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What do these drugs treat?
Norepi
Dopamine
Isoproteerenol
Phenylephrine
Dobutamine
Sodium nitroprusside
Diphenhydramine HCL
Shock, Cardiac Arrest and anaphylaxis
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Nursing considerations for:
Norepi
Dopamine
Isoproterenol
Phenylephrine
Dobutamine
Sodium nitroprusside
Diphenhydramine HCL
- Serious rebound effects....
- watch VS
- monitor urine output
- assess for extravasation
- observe extremities for color and perfusion
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What do these drugs treat?
Chloriazepoxide
Diazepam....all "pam"s
Midazolam
Buspirone
Hydroxizine
Anxiety disorders
-
All anxiety disorder meds Nursing considerations....
- causes.....sedation
- depression/confusion
- dry mouth
- brady
- Elevate LDH, AST, ALT
- **Avoid alcohol, monitor liver function**
-
2 Herbals that are used to treat anxiety disorders and what are their nursing considerations?
- Kava and Melatonin....
- similar to benzos, dont take with CNS depressants
- dont take if prego or under 12
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What do these drugs treat?
Gentamicin
Neomycin
Streptomycin
Tobramycin
Amikacin
Bacterial infections
-
Nursing considerations when taking:
Gentamicin
Neomycin
Streptomycin
Tobramycin
Amikacin
- Ototoxicity...check CN #8
- Nephrotoxicity....check renal fxn
- Anorexia, N/V/D
- Encourage fluids and eating small frequent meals because it is hard on the GI tract
-
Nursing considerations for Cephalexin, Cefaclor, Ceftriaxone and Cefepime
- Take with food
- No alcohol while taking these meds....and for 3 days after done
- **Cross allergy with penicillins
- Watch renal and hepatic fxn
- Increased risk for bleeding
-
Nursing considerations for Ciprofloxacin, Levooxacin, Norfloxacin
- Take 1 hr before or 2 hours after meals with water....encourage fluids
- Photosensitivity
- Decreases WBC and HCT
- Elevates BUN AND ALT, AST
-
Prior to administering all antibiotics....
take blood for culture and sensitivity
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Nursing considerations for Vancymcin
- Nephrotoxicity
- Ototoxicity
- Abscess formation
- Thrombophlebitis...extravasation
-
Vancomycin can cause this.....what do I give?
Red Man Syndrome....decreased blood pressure, flushed face and neck, sore throat, fever, fatigue
give antihistamine
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Nursing considerations for Clindamycin
- take with a full glass of water
- watch for N/V/D, fever and super infections
-
Nursing considerations for Erythyromycin and Azithromycin
- Take 1 hour before or 2 hours after meals with full glass of water
- Abd. cramps
- Diarrhea
- Hepatotoxicity
- Superinfections
-
Nursing considerations for all of the penicillins
- Gastritis....so eat dairy
- Good mouth care
- Monitor for electrolytes and cardiac problems if given IV
- Dont double dose if forget
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Nursing considerations for:
Sulfisoxazole
Sulfasalazine
Trimethoprim/Sulfamethoxazole
- PHOTOSENSITIVITY
- GI upset
- Stomatitis
-
Nursing considerations for
Doxycycline
Minocycline
Tetracycline
- discolors teeth of baby if take while prego
- Phototoxic reactions
- Super infections
- Take 1 hr before or 2 hrs after meals
- Dont take with antacids, milk or iron
- Protect from sunlight
- Monitor renal fxn
- Use other BC methods if on the pill
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Nursing considerations for
Propantheline
Atropine Sulfate
Ipratropium
Benztropine
Scopolamine
ANTICHOLINERGICS....cant see, pee, spit, shit
Contraindicated for clients with glaucoma
