Nursing Drug Classes – Flashcards

Thrombolytic. Clot buster. Side effects include hemorrhage, hypotension & cardiac dysrhythmias. Nursing considerations: DO NOT GIVE IM. Interact with anticoagulant & antiplatelet meds.

Antifungal antimicrobial. Fungicide. Side effects include fever, chills, shaking, myalgia, arthralgia, weakness, hypotension, insomnia, vertigo, ototoxicity, nephrotoxicity, Stevens-Johnson syndrome, hepatic necrosis, cardiovascular collapse. Nursing considerations: Risk of cardiac toxicity. Use with caution in renal impairment & severe bone marrow suppression. Take with food to increase absoprtion & decrease n/v. Monitor serum levels. Eat small frequent meals with increased protein. Interact with anticoagulants, corticosteriods, nephrotoxic drugs, antidiabetic agents, antacids, benzodiazepines, oral contraceptives, tetracyclines, acetaminophen, Rifampin, Dilantin, & cyclosporine.

Cephalosporins. Antibiotic (r/t penicillins). Contraindicated if allergy to penicillins. Side effects include lethargy, hallucinations, anxiety, depression, twitching/convulsions/seizures, coma, colitis, anemia, increased liver labs, increased bleeding time, alkalosis, taste alteration, sore mouth, discolored tongue, hives, pruritis, edema. Nursing considerations: Monitor for toxicities (renal, hepatic). Monitor BS in diabetics. Refrain from alcohol use during tx. Interact with loop diuretics, aminoglycosides, anticoagulants, ethanol, antacids, iron supplements/iron rich foods.

Aminoglycoside. Antibiotic. Contraindicated in renal disease, myasthenia gravis, and concurrent use with renal toxic agents. Side effects include paresthesia, rash, fever, nephrotoxicity, ototoxicity, purpura, urticaria, dermatitis, pseudomembranous colitis. Nursing considerations: Monitor peak/trough levels of drug. Eat small frequent meals. Interact with penicillins, oral anticoagulants, and no other meds in the same IV fluid.

Flouroquionlone. Antibiotic. Contraindicated in renal impairment or if hx of seizures. Side effects include dizziness, fatigue/lethargy, insomnia, depression, restlessness, conflusion, convulsions, oral candidiasis, dysphagia, pseudomembranous colitis, increased liver labs, rash, pruritis, urticaria, photosensitivity, flushing, fever, chills, piloerection, tinnitus, blurred vision. Nursing considerations: Monitor PT & INR, check for increased bleeding. Eat small frequent meals with increased protein. Report dyspnea, severe h/a, dizziness or weakness ASAP. Interact with oral antacids, iron/zinc/sucralfate supplements, glucocorticosteroids, alkaline foods (dairy, veggies, legumes).

Macrolide. Antibiotic. Contraindicated in liver/renal dysfunction, GI disorders, UC/enteritis, and in infants/elderly. Side effects include palpitations, chest pain, dizziness, vertigo, lethargy, somnolence, confusion, hearing loss, stomatitis, hepatotoxicity, ototoxicity, nephrotoxicity. Nursing considerations: Assess GI function. Observe for bleeding. Increase protein in diet. Interact with anticoagulants, antihistamines, penicillins.

Penicillin. Antibiotic. Contraindicated in anemia, thrombocytopenia, & bone marrow depression. Side effects include rash, urticaria, pruritis, angioedema, colitis, increased liver labs, taste alteration, sore mouth, sore/discolored tongue, increased bleeding time, lethargy, anxiety, depression, hallucinations, twitching/convulsions, coma, metabolic alkalosis, hypo/hyperkalemia. Nursing considerations: Do not admin with fruit juices, milk or carbonated beverages. Interact with diuretics, oral contraceptives, aminoglycides, tetracyclines, lithium, aspirin, & sulfonamides.

Sulfonamide. Antibiotic. Contraindicated in pregnancy/lactation, age <2 months, porphyria, renal/hepatic dysfunction, intestinal/urinary blockage, asthma, blood dyscrasias, G6PD deficiency. Side effects include rash, jaundice, stomatits, insomnia, drowsiness, depression, psychosis, photosensitivity, crystalluria, peripheral neuropathy, tinnitus/hearing loss, vertigo, ataxia, convulsions, heptatitis, pancreatitis, exfoliative dermatitis, Stevens-Johnson syndrome, serum sickness, drug fever. Nursing considerations: Baseline assessments of renal/hepatic function and skin. Monitor for neurotoxicity if ataxia or convulsions develop. Small frequent meals. Empty bladder frequently (q2h when awake). Interact with oral anticoagulants, oral antidiabetic agents, iron, some abx, & phenytoin.

