Aerosols, ointments, creams, pastes, powders, solutions, foams, gels, transdermal patches, inhalers, rectal and vaginal suppositories Data collection, review and analysis
-Objective v subjective data which includes Medication profile, physical exam, allergies, any and all drug use, culture, developmental stage, social history, labs, current and past medical history, compliance and adherence.
combination products with less than 1.5 milligram of hydrocodone per dosage unit (Vicodin), cocaine, methamphetamine, methadone, hydromorphone (Dilaudid), meperidine (demerol), oxycodone (oxycontin), fentanyl, dexedrine, adderall, and ritalin Alcohol, antihistamines, barbiturates, benzodiazepines can cause extreme sleepiness, respiratory depression, coma, and death.
Monoamine oxidase inhibitors, phenothiazine, CNS depressants.
Labs may include: increase in the serum levels of amylase, alanine aminotransferase, alkaline, phosphatase, bilirubin, lipase, creatinine, kinase, and lactate dehydrogenase.
Most side effects are dose related
as patient becomes tolerant, the patient tolerates the side effects.
-CNS Depression, respiratory depression, nausea and vomiting, overdose, hypotension/bradycardia, dependence (physical and psychological) vs. tolerance, urinary retention, diaphoresis and flushing, pupil constriction (miosis), constipation & N/V, itching
-Naloxone (narcan) IV 0.4-2 mg= work to block response at receptor sites and reverse the toxicity; lasts for about one hour; doesn't produce analgesia or respiratory depression; DRUG OF CHOICE
-opioid withdrawal or opioid abstinence syndrome occurs manifested as: anxiety, irritability, chills and hot flashes, joint pain,, lacrimation, rhinorrhea, diaphoresis, nausea, vomiting, abdominal cramps, diarrhea, confusion.
-prevented with gradual reduction of dose
-may need ventilate support
-side effects of narcan= hypo/hypertension, dysrhythmias, pulmonary edema, withdrawal symptoms
-not currently classified as a controlled substance
-Indicated for treatment of moderate to moderately severe pain
-Absorption is unaffected by food
-adverse effects are similar to those of opioids: drowsiness, dizziness, headache, nausea, constipation,, seizures, respiratory depression.
-increased risk for serotonin syndrome when tramadol is taken concurrently with SSRIs
-Contraindications: drug allergy including opioids.
-Available in oral dosage forms, including a combination with acetaminophen
-assist with ambulation, injury prevention, constipation and nausea interventions
-Localized protective response stimulated by injury to tissues, which serves to destroy, dilute, or wall off (sequester) both the injurious agent and the injured tissues
-pain, fever, loss of function, redness, and swelling
-mediated by endogenous compounds, including proteins of complement system, histamine, serotonin, bradykinin, leukotrienes, and prostaglandins
Large and chemically diverse group of with the following properties: Analgesic, anti-inflammatory, antipyertic, aspirin-platelet inhibitor
NSAIDS are also used for the relief of: mild to moderate headaches, fever, dysmenorrhea, myalgia, arthralgia, postop pain, arthritic disorders, gout & hyperuricemia
Increased heart rate, tinnitus, hearing loss, dimness of vision, headache, dizziness, mental confusion, drowsiness, nausea, vomiting, diarrhea, heartburn, GI bleed, Acute Renal Failure, Hepatotoxicity, sweating, thirst, hyperventilation, hypoglycemia or hyperglycemia, metabolic acidosis or respiratory alkalosis
analgesic, anti-inflammatory, antirheumatic, and antipyretic properties.
Uses: RA, OA, Acute bursitis or tendonitis, ankylosing, spondylitis, acute gouty arthritis, and treatment of preterm labor.
-oral, rectal, intravenous use
-A common type of recurring headache, usually lasting from 4 to 72 hours
-thought to be caused from abnormal dilation of blood vessels in brain from lack of serotonin
-Typical features: pulsatile quality with pain that worsens with each pulse
-most commonly unilateral but may occur on both side of the head
-associated symptoms:nausea, vomiting, photophobia (avoidance of light), and phonophobia (avoidance of sounds)
-causes: stress, hypoglycemia, menses, endogenous estrogen (BC pills), exercise; intake of alcohol, caffeine,, cocaine, nitro, aspartame, MSG abortive therapy v preventative.