-
Nursing considerations for
Clomazepam
Diazepam
Fosphenytoin
Levetiracetam
Phenytoin
Phenobarbitol
Primidone
Mag Sulfate
Valproic Acid
Carbamazepine
Gabapentin
Anti seizure meds
- Watch for cardio and resp. depression
- Anemia
- DONT D/C abruptly
- Dangerous for older adults
-
Nursing considerations for
Phenelzine Sulfate
Isocarboxaid
Tranylcypromine
Anti depressants
- Hypertensive crisis when taken with aged cheese, bologna, salami, bananas, beer, wine or with OTC meds with ephedrine, seudophedrine
- photosensitivity
- weight gain
- sexual dysfunction
- Orthostatic hypotension
- Dont take with other CNS Depressants
-
Nursing considerations for
Fluoxetine
Citalopram
Escitalopram
Paroxetine
Sertraline
- anti depressant/OCD/Bulimia
- Take in AM
- Take 4 weeks to get full effect
- monitor weight
- good mouth care
- Thrombocytopenia, leukopenia, anemia
-
Nursing considerations for patients on St. John Warts
- causes HTN, dizziness
- Phototoxicity
- Dont take MAOI's within 2 weeks of each other
- NO alcohol
- D/C 1-2 weeks before surgery
-
Nursing considerations for Amphotericin B
- Seizures
- IV Infiltrates
- Hematological, renal, hepatic abnormalities
- Skin irritation
- Refrigerate and keep out of the sun
- Check for HYPOKALEMIA
-
Nursing considerations for Colchicine, Probenecid and Allopurinol
Antigout meds
- GI upset
- Take with meals/milk
- Watch renal fxn
-
Nursing considerations for Chlorpheniraminemaleate
Promethazine HCL
Loratadine
Cetrizine
Fexofenadine
Anti-histamines
- Drowsy
- Dry mouth
- Photosensitivity
- Avoid alcohol
- Take with food
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Nursing considerations for
Cholestyramine
Colestipol
Nicotinic Acid
Lovastatin, Pravastatin...all statins
Niacin
Fenofibrate
Gemfibrozil
Lowers cholesterol
- Varies by med....but watch for constipation
- Increased liver enzymes
- gout
- Make sure they exercise and stop smoking and eat better too
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What does flax seed do?
decreases the absorption of other meds
-
What does garlic do?
increases the effects of anticoagulants and increases the hypoglycemic effects of insulin
-
What does green tea do?
Increases the stimulant effect if the tea contains caffeine soy
-
Nursing considerations for
Catopril
Enalapril
Fosinopril.....all ACE Inhibitors
- Give 1 our before or 2 hours after eating
- eat small/frequent meals
- change positions slowly
- Watch for tachycardia, MI and persistent dry non productive cough
-
Nursing considerations for
Atenolol
Aceputolol.....all Beta Blockers
- Bronchospasm
- Dont d/c abruptly...do gradually over 2 weeks
- Take with meals
- Monitor blood glucose cuz blocks normal signs of hypoglycemia
- Has antianginal and antiarrhythmic actions
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Nursing considerations for
Nifedipine
Verapamil
Diltiazem
Amlodipine....All Calcium Channel Blockers
- Dont use if have heart block
- Call Dr. if BP is less than 90/60
- NO GRAPEFRUIT JUICE
- Monitor VS and watch for signs of CHF
-
Nursing considerations for
Candesartan
Eprosartan
Losartan
Valsartan
Angiotensin II Blockers
- Watch for edema and call Dr. if it happens
- Change positions slowly
-
Nursing considerations for
Doxazosin
Prazosin
Terazosin
Apresoline
Alpha Adrenergic Blockers-HTN
- Watch for reflex tachy
- Give 1st dose at bedtime to avoid fainting
- Monitor weight, BUN/Creatinine
-
Nursing considerations for
Clonidine
Methyldopa
Centrally acting alpha adrenergics-HTN
- Dont D/c abruptly
- Watch for fluid retention
- Watch for orthos....especially in elderly
-
Ma-huang and anti hypertensives
decreases the effects
-
Ephedra....
