Ebow’s nursing Drug Cards – Flashcards

drug Classification: Penicillin Therapeutic Use:same as penicillin G Contraindication: AUGMENTIN is contraindicated in patients with a history of allergic reactions to any penicillin. It is also contraindicated in patients with a previous history of cholestatic jaundice/hepatic dysfunction associated with AUGMENTIN. Therapeutic Blood Serum Level: 10 to 30 mL/minute Adverse effects: same as penicillin G Usual Dose: 250 mg orally q8h or 500 mg orally q12h For severe infections: up to 875 mg q12h Nursing Implications: should be used cautiously with expectant mothers and a high percentage of patients with mononucleosis who receive ampicillin develop an erythematous skin rash. Thus, ampicillin-class antibiotics should not be administered to patients with mononucleosis.

Trade Name: Ery-Tab Classification: Macrolide antibiotic Route of Administration: PO Dosage Range: 250mg qid Action: Binds susceptible bacterial ribosomes, suppressing protein synthesis in bacterial cells and causing cell death. Uses: Treatment of systemic infections; Treatment of diphtheria carriers. Side Effects: Reversible hearing loss; abdominal cramps, rash Contraindications: Hypersensitivity Special Nursing Considerations: Take 1 hr before or 2 hours after meals with a full glass of water. Make sure to avoid citrus juice. Assess history of erythromycin hypersensitivity. Complete full course of therapy. Maintain hydration/ personal hygiene. Consider alternate birth control.

Drug Classification:Cephalosporins Therapeutic Use: same as cefadroxil Contraindication:Cephalexin is contraindicated in patients with known allergy to the cephalosporin group of antibiotics. Therapeutic Blood serum level: 50 to 200 ng/mL Adverse effects:same as cefadroxil Usual Dose:1-4 g/d orally in divided doses Nursing Implications:hypersensitivity to chephalosporins, pregnancy, hypersensitivity to pencillins,lactation, renal disease. Patient/family teaching:Advise patient to report signs of superinfection (furry overgrowth on the tongue, vaginal itching or discharge, loose or foul-smelling stools) and allergy. Instruct patient to notify health care professional if fever and diarrhea develop, especially if diarrhea contains blood, mucus, or pus. Advise patient not to treat diarrhea without consulting health care professional.

GENERIC NAME: AMOXICILLIN TRADE NAME: Amoxil, DisperMox, Trimox, Wymox, Polymox CLASSIFICATION : Antibiotic, penicillin ACTION: Synthetic broad-spectrum penicillin closely related to ampicillin; Binds to bacterial cell wall (PBP-1 and PBP-3; penicillin-binding sites), causing cell death byinhibiting cell wall synthesis; bactericidal action; spectrum is larger than penicillin's INDICATIONS: Ear, nose, and throat infections due to Streptococcus species, S. pneumoniae, Staphylococcus species or Haemophilus influenzae ; GU infections due to E.coli, P. mirailis, or E. faecalis ; lower resp tract infections due to Streptococcus species, S. pneumoniae, Staphylococcus species, or H. haemophilus ; acute uncomplicatedgonococcal infections due to N. gonorrhoeae ROUTES OF ADMINISTRATION: Capsules; Oral Suspension; Tablets; ChewableTablets USUAL DOSAGE: Over 40 kg: 500 mg q 8 hr or 500 mg q 12 hr; under 40 kg: 20mg/kg/day in divided doses q 8 hr or 25 mg/kg/day in divided doses q 12 hr Less than 40 kg: 20 mg/kg/day in divided doses q 8 hr OR 25 mg/kg/day in divided dosesq 12 hr ADVERSE REACTIONS : Hypersensitivity, nausea & vomiting, gastritis, stomatitis;specific allergies INTERACTIONS : Antacids ↓ effect of PCNs related to ↓ GI tract absorption, antibiotics↓ effect of PCNs, aspirin ↑ effect of PCNs by ↓ plasma protein binding, chloramphenicoland erythromycins either ↑ or ↓ effects, tetracyclines ↓ effect of PCNs CONTRAINDICATIONS : Hypersensitivity to PCNs; PO use of PCNs during acutestages of emphysema, bacteremia, pneumonia, meningitis, pericarditis, and purulent or septic arthritis; lactation NURSING CONSIDERATIONS : Inject slowly; causes local irritation via IV/IM; IMinjections deep into gluteal muscle; IV injections usually diluted with IV solution; Assessfor allergic reactions (if reaction occurs, stop drug immediately); monitor vitals, chem.Results; assess for 20 min after administering to check for allergies; should be prescribedcautiously to nursing mothers; take full dosage; report unusual symptoms i.e. ↑ bruising/bleeding, sore throat, rash, diarrhea, symptoms worsening, or lack of response

