Pharm Drugs List
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Transcript of Pharm Drugs List
Hematologic & Immune System Medications CLASSIFICATIO
N NAMEMECHANISM
OF ACTIONINDICATIONS SIDE EFFECTS NURSING
CONSIDERATIONS AND PATIENT EDUCATION
Cytoxan
Antineoplastic, immunosuppressants
Death of rapidly replicating malignant cells.
↓ or prevent an immune response and suppress the immune system
Cancers, lymphomas, myelomas, leukemias.Prevent organ transplant rejection.Tx for autoimmune diseases
BM suppression:(pancytopenia), N/V/D, hepatotoxic, alopecia, cardio-pulmo. fibrosis
Rx for infection.Rx for hemorrhageMonitor VSMonitor kidney fx (↑ fluids)Take meds w/ meals.
Folic Acid
Antianemic, vitamin
Maintains and restores normal erythropoiesis.
Prevention and Tx of megaloblastic anemias. During pregnancy: promotes normal fetal growth. Prevent NTD.
Allergic RxRashesfever
Monitor folate and B12 levelsH & HEncourage to eat foods ↑ in Folic acid:(veggies, organ meats)
Cyanocobalamine
(Vit. B12)
Antianemic, vitamin
Corrects manifestations of pernicious anemia. (Megaloblastic anemia, GI lesions, and neuro damage)
Vit.B12 deficiency, to meet demands.
Confirmed w/ Schilling
AnaphylaxisDiarrheaItchingHypokalemiaPain at inj. site
Given IMLife-long medicationGive w/ mealsEncourage to eat animal products
Ferrous Sulfate
Iron supplement,antianemic
Prevent and Tx iron deficiency.
Need for hemoglobin formation.
Prevent and Tx iron deficiency anemia.
GI upset (constipation, dk stools), hypotension,Seizures, stains teeth (PO) or skin (IM),Anaphylaxis
Assess bowel fx; dk stool (- occult bld)Monitor BP and HR; H&HEncourage to eat gr. leafy veggiesand organ meats; take w/ OJ to ↑ absorp.PO: Use straw; Z-track IM
Lovenox(Enoxaprin)
Anticoagulant, low molecular heparin
Prophylactic/ Prevention of further thrombus (clot) formation.
DVT, PE- thromboemboli, ischemic complications;
(prevents clots, especially in immobile patients).
Bleeding, anemia, thrombocytopenia, dizziness, HA, constipation, N/V
Assess s/s of bleeding and hemorrhageAssess nuero & pulmonary fxMonitor CBCAntidote: Protamine sulfate
Epogen(Erythropoetin)
Hormone,antianemic
Maintains and may elevate RBCs
Tx of anemia assoc. w/ renal failure or AIDS therapy.
HTN, arthralgias, fatigue, HA, SEIZURES
Monitor BP, CBCEncourage foods ↑ in iron
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Gastrointestinal System Medications CLASSIFICATI
ON NAMEMECHANISM
OF ACTIONINDICATIONS SIDE EFFECTS NURSING
CONSIDERATIONS AND PATIENT EDUCATION
Lactulose
Osmotic, laxative
↑ water content and softens the stool.↓ pH of colon→↓ NH4
Tx of chronic constipationManagement of hepatic encephalopathy.
Belching, cramps, distention, flatulence, diarrhea, hyperglucemia
Assess abdominal distention, bowel sounds, stoolsMonitor mental status, BG, NH4
Take w/ fruit juiceDesmopressin
(DDAVP)
Hormone, antidiuretic / vasopressin
Controls bleeding in hemophilia.Prevents nocturnal enuresis
Maintains approp. water content in Diabetes Insip.
Controls bleeding in hemophiliaManagement of nocturnal enuresis;
Tx of D.I.
Drowsiness, pharyngitis, dry mouth, anaphylaxis
Assess allergy symptoms, lung sounds and bronchial secretionsMaintain fluid intake 1500-2000 ml/dayAvoid EOTH
Neomycin(Aminoglycosi
des)
Anti-infectives
Bacterialcidal action.Powerful antibiotics used to treat serious infections caused by gram (-) bacteria
To suppress GI bacteria→ ↓ NH4 →preventing hepatic coma.Tx for skin wounds and infections
Ototoxicity, nephrotoxicity, hypomagnesium, muscle paralysis, hypersensitivity
Short-term IV or IMAssess for infection, I/O, daily weight,Hearing lossMonitor mental status, renal fx
Zantac(Ranitidine)
Tagamet(Cimetidine)
Antiulcer agents, histamine H2 antagonist
Healing and preventing ulcers. ↓ symptoms of GER and secretions of gastric acid.