Tetracycline. Antibiotic. Contraindicated in renal/hepatic dysfunction, last 1/2 of pregnancy, 0-8 years old, asthma, hay fever, and myasthenia gravis. Side effects include dry mouth, dysphagia, bulky/loose stools, steatorrhea, photosensitivity, increased ICP, rash, urticaria, exfoliative dermatitis, angioedema, discoloration of developing teeth, conjuctive pigmentation, lossening of nails, increased liver labs, decreased cholesterol, jaundice, anaphylaxis, serum sickness, drug fever, retrosternal pain, increased sodium retention, hepatotoxic, renal toxic, metabolic acidosis, itching, and wheezing. Nursing considerations: Unstable with age & light exposure, store in tightly covered container in a dry area protected from light & heat. Practice good oral care/hygeine. Report onset of severe h/a or visual disturbances. Take oral doses with full glass of water on an empty stomach to increase absorption. Interact with antacids, antidiarrheals, anticoagulants, oral contraceptives, penicillins, , digoxin, dairy & iron supplements.

Peripherally acting alpha-1 blocker. Antihypertensive. Side effects include first dose syncope, h/a, drowsiness, hypotension, palpitations, impotence, nasal congestion, tachycardia, anaphylaxis & arrhythmia. Nursing considerations: May cause syncope within 30-60 min of first dose. DO NOT STOP TAKING ABRUPTLY. Monitor VS, especially BP & pulse. Monitor for CHF/edema. Monitor diabetic clients for hypoglycemia. Abrupt d/c may worsen angina or precipitate MI. Change position slowly to prevent dizziness/falls. Weigh daily, report weight gain >5lbs/week. May take 3-4 weeks for tx response. Interact with oral antidiabetic agents, digoxin, & beta blockers.

Beta blocker. Antihypertensive. Contraindicated in symptomatic bradycardia, greater than first degree heart block, class IV heart failure & asthma. Side effects include insomnia, fatigue, dizziness, nervousness, edema, increased airway resistance, muscle/joint pain, bradycardia, hyptotension, heart failure & bronchospasm. Nursing considerations: Monitor apical pulse for increased risk of bradycardia. DO NOT STOP TAKING ABRUPTLY. Interact with antihypertensives, insulin, & oral antidiabetic agents.

ACE inhibitor. Antihypertensive. Contraindicated in pregnancy and with use of potassium supplements or potassium-sparing diuretics. Side effects include anxiety, fatigue, insomnia, nervousness, hypotension, palpitations, persistent dry non-productive cough, dyspnea, angioedema, CVA, MI & hypertensive crisis. Nursing considerations: D/C asap if pregnancy is suspected. Administer 1h before meals to increase absorption. Take BP before dose and monitor regularly. Diuretics should be d/c 2-3 days before ACE inhibitor tx. Report peripheral edema, signs of infection, facial swelling, loss of taste or dyspnea. Do not skip doses or stop drug abruptly. Notify provider if persistent dry cough develops. Take antacids 2h before/after ACE inhibitors. Eliminate licorice from diet. Interact with potassium-sparing diuretics, potassium supplments. lithium, digoxin, licorice, sodium substitutes, & high fat foods.

Angiotension II antagonists. Antihypertensive. Side effects include hypotension, dizziness, cough, GI upset, insomnia, nasal congestion, pharyngitis, myalgia/arthralgia, flu-like symptoms, angioedema, tachycardia & bradycardia. Nursing considerations: D/C asap if pregnancy is suspected. Use with caution in patients with renal/hepatic disease. Regularly assess renal function. Monitor potassium levels. Monitor BP & apical pulse often. Do not d/c abruptly. Use non-hormonal birth control options. Interact with potassium-sparing diuretics, salt subsititutes and red yeast rice.

Calcium channel blocker. Antiarrhythmic. Contraindicated in sick sinus syndrome, second & third degree heart blocks, severe hypotension. Side effects include h/a, fatigue, constipation, postural hypotension, heart block, profound bradycardia, CHF, syncope, palpitations, fluid overload, dizziness, nervousness, insomnia, confusion, tremor, gait disturbance, impaired taste, & skin rash. Nursing considerations: Evaluate BP & ECG before initiation of tx. Monitor for h/a, analgesic may be required. Hold med if BP is less than 90/60. May induce hyperglycemia, monitor diabetic patients closely. Report gradual weight gain & evidence of edema. Take pulse before each dose. Stop smoking and avoid alcohol consumption. Interact with beta blockers, digoxin, furosemide (incompatible in IV solution), grapefruit and grapefruit juice.