-used to manage migraine during aura phase or when the headache started.
-Triptans [sumatriptan (imitrex); almotriptan (axert); eletriptan (relpax); naratriptan (amerge); rizatriptan (maxalt); zolmitriptan (zomig), frovatriptan (froval) are used for servere migraines.
-some times caffeine or fioricet
-ergot alkaloids (ergotamine); previously used
-stimulate 5-HT receptors in cerebral arteries, causing vasoconstriction and reducing headache symptoms; reduce the production of inflammatory neuropeptide
-used cautiously with cardiovascular disease
side effects: vasoconstriction, irritation at injection site, tingling, flushing, congestion, rebound, headache, chest pain; overuse can cause rebound headache
Nursing implications: monitor for side effects; contraindication for its with cardiac issues; teach client about injections; available in tablets, SL, SQ, nasal sprays; monitor cardiac status
Client education: Teach how to administer med, avoid triggers, keep room dark, keep journal, avoid things that require alertness, contact HCP immediately if chest pain, SOB, palpitations, pain weakness occurs; proper administration
Aloe, feverfew, gingko, goldenseal, St. John's wort, valerian, echinacea, garlic, ginseng, glucosamine, hawthorn, saw palmetto, kava, chamomile, black cohosh, ginger Indications for Use: Traditionally chamomile has been used to treat inflammation of the skin and mucous membranes. It can also be used to treat bacterial infections of the skin, colic, croup, diarrhea, and mastitis.
Adverse Effects: Some adverse effects of chamomile use can include: anaphylaxis, contact dermatitis, vomiting, and eye irritation.
Interactions: Chamomile has been found to interact with sedatives, NSAIDs, anti-platelet drugs, and aspirin.
Nursing Implications: Chamomile is not contraindicated for breastfeeding mothers. It is sometimes used as a galactagogue. Galactagogues are believed to increase breastmilk production, though this has not been proven.
Uses-Saw palmetto is a tree use to make medicine. It is mostly used for decreasing symptoms of an enlarged prostate (benign prostatic hypertrophy-BPH). It is also used to prevent complications from prostate surgery and other types of prostate conditions. It has a suggested use for treating baldness in men and women.
Research has shown that taking 320 mg of saw palmetto daily for two months before prostate surgery can reduce the time spent in surgery, blood loss, the development of problems during surgery, and the total time spent in the hospital. However, taking 160mg for 5 weeks prior to surgery did not lower the risk for problems.
Side effects and Safety-Saw palmetto is likely safe for most people when taken by mouth for up to three years. Some people have reported dizziness, headache, nausea, vomiting, constipation, and diarrhea. Some people have reported that it causes impotence. There is some concern that saw palmetto may cause liver or pancreas problems. However, these side effects do not seem to occur anymore often with saw palmetto than with a sugar pill and not enough information to know if it causes these side effects.
Saw palmetto is likely unsafe when taken by mouth during pregnancy or breastfeeding. It acts like a hormone, and this could be dangerous to the pregnancy. Saw palmetto might slow blood clotting. There is some concern that it might cause extra bleeding during and after surgery. Stop using saw palmetto at least 2 weeks before a scheduled surgery.
Saw palmetto is possibly safe when administered into the rectum appropriately for up to 30 days. It is not known if its safe to use longer.
Interactions- It has a moderate interaction with birth control pills. It may decrease the effectiveness of birth control pills. Some medications that slow blood clotting might increase the chances of bruising and bleeding. These medications include aspirin, clopidogrel (Plavix), diclofenac (Voltaren, Cataflam, etc.), Ibuprofen (Advil, Motrin, etc.), naproxen (Anaprox, Naprosyn, etc.), dalteparin (Fragmin), enoxaparin (Lovenox), heparin, warfarin (Coumadin) and others.