Prevents acid inactivation of pancreatic enzymes.GERD, multiple peptic ulcers.Prevent and Tx heartburn, acid indigestion, sour stomach
Confusions, HA, dizziness, arrhythmias, impotence, gynecomastia, thrombocytopenia
Take meds before meals and bedtimeDon’t stop taking meds abruptlyNo EOTH or other CNS depressantsAvoid taking meds antacidsReduce stress and help heal ulcersAssess abdominal pain, occult blood,Monitor CBC
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Neurological System MedicationsCLASSIFICATION
NAMEMECHANISM
OF ACTIONINDICATIONS SIDE EFFECTS NURSING
CONSIDERATIONS AND PATIENT EDUCATION
Riluzole(Rilutek)
Glutamate antagonist
Exact mechanism of action in ALS is unknown.Slows the deterioration of motor neurons by counteracting the excitatory glutaminergic pathways.
Slows the progress of Amyotrophic Lateral Sclerosis. May delay the need for a tracheostomy, not a cure for ALS.
Dizziness, tiredness, upset stomach, stomach pain, diarrhea, muscle weakness or aches, anorexia, HA
Monitor liver function: ↑ liver enzymes.Monitor WBC.Take on an empty stomach (1 hour before or 2 hours after meals). Avoid drinking or eating a lot of caffeine. Avoid eating charcoal-broiled foods.
Prostigmin(neostigmine)
AnticholinesteraseAntimyasthenics, cholinergics
Provide symptomatic relief by ↑ concent. Of available Ach at neuromuscular junction → ↑ muscle fx.Improved bladder-emptying in pt with urinary retention.
Improvement in muscle strength in MG.Prevention and Tx of post-op bladder distention and urinary retention or ileus.
SEIZURES, dizziness , bronchospasm, n/v/d,XS secretions, bradycardia, abdominal cramps, hypotension
Assess VS, neuromuscular status.Assess for under/over-dosage (cholinergic crisis). Use Tensilon test to distinguish. Monitor abdomen/ bladder status, I/O, Maintain stable blood levels of Ach med. Give ON TIME & w/ food
Tensilon(Edrophonium Cl)
Anticholinesterase
Stops breakdown of Ach→↑ Ach availability. Tensilon is given IV 2mg -10mg. After 30sec facial`1q weakness resolves and ptosis in 5min. Immediate improvement= positive test & confirms dx.
Diagnostic test for myasthenia gravis.
Because brief duration of action, it’s not recommended for maintenance therapy in MG.
SEIZURES, Capillary constriction, diplopia, laryngospasm, arrhythmias, twitching,↓CO→ hypotension, abdominal cramps, N/V/D, urinary freq.
Observe for severe cholinergic reaction (stop meds). Myasthenic crisis (↑ meds) Observed for bradycardia or cardiac standstill and cholinergic reactions if an overdose is given.Give Atropine 0.4 mg to control s/e of Tensilon (bradycardia, sweating, cramps)
Baclofen
Antispasticity agents, skeletal
muscle relaxants
Inhibits reflexes at spinal level.↓ muscle spasticity; bowel and bladder fx may also be improved.
Tx of reversible spasticity due to MS or spinal cord lesion
SEIZURES, drowsiness, dizziness, fatigue, confusion, HA, edema, hypotension, nausea, constipation, hyperglycemia, ataxia
Assess muscle spasticity. Observe for adverse effects.Monitor BG and liver enzymes.Administer w/ milk or food to ↓ gastric irritation.
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Levodopa
Antiparkinson agent, Dopamine agonist
Relief of tremor and rigidity in Parkinson’s syndrome.
Converts to dopamine in CNS, serves as neurotransm.
(↑ dopamine)
Parkinson’s disease.
Not useful for drug-induced EPS.
