HESI MED CHART
• Androgens: Most names end with -terone (e.g., testosterone).
• Angiotensin-converting enzyme (ACE) inhibitors: Most names end with... [Show More] -pril (e.g., enalapril).
• Antidiuretic hormones: Most names end in -pressin (e.g., desmopressin).
• Antilipemic medications: Many end with -statin (e.g., atorvastatin).
• Antiviral medications: Most contain vir (e.g., acyclovir).
• Benzodiazepines: Although this class includes medications such as alprazolam and chlordiazepoxide, most names such as diazepam end in -pam. (Another tip for identifying a benzodiazepine: The name includes a vowel-z-vowel combination.)
• Beta-adrenergic blockers: Most names end with -lol (e.g., atenolol).
• Calcium channel blockers: Most names end in -pine (e.g., amiodipine); exceptions include diltiazem and verapamil.
• Carbonic anhydrase inhibitors: Most names end in -mide (e.g., dorzolamide). These medications are used to treat glaucoma.
• Estrogens: Most names contain -est (e.g., estradiol or conjugated estrogen).
• Glucocorticoids and corticosteroids: Most names end in -sone (e.g., prednisone).
• Histamine H2 receptor antagonists: Most names end in -dine (e.g., cimetidine).
• Nitrates: Most names contain nitr (e.g., nitroglycerin).
• Pancreatic enzyme replacements: Most names contain pancre (e.g., pancrealipase).
• Proton pump inhibitors: Most names end in -zole (e.g., lansoprazole).
• Sulfonamides: Most names include sulf (e.g., sulfasalazine).
• Sulfonylureas: Most names end in -ide (e.g., glipizide). These medications are used to treat diabetes mellitus.
• Thiazide diuretics: Most names end in -zide (e.g., hydrochlorothiazide).
• Thrombolytics: Most names include -ase (e.g., alteplase).
• Thyroid hormones: Most names contain thy (e.g., levothyroxine).
• Xanthine bronchodilators: Most names end in -line (e.g., theophylline).
Nursing Considerations from HESI
• Donepezil: Side effects include nausea and diarrhea, and the medication may slow the heart rate by means of its vagotonic effect.
• Tacrine: Side effects include ataxia, loss of appetite, nausea and vomiting, and diarrhea; hepatotoxicity is an adverse effect, and liver function parameters must be monitored.
• Galantamine: Side effects include nausea and vomiting, diarrhea, anorexia, and weight loss; it can also cause bronchoconstriction and is used with caution in clients with asthma and COPD.
• Memantine: Side effects include dizziness, headache, confusion, and constipation; sodium bicarbonate and other medications that alkalinize the urine can decrease renal excretion of memantine, resulting in accumulation to toxic levels.
• Rivastigmine: Side effects include nausea and vomiting, diarrhea, abdominal pain, and anorexia; it is used with caution in clients with peptic ulcer disease, bradycardia, sick sinus syndrome, urinary obstruction, and lung disease, because it enhances cholinergic transmission, thereby intensifying symptoms of these disorders.
HESI Pharmacology Notes:
• The antidote to heparin is protamine sulfate.
• The antidote to acetaminophen is acetylcysteine
• Withhold opioids if RR is less than 12
• Vitamin K is the antidote to warfarin.
• Cardiac glycosides- digoxin increase force of myocardial contractions and slows the HR
o Above 2 is a toxic level. 0.5-2 is ok
• A persistent dry cough is a common complaint amongst clients taking ACE inhibitors
• BB can mask signs of hypoglycemia
• No nitrates for pts with hypotension, increased ICP, or severe anemia
• Epinephrine= for cardiac arrest
• Norepinephrine- for shock or hypotension
• Cholinergics- increase bladder tone and function
o Bethanechol is a cholinergic, antidote is atropine sulfate
• Anticholinergics for overactive bladder. Incontinent patients
o Tolterodine caution in pts with glaucoma
o Provide gum or candy for dry mouth
o Can’t see, cant shit, cant spit
• Cyclosporine- grapefruit increases toxicity.
