Pharm 1 – Flashcard

Dose: 20 mg, 40 mg, 80 mg, 10 mg/mL, 40 mg/5 mL Route: oral. Purpose: treatment for edema associated with CHF, cirrohosis of liver, kidney disease. Used for management of hypertension Contraindications: hypersensitivity, increasing oliguria, anuria, fluid and electrolytes, hepatic coma. Precautions: MI, older adults, history of gout. Side effects: hypotension, dizziness, nausea, vomiting, vertigo, hypokalemia Nursing implications: monitor blood pressure, monitor I&O ratio and pattern, monitor urine and blood glucose Patient teaching: avoid prolonged exposure to direct sun, make position changes slowly, consult physician regarding allowable salt and fluid intake

Dose: 12.5 mg capsules, 25 mg, 50 mg, 100 mg tablets, 50 mg/5 mL Route: Oral. Purpose: enhances excretion of sodium, chloride, potassium, bicarbonates and water . Contraindication: Hypersensitivity, anuria, pregnancy Precautions: Bronchial asthma, allergy, renal dysfunction, older adults. Side effects: mood changes, weakness, dry mouth, vomiting, blurred vision Nursing Implications: Monitor for therapeutic effectiveness, assess blood pressure, monitor I&O, check for edema Patient teaching: monitor weight daily, photosensitivity may occur, report signs of hypokalemia

Dose: 250 mg, 500 mg tablets, 250 mg/5mL suspension, 500 mg injection Route: oral & injection Purpose: Adjunctively to manage edema associated with CHF, hepatic cirrhosis, renal dysfunction, corticosteroid, or estrogen therapy. Used alone as step 1 agent in stepped-care approach, or in combination with other agents for treatment of hypertension. Contraindications: Hypersensitivity, anuria, hypokalemia, pregnancy Precautions: History of sulfa allergy, impaired renal or hepatic function or gout, lactation; hyperkalemia, diabetes mellitus and older adults. Side Effects: fever, respiratory distress, diarrhea, skin rash, orthostatic hypertension headache, vertigo Nursing implications: Monitor for therapeutic effect, monitor BP closely during early drug therapy, Monitor I&O rates and patterns: Patient Teaching: urination will occur in greater amounts, avoid large quantities of coffee or caffeine drinks

Dose: 25 mg, 50 mg, 100 mg tablets Route: oral. Purpose: Clinical conditions associated with augmented aldosterone production, as in essential hypertension, refractory edema due to CHF, hepatic cirrhosis, nephrotic syndrome, and idiopathic edema Promotes sodium and chloride excretion without concomitant loss of potassium. Contraindications: Anuria, acute renal insufficiency; progressing impairment of kidney function, hyperkalemia; pregnancy Precautions: BUN of 40 mg/dL or greater, liver disease. Side Effects: lethargy, irregular periods, abdominal cramps, rash, inability to maintain erection, elevated BUN Nursing implications: monitor blood pressure, monitor I&O, assess for signs of fluid and electrolyte imbalance Patient teaching: weigh 2-3 times a week, avoid excessive intake of high potassium foods

Dose: 50 mg, 100 mg capsules Route: Oral Action: promotes excretion of sodium, it blocks potassium excretion by direct action rather than inhibiting aldosterone Contraindications: hypersensitivity, anuria, hyperkalemia. Precautions: impaired kidney or liver function, diabetes, history of kidney stones Side effects: headache, dry mouth, dizziness, weakness, muscle cramps or diarrhea Nursing implications: monitor BP during doses, weigh patient constantly, monitor I&O, Patient teaching: Do not take potassium supplements, potassium-rich diet, report overpowering fatigue or weakness, avoid exposure to sun (it could cause photosensitivity)

Dose: Oral: 40 to 100 mEq orally once a day Route: Oral and Parenteral. Action plays a roles in both formation and correction of imbalances in acid-base metabolism Contraindications: dehydration, heat cramps, chronic renal failure, hyperkalemia Precautions: cardiac or kidney disease, systemic acidosis, slow-release potassium Side effects: Diarrhea, nausea, stomach discomfort, abdominal distention, respiratory depression, vomiting, difficulty breathing, black, tarry stools; chest pain;. Nursing Implications: Monitor I&O ratio, monitor patients receiving parenteral potassium closely with cardiac monitor. Irregular heartbeat could mean early sing of hyperkalemia Patient Teaching: report any signs of potassium deficit, do not use self-prescribe laxatives, do not breast feed