Dyskinesia, involuntary movements, anxiety, dizziness, blurred vision, N/V, anorexia, dry mouth, hemolytic anemia, ↓ WBC
Assess parkinsonian symptomsAssess BP and pulse freq. Give with mealsMonitor bowel fxMonitor I/OMonitor hepatic and renal fx
Neurological System MedicationsCLASSIFICATION
NAMEMECHANISM
OF ACTIONINDICATIONS SIDE EFFECTS NURSING
CONSIDERATIONS AND PATIENT EDUCATION
Symmetrel
Antiparkinson agent, antiviral
Antiviral that ↑ the release of dopamine.Relief of parkinsonian symptoms.Prevent and Tx influenza A
Symptomatic initial and adjunct Tx of Parkinson’s disease.Prophylaxis and Tx of influenza A viral infections
Confusion, ataxia, dizziness, insomnia, blurred vision, hypotension, mottling.
Monitor blood pressure freq. (OH)Monitor I/OMonitor VS and mental status.Do not give close to bedtime
Beta Interferons
Avonex, Rebif(interferone beat-
1a)
Betaseron(interferon beta-
1b)
interferons,Anti-MS agents
Anti viral and immunoregulatory properties →↓ T-cell proliferation.
↓ incidence of relapse (neurologic dysfunction) and slow physical disability.
Multiple Sclerosis Flu-like symptoms, seizures, HA, mental depression, weakness, N/V/D, conjunctivitis, sweating, photosensitivity,neutropenia, injection-site reaction (w/ beta-1b), myalgia, chills, fever, pain
Assess freq. of exacerbations of MS.
Monitor for signs of depression.
Monitor Hgb, WBC, platelets, and blood chemistry and liver function.
May give analgesic for flu-like symptoms.
Take measures to prevent photosensitivity reactions.
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Genitourinary System Medications CLASSIFICATIO
N NAMEMECHANISM
OF ACTIONINDICATIONS SIDE EFFECTS NURSING
CONSIDERATIONS AND PATIENT EDUCATION
DIURETICSLoop Diuretics
Furosemide (Lasix)
Bumetanide (Bumex)
Ethacrynic acid (Edecrin)
Inhibit sodium & chloride reabsorption from loop of Henle and distal renal tubule.
↑ renal excretion of H2O, Na, Cl, Mg, H, and Ca.
↑Vasodilation→↓peripheral resistance→↓BP
Edema associated with:
CHF Hepatic or
renal disease
Adjunct therapy for control of HTN.
Dizziness, HA, tinnitus, hypotension, N/V/D, constipation, dehydration, hypokalemia, hyperglycemia, hyperuricemia, neutropenia, agranulocytosis, cramps,Thrombocytopenia, spasms
Monitor VS (BP & P) and fluid status freq. Monitor daily weight, I/O, serum electrolyte values.
Assess edema (amount & location), lung sounds, skin turgor, mucous membranes.
Monitor potassium levels (3.5-5.0).
Monitor blood glucose (100 mg/dL) -in loop/thiazide diuretics.
Potassium-sparing
Diuretics
Spironolactone (Aldactone)
Amiloride (Midamor)
Triamterene (Dyrenium)
Weak diuretic and antihypertensive.
Blocks effects of aldosterone in renal tubule, causing loss of Na and H2O and retention of potassium.
Prevents hypokalemia caused by other diuretics.Used with other diuretics to treat edema or HTN.Spironolactone: Hyperaldosteronism. Management of CHF.
Dizziness, HA, cramps, N/V/D, urinary frequency, weakness, hyperkalemia.
Spironolactone:Clumsiness, gynecomastia, amenorrhea
Change position slowly to prevent OH.
If receiving digoxin, watch for digitalis toxicity.
↑ foods high in potassium (bananas, oranges, potatoes, meat, fish, raisins)
Take in AM to avoid sleep disturb.
Osmotic Diuretics
Mannitol(Osmitrol, Resectisol)
Pulls water into blood vessels and nephrons from surrounding tissues→ inhibits reabsorption of H2O and electrolyes, along with toxins from kidney.
Adjunct tx of :∙ acute oliguric renal failure∙ edema∙ ↑ICP or intraocular pressure∙ excretion of toxic substances.
Confusion, HA, hypotension, rash, nausea, anorexia, dry mouth, thirst, diuresis,fluid and electrolyte imbalances.
Report to MD: rapid HR or syncope, weight gain 2lbs or more.
Report adverse effects: N/V/D
Hypokalemia (muscle weakness & twitching, lethargy, irregular pulse)
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Genitourinary System Medications CLASSIFICATIO
N NAMEMECHANISM
OF ACTIONINDICATIONS SIDE EFFECTS NURSING
CONSIDERATIONS AND PATIENT EDUCATION
Phosphate Binders
Sevelamer(Renagel)
electrolyte modifiers
Binds with phosphate in the GI tract, preventing its absorption.