Trade Name: Lasix Classification: Loop diuretic Route of Administration: PO Dosage Range: PO-Edema- 20-80mg/d as single dose. Hypertension-40mg bid (adjust according to response) Action: Antihypertensive effect due to decrease flow of blood in vessels. Inhibits the reabsorption of sodium and chloride in the proximal and distal tubules Uses: Edema associated with CHF, to treat hypertension Side Effects: Dizziness, headache, blurred vision, anorexia, N&V, jaundice, hypotension Contraindications: Never use with ethacrynic acid. Hypersensitivity, anuria, severe electrolyte imbalance. Special Nursing Considerations: Asses potassium level (3.5-5mEq/L). Monitor weight, blood pressure, and I/O. Elderly may require lower dosage. If used with other hypertensions try to lower dose 50% in order to prevent excessive BP drop. Take in morning on empty stomach.

Classification: Anti-diabetic. Biguanides Therapeutic Effects: Decrease hepatic glucose production & intestinal absorption, increased receptor site sensitivity, GI effects Adverse Reactions & side effects: Abdominal bloating. Lactic acidosis. Metallic taste Nursing Implications & teaching: Educate about lactic acidosis when food or fluid is decreased. (S/S - chills, diarrhea, dizziness, low BP, weakness, muscle pain, slow HR. Notify MD IMMEDIATELY). Stop drug before dye based studies. Check renal function. TAKE WITH FOOD

Classification: Potassium supplement Therapeutic Effects: Transmit nerve impulses; contraction of cardiac, skeletal, and smooth muscle; gastric secretion; renal function; tissue synthesis; and CHO metabolism. Adverse Reactions & side effects: ARRHYTHMIAS, ECG changes oral—abdominal pain, diarrhea, flatulence, nausea & vomiting, GI effects Nursing Implications & teaching: (IV rate should generally not exceed 20 mEq/hr, unless closely monitored.) Check for s/s hypokalemia/hyperkalemia, TAKE WITH FOOD

Classification: Anti-platelet Therapeutic Effects: Decrease atherosclerotic events Adverse Reactions & side effects: GI bleed, neutropenia, thrombotic thrombocytopenic purpura Nursing Implications & teaching: Monitor for bleeding, CBC, diff, platelet count, Do not double dose, Avoid NSAIDs. Watch for fever, chills, sore throat, bleeding/bruising. Caution in brushing/flossing teeth

Trade Name: Wellbutrin Classification: Antidepressant Route of Administration: PO Dosage Range: Initial dose 100mg in the a.m. and p.m. for the first 3 days. Then 100mg tid. (morning, midday, evening) Action: Mechanism of action is not known. Weakly block neuronal uptake of epinephrine, serotonin, and dopamine. Uses: Treatment of depression. Side Effects: Headache, migraine, insomnia, dizziness, visual and auditory disturbances, anorexia, bleeding, male sexual dysfunction Contraindications: Hypersensitivity, seizure disorders, abrupt D/C of alcohol or sedatives Special Nursing Considerations: Avoid abrupt withdrawal of medication. Monitor suicidal indication. May take several weeks before results can be seen. Increase fluid intake. Constipation may occur.

Trade Name: Dilantin Classification: Anticonvulsant, Antiarrhythmic Route of Administration: PO Dosage Range: Initial 100mg 3 times per day, then individualized dose. Maintance range 100mg 3-4 times/day. Action: Inhibition of seizure activity in motor cortex. Uses: Treatment of grand mal, psychomotor seizures. Prevention and treatment of seizures during neurosurgery. Side Effects: Headache, mental confusion, slurred speech, constipation, insomnia Contraindications: Hypersensitivity, Adams-Stokes syndrome. Special Nursing Considerations: Do not interchange brands, may be crushed and mixed with food or liquid. Elderly may require lower dosage. Monitor drug level (10-20mcg/mL).