Indications for use: Garlic can be used for many purposes such as, treating or preventing high blood cholesterol, high blood pressure, coronary artery disease, and the common cold, as well as in attempts to prevent cancer (stomach, colon or rectal) and other diseases.
Adverse effects: Breath and body odor, burning sensation in the mouth or stomach, heartburn, upset stomach, nausea, vomiting or diarrhea.
Interactions: Possible interference with hypoglycemic therapy and anticoagulant Warfarin (Coumadin). Garlic also interacts with Isoniazid, Saquinavir, HIV or AIDS medications, and NSAIDS.
Nursing implications: Garlic may pass into breast milk and may harm a nursing baby. Do not use this product without medical advice if breast-feeding a baby. Do not give any herbal/health supplement to a child without medical advice. Garlic taken by mouth in large doses may be harmful to children.
Indications for us it treats/prevents: Hawthorn can be used for countless purposes mainly for treatment. Studies shows that is is used for a disease of the heart, and blood vessels such as congestive heart failure, chest pain, and irregular heartbeat. It can also be used to treat both low blood pressure and high blood pressure, atherosclerosis, and high cholesterol. Hawthorn can also be used for the digestive system, regarding indigestion, diarrhea, and stomach pain. The herb can be used to reduce anxiety and be used as a sedative to increase urine output and for menstrual problems. Hawthorn can also be used to treat tapeworms and intestinal infections. Some people utilize hawthorn and apply it to the skin for boils, sores, and ulcers.
Hawthorn is possibly safe for short term use (up to 16 weeks). It is not known if hawthorn has been successful as a long-term use.
Adverse effects: Taking hawthorn can cause nausea, upset stomach, fatigue, sweating, headache, dizziness, palpitations, nosebleeds, insomnia, and agitation.
Interactions: This herb cannot be taken with digoxin (Lanoxin) because it can increase the effects of digoxin and increase the risks of side effects. It can not be taken with any blood pressure medication because it can cause your blood pressure to decrease. Males can't take hawthorn and any medication for sexual dysfunction because it may cause your blood pressure to go too low. Lastly, this herb can't be taken with any medication that increases the blood flow to the heart (nitrates) because it may increase the chance of dizziness and lightheadedness. Interacting Hawthorn with drugs may lead to toxic levels of cardiac glycosides (e.g., digitalis).
Nursing implications: For pregnant and breast feeding: not enough tests have been conducted to know to see the effects of hawthorn during pregnancy or while breastfeeding therefore patient should stay on the safe side and avoid the use. If client has a heart condition and is taking any heart medications avoid the use of hawthorn. Preoperative patients should avoid using this herb 2 weeks before surgery because hawthorn may slow blood clotting and increase the risk of bleeding during and after surgery. Always monitor for any unusual or adverse effects while taking Hawthorn including therapeutic effects.
INDICATIONS FOR USE:
Depression, anxiety, nervousness, heart palpitations, mood disturbances associated with menopause, Attention Deficit / Hyperactivity Disorder (ADHD), obsessive-compulsive disorders (OCD), Seasonal Affective Behavior (SAD), Pre-menstrual Syndrome (PMS), and Social Phobia.
COMMON SIDE EFFECTS:
May cause insomnia, vivid dreams, restlessness, dry mouth, dizziness, fatigue, and headaches.
Agitation, irritability, Gastrointestinal discomfort, diarrhea, severe skin rash
May decrease effects of alprazolam, amitriptyline, oral contraceptives, cyclosporine, imatinib, irinotecan, NNRTIs, phenytoin, protease inhibitors, tacrolimus, warfarin, benzodiazepines, valproic acid, phenobarbital, immunosuppressants, sympathomimetic amines, tyramine-containing foods, opioids, digoxin, estrogens, HIV drugs, monoamine oxidase inhibitors, zolpidem and other hypnotic drugs, theophylline, triptans, dextromethorphan, loratadine, cetirizine, fexofenadine.
