Albuterol Aerosol
Bronchodilator Beta 2 agonist
Therapeutic Effects: Bronchodilation for asthma, COPD, acute bronchospasm
A/R: Nervousness,
... [Show More] restlessness, tremor, chest pain, palpitations.
Assess lung sound before & after TX. Observe for paradoxical bronchospasm (wheezing). Consider aerochamber. Monitor K+ and glucose. Rinse mouth with water to minimize dry mouth.
Zolpidem (Ambien)
Sedative / hypnotic
Therapeutic Effects: Sedation and induction of sleep
A/R: Amnesia, daytime drowsiness, drugged feeling, physical & psychological dependence, tolerance, GI effects
Assess sleep, mental status, potential for dependence. Don't use more than 7-10 days. Avoid ETOH & other CNS depressants
Lorazepam (Ativan)
Antianxiety Sedative / hypnotic. Benzodiazepine.
Therapeutic Effects:Management of anxiety, insomnia, Status Epilepticus. Preoperative sedation. Postoperative amnesia
A/R: Dizziness, drowsiness, lethargy, APNEA, CARDIAC ARREST with rapid IVP
Assess anxiety, mental status,. Avoid ETOH & other CNS depressants
Rosiglitazone
Classification: Antidiabetic. Thiazolidinediones
Therapeutic Effects: Decrease insulin resistance
A/R: Edema, anemia, wt gain, increased cholesterol
Monitor for fluid retention, hypoglycemia. Check PLFTs & CBC High Alert Medication!
Diltiazem
Antianginal, antiarrhythimics, antihypertensive. (CA++ channel blocker)
Therapeutic Effects: Decreased blood pressure. Coronary vasodilation.
A/R: Arrhythmias. CHF. Peripheral edema, Postural hypotension
Assess for signs of CHF. Monitor BP &P, notify < 50 bpm. May cause drowsiness of dizziness. Avoid driving until response to medication is known. Gingival hyperplasia- teach good oral care
Celecoxib
NSAIDs, COX-2 inhibitor
Therapeutic Effects: Analgesic, anti- inflammatory, & anti- pyretic
A/R: GI BLEEDING, dermal rash, GI effects
Assess pain, ROM and swelling. Do not give if allergic to sulfonamides, aspirin or NSAIDs. Watch for tarry stools.
Losartan
Classification: Angiotensin II receptor blocker
Therapeutic Effects: Antihypertensive. Decreases risk of stroke.
A/R & S/E:
Orthostatic hypotension, diarrhea. Dizziness, ANGIOEDEMA. Use cautiously in CHF
Nursing Implications & teaching: Assess orthostatic blood pressures. Use care when changing positions to prevent orthostatic hypotension. Monitor BUN/Creatinine for possible early renal failure.
Warfarin
Classification:Anticoagulant. Interferes with hepative syntheses of Vitamin K- dependant clotting factors
Therapeutic Effects: Prophylaxis/Treatment of venous &/or pulmonary embolism (PE) and atrial fibrillation w/ embolization. Antidote = Vitamin K
Adverse Reactions & side effects: Bleeding. Numerous drugs and natural products affect the activity of warfarin!
Nursing Implications & teaching: Asses for bleeding, or increased thrombosis. Check INR/PT before administration and regularly. PT may be 1.3-1.5 times greater than control. INR goal dependent on medical diagnosis. Maintain consistent vitamin K, Take in evening. Avoid ETOH & OTC medications. High Alert Medication
Prednisone
Anti-inflammatory (intermediate acting) corticosteroid
Therapeutic Effects: inflammation & modification of the normal immune response; replacement therapy in adrenal insufficiency. Management of cerebral edema. Potentiates anti-N/V action of Zofran.
A/R: PEPTIC ULCERATION, THROMBOEMBOLISM, mood changes, hypertension, anorexia, nausea, acne, decreased wound healing, ecchymosis, fragility, hirsutism, petechiae, adrenal suppression, muscle wasting, osteoporosis, cushingoid appearance, GI effects
Monitor for: fluid retention, hyperglycemia, infections, bleeding, steady weight gain, crackles, dyspnea.
