NCLEX Meds 15% of questions = 11 minimum

Metronidazole (Flagyl)

1. Used to treat anaerobic infections 2. DO NOT USED ALCOHOL (antabuse effect will be nauseous) Metronidazole is an antimicrobial agent used to treat Helicobacter pylori infection.

Sucralfate (Carafate)

Adheres to injured gastric ulcers upon contact with gastric acids; protective action for up to 6 hour, has no systemic effects. Used for gastric and duodenal ulcers and GERD. Administer on an empty stomach at least one hour before meals and do not administer within 30 minutes of antacids.

beta blockers slow down the heart rate and decrease the strength of contractions (negative inotropic effect), which can lead to heart failure in SOME patients, and this is why the nurse must monitor for this.

It must be tapered off over a period of time (usually about 2 weeks). This will prevent the development of rebound hypertension, myocardial ischemia, and angina.

Indomethacin (Indocin)

NSAID. Inhibit prostaglandin synthesis resulting in decreased inflammatory responses. Uses: provide rapid, symptomatic relief of inflammation and pain. Precautions/Interactions: hypersensitivity to aspirin or other NSAIDs, may increase the risk of MI and stroke.

Misoprostol (Cytotec)

Prostaglandin E analog Used w/ NSAIDs to prevent gastric ulcers Can induce labor Can cause diarrhea, abdominal pain, dysmenorrhea, spotting Take w/ meals and at bedtime Misoprostol is a prostaglandin analogue that protects against nonsteroidal anti-inflammatory drug (NSAID)-induced ulcers.

Zidovudine (Retrovir)

Tx: HIV Class: antiretroviral AE: paresthesia, N/V, lactic acidosis, Teaching: monitor hemoglobin Zidovudine can cause anemia, leukopenia, and granulocytopenia; these blood dyscrasias can be life threatening, and the CBC should be monitored.

Zosyn (piperacillin/tazobactam)

antibiotic bacterial infection

Amitriptyline

tricyclic antidepressant

Vasopressen (ADH) Vasopressen in Septic shock is a 2nd line presser started at 0.01 units/minute and titrate every 15 minutes to achieve a goal MAP of >65. Max dose 0.1 units/min.

vasoconstrictor

Neomycin belongs to a class of drugs known as aminoglycoside antibiotics. It works by stopping the growth of bacteria in the intestines. Neomycin may also be used along with a special diet to treat a certain serious brain problem (hepatic encephalopathy).

Aminoglycoside drugs, which include neomycin, are nephrotoxic and ototoxic, and must not be taken by clients with hepatic encephalopathy. neomycin is used to decrease serum ammonia levels

A microdrip chamber should be used for both children and clients needing to receive exact amounts of a potent drug. With a microdrip infusion set, 60 gtt is equal to one mL. Conversely, in a standard or macrodrip set 20 gtt is equal to 1 mL.

An infusion is usually set to alarm when 50 mL of the solution is remaining in the bag. Dopamine is a potent drug that should be administered using a microdrip chamber for precision. A volume-controlled administration set delivers a small amount of IV solution rather than a large amount.

Beta 1 receptors can be found in the HEART and KIDNEYS.

Beta 2 receptors can be found in the lungs (bronchioles), GI system, vascular smooth muscle, skeletal muscle and even the ciliary body of the eye (not listed).

Midazolam Hydrochloride (Versed)

Class: Benzo, short/intermediate acting, schedule IV Indications: sedation for intubation, ventilated patients and cardioversion. Also given for seizures.

celebrex (Celecoxib)

Classification:NSAIDs, COX-2 inhibitor Therapeutic Effects: Analgesic, anti- inflammatory, & anti- pyretic Adverse Reactions & side effects: GI BLEEDING, dermal rash, GI effects Nursing Implications & teaching: Assess pain, ROM and swelling. Do not give if allergic to sulfonamides, aspirin or NSAIDs. Watch for tarry stools.

Ranitidine (Zantac) for GERD adverse effects:

Green Sputum from low stomach PH (Pneumonia)

ranitidine (Zantac)

H2 antagonist

Famotidine (Pepcid)

H2 receptor antagonist

Nizatidine (Axid)

H2 receptor antagonist

Diazoxide (Hyperstat)

IV push for hospitalized patients with severe hypertension; increases blood glucose levels

cyclosporine

Immunosuppressant

Alendronate Fosamax ther class bone resorption inhibitor pharm class bisphosphonates nursing considerations take 1st thing in morning with full glass of water 30 minutes before prior to eating, assess serum calcium and vitamin D, may lead to muscle pain,

Indication: osteoporosis. aging - menopause and corticosteroid induced It can also treat Paget's disease of the bone action inhibits osteoclast activity, leading to inhibition of reabsorption of bone

lactulose (Evalose)

Lactulose therapy increases the frequency of stools. A bedside commode is especially necessary if the client has difficulty reaching the toilet. In a client with cirrhosis, the administration of lactulose reduces serum ammonia levels by causing the client to excrete ammonia through the GI tract.

The effects of heparin are monitored by the PTT is normally 30 to 45 seconds; the therapeutic level is 1.5 to 2 times the normal level.