Nitrate. Contraindicated in hypotension and/or hypovolemia, severe bradycardia/tachycardia, and right ventricular MI. Side effects include h/a, postural hypotension, flushing, local burning or tingling sensation, contact dermatitis (topical administration), GI upset (oral administration), blurred vision, dry mouth, weakness, dizziness, vertigo, faintness, and fecal & urinary incontinence. Nursing considerations: Wear gloves when applying NTG paste or patch. Rotate application sites. Make sure patient is sitting or lying down when taking NTG to prevent dizziness or fainting. Give one tablet q5min (no more than 3 tablets total) and notify physician or emergency services if pain is unrelieved after 3rd dose. Store in a cool, dry, dark place with lid attached tightly. Patient may swim/bathe with a NTG patch in place. Take sublingual or spray NTG before events that cause angina (sex, exercise). Do not mix with any other meds in the bottle or IV tubing. Interact with Viagra, antihypertensives, vasodilators, heparin (if NTG is given IV), and alcohol.

Heparin or heparinoid. Anticoagulant. Contraindicated in uncontrolled bleeding and in patients with pork allergies. Side effects include hemorrhage, hematuria, epistaxis, bleeding gums, thrombocytopenia, and osteoporosis (with long-term tx). Nursing considerations: Can be given IV or SUBQ. Monitor PTT when on heparin tx. Should be given via an infusion pump with a dedicated IV line due to its incompatibility with other drugs. Protamine sulfate is the antidote for heparin overdose. Monitor for signs of bleeding. Verify correct dosage with another licensed provider before administration. Rotate sites for SUBQ administration. Once patient is stabilized, an oral anticoagulant is added for long-term tx. Decrease intake of green leafy vegetables if adding warfarin to tx regimen. Interact with aspirin, NSAIDS, antiplatelets, and green leafy vegetables.

Antiviral. Contraindicated in preexisting hepatic/renal dysfunction, with concurrent use with nephrotoxic drugs, pregnancy & lactation. Side effects include anemia, h/a, mood changes, depression, seizures, diarrhea, local irritation/phlebtitis (with IV administration), inflammation (with topical admnistration), fever, metabolic acidosis, dysrhythmias, fluid overload, ocular hypertrophy, infertility, and pancreatitis. Nursing considerations: Administer as soon as possible to improve effectiveness. Wear gloves when administering topically. Preferred central venough access when given IV. Assess & monitor kidney/liver function. Assess skin and any lesions regularly. Hydrate to reduce risk of nephrotoxicity. Frequent, small meals in high in protein. Interact with nephrotoxic drugs, zidovudine, and probenecid.

Salicylate. Nonopioid analgesic. Contraindicated in GI bleeding, bleeding disorders, younger than 12 years (due to risk of Reye's syndrome), children/teens with flu-like syndromes, pregnancy/lactation, with vitamin K deficiency, PUD, anemia, renal or hepatic dysfunction. Side effects include increased bleeding time, drowsiness, dizziness, confusion, h/a, hallucinations, heartburn, anorexia, rash, urticaria, bruising, tinnitus, seizures, coma, GI bleeding, hepatitis, and Reye's syndrome. Nursing considerations: Dosage dependent upon age of patient & condition being treated. GI upset may be decreased by giving with full glass of water, milk, food or an antacid. Administer at least 30 minutes prior to PT or planned activity to minimize discomfort. Report any signs/symptoms of hepatic/renal toxicity Report visual changes, tinnitus, allergic reactions, and bleeding. Do not exceed recommended dosage. Avoid alcohol to reduce chance of GI bleeding. Interact with antacids, urinary alkalizers, anticoagulants, alcohol, corticosteroids, warfarin, insulin, thrombolytic agents, penicillins, phenytoin, valproic acid, oral hypoglycemics, sulfonamides, ammonium chloride, urinary acidifiers, nizatidine, probenecid, spironolactone, NSAIDs, beta blockers, ginger, & caffeine.

Benzodiazepine. Sedative-hypnotic, antianxiety. Contraindicated in pregnancy/lactation, preexisting CNS depression, severe uncontrolled pain, with narrow-angle glaucoma, and hepatic dysfunction. Side effects include decreased mental alertness, drop in BP (especially when standing), dry mouth, ataxia, dizziness, drowsiness, n/v, withdrawal symptoms, and overdose (s/s somnolence, confusion, coma, diminished reflexes & hypotension). Nursing considerations: Start at a low dose & gradually increased until desired results are achieved. Assess degree & manifestation of anxiet before beginning tx. Monitor BP, HR, & RR and provide supportive care as indicated. Prolonged tx can lead to dependence. Take exactly as prescribed. Abrupt withdrawal of med may cause sweating, vomiting, muscle cramps, tremors & convulsions. Avoid alcohol. Interact with CNS depressants, antacids, TCAs, & MAOIs.

