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296 Meds you need to know for nclex. Including must know s/e, nursing considerations

Cetirizine HCL (zyrtec)

ANTIHISTAMINE - Allergy and asthma medication
s/e: drowsiness, fatigue, dry mouth
Nursing considerations:
relief of seasonal allergic rhinitic symptoms. relief of perennial allergic rhinitis caused by molds, animal dander, and other allergens.
avoid alcohol during cetirizine tx.
rx: preg cat b

fexofenadine (allegra)

ANTIHISTAMINE - Allergy and asthma medication
s/e: drowsiness
nursing considerations:
management of rhinitis, allergy symptoms, chronic idiopathic urticaria.
avoid alcohol, other cns depressants.
60 mg tablet: onset within 1 hr, peak 2-3h, duration about 12h.
180 mg tablet: duration 24h
rx; preg cat c

hydroxyzine (atarax, vistaril)

ANTIHISTAMINE - Allergy and asthma medication
s/e: drowsiness, dry mouth
nursing considerations:
treatment of prutitis, pre-op anxiety, post-op n/v, to potentiate opioid analgesics, sedation.
PO: onset 15-30m, duration 4-6h. avoid use with alcohol, other cns depressants. teach pt. dizziness/drowsiness may occur; use caution in potentially hazardous activities
rx; preg cat c

loratadine (claritin)

ANTIHISTAMINE - Allergy and asthma medication
s/e: drowsiness
nursing considerations:
management of seasonal rhinitis. avoid alcohol, other cns depressants. take on empty stomach 1h before or 2h after meals. onset 1-3h, peak 8-12h, duration greater than or equal to 24h
rx/otc; preg cat b

beclomethasone (beclovent, beconase)

CORTICOSTEROIDS- Allergy and asthma medication
s/e: dystonia, hoarseness, oropharyngeal fungal, infections, h/a, sore throat, dyspepsia
nursing considerations:
used in chronic asthma tx, seasonal or perennial rhinitis.
nasal spray: onset 5-7d (up to 3w in some pts), peak up to 3w.
inhaler: onset 10m. use regular peak flow monitoring to determine resp status
rx; preg cat c

flunisolide (nasolide, aerobid)

CORTICOSTEROIDS- Allergy and asthma medication
s/e: dystonia, hoarseness, oropharyngeal fungal, infections, h/a, sore throat, nasal congestion, cold symptoms, n/v/d, unpleasant taste, upset stomach
nursing considerations:
used in chronic asthma tx, seasonal or perennial rhinitis.
onset: few days
use regular peak flow monitoring to determine resp status
rx; preg cat c

fluticasone (flonase)

CORTICOSTEROIDS- Allergy and asthma medication
s/e: dystonia, hoarseness, oropharyngeal fungal, infections, h/a, sore throat, nasal congestion, cold symptoms, n/v/d, unpleasant taste, upset stomach
nursing considerations:
used in chronic asthma tx, seasonal or perennial rhinitis.
nasal spray onset within 2d, peak 1-2w
use regular peak flow monitoring to determine resp status
rx; preg cat c

mometasone (nasonex)

CORTICOSTEROIDS- Allergy and asthma medication
s/e: dystonia, hoarseness, oropharyngeal fungal, infections, h/a, sore throat, nasal congestion, cold symptoms, n/v/d, unpleasant taste, upset stomach
nursing considerations:
used in chronic asthma tx, seasonal or perennial rhinitis.
nasal spray onset within few days, peak 3w
use regular peak flow monitoring to determine resp status
rx; preg cat c

triamcinolone (nasocort spray, amcort)

CORTICOSTEROIDS- Allergy and asthma medication
s/e: dystonia, hoarseness, oropharyngeal fungal, infections, h/a, sore throat, nasal congestion, cold symptoms, n/v/d, unpleasant taste, upset stomach
nursing considerations:
used in chronic asthma tx, seasonal or perennial rhinitis.
nasal spray onset within 3d, PO/IM peak 1-2h
use regular peak flow monitoring to determine resp status
rx; preg cat c

acetaminophen (tylenol)

NONOPIOID ANALGESIC
s/e: anemia (long term use), liver/kidney failure (high prolonged use)
nursing considerations:
tx of mild pain or fever
PO: onset less than 1 h, peak 1/2-2h, duration 4-6h
rectal: onset slow, peak 1-2h, duration 3-4h
take crushed or whole with full glass of water
can give with food or milk to decrease GI upset
signs of chronic poisoning: rapid, weak pulse, dyspnea, cold, clammy extremities
signs of chronic overdose: bleeding, bruising, malaise, fever, sore throat
OTC; preg cat b

aspirin

NONOPIOID ANALGESIC-NSAID
s/e: n/v, rash
nursing considerations:
management of mild to moderate pain or fever, TIA, prophylaxis of MI, ischemic stroke, angina
PO: onset 15-30m, peak 1-2h, duration 4-6h
rectal: onset slow, 20-60% absorbed if retained 2-4h
with long-term use, check for liver damage: dark urine, clay-colored stools

celecoxib (celebrex)

