-Decreases hepatic glucose production and intestinal glucose absorption in management of type II DM
-Increases sensitivity to insulin.
-Used in polycystic ovarian syndrome.
Metformin (Glucophage) side effects?
What should you assess before giving a patient Metformin (Glucophage)?
-If they are having any procedures requiring radiologic contrast.
-May resume drug when BUN and creatinine are normal
Metformin (Glucophage) is contraindicated in who?
What would you teach someone taking Metformin (Glucophage)?
NOT a cure for DM, just helps control hyperglycemia
Follow diet and exercise regiment
S/S of lactic (hyperventilation, myalgia, malaise, and somnolence)
Furosemide (Lasix) class?
Furosemide (Lasix) oral, IV, and IM dosage?
Furosemide (Lasix) oral, IV, and IM time of onset?
PO: 30-60 min
IV: 5 min
Furosemide (Lasix) action?
-Inhibits reabsorption of sodium and chloride
-Increases renal excretion of H2O, Na,
Cl, Mg, K and Ca to combat edema due to heart failure, hepatic impairment or renal disease
Furosemide (Lasix) side effects?
what would you assess before giving a patient Furosemide (Lasix)?
-don't want low BP
-don't want s/s of dehydration
-give slowly if an IV push (fast could cause hearing loss)
-Discontinue if rash develops
Furosemide (Lasix) is contraindicated in who?
-hepatic coma or anuria
-Use cautiously in severe liver disease and DM.
What would you teach a patient with Furosemide (Lasix)?
-Notify doc if rash, muscle weakness, cramps, nausea, dizziness, numbness or tingling of extremities
Metoprolol (Lopressor/Toprol) class?
Metoprolol (Lopressor/Toprol) oral and IV dosage?
IV: 5mg every 2 min for 3 doses
Metoprolol (Lopressor/Toprol) oral and IV time of onset?
Rapid for both
Metoprolol (Lopressor/Toprol) action?
-Decreases blood pressure, heart rate and frequency of attacks of angina pectoris.
-Blocks the stimulation of beta1-adrenergic receptors which decreases heart rate,
workload of heart, peripheral vascular resistance, and dysrhythmias.
Metoprolol (Lopressor/Toprol) side effects?
What should you assess before giving Metoprolol (Lopressor/Toprol)?
-HR (must be above 50)
-BP (no hypotension or signs of HF - dyspnea, rales, crackles, weight gain, and peripheral edema)
Who is Metoprolol (Lopressor/Toprol) contraindicated in?
What would you teach a patient taking Metoprolol (Lopressor/Toprol)?
-Notify doc if rash occurs
-Do not stop drug abruptly (Must be tapered over 1-2 weeks to avoid rebound dysrhythmias)
Benazepril (Lotensin/Lisinopril) class?
Benazepril (Lotensin/Lisinopril) oral dosage?
PO: 10 mg/day
Benazepril (Lotensin/Lisinopril) oral dosage time of onset?
within 1 hour
Benazepril (Lotensin/Lisinopril) action?
-Blocks the conversion of angiotensin I to angiotensin II
-leads to blood vessel dilation (antihypertensive effect), prevents and/or reverses remodeling of the heart (HF and post MI).
Benazepril (Lotensin/Lisinopril) side effects?
What would you assess before giving patient Benazepril (Lotensin/Lisinopril)?
Patients may experience a cough which, if disturbing, could lead to having to d/c drug
Benazepril (Lotensin/Lisinopril) is contraindicated in who?
bilateral renal artery stenosis
hypersensitivity and history of angioedema with previous ACE inhibitors
What would you teach a patient taking Benazepril (Lotensin/Lisinopril)?
Avoid K+ supplements
Notify doc if rash, mouth sores, sore throat, fever, swelling of hands or feet, irregular heart beat, chest pain, dry cough, hoarseness, swelling of face, eyes, lips or tongue and difficulty swallowing or breathing occur.
