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37 Cards in this Set
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Advil (ibuprofen) - 400 mg q 4-6 hours PRN pain
Class: Nonopioid Analgesic, antipyretic, antirheumatics, NSAIDs Indications: mild-moderate pain, inflammation, lowering fever Action: inhibits prostiglandin synthesis Therapeutic Effects: decreased pain & inflammation,reduction of fever Safe Dosage: 200-400 mg q 4-6 hrs ( X exceed 1,200 mg/day) |
Medication Interactions:
Additive adverse GI side effects with aspirin, oral potassium and other NSAIDs, corticosteroids, or alcohol Chronic use with acetaminophen may ↑ risk of adverse renal reactions May ↓ effectivenessof diuretics or antihypertensives May ↑ hypoglycemic effects of insulin or oral hypoglycemic agents May slightly ↑ serum digoxin levels ↑ risk of bleeding with drugs effecting platelet function |
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Advil
Side Effects: CNS: headache, dizziness, drowsiness, psychic disturbances EENT: amblyopia, blurred vision, tinnitus CV: arrhythmias, edema GI: GI BLEEDING, HEPATITIS, constipation, dyspepsia, nausea, vomiting, abdominal discomfort GU: cystitis, hematuria, renal failure Derm: EXFOLIATIVE DERMATITIS, STEVENS-JOHNSONSYNDROME, TOXIC EPIDERMAL NECROLYSIS, rashes Hemat: blood dyscrasias, prolonged bleeding time Misc: ALLERGIC REACTIONS INCLUDING ANAPHYLAXIS |
Nursing Considerations:
Geri: ↑ risk for GI bleeding. ↑ risk of hepatic & renal toxicity. Assess for s/s symptoms of GI bleeding, renal dysfunction, & hepatic impairment Use ↓ effective dose for shortest time Coadmin w/ opioid analgesics may have + analgesic effects & may permit ↓ opioid doses Pain: Assess pain prior to & 1–2 hr after PO: For rapid initial effect, admin 30 min before or 2 hr after meals. May be admin w/ food, milk, or antacids. Tabs may be put in fluids or food. Take w/ a full glass of water & remain in upright position for 15–30 min after admin |
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Amoxicillin 500 mg BID x 3 weeks PO
Class: aminopenicillins Indications: Treats skin & skin structure infections, Otitis media, Sinusitis, Resp & GU infections. Action: Binds to bacterial cell wall, causing cell death Safe Dosage: 500–875 mg q 12 hr (not to exceed 2–3 g/day) May be given w/o regard to meals or w/ meals to - GI side effects. Capsule contents may be emptied & swallowed with liquids |
Med Interactions: none on this list
Side Effects: CNS: SEIZURES (HIGH DOSES) GI: PSEUDOMEMBRANOUS COLITIS, diarrhea, nausea, vomiting, ↑ liver enzymes Derm: rash, urticaria Hemat: blood dyscrasias Misc: ALLERGIC REACTIONS INCLUDING ANAPHYLAXIS, SERUM SICKNESS, superinfection Nursing Considerations: use cautiously in severe renal insufficiency, Infectious mononucleosis, acute lymphocytic leukemia, or cytomegalovirus infection |
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Amoxicillin
Nursing Considerations: tell patient finish drug completely. sharing med is dangerous. Assess for infection at beginning & throughout. Obtain a history before initiating therapy to determine previous use of & reactions to penicillins or cephalosporins. Observe for s/s of anaphylaxis (rash, pruritus, laryngeal edema, wheezing). Notify PCP immediately if these occur. |
Obtain specimens for culture and sensitivity prior to therapy. First dose may be given before receiving results.