May cause addictive serotonergic effects with antidepressants, paroxetine, sertraline, and tramadol.
St. John's Wort is contraindicated in patients with bipolar depression, schizophrenia, Alzheimer's disease, and dementia.
Do not take St. John's Wort without medical advice if you regularly use other medications. Avoid sun exposure while taking this drug, for product can make you sunburn more easily. This drug can affect fertility. You should avoid taking this drug if you are trying to get pregnant. St. John's Wort may harm an unborn baby. Do not use this product without the medical advice if you are pregnant. This product can also pass through breast milk and cause unwanted effects while breastfeeding. Should not be given to children under the age of 6, but permitted (under medical supervision) for children and teens (6-17 years of age). St. John's Wort should be taken for 4-6 weeks and if condition persists, new evaluation and medications should be considered.
Indications for use: Valerian is an herb sold as a dietary supplement in the United States. It is a native plant to Europe and Asia. Valerian is used to treat sleep disorders such as insomnia. There are other uses that have not been proven by research such as: treatment for attention deficit-hyperactivity disorder, anxiety disorders, depression, restlessness, chronic fatigue syndrome, and tremors.
Adverse effects: Headaches, dizziness, and gastrointestinal disturbances are the most common effects reported in clinical trials but similar effects were also reported for the placebo.
Interactions: Valerian may have additive therapeutic and adverse effects if taken with Xanax, Valium, Ativan, and Central nervous system depressants.
Nursing implications: Women who are pregnant or nursing should not take valerian without medical advice because the possible risks to the fetus or infant have not been evaluated.
Indication: relieving nausea, loss of appetite, motion sickness, and pain
Adverse effects: increases bleeding, heartburn, diarrhea, mouth, and throat irritation
Interactions: May increase the risk for bleeding if taken with anticoagulants and antiplatelets
Nursing impactions: must enhance safety, teach clients strategies to prevent adverse, interactions and toxicity. Also, determine the dosage frequency and amount.
Herb: Goldenseal (Yellow Root)
Indications for use (disease it treats and/or prevents): Common cold, respiratory tract infections, allergic rhinitis (hay fever), ulcers, diarrhea, constipation, skin rashes, a mouthwash for sore gums, and an eyewash for conjunctivitis.
Adverse effects: Mainly safe for most adults, Adults: Those who are pregnant or breast-feeding it is most likely unsafe for the infant. A chemical in the root can cross the placenta and be found in the breast milk which can cause brain damage. Children: Unsafe for newborn babies
Interactions: Cyclosporine: will decrease how fast the body breaks down the drug which can result in too much being present in the body. Digoxin: can cause a slight increase in the digoxin levels in the body. Medications changed by the liver: can decrease how quickly the liver breaks down some medications. Medications moved by pumps in cells: can make the pumps less active and increase how much of medication is absorbed.
Nursing implications: For dose information: it is by the person's age, health, and other factors. There is not enough information on this herb, further research must be conducted.
Herb: Echinacea (herbal supplement)
Indications: used as a treatment for common colds, herpes simplex infection (topical), immunostimulant, psoriasis (topical), upper respiratory infection (viral), Urinary Tract Infection, vaginal yeast infection, skin wounds (topical), skin ulcers (topical).
Contraindications: autoimmune disorders, HIV/AIDS, leucosis, multiple sclerosis, tuberculosis, collagen diseases; hypersensitivity to Asteraceae/Compositae plants, chrysanthemums, daisies, marigolds, ragweed.
Adverse effects: Using echinacea for more than 8 weeks could damage your liver or suppress your immune system. Herbalists do not recommend Echinacea if you are taking medicines known to affect your liver. Possible interference with or counteraction to immunosuppressant drugs and antivirals. Exercise caution with autoimmune disease. Risk of altered fertility, diarrhea, nausea/vomiting.
Interactions: Tizanidine: Echinacea may significantly increase pharm actions of Tizanidine. Rasagiline: Echinacea may increase plasma concentrations of rasagiline. Beclomethasone (inhalant).