NONOPIOID ANALGESIC-NSAID
s/e: increased risk of heart attack or stroke, serious skin reactions and intestinal problems (bleeding can occur w/o warning, fatigue, anxiety, depression, nervousness, n/v/a, dry mouth, constipation
nursing considerations,
management of acute, chronic arthritis pain and primary dysmenorrhea pain relief. can take w/o regard to meals. increasing doses does not increase effectiveness. do not take if allergic to sulfonamides or aspirin, or nsaids, caution with any hx of drug allergies
rx; preg cat c for first and second trimester; preg cat d for third trimester

ibuprofen (motrin, advil)

NONOPIOID ANALGESIC
s/e: h/a, n/a, GI bleeding, blood dyscrasias
nursing considerations:
tx of rheumatoid arthritis, osteoarthritis, primary dysmenorrhea, gout, dental pain, musculoskeletal disorders, fever
onset 1/2h peak 1-2h
contact MD if ringing/roaring in ears, which may indicate tox. contact MD if changes in urinary pattern, increased wt, edema, increased pain in jts, fever, blood in urine, which may indicate kidney damage. use sunscreen to prevent photosensitivity. avoid use w/ ASA, nsaids and alcohol which may precipitate GI bleeding.
OTC/rx; pre cat b

codeine

OPIOID ANALGESIC
s/e: drowsiness, sedation, n/v/a, resp depression, constipation, orthostatic hypotension
nursing considerations:
tx of mod to severe pain, nonproductive cough
PO: onset 30-45m, peak 60-120m, duration 4-6h, IM/subq: onset 10-30m, peak 30-60m, duration 4-6h. do not give if resp <12m. avoid use w/ alcohol, other cns depressants, withdrawal symptoms may occur: n/v, cramps, fever, faintness, anorexia.
physical dependency may result from long-term use
rx; schedule c-II, III, IV, V (depends on route); preg cat c

hydrocodone bitartrate & acetaminophen (Lortabs)

OPIOID ANALGESIC
s/e: dizziness, drowsiness, constipation, n/v
Nursing considerations:
used for relief of moderate to moderately severe pain. use w/ cns depressants and/or alcohol may result in additive cns depression. may be habit forming. avoid alcohol during tx. use w/ caution in pts w/ pulmonary considerations
rx; schedule c-III; preg cat c

hydromorphone (dilaudid)

OPIOID ANALGESIC
s/e: dizziness, drowsiness, constipation, n/v/a, sedation, resp depression, cramps, orthostatic hypotension, confusion, h/a, rash
Nursing considerations:
used for relief of moderate to severe pain; non productive cough
PO: onset 15-30m, peak 30-60m, duration 4-6h
IM: onset 15m, peak 30-60m, duration 4-5h
IV: onset 10-15m, peak 15-30m, duration 2-3h
SubQ: onset 15m, peak 30-90m, duration 4h
rectal: duration 6-8h. do not give if resp <12m. avoid use w/ alcohol, other cns depressants. withdrawal symptoms may occur: n/v/a, cramps, fever, faintness.
physical dependency may result from long term use
rx; schedule c-II; preg cat c

meperidine (demerol)

OPIOID ANALGESICS
s/e: drowsiness, sedation, resp depression, euphoria, orthostatic hypotension, confusion, h/a,
Nursing considerations:
used for relief of moderate to severe pain; pre-op sedation, post-op and OB analgesia
PO: onset 15-30m, peak 30-60m, duration 2-4h
IM: onset 10-15m, peak 30-50m, duration 2-4h
IV onset <5m, peak 5-7m, duration 2-4h
subQ: onset 10-15m, peak 30-50m, duration 2-4h.
do not give if resp <12m. avoid use w/ alcohol, other cns depressants. withdrawal symptoms may occur: n/v/a, fever, faintness. physical dependency may result from long-term use
rx; schedule c-II; Preg cat c

methadone

OPIOID ANALGESICS
s/e: drowsiness, sedation, n/v/a, constipation, cramps, resp depression, euphoria, orthostatic hypotension, confusion, h/a, rash
Nursing considerations:
used for relief of pain; detox/maintenance of narcotic addiction
PO: onset 30-60m, peak 30-60m, duration 4-6h
IM: onset 10-20m, peak 60-120m, duration 4-5h
IV onset peak 15-30m, duration 3-4h
do not give if resp <12m. avoid use w/ alcohol, other cns depressants. withdrawal symptoms may occur: n/v/a, fever, faintness. physical dependency may result from long-term use
rx; schedule c-II; Preg cat c

morphine (MS contin)

