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ATI —Musculoskeletal, Respiratory, CV

Terms in this set (37)

calcitonin-salmon
First time dose: need skin testing to chrck for clients allergies, monitor for hypocalcemia—causes calcium excretion . Assess for nasal irritation . Rebound hypercalcemia. Look for nausea vomiting, flank, pain and lethargy , deep bone pain. Joint pin and muscle pain occurs treat with analgesics. Report rash or itching , must prime the tubing first and report nasal irritation. Avoid if fish or salmon allergy
Methotrexate
Black tarry stools. Can cause GI ulceration can lead to perforation and bleeding. Monitor stool and emesis. Take birth control to avoid pregnancy and preform pregnancy test. Given once a week. Take NSAIDS first to decrease pain and I flamm since it can take weeks to show effects. Drink 2-3 L to promote excretion can cause kidney damage . Or take sodium bicarbonate. Take on an empty stomach . Immunotherapy May occur avoid crowds or being near communicable disease report bruising or petechia, avoid drinking alcohol . Monitor lab test periodically
Usual adverse effects affect the respiratory, CNS, dermatologic, hematology .
Alendronate
Muscle pain is common. Decrease activity of osteoclasts. Reduces bone loss and increase bone mass. Can cause muscle and jaw pain as well as blurred vision and headache. Must be able to sit or stand up to take the med for 30 min. To prevent esophagitis
Raloxifene
AE: DVT can lead to CVA or PE accidents. Reports signs of calf pain/red/swelling calf. Avoid periods of activity. Increase physical activity by taking walks, use contraceptive and increase intake of calcium and vit. D. Med mimics the effects of estrogen on bone tidsye
Etanercept
HF is an adverse effect , report signs of infection immediately, subQ injection . Be up to date on vaccines. Can cause serious skin infection. Can cause serious reaction Stevens Johnson syndrome or TPN. Administrator TB TEST, blood draws are important the patient is at risk for systemic fungal infections and opportunistic. CBC needs to be monitored. This med helps prevent TNF binding thus prevents the autoimmune response and subsequent inflamm.
Zileuton
a leukotriene modifier. Can cause chest pain. Used throughout the day to decrease bronchoconstriction—and inflammation. Given orally. can cause liver injury—as the nurse should monitor liver function once a month for 3 months, then every 2-3 months throughout the first year of treatment.
Montelukast: is also a leukotriene modifier that needs to be taken once per evening this is taken prophylactically
Codeine
the greatest risk to clients taking this medication (opioid agonist) severe respiratory depression. Can also cause hypotension, slow heart rate, sedation
Ipratropium inhaled anticholinergic
adverse effects urinary retention and dry mouth. Wait 5 min. between other inhaled drugs to allow for bronchodilation to take effect. Drink water after to minimize unpleasant taste
Methylxanthines:
can cause insomnia
Cromolyn sodium:
Cromolyn sodium is a mast cell stabilizer. It decreases the activity of leukocytes and eosinophils. prevents bronchospasm. Therapeutic effects include reduce inflammation (inhibit the inflammatory response)
Phenylephrine
adverse effect of this drug is a headache can cause vessel constriction-leading to HA/nervousness/blurred vision, and tremors. insomnia, hypertension, N/V and epigastric pain. Since this drug causes vasoconstriction it should be avoided in prostatic hypertrophy and hyperthyroidism, CAD or severe hypertension
Albuterol:
when taken with fluticasone it will increase the absorption. So, albuterol should be taken first. Report adverse effects: palpitations, CP, HTN and arrythmias, muscle cramps, N/V and HA
Fluticasone propionate/salmeterol therapy
weight bearing activity helps to minimize bone loss. Take it on a schedule rather than PRN.
Guaifenesin
avoid over the counter drugs because OTC drugs.
Diphenhydramine:
common adverse effects include drowsiness, excitation in children.
Mucolytic (acetylcysteine):
therapeutic effect includes thins and loosens secretions. Which in turn makes the mucus less viscous to increase a coughs productivity
Dextromethorphan
an expectorant used to treat a cough. reduces surface tension. When combined with morphine. Increases the risk for decreased respirations and other depressed CNS responses.
