NCLEX-RN Must Know Medications
1 P H A R M A C O L O G Y F O R T H E N C L E X - R N
MUST KNOW DRUGS
2 ALTEPLASE
• MOA
– thrombolytic –
... [Show More] plasminogen activator
–
• Indications
– MI
– Acute ischemic stroke
– Occluded Central lines
• Nursing Considerations
– Contraindicated in active bleeding
– Monitor for active bleeding (q15m x 1hr; q15-30m x 8hr)
– May cause intracranial hemorrhage
– Monitor for anaphylaxis
– Use caution with uncontrolled hypertension
– Assess neuro status during therapy
•
3
A patient is admitted to the emergency department with chest pain. An electrocardiogram shows changes consistent with an evolving myocardial infarction. The patient’s cardiac enzymes are pending. The nurse caring for this patient will expect to:
A. administer aspirin when cardiac enzymes are completed.
B. give alteplase [Activase] within 2 hours.
C. give tenecteplase [TNKase] immediately.
D. obtain an order for an INR.
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A patient is admitted to the emergency department with chest pain. An electrocardiogram shows changes consistent with an evolving myocardial infarction. The patient’s cardiac enzymes are pending. The nurse caring for this patient will expect to:
A. administer aspirin when cardiac enzymes are completed.
B. give alteplase [Activase] within 2 hours.
C. give tenecteplase [TNKase] immediately.
D. obtain an order for an INR.
5 ATORVASTATIN
• MOA
– HMG-CoA reductase inhibitor – lipid lowering agent
–
• Indications
NCLEX-RN Mus5t
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ow Medications
–
• Indications
– Management of hypercholesterolemia (primary prevention of cardiovascular disease)
• Nursing Considerations
– Contraindicated in active liver disease
– May cause rhabdomyolysis
– Monitor renal function
– Monitor serum cholesterol before treatment and 4 weeks after starting therapy
– Monitor LFTs
– Instruct patient to report muscle weakness (sign of rhabdomyolysis)
A patient who is recovering from a STEMI 3 months prior is in the clinic for a follow-up evaluation. The patient is taking 81 mg of aspirin, a beta blocker, and an ACE inhibitor daily and uses nitroglycerine as needed for angina. The patient’s BMI is 24.5 kg/m2, and serum LDL is 150 mg/dL. The patient has a blood pressure of 135/80 mm Hg. What will the nurse expect the provider to order for this patient?
A. An antihypertensive medication
B. Counseling about a weight loss diet
C. Discontinuing the ACE inhibitor
D. High-dose statin therapy
A patient who is recovering from a STEMI 3 months prior is in the clinic for a follow-up evaluation. The patient is taking 81 mg of aspirin, a beta blocker, and an ACE inhibitor daily and uses nitroglycerine as needed for angina. The patient’s BMI is 24.5 kg/m2, and serum LDL is 150 mg/dL. The patient has a blood pressure of 135/80 mm Hg. What will the nurse expect the provider to order for this patient?
A. An antihypertensive medication
B. Counseling about a weight loss diet
C. Discontinuing the ACE inhibitor
D. High-dose statin therapy
ACETAMINOPHEN
• MOA
– non-opioid analgesic – prostaglandin inhibitor
–
• Indications
– Pain
– Fever
• Nursing Considerations
– Do not exceed 4g of acetaminophen per day to limit risk of renal, liver and cardiac damage
Overdose will lead to hepatotoxicity
damage
– Overdose will lead to hepatotoxicity
– Acetylcysteine (acetadote) is the antidote for overdose
– May increase the risk for bleeding with warfarin therapy
– May alter blood glucose measurements
•
9
A patient who is taking gentamicin and a cephalosporin for a postoperative infection requests medication for mild postsurgical pain. The nurse will expect to administer which of the following medications?
A. Acetaminophen
B. Aspirin
C. Ibuprofen
D. Morphine
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A patient who is taking gentamicin and a cephalosporin for a postoperative infection requests medication for mild postsurgical pain. The nurse will expect to administer which of the following medications?