increases htn when taken with beta blockers
-
Black Cohosh.....
increases hypotensive effects of all anti hypertensives
-
Goldenseal.....
counteracts the effects of all antihypertensives
-
Nursing considerations for
Lithium
Carbamazepine
Divalproex sodium
Treat bi polar disorder
- watch for dizziness
- Hand tremors
- Watch for blood disorders, leukocytosis, aplastic anemia, thrombocytopenia
- Pancreatitis
-
Levodopa nursing considerations
- causes N/V...GIVE WITH FOOD
- twitching
- Contraindicated in glaucoma and hemolytic anemia
- AVOID OTC meds and foods with V. B
- Orthos
- Avoid other CNS depressants
-
Nursing Considerations for
Holoperidol
Fluphenazine
Risperidone and Ziprasidone
Quetiapine, Clozapine, Olanzapine
Apriprazole
Antipsychotics
- High incidence of EPS
- Orthos
- Dry mouth
- Sleepy
- Akathesia
-
Nursing considerations for INH
- hepatitis
- no alcohol
- watch for orthos
- Take BEFORE Meals
-
Nursing considerations for Ethambutol
- Optic neuritis...check visual acuity
- use cautiously with renal disease
-
Nursing considerations for Rifampin
- Hepatitis
- Fever
- Orange urine, tears, saliva
- check LFT
- TAKE WITH FOOD
-
Nursing considerations for Streptomycin
- neprotoxicity
- CN #8 damage
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Nursing considerations for
Dextromethorphan
Guaifenesin
Cough meds
- Drowsy/Dizzy
- Respiratory depression
- Hypotension/Brady
- Anti cholinergic effects
- Photosensitivity
- NO alcohol
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Nursing considerations for
Acyclovir
Ribavarin
Zidovudine
Zalcitabine
Famciclovir
Ganciclovir
Amantadine and Rimantadine
Oseltamivir and Zanamivir
Anti Virals
- Watch for vertigo
- Depression
- Headache
- Hematuria
- Encourage fluids and sm. frequent meals
- Wear gloves when applying
-
Nursing considerations for Digoxin
- Anorexia
- Brady
- Visual disturbances/Confusion
- Abdominal pain
- Monitor renal and elelctrolytes
- TAKE APICAL pulse for 1 full min. before giving...hold if <60
-
Important things to teach about Digoxin
- Give a loading PO dose of 0.5-0.75 then 0.25 q6-8 hrs after
- Low K increases risk of dig toxicity
- Serum therapeutic levels 0.5-2
- Toxic levels are > or = to 2
-
Licorice and Digoxin
potentiates the action of dig by increasing K loss
-
Hawthorn and dig...
increases the effects of digoxin
-
Ma Huang and digoxin
can increase the risk of dig toxicity
-
What does digoxin do?
increase force of contraction and slows the HR
-
Nursing considerations for Sucralfate
taken for duodenal ulcers
- take 1 hr before breakfast and dont take with antacids or H2 blockers
- Give 2 hours before or after most meds
-
Gingko and thiazide diuretics
can increase B/P
-
Nursing considerations for Cortisone.....
Hydrocortisone
Dexamethasone....all steroid/Glucocorticoids
- infection risk
- Delayed wound healing
- Hypokalemia/Hypocalcemia
- Peptic Ulcers
- Psychosis
- Growth retardation
- Addisons/Cushings
- GIVE WITH ANTACIDS
- Dont stop abruptly
-
Nursing considerations for
Fludrocortisone...Mineralcorticoid/Steroid
- causes HTN
- Sodium retention
- muscle weakness and dysrhythmia from hypokalemia
- Monitor BP and electrolytes
-
Which meds will increase their serum drug levels with the drinking of grapefruit juice?
- CCB----Amlodi"pine", Diltiazem, Verapamil
- SSRI's---Fluoxetine, Fluvoxamine, Sertraline
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