Classification: Lipid-Lowering agent Therapeutic Effects: Decrease LDL/VLDL/Triglycer.; Increase HDL (slightly) Adverse Reactions & side effects: RHABDOMYOLYSIS = muscle cell lysis, toxins into circulation, rashes, constipation, flatus, GI effects Nursing Implications & teaching: Avoid grapefruit & grapefruit juice. With unexplained muscle pain/tenderness-monitor CPK -- if it increases, d/c med = life threatening. Check LFTs

Classification: Antianxiety Sedative / hypnotic. Benzodiazepine. Therapeutic Effects:Management of anxiety, insomnia, Status Epilepticus. Preoperative sedation. Postoperative amnesia Adverse Reactions & side effects: Dizziness, drowsiness, lethargy, APNEA, CARDIAC ARREST with rapid IVP Nursing Implications & teaching: Assess anxiety, mental status,. Avoid ETOH & other CNS depressants

Trade Name: Lopressor Classification: Beta-blocker; antihypertensive Route of Administration: PO Dosage Range: Angina-100-400mg/d Hypertension-100-400mg/d Action: Blocks stimulation of B1 receptors located in heart. Uses: Treatment of hypertension as sole agent; long treatment of angina. Side Effects: Dizziness, mental confusion, bradycardia, shortness of breath, constipation, rash Contraindications: Hypersensitivity, overt cardiac failure, sinus bradycardia Special Nursing Considerations: Check BP; check pulse if lower than 60 bpm, hold, notify physician. Take with food. Maintain diet low in Na. Do not skip doses.

Generic name: Enalapril or Enalaprilat Drug Category: Anti-hypertensives, A.C.E. (angiotensin converting enzyme) inhibitors Drug Action: lowers blood pressure, decrease in signs and Adverse effects: Dizziness, headache, cough, hypotension,diarrhea, rashes Contraindications: in hypersensitivity cross sensitivity may occur in A.C.E. inhibitors.Pregnancy. Angioedema Interactions:Exsessive hypotension may occur with concurrent use of diuretics and nitrate. Hyperkalemia may result from concurrent use of potassium supplments. Nursing Implication: Monitor BP,pulse, weight, edema, WBC,BUN,creatine Teaching: take at the same time each day even if you're feeling well Don't discontinue without M.D.'s order Avoid salty foods Don't drive or operate a vehicle while taking this medication May cause taste impairment,which resolves in 8-12 wks Notify M.D. if rash,chest pain, or fever occur

GENERIC NAME : PAROXETINE HYDROCHLORIDE, PAROXETINE MESYLATE TRADE NAME : Paxil, Paxil CR, Pexeva CLASSIFICATION : Antidepressant, selective serotonin reuptake inhibitor (SSRI) ACTION : Antidepressant effect likely due to inhibition of CNS neuronal uptake of serotonin and to a lesser extent norepinephrine and dopamine; Results in increased levelsof serotonin in synapses INDICATIONS : Treatment of major depressive episodes as defined in the DSM-III(immediate-release) or DSM-IV (controlled-release); panic disorder with or withoutagoraphobia; treatment of social anxiety disorder (social phobia) as defined in the DSM-IV; generalized anxiety disorder; up to 24 weeks for maintenance therapy ROUTES OF ADMINISTRATION : Oral suspension - 10mg/5mL; tablets - 10 mg, 20mg, 30 mg, 40 mg; tablets, controlled-release - 12.5 mg, 25 mg, 37.5 mg USUAL DOSAGE : Major depressive disorder, initial - 25 mg/day usually given assingle dose in AM; can increase dose by 12.5 mg/day up to 62.5 mg/day; maintenance -mg/day average: Social Anxiety disorder - 12.5 mg/day with range 12.5-37.5 mg/day:Diabetic neuropathy - 10-60 mg/day (oral suspension): Panic disorder - 12.5 mg/day;increase dose by 12.5 mg/day at 1 week intervals up to 75 mg/day ADVERSE REACTIONS : Insomnia, somnolence, nausea, dry mouth, asthenia,headache, dizziness, tremor, excessive sweating, diarrhea/loose stools, constipation,abnormal ejaculation INTERACTIONS : Antiarrhythmics (type IC) - possible ↑ effect R/T ↓ liver breakdown;Cimetidine - ↑ Paroxetine effect R/T ↓ liver breakdown; Digoxin - possible ↓ plasmalevels; Phenobarbital - possible ↓ paroxetine effect R/T ↑ liver breakdown; Phenytoin - possible ↓ paroxetine effect R/T ↑ liver breakdown and also ↓ phenytoin levels CONTRAINDICATIONS : Lactation, use of alcohol, use during the first trimester of pregnancy; concomitant use of thioridazine, use in children and adolescents less than 18years of age with major depressive disorder due to increased risk of suicidal thoughts andattempts NURSING CONSIDERATIONS : Even though beneficial effects may be seen in 1-4weeks, continue therapy as prescribed; effectiveness is maintained for up to 1 year withdaily doses averaging 30 mg of immediate-release or 37.5 mg of controlled-release; if decreasing dose, decrease incrementally (stopping suddenly can cause dizziness, sensorydisturbances, agitation, anxiety, nausea, and sweating); document mania, alteredmetabolic or hemodynamic states, seizures; note reasons for therapy, type, onset,characteristics of S&S, other therapy trialed, and outcomes; may be given with or withoutfood; monitor weight, vital signs, ECG, electrolytes, CBC, renal and LFT's and note anydysfunction

