NS2P2 Medications

=>Class: Opioid.

=>Purpose: Pain Management; Bind to the opiate receptors in the CNS

• =>Admin Precautions
• -SE's: confusion, dizziness, respiratory depression, hypotension, flushing, itching, constipation

-Safe dose: 2-5 mg (IV)

-monitor pain level before and after, assess LOC, BP, P and no if R<10,

• =>Lab Levels:
• may increase amylase and lipase levels

=>Antidote:  Narcan.

=> Class: anti-infectives

• => Purpose:
• -Inhibits protein synthesis in susceptible bacteria at the level of the 50S ribosome.

• => Admin Precautions
• -Safe: PO Most infections– 150–450 mg q 6 hr.
• -SE: dizziness, headache, vertigo, arrhythmias, hypotension
• -Therapeutic Effect(s):Bactericidal or bacteriostatic, depending on susceptibility and concentration. (For Skin infections, Acne,Osteomyelitis, Septicemia)
• -Assess for infection (vital signs; appearance of wound, sputum, urine, and stool; WBC) at beginning of and during therapy; Obtain specimens for culture and sensitivity prior to initiating therapy. First dose may be given before receiving results.
• -Monitor bowel elimination. Diarrhea, abdominal cramping, fever, and bloody stools should be reported to HCP promptly as a sign of pseudomembranous colitis.
• -Assess patient for hypersensitivity (skin rash, urticaria).

• => Lab Levels:
• Monitor CBC; may cause transient ↓ in leukocytes, eosinophils, and platelets. May cause ↑ alkaline phosphatase, bilirubin, CPK, AST, and ALT concentrations.

=> Antidote? No.

• =>Class:
• -Ther. Class: antiulcer agents
• -Pharm. Class: histamine h2 antagonists

• => Purpose: Inhibits the action of histamine at the H2-receptor site located primarily in gastric parietal cells, resulting in inhibition of gastric acid secretion.
• Therapeutic Effect(s): Healing and prevention of ulcers., Decreased symptoms of gastroesophageal reflux., Decreased secretion of gastric acid.

• => Admin Precautions
• -Assess patient for epigastric or abdominal pain and frank or occult blood in the stool, emesis, or gastric aspirate.
• -nform patient that smoking interferes with the action of histamine antagonists. May cause drowsiness or dizziness. Advise patient to avoid alcohol, products containing aspirin or NSAIDs, and foods that may cause an increase in GI irritation.

• =>Lab Levels
• -Monitor CBC with differential periodically throughout therapy.,May cause ↑ serum transaminases and serum creatinine.

=>Antidote?

=>Class: Antithrombotics

=>Purpose: anticoagulants Potentiates the inhibitory effects of antithrobin on factor Xa and thrombin

• =>Admin Precautions
• -Safe dose: 1000U- 5000U (IV)
• -SE: alopenia, bleeding, HIT, fever, osteoporosis
• -NC: S/S of bleeding, decrease in HCT, BP
• -PT: watch for occult bleeding, no medication containing aspirin and NSAIDS, carry anticoag identification

=>Lab Levels: monitor aPTT, PTT, platelet, CR, KFT, CBC

=> Antidote:  protamine sulfate (1% solution) by slow infusion will neutralize heparin sodium. No more than 50 mg should be administered, very slowly in any 10 minute period.

• =>Class: anti anxiety anticonvulsants sedative/hypnoticsskeletal muscle relaxants
• -Benzodiazepine

• =>Purpose: depresses the CNS=>Admin Precautions
• -Safe: 2-10mg 2-4 times day
• -SE: dizzness, drowiness, lethargy, blurred vision, repiratory depresion, constiption, diarrhea, n/v
• -NC: Monitor BP, P, R, mental status, sedtion level, observe for seizures, monitor muscle spams and tremors if used for alcohol withdraw (Pt should be on bedrest for 3 hours to observe the effecs of medication when starting)
• PT: Medication will cause drowiness, change postions slowly, avoid other CNS depressants, notify dr if preggie.

=>Lab Levels: LFT, KFT overdose med- Flumazenil

=>Antidote? Flumazenil

• =>Class:
• Ther. Class.: vaccines/immunizing agents
• Pharm. Class: immune globulins

=> Purpose: An immune gamma-globulin fraction containing high titers of antibodies to the hepatitis B surface antigen. Confers passive immunity to hepatitis B infection.

Therapeutic Effect(s): Prevention of hepatitis B infection.

• => Admin Precautions
• -Safe: 0.06 mL/kg (usual dose 3–5 mL) within 7 days of exposure, repeated 28–30 days after exposure.
• -Assess: For passive immunity, determine the date of exposure to infection. Hepatitis B immune globulin should be administered preferably within 24 hr but not later than 7 days after exposure to hepatitis B.
• -Assess patient for signs of anaphylaxis (hypotension, flushing, chest tightness, wheezing, fever, dizziness, nausea, vomiting, diaphoresis) after administration. Epinephrine and antihistamines should be available for treatment of anaphylactic reactions.