Monitor bowel function. Diarrhea, abdominal cramping, fever, and bloody stools should be reported to health care professional promptly as a sign of pseudomembranous colitis. May begin up to several weeks following cessation of therapy. |
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Cardizem 180 mg QD
Class: Calcium Channel Blocker, antianginal, antihypertensives Indications: Hypertension, Angina pectoris & vasospastic (Prinzmetal's) angina, Supraventricular tachyarrhythmias and rapid ventricular rates in atrial flutter or afib. Action: Systemic vasodilation resulting in - BP. Coronary vasodilation resulting in - frequency & severity of attacks of angina. Reduction of ventricular rate in afib or flutter. Safe Dose:180–240 mg once daily as CD or XR capsules or LA tablets |
Side Effects:
CNS: abnormal dreams, anxiety, confusion, dizziness, drowsiness, headache, nervousness, psychiatric disturbances, weakness EENT: blurred vision, disturbed equilibrium, epistaxis, tinnitus Resp: cough, dyspnea CV: ARRHYTHMIAS, HF, peripheral edema, bradycardia, chest pain, hypotension, palpitations, syncope, tachycardia GI: ↑ liver enzymes, anorexia, constipation, diarrhea, dry mouth, dysgeusia, dyspepsia, nausea, vomiting |
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Cardizem
Side Effects Cont. Endo: gynecomastia, hyperglycemia Hemat: anemia, leukopenia, thrombocytopenia Metabolic: weight gain MS: joint stiffness, muscle cramps Neuro: paresthesia, tremor Misc: gingival hyperplasia GU: dysuria, nocturia, polyuria, sexual dysfunction, urinary frequency Derm: STEVENS-JOHNSON SYNDROME, dermatitis, erythema multiforme, flushing, sweating, photosensitivity, pruritus/urticaria, rash |
Med Interactions:
May ↑ digoxin levels. Concurrent use with beta blockers, clonidine, digoxin, disopyramide, or phenytoin may result in bradycardia, conduction defects, or HF. Grapefruit juice ↑ levels and effect. Nursing Considerations: check serum dig levels, assess all systems daily, I&O, can take w/ or w/o food, monitor ECG, assess for rash, comply w/ other hypertension interventions |
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Colace 50mg QD PO
Class: laxative, stool softener Promotes water into stool, resulting in softer feces. May also promote electrolyte and water secretion in colon Safe Dose: 50–400 mg in 1–4 divided doses Side Effects: EENT: throat irritation GI: mild cramps, diarrhea Derm: rashes No drug interactions |
Nursing Considerations:
Administer with a full glass of water or juice. May be administered on an empty stomach for more rapid results. laxatives should be used only for short-term therapy. Do not administer within 2 hr of other laxatives, especially mineral oil. Assess abdomen and stool |
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Coumadin 10 mg QD PO
Class: anticoagulant Action- Prevention of thromboembolic events Safe Dose:2–5 mg/day for 2–4 days; then adjust daily dose by results of INR Side Effects: GI: cramps, nausea Derm: dermal necrosis Hemat: BLEEDING Misc: fever |
Medication Interactions:
thrombolytics, NSAIDs, sulfonomides, chronic use of tylenol, and aspirin may + risk of bleeding Many other drugs interact with coumadin high vitamin K foods may antagonize anticoagulation Nursing Considerations: Monitor PT, INR & other clotting factors frequently, antidote is Vitamin K, have second practitioner check order before giving, monitor CBC, Stool, urine, hepatic function before and periodically |
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Depakene 500 mg BID PO
Class: anticonvulsants, vascular headache suppressant Safe Dose: not to exceed 60 mg/kg/day; when daily dose exceeds 250 mg, give in divided doses Nursing Considerations: CBC, platetlets, bleeding time, hepatic function, serum ammonia before and during. Administer w/ or immediately after meals to minimize GI irritation |
Side Effects:
CNS: SUICIDAL THOUGHTS, agitation, dizziness, headache, insomnia, sedation, confusion,depression CV: peripheral edema EENT: visual disturbances GI: HEPATOTOXICITY, PANCREATITIS, abdominal pain, anorexia, diarrhea, indigestion, nausea, vomiting, constipation, ↑ appetite Derm: alopecia, rashes Endo: weight gain Hemat: leukopenia, thrombocytopenia Metabolic: HYPERAMMONEMIA Neuro: HYPOTHERMIA, tremor, ataxia |