A. Acetaminophen
B. Aspirin
C. Ibuprofen
D. Morphine
11 ACYCLOVIR
• MOA
– antiviral – purine analogue
–
• Indications
– Genital herpes
– Herpes zoster
– Chicken pox
• Nursing Considerations
– May cause seizures, renal failure, Stevens-Johnson syndrome, thrombotic thrombocytopenic purpura syndrome, diarrhea, dizziness, nausea
– Monitor renal panel during administration
– Assess lesions during therapy
– Instruct patient to use proper protection during sexual intercourse
•
12
The nurse is caring for a patient receiving intravenous acyclovir. To prevent nephrotoxicity associated with intravenous acyclovir, the nurse will:
A. hydrate the patient during the infusion and for 2 hours after the infusion.
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associated with intravenous acyclovir, the nurse will:
A. hydrate the patient during the infusion and for 2 hours after the infusion.
B. increase the patient’s intake of foods rich in vitamin C.
C. monitor urinary output every 30 minutes.
D. provide a low-protein diet for 1 day before and 2 days after the acyclovir infusion.
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The nurse is caring for a patient receiving intravenous acyclovir. To prevent nephrotoxicity associated with intravenous acyclovir, the nurse will:
A. hydrate the patient during the infusion and for 2 hours after the infusion.
B. increase the patient’s intake of foods rich in vitamin C.
C. monitor urinary output every 30 minutes.
D. provide a low-protein diet for 1 day before and 2 days after the acyclovir infusion.
14 ALBUTEROL
• MOA
– bronchodilator – binds to Beta2 adrenergic receptors in airway leading to relaxation of the smooth airway muscles
–
• Indications
– Airway obstruction
– COPD
– Asthma
• Nursing Considerations
– May decrease effectiveness of beta blockers
– Use with caution: heart disease, diabetes, glaucoma, seizure disorder
– Overuse of inhaler can lead to bronchospasm
– Monitor for chest pain and palpitations
– Can increase digoxin levels
•
15
A patient is using a metered-dose inhaler containing albuterol for asthma. The medication label instructs the patient to administer “2 puffs every 4 hours as needed for coughing or wheezing.” The patient reports feeling jittery sometimes when taking the medication, and she doesn’t feel that the medication is always effective. Which action is outside the nurse’s scope of practice?
A. Asking the patient to demonstrate use of the inhaler
B. Assessing the patient’s exposure to tobacco smoke
C. Auscultating lung sounds and obtaining vital signs
D. Suggesting that the patient use one puff to reduce side effects
•
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A patient is using a metered-dose inhaler containing albuterol for asthma. The medication label instructs the patient to administer “2 puffs every 4 hours as needed for coughing or wheezing.” The patient reports feeling jittery sometimes when taking the medication, and she doesn’t feel that the medication is always effective. Which action is outside the nurse’s scope of practice?
A. Asking the patient to demonstrate use of the inhaler
B. Assessing the patient’s exposure to tobacco smoke
C. Auscultating lung sounds and obtaining vital signs
D. Suggesting that the patient use one puff to reduce side effects
•
17 ALEDRONATE
• MOA
– biphosphnate – inhibits osteoclast activity leading to inhibition of resorption of bone
–
• Indications
– Osteoporosis (aging, menopause, corticosteroid induced)
• Nursing Considerations
– Take first thing in the morning with full glass of water 30 mins prior to eating
– Assess serum calcium and vitamin D
– May lead to muscle pain
•
18 ALPRAZOLAM
• MOA
– benzodiazepine – works in CNS to produce anxiolytic effect causing CNS depression
–
• Indications
– Anxiety, panic disorder, manage symptoms of PMS, insomnia, mania, psychosis
• Nursing Considerations
– Use caution with existing CNS depression, sleep apnea, renal dysfunction, hepatic dysfunction
– May cause CNS depression, drowsiness, lethargy
– May lead to physical dependence, may experience tolerance effect
– Assess anxiety and mental status
– Flumazenil is antidote for overdose
– Grapefruit juice may increase blood levels
•
19 AMIODARONE
• MOA
– potassium channel blocker – class III antiarrhythmic – prolongs action potential, inhibits adrenergic stimulation, slows rate, decreases peripheral vascular resistance causing vasodilation
NCLEX-RN Mu1s9t ow Medications
adrenergic stimulation, slows rate, decreases peripheral vascular resistance causing vasodilation
–
• Indications
– Ventricular arrhythmias, SVT
– ACLS protocol for V-Fib and V-Tach
• Nursing Considerations
– May lead to ARDS, pulmonary toxicity, CHF, bradycardia, hypotension
– Increases risk for QT prolongation
– Increases digoxin levels
– Increases activity of warfarin
– Monitor EKG continuously while on therapy
– Assess for signs and symptoms of ARDS
– Monitor LFTs
– Check dosage with another RN
– Teach pt to monitor pulse daily and report abnormalities
– Avoid drinking grapefruit juice
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A nurse is providing teaching to a patient who is admitted to the hospital for initiation of treatment with amiodarone [Cordarone] for atrial fibrillation that has been refractory to other medications. Which statement by the patient indicates a need for further teaching?