The PTT is not used to monitor warfarin therapy, but PTT may be prolonged by warfarin at high doses. Warfarin markedly affects PTT, for each increase of 1.0 in the international normalized ratio, the PTT increases 16 seconds.

Heparin Heplock anticoag antithrombotic monitor for signs of bleeding, monitor platelet count, may cause hyperkalemia, have pt report any signs of bleeding,

VTE prophylaxis and treatment low dose used to ensure patency of IV catheters increases the inhibatory effect of antithrombin on X factor Xa (?)

Levophed (norepinephrine)

adrenergic agonist - vasopressor commonly used in cardiac arrest scenarios to treat low blood pressure In Septic shock, if hypotension is persistent after the inital 30mL/kg bolus you would notify provider for possible presser order - Levophed is commonly the presser of choice started at 1-30 mcg/min and titrated every 5-10 minutes to achieve a goal MAP of >65. Max 30mcg/min. Provides venous constriction (alpha adrenergic) and inotropic stimulation (beta adrenergic) Acidosis diminishes the effect! (2nd line Vasopressen)

phenylephrine

alpha 1 agonist Phenylephrine is a decongestant. It works by constricting blood vessels to relieve congestion in the nasal passages. One serious adverse effect of phenylephrine is severe hypertension, signs of which include a headache, irregular or fast pulse, ringing in the ears, and blurred vision.

Magnesium hydroxide (Maalox)

antacid Magnesium hydroxide is an antacid that may be used to neutralize stomach secretions but is not used specifically to help prevent NSAID-induced ulcers.

Guafenesin Mucinex, Robitussin ther class: allergy, cold and cough remedy, expectorant pharm class exectorant or mucolytic pt should avoid otc cold meds, assess lung sounds maintain adequete fluid intake

cought suppressent, expectorant decreases viscosity of and mobilizes secretions

Fluoxetine (Prozac) antidepressent SSRI do not use while taking MAOI may cause suicidal thoughts, drowsiness, anxiety, sexual dysfunction, insomnia, palpations, monitor closely for sertoninin syndrome, concurrent use with certain meds can lead to QT prolongation, monitor mood changes and assess for suicidal ideation, monitor nutrition status, may cause elevated Liver Enzymes, instruct pt to maintain good oral hygeine

depressive disorder, OCD, belemia, panic disorder, bipolar, anorexia, ADHD, DM neuropathy, obesity inhibits reuptake of serotonin allowing it to persist longer in synaptic cleft

Bismuth subsalicylate (Pepto-Bismol)

destroys the cell wall of H. pylori and does not affect gastric acid secretion Bismuth subsalicylate is an antidiarrheal drug that contains salicylates, which can cause bleeding and would be avoided in patients who have PUD

Furosemide (Lasix) diuretic pharm class loop diuretic rn consid: use caution with liver disease, may cause hypotension, dry mouth, excessive urination, dehydration, electrolyte abnormalities, metabolic alkalosis, hypokalemia may lead to increased risk of digoxin toxicity monitor renal panel use caution with other antihypertensives, causes arthitic symptoms, do not adminster with aminoglycosides due to ototoxicity

edema, htn, prevents of reabsorption of sodium and chloride in kidneys, increase excretion of water, sodium, chloride, magnesium, potassium,

Hydrochlorothiazide (HCTZ) Hydrodril diuretic antihypertensives thiazide diuretics may cause dizziness, hypokalemia, hypnatremia, hypophosphatemia, hypomagnesemia, dehydration, hypokalemia can increase risk of digoxin toxicity monitor bp i's and o's monitor electrolyte levels, take at same time each day even if feeling better instruct pt on how to take bp

htn, chf, renal dysfunction cirrhosis, glucocorticoid therapy increases Na and H20 excretion and causes vasodilation

therapeutic class pharmacologic class: nursing considerations

indication action

Cyclosporine ther class immunosuppressant, antirheumatic pharm class polypeptides, cyclic rn consid may cause seizures, tremors, hypertension, hepatotoxicity, diarrohea, NV, gingival hyperplasia, increases immune suppression with corticosteroids, avoid grapefruit while taking, assess signs of organ rejection, monitor renal panel, liver enzymes, take as directed, lifelong therapy required for transplant patients, instruct pts how to take blood pressure

indication prevention of rejection in trasnplantation treatment of severe RA management of ulcerative collitis action: inhibits normal immune response primarily by reducing the activity of T cells

Gabapentin Neurontin analgesic adjunct anticonvulsant / mood stabilizer pharm class - none may cause suicidal thoughts, confusion, depression, drowsiness, ataxia, facial edema, htn, monitor pt closely for changes in behavior and depression, assess seizure activity, assess pain level, take exactly as prescribed,

indication seizures, peripheral neuropathy, migraines action exact method unknown, may play a role in stabilizing neural membranes

Clopidogrel (Plavix) ther class anti platelet agent pharm class platelet aggregation inhibitors RN consid may cause GI bleeding, neutropenia, hypercholesteremia, may cause increase bleeding with garlic, ginko, ginger, monitor for signs of bleeding, monitor bleeding times, monitor cbc and platelet count, discontinue use 5-7 days before surgery,

indication atheroslerotic events, MI, CVA, PVD, acute coronary syndrome action inhibits platelet aggregation