Pseudoephedrine
legal restrictions apply due to use in methamphetamines. Adverse effects: restlessness, insomnia, anxiety
Beclomethasone:
treats asthma intranasal glucocorticoid that reduces inflammation. it can take 2-3 weeks to see the full therapeutic effect. take prophylactically to tx allergic rhinitis Avoid taking prednisone with NSAIDs. Gastric protective measures are essential for clients who are taking oral glucocorticoids. Avoid stopping abruptly. Can cause hypoglycemia
Verapamil
CCB. used to treat A fib/ SVT w/o causing dysthymia, migraine HALarge amounts of grapefruit juice can increase blood levels of verapamil by inhibiting its metabolism. An excess amount of the drug in the body can intensify otherwise therapeutic effects like hypotension—risk for syncope and dizziness/bradycardia./edema from fluid retention.Can cause constipation. Clarify prescription if patient has a history of second/third degree AV block or sick sinus syndrome
Losartan
ARBS is used to treat hypertension. Adverse effects of this medication that should be reported is facial edema. Instruct the patient to stop taking the drug and seek medical attention. Can cause insomnia, diarrhea
Diuretics
-education on increasing potassium. Raisins and dried fruit, artichokes, potatoes, chocolate milk and yogurt, soy nuts and fish avoid with NSAIDS
- Loop diuretic can cause hypokalemia—orthostatic hypotension, irregular pulse, confusion, anxiety, muscle weakness, hypoactive BS, polyuria, N/V
- Hydrochlorothiazide—the drug does not promote diuresis without renal insufficiency. Such as a low GFR. Used for clients with gouty arthritis. Monitor for hyperuricemia, can cause hyponatremia. Hypokalemia, hyperglycemia
- Spironolactone: potassium sparring diuretic. Immediate intervention needs to be done if potassium above 5 which can cause cardiac dysrhythmias.
Nitroglycerin:
adverse effects: HA, can be severe in the beginning of nitrate but decrease in severity with cont. exposure to nitrates, hypotension due to vasodilation
- Patch apply on dry skin and area with plastic wrap, apply a new patch every day and remove the patches 10-12 hrs. each day
Dobutamine:
verify the prescription if taking any of the following medications: MAOI—tachydysrhythmias, general anesthetic-dysrhythmias, tricyclic antidepressant, b-blocker.
Beta-blocker
propranolol used to treat tachydysrhythmias. Avoid the use of OTC--:NSAIDS can interact and decrease the anti-hypertensive action because vasoconstriction can occur in some COX-2. Can cause GI DISTURBANCE if taking more than 2 g
Quinidine
monitor pulse rate and report changes. It is a sodium channel blocker used to treat SVT & ventricular dysrhythmias. Can cause new dysrhythmias Can double digoxin levels, cause nausea, can cause urinary retention. Provide written record for provider
Milrinone
phosphodiesterase is contraindicated in patients who have a history of Acute MI, a recent reaction to the drug or pulmonary valve disorders. Contraindicated : use of atenolol concurrently
Gemfibrozil
a fibrate can cause gallstones client should monitor and report any signs of new intolerance to fried foods, as well as bloating or upper abd. Pain. Report muscle tenderness since it can cause myopathy. Clients should monitor and report any unexplained muscle or joint pain. LFT test should be done periodically. Take 2X a day, take 30 min before meals
Statins:
atorvastatin and gemfibrozil taken together can cause increased risk of myopathy. don't take with other lower cholesterol drugs. Can cause hyperglycemia, CP, pancreatitis
Simvastatin can block the synthesis of cholesterol by the body to help lower cholesterol levels
Can cause myopathy or pain in the muscle and joints can progress to rhabdomyolysis -resulting in kidney damage
Amiodarone:
avoid takin with grapefruit juice can increase toxicity. Take drug with milk if GI reaction occurs.
Captopril:
ACE inhibitor adverse effects that would indicate the patient to d/c the drug therapy is rash, distorted taste, swelling of the tongue, dry cough.
Aliskiren-direct renin inhibitor
used to treat hypertension. Adverse effects include: hyperkalemia (especially with ACE inhibitor, potassium supplements or potassium sparring diuretic—should be monitored , throat swelling-angioedema—stop taking and seek medical attention and cough, HA, diarrhea.
Procainamide:
Sodium channel blocker. used only for the short term treatment of cardiac dysrhythmias because of the serious AE such as cardiotoxicity and arterial embolism.
Carvedilol:
at risk for hypoglycemia if taken with medications to treat DM2. Can cause hypotension and Brady cardio if given with MAOI. Also can mask tachycardia that occurs in hypoglycemic patient
Digoxin toxicity:
antidote is an antigen binding fragment-digoxin immune fab. Administer IV
Reserpine
is contraindicated in those with a depressive disorder/ulcerative colitis . Has an increased risk for suicide due to the depletion of serotonin and norepinephrine an can persist after clients d/c taking the drug
Theophylline
A Methylxanthine that can cause seizures when drug levels of theophylline that exceed 30. Indicating toxicity,
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