Dose: 15 g/60 mL suspension, 100 mg/g powder Route: oral and rectal powder, oral suspension, rectal suspension. Purpose: removes potassium from the body by exchanging sodium ion for potassium, particularly in the large intestine, potassium is the excreted Contraindications: patients with hypokalemia and hypersensitive to Kayexlate. Precautions: CHF, severe hypertension, acute or chronic kidney failure, marked edema Side effects: constipation, fecal impaction, black, bloody, or tarry stools, gastric irritation. Nursing implications: assess serum potassium levels daily throughout therapy. Monitor acid-base balance, electrolytes, and minerals in patients receiving repeated doses. Observe patient for signs of hypokalemia. Patient Teaching: Check bowel function daily.

Dose: IV: 10-25 g, PO: 4-20 g as a single dose Route: Oral and IV. Action/Purpose: used to increase the level of blood sugar when the level falls too low. It is a glucose-elevating agent. Contraindications: dysphagia, issues with gag reflex Side Effects: rash, hives; difficulty breathing, tightness in the chest. Nursing implications: Monitor skin, monitor breathing and vital signs. Patient Teaching: know the signs and symptoms of a glucose reaction

Dose: according to patient's requirements Route: Injection Action: increased glycogen synthesis, forces storage of glucose in liver Contraindications: Hypersensitivity, severe renal, hepatic disease. Precautions: pregnancy, alcohol, cardiac disease, breastfeeding Side effects: severe allergic reactions - difficulty breathing, shortness of breath, rash, hives. Nursing implications: assess blood and glucose levels Patient Teaching: avoid alcohol, ways to properly exercise and remain healthy

Dose: 325 mg, 520 mg, 650 mg tablets, 4.2%, 5% injection Route: oral, IV Action: Orally neutralizes gastric acid to form sodium chloride, carbon dioxide and water. Contraindications: prolonged therapy with bicarbonate heart disease, hypertension hypocalcaemia. Precautions: edema, sodium-retaing disorders, lactation, older adult patients Side effects: belching, confusion, diarrhea, edema, tremors, irregular pulse, cardiac arrest, seizures, tetany, weakness. Nursing implications: Assess respiratory and pulse, rate and rhythm. Patient Teaching: Do not take with milk

Dose: 0.9% Route: injection solution or infusion Action: Is used for preventing or treating sodium loss due to excessive sweating or dehydration Contraindications: severe renal impairment, edema, CHF. Precautions: pregnancy, breastfeeding, CHF, hypertension Side effects: shortness of breath, difficulty breathing, fast heartbeat, fever, hives, itching, joint pain Nursing implications: monitor IV site for irritation Patient Teaching: report any allergic reactions to physician immediately

Dose: Adult 20 to 80 MEq Route: oral Purpose: treating acid indigestion, works by neutralizing the acid in the stomach and stimulating the bowels to move Contraindications: Hypersensitivity Precautions: pregnancy, allergies to food, medicine, appendicitis, , stomach pain Side effects: diarrhea, flushing, sweating, difficulty breathing, tightness in chest, loss of appetite Nursing implications: monitor therapeutic effective of magnesium hydroxide Patient Teaching: report signs of allergic reactions

Dose: 500-1000 mg Route: oral Purpose: to prevent and treat low amounts of magnesium in the blood Contraindications: allergic to magnesium, have kidney disease Precautions: hypersensitivity, diabetes, alcohol dependence, liver disease, phenylketonuria. Side Effects: diarrhea, rash, itching/swelling, confusion, severe drowsiness, severe vomiting, fast or slow heart rate Nursing Implications: evaluate response to magnesium gluconate supplements Patient Teaching: maintain a well-balanced diet