Amiodarone (Cordarone) ther class antiarrhythmic class 3, potassium channel blocker pharm class none nursing considerations may lead to ARDS, pulmonary toxicity, CHF, bradycardia, hypotension, increases risk for QT prolongation, increases digoxin levels, increases activity of warfarin, monitor EKG continously while on therapy, assess for s/s of ARDS, monitor LFT, check dosage with another RN, check PT to monitor pulse daily, avoid drinking grape juice.

indication Afib, ventricular arrythmias, SVT, ACLS protocol for VFib and VTach action prolongs phase 3 of the action potential, makes the heart more tolerant to arrythmias, inhibits adrenergic stimulation, slows rate, decrease peripheral vascular resistance causing vasodilation

Digoxin (Lanoxin) ther class anti-arrythmic, inotropic pharm class cardiac glycoside rn consid excreted by kidneys, assess pt for hypersensitivity, contraindicated with uncontrolled ventricular arrythmias, hypokalemia increases risk for toxicity hypercalcemia increases risk for toxicity, use caution with diuretic use as they may cause electrolyte abnormality which can lead to toxicity, assess pt for cardiac arrythmias including bradycardia, signs for toxicity include vision changes, blurred vision, yellow/green vision disturbances, monitor pulse rate for 1 full min prior to dosing pt

indication CHF, AFIB, a flutter action: positive inotropic effect, increase force of mycoardial contraction, prolongs refractory period, decreases conduction through SA and AV nodes, given to increase CO and slow the rate.

Hydralazine Apresoline antihypertensive, vasodilator rn consi: may cause tachycardia, sodium retention, arrythmias, angina, use with catuion with MAOIs, monitor BP

indication HTN arterial vasodilation by unclarified mechanism

Amlodipine Norvasc ther class antihypertensive pharm class CCB nursing considerations may gause gingival hyperplasia, grapefruit juice may increase drug level, monitor bp and pulse prior and during therapy, monitor intake and output, assess for signs of CHF, assess characteristics of angina, educate on htn and how to take bp

indication HTN, Angina action blocks transport of calcium into muscle cells inhibiting excitation and contraction

atentolol tenormin ther class anti anginal, anti hypertensive pharm class beta blocker RN consid contraindicated in CHF, pulmonary edema, cardiogenic shock, bradycardia, heart block, monitor hemodynamic parameters HR BP may cause bradycardia, chf, pulmonary edema, masks symptoms associated with DM advise to change positions slowly to avoid orthostatic hypotension instruct pt on how to take BP

indication HTN, angina, prevention of MI action blocks stimulation of beta1 receptors in the SNS, minimal effects on beta 2 receptors

Celecoxib (Celebrex) ther class antirheumatics / nsaid pharm class Cox 2 inhibitor rn consid use caution with CV disease, increases risk for MI, CVA, thrombosis, may cause bleeding Stevens Johnson syndrome, dermatitis, notify provider for new onset abd pain, or black stool

indication OA/RA, acute pain, action inhibits pain and inflammation by inhibiting synthesis of prostaglandins,

Aspririn (ASA) acetylsalicylic acid ther class atnipyretic, non opioid analgesics pharm class salicylates RN consid use caution in bleeding disorders, chronic etoh use, may lead to steven's johnsons syndrome, laryngeal edema and anaphylaxis, increases risk for bleeding with warfarin heparin and clopidigrel increase risk for GI bleeding with NSAID use, monitor LFT, concurrent use with alcohol may increase risk for GI bleeding, aspirin with viral infections can cause Rye Syndrome.

indication RA, osteoarthritis, ischemic stroke and MI prophylaxis action inhibits the production of prostaglandins, leads to a reduction of fever and inflammation, reduces platelet aggregation, leading to a decrease in ischemic diseases,

Glipizide glucotrol antidiabetic sulfonylurea may cause aplastic anemia, hypoglycemia, photosensativity, dizziness, drowsiness, headache, diarrhea, monitor cbc, assess for allergy to med class, beta blockers may create signs of hypoglycemia, instruct pt on how to take blood sugars, instruct pt on importance of carrying a source of sugar in case of hypoglycemia,

indication TDM stimulates release of insulin from beta cells in pancreas leads to increased sensitivity to insulin

Azithromycin Zithromax ther class - agents for atypical micro bacterium, anti-infectives phar macrolide nurs consid may lead to pseudomembranous collitus, pain, diarrhea, nausea, steven's johnsons syndrome, angioedema, may increase risk for warfarin for toxitiy, monitor pt for signs of anaphylaxis, instruct pt to notify for blood, puss in stool or diarrhea

indication URI chronic bronchitis lower resp infections, ottitis media, skin infections, various STIs, prevention of bacterial endocarditis, tx of Cystic Fibrosis, action inhibits bacterial protein synthesis,

