infections, otitis media, sinusitis, respiratory infection, GU infections, meningitis, septicemia
* *Action** bactericidal, broader spectrum than penicillins, binds to cell wall leading to bacterial cell death
* *Class** antiinfective
* *Nursing Considerations** super infection fury overgrowth on tongue, vaginal itching, loose and foul smelling stool, pt should not use with oral contracetive, liver function, can cause seizures, diarrhea, anaphylaxes super infection
149
Methadone
* *Indication** withdrawal symptoms, pain
* *Action** binds to opiate receptors in the CNS and alters perception of pain while producing a general depression of the CNS. Decrease in the cough reflex and GI motility
* *Class** opioid analgesic
* *Nursing Consideration** caution with MAOIs may cause QT prolongation, hypotension, respiratory depression, dependence, confusion, sedation. Assess pain, vital signs, bowel function. May increase pancreatic enzyme levels. Assess withdrawal symptoms
150
What drogs are nephrotoxic?
* cyclosporine
* Aminoglycoside Antibiotics (Gentamycin)
* NSAIDS
* Antiviral agnes such as Acyclovir
151
-sporin
immunosuppresants
152
Midazolam
* *Indication** Sedation, conscious sedation, anesthesia, status epilepticus
* *Action** CNS depressant, mediated by GABA
* *Class** Benzo, antianziety, sedative
* *Nursing Considerations** assess level of sedation 2-6 hours following. Monitor BP, Pulse, Respirs, IV administratiaon, Antidote is *_Flumazenil_*
153
Beta 2 means
2 lungs- constrict bronchi lead to increase in blood glucose concentration
154
Nalpuphine
* *Indication** pain, analgesia during labor, sedation before surgery, supplement of balance anesthesia
* *Action** alters perception and response to pain, causes CNS depression
* *Class** opioid analgesic
* *Nursing Considerations** caution with head trauma, dizziness, headache, N/V, respiraotry depression. Do not use with MAOIs, assess pain, hemodynamics, can elevate pancreatic enzymes. NARCAN antidote
155
Amiodarone
* *Indication** ventricular arrthythmias, SVT, ACLS V-fib, Vtach
* *Action** prolongs action potential, inhibits adrenergic stimulation, decreases peripheral vascular resistance causing *vasodilation*
* *Class** Antiarrthymic Class III, Potassium channel blocker
* *Nursing Considerations** can cause ARDS, pulmonary toxicity, CHF, bradycardia, hypotension, increases dig levels, increases activity of warfarin, 2 RN check, monitor pulse daily and pt report abnormaility, avoid drinking grapefruit juice
156
Erythromycin
**Indication** in place of peniccillin, upper and lower respiratory tract infections, otitis media, skin infections, pertussis, syphilis, rheumatic fever
**Action** suppress bacterial protein synthesis, bacteriostatic
**Class** antiinfective, macrolide
**Nursing** QT prolongation, ventricular arrhythmias, diarrhea, liver function
157
What drugs are hepatotoxic?
* INH
* Acetominophen
* Statins
* Valproic Acid
* Antifungal Agents- "Azoles"
158
What does a scheduled I drug mean
very addictive (heroin, LSD)
159
Fluticasone (Flovent)
**Indication** prophylactic asthma treatmt
**Action** local anti-inflammatory
**Class** corticosteroid, inhalation, anti-asthmatic
**Nursing** watch for untreated infectios and suppressed immune function. Can cause headaches, insomnia, bronchospasm, nasal congestion, adrenal suppression. Monitor respiratory status, may lead to decreased bone density. Bronchodilators should be used BEFORE corticosteroids. Stop smoking
160
Acyclovir
* *Indication** genital herpes, herpes zoster, chicken pox
* *Action** interferes w/ viral DNA synthesis
* *Class** antiviral, purine analogues
* *Nursing Considerations** seizures, renal failure, Steven Johnson syndrome, thrombotic pprpura syndrome, diarrhea, dizziness, nausea, renal panel during administration, assess lesions, use proper protection druing sexual intercourse
161
-cef
cephlosporin
162
Rifampin
* *Indication** TB
* *Action** inhibits RNA synthesis
* *Class** antitubercular, rifamycin
* *Nursing Considerations** can turn body fluids red. N/V, confusion. Assess lung sounds and sputum, evaluate renal and liver tests, instruct patient not to skip or double dose
163
Escitalopram (Lexapro)