Dose: 0.8 mEq/mL, 1 mEq/mL, 4 mEq/mL injection Route: IM, orally Action: acts as a laxative by osmotic retention of fluid, increases water content of feces. Acts as CNS depressant and a depressant of smooth, skeletal and cardiac muscle function Contraindications: myocardial damage, heart block, cardiac arrest, fecal impaction Precautions: impaired kidney function, CNS depressants, pregnancy Side Effects: flushing, extreme thirst, hypotension, depressed cardiac function, sedation, depressed reflexes, flaccid paralysis, heart block, respiratory depression Nursing Implications: observe constantly when given IV, monitor blood pressure, check urinary output Patient teaching: drink lots of water during the day, obtain with a regular normal diet

Dose: 600 mg-400 IU Route: Oral Action: Purpose: keep bones and teeth strong, supporting skeletal structure and function. Contraindications: hyperkalemia, kidney disease Precautions: pregnancy and breastfeeding Side Effects: rash, difficulty breathing, constipation Nursing Implications: evaluate response to taking daily vitamin - if still deficit Patient Teaching: do not take more than prescribed amount

Dose: 400-1,100 IU Route: oral. Purpose: for correction and prevention vitamin deficiencies Contraindications: Hypersensitivity, pregnancy Precautions: pregnancy or breastfeeding; Side Effects: weakness, fatigue, loss of appetite Nursing Implications: evaluate for vitamin deficiency Patient Teaching: take with food for better absorption, do not take more than prescribed amount

Dose: 10 mg, 15 mg tablets, 15/20 mg controlled release tablets, 50 mg/mL injection, 20mg/30 mg suppositories Route: IV/IM/SUBQ/ rectal. Action: Depresses pain impulse transmission at the spinal cord level by interacting with opioid receptors Contraindications: hypersensitivity to opioids, respiratory depression, edema, acute alcoholism Precautions: cardiovascular disease, emphysema, reduced blood volume Side effects: shock, cardiac arrest, tachycardia, thrombocytopenia, respiratory depression, respiratory arrest, coma, deep sleep, decreased cough reflex Nursing implications: assess pain, assess vital signs, monitor respiratory rate and rhythm Patient Teaching: avoid alcohol, use caution with tasks because dizziness may occur, report blurred vision

Dose: 0.05 mg/mL injection, 100 mcg, 200 mcg, 100 mcg/h transdermal patch Route: nasal, anesthesia, transmucosal. Action: agonist analgesic, pain perception by binding to opiate receptors Contraindications: labor and delivery, lactation Precautions: head injuries, older adults, COPD, liver and kidney dysfunction Side effects: sedation, cardiac arrest, respiratory depression, delirium, blurred vision, nausea Nursing implications: assess vital signs, watch carefully for respiratory depression Patient Teaching physical dependence, not to use with alcohol

Dose: 2.5-10mg, 1-2mg q4-6h, IV 0.2-1mg q2-3hr. Route: Oral, injection, rectal Action: Inhibits ascending pain pathways in CNS, increases pain threshold Contraindication: pregnancy, acute bronchial asthma, COPD, upper airway obstruction Precautions: abrupt discontinuation, alcoholism, renal disease, renal impiarement, older adults, GI disease Side effects: Drowsiness, dizziness, confusion, headache, sedation, seizures, nausea, vomiting, anorexia, constipation, cramps, dry mouth, rash, respiratory depression, blurred vision Nursing implications: assess respiratory rate, monitor vital signs, monitor I&O ratio and pattern Patient teaching: report any symptoms of CNS changes, to avoid drinking, use caution with activities (it may cause drowsiness)