Ciprofloxacin (Cipro) ther class anti-infectives pharm class Fluoroquinolone Antibiotic RN consid contraindicated in allergies, may cause QT prolongation, avoid use with other drugs that can cause QT prolongation, can cause arrhythmias and seizures, can cause CDiff and anaphylaxis, Steven's Johnson syndrome, may decrease effects of phenytoin, monitor renal panel, assess for infection, obtain cultures prior to therapy, monitor LFTs,

indication UTI, ghonorrhea, RTIs, bronchitis, pneumonia, skin and bone infections, infectious diarrhea, abd infections, action inhibits bacterial DNA synthesis,

Diphenhydramine Benadryl ther class - allergy cold and cough remedy, antihistamine, antitussive pharm class - antihistamine rn consid may cause drowsiness, annorexia, dry mouth, nausea, chest tightness, thick secretions, hypotensions, blurred vision, headache, anticholinergic effects: dry mouth, blurred vision, constipation, sedation assess purpose prior to giving assess allergies, sleep paterns, lung sounds

indication allergy anaphylaxis, sedation, motion sickenss,antitussive action antagonizes effects of histamine, CNS depression,

Acetaminophen Tylenol therapeutic class antipyretic / non opioioid analgesic pharmacologic class: nursing considerations do not exceed 4g of APAP / day to limit risk for liver, renal and cardiac damage overdose will lead to hepatotoxicity may increase risk for bleed w/ warfarin therapy may alter blood glucose measurements

indication analgesic, antipyretic action inhibits the synthesis of prostaglandins which play a role in transmission of pain signals and fever response.

Alprazolam (Xanax) ther class anti anxiety agent pharm class benzo nursing considerations use caution with existing CNS depression, sleep apnea, renal dysfunction, hepatic dysfunction, may cause CNS depression, drowsiness, lethargy, may lead to physical dependence, may experience tolerance effect, assess anxiety and mental status, grapefruit juice may increase blood levels.

indication anxiety, panic disorder, manic symptoms of pms, insomnia, mania, psychosis action works in CNS to produce anxiolytic effect causing CNS depression Romazicon (flumazenil) -Reverses benodiazepines -can cause seizures if reversal is too rapid

Diazepam (Valium) ther class anti anxiety agents, anticonvulsants, sedative hypnotics, pharm class - benzo rn consid contra in hepatic dysfunction, can cause dizziness, draowsiness, lethargy, hypotension, physical dependence, tolerance, avoid alochol use

indication anxiety, pre-op sedation, tx of seizures, insomnia, mgmt of alcohol withdrawal action decreases effect of voltage gated CNS channels to depress the CNS Flumazenil (Romazicon) is the antidote

Epinephrine (adrenaline) (epipen) ther class antiashtmatic, broncodilator, vasopresser pharm class adrenergic agonist, nursing consid: side effects include angina, tachycardia, hypertension, restlessness, nervousness, hyperglycemia, use with MAOI - may lead to hypersensitive crisis, pt should not use stimulants like caffeine, excessive use may lead to bronchospasm, assess lung sounds pulse blood pressure and other hemodynamic parameters, monitor for chest pain. pain should ensure adequeate intake, rinse mouth, beta blockers may negate effects, may increase blood glucose.

indication asthma and copd exasperation or allergic reaction, cardiac arrest, anesthesia adjunct action: effects both beta 1 and beta 2 also has alpha agonist properties resulting in bronchodilaton and increases in HR and BP. inhibits hypersensitivity reactions.

Albuterol Proventil ther class broncodilator pharm class adrenergic nursing consideration may decrease effectiveness of beta blockers use caution with heart disease, diabetes, glaucoma, seizure disorders, over use of inhalers can lead to bronchospasm monitor for chest pain and palpatations can decrease digoxin levels

indication bronchodilator used to prevent bronchoconstriction in asthma and COPD action binds to Beta 2 adrenergic receptors in the airway, leading to relaxation of the smooth muscles in the airways

Amitriptyline (Elavil) ther class antideppressent pharm class tricyclic antidepressant nursing considerations: contraindicated in MI, HF, QT prolongation, glaucoma, may increase risk for suicidal ideation, may cause arrythmias, hypotension, ekg abnormalities, may cause alteration in blood glucose levels, may lead to general sedation and lethargy, do not use within 2 wks of MAOIs, instruct pt to take med exactly as instructed, monitor for orthostatic hypotension, photosensativity - instruct pt to use sun screen, may turn urine blue or green color

indication depression, anxiety, insomnia, parkinsons action increases amount of serotonin and norepinephrine in CNS, exhibits anticholinergic effectss

Captopril Capoten ther class antihypertensives pharm class ACE inhibitor RN consi can cause neutropenia, check WBC regularly, use cautiously w/ K supplements and K sparing diuretics, use cautiously with diuretic therapy, administer 1 hr before meals, monitor BP often, monitor wt and fluid status, monitor renal profile, monitor CBC frequently, may lead to Rabdo and dry cough

indication htn, mgmt of chf, decreases progression of DM neuropathy action blocks conversion of Angiotensin 1 and Angiotensin 2, increases Renin levels and decreases aldosterone leading to vasodilation Ace Inhibitor-pril Used to treat HBP (HTN), CHF, kidney problems caused by diabetes and to imrpove survival after a heart attack.