**Indication** major depressive disorder, anxiety, PTSD, social phobia
**Action** selectively inhibits reuptake serotonin
**Class** antidepressant, SSRI
**Nursing** contraindicated wtih MAOI, citallrpan use, may cause suididal thoughts, insomnia, diarrhea, nausea, serotonin syndrome, QT prolongation, sexual dysfunction, 406 weeks for full affect to take place
164
Insulin (Short Acting)
* *Indication** hyperglycemia with diabetes type 1 and type 2, ketoacidosis
* *Action** stimulates uptake of glucose into muscle and fat cells, inhibits production of glucose in the livere, prevents breakdown of fat and protien
* IV onset 1-2 hr, Peak 4-12 hr*
* *Class** lpancreatics, antidiabetics
* *Nursing Considerations** monitor body weight over time, may cause decreased inorganic phsophates, potassium and mag. Monitor B/S Q6, monitor A1C every 3-6 months
165
Methlergonovine
* *Indication** postpartum hemorrhage
* *Action** stimulates uterine muscles causing uterine contraction
* *Class** oxytocic, ergot alkaloids
* *Nursing Considerations** can cause hypertension, cramps, N/V, dyspnea. Monitor BP, HR and uterine response. Assess caclium levels
166
Diphemhydramine (Benadryl)
**Indication** allergy, anaphylaxis, sedation, motion sickness, antitussive
**Action** antagonizes effects of histamine, CNS depression
**Class** allergy, cold and cough, antihistamine, antitussive
**Nursing** drowsiness, anorexia, dry mouth, nausea, chest tightness, thick secreations, hypotension, blurred vision, headache, anticholinergic effects, monitor cough and lung sounds, avoid otc meds.
167
Enoxaparin
**Indication** prevention of VTE, DVT, and PE
**Action** iprevents thrombus formation by potentiating the inhibitory effect of antithrombin on factor Xa
**Class** anticoagulant, antighrombotic
**Nursing** contraindicated in pork hypersensitivity, onitor signs of bleeding, admin in SUBQ tissues, do not eject air bubble prior to injection, do not aspirate or massage site
168
-azepam
Antianxiety
169
-pressin
vasoconstrictor
170
Nal-
narcotic agonist/antagonist
171
Cyclosporine
I**ndication** prevent rejection in transplantation, treatment of RA, MGMT of ulcerative colitits
**Action** inhibits normal immune response,
**Class** apolypeptides,immunosuppresants, antirheumatics (DMARD)
**Nursing** cseizures, tremors HTN, hepatoxicity, diarrhea, N/V, gingival hyperplasia, increase immune suppression, avoid grapefruit juice, renal panel, liver enzymes, lifelong therapy required for transplant patients, teach how to take bp
172
Fluoxetine (Prozac)
**Indication** depressive disorder, PCD, bulimia, panic, bipolar, ADHD, DM neuropathy, obesity
**Action** inhibits reuptake of serotonin,
**Class** antidepressant, SSRI
**Nursing** contraindicated wtih MAOI, citallrpan use, may cause suididal thoughts, insomnia, diarrhea, nausea, serotonin syndrome, QT prolongation, monitor nutrition, good oral hygiene. 4-6 weeks for full affect to take place
173
Mannitol
* *Indication** increased ICP, oliguric renal failure, edema introcular pressure
* *Action** reeabsorption of water and electrolytes by increasing osmotic pressure excreted by the kidneys
* *Nursing Considerations** phlebitis at IV site. Dehydration, F/E imbalance. Monitor neuro status
174
Barb
Barbituric Acid derivatives
175
Meperidine
* *Indication** moderate to severe pain, sedation
* *Action** binds to opiate receptors in the CNS and alters perception of pain, while producing a general depression of the CNS
* *Class** opioid Analgesic
* *Nursing Considerations** altered mentation, hypotension, constipation, N/V. Assess BP, pulse and respriatory rate. Use caution if matient is receiving MAOIs. Narca is the antidote. Can cause seizures. May increase pancreatic enzyme levels. Assess bowel function
176
ACE Inhibitor consideration
* *Indication** hypertension, CHF
* *Action** block convfersion of angiotensin I to angiotensin II, increases renin levels and decreases aldosterone leading to *vasodilation*
* *Nursing Considerations** caution with potasssium supplements and potassium sparing diuretics. Caution with diuretic therapy, Administire 1 hour before meals, Monitor BP often. Monitor weight and fluid status. Monitor renal profile. Monitor liver function tests
177
Potassium antidote
insulin, NaHCO3, Kayexalate, Albuterol
178
Opioids antidote
naloxone
179
Codeine