Do not D/C abruptly. Monitor serum electrolytes, cholesterol/lipids
Avoid people w/contagious illnesses, TAKE WITH FOOD
Dexamethasone
Anti-inflammatory (long acting) corticosteroid
Therapeutic Effects: inflammation & modification of the normal immune response; replacement therapy in adrenal insufficiency. Management of cerebral edema. Potentiates anti-N/V action of Zofran.
Adverse Reactions & side effects: PEPTIC ULCERATION, THROMBOEMBOLISM, mood changes, hypertension, anorexia, nausea, acne, decreased wound healing, ecchymosis, fragility, hirsutism, petechiae, adrenal suppression, muscle wasting, osteoporosis, cushingoid appearance, GI effects
Nursing Implications & teaching:Monitor for fluid retention, hyperglycemia, infections, bleeding, steady weight gain, crackles, dyspnea. Do not D/C abruptly. Monitor serum electrolytes, cholesterol/lipids. avoid people w/contagious illnesses, TAKE WITH FOOD
Phenytoin
Antiarrhythmic/ Anticonvulsant
Therapeutic Effects: Decrease seizures & pain, control arrhythmias
A/R: Aganulocytosis, aplastic anemia, Stevens-Johnson syndrome. diplopia, nystagmus, hypotension, gingival hyperplasia, nausea, rashes
Nursing Implications & teaching: Assess for hypersensitivity syndrome; monitor CBC, platelet count, avoid driving till MD ok; avoid ETOH & OTC meds; maintain oral hygiene; urine can be pink/red;
Diabetic-monitor glucose closely;
Avoid taking within 2-3hr of antacids/antidiarrheals; decrease contraceptive(hormonal), TAKE WITH FOOD
Metronidazole (Flagyl)
Antiinfective, antiulcer, Antiprotozoal
Therapeutic Effects: Treatment of anaerobic and parasitic infections
A/R: SEIZURES, dizziness, HA, anorexia, nausea, GI effects
Monitor WBC, neurological status, and I/Os, TAKE WITH FOOD
Tamsulosin (Flomax)
Classification: Peripherally acting anti-adrenergic.
Therapeutic Effects: Decreased symptoms of prostatic hyperplasia, i.e. male urinary outflow obstruction
Adverse Reactions & side effects: Dizziness, headache, orthostatic hypotension, retrograde/ diminished ejaculation. Cautious in patients at risk for prostate carcinoma
Nursing Implications & teaching: Monitor for dizziness, hypotension. Have patient change positions slowly to minimize symptoms.
Alendronate
Bone resorption inhibitor. Bisphosphonate
Therapeutic Effects: TX and prevention of post-menopausal and cortico-steroid-induced osteoporosis,
A/R: Altered taste, photosensitivity, rash, musculoskeletal pain, fluid overload, esophagitis. Common upset stomach & heartburn, GI effects
Take first thing in the AM, before eating anything; then pt MUST remain upright for at least 30 mins! Take only with plain water. Monitor for GI side effects. Use sunscreen to prevent photosensitivity reactions.
Gentamycin
Antiinfective/ Aminoglycoside
Therapeutic Effects: Treatment for enterococcal infections
Adverse Reactions & side effects: Ototoxicity and nephrotoxicity
Do peak and trough levels, report to MD for dose adjusting. Assess hearing periodically throughout TX. Monitor for superinfections
Metformin
Anti-diabetic (Biguanides)
Therapeutic Effects: Decrease hepatic glucose production & intestinal absorption, increased receptor site sensitivity, GI effects
A/R: Abdominal bloating. Lactic acidosis. Metallic taste
Educate about lactic acidosis when food or fluid is decreased. (S/S - chills, diarrhea, dizziness, low BP, weakness, muscle pain, slow HR. Notify MD IMMEDIATELY).
Stop drug before dye based studies. Check renal function. TAKE WITH FOOD
Heparin
Anticoagulant
Therapeutic Effects: Antithrombotic. Prevention of extension of existing thrombi Antidote = protamine sulfate
A/R: BLEEDING. Thrombocytopenia, anemia. Has multiple drug reactions
Assess for bleeding (nose, gums, urine, stool), anemia, thrombocytopenia.