GENERIC NAME : LANSOPRAZOLE TRADE NAME : Prevacid, Prevacid IV CLASSIFICATION : Proton pump inhibitor ACTION : Gastric acid (proton) pump inhibitor, blocks final step of acid production;suppresses gastric acid secretion by inhibition of the (H + , K + )-ATPase system located atthe secretory surface of the parietal cells in the stomach INDICATIONS : Short-term treatment (up to 4 weeks) for healing and symptomaticrelief of active duodenal ulcer (PO only); maintain healing with duodenal ulcer; short-term treatment (up to 8 weeks) for healing and symptomatic relief of benign gastric ulcer ROUTES OF ADMINISTRATION : Capsules, delayed-release: 15 mg, 30 mg; granulesfor oral suspension, delayed release: 15 mg, 30 mg; tablets, orally disintegrating: 15 mg,30 mg USUAL DOSAGE : Treatment of duodenal ulcer (initial) - 15 mg once daily before breakfast for 4 weeks (maintenance) - 15 mg once daily; treatment of gastric ulcer - 30mg once daily up to 8 weeks; GERD - 30 mg once daily before meals up to 8 weeks andif symptoms remain after 2 or more weeks, can up to 30 mg once daily; erosiveesophagitis - 30 mg once daily before meals up to 8 weeks; if symptoms persist, maycontinue for another 8 weeks ADVERSE REACTIONS : Diarrhea, headache, N&V, constipation, rash INTERACTIONS : Ampicillin - ↓ ampicillin effect R/T ↓ absorption; clarithromycin - ↑lansoprazole AUC and peak plasma levels R/T inhibition of metabolism by CYP2C19;Digoxin - ↓ digoxin effect R/T absorption; Iron salts - ↓ effect of iron salts R/Tabsorption; sucralfate - delayed absorption of lansoprazole CONTRAINDICATIONS : Lactation; use with rabeprazole NURSING CONSIDERATIONS : Do not crush or chew any lansoprazole products;consider dosage reduction in those with severe liver disease; for those unable to swallow pills, open capsule and sprinkle on a spoon of applesauce; to give capsules in NG tube,open capsule and mix intact granules with 40 mL of apple juice and instill through NGtube into the stomach, flushing with additional apple juice to clear tube; store in tightcontainer protected from moisture and store between 15-30

Classification: Thyroid preparation Therapeutic Effects: Restoration of hormonal balance, suppression of cancer Adverse Reactions & side effects: Insomnia, arrhythmias, tachycardia, wt. loss. Avoid use in thyrotoxicity Nursing Implications & teaching: Assess apical pulse and BP prior to admin & during therapy, & for chest pain, tachyarrhythmia. Give prior to breakfast. Monitor T3 and TSH. Important drug interactions

Classification: Sedative / hypnotic Therapeutic Effects: Sedation and induction of sleep Adverse Reactions & side effects: Amnesia, daytime drowsiness, drugged feeling, physical & psychological dependence, tolerance, GI effects Nursing Implications & teaching: Assess sleep, mental status, potential for dependence. Don't use more than 7-10 days. Avoid ETOH & other CNS depressants