Dose: 50 mg, 100mg tablets, 50mg/5mL, syrup, 10 mg/mL, 25 mg/mL, 100 mg/mL injection Route: injection and oral Action: produces CNS stimulation in toxic doses, synthetic morphine-like compound. Contraindications: hypersensitivity, acute abdominal conditions, pregnancy Precautions: head injuries, asthma and other respiratory conditions, impaired kidney or liver function, glaucoma, hypothyroidism Side effects: dizziness, confusion, headache, sedation, respiratory depression, cardiac arrest, hallucinations, tremors, seizures, tachycardia, hypotension, Nursing implications: monitor vital signs closely, assess pain, monitor respiratory rate Patient teaching: allergic reactions, do not smoke and walk without assistance, drowsiness/dizziness may occur

dose: 5-15 mg PO q4-6 hrs, extended release: 10 mg PO q12 hrs. Route: orally. Action: analgesia and narcotic Contraindication: respiratory depression, acute or severe bronchial asthma, coma or impaired consciousness Precaution: respiratory depression, sedation Side Effects: constipation, respiratory depression, cardiac arrest orthostatic hypertension Nursing Implications: assess vital signs such as blood pressure, oxygen saturation and respiration rate Patient teaching: Swallow the capsule whole, cutting or chewing not the best solution.

Adult dose: 15-60 mg IM/IV/SC Route: oral/ injectable Action: opioid analgesic, related to morphine, but with less potent analgesic properties Contraindication: hypersensitive to codeine or other morphine derivatives, acute asthma, head injury, renal dysfunction Precaution: respiratory depression, history of drug abuse Side Effects: constipation, blurred vision, unconsciousness, shortness of breath, nausea, orthostatic hypertension Nursing Implications: record pain relief, monitor for nausea, monitor for dependency Patient teaching: make position changes slowly, avoid driving or operating machinery

Adult dose: 10 mg PO q12 hrs Route: oral Action: semisynthetic narcotic analgesic Contradiction: hypersensitivity, respiratory depression, acute or severe bronchial asthma Precaution: respiratory depression, hypertension Side Effects: lethargy, depression, constipation, respiratory depression, dyspnea, drug dependency Nursing Implications: assess oxygen saturation and respiratory rate, monitor bowel movements and for abdomen distention Patient teaching: patients to not consume alcohol, avoid driving or operating machinery

Adult dose: 50-100 mg IM/IV q4-6 hrs, extended-release tabs: 100-300 mg PO daily, tabs: 50-100 mg PO q4-6 hrs Route: IV,IM, Oral Action: agonist of mu receptors and preferentially inhibits serotonin reuptake. Opioid analgesic. Contradiction: acute intoxication with alcohol, pregnancy, acute or severe bronchial asthma, hypercapnia, severe renal and hepatic impairment Precaution: chronic respiratory disordes, respiratory depression, hypothyroidism, head injury, seizures. Side Effects: constipation, diarrhea, body aches or pains, loss of appetite, vertigo, headache Nursing Implications: monitor bowel movements, assess pain, monitor nutrition Patient teaching: understand potential adverse effects and report problems with bowel and bladder

Adult Dose: 0.02mg/mL, 0.4mg/mL injection Route: Injection solution or infusion. Action: Competes with opioids at opiate receptor sites. Contraindication: hypersensitivity, respiratory depression due to nonopioid, safety during pregnancy. Precaution: pregnancy, breastfeeding, dependency, cardiac irritability Side effects: tremors, hyperventilation, slight drowsiness, sweating, hypertension Nursing implications: monitor BP, monitor respirations and other vitals, anxiety, vomiting, signs of withdrawal, assess pain. Patient teaching: report any pain that emerges with taking the drug

Dose: Tabs 81, 325, 500,650, 800 mg; chewable tabs 81 mg; sup 300, 600 mg; gum 227 mg; enteric coated tabs 81, 325, 500, 975 mg; ext rel tabs 800 mg; del rel tabs 325, 500 mg; suppository 300, 600 mg. Route: PO or rectal. Action: Blocks pain impulses by blocking COX-1 in CNS, reduces inflammation by inhibition of prostaglandin synthesis Contraindication: hypersensitivity, pregnancy, history of GI ulceration, CHF Precaution: otic diseases; gout, hyperthyroidism, cardiac disease, renal or hepatic impairment, anemia Side effects: heartburn, stomach pains, dizziness, nausea, confusion, renal dysfunction Nursing implications: assess pain, monitor for loss of tolerance for aspirin. Patient teaching: use enteric-coated tablets or extended release tablets to reduce GI disturbances