Enalapril (Vasotec) ther class antihypertensive pharm class ace inhibitor RN consid: can cause neutropenia, check WBC regularly, use cautiously w/ K supplements and K sparing diuretics, administer 1h before meals, monitor bp often, monitor wt and fluid status, monitor renal profile monitor CBC frequently, dray cough

indication hyptertension, mgmt of CHF, action block conversion of ang I to ang II, increases renin levels and decreases aldosterone, leading to vasodilation

Dexamethasone (Decadron) ther class antiasthmatic corticosteroids pharm class corticosteroids rn consid excreted by liver, monitor liver profile, avoid inactive untreated infections, may cause CNS alterations, may cause Cushing-oid apperance, may cause weight gain, may cause osteoperosis, may cause peptic ulcers, decreases wound healing, may elevate blood sugars, may increase cholesterol and lipid values,

indication manage cerebral edema (monitor for cushings disease) action suppresses a normal immune response, used in inflammatory states to reduce inflammation

Atorvostatin Lipitor similar meds: simvastatin (zocor), retuvastatin (crestor), therapeutic class: lipid lowering agent pharmacologic class: HMG CoA reductase inhibitor nursing considerations contraindicated in active liver disease, may cause rabdo, monitor renal function, monitor serum cholesterol before, about 4 wks after starting, and frequently during drug therapy, monitor LFTs, instruct pt to report muscle weakness,

indication management of high cholesterol, primary prevention of cardiovascular disease, lowers total cholesterol, as well as LDL while slightly increasing HDL, inhibits HGA-Coa A reductase which plays a role in the liver in cholesterol formation, action

Codeine ther class allergy , cold, cough, remedy, antitussive, opioid analgesic pharm class opoioid aganost rn consid altered mental status, hypotension, constipation, nasuea, vomiting, assess bp, pulse RR prior to and druing admin, use with caution when pt receiving MAOIs, narcan antidote for opioid aganoists

indication management of pain, diarrhea, cough suppressant action binds to opioid receptors in CNS and alters perception of pain while producing general depression of CNS causes decrease in cough reflex and GI motility

Cortisone (Steroids) cortone pharm class corticosteroids ther class anti asthmatic corticosteroids rn consid excreted by liver, monitor LFTs, avoid in active infections, may cause CNS alteration may cause Peptic ulcers and cushingoid appearance, decreased wound healing and osteoporosis, may elevate blood sugar, increase cholestrol levels

indication mgmt of adrenal cortical insufficiency addisons disease, replace cortisol in states of insuffiency action adrenal glands secrete cortisol which play a role in blood sugar, metabolism, immune function, metab of fat protein and carb and decrease bone formation Wt gain, Na+ retention, K+ Loss NEVER STOP SUDDENLY

Carbadopa/Levodopa Sinemet ther class antiparkinson agent pharm class dopamine agonist RN consid may cause orthostatic hypotension, may cause dark urine, weeks to months to take effect, do not use with MAOIs, do not use with glaucoma, melanoma, assess for parkinsonian symptoms, take as directed

indication parkinsons disease action Levodopa is converted to dopamine and works as a ntm, carbadopa prevents the destruction of levodopa allowing it to cross the BBB

Ferrous Sulfate Feosol ther class anti anemics pharm class iron supplements rn consid may cause seizures, hypotension, constipation, epigastric pain, diarrhea, skin staining, anaphylaxis, assess nutritional status, bowel function, monitor hemoglobin, hematocrit, iron levels, may cause elevated liver enzymes, take on an empty stomach to increase absorption, VIT C helps with absorption, use z track with IM injections,

indication prevention and treatment of iron deficiency anemia action iron is essential for hemoglobin, myoglobin and enzymes, it is transported to organs where it becomes part of iron stores

Enoxaparin (Lovenox) ther class - anticoag pharm class - LMWH nursing consid contraindicated in pork hypersensitivyt, monitor for signs of bleeding, administer subcut, do not eject air bubble prior to injection, do no aspirate or massage site

indication prevention of VTE, DVT and PE action prevents thrombis formation by potentiating inhibitory effect of antithrombin on factor Xa and thrombin LMWH -

Carbamazepine Tegretol ther class anticonvulsant pharm class dibenzoazepine rn consid interferes with oral contraceptives, do not use with MAOIs, may cause suicidal thoughts, may cause stevens johnson syndrome, agranulocytosis, aplastic anemia, thrombocytopenia, do not consume grapefruit while taking med, monitor CBC and platelet count, monitor serum blood levels of medication often

indication seizures, DM neuropathy, pain associated with trigeminal neuralgia action effects sodium channels in neurons leading to decreased synaptic transmission

Dobutamine (Dobutrex) ther class inotropic pharm class beta adrenergic agonist rn consid monitor hemodynamics, hypertension, increases HR, pvcs, skin reactions may occur with hypersensitivity, beta blockers may negate therapeutic effects, monitor CO, monitor peripheral pulses before during and after therapy.

