Medication Review - RN NCLEX

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Combination of many other sets

ACE Inhibitors, - pril suffix, ex Captopril,

Prevent the synthesis of angiotensin II by "inhibiting" angiotensin-converting enzyme, a potent vasoconstrictior; decrease afterload and preload in heart failure; used to treat HTN, CHF;Interacts with: NSAID, Diuretics, sulfameth/trimethoprim, side effects: 1st dose hypotension, hacking cough, loss of taste. Hyperkalemia, renal tubular damage, decreased B/P, dizziness, nausea & diarrhea NRSG: Administer 1 hr before meals to increase absorption, teach patient to sit up,stand up slowly due to orthostatic BP's, teratogenic, Labs:BUN,creatinine,protein,BG, report bruising, petechial rash,

Ascetylcholinesterase Inhibitors -ine suffix-ex rivastigmine, memantine, galantmine, different suffix -Aricept(donepezil)

(AChe inhibitor) an enzyme to break down AChe-Promote the accumulation of actylcholine in neuron receptors, resulting in prolonged cholinergic, improves cognition in Alzheimer's pt's side effects: Nausea, vomiting, diarrhea, dizziness, decreased appetite or weight loss interacts with: anticholinergic drugs (e.g., benztropine, scopolamine), cholinergic drugs (e.g., bethanechol), other cholinesterase inhibitors succinylcholine-type muscle blocking drugs, aspirin, NSAIDS

Alpha Adrenergic blockers -zosin suffix, ex prazosin(Minipress), dozazosin(Cardura)

Decreases peripheral vascular resistance and lowers blood pressure by selectively blocking receptors in the vascular smooth muscle, Used for HTN, side effects: 1st dose Hypotension, dizziness, lightheadedness, faint, interacts with:NSAIDS, clonidine NRSG-teach pt to rise slowly lying to sitting, sitting to standing, take at bedtime

Aldosterone Receptor antagonists

Block stimulation of mineralocorticoid receptors by aldosterone, thus reducing high blood pressure by preventing sodium reabsorption; interacts with: side effects:

Aminoglycosides

Gentamicin, Tobramycin, and related antibiotics; particularly effective against gram-negative microorganisms; noted for potentially dangerous toxicity; interacts with: side effects:

Analgesics, ex's- acetaminophen, aspirin, Morphine sulfate, Demerol, fentanyl

Narcotic and nonnarcotic; relieve pain without producing loss of consciousness or reflex activity; interacts with:ALCOHOL, ASA-coumadin side effects:Acute toxicity to liver(tylenol) or kidneys

Androgens

These steroid hormones produce masculinizing effects; interacts with: side effects:

Angiotensin II receptor antagonists - tan suffix, ex irbesartan, Valsartan

Also known as ARBs (a very potent vasoconstrictor) from binding to receptor sites is vascular smooth mucle, brain, heart, kidneys, and adrenal gland, thus blocking the blood pressure-elevating and sodium-retaining effects of angiotensin II; interacts with: side effects:

Anesthetics

For example, local anesthesia, general anesthesia; cause a loss of sensation with or without a loss of consciousness; interacts with: side effects:

Antacids

Reduce the acidity of the gastric contents; interacts with: side effects:

Antianginals

Used to prevent or treat attacks of angina pectoris; interacts with: side effects:

Antianxiety

Used to prevent anxiety symptoms or disorders; also known as minor tranquilizers or anxiolytics, although the term tranquilizer is avoided today to prevent the misperception that the patient is being tranquilized

Antiarrhythmics

Used to correct cardiac arrhythmias (any heart rate or rhythm other than normal sinus rhythm); interacts with: side effects:

Antibiotics

Used to treat infections caused by pathogenic microbes; the term in often used interchangeably with antimicrobial agents; interacts with: side effects:

Anticholinergic

Block the action of acetylcholine in the parasympathetic nervous system; also known as cholinergic blocking agents, antispasmodics, and parasympatholytic agents; interacts with: side effects:

Anticoagulants-Parenteral -Heparin, enoxaprin (lovanoxn

Do not dissolve existing blood clots, but so prevent enlargement or extension of blood clots; interacts with: side effects:

Anticonvulsants

Suppress abnormal neuronal activity in the CNS, preventing seizures; interacts with: side effects:

Antidepressants

Relieve depression; interacts with: side effects:

Antidiabetics

Also known as hypoglycemics; include insulin (used to treat type 1 diabetes mellitus) and oral hypoglycemic agents (used in the treatment of type 2 diabetes mellitus); interacts with: side effects:

Antidiarrheals

Relieve or control the symtoms of acute or chronic diarrhea; interacts with: side effects:

Antiemetics

Used to prevent or treat nausea and vomiting; interacts with: side effects:

Antifungals

Used to treat fungal infections; interacts with: side effects:

Antiglaucoma

Used to reduce intraocular pressure; interacts with: side effects:

Antigout

Used in the treatment of active gout attacks or to prevent future attacks; interacts with: side effects:

Antihypertensives

Used to treat elevated blood pressure (hypertension); interacts with: side effects:

Antilipemics-Statins -statin, ex's simvastatin(Zocor), lovastatin(mevacor)

Supresses cholesterol synthesis in the liver. Can increase HDL and decrease LDL, promotes vasodilation, decreases plaque site inflammation, decreases risk of thromboembolism.Uses to reduce serum cholesterol and/or triglycerides in hypercholesterolemia, prevention of coronary events, protect against MI and stroke in clients with Diabetes. interacts with:fibrates-gemfibrozol, fenofibrate-increase myopathy, meds that suppress CYP3A4-erythromyacin(can increase dose of statin when taking concurrently), Grapefruit juice-increases toxicity. side effects:hepatoxicity, myopathy, peripheral neuropathy-numbness, tingling, and pain to hands and feet. NRSG: take with evening meal, renal insuff pt's need decreased dose, msut get baseline liver enzymes, cholesterol levels with periodic lab levels. Cat C

Antimicrobials

Chemicals that eliminate living microorganisms pathogenic to the patient; also called antibiotics or antiinfectives; interacts with: side effects:

Antineoplastics

Also called chemotherapy agents; used alone or in combination with other treatment modalities such as radiation, surgery, or biologic response modifiers for the treatment of cancer; interacts with: side effects:

Antiparkinson's

Used in the treatment of Parkinson syndrome and other dyskinesias; interacts with: side effects:

Antiplatelets

Prevent paltelet clumpling (aggregation), thereby preventing an essential step in formation of a blood clot; interacts with: side effects:

Antipsychotics

Used in the treatment of severe mental illnesses; also known as major tranquilizers or neuroleptics, although the term tranquilizer is avoided today to prevent the misperception that the patient is being tranquilized; interacts with: side effects:

Antipyretics

Used to reduce fevers associated with a variety of conditions; interacts with: side effects:

Antispasmodics

Actually anticholinergic agents; interacts with: side effects:

Antithyroid

Used to treat the symptoms of hyperthyroidism; also known as thyroid hormones antagonists; interacts with: side effects:

Antituberculins

Used to prevent or treat an infection caused by Mycobacterium tuberculosis

Antitussive

Used to suppress a cough by acting on the souch center of the brain

Antiulcer agents

These drugs, such as histamine-2 antagonist, decrease the volume and increase the pH of gastric secretions; interacts with: side effects:

Antivirals

Used to treat infections caused by pathogenic viruses; interacts with: side effects:

Bronchodilators

Stimulate receptors within the tracheobronchial tree to relax and dilate the airway passages, allowing a greater volume of air to be exchanged and improving oxygenation; interacts with: side effects:

Beta andrenergic blockers -lol suffix, metoprolol, atenolol, popranolol

Inhibit the acivity of sympathetic transmitters, norepinephrine, and epinephrine; used to treat angina, arrhythmias, hypertension, and glaucoma; Used for: Angina,HTN,Cardiac dysrrhythmias,MI,CHF,interacts with: Calcium channel blockers,(verapamil, diltiazem) other antihypertensives, Insulin-may need to adjust Insulin doses for DM's, side effects:bradycardia, decreased cardiac output,AV block,ortho hypotension, rebound myocardium excitement,bronchoconstriction, glycogenolysis is inhibited (inhibits the breakdown of glycogen) NRSG: close BG monitoring for Diabetics,Asthmatics should not have this drug!,do not stop drug suddenly,daily HR & BP monitoring,daily weights for CHF pts

Calcium channel blockers -pine suffix ex amlodipine(Norvasc) felodipine(Plendil), also, diltiazem (Cardizem) verapamil (Calan)

Also called calcium ion antagonists, inhibit the entry of calcium ions in heart muscle cells, causing a slowing of the heart rate, lessening the demand for oxygen and nutrients, and relaxing of the smooth muscle cells causing vasodilation; Use: prevent or treat angina pectoris, HTN, only verapamil usually used for cardiac dysrhythmias, Side effects: reflex tachycardia, peripheral edema,acute toxicity,ortho BP's, constipation,bradycardia, CHF, Interacts with:Digoxin - increased levels, grapefruit- toxicity, other beta blockers-CHF, AV block, bradycardia NRSG:do not chew, cut or crush sustained release pills,IV admin slowly over 2-3 min, Angina pts-keep a record of chest pain(freq, intensity,duration, location and notify Dr. with increases), daily monitoring BP,HR & weights

Carbapenems

Antiboitics (imipenen, ertapenem, meropenerm) that have a broad spectrum ot activity against gram-positive and gram-negative bacteria; they act by inhibiting cell wall synthesis; interacts with: side effects:

Carbonic anhydrase inhibitors

Interfere with the production of aque humor, thereby reducing intraocular pressure associated with glaucoma; interacts with: side effects:

Cell-stimulating agents

Improve immune function by stimulating the activity of various immune cells; interacts with: side effects:

Cholinergic

Also known as parasympathomimetics; produce effects similar to those of acetylcholine; interacts with: side effects:

Cholinesterase inhibitors

These enzymes destroy acetylcholine, the cholinergic neurotransmitter; interacts with: side effects:

Coating agent

This drug, sucralfate, forms a complex that adheres to the carter of an ulcer, protecting it from aggravation by gastric secretions; interacts with: side effects:

Colony-stimulating factors

Stimulate progenitor cells in bone marrow to increase numbers of leukocytes, thereby improving immune function; interacts with: side effects:

Corticosteroids

These hormones are secreted by the adrenal cortex the adrenal gland; interacts with: side effects:

Cycloplegics

Anticholinergic agents that paralyze accommodation of the iris of the eye; interacts ; interacts with: side effects:with: side effects:

Cytotoxics

Agents that cause direct cell death; often used for cancer chemotherapy; interacts with: side effects:

Decongentants

Reduce swelling in the nasal passages caused by common cold or allergic rhinitis; interacts with: side effects:

Digestants

Combination products containing digestive enzymes used to treat various digestive disorders and to supplement deficiencies of natural digestive enzymes; interacts with: side effects:

Digitalis glycosides

A class of drugs, also konwn as cardia glycosides, that increase the force of contraction and slow the heart rate, thereby improving cardiac output; interacts with: side effects:

Diuretics

Act to increase the flow of urine; interacts with: side effects:

Emetics

Used to induce vomiting; interacts with: side effects:

Estrogens

Steroids that cause feminizing effects; interacts with: side effects:

Expectorants

Liquefy mucus by stimulating the natural lubricant fluids from the bronchial glands; interacts with: side effects:

Fluoroquinolones

Ciprofloxacin and related agents; widely used broad-spectrum antibiotics; interacts with: side effects:

Gastric stimulants

Used to increase stomach contractions, relax the pyloric valve, and increase peristalsis in the gastrointestinal tract; result in a decrease in gastric transit time and more rapid emptying of the interstinal tract; interacts with: side effects:

Glucocorticoids

Also known as adrenocorticosteroids; are used to regulate carbohydrate, fat, and protein metabolism

Gonadal hormones

Hormones produced by the testes in the male and ovaries in the female; interacts with: side effects:

Herbals

Plant products usually sold as food supplements; may have pharmacologic effects that are not evaluated or regulated by the FDA; interacts with: side effects:

Histamine (H2) antagonists

Decrease the volume and increase the pH of gastric secretions both during the day and the night; interacts with: side effects:

HMG-CoA reductase enzyme inhibitors

Also known as the statins: antilipemic agents that inhibit hydroxymethyl-glutaryl coenzyme A (HMG-CoA) thus reduce potential for atherosclesrosis; interacts with: side effects:

Hyperuricemics

Used to decrease the production or increase the excretion of uric acid; interacts with: side effects:

Immunizations

Produces antibodies that provide active immunity, prevents childhood infectious diseases

Immune Globullin-ex's Gamma globulin, Immunoglobulin G (IgG) Route: deep IM

Provides passive immunity and provide antibodies, interacts with: Live virus, side effects:local reaction, systemic allergy,

Immunostimulants-ex's Interferon alfa, Interleukin 2 Route: SQ or IM

enhance immune responses & decrease proliferation of cancer cells; interacts with: Antihypertensives,Theo-dur, Zydovudine(Retrovir) side effects:Cardiotoxicity, Hypotension, flu-like symptoms(fever, headaches,fatigue,chills,myalgias) Bone marrow suppression, alopecia,

immunosuppressants-ex's cyclosporine(Sandimmune, Gengraf,Neoral)

Act on T lymphocytes to suppress production of immune response components, supresses B cells Cytotoxic T's; interacts with: Phentoin, phenobarbitol,rifampin,tegretol, causing decrease in cyclosporine effects; Grapefruit juice,Ketoconizole, erythromycin, Amph B, cyclosporine increased effects, NSAIDs causes nephrotoxicity, glucocorticoids- cause hyperglycemia, side effects:hepatoxicity-jaundice, Nephrotoxicity,Osteporosis,adrenal insufficiency,fluid retention,bone marrow depression

Antihistamines ex's-1st gen H1antagonists-Diphenhydramine, promethazine, dramamine, 2nd gen H1 antagonists-loratadine (claritin) cetirizine(Zyrtec), fexofenadine(allegra)

Antihistamne action is on the H1 receptor results in blocking histamine relase in small blood vessels, nerves during allergic reactions. ; Used to treat allergy symptoms; may also be used to treat motion sickness, insomnia, and other nonallergic reactions; interacts with:ALCOHOL side effects:Sedation, anticholinergic effects(dry mouth, constipation) GI-nausea,vomiting,constipation,acute toxicity(flushed face, high fever, tachycardia) children-excitations,hallucinations,uncoordination,seizures

NSAIDs-Nonsteroidal Anti-Inflammatory ex's-1st gen-COX & COX 2 inhibitors-Aspirin, 2nd gen-selective Cox 2 inhibitors-Celebrex. 1st gen Ibuprofen, naproxen, ketorolac, 2nd gen-valdecoxib(Bextra)

Inhibits cyclooxygenase (inhibits COX 2 reducing inflammation, pain, fever. Inhibits COX 1 reducing platelet aggregation; interacts with: Warfarin increases bleeding times, glucocorticoids-increasing GI bleed risk, ALCOHOL- risk of bleeding, Ibuprofen-decreases platelet effects, Aspirin side effects: GI -dyspepsia, abdom pain, heartburn, nausea, renal dysfuntion- urine output, weight gain, increased BUN and creatinine levels, Salicylism( tinnitus,sweating, Headache, dizziness, repsiratory alkalosis, Reyes syndrome