**Indication** mgmt of pain, diarrhea, cough suppressant
**Action** binds to opiate receptors in the CNS and alters perception of pain while producing genereal depression of CNS. Decreases cough reflex and GI motility
**Class** allergy, cold, cough remedy, antitussive, opioid analgesic, opioid agonist
**Nursing** alteration in mentation, hypotension, constipation, N/V, asses vitals before admin, caution with MAOIs
180
Methylphenidate
| (ritalin)
* *Indication** ADHD, narcolepsy
* *Action** improves attention span
* *Class** CNS stimulatn,
* *Nursing Considerations** sudden death, hypertension, plapitations, anorexia, hyperactivity, insomnia. decreased effects of warfarin and phenytoin. Do not use with MAOIs. Do not consume caffeniated beverages. Monitor for dependence
181
Metoclopramide
| (Reglan)
* *Indication** prevention of N/V hiccups, migrains, gastric stasis
* *Action accelerates gastric emptying by stimulating motility**
* *Class** anti-emetic
* *Nursing Considerations** do not use with GI obstruction. Can cay extrapyramidal reaction, Neurolyptic malignant syndrome, Tardive dyskinesia, dysrithymias, BP alterations, hematologic alteration, facila movements, sedation. Can decrease effects of levodopa. Monitor liver function
182
-Alol
combined alpha and beta blockers
183
Atropine
* *Indication** decreases oral and respiratory secretions, treats sinus bradycardia and heart block, treatment of brochospasm
* *Action** anticholinergic inhibits the effects of PNS, acetycholine. Increases HR, bronchodilation decreased GI and respiratory secretions
* *Class** antiarrthmic, anticholinergic, antimuscarinic
* *Nursing Considerations** avoid acute hemorrhage, tachycardia, and angle closure glaucoma, monitor tachycardia and palpitations, may cause urinary retention, constipation
184
Dobutamine
**Indication** short term mgmt of heart failure
**Action** positive inotropic effects, little effect on heart rate. Stimulates beta receptors in the heart
**Class** inotropic, adrenergic
**Nursing** hemodynapics, hypertension, increase HR, PVCs, skin reactions, beta blockers may negate therapeutic effects, montior CO, watch peripheral pulses, do not confuse with dopamine
185
Insulite (Intermediate Acting)
NPH, Humulin N, Novolin N
* *Indication** hyperglycemia with diabetes type 1 and type 2, ketoacidosis
* *Action** stimulates uptake of glucose into muscle and fat cells, inhibits production of glucose in the livere, prevents breakdown of fat and protien
*IV onset 10-30min, Peak 15-30min*
* subQ 30-60 min, peak 2-4 hours*
* *Class** lpancreatics, antidiabetics
* *Nursing Considerations** monitor body weight over time, may cause decreased inorganic phsophates, potassium and mag. Monitor B/S Q6, monitor A1C every 3-6 months
186
Levothyroxine
* *Indication** thyroid hormone replacement in hypothyroidism
* *Action** replaces thyroid hormone increasing metabolism, promotes gluconeogensis, stimulates protein synthesis, restores normal hormone balance ans uppresses thyroid cancer
* *Class** thyroid prep, hormone
* *Nursing Considerations** assess pulse, monior dyrthymias, chest pain, monitor TSH levels, OD is presents as hyperthyroidsm, start with low doses and increase as indicated, therapy is lifelong. Take directly after breast feeding, increases the effects of *warfarin.*
187
Azithromycin
* *Indication** URI, chronic bronchitis, lower respiratory infections, otitis media, skin infections, STIs, prevention of bacterial endocarditis, tx of CF
* *Action** inhibits bacterial protein synthesis
* *Class** atypical myobacterium antiinfective, macrolide
* *Nursing Considerations** pseydomembranous colitis, pain, diarrhea, nausea, Stevens Johnson Syndrome, Angioedema, increase risks for warafin toxicity, anaphylaxis, notify physician for diarrhea or blood in the stool, take meds exactly as prescribed.
188
Methylpredinosone
* *Indication** inflammation, allergy, autoimune disorders, prevent *organ rejection*
* *Action** isuppress inflammation and normal immune response. Increase B/S, immune suppression, metabolism of fat, protein and carbohydrates. Decrease Bone formation
* *Class** antiasthmatics, corticosteroids
* *Nursing Considerations** monitor liver profile, avoid active untreated infections. CNS alterations. Peptic ulcers. Cushings. Weight gain, osteoporosis, Decrease wound healing. Elevate blood sugars. Increase cholesterol and lipid values.