*AKA: Amlodipine *Action: inhibits Ca++ ion influx across cell membrane during cardiac depolarization, incrs myocardial oxygen, relaxes vascular smooth muscle. *Uses: chronic stable pectoris angina, HTN, variant angina; may use with other anti HTN & antianginals. *Dose & RTE: CAD - Adult PO 5-10mg/day HTN - Adult PO 2.5-5mg/day initial, max 10 mg/day; Geriatric PO 2.5 mg/day, may incrs to 5mg/day, max 10mg/day. Hepatic dose - Adult PO 2.5mg/day, may incrs to 10mg/day (antiHTN); 5mg/day may incrs to 10mg/day (antianginal) Nusr Consids: Assess - cardiac status, BP, pulse, respirations, ECG; if severe CAD may develop severe angina, acute MI after Ca++ channels blocked; I&O ratio, daily weight, CHF, peripheral edema, dyspnea, jugular vein distention, crackles; angina intensity, duration and location. Evaluate - decr angina pain & BP, incrs exercise tolerance. Teach - take every dose; avoid hazardous activities, avoid OTC, keep medical regimen; notify id irregular heart beat, SOB, edema (feet, face, hands), dizzy, constipated, nausea, HTN, chest pain doesnt improve; monitor pulse, notify below 50 bpm, avoid alcohol & alor of grapefuit juice, prevent orthostatic HTN, use sunscreen.

Trade Name: Colace Classification: Laxative Route of Administration: PO Dosage Range: 50-500mg, depending on the product Action: Acts by lowering the surface tension of intestinal fluids, resulting in water and fat passage into fecal mass. Uses: Used for constipation, to lessen strain of defecation in person with hernia or CV diseases in which straining should be avoided. Side Effects: N&V, cramps, diarrhea Contraindications: Appendicitis, fecal impaction, obstruction of intestinal tract Special Nursing Considerations: Do not chew the tablets, swallow whole. Assess diet and activity levels, bowel sounds, and duration of constipation. Assess medication history contributing to constipation.

GENERIC NAME : MAGNESIUM HYDROXIDE TRADE NAME : (Phillips) Milk of Magnesia, Ex-Lax Milk of MagnesiaCLASSIFICATION: Laxative ACTION : Important for many systems in the body, especially the muscles and nerves;reduces stomach acid and increases water in the intestines (aides in defecation) INDICATIONS : Used as a laxative to relieve occasional constipation (irregularity); asan antacid to relieve indigestion, sour stomach, heartburn ROUTES OF ADMINISTRATION : Tablets, capsules, tablets (chewable), suspension USUAL DOSAGE : Adults - 2-4 tablespoons or 6-8 chewable tablets (Laxative); 1-3teaspoons with a little water up to 4 times daily (Antacid) ADVERSE REACTIONS : Symptoms of magnesium hydroxide overdose (nausea,vomiting, flushing, low blood pressure, bradycardia, drowsiness, coma, death INTERACTIONS : Tetracyclines, fluoroquinolone antibiotic, penicillamine, digoxine,nitrofurantoin CONTRAINDICATIONS : No restrictions on food, beverages, activity unless advised by PMD; seek emergency attention if an allergic reaction occurs; Kidney disease NURSING CONSIDERATIONS : Do not take magnesium hydroxide if abdominal pain,nausea, vomiting is present unless prescribed; do not use for longer than one week; rectal bleeding or failure to have bowel movement after l;axative may indicate a more serious condition

Trade Name: Lanoxin Classification: Cardiac glycoside Route of Administration: PO Dosage Range: (tablets) (maintenance) 0.125-0.5mg/d Action: Increases the force and velocity of heart contraction by increasing the refractory period of the AV node and increasing peripheral resistance. Uses: CHF, Control rapid ventricular contraction rate in clients with AF; slows heart rate in sinus tachycardia due to CHF Side Effects: Headache, dizziness, blurred vision or yellow vision Contraindications: Ventricular fibrillation or tachycardia, beriberi heart disease Special Nursing Considerations: Assess the apical pulse for 1 full minute prior to administering. If less than 60 bpm wait 1 hr then recheck. If remains less than 60 notify physician. Monitor vital signs. Monitor digoxin level (0.5-2.0mg/ml). Observe S/S of toxicity.