Alpha 2 Agonist -ine suffix, ex clonidine (Catapress)

Act within the CNS to decrease sympathetic outflow resulting in decreased stimulation to the adrenergic receptors (both alpha & beta) of the heart and peripheral vascular system. Results in vasodilation,bradycardia & decreased cardiac output. Used for: HTN, Severe Cancer pain Side effects:drowsiness, sedation, dry mouth,rebound HTN, Interacts with:ALCOHOL,antihypertensive meds,Prazosin,MAOI's,trycyclic antidepressants,clonidine,CNS depressant, category C, NRSG: hypotension, don't stop taking med suddenly,teach pt to rise slowly lying to sitting, sitting to standing, take at bedtime

Hypertensive Crisis Medications/treatment -no common suffix, labetalol (Trandate), diazoxide(Hyperstat),fenoldopam(Corlopam), trimethaphan(arfonad), IV sodium nitroprusside(Nitropress)

Hypertensive emergencies are severe elevations in BP, often higher than 220/140 mm Hg, complicated by clinical evidence of progressive target organ dysfunction. A potentially life-threatening syndrome that results when an individual taking MAOIs eats a product high in tyramine(Alcohol, aged cheese overripened fruit,processed meats, soy products, caffienated drinks,yeast products, chocolate, OTC cold meds, diet pills). Symptoms:severe occipital headache, palpitations, nausea and vomiting, nuchal rigidity, fever, sweating, marked increase in blood pressure, chest pain, and coma. Meds listed(antihypertensives) cause vasodilation to cause decrease in preload and afterload. Side effects: excessive hypotension, cyanide and Thiocyanate toxicity (the pharmacokinetics of nitroprusside with metabolism to highly toxic cyanide. Simultaneous infusion of thiosulfate with nitroprusside provides the sulfur donor necessary to prevent cyanide accumulation - this is more common problem in peadiatrics) NRSG: IV solutes can be slightly brown discard any solutes dark blue, green, or red. protect Sodium nitroprusside from light, continuous monitoring of BP and EKG! Category C

Organic Nitrates -Nitroglycerin ex's Nitrol, Nitrostat, Isosorbide dinitrate(Imdur)

in stable angina-decreases cardiac 02 demand by dilating veins and decreasing venous return(preload), in variant angina-relaxes or prevents spasm in coronary arteries, increasing 02 supply. Uses:Acute attack & prophylaxsis in stable angina,variant angina, refractive angina,CHf due to acute MI, Side effects: headache,ortho BP's, reflex tachycardia, tolerance, Interacts with: ALCOHOL,anthypertensive meds, Viagr,a NRSG:teach pt use for acute attack & prophylaxsis, may take up to two doses at 5 min intervals or as prescribed.

Cardiac Glycosides - only med is digoxin(Lanoxin,Lanoxicaps,Digitek)

positive inotropic effect=increased force and efficiency of myocardial contraction improving pumping of heart, Stroke Volume(SV), and Cardiac Output(CO). Negative chronotropic effect=decreased heart rate, at therapeutic levels it slows rate of SA node depolarization & rate of impulses through the conduction system resulting in longer time for the ventricles to fill with blood coming from the atria, which leads to increased SV and increased CO. Uses: treatment CHF, Cardiac dysrhythmias-atrial fib, Side Effects: cardiotoxicity-bradycardia, increased dysrhythmias in some, GI effects-anorexia, nausea,vomiting,abd pain, CNS effects-fatigue,weakness,vision changes,diplopia,blurred vision,yellow-green or white halos around objects, Interacts with: thiazide diuretics and loop diuretics, Lasix(may cause increased dysrhythmias, Ace inhibitors and ARBS-risk of hyperkalemia decreasing dig effects,sympathomimetic meds like dopamine-complement inotropic action of digoxin, Quinidine-increase dig toxicity, Verapamil increases plasma levels of dig NRSG: check pulse and rhythm prior to each dose and if <60 hold the med, take same time daily, watch for hypokalemia- muscle weakness, Labs:therapeutic levels 0.5 - 2.0ng/ml,Cat C