Reduction of the level of phosphorus in the blood of patients with end-stage renal disease (ESRD).
Nausea Vomiting Diarrhea Dyspepsia Constipation Flatulence
Assess GI side effects.
Monitor serum phosphorus, calcium, bicarbonate, chloride levels
Swallow whole (Don’t crush or chew)
Take all other medicines at least one hour before or three hours after.Take with meals.
Aluminum hydroxide(Alu-Cap)
antacids, phosphate
binders
Prevent a continuing rise in serum phosphate levels by decreasing the absorption of phosphate from intestinal tract
Neutralizes gastric acid and inactivates pepsin
Treatment for Hyperphosphatemia, hypocalcemia in CRF.
Adjuct therapy in treating gastric ulcers, hyperacidity, indigestion.
Constipation Hypophosphate
mia
** Prolong use leads to toxicity: neuro symptoms and osteomalacia. MD may recommend Calcium Carbonate instead**
Assess gastric pain.Monitor phosphate and calcium levels.
Take with full glass of water
Should be swallowed whole 10-15 minutes before meals.
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Calcium Salts
Calcium acetate
(Calphron, PhosLo)
Calcium carbonate(Titralac,
Calci-chew)
Calcium gluconate(Kalcinate)
Mineral & electrolyte replace/ supplements
Maintain cell membrane and capillary permeability.
Replacement of calcium deficiency.
Control of hyperphosphatemia in end-stage renal disease without promoting aluminum absorption.
Calcium carbonate:Protects heart from effects of hyperkalemia.
Tx and prevention of hypocalcemia.
Emergency tx of hyperkalemia and hypermagnesemia and adjunct in cardiac arrest.
Calcium acetate:Control of hyperphosphatemia in ESRD.
Calcium carbonate:May be used as antacid.
Cardiac Arrest Arrhythmias Bradycardia Constipation Phlebitis Syncope Tingling Calculi Hypercalciuria
.
Monitor VS (BP & P) and ECG freq.
Observe for s/s of hypocalcemia (paresthesia, muscle twitching, colic)
Monitor pt on digitalis glycosides for signs of toxicity.
Monitor phosphate levels and electrolytes.
For Hyperphosphatemia, hypocalcemia; must take with food.
Endocrine System Medications CLASSIFICATIO
N NAMEMECHANISM
OF ACTIONINDICATIONS SIDE EFFECTS NURSING
CONSIDERATIONS AND PATIENT EDUCATION
Synthroid(levothyroxine)
Hormones, thyroid preparations
↑ metabolic rate of body tissues.Restores normal hormone balance.Suppresses thyroid cancer.
Replacement/substitution in diminished or absent thyroid function.Thyroid cancer (thyrotropin-dependent)
Irritability, Insomnia, HA, arrhythmias, tachycardia, weight loss, Cardiovascular Collapse, HTN, ↑ CO
Assess AP & BP. For tachyarrhythmias & chest pain.Monitor thyroid function; blood & urine glucose.Give before breakfast (to avoid insomnia)
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Tapazole(methimazole)
Propylthiouracil
(PTU)
Thioamides,Antithyroid agents
Prevents the formation of thyroid hormone within the thyroid cells→ ↓serum levels of thyroid hormone.
Blocks the utilization of iodine→ prevents synthesis of thyroid hormone
Palliative treatment of hyperthyroidism.
Rash, N/V, lethargy, drowsiness, bradycardia, Agranulocytosis
Methimazole:BM suppressionPTU:GI distress
Monitor hyperthyroidism response (tachycardia, palpitations, insomnia, fever, heat intolerance, tremors, wt loss)Monitor hypothyroidism (intolerance to cold, constipation, dry skin, HA, weakness)Assess skin for rashes or swollen nodes.Give before breakfast. Seafood and iodine may be restricted.Monitor CBC & differential.Monitor for s/s of infection or bleeding.
Bromocriptine
(Parlodel)
Dopamine agonist/ antineoplastic
Direct dopamine agonist on dopamine receptor sites in substantia nigra. Inhibits GH secretion.Antiparkinson agent.Tx of acromegaly.
Tx of Parkinson; hyperprolactinemia assoc. with pituitary adenomas, female infertility assoc. with hyperprolactinemia.