=> Lab Levels: none

=> Antidote: None

=>Class:

• Ther. Class: antiulcer agents
• Pharm. Class: proton pump inhibitors

=> Purpose: Binds to an enzyme on gastric parietal cells in the presence of acidic gastric pH, preventing the final transport of hydrogen ions into the gastric lumen.

• -Therapeutic Effect(s):Diminished accumulation of acid in the gastric lumen with lessened gastroesophageal reflux. Healing of duodenal ulcers.
• -For: GERD/ Duodenal Ulcers, Gastric ulcers. OTC: Heartburn.

• =>Admin Precautions
• -Safe: 20-260 mg PO
• -Use Cautiously in liver disease (dose ↓ may be necessary)
• -SE: dizziness, drowsiness, fatigue, headache, weakness, chest pain, Hypomagnesia (> 3months)
• - Assess patient routinely for epigastric or abdominal pain and frank or occult blood in the stool, emesis, or gastric aspirate.
• Monitor bowel function. Diarrhea, abdominal cramping, fever, and bloody stools should be reported to health care professional promptly as a sign of pseudomembranous colitis.
• -Capsules should be swallowed whole; do not crush or chew.

• =>Lab Levels: : Monitor CBC with differential periodically during therapy.May cause ↑ AST, ALT, alkaline phosphatase, and bilirubin.May cause serum gastrin concentrations to ↑ during first 1–2 wk of therapy. Monitor INR & Prothrombin time in pts taking Warfaring.
• Monitor Serum Magnesium (can cause Hypomagnesemia)

=> Antidote? NONE.

• => Class
• Ther. Class.: bone resorption inhibitors
• Pharm. Class:  selective estrogen receptor modulators

=>Purpose: Binds to estrogen receptors, producing estrogen-like effects on bone, resulting in reduced resorption of bone and decreased bone turnover.

-Therapeutic Effect(s): Prevention of osteoporosis in patients at risk & Decreased risk of breast cancer.

• => Admin Precautions:
• -Safe Dose: 60 mg daily PO
• -Contraindicated: Hypersensitivity, History of Thromboembolic events.
• -SE's: Stroke, Thromboembolism, leg cramps, hot flashes
• -Assess: for bone mineral density with x-ray, serum, and urine bone turnover markers (bone-specific alkaline phosphatase, osteocalcin, and collagen breakdown products) before and periodically during therapy.
• -PT: Advise patient to discontinue smoking and alcohol consumption.Emphasize the importance of regular weight-bearing exercise.

=> Lab Levels:

• - May cause ↑ apolipoprotein A-I and reduced serum total cholesterol, LDL cholesterol, fibrinogen, apolipoprotein B, and lipoprotein.
• -May cause ↑ hormone-binding globulin (sex steroid-binding globulin, thyroxine-binding globulin, corticosteroid-binding globulin) with ↑ total hormone concentrations.
• -May cause small ↓ in serum total calcium, inorganic phosphate, total protein, and albumin.
• -May also cause slight decrease in platelet count.

Antidote: NONE

=>Class: antianginals antiarrhythmics antihypertensive

=> Purpose: Inhibits the transport of CA into mycardial and smooth tissue;

• =>Admin Precautions
• -Safe: 30-120mg 3/4 x daily (PO)
• -SE: abnormal dreams, drowiness, tinnitus, arrhythmias, HF, peipherial edema, dry mouth, Stevens- Johnson syndrome, rash, hyperglycemia
• -NC: Monitor BP, P, ECG, I/O, rash,
• -PT: Avoid foods with grapefruit, how to monitor pulse and if <50 call dr, change postions slowly, good oral hygiene, if med is for HTN proper diet and exercise

=> Lab Levels: K, KFT, LFT

Antidote? NO?

=>Class: Loop Diuretic

=>Purpose: diuretics; inhibits the reabsorption of NA and Cl in the loop of Henle

• => Admin Precautions
• -Safe: 10mg- 40mg (IV)
• -SE: blurred vision, hypotension, hyperglycemia, hypokalemia, dehydration, aplastic anemia, and muscle cramps
• -NC: Assess fluid status, Monitor I/O, lung sounds, BP, P tinnitus, and check K with pts using digoxin
• -PT: Take with food, orthostatic hypotension, call if weight gain is more than 3lbs in 1 day, call if mucle weakness or cramps

=>Lab Levels: Electrolytes, renal function, glucose and Uric acid levels, May increase BUN

=>Antidote: NONE!

Medication Class: Anticoagulants 

• Purpose:  treatment of Venous thrombosis, Pulmonary embolism, Atrial fibrillation  with embolization. 
• Interferes
• with hepatic synthesis of vitamin K-dependent clotting factors (II, VII, IX,
• and X).

 

• Administration precautions:  Assess
• for signs of bleeding and hemorrhage, occult stool  

Pertinent lab levels:  PT, INR and other clotting factors frequently during therapy

Antidote: vitamin K (phytonadione, AquaMEPHYTON)

Medication Class: anti-infectives 

• Purpose:
• Binds to bacterial cell wall, resulting in cell death.
• Treatment of potentially life-threatening infections

•  
• Administration precautions:  Observe
• patient for signs and symptoms of anaphylaxis. Discontinue drug and notify health care professional immediately if these problems occur.
• Keep epinephrine, an antihistamine, and resuscitation equipment close by in case of an anaphylactic reaction.