Antilipemics-Fibrates -gemfibrizol(Lopid), fenofibrate(Tricor,Lofibra)

Decreases triglyceride levels-very low density lipoproteins(VLDL) by increasing the rate of VLDL excretion by inhibiting absorption of cholesterol secreted by the bile and from food. Increases HDL levels by promoting production of presursors to HDL's. Uses:reduce plasma triglycerides(VLDL), increase HDL, side effects: Gall stones, Myopathy, Hepatoxicity Interacts with: Warfarin(Coumadin) Statins, bile acid sequestrants-cholestyramine NRSG: advise pt to get baseline cholesterol levels and will need periodic monitoring of labs, take 30 min's prior to breakfast and dinner. Cat X

Antilipemics-Bile acid sequestrants - cholesteryamine(Questran), colestipol(Colestid)

Increases LDL receptor sites on liver cells resulting in increased uptake of serum cholesterol lowering LDL levels. Used in adjunct therapy with atorvastatin and dietary changes to lower cholesterol levels. SE's-constipation, Interacts wtih: Digoxin, Warfarin, Thiazides, tetracyclines by interfering with absorption. NRSG: contraindicated for pt's with biliary disease, advise to take other meds 1 hr prior or 4 hrs after taking this.

Norepinephrine/ Epinephrine

Vasoconstrictor, increases BP and cardiac output
S/E: Palpitations, TISSUE NECROSIS with extravasation

Dopamine

Low dose- dilates renal & coronary arteries, high-dose- vasoconstrictor
S/E: Incr ocular pressure, tachycardia, decr urinary output
Headache- sign of drug excess

Benadryl

Blocks effect of histamines (allergic rx)
S/E: DROWSINESS, confusion

Antianxiety Meds

S/E: Sedation, lethargy, depression, dry mouth, constipation, bradycardia, elev of liver enzymes, urinary retention
**starred have potential for abuse** Do NOT dc abruptly, avoid alcohol

Valium, Librium

Antianxiety, ***
S/E: lethargy, respiratory depression

Ativan, Xanax

Antianxiety, ***
S/E: CONFUSION
Check renal/hepatic function

Versed

Antianxiety- used preop and pre-procedures
S/E: RETROGRADE AMNESIA, hypotension

BuSpar

Antianxiety
S/E: Confusion, hypotension
Requires 3 wks to be effective, not PRN
Avoid alcohol/grapefruit juice

Antacid Meds

S/E: Constipation, diarrhea, metabolic acidosis
Absorp of other meds may be decr if given together
Give with fluids

Maalox

Antacid
S/E: LAXATIVE effect

Milk of Magnesia

Antacid, ***
S/E: when excessive- nau, vom, diarrhea

Antidysrhythmic Meds

Monitor blood pressure (for hypotension), heart rate, QT intervals

Lidocaine

Antidysrhythmic Meds
S/E: Slurred speech, confusion, bradycardia

Propanolol

Antidysrhythmic Meds
S/E: BRONCHOSPASM
Contraindicated for asthma, COPD

Amiodarone

Antidysrhythmic Meds
S/E: Liver toxicity

Verapamil

Antidysrhythmic Meds
S/E: Orthostatic hypertension

Gentamicin, Neomycin

Aminoglycosides
S/E: Ototoxicity, nephrotoxicity
Encourage fluids, small frequent meals

Cephalexin, Ceftriaxone

Cephalosporins
S/E: Incr risk of bleeding, superinfections, thrombophlebitis IV
Take with food, avoid alcohol, CROSS ALLERGY: penicillins