Eye and Ear
• Monitor HR if pt is on an ophthalmic BB, withhold if HR is less than 50-60 bpm
• Miotic agents contraindicated with pts with retinal detachment
• Oxytocin not given to a woman who cannot deliver vaginally
o If a nonreassuring FHT, stop oxytocin, turn to side, increase additive IV solution, give oxygen
• Mg sulfate, not used two hours pre delivery
o Antidote is calcium gluconate
• Naloxone antidote for opioids
• Rhogam twice at 28 weeks and once 72 hours after birth
o For rh neg mom with a rh positive baby
• Vitamin k for baby because lack of intestinal flora and clotting
Maternal health medications
• Oxytocin to augment labor or to control postpartum bleeding
o Do not leave unattended
o Assess vitals every 15 min
• Tocolytics stop uterine contractions to prevent preterm birth
o Mg sulfate, stop preterm birth and preeclampsia and eclampsia used for
Slows RR, HR, and reflexes
Calcium gluconate antidote
• Prostaglandins soften and promote dilation of cervix for delivery
o s/e: fever, chills, hypotension, nausea, vomiting, stomach cramps.
• Opioids- if RR less than 12 hold
o Make sure antidote naloxone is available
• Rubella: give to pt who has titer less than 1:8
o Not for anyone who is immunocompromised
o Tell pt not to get pregnant for 1-3 months
o Cant have allergy to eggs
Extra Side Notes
• Immunosuppressant’s- monitor closely for infection
• Hypoparathyroidism needs calcium and vitamin D supplements
• H2 use caution in impaired renal or hepatic function pts
• Bronchodilators are contraindicated in individuals with peptic ulcer disease, severe cardiac disease or cardiac dysrhythmias, hyperthyroidism, and uncontrolled seizure disorders.
o Admin after meals to minimize GI irritation
o Theophylline levels 10-20 therapeutic
o Montelukast. Monitor lung sounds
• If APTT shorter than 60 seconds dose needs to be increased
• PT 10-13 seconds. Warfarin prolongs this time
• Normal INR is 1-1.3. on warfarin maintained at 2-3
• Therapeutic digoxin range= 0.5-2
• Antilipemic :monitor LFT’s
o Work by inhibiting synthesis of folic acid
o Photosensitivity, stop taking if rash occurs.
o Drink 8-10 glasses a day to prevent renal damage
o May get SJS- rash with widespread lesions
• Miotic agents for the eye reduces IOP
• Beta adrenergic blockers decrease amount of aqueous humor without affecting accommodation
• Osmotics used to lower IOP and vitrious humor
• Macular degeneration. ARMD most common. Loss of central vision
o Wet and dry types
o Wet ARMD progresses faster
• Under three for ear drops pinnae down and back
• Irrigations of TM should be body temp of 98 or 36.7 C
• Edrophonium chloride is used to diagnose myasthenia gravis and to distinguish cholinergic crisis from myasthenic crisis (may be called the Tensilon test).
• Cholinergic crisis: sweating, HTN , increased salavation and tearing, increased bronchial secretions, GI disturbances
• For parkinsons avoid multivitamins that contain pyriodoxine bc it decreases the amount of levodopa that gets to the CNS
• Do not take muscle relaxants with CNS depressants
• MAIO no thyramine containing food. Watch for HTN crisis
o Nausea, vomiting , htn, headache, stiff neck, flushing
o Foods like beef, smoked foods, wine, fermented cheese,fig, soy, yeast, caffeine
• SSRI watch serotonin syndrome
o Agitation, confusion, anxiety, hallucination, tremor, sweating,
o MAIO must be D/c 14 days before starting SSRI
• TCA’s block Norepinephrine, and Serotonin
o Not admin with MAIO or cause HTN CRISIS; big NOOOOO
o Monitor for anticholinergic s/e
• Lithium enhances Serotonin functioning
o 0.6-1.2 is therapeutic level
o Level checked every 2-3 days initially and 1-3 months during maintenance
o Adequate Na intake and 12 glasses of water a day, no caffeine
• Acetylcholinesterase inhibitors may be used to treat Alzheimer disease to improve cognitive function in the early stages. [Show Less]