A. “I may have itching, malaise, and jaundice, but these symptoms will subside.”
B. “I need to use sunblock to help keep my skin from turning bluish gray.”
C. “I should not drink grapefruit juice while taking this medication.”
D. “I should report shortness of breath and cough and stop taking the drug immediately.”
21
A nurse is providing teaching to a patient who is admitted to the hospital for initiation of treatment with amiodarone [Cordarone] for atrial fibrillation that has been refractory to other medications. Which statement by the patient indicates a need for further teaching?
A. “I may have itching, malaise, and jaundice, but these symptoms will subside.”
B. “I need to use sunblock to help keep my skin from turning bluish gray.”
C. “I should not drink grapefruit juice while taking this medication.”
D. “I should report shortness of breath and cough and stop taking the drug immediately.”
22 AMITRYPTILINE
• MOA
– tricyclic antidepressant – increases effect of serotonin and norepinephrine in the CNS, exhibits anticholinergic effects
–
• Indications
Depression, anxiety, insomnia
• Indications
– Depression, anxiety, insomnia
• Nursing Considerations
– Contraindicated in MI, heart failure, QT prolongation, glaucoma
– May increase risk for suicidal ideation
– May lead to photosensitivity, instruct pt to use sunscreen
– May turn urine blue/green color
– May cause arrhythmias, hypotension, EKG changes
– May cause alterations in blood glucose levels
– May lead to general sedation and lethargy
– Do not use within 2 weeks of MAOIs
– Instruct pt to take exactly as instructed
– Monitor for orthostatic hypotension
23 AMLODIPINE
• MOA
– Calcium channel blocker – antihypertensive – blocks transport of calcium into muscle cells inhibiting excitation and contraction
–
• Indications
– Hypertension
– Angina
• Nursing Considerations
– May cause gingival hyperplasia
– Grapefruit juice may increase drug level
– Monitor BP and pulse prior to and during therapy
– Monitor for signs of CHF
– Assess characteristics of angina
– Instruct patient of interventions for hypertension and how to take BP
24 AMOXICILLIN
• MOA
– anti-infective/antiulcer agent – aminopenicillins - inhibits synthesis of bacterial cell wall leading to cell death
–
• Indications
– Skin infections, respiratory infections, sinusitis, endocarditis prophylaxis, lyme disease
• Nursing Considerations
– Contraindicated with penicillin allergy
– May cause seizures
– Assess for rash, anaphylaxis
– Excreted by kidneys – monitor renal function
– Monitor patient for diarrhea – bloody stool should be reported immediately
25 AMPICILLIN
• MOA
25 AMPICILLIN
• MOA
– Anti-infective – aminopenicillin – bactericidal, broader spectrum that penicillin, binds to cell wall leading to bacterial cell death
–
• Indications
– Skin infections, soft tissue infections, otitis media, sinusitis, respiratory infections, GU infections, meningitis, septicemia
• Nursing Considerations
– Contraindicated in penicillin allergy
– Use caution in renal insufficiency
– May lead to seizures, diarrhea, anaphylaxes, super infection
– Monitor LFTs
– Instruct patient on signs of super infection: furry overgrowth on tongue, vaginal itching, loose and foul smelling stool
– Pt should not use with oral contraceptive use
26 ASPIRIN
• MOA
– non-opioid analgesic and antipyretic – salicylates – inhibits the production of prostaglandins which leads to a reduction of fever and inflammation, decreases platelet aggregation leading to a decrease in ischemic diseases
–
• Indications