Ciprofloxacin, Levofloxacin

Fluoroquinolones
S/E: Superinfections, hepatotoxicity
Take on empty stomach, monitor liver function

Penicllin G

Penicillins
S/E: Gastritis, diarrhea, allergy

Sulfamethoxazole, Trimethoprim

Sulfonamides
S/E: Peripheral neuropathy, crystalluria, photosensitivity
Take on empty stomach, push fluids, protect from light

Doxycycline

Tetracyclines
S/E: Glossitis, phototoxic rx, decr oral contraceptives effectiveness
Take on empty stomach, protect from sunlight, monitor renal

Bacitracin ointment

Antibacterial ointment
S/E: Nephrotoxicity, ototoxicity

Silver sulfadiazine cream

Tx for burns
S/E: Neutropenia, burning
CROSS-ALLERGY: sulfonamides

Pyridium

Genitourinary med, antispasmodic & analgesic
S/E: Bright orange urine

Ditropan

Genitourinary med, tx, incontinence, antispasmodic
S/E: Drowsiness, blurred vision, dry mouth
Increase fluids and fiber in diet

Viagra

Tx of ED
S/E: Flushing, hypotension, priapism
DO NOT USE WITH NITRATES- fatal hypotension
Do not drink grapefruit juice

Proscar

Tx of BPH
S/E: Decr libido, impotence
Pregnant women should avoid contact with drug or pts semen

Atropine sulfate

Tx of bradycardia
S/E: Headache, dry mouth, urinary retention
Check for hx of glaucoma, asthma, HTN

Anticholinergic medications

Competes with acetylcholine at receptor sites in ANS for a variety of effects
S/E: Blurred vision, dry mouth, urinary retention, change in HR

Atrovent

Used for longterm tx of bronchospasm, asthma
S/E: Dry mouth

Cogentin

Used for Parkinson's Disease to reduce symptoms
S/E: Anticholinergic eff, orthostatic hypotension
Taper before d/c

Anticoagulant Medications

S/E: Alopecia, hemorrhage, bleeding
Soft toothbrush, electric razor, report black tarry stools, monitor platelet counts

Heparin

Anticoagulant
S/E: thrombocytopenia, anemia
Monitor PTT at 1.5 to 2.0 x control
Antidote: Protamine sulfate

Coumadin

S/E: Diarrhea, rash
Monitor PT at 1.5 to 2.0 x control, avoid diet high in vit K
Antidote: Vitamin K

Anticonvulsant Medications

S/E: Cardiac depression, resp depression, agranulocytosis, aplastic anemia, ataxia
Tolerance with longterm use, don't dc abruptly

Tegretol

Anticonvulsant
S/E: Myelosuppression, diplopia
Monitor CBC, wear sun protectant

Klonopin

Anticonvulsant, Benzodiazepine
S/E: Confusion, drowsiness

Topamax

Anticonvulsant
S/E: Vision problems, renal calculi

Valium

Anticonvulsant, ***
S/E: Hypotension, tachycardia
Alcohol incr CNS depression

Keppra

Anticonvulsant
S/E: Dizziness, suicidal ideation
Avoid alcohol

Dilantin

Anticonvulsant
S/E: Hirsutism, GI upset, gingival hypertrophy
Urine/sweat may turn red/brown, incr exposure to sunlight

Phenobarbital

Anticonvulsant, ***
S/E: Drowsiness, initially constricts pupils

Magnesium sulfate

Anticonvulsant, used for pre-eclampsia
S/E: Flushing, extreme thirst, hypotension
Monitor intake and output, check knee jerks before each dose

Depakote

Anticonvulsant
S/E: Sedation, tremors, prolonged bleeding time
Monitor platelets, bleeding time, liver functions

Nardil, Marplan

Antidepressive, MAOi
S/E: Hypertensive crisis when taken with foods containing tyramine, photosensitivity, sexual dysfunction
Do not take with SSRIs, avoid other CNS depressants, monitor for urinary retention