Confusion, dizziness, hypotension, N/V, HA, visual disturbances, abdominal pain, leg cramps, fatigue, nasal congestion
Monitor thyroid function, glucose tolerance, and GH levels.Assist with ambulation.Avoid tasks that require alertness, motor skills until response to drug.Teach contraceptives (other than PO)
Calcium gluconate
Mineral & electrolyte replace/ supplements
Act as activator in transmission of nerve impulses and contraction of cardiac, skeletal, and smooth muscle.
For hypoparathyroidism.
Replacement of Ca in deficient states.
Arrhytmias, constipation, phlebitis, cardiac arrest
Assess & monitor: BP, ECG, & renal fxAssess & monitor electrolytes: Mg, Ph, KMonitor serum and urine Ca levelsIV- push slowly, tabs 30 min-1hr after meals, liquids before meals.
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Mineral-corticoids
Fludrocortisone
(Florinef)
Hormones/ corticosteroids
↑ Na reabsorption in renal tubules and ↑ K and H excretion→ Na & H2O retention
Adrenal insufficiency (Addison’s); replacement therapy in combination with glucocorticoid.Tx of salt-losing adrenogenital syndrome.
Frontal and occipital HA, arthralgia, weakness, ↑ blood volume, edema, HTN, CHF, rash, anaphylaxis, hypokalemia
Assess VS, breath sounds, weight, tissue turgor; reflexes and bilateral grip strength, serum electrolyte.Monitor for hypokalemia.Avoid infections; avoid fresh fruits and veggies or wash very carefully
Endocrine System Medications CLASSIFICATIO
N NAMEMECHANISM
OF ACTIONINDICATIONS SIDE EFFECTS NURSING
CONSIDERATIONS AND PATIENT EDUCATION
Gluco-corticoid
Celestone(betamethasone)
Cortisone(Cortone Acetate)
Cortef(hydrocortisone)
Medrol(methyprednisol
one)
Delta-Cortef(prednisolone)
Deltasone(prednisone)
Corticosteroids
Initiate complex reactions responsible for anti-inflammatory and immunosuppressive effects.
Causes release of epinephrine from adrenal medulla.
Stimulate ↑ of glucose levels for energy.
When combined with mineralocorticoids some of these drugs can be used in replacement therapy for adrenal insufficiency.
Management of adrenal insufficiency.
Used systemically and locally for chronic diseases including: inflammatory, allergic, hematologic, neoplastic, autoimmune disorders.
Immunosupressant s in prevention of organ rejection.
Management of acute spinal cord injury (methylprednisolone)
Depression euphoria HTN Peptic ulcers N/V ↓ wound healing Adrenal
suppression Hyperglycemia Weight gain Na & H2O
retention CHF Immunosuppressi
on Osteoporosis Muscle wasting Cushingoid appearance.
Administer daily in AM.
Do not discontinue abruptly.
Protect from infection or invasive procedures.
Caution in pts with DM or peptic ulcers.
Monitor I/O, daily weight & electrolytes.
Signs of fluid retention.
Give with meal.
Monitor for s/s of adrenal insufficiency(HA, hypotension, wt. loss, weakness)
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Multi-System Medications CLASSIFICATION
NAMEMECHANISM
OF ACTIONINDICATIONS SIDE EFFECTS NURSING
CONSIDERATIONS AND PATIENT EDUCATION
Silver sulfadiazine(Silvadene)
Anti-infective/ bactericidal
Antibacterial and antifungal agent.
Adjunct for prevention and treatment of wound sepsis in patients with 2º and 3º burns.
Burning feeling at site, N/V/D, HA, anorexia, photosensitivity, joint pain, hemolytic anemia, hypoglycemia, Lupus, Liver/kidney problems
Monitor CBC & hepatic/renal fx.Monitor for leucopenia for 2-3 days.If burns are extensive or prolonged therapy: monitor electrolytes, UA,CBCCover entire woundMay cause brown-gray discoloration.
Mafenide acetate
(Sulfamylon)
Bacteriostatic for many gram-negative and gram-positive organisms,
Control bacterial infection when used under moist dressings over meshed autografts on excised burn wounds.
Pain or burning sensation, allergic reaction, bleeding or oozing of skin, or metabolic acidosis
Apply with sterile gloves/ ∆ dressing q6º. Monitor ABGs (d/c if acidosis).Give analgesic prior, may cause severe burning pain for up to 20 mins after application.