– Rheumatoid arthritis, osteoarthritis, ischemic stroke, MI prophylaxis
• Nursing Considerations
– Use caution with bleeding disorders and chronic alcohol use
– May lead to Stevens-Johnson syndrome, laryngeal edema, and anaphylaxis
– Increases risk for bleeding with warfarin, heparin, and clopidogrel
– Increased risk for GI bleeding with NSAID use
– Monitor LFTs
– Concurrent use with alcohol may increase risk for GI bleeding
27 ATENOLOL
• MOA
– beta blocker – antianginal/antihypertensive – blocks the stimulation of beta 1 receptors in the SNS with minimal effects on beta 2 receptors
–
• Indications
– Hypertension, angina, prevention of MI
• Nursing Considerations
– Contraindicated in CHF, pulmonary edema, cardiogenic shock, bradycardia, heart block
– Monitor HR/BP
– May cause bradycardia, CHF, pulmonary edema
– Masks symptoms associated with DM Advise to change positions slowly
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– Masks symptoms associated with DM
– Advise to change positions slowly
– Instruct pt how to take BP
28 ATROPINE
• MOA
– antiarrhythmic/anticholinergic – inhibits effects of the parasympathetic nervous system, specifically acetylcholine – increases HR, bronchodilation, decreased GI and respiratory secretions
–
• Indications
– Decreases oral and respiratory secretions, treats sinus bradycardia and heart block, treatment of bronchospasm
–
• Nursing Considerations
– Avoid in acute hemorrhage, tachycardia, and closed-angle glaucoma
– Monitor pt for tachycardia and palpitations
– May cause urinary retention in elderly patients
– Patients may experience constipation due to slowed GI motility
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A patient is brought to the emergency department after ingesting a handful of diphenhydramine tablets. The patient has dilated pupils, a flushed face, and tremors. The patient is agitated and has a heart rate of 110 beats per minute. The nurse may anticipate administering which agents? (Select all that apply.)
A. Activated charcoal
B. Atropine
C. Cathartics
D. Lorazepam
E. Second-generation H1 antagonists
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A patient is brought to the emergency department after ingesting a handful of diphenhydramine tablets. The patient has dilated pupils, a flushed face, and tremors. The patient is agitated and has a heart rate of 110 beats per minute. The nurse may anticipate administering which agents? (Select all that apply.)
A. Activated charcoal
B. Atropine
C. Cathartics
D. Lorazepam
E. Second-generation H1 antagonists
31 AZITHROMYCIN
• MOA
macrolide – anti-infective for atypical mycobacterium – inhibits bacterial protein
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• MOA
– macrolide – anti-infective for atypical mycobacterium – inhibits bacterial protein synthesis
–
• Indications
– URI, chronic bronchitis, lower respiratory infections, otitis media, skin infections, STIs, prevention of bacterial endocarditis, treatment of cystic fibrosis
• Nursing Considerations
– May lead to pseudomembranous colitis, pain diarrhea, nausea, Stevens-Johnson syndrome, angioedema
– May increase risks for warfarin toxicity
– Monitor for anaphylaxis
– Notify PCP for diarrhea or blood or pus in stool
– Instruct pt to take as prescribed
32 BENZOTROPINE
• MOA
– Anti-Parkinson agent – anticholinergic – anticholinergic properties reduce tremors and rigidity
–
• Indications
– Treatment for Parkinson’s Disease
• Nursing Considerations
– May lead to arrhythmias, hypotension, palpitations, and tachycardia