HMG-Coenzyme A (HMG-CoA) reductase inhibitors. Lipid lowering agent. Contraindicated in active liver disease and in pregnancy/lactation. Side effects include GI upset, dyspepsia, flatulence, pain, myalgias, h/a, rash, dizziness, sinusitis, & altered liver function tests. Nursing considerations: Usually administered at night. Not recommended for us in patients less than 20 years old. Lab monitoring is required is to maintain compliance and assess client response. Report immediately any unexplained muscle pain, tenderness, yellowing of skin/eyes, or loss of appetite. Alcohol intake should be minimized/avoided. Women of child-bearing age should use contraception during tx. Interact with immunosuppressants, antifungals, erythromycin, cholestyramine, and warfarin.

Proton pump inhibitor (PPI). Antiulcer. Contraindicated in children & nursing mothers. Side effects include h/a, diarrhea, constipation, flatulence, rash, hyperglycemia, dizziness, pruritis, dry mouth, pancreatitis, liver necrosis, hepatic failure, toxic epidermal necrolysis, Stevens-Johnson syndrome, MI, shock, CVA, & GI hemorrhage. Nursing considerations: May be given with antacids. Dosage should be reduced in severe liver disease. Monitor hepatic & renal labs. Increase water intake to 8-10 glasses per day to prevent constipation. Report diarrhea. Interact with digoxin, iron preparations, ampicillin, theophylline, diazepam, pheytoin, warfarin, and benzodiazepines.

H2 antagonist. Antiulcer. Contraindicated in impaired renal/hepatic function. Side effects include somnolence, diaphoresis, rash, h/a, hypotension, taste disorder, diarrhea, constipation, dry mouth, cardiac dysrhythmias, impotence (with cimetidine), & anaphylaxis. Nursing considerations: Should not be given with other drugs via IV. Avoid antacids within 1h of administration. Reduced dosages for patients with renal/hepatic dysfunction. Evaluate need for tobacco/alcohol cessation. Cigarette smoking reduces drug effectiveness. Interact with beta blockers, lidocaine, benzodiazepines, TCAs, oral contraceptives, warfarin, iron salts, tetracyclines, diazepam, and glipizide.

Corticosteriod. Contraindicated in systemic infections, UC, diverticulitis, active or latent PUD, and pregnancy/lactation (safety not established). Side effects include euphoria, h/a, insomnia, psychosis, edema, muscle weakness, delayed wound healing, osteoporosis, spontaneous fractures, & hyperglycemia. Nursing considerations: Oral forms should be given with meals. IV form should be given slowly IVPB to prevent vaginal & anal burning. Establish baseline & montior BP, I & O, weight & sleep patterns. Measure 2h post-meal blood glucose, potassium & calcium prior to tx & regularly thereafter. Watch for changes in mood, emotional stability, & sleep. Interact with phenytoin, rifampin, amphotericin-B, diuretics, vaccines & toxoids.

Xanthine bronchodilator. Contraindicated in patients with tachyarrhythmias, PUD, GI disorders, cardiovascular disorders (use with caution), seizure disorders, and hyperthyroidism. Side effects include anorexia, GERD, sinus tachycardia, extrasystoles, palpitations, ventricular dysrhythmias, hyperglycemia, transient increased urination, tremors, dizziness, hallucinations, restlessness, agitation, h/a, insomnia, & chest pain. Nursing considerations: Administer cautiously in elderly due to potential for increased sensitivity. Give to children over 6 months of age with caution. Dosages should be based on lean body weight as it does not enter adipose tissue. Start dosage low and titrate up until therapeutic response is achieved. Do not omit or double-up doses, take exactly as prescribed. Avoid use of caffeine as this can increase CNS stimulation. Increase fluid intake if not contraindicated. Interact with allopurinol, cimetidine, erythromycin, flu vax, oral contraceptives, sympathomimetics, smoking, barbiturates, phenobarbital, caffeine, and tobacco.

Beta-adrenergic bronchodilator. Contraindicated in tachyarrhythmias, severe CAD, cardiovascular disease, & children under 12 years old (with the inhaled forms). Side effects include nervousness, tremors, increased heart rate, increased BP, insomnia, restlessness, anorexia, cardiac stimulation, vascular h/a, anginal pain, hypotension, arrhythmias, paradoxic bronchospasm, urinary retention, & agitation. Nursing considerations: Monitor elderly clients closely. Monitor BP & pulse closely. Ensure proper use of MDIs. Note amount, color & character of sputum. Monitor blood glucose levels in diabetic patients. Avoid IM injections. Report any chest pain, palpitations, seizures, h/a, hallucinations or blurred vision. Teach proper care of nebulizer and/or inhaler. Wait 1-3 minutes between inhalations of aerosol meds. Take exactly as ordered, do not double-up doses or increase frequency. Increase fluid intake if not otherwise contraindicated. Interact with MAOIs, sympathomimetics, beta blockers, potassium-losing diuretics, cardiac glycosides, other bronchodilators, digoxin, thyroid hormones, decongestants, & antihistamines.