Dose: 100 mg, 200 mg, 400 mg, 800 mg tablets; 50 mg, 100 mg chewable tablets. Route: oral. Action: blocks prostaglandin synthesis, with anti-inflammatory activity and analgesic properties. Contraindications: severe rhinitis, active peptic ulcer, bleeding abnormalities Precautions: hypertension, history of GI ulceration, impaired hepatic or renal function. Side effects: nausea, vomiting, dizziness, anorexia, constipation, cramps. Nursing implications: monitor for GI distress, monitor edema and fluid rentention, monitor for therapeutic effectiveness Patient teaching: notify physician for black stools, do not take aspirin with ibuprofen, avoid alcohol

Dose: 200 mg, 250 mg, 375 mg, 500 mg tablets, 375 & 500 mg sustained release tablets. Route: oral. Action: inhibits COX-1, COX-2 by blocking arachidonate; analgesic, anti-inflammatory, antipyretic. Contraindications: Pregnancy 3rd trimester, hypersensitivity to NSAIDs, salicylates. Precautions: pregnancy, breastfeeding, impaired kidney or liver, fluid retention, hypertension, heart failure, older adults. Side effects: MI, stroke, hepatitis, GI ulceration, bleeding, edema, blurred vision, depression, CHF, tachycardia. Nursing implications: observe for signs of allergic response, in health history ask abut drug history, assess vital signs Patient teaching: avoid alcohol and aspirin, therapeutic effect may not be experienced for several weeks

Dose: 25 mg, 50 mg, 75 mg tablets Route: oral Action: decreases prostaglandin synthesis Contraindications: hypersensitivity, asthma, pregnancy, rhinitis, shock Precautions: geriatrics, children, impaired hepatic function, heart failure, hypertension Side effects: dyspepsia, abdominal distention, vomiting, nausea, cramps, drowsiness, constipation Nursing Implications: monitor weight and report gains, monitor therapeutic effectiveness, assess blood pressure, observe and report signs of bleeding Patient teaching: Administer with food to decrease GI symptoms, do not lie down for 15-30 minutes after administration

Dose: 10 mg tablets, 15 mg/ML, 30 mg/mL injection, 0.4% - 0.5% ophthalmic solution Route: injection, oral, nasal administration Action: inhibits prostaglandin synthesis and acts as an analgesic Contraindications: hypersensitivity, third trimester pregnancy, hepatic disease, peptic ulcer disease Precautions: Pregnancy, breastfeeding, GI or cardiac disorders, impaired renal or hepatic function Side effects: black or tarry stools, frequent urination; pain in the lower leg (at injection site), GI pain Nursing Implications: Assess pain 1 hour, monitor for fluid retention and edema in patients with history of CHF Patient teaching: do not use other NSAIDs while taking this drug

Dose: 325-650mg every 4-6 hours by mouth, max 4g a day; Route: oral Action- blocks pain impulses peripherally in response to prostaglandin, has little effect on platelet aggregation and produces on gastric bleeding; Contraindications: hypersensitivity, use with alcohol Precautions: overdose causes liver damage, pregnancy, arthritic conditions; Side effects: anemia, renal failure, hepatic seizure (overdose) , cyanosis Nursing Implications: give with food or water, assess for pain or fever

Dose: 200mg, 400 mg capsules Route: Oral Action: inhibits prostaglandin synthesis by selective inhibiting; treatment of acute pain and primary dysmenorrhea Contraindications: hypersensitivity, advanced renal disease, anemia, pregnancy Precautions: pregnancy, heart failure, kidney disease, hypertension, fluid retention Side effects: back pain, edema, cardiovascular risk, abdominal pain, diarrhea, dizziness, insomnia Nursing Implications: therapeutic effectiveness, monitor for fluid retention, monitor lithium levels Patient teaching: avoid during third trimester of pregnancy, report any weight gain, edema or rash