• Monitor intake and output ratios and daily weight. Cloudy or pink urine may be a sign of
• nephrotoxicity.

• Evaluate eighth cranial nerve function by
• audiometry 

•  
• Pertinent lab levels: casts, albumin, or
• cells in the urine or decreased specific gravity, CBC, and renal function. May cause increased BUN levels.

  

Antidote: none

Medication Class: antiarrhythmics

• Purpose:
• Increases the force ofmyocardial contraction. Prolongs refractory period of the AV node. Decreases conduction through the SA and AV nodes.

Heart failure.

Atrial fibrillation and atrial flutter (slows ventricular rate).

Paroxysmal atrial tachycardia.

 

• Administration precautions:  Monitor
• apical pulse for 1 full min before administering. Withhold dose and notify
• health care professional if pulse rate is <60 bpm in an adult, <70 bpm in
• a child, or <90 bpm in an infant.

• Pertinent lab levels: electrolyte levels
• (especially potassium, magnesium,
• and calcium) and renal and hepatic functions.

 

• Antidote: discontinuation of digitalis
• glycoside potassium salts, lidocaine, procainamide, quinidine, propranolol, or
• phenytoin.  Treatment of life-threatening
• arrhythmias: digitalis glycoside molecule.

Medication Class: anti-infectives

Purpose: Inhibits protein synthesis in bacteria at level of 30S ribosome. 

• Treatment of serious Gram-negative bacterial infections and infections caused by
• staphylococci when penicillins or other less toxic drugs are contraindicated  

• Administration precautions: 
• Monitor bowel function. Diarrhea, abdominal cramping, fever, and bloody stools should
• be reported to health care professional promptly as a sign of pseudomembranous
• colitis.

Evaluate eighth cranial nerve function by audiometry before and throughout therapy.

Hearing loss is usually in the high-frequency range. 

• Pertinent lab levels:
• Monitor renal function by urinalysis, specific gravity, BUN, creatinine, and CCr. 
• May cause ↑ BUN, AST, ALT, serum alkaline phosphatase, bilirubin, creatinine, and LDH concentrations.

May cause ↓ serum calcium, magnesium, potassium, and sodium concentrations.

•  
• Antidote: NONE

Medication Class: anti-infectives

Purpose: Binds to bacterial cell wall, resulting in cell death.

• Treatment of the following
• infections:
• Skin and skin
• structure infections,Soft-tissue
• infections, Otitis media, Sinusitis, Respiratory
• infections, Genitourinary infections, MeningitisSepticemia.

Endocarditis prophylaxis.

 

Administration precautions:   allergic response. signs and symptoms of anaphylaxis, sign of pseudomembranous colitis, ampicillinrash, and pruritic rash.

Pertinent lab levels: LFT’s, CBC, Renal

Antidote:NONE

Medication Class: opioid

Purpose: Pain Management   Binds to opiate receptors in the CNS

• Administration precautions:   Assess pain and location, BP, P, R (If
• <10 do not give), bowel function, LOC 

• Pertinent lab levels: amylase and lipase
• may increase  

Antidote: naloxone (Narcan)

• Medication Class: antianxiety agents
• antihistamines  sedative/hypnotics

• Purpose:
• Acts as a CNS depressant at the subcortical level of the CNS. Has anticholinergic,
• antihistaminic, and antiemetic properties. Blocks histamine 1 receptors.

• • Treatment of anxiety.
• • Preoperative sedation.
• • Antiemetic.
• • Antipruritic.
• • May be combined with opioid analgesics.

 

• Administration precautions
• Assess patient for profound sedation
• and provide safety precautions   mental
• status degree of nausea and frequency and amount of emesis. degree of itching and character of involved
• skin. 

Pertinent lab levels: May cause false-negative skin test results using allergen extracts

Antidote: none

• Medication Class: Antidiabetic
• Insulin, Rapid Acting 

• Purpose: Pain Management  
• TX of Diabetes / Hyperglycemia. 
• Lowers BG  facilitating the  uptake of glucose.

• Administration precautions
• symptoms of hypoglycemia 
• Changes in weight may necessitate changes in insulin dose.

• Pertinent lab levels: blood glucose levels,
• Potassium, Urine Ketones

Antidote: oral glucose, IV glucose, glucagon, or epinephrine.

Medication Class: pancreatic

• Purpose: Control of hyperglycemia in patients with type 1 and type 2 diabetes mellitus. (long acting)
• • Lowers blood glucose by :stimulating glucose uptake in skeletal muscle and fat,o inhibiting hepatic glucose production.
• • Other actions of insulin:
• o inhibition of lipolysis and proteolysis,
• o enhanced protein synthesis.

• Administration precautions
• symptoms of hypoglycemia
• Changes in weight may necessitate changes in insulin dose.

Pertinent lab levels: blood glucose levels, Potassium, Urine Ketones

Antidote: oral glucose, IV glucose, glucagon, or epinephrine.