Morphine
Opioid agonist, narcotic
Acts as agonist at specific opioid receptors in CNS to produce analgesia, euphoria, and sedation.
Relief of moderate to severe acute or chronic pain.Pulmonary edema.Pain assoc. with MI.
Confusion, sedation, Respiratory depression, hypotension,↓HR,constipation, N/V, shock, urinary retention
Assess pain, LOC, BP, pulses, respirations, bowel fx.Monitor for dependence or tolerance.Have Narcan available for OD
Versed(midazolam)
Sedatives/ hypnotics
benzodiazepines
Acts at many levels of CNS to produced generalized CNS depression.Short-term sedation; post-op amnesia.
Sedation, anxiolysis and amnesia before procedureInduction of anesthesia; continuous sedation of intubated patients.
Respiratory depression, laryngospasm, cardiac arrest, drowsiness, HA, XS sedation, N/V, arrhythmias, phlebitis
Monitor VS, respirations and level of sedation q 3-5min.Give Romazicon for OD.Grapefruit juice ↓metabolism & ↑effectsMonitor LOC and sedation
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Digoxin(Lanoxin)
Digitalis glycosides
↑ force of myocardial contraction.↑ cardiac output and ↓ heart rate.
Tx of CHF, atrial fibrillation & atrial flutter, tachyarrhythmias
HA, weakness, drowsiness, visual disturbances, N/V arrhythmias, fatigue, bradycardia, GI upset
Monitor apical pulse for 1 min before administration. Hold if <60 bpm.Monitor pulse, wt., I/O and ECG.Adm. IV slowly >5 min, avoid IM.Monitor electrolytes & digoxin levelsTherapeutic level: 0.5-2; toxic >2Have Digoxin immune FAB available.
Multi-System Medications CLASSIFICATIO
N NAMEMECHANISM
OF ACTIONINDICATIONS SIDE EFFECTS NURSING
CONSIDERATIONS AND PATIENT EDUCATION
Dopamine
vasopressor/adrenergic
Sm. Doses stimulate dopaminergic receptors, producing renal vasodilation. Lg. doses stimulate dopaminergic and beta1 adrenergic receptors, producing cardiac stimulation and renal vasodilation
↑ Cardiac output, BP, and improves renal blood flow.
Tachycardia, ectopic beats, anginal pain, hypotension, dyspnea, N/V, HA
Monitor BP, HR, ECG, cardiac output, and urinary output continuously.Report chest pain, dyspnea, numbness, tingling, or burning of extremities.
Inderal(propanalol)
Beta blockers
Blocks beta-adrenergic receptors in the heart and kidney, has a membrane-stabilization effect and ↓ influence of sympathetic nervous system.↓ HR & BP, suppression of arrhythmias & prevent MI
Management of HTN; angina pectoris; arrhythmias. Prevention and management of MI.Prevent vascular HA.Manage thyrotoxicosis.
Bradycardia, CHF, cardia arrhythmias, heart blocks, CVA, pulmonary edema, gastric pain, flatulence, N/V/D, ↓ exercise tolerance, impotence.
Monitor BP and PulsesPts on IV must have continuous ECG monitor.Hypotensive effect is associated with ↓ cardiac output.Don’t stop med abruptly, it throws in 1º heart block
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Code Drugs CLASSIFICATIO
N NAMEMECHANISM
OF ACTIONINDICATIONS SIDE EFFECTS NURSING
CONSIDERATIONS AND PATIENT EDUCATION
Epinephrine
Adrenergic, sympathomimetic
Reacts at alpha- and beta- receptor sites in the SNS to cause bronchodilation, ↑ HR, RR, BP.
Treatment of shock, bronchospasm. Management of severe allergic reactions, cardiac arrest.
Nervousness, tremor restlessness, angina, arrhythmias, HTN, tachycardia, HA, N/V insomnia, hyperglycemia
Assess pulmonary function: lung sounds, respiratory pattern; pulse, BP.Monitor ECG; for arrhythmias, chest pain.Correct hypovolemia prior to IV use.May cause ↓ serum K and ↑ glucose.
Sodium Bicarbonate
Antiulcer, alkalinizing
Neutralizes or ↓ gastric acidity→↑ gastric pH.Acts as alkalinizing agent by releasing bicarbonate ions.
Relief of hyperacidity;Management of metabolic acidosis; Treatment of certain drug intoxications.