indication short term management of HF action positive inotropic effect, increases CO, with very little effect on Heart Rate, stimulates beta1 receptors in the heart, Adrenergic agonist (catecholamine) Beta-1 Used for HF Can cause increased HR

Clindamycin Cleocin ther class - anti infectives pharm class lincosamide rn consid arrhtymias, cdiff, diarrhea, phlebitis, monitor bowel function, assess for infection cultures prior to theray, monitor LFT and CBC

indication skin infection, RTI, septicemia, intra abd infection, osteomyetis action: bacteriostatic, inhibits protein synthesis

Cephalexin (Keflex) ther class - anti infectives pharm class cephalosporin 1st gen rn consid contraindicated in ceph and pene allergies, may lead to seizures, cdiff, diarrhea, phelbitis at IV site, anaphylaxis, assess infection and allergies, obtain culture prior to giving med, monitor bowel function, may lead to superinfection may cause elevated LFT

indication skin infections, pheumonia, uti, ottis media action bacterialcidal

Amoxicillin moxatag pharm class aminopenicillins ther class antiinfective nursing considerations contraindicated w/ penecillin allergy, may cause seizures, assess for rash, anaphylaxis, excreted by kidneys, monitor renal labs, monitor pt for diarrhea, blood stools should be reported immediately

indication skin infections, resp infections, sinitus, endocarditis, prophylaxis for lime disease action inhibits synthesis of bacterial cell wall leading to cell death

Ampacillin principen phar aminopenicillin ther anti-infective rn consid contraindicated in penicillin allergy, use w/ caution in renal insufficiency, may lead to seizures, diarrhea, anaphylaxis, superinfection, assess for infection, monitor LFTs, instruct pt on signs of superinfection, furry overgrowth on tongue vaginal itching, loose and foul smelling stool, pt should not use with oral contraceptive use,

indication skin infections, soft tissue infections, otitis media, respiratory infection, GU infections, meningitis, septicemia, action: bactericidal broader spectrum then penicillin, binds to cell wall

Cimetidine (Tagamet) ther class anti ulcer agent pharm class H2 receptor antagonist, h2 blocker rn consid increases serum level of warfarin, can lead to respiratory infection and green sputum, monitor for arrythmias, may cause agranulocytosis, aplastic anemia, monitor CBC during therapy, take as directed, increase fluid and fiber intake to decrease constipation,

indication tx of duodenal ulcers, GERD, heart burn, prevention of GI bleeding in critical pts action inhibits action of histamine leading to inhibition of gastric acid secretion

calcium acetate phoslo - phosphate binder ther class - mineral / electrolyte supplements pharm class antacids phosphate regulator nursing considerations may cause cardiac arrest and arrythmias, phlebitis at site of insertion, monitor hemodynamics, may cause hypotension, bradycardia, and arrhythmias, hypercalcemia can increase risk for digoxin toxicity administer slowly, educate on foods that contain vit D and encourage adequate intake monitor parathyroid hormone

indication tx of hypocalcemia, prevention of post menopausal osteoporosis, tx of hyperkalemia and hypermagnesia, adjunct in cardiac arrest, control of hyperphosphatemia with ESRD, binds to phosphate in food and prevents absorption action calcium is essential for nervous, skeletal and muscular systems, helps maintain cell membranes, aids in transmission of nerve impulses and muscle contraction, aids in blood formation and coagulation

Calcium Carbonate (Tums, Rolaids) ther class mineral / electrolyte replacement / supplements pharm class antacids nursing considerations may cause cardiac arrest and arrhythmias, monitor hemodynamics, may cause hypotension, bradycardia, and arrhythmias, hypercalcemia can increase risk for digoxin toxicity administer slowly, educate on foods that contain vit D and encourage adequate intake monitor parathyroid hormone

indication tx of hypocalcemia, prevention of post-menopausal osteoporosis, tx of hyperkalemia and hypermagnesia, used as antacid action calcium is essential for nervous, skeletal and muscular systems, helps maintain cell membranes, aids in transmission of nerve impulses and muscle contraction, aids in blood formation and coagulation

Cefaclor 2nd gen cephalosporin Ceclor ther class anti-infectives pharm class cefalosporin 2nd gen rn consid contraindicated in cefalosporin and possibly penicillin allergies, may lead to seizures, phlebitis at IV site, anaphylaxis, assess infections / allergies, obtain cultures prior to therapy, assess bowel function may lead to diarrhea, may lead to superinfection

indication tx of respiratory tract infections, skin infections, ottitis media, action bacterialcidal, binds to bacterial cell wall causing cell death

Dopamine intropin ther class inotropic vasopressor pharm class adrenergic rn consid: monitor hemodynamics closely, bp, hr, ekg, cvp and paop if avail, obtain parameters for hemodynamic values, titrate for specific bp, more vasoconstrictors may be required, irritation may occur at IV site, beta blockers may counteract therapeutic effects,

indication use to improve bp, co and urine output action smaller doses result in renal vasodilation, doses 2-10mcg/kg/min result in cardiac stimulation by acting on beta 1 receptors, greater doses stimulate alpha receptors leading to vasoconstriction,