– Anticholinergic effects like constipation, dry mouth
– Assess for extrapyramidal symptoms
– Instruct pt to take as directed
– Instruct pt to maintain good oral hygiene
33 BISCODYL
• MOA
– stimulant laxative – stimulates peristalsis leads to fluid accumulation in the colon
–
• Indications
– Treatment of constipation
– Bowel regimen
• Nursing Considerations
– May lead to hypokalemia
– May cause abdominal pain and cramps
– Use caution with milk
– Assess for abdominal distension and bowel function
– Instruct pt to drink 1500-2000 mL/day during therapy
– Monitor fluid and electrolyte levels
34 BISMUTH SUBSALICYLATE
• MOA
34 BISMUTH SUBSALICYLATE
• MOA
– adsorbent antidiarrheal/antiulcer – stimulates the absorption of fluids and electrolytes in the intestinal wall, reduction in hypermotility of the stomach, and binds to toxins
–
• Indications
– Diarrhea, heartburn, indigestion, H. pylori-associated ulcers
• Nursing Considerations:
– Contraindicated in aspirin hypersensitivity
– Increased risk for impaction with geriatric and pediatric patients
– Monitor LFTs
– Bismuth may interfere with radiologic exams
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A patient is taking bismuth subsalicylate to prevent diarrhea. The nurse performing an assessment notes that the patient’s tongue is black. What will the nurse do?
A. Assess further for signs of gastrointestinal (GI) bleeding.
B. Reassure the patient that this is an expected side effect of this drug.
C. Request an order for liver function tests to evaluate for hepatotoxicity.
D. Withhold the drug, because this is a sign of bismuth overdose.
•
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A patient is taking bismuth subsalicylate to prevent diarrhea. The nurse performing an assessment notes that the patient’s tongue is black. What will the nurse do?
A. Assess further for signs of gastrointestinal (GI) bleeding.
B. Reassure the patient that this is an expected side effect of this drug.
C. Request an order for liver function tests to evaluate for hepatotoxicity.
D. Withhold the drug, because this is a sign of bismuth overdose.
•
37 BUPROPION
• MOA
– aminoketones – antidepressant/smoking deterrent – relieves anxiety by binding to dopamine and serotonin receptors
–
• Indications
– Depression, smoking cessation, treat ADHD in adults
– Management of anxiety
• Nursing Considerations
– May lead to seizures, suicidal thoughts
– Do not administer if pt is taking MAOIs or with grapefruit juice
– Use caution with renal and liver impairment
– Assess mental status
– Instruct pt to avoid alcohol and CNS depressants while taking bupropion May lead to dizziness, drowsiness, fatigue, and weakness
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– Instruct pt to avoid alcohol and CNS depressants while taking bupropion
– May lead to dizziness, drowsiness, fatigue, and weakness
– Pt may experience chest pain, palpitations, tachycardia
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A patient who has been taking an SSRI tells the nurse that the drug has caused reduced sexual performance, weight gain, and sedation. The nurse will suggest that the patient ask the provider about using which drug?
A.
B.
C.
D.
• Bupropion Imipramine Isocarboxazid Trazodone
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A patient who has been taking an SSRI tells the nurse that the drug has caused reduced sexual performance, weight gain, and sedation. The nurse will suggest that the patient ask the provider about using which drug?