Potassium (K-Dur) class?
mineral and electrolyte replacement
Potassium (K-Dur) oral and IV dosage?
PO: 40-100 mEq/day
IV: 10-80 mEq/day
Potassium (K-Dur) oral and IV time of onset?
Potassium (K-Dur) action?
-Treats and prevents K+ deficiency by maintaining an acid-base balance,
isotonicity and electrophysiological balance of the cell
-Essential to transmission of nerve impulses and contraction of cardiac, skeletal and smooth
-Treats arrhythmias due to digoxin toxicity
Potassium (K-Dur) side effects?
What should you assess before giving a patient Potassium (K-Dur)?
-Serum potassium levels (prior to administration of IV form)
-Infuse at a rate no greater than 10 mEq/hour in a diluted solution (Never administer IV push)
Potassium (K-Dur) is contraindicated in who?
-severe renal impairment
-untreated Addison’s disease
-severe tissue trauma
What should you teach a patient taking Potassium (K-Dur)?
-purpose of the medication (especially when digoxin or diuretics are taken at
the same time)
-take drug with food or at least a full glass of water
-Report dark, tarry or bloody stools,
weakness, unusual fatigue or tingling of extremities
atorvastatin (lipitor) class?
atorvastatin (lipitor) oral dosage?
10-40 mg everyday
atorvastatin (lipitor) oral time of onset?
atorvastatin (lipitor) action?
-Treats hypercholesterolemia by inhibiting the enzyme HMG-CoA reductase, resulting in lower
levels of LDL cholesterol
-Decreases the risk of MI or stroke
atorvastatin (lipitor) side effects?
who is atorvastatin (lipitor) contraindicated in?
-active liver disease
-unexplained persistent increase in AST or ALT
What would you teach a patient taking atorvastatin (lipitor)?
-Take before bed (cholesterol synthesis is greater at night)
-Notify doc if signs of liver injury, unexplained
muscle pain, tenderness, or weakness occurs (especially if accompanied by fever or malaise) -should be used in conjunction with diet restrictions
oxycodone & acetaminophen (percocet) class?
antipyretic, opioid analgesic
oxycodone & acetaminophen (percocet) oral dosage?
PO: 5/325-10/325 mg every 3-4
oxycodone & acetaminophen (percocet) oral time of onset?
Action of the oxycodone part of percocet?
-Binds to opioid receptors in the CNS and alters the perception of and response to
-Used to treat moderate to severe pain.
Action of the acetaminophen part of percocet?
Decreases prostaglandin synthesis only in the CNS which results in antipyretic and decreased pain effects
oxycodone & acetaminophen (percocet) side effects?
What should you assess before giving a patient oxycodone & acetaminophen (percocet)?
-effectiveness of the drug to relieve pain
-Do NOT give other meds containing acetaminophen
Who is oxycodone & acetaminophen (percocet) contraindicated in?
-significant respiratory depression
-Acute or severe bronchial asthma
-Use caution while pregnant and lactating
What should you teach a patient taking oxycodone & acetaminophen (percocet)?
-DONT take any other medications containing acetaminophen (=liver toxicity)
-Drug has a known abuse potential
-Drowsiness or dizziness may occur so avoid alcohol and driving
-stool softeners might be needed
Bupropion (Wellbutrin) class?
Bupropion (Wellbutrin) oral dosage?
PO: 100-450 mg/day
Bupropion (Wellbutrin) oral time of onset?
Bupropion (Wellbutrin) action?
-Decreases neuronal reuptake of dopamine in the CNS
-Diminishes neuronal uptake of serotonin and norepinephrine
Bupropion (Wellbutrin) side effects?
suicidal thoughts or behaviors
Who is Bupropion (Wellbutrin) contraindicated in?
concurrent use of MAO inhibitors
severe head injury/stroke
What would you teach someone taking Bupropion (Wellbutrin)
Take at same time every day.
look out for suicidal thoughts and actions
stop taking if agitation, depressed mood or any changes in behavior occur