Haloperidol (Haldol) ther class anti psychotic extrapyramidal symptoms, tardive dyskonesia, use caution in QT prolongation, may cause seizures, constipation, dry mouth, agranulocytosis, assess for hallucinations, monitor hemodynamics, monitor for neuroleptic malignant syndrome, fever, muscular rigidity, altered mental status, and autonomic dysfunction, monitor CBC with differential,

indication: schizophrenia, mania, aggressive and agitated pt action: alters the effects of dopamine

Divalproex Sodium (Depakote) ther class anticonvulsant, vascular headache suppresent, anticonvulsant, mood stabilizer may cause suicical thoughts, agitation, dizziness, insomnia, hepatoxicity, pancreitus, increases risk for bleeding with warfarin, use caution with MAOI, monitor LFT,

indication: seizures, manic episode, prevention of headache action increases the level of GABA inhibitory NTM in CNS

Chlorapromazine (Thorazine) ther class: antipyschotic / anti emetic pharm class - dopamine receptor antagonist rn consid may cause neuroleptic malignant syndrome, sedation, tardive dyskinesia, hypotension, agranulocytosis, assess mental status prior to and during treatment, monitor BP, ensure pt is taking med, monitor CBC and LFTs, instruct pt not to skip doses or double dose,

indication: 2nd line treatment of shiz and psychosis N&V, pr-op sedation, acute /intermittent, headache bi-polar, actions: exhibits anticholinergic activity, alters effects of dopamine in CNS

Diltiazem (Cardizem) ther class antianginals, antiarrtymicss, antihypertensives pharm class CCB nursing consid: contraindicated in 2nd and third AV block, may cause arrythmias, CHF, bradycardia, peripheral edema, gingival hyperplasia, increases digoxin levels, don't drink grapefruit juice, assess for signs of CHF monitor ekg continously, change positions slowly, monitor serum K, instruct pt on how to take blood pressure,

indication: HTN, angina, SVT, Afib, aflutter action: inhibits calcium transport, resulting in inhibition of excitation and contraction leads to depression of SA and AV node leading to decreased HR, leads to vasodilation and decreased BP

Altaplase / Activase /TPA therapeutic class thrombolytics pharmacologic class: plaminogen activators nursing considerations contraindicated in active bleeding monitor closely for signs of bleeding q15m x 1hr or q15-30m x 8hr use w/ caution in pt w/ recent surgery ,may cause intracranial hemorrhage, monitor for anaphylaxis, use caution w/ uncontrolled hypertension, assess neuro status during therapy

indication: MI, acute ischemic stroke, occluded central lines action: converts plasminogen to plasmin, which degrades the fibrin found in clots

Epoetin Epogen ther class: anti anemics pharm - hormones rn consi contraindicated in albumin hypersensitity, may cause seizures, CHF, MI, CVA, HTN, monitor BP during therapy, monitor signs of anemia, assess dialysis shunts, monitor bleeding times, initiate seizure precautions, do not shake vile.

indication: anemia action: stimulates erythropoiesis (production or RBC)

Atropine atropen ther class: anti-arrhythmic pharm class anticholinergic, antimuscarinic nursing considerations avoid in acute hemorrhage, tachycardia and angle closure glaucoma, monitor pt for tachycardia and palpations, may cause urinary retention in elderly patients, pts may experience constipation due to slow GI motility

indication: decreases oral and respiratory sections, treats sinus bradycardia and heart block tx of broncospasm action: an anticholinergic which means that it inhibits effects of parasympathetic nervous system specifically acetylcholine this inhibition causes increase in HR, bronchodilation, decreased GI and respiratory secretions,

Acyclovir Zovirax therapeutic class antiviral pharmacologic class: purine analogs nursing considerations may cause seizures, renal failure, stevens johnson's syndrome, thrombotic, thrombocytopenia purpura syndrome, diarrhea, dizziness, nausea monitor renal panel during administration, assess lesions, educate pt on proper protection during sexual intercourse,

indication: genital herpes / herpes zoster / chicken pox/ action interferes w/ viral dna synthesis An antiviral. Used for cold sores (HSV) and VZV. Inhibits viral DNA polymerase.

Famotidine Pepcid ther class antiulcer agent pharm class histamine H2 antagonist rn consid may cause arrhthmias, agranulcytosis, aplastic anemia, assess for abd pain and occult blood, monitor CBC, instruct pt to increase fluid and fiber intake to prevent constipation,

indication: short term treatment of active liver ulcer, GERD, hearburn, injestion, prevention of gi bleeding in critcially ill pts, management of overuse of NSAIDS action: blocks action of histamine located in gastric parietal cells, inhibits gastric acid secretion,

Diphenoxylate with Atropine Lmotil ther class anti diarrheal pharm class anticholinergic rn consid: contraindicated with angle closure glacoma dehydration, structurally related to opioids so use caution with pts that have allergies to opioids may cause constipation, tachycardia, ileus, dizziness, monitor LFT as med excreted by liver

indication: tx for diarrhea action: inhibits GI motility via anticholinergic effects