Metabolic alkalosis, gas,Gastric acid rebound, hypernatremia, hypocalcemia, hypokalemia, Na & H2O retention
Assess GI & renal function, serum electrolytes.Assess signs of acidosis/alkalosis, ABGs
Dopamine
Adrenergic, sympathomimetic inotropics, vasopressors
Stimulates dopaminergic receptors:↑cardiac output, ↑ BP, and improved renal blood flow
Choice for tx of shock.
Arrhythmias, angina, Hypotension, tachycardia, dyspnea, N/V, HA,
Monitor BP, HR, ECG, CO.Monitor urinary output frequently.Palpate peripheral pulses and assess appearance of extremities.
Atropine
Anticholinergic, antiarrhythmic
Inhibits the action of acetylcholine, blocking the effects of parasympathetic NS.↑HR, ↓ GI & respiratory secretions.
Antidote for cholinergic OD and mushroom poisoning. Pre-op to ↓ secretions.Restores cardiac rate and arterial pressure.
Drowsiness, blurred vision, tachycardia, dry mouth, urinary hesitancy, constipation, decreased sweating.
Assess VS and ECG. Monitor I/O.Assess abdomen and bowel sounds.Observe for toxicity or OD; antidote physostigmine.Give 30 mins. before meals.
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Lidocaine
Antiarrhythmic, anesthetic
Control of ventricular arrhythmias.Local anesthesia.
Management of ventricular arrhythmias.Infiltration/ mucosal/topical anesthetic.
Seizures, confusion, drowsiness, Cardiac arrest, stinging, anaphylaxis, hypotension, N/V, fatigue
Monitor ECG and BP and Respiratory status.Monitor serum electrolyte levels.Monitor for toxicity and OD: serum levels: 1.5-5 μg/mL
Code Drugs CLASSIFICATIO
N NAMEMECHANISM
OF ACTIONINDICATIONS SIDE EFFECTS NURSING
CONSIDERATIONS AND PATIENT EDUCATION
Adenosine
antiarrhythmics
Restores normal sinus rhythm.
Treatment of supraventricular tachycardias,(Diagnostic agent to assess myocardial perfusion)
SOB, facial flushing, transient arrhythmias, HA, dizziness, chest pain, hyperventilation, nausea, sweating, hypotension
Monitor HR (q15-30min) & ECG, BP.Assess Respiratory status: breath sounds and rate.Change positions slowly ( to ↓ OH)Report adverse effects.
Amiodorone
antiarrythmics
Suppression of arrhythmias.Blocks beta-adrenergic receptors in heart.
Life-threatening ventricular arrhythmiasManagement of supraventricular tachycardia
Dizziness, fatigue, malaise, ARDS, HApulmonary fibrosis, CHF, bradycardia, hypotension, anorexia, constipation, N/V, hypothyroidism, ataxia, peripheral neuropathy, tremors
Monitor ECG, HR and rhythm.Assess signs of pulmonary toxicity (crackles, ↓breath sounds, dyspnea)Assess s/s of ARDS.Monitor BP.Monitor liver and thyroid function.Assess for hypokalemia, hypomagnesemiaAssist with ambulation.May be given with meals or divided doses
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Nitroglycerines
Antianginal, nitrates
Relief or prevention of anginal attacks.↑ cardiac output↓BP
Acute & long term prophylactic management of angina pectoris.Adjunct tx of CHF & acute MI.Production of controlled hypotension.
Dizziness, HA, hypotension, tachycardia, restlessness, blurred vision, rash, flushing, N/V, weakness.
HA is common s/e.
Assess anginal pain.Monitor BP & pulse. Monitor ECG.PO: Administer 1 hr before or 2 hr after meals w/ full glass of water.SL: Hold tablet under tongue until dissolved; avoid eating or drinking.Change position slowly (prevent OH)
Dobutrex(Dobutamine)
Adrenergics, inotropics
Increased cardiac output without significantly increased heart rate.
Treatment of CHF because ↑ myocardial contractility without much change in rate and doesn’t ↑ O2
demand of heart muscle.
HTN, ↑HR, premature ventricular contractions, SOB, HA, angina pectoris, arrhythmias, hypotension, N/V, phlebitis.
Monitor BP, HR, ECG, CO, urinary output.Palpate peripheral pulses and assess extremities.Monitor electrolytes, BUN, Creat, prothrombin time.Check for signs of extravasation.
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