Nursing implementations: The registered nurse should be aware that Echinacea stimulates increased activity of the immune system. Clients with autoimmune disorders should avoid using this. The nurse should encourage the client to tell the health care provider about any other medications or dietary/herbal supplements the client chooses to use. This will help to prevent possible drug interactions. The nurse should also be aware of contraindications for this herbal supplement. The nurse should encourage any female patients to consult their health care provider regarding pregnancy since there is no known information regarding the use of Echinacea during pregnancy or breastfeeding.
Indications for use: Glucosamine is most commonly used to provide relief pain and improve joint function for those with osteoarthritis, rheumatoid arthritis, and joint pain. Glucosamine is stated to have further uses but has not been proven with adequate research such as heart disease, knee pain, multiple sclerosis, stroke, jaw pain, glaucoma, interstitial cystitis, temporomandibular joint disorder, and weight loss.
Adverse effects: Glucosamine is mostly safe in adults but can cause the following side effects: nausea, heartburn, diarrhea, constipation, drowsiness, skin reactions, headaches, and hyperglycemia.
Interactions: Glucosamine has a MAJOR interaction with Warfarin. It may enhance the anticoagulant effects of warfarin. Glucosamine may also cause an increase in insulin resistance, which results in the need for higher dosages of oral hypoglycemics or insulin. Glucosamine may also decrease the effectiveness of chemotherapy medications such as etoposide, teniposide and doxorubicin Lastly, it may decrease the effectiveness of acetaminophen.
Nursing implications: Women who are pregnant or breastfeeding should not take glucosamine since there is not enough research to support its safe use. People who are allergic to shellfish should not take glucosamine since the supplement is derived from crabs, shrimps and the shell of lobsters. Stop taking glucosamine at least two weeks before a scheduled surgery as it may impact the body's ability to regulate blood sugar. Monitor pain and range of motion periodically while taking glucosamine.
Ginseng is an herb that is used in alternative medicine to possibly lower blood glucose level after meals in patients with type 2 diabetes and respiratory infections to prevent cold of flu symptoms. It is not yet proven that ginseng is effective for treating any medical conditions and has not been approved by the FDA.
Adverse effects include diarrhea, insomnia, headache, rapid heartbeat, increased or decreased blood pressure, breast tenderness and vaginal bleeding.
Since Ginseng has anticoagulant effects, patients should avoid with warfarin (Coumadin) and NSAIDs. Other drug interactions include diabetes medications, antidepressants, immunosuppressants (like azathioprine, cyclosporine, daclizumab, basiliximab, tacrolimus, sirolimus, and prednisone) and other corticosteroids (glucocorticoids).
Nursing implications include getting a thorough medication history that includes any prescription, OTC, herbal products, vitamins, minerals, and other dietary supplements to assess for potential drug-drug or drug-herb interactions. Assess heart rate, blood pressure, blood glucose and respirations before and after taking ginseng. Ask patient to report any breast tenderness, vaginal bleeding or insomnia. Increase fluid intake if diarrhea occurs.
Back Ground: Aloe or Aloe Vera is a perennial plant that belongs to the Liliaceae family. Aloe Vera has been used medicinally since 1500 BC primarily for skin integrity and the healing process. Queen Nefertiti and Cleopatra used it daily as part of their beauty regime. Aloe has at least 75 different compounds that include 20 different Amino Acids, 20 minerals, vitamins and water.
Medicinal use: Several Studies have shown that Aloe Vera can inhibit a Thromboxane, which is an inhibitor of wound healing. By inhibiting this it greatly increases the wound healing process and reduces inflammation along cuts and burns. There is also Magnesium Lactate that comes from Aloe that can block histamines that trigger itchiness and skin irritation. This can be used to further prevent against skin breakdown such as pressure ulcers. When Aloe is taken, it helps synthesis the collagen in the body by changing its chemical composition to increase the cross-linking effects and increases wound healing. Additionally, mucopolysaccharides along with amino acids and zinc present in Aloe Vera can lead to skin integrity, moisture retention, erythema reduction, and helps to prevent skin ulcers.