A. Bupropion
B. Imipramine
C. Isocarboxazid
D. Trazodone
•
40 BUTORPHANOL
• MOA
– opioid analgesic – alters perception and response to pain by binding to opiate receptors in CNS
–
• Indications
– Moderate to severe pain, labor pain, sedation
• Nursing Considerations
– Use caution with concurrent use of MAOIs
– May cause confusion, hallucinations, sedations
– Monitor for CNS depression
– Assess BP/HR/RR during administration
– Administer slowly through IV line
41 CALCIUM ACETATE
• MOA
–(antacids – essential for nervous muscular and skeletal systems, helps maintain cell membranes, aids in nerve impulses and muscle contraction, aids in blood formation and coagulation
–
• Indications
– Treatment of hypocalcemia, prevention of postmenopausal osteoporosis, adjunct in cardiac arrest, control of hyperphosphatemia with ESRD
– Treatment of hypocalcemia, prevention of postmenopausal osteoporosis, adjunct in cardiac arrest, control of hyperphosphatemia with ESRD
• Nursing Considerations
– May cause cardiac arrest and arrhythmias
– Phlebitis at site of insertion
– May cause hypotension, bradycardia, and arrhythmias
– Administer slowly
– Instruct pt on foods that contain Vit D and encourage adequate intake
– Monitor parathyroid hormone
42 CAPTOPRIL
• MOA
– ACE-inhibitor – antihypertensive – blocks conversion of angiotensin I to angiotensin II, increases renin levels and decreases aldosterone leading to vasodilation
–
• Indications
– Hypertension, management of CHF, decrease progression of DM neuropathy
• Nursing Considerations
– Can cause neutropenia – check WBCs regularly
– Use cautiously with K+ supplements and K+ sparing diuretics
– Use cautiously with diuretic therapy
– Administer 1 hour before meals
– Monitor BP, weight, renal panel, and fluid status
– Monitor CBC frequently
– May lead to rhabdomyolysis
– Dry cough
43 CARBAMAZEPINE
• MOA
– anticonvulsant – affects Na+ channels in neurons leading to decreased synaptic transmission
–
• Indications
– Seizures, DM neuropathy, pain associated with trigeminal neuralgia
• Nursing Considerations
– Interferes with oral contraceptives
– Do not use with MAOIs or grapefruit juice
– May cause suicidal thoughts
– May cause Stevens-Johnson syndrome, agranulocytosis, aplastic anemia, thrombocytopenia
– Monitor CBC and platelet count
– Monitor serum blood levels of medication often
–
44 CARBIDOPA/LEVODOPA
• MOA
44 CARBIDOPA/LEVODOPA
• MOA
–(dopamine agonist – levodopa is converted to dopamine and works as a neurotransmitter and carbidopa prevents the destruction of levodopa
–
• Indications
– Parkinson’s Disease
• Nursing Considerations
– May cause orthostatic hypotension
– May cause dark urine
– Weeks to month for full effect
– Do not use with MAOIs
– Don’t use with glaucoma or melanoma
– Assess for Parkinson’s symptoms
– B6 supplement
45 CEFACLOR
• MOA
– 2nd generation cephalosporin – bactericidal, binds to bacterial cell wall causing cell death
–
• Indications
– Treatment of respiratory tract infections, skin infections, otitis media
• Nursing Considerations
– Contraindicated in cephalosporin and possibly penicillin allergies
– May lead to seizures, pseudomembranes colitis, diarrhea, phlebitis at IV site, anaphylaxis
– Assess infection and allergies
– Obtain cultures prior to therapy
– Monitor bowel function
– May lead to super infection
46 CEFDINIR
• MOAI
–(2nd generation cephalosporin – binds to bacterial cell wall causing cell death
•
• Indications
– Treatment of skin infections, otitis media
• Nursing Considerations
– Contraindicated in cephalosporin and possibly penicillin allergies
– May lead to seizures, pseudomembranous colitis, diarrhea, phlebitis at IV site, anaphylaxis
– Assess infection and allergies
– Obtain cultures prior to therapy
– Monitor bowel function May lead to super infection
– Monitor bowel function
– May lead to super infection
–
47 CELECOXIB
• MOA
– antirheumatic/NSAID – decreases pain and inflammation by inhibiting synthesis of prostaglandins
–
• Indications
– Osteoarthritis, rheumatoid arthritis, acute pain
• Nursing Considerations
– Use caution with cardiovascular disease
– Increases risk for MI, CVA, thrombosis
– May cause GI bleeding, Stevens-Johnson syndrome, dermatitis