Dose: 5mg, 10 mg, 20mg tablets, 2.5% cream Route: oral and topical Action: replacement therapy in adrenocortical insufficiency to reduce serum calcium in hypercalcemia, to suppress undesirable inflammatory or immune response Contraindications: fungal infection, viral or bacterial diseases of the skin, pregnancy, hypersensitivity. Precautions: children, diabetes, chronic hepatitis, cirrhosis,, osteoporosis, fungal infection, history of allergies Side effects: hypersentivity, weight gain, depression, cramping, bleeding, sweating, headache, skin thinning, mental disturbances, mood changes, insomnia, seizures, hypertension, tachycardia, edema, heart failure, diarrhea, nausea, and vomiting. Nursing implications: monitor and report changes in mood, be alert for possible infection, severe stress could result from patient, monitor for adverse effects Patient teaching: expect slight weigh gain, avoid alcohol or caffeine, do not use aspirin, notify physician of slow healing process

Dose: 1 mg, 2.5 mg, 50 mg tablets, 5 mg/5mL solutions Route: Oral. Action: single agent or conjunctively with antineoplastics in cancer therapy, immediate-acting synthetic analog of hydrocortisone Contraindications: Fungal infections, pregnancy, hypersensitivity. Precautions: patient with infections, active or latent peptic ulcer, renal insufficiency, hypertension, osteoporosis Side effects: confusion, insomnia, Depression, flushing, sweating, headache, muscle weakness, nausea, vomiting, mood changes, hypertension, osteoporosis Nursing implications: assess blood pressure during dose, monitor bone density, monitor for withdrawal symptoms Patient teaching: take drug as prescribed only, weight gain, avoid alcohol, report symptoms of GI pain

Dose: 0.025%, 0.075%, 0.05% Route: topical Action: temporary relief of pain from arthritis, diabetic neuropathy and herpes zoster Contraindications: hypersensitivity to any ingredient in capsaicin cream. Precautions: patients on ACE inhibitors, pregnancy, children Side effects: burning, stinging, redness, itching, cough Nursing implications: Monitor for significant pain relief and monitor for signs of skin breakdown (this could indicate drug discontinuation) Patient teaching: report discomfort at site of application, apply frequently three or four times a day.

Dose: 15 units / 100mL Route: Injection Action: a viscous fluid carbohydrate in connective tissue, synovial fluid and the humors of the eyes; increases the absorption and dispersion of solutions in the intercellular space. Contraindications: hypersensitivity. Precautions: Pregnancy, breastfeeding, avoid activies such as jogging Side effects: difficulty in moving, muscle pain or stiffness, swelling, edema implications: assess hypersensitivity, check blood pressure (assess for hypotension) Patient teaching: report any severe allergic reactions to physician

Dose: 300-500 mg 3x times a day, for a total daily dose of 900-1500 mg. 30mg/g on skin (with 50 mg/g of chondroitin sulfate) Route: Orally or topically Action: Glucosamine is employed by the body in the synthesis of cartilage and synovial fluid. It acts as substrate for making cartilage and synovial fluid. It also can stimulate the activity of chondrocytes; the cells in joints that make cartilage and synovial fluid and it can suppress production of cytokines that mediate joint inflammation and cartilage degradation. Contraindication: glucosamine is produced from the exoskeletons of shellfish; glucosamine should be used with caution in patients with shellfish allergy. Precautions: pregnancy, breastfeeding, asthma, diabetes, high cholesterol, high blood pressure, shellfish allergy, and surgery. Side effects: drowsiness, skin reactions, headache, heartburn, diarrhea and constipation. Nursing implications: monitor blood sugar levels, assess BP, and assess eyes for dryness. Patient teaching: instruct patient to take it with meals to prevent upset stomach.

Dose: 200-400 mg two to three times daily or 1000-1200 mg as a single daily dose. 50 mg/g applied to the skin (as well as glucosamine) Route: Orally or topically. Action: Chondroitin sulfate is a chemical normally found in cartilage around joints in the body. Taking chondroitin slows down the breakdown of joints. Contraindications: patient's taking blood-thinking medications or daily aspirin, hypersensitivity. Precautions: pregnancy, asthma, blood clotting disorders, and prostate cancer. Side effects: diarrhea, constipation, swollen eyelids, leg swelling, hair loss, and irregular heartbeat. Nursing implications: monitor heart rhythm, monitor for increasing BP, assess skin for hair loss, hives, and skin irritation. Patient teaching: Do not use if allergy to shellfish or any kind of shrimp.