Dosage routes: Topical, liquid gel capsule, tincture, liquid
Positive Effects of Aloe Vera: treats wounds, psoriasis, mouth sores, ulcers, diabetes herpes, bedsore and burn wounds. It is known for its anti-tumor, anti-inflammatory, skin protection, anti-diabetic, anti-bacterial, anti-viral, antiseptic, and wound healing properties
Adverse Effects: Hypoglycemia, can sometimes cause stomach cramps and pain, liver problems, Bloody urine, low potassium, weight loss, heart disturbances.
Drug Interactions: There are no known drug interactions at this time associated to Aloe Vera.
Do not take : if you have GI disturbances (orally), appendicitis (orally), liver/kidney disease (orally) or peptic ulcer disease (orally)
Indications: To treat the symptoms of menopause, PMS, painful periods, acne, osteoporosis, and starting labor in pregnant women. Other lesser know treatments are anxiety, rheumatism, insect repellent, fever, and cough.
Adverse Effects: Possibly safe when taken by mouth by adults for one year. Mild side effects include: upset stomach, cramping, rash, a heavy feeling, vaginal spotting / bleeding, and weight gain.
Interactions: Atorvastatin commonly know Lipitor has harmful effects with Black Cohosh. Black Cohosh has the potential to harm the liver, so taking Lipitor might increase the chance of liver damage. However, it's not enough scientific data to know if this is an impact or concern. Please alert your healthcare provider before taking this herb while on Lipitor.
Cisplatin also known as Plantinol- AQ is a cancer treating medicine that will lose it effectiveness if taken with Black Cohosh.
Any Medicine that is broken down in the liver should not be taken with Black Cohosh. Due to the possibility of liver damage. Some examples are : Elavil, Clozaril, Fentanyl, Zofran, and Tylenol.
Nursing: Possibly unsafe for pregnancy and breastfeeding. Since Black Cohosh can act as a female hormone, it increases the risk of mischarges.
- Penicillin G & V (resistance via. β-lactamase)
- Naf*cillin*, Oxacillincillinllin*, Oxa*cillin*
- Amoxicillin & Clavulanic acid = Augmentin
- Ampicillin & Sulbactam
- Methi*cillin*, Oxa*cillin*, Dicloxa*cillin*, Cloxa*cillin*, Nafacillincillincillin*, Oxa*cillin*, Dicloxa*cillin*, Cloxa*cillin*, Nafacillincillincillin*, Oxa*cillin*, Dicloxa*cillin*, Cloxa*cillin*, Nafacillin
- Carbeni*cillin*, Tricar*cillin*, Piperacillincillini*cillin*, Tricar*cillin*, Piperacillin
- 5 generations of cephalosporins
>> Cephalexin, *Cef*aclor, *Cef*otaxime, *Cef*ipime, CefCefphalexin, *Cef*aclor, *Cef*otaxime, *Cef*ipime, CefCefphalexin, *Cef*aclor, *Cef*otaxime, *Cef*ipime, *Cef*taroline
Clavulanic acid & sulbactam are β-lactamase inhibitors, NOT antibiotics.
CNS: dizziness, drowsiness, excitement, fatigue, headache, insomnia, nervousness, weakness, and personality changes
EENT: blurred vision, nasal congestion, sore throats, tinnitus, altered taste or smell, conjunctivitis
Resp: chest congestion, hyperventilation, shortness of breath
CV: chest pain, palpating, tachycardia, hypertension, hypotension, syncope
GI: nausea, abdominal pain, constipation, diarrhea, dry mouth, vomiting
GU: changes in libido, dysuria, urinary frequency, urinary hesitancy
Derm: rashes, alopecia, blisters, dry skin, easy bruising, edema, flushing, pruritus
Endo: irregular menses
Neuro: incoordination, numbness, paresthesia, tremor
Misc: claimed, sweating, fever
Muscle rigidity, sudden high fever, altered mental status, blood pressure fluctuations, tachycardia, dysrhythmias, seizures, rhabdomyolysis, acute renal failure, respiratory failure, and coma Take with food, monitor liver function, check vital signs, don't stop abruptly, avoid alcohol
Notify provider is serotonin syndrome occurs, this is severe
Confusion, agitation, rapid heart rate and blood pressure, high fevers, seizures, urinary retention
Side effects/adverse reactions include: bradycardia, hypotension, dysrhythmias, headaches, dizziness, fainting, fatigue, mental depression, nausea, vomiting, diarrhea, blood dyscrasias, and hypoglycemia. Side effects/adverse reactions include: blurred vision, miosis, hypotension, bradycardia, sweating, increased salivation and gastric acid, nausea, vomiting, diarrhea, bronchoconstriction, and abdominal cramping.