OPIOID ANALGESICS
s/e: sedation, n/v/a, resp depression, euphoria, orthostatic hypotension
Nursing considerations:
used for relief of severe pain; continuous dosing is more effective than prn; may be given by PCA
PO: onset 15-60, peak 30-60m, duration 3-6h
IM: onset <5m, peak 18m, duration 3-6h
subq onset peak 10-15m, duration 2-4h
withdrawal symptoms may occur: n/v/a, fever, faintness. physical dependency may result from long-term use
rx; schedule c-II; Preg cat c

oxycodone (oxy contin; w/ aspirin: percodan, w/ acetaminophen: Percoset)

OPIOID ANALGESICS
s/e: drowsiness, sedation, n/v/a, constipation, cramps, resp depression, euphoria, orthostatic hypotension, confusion, h/a, rash
Nursing considerations:
used for relief of mod to severe pain
PO: peak 30-60m, duration 4-6h
controlled release; peak 3-4m, duration 12h
do not give if resp <12m. avoid use w/ alcohol, other cns depressants. withdrawal symptoms may occur: n/v/a, fever, faintness. physical dependency may result from long-term use
rx; schedule c-II; Preg cat b

propoxyphene (darvon, propoxyphene w/ acetominophen - darvocet-N)

OPIOID ANALGESICS
s/e: drowsiness, sedation, n/v/a, constipation, cramps, resp depression, orthostatic hypotension, confusion, h/a, rash
Nursing considerations:
used for relief of mild/mod pain
PO: onset 30-60m, peak 120m, duration 4-6h
low schedule rating for misuse potential, addiction liability. do not use in suicidal pts.
avoid use w/ alcohol, other cns depressants. withdrawal symptoms may occur: n/v/a, fever, faintness. physical dependency may result from long-term use
rx; schedule c-IV; Preg cat c

tramadol (Ultram, Ultram ER, tramadol w/ acetominophen - Ultracet)

OPIOID ANALGESICS
s/e: dizziness, drowsiness, sedation, insomnia, h/a, nervousness, agitation, uncontrollable shaking, muscle tightness, changes in mood
Nursing considerations:
used for relief of mod to moderately severe pain
notify prescriber of significant symptoms: seizures, sores in mouth, nose or throat; flu-like symptoms; hives; rash; difficulty swallowing or breathing; hallucinations
sudden discontinuation may cause withdrawal symptoms: nervousness, panic, sweating, insomnia
rx; not controlled substance; Preg cat c

heparine

ANTICOAGULANT
s/e: can produce hemorrhage from any body site (10%), tissue irritation/pain at injection site, anemia, thrombocytopenia, fever
nursing considerations:
prophylaxis and tx of thromboembolic disorders. in very low doses (10-100u) to maintain patency of IV catheter (hep flush).
therapeutic PPT @ 1.5-2.5 times the control w/o signs of hemorrhage
IV: peak 5m, duration 2-6h
injection: give deep subQ; never IM (danger of hematoma), onset 20-60m, duration 8-12h
antidote: protamine sulfate within 30m
signs of hemorrhage: bleeding gums, nosebleed, unusual bleeding, black, tarry stools, hematuria, fall in hct or bp, guaiac-positive stools
avoid ASA-containing products and NSAIDS. wear med tag. rx; preg cat c

warfarin (coumadin)

ANTICOAGULANT
s/e: hemorrhage, diarrhea, rash, fever
nursing considerations:
management of pulmonary emboli, dvt, MI, atrial dysrhythmias, postcardiac valve replacement
therapeutic PT @ 1.5-2.5x control, INR: 2-3
onset: 12-24h, peak 1 1/2-3d; duration 3-5d
antidote: vit K, whole blood, plasma
avoid foods high in vit K: many leafy green vegetables
do not interchange brands; potencies may not be equivalent.
avoid ASA containing products and nsaids. wear med tag. rx; preg cat x

carbamazepine (tegretol, tegretol xr)

ANTICONVULSANT
s/e: myelosuppression, dizziness, drowsiness, ataxia, diplopia, rash, photosensitivity
nursing considerations:
management of seizures, trigeminal neuralgia, diabetic neuropathy. avoid driving and other activities requiring alertness the first 3d. monitor blood levels, CBC regularly, esp during first 2m; periodic eye exams. take w/ food or milk to decrease GI upset; tablets (non ER) may be crushed, extended release capsules may be opened, mixed w/ juice or soft food. urine may turn pink to brown. avoid abrupt withdrawal; discontinue gradually. avoid use w/ alcohol, other cns depressants
rx; preg cat c

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