Gentomycin tehr class antiinfective pharm class aminoglycoside causes tinnitus /hearing loss, do not administer with penecillin, use caution in renal impairment, assess for infection, obtain cultures prior to therapy, monitor LFT, monitor blood levels of drug

indication: tx of Gram - infections when penicillin isn't effective action: inhibits bacterial protein synthesis

Ethromycin Emycin ther class - antiinfective pharm class macrolide rn consi causes QT prolongation, ventricular arrythmias, diarrhea, assess infection, monitor LFTs, take fully even if feeling better. Do not share meds

indication: useful in place of penecillin when pt cannot take penicillin, U+L RTI, Ottis Media, skin infections, pertussis, syphillus, rheumatic fever action : bacterialstatic suppresses bacterial protein synthesis

Cefdinir Omnicef ther class anti-infectives pharm class cephalosporin third generation rn consid contraindicated in cephalosporin and possibly penicillin, may lead to seizures, c diff, diarrhea, phlebitis, anaphylaxis, assess infection and allergies, obtain cultures prior to therapy, monitor bowel function, monitor for bleeding, may lead to superinfection

indications tx of skin infections ottis media action bacterialcidal, binds to bacterial cell wall causing cell death

Escitalipram Lexapro ther class anti depressant pharm class SSRI rn consid contraindicated with MAOI, may cause suicidal thoughts, insomnia, drowsiness, diarrhea, nausea, serotonin syndrome, may cause QT prolongation with certain meds, assess for sexual dysfunction, may take 4- 6 week for therapeutic effects, monitor for serotonin syndromes, tachycardia, NV, mental changes, hyperthermia

major depressive disorder, anxiety disorder, psd, ptsd, social phobia, action: increases the extracellular level of serotonin in the synaptic cleft but selectively inhibiting its reuptake

hydrocodone/acetaminophen narcotic opioid analgesic , allergy, cold and cough remedy, antitussive opioid agonists use caution with concurrent use of MAOI avoid use within 14 days of eachother, hypotension, monitor hemodynamics and respirations after adminstering, may increase ICP use caution with head trauma, narcan is the antidote for overdose do not exceed 4g of apap per day

management of moderate to severe pain alters the perception and reaction to pain by binding to opioid receptors in the CNS also suppresses the cough reflex

Ibuprofen (Advil, Motrin) antipyretics, antirheumatics, non opioid analgesics, NSAID may cause GI bleeding, hepatitis, Stevens Johnson Syndrome, may cause anaphylaxis, monitor for headache, nausea, vomiting, constipation, therapy should be discontinued after first sign of rash, monitor renal and liver labs, pt should avoid using alcohol

mild to moderate pain, inflammatory states decreases pain and inflammation by inhibiting prostaglandins

Hydromorphone (Dilaudid) narcotic opioid analgesic , allergy, cold and cough remedy, antitussive opioid agonists use caution with concurrent use of MAOI avoid use within 14 days of eachother, hypotension, monitor hemodynamics and respirations after adminstering, may increase ICP use caution with head trauma, narcan is the antidote for overdose in use as an antitussive dilute with NS assess bp respirations and pulse before and during med admin

moderate to severe pain alters the perception and reaction to pain by binding to opioid receptors in the CNS also suppresses the cough reflex

Fluticasone/Salmeterol flovent antiasthmatic, antiinflam. steroid corticosteroids (inhallation) use cautiouslly with untreated infections, may cause headache, insomnia, bronchospasm, nasal congestion, adrenal suppression, monitor pt resp status, may lead to decreased bone density, for pts using corticosteroids and bronchodilators they need to use bronchodilators first, instruct pt to stop smoking.

prophylactic asthma treatment locally acting antiinflammatory

omeprazole (Prilosec)

proton pump inhibitor Suppresses acid secretion by irreversibly inhibiting H,K-ATPase (proton pump) which is the enzyme that makes gastric acid. Reduces acid secretion in the stomach by blocking parietal cell that secretes HCl to allow ulcers to heal adverse effects: Bone loss (long-term use) N/V diarrhea Usually inconsequential with short-term use Headache GI effects Pneumonia Fractures Hypomagnesemia Rebound acid hypersecretion C. difficile infection Gastric cancer

Glucagon Glucagen therapeutic class - hormones pharm class: pancreatics may cause anaphylaxis, may cause hypotension, assess for signs of hypoglycemia, neuro status, monitor serum glucose levels, teach pt's signs of hypoglycemia,

severe hypoglycemia, antidote for beta blockers and CCBs, action: stimulates production of glucose from stores, relaxes GI tract, A protein hormone secreted by pancreatic endocrine cells that raises blood glucose levels; an antagonistic hormone to insulin.

Fentanyl Sublimze therapeutic class opioid analgesic pharm class opioid agonists rn consid use caution with increase ICP, head trauma, adrenal insufficiency, avoid use with MAOI, may cause acnea, laryngospasm, decreased respirations, bradycardia, hypotension, do not consume grapefuit while taking med, monitor hemodynamics while taking med, assess pain scale frequently

supplement to general anesthesia continous IV infusion for purpose of analgesia action: binds to opioid receptors in CNS altering perception of pain causing CNS depression