Prozac, Zoloft

Antidepressive, SSRI
S/E: Dry mouth, sexual dysfunction, weight gain
Take in AM, 4 full weeks for full effect, do not give with MAOi, monitor for thrombocytopenia, leukopenia, and anemia

Elavil

Antidepressive, Tricyclic
S/E: Photosensitivity, anticholinergic effs, bone marrow depression
Therapeutic eff in 1-3 wks, give at night, S/E decr over time, do not abruptly stop, avoid alcohol, avoid exposure to sunlight

Humalog

Rapid-acting Insulin, used in insulin pumps
Onset: 5-15 min, peak: 1 hr, duration: 3hr

Humalin R

Short-acting insulin
Onset: 30-60 min, peak: 2-3 hr, duration: 4-6hr

NPH

Intermediate-acting insulin
Onset: 2-4hr, peak: 6-12 hr, 16-20 hr

Lantus

Very long acting insulin
Onset: 1 hr, peak: none (continuous), duration: 24 hr

Insulin

S/E: Hypoglycemia
Have pts rotate sites, only reg insulin given IV, all others SQ
-when mixing insulin in one syringe, draw up regular (clear) before Lantus (cloudy)

Glucophage

Oral hypoglycemic
S/E: Diarrhea, abdominal discomfort, hypoglycemia
Avoid alcohol

Glucagon

Oral hyperglycemic
S/E: Nausea, vomiting, bronchospasm, hypotension
May repeat q15 mins

Antidiarrheal Meds

S/E: Drowsiness, constipation, anticholinergic effs
Monitor for urinary retention

Pepto-Bismol

Antidiarrheal
S/E: Darkening of stools and tongue, constipation
Give 2 hr before and 3 hr after other meds, do not give for more than 48hr

Lomotil

Antidiarrheal
S/E: Sedation, tachycardia, dizziness
Decr peristalsis, onset 45-60 min

Compazine

Antiemetic med
S/E: Orthostatic hypotension, diplopia, photosensitivity

Antiemetic Meds

S/E: Drowsiness, sedation, anticholinergic effs
Check CBC and liver func with prolonged use

Reglan

Antiemtic med
S/E: Restlessness, extrapyramidal symptoms, dystonic rx
Take before meals, use with tube feedings to decr asp

Amphotericin B

Antifungal med
S/E: GI upset, hypokalemia, seizures, hematological, cardiac, and hepatic abnorms
Protect med from sunlight

Questran

Antilipemic med
S/E: Constipation, rash, fat-soluble vitamin deficiency
Sprinkle powder in beverage or wet food

Lisinopril

AntiHTN, ACE inhibitor
S/E: Tachycardia, MI, persistent dry cough
Small, freq meals, change position slowly

Propanolol

AntiHTN, Beta Blocker
S/E: Bradycardia, cardiac dysrhythmias, impotence, bronchospasm
Do not dc abruptly, provide rest periods, take with meals.

Cardizem

AntiHTN, Calcium Channel Blocker
S/E: Peripheral edema, angina, flushing, rash, impotence
Do not chew sustained-release tabs, avoid grapefruit juice, monitor VS

Losartan

AntiHTN, Ace Receptor Blockers
S/E: Angioedema, renal failure, orthostatic HTN
Monitor for edema.

Methyldopa

AntiHTN
S/E: Drowsiness, orthostatic hypotension, CHF
Don't dc abruptly

Hydralazine

AntiHTN

Lithium

Bipolar med, mood stabilizer
S/E: Fine hand tremors, reversible leukocytosis
Monitor blood levels, norm = 1-1.5meQ/L
Intoxication signs: Vom, diarrhea, drowsiness, ataxia
Have good fluid and salt intake

Tegretol

Bipolar med, mood stabilizer
S/E: Drowsiness, ataxia, CHF, thombocytopenia
Check CBC, BUN, LFTs, basic urinalysis
Drowsiness disappears in 3-4 days

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