Closely monitor aPTT. High Alert Medication. Use heparin nomogram/protocol. Immediate onset when given IV
Hydrochlorothiazide
Antihypertensive. (Non K+ sparing diuretic)
Therapeutic Effects: Decrease Blood Pressure. Increase in Urine output
A/R Hypokalemia. Drowsiness. Digoxin toxicity. Increased glucose levels
Monitor blood pressure, I & O, daily wt, Monitor lytes.
Administer in AM. Change positions slowly to minimize orthostatic hypotension.
Azathioprine
Immunosuppressant
Therapeutic Effects: Prevent renal transplant rejection. Treat Rheumatoid arthritis and Chron's
A/R: Blood dyscryasias, hepatotoxicity, GI effects
Check CBC, LFT. Assess for infection, fluid retention, bleeding.
Contraception and teratogenic concerns. Do not d/c abruptly
Insulin glargine
Antidiabetic; pancreatic hormone. Long acting 24 hours
Onset: 1H
Therapeutic Effects: Lowers blood glucose by increasing transport into cells and promoting conversion of glucose to glycogen. Inhibits release of free fatty acids.
A/R: HYPOGYCEMIA, lipodystrophy, anaphylaxis
Watch for interactions with beta blockers, thiazide diuretics, corticosteroids.
Do not mix with any other insulin. No peak.
High Alert Medications
(Humulin 70/30) NPH/Regular insulin mixture
Anti-diabetic; pancreatic hormone.
Onset 30 min- 1H
Peak (regular): 2-3H (NPH): 4-12 H
Duration (regular): 5-7 H (NPH): 18-24 H
Therapeutic Effects: Lowers blood glucose by increasing transport into cells and promoting conversion of glucose to glycogen. Inhibits release of free fatty acids.
A/R: HYPOGYCEMIA, lipodystrophy, anaphylaxis
Watch for interactions with beta blockers, thiazide diuretics, corticosteroids.
Humulin 70/30: 2 Peaks .
High Alert Medications
Insulin lispro
Anti-diabetic pancreatic hormone
Onset < 15 min
Peak: 30min-1 H
Duration: 3 H
Therapeutic Effects: Lowers blood glucose by increasing transport into cells and promoting conversion of glucose to glycogen. Inhibits release of free fatty acids.
A/R: HYPOGYCEMIA, lipodystrophy, anaphylaxis
Watch for interactions with beta blockers, thiazide diuretics, corticosteroids
Do not give sooner than 15 minutes before a meal . High Alert Medications
Potassium Chloride
Potassium supplement
Therapeutic Effects: Transmit nerve impulses; contraction of cardiac, skeletal, and smooth muscle; gastric secretion; renal function; tissue synthesis; and CHO metabolism.
A/R: ARRHYTHMIAS, ECG changes oral—abdominal pain, diarrhea, flatulence, nausea & vomiting, GI effects
IV rate should generally not exceed 20 mEq/hr, unless closely monitored.
Check for s/s hypokalemia/hyperkalemia, TAKE WITH FOOD
Digoxin
Antiarrhythmic, cardiotonic & inotropic agent
Therapeutic Effects: TX of CHF, tachyarrhythmia.
Antidote immune Fab (Digibind)
A/R: NARROW THERAPUETIC RANGE visual disturbances and fatigue, blurred vision, ECG changes, GI effects
Monitor apical pulse for one full minute. Hold if pulse is < 60. Second person check calculations in IV & Peds.
Monitor levels (0.5-2)
Hypokalemia increases risk for toxicity
Furosemide
Loop Diuretic
Therapeutic Effects: Diuresis. Lowering of blood pressure and BG levels
A/R: Dehydration, hypochloremia, hypokalemia, hypomagnesaemia, hyponatremia, hypovolemia, metabolic alkalosis
Monitor for thirst, dry mouth, lethargy, weakness, hypotension, oliguria and notify physician. Monitor K+, Ca++, Mg.
Can increase BUN, glucose and creatinine, TAKE WITH FOOD
Levofloxacin
Antiinfective, Fluoroquinolone
Therapeutic Effects: Broad spectrum against gram positive and gram negative
A/R: Dizziness, drowsiness, headaches, GI effects
Watch for anaphylactic rxn.
Do not administer <4 hr before or 2 hr after giving an Al/Mg/ Fe or Zn preparation. Monitor for superinfections [Show Less]