– Notify HCP for new-onset abdominal pain or black stool
48 CEPHALEXIN
• MOA
– Anti-infective (1st generation cephalosporin) – bactericidal: binds to bacterial cell wall leading to cell death
–
• Indications
– Skin infections, pneumonia, UTI, otitis media
• Nursing Considerations
– Contraindicated with serious penicillin allergies
– May lead to seizures, pseudomembranous colitis, diarrhea, phlebitis at IV site, anaphylaxis
– Obtain cultures prior to therapy
– Monitor bowels
– May lead to super infection
– May cause elevated LFTs
49 CHLORPROMAZINE
• MOA
– Antipsychotic/antiemetic – phenothiazines (dopamine D2 receptor antagonist) – exhibits anticholinergic activity, alters effects of dopamine in CNS
–
• Indications
– 2nd line treatment of schizophrenia and psychosis, nausea/vomiting, pre-op sedation, acute intermittent porphyria, headache, bipolar d/o
• Indications
– May cause neuroleptic malignant syndrome, sedation, tardive dyskinesia, hypotension, agranulocytosis
– Assess mental status prior to and during treatment Monitor BP
NCLEX-RN Must K2now Medications
– Assess mental status prior to and during treatment
– Monitor BP
– Monitor CBC and LFTs
– Ensure adherence
50 CIMETIDINE
• MOA
– Antiulcer agent – histamine H2 antagonist – inhibits action of histamine leading to inhibition of gastric acid secretion
–
• Indications
– Treatment of duodenal ulcers, GERD, heartburn, Zollinger Ellison Syndrome, prevention of GI bleeding in critical patients
• Nursing Implications
– Increases serum warfarin level
– Can lead to respiratory infection
– Monitor for arrhythmias
– May cause agranulocytosis, aplastic anemia
– Monitor CBC during therapy
– Instruct pt to increase fluid and fiber to decrease constipation
51 CIPROFLOXACIN
• MOA
– Anti-infective – fluoroquinolone – inhibits bacterial DNA synthesis
–
• Indications
– UTI, gonorrhea, respiratory tract infections, bronchitis, pneumonia, skin and bone infections, infectious diarrhea, abdominal infections
• Nursing Implications
– May cause QT prolongation, avoid use with other drugs that cause QT prolongation
– Can cause seizures, arrhythmias, pseudomembranous colitis, anaphylaxis, Stevens Johnson syndrome
– May decrease phenytoin levels
– Monitor renal function and LFTs
52 CLINDAMYCIN
• MOA
– Anti-infective – inhibits bacterial protein synthesis
–
• Indications
– Skin infections, respiratory tract infections, septicemia, intra-abdominal infections, osteomyelitis
• Nursing Implications
– Potential for arrhythmias, pseudomembranous colitis, diarrhea, phlebitis
– Monitor bowel function Monitor CBC and LFTs
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– Monitor bowel function
– Monitor CBC and LFTs
53 CLOPIDOGREL
• MOA
– Platelet aggregation inhibitor – antiplatelet agent
–
• Indications
– Atherosclerotic events, MI, CVA, PVD, ACS
• Nursing Implications
– May cause GI bleeding, neutropenia, hypercholesterolemia
– May increase risk for bleeding in warfarin, aspirin, heparin therapy
– Can increase risk for bleeding with garlic, gingko, ginger
– Monitor CBC and platelet count
– Discontinue use 5-7 days before surgery
54 CODEINE
• MOA
– Opioid agonist – binds to opiate receptors in the CNS and alters perception of pain while producing a general depression of the CNS – the depression also causes a decrease in the cough reflex and GI motility
–
• Indications
– Management of pain, diarrhea, cough suppressant
• Nursing Implications
– May cause alterations in mentation, hypotension, constipation, nausea, vomiting
– Assess BP, HR, and RR prior to administration and throughout therapy
– Use caution in pt on MAOI
– Naloxone is antidote for opioid agonists
55 CORTISONE
• MOA
– Corticosteroid – antiasthmatic, corticosteroid – Replaces cortisol ins states of deficiency, suppresses inflammation and normal immune response
–
• Indications
– Management of adrenocortical insufficiency (Addison’s Disease)
• Nursing Implications
– Excreted by liver – monitor LFTs
– Avoid in active untreated infections
– May cause CNS alterations
– May cause peptic ulcers
– May cause Cushingoid appearance (buffalo hump, mood face)
– Weight gain
– Osteoporosis
– Decreased wound healing
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