Contraindications include: bradycardia, hypotension, COPD, peptic ulcer, Parkinsonism, and hyperthyroidism.
Side effects/adverse reactions include: tachycardia, palpations, dizziness, hypertension, sleeplessness, restlessness, nervousness, tremors, irritability, increased hyperactivity, anorexia, dry mouth, vomiting, diarrhea, weight loss, and thrombocytopenia. Side effects include: anorexia, nausea, depression, edema, dry mouth, seizures, bradycardia, orthostatic hypotension, cataracts, myocardial infarction, and heart failure. drug interactions: vasoconstriction and cold medications containing phenylephrine and pseudoephedrine can cause a hypertensive crisis when taken with an MAOI
food interactions (contain tyramine) and can cause a hypertensive crisis: some cheeses, cream, yogurt, coffee, chocolate, bananas, raisins, Italian green beans, liver, pickled foods, sausage, soy sauce, yeast, beer, and red wines
Check C&S before 1st dose
Monitor for excessive CNS stimulation (restlessness, confusion)
Must drink 1.5L - 2L H20 q day
DO NOT take with antacids, multivitamins, dairy, calcium, flouride, magnesium, iron, zinc, (binds and makes inactive) (can have 6 hours before or 2 hours after dose)
MUST Take all of med, and shouldnt be retaken
Risk of tendon rupture
Should not be given in someone who is prone to seizures
Long term use can cause hypoglycemia
-INDICATIONS: Respiratory, dermatological, UT, ear, eye, bone and joint infections; Treatment after anthrax, typhoid fever
-ACTIONS: Interferes with DNA replication in gram-neg bacteria
-ADR: Tendon pain*, headache, dizziness, hypotension, nausea, vomiting, diarrhea, fever, rash
-INTERACTIONS: Ca binds to medication and prevents absorption —> HIGH resistance developed in urban areas b/c of this
(Magnesium and Iron supp. as well - multivitamins/maalox) - careful with dairy.
-usual duration: 7-10 days
-if long-acting/high-dose: can be fewer days, 3-5 days
-INDICATIONS: Gestational choriocarcinoma, chorioadenoma destruens, hydatidiform, meningeal leukemia; control of severe psoriasis, RA, JRA
-ACTIONS: Inhibits folic acid reductase, leading to inhibition of DNA synthesis and inhibition of cellular replication; affects most rapidly dividing cells
-ADR: Malaise, alopecia (hair loss), ulcerative stomatitis (stomach ulcers), hepatic toxicity, BMS, interstitial pneumonitis
-Measure heptatotixicity and BMS via liver enzymes↑, platelets↓, RBCs↓, WBCs↓
-Pneumonitis might occur without rise in WBCs
-INDICATIONS: Produces regression in acute lymphoblastic lymphoma, acute myeloblastic leukemia, Wilms tumor, neuroblastoma, soft tissue and bone sarcoma, breast carcinoma, ovarian carcinoma, thyroid carcinoma, Hodgkin and non-Hodgkin lymphoma, bronchogenic carcinoma; and AIDS-related Kaposi sarcoma
-ACTIONS: Binds to DNA and inhibits DNA synthesis
-ADR: Cardiac toxicity (leading to bradycardia), alopecia, red urine, myelosuppression
-MONITOR: BP and EKG