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Dyazide 37.5/25 mg QD PO
Class: diuretic potassium sparing/ antihypertensive/ thiazide diuretic Safe Dose: 25–100 mg/day, 12.5–100 mg/day in 1–2 doses Drug Interactions: Hypokalemia ↑ risk of digoxin toxicity Use with ACE inhibitors,indomethacin,angiotensin II receptor antagonists potassium supplements, or cyclosporine ↑ risk of hyperkalemia. Take in the morning |
Side Effects:
CNS: dizziness, drowsiness, lethargy, weakness CV: arrhythmias, hypotension GI: nausea, vomiting, hepatitis, anorexia, cramping GU: erectile dysfunction, bluish urine, nephrolithiasis Derm: photosensitivity, rash, Steven J S F and E: hyperkalemia, hyponatremia Hemat: blood dyscrasias MS: muscle cramps Misc: allergic reactions, pancreatitis |
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Digoxin 125 mcg QD PO
Class: anti-arrhythmic, intropics, digitalis glycosides Safe Dose: Maintenance dose –0.125–0.5 mg/day Action: Increased CO and slowing of the HR Side Effects: CNS: fatigue, headache, weakness EENT: blurred vision, yellow or green vision CV: ARRHYTHMIAS, bradycardia, ECG changes, AV block, SA block GI: anorexia, nausea, vomiting, diarrhea Hemat: thrombocytopenia Metabolic: electrolyte imbalances with acute dig tox |
Drug Interactions:
Thiazide and loop diuretics, piperacillin, ticarcillin, amphotericin B, corticosteroids, and excessive use of laxatives may cause hypokalemia which may ↑ risk of tox. Additive bradycardia may occur with B blockers. Thyroid hormones may ↓ thera effects. Nursing Implications: give 1 hr before or 2 hr after high fiber meal. monitor apical pulse full min before, withhold HR <60, falls risk, serum electrolytes, give with meal or fluid, assess for toxicity |
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Percocet
Class: Opioid analgesic, opioid agonist-nonopioid anagelsic combo Action: Binds to opiate receptors, decrease pain Indications: moderate to severe pain Onset: 10-15 minutes Peak: 60-90 minutes Contraindications: hypersensitivity to oxycodone or aspirin/acetaminophen/ibuprofen, bleeding disorders, liver or kidney disease, peptic ulcer disease, increased intracranial pressure Interactions: alcohol, antihistamines increase CNS depression, kava kava |
Adverse effects: confusion, sedation, dizziness, respiratory depression, constipation, orthostatic hypotension, dry mouth
Safe Dose: 5-10 mg q3-4hr Assessment: PQRSTU pain questions, pain rating, BP, pulse RR, bowel function, administer Narcan for toxicity overdose Administration: Can be given with food or milk Teaching: Call for assistance when ambulating, make position changes slowly, turn cough and breathe deeply every 2 hours |
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Gentamicin Sulfate Class: Antibiotic, antiinfective
Action: bactericidal action Indication: Treatment of serious bacterial infections when penicillins are contraindicated Onset: rapid Peak: 15-30 minutes Contraindications: Hypersensitivity to gentamicin or other aminoglycosides, renal impairment, hearing impairment Adverse effects: ataxia, vertigo, ototoxicity, nephrotoxicity, hypersensitivity reactions Interactions: inactivated by penicillins and cephalosporins in patients with renal insufficiency |
Safe Dose: IV: 1-2 mg/kg q8hr up to 6 mg/kg/day in 3 divided doses; once daily dosing: 4-7 mg/kg q 24 hr
Assessment: signs of infection, obtain specimen for C&S first, evaluate Cranial nerve VIII before & through therapy, monitor for vestibular dysfunction, monitor I&O & daily weight, assess for signs of superinfection, monitor urinalysis, specific gravity, BUN, creatinine, ALT, AST, bilirubin. Admin: Keep pt well hydrated, dilute dose in 50-200 mL of D5W or 0.9% NaCl, Infuse slow 30 min-2 hr. Teach: Report signs of hypersensitivity (tinnitus, rash, vertigo, dizziness), drink plenty of liquids. |
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Glucophage: Class: antidiabetics
Action: Decreases glucose production, increases sensitivity to insulin, maintenance of blood glucose Indications: Management of Type II DM Onset: unknown Peak: 4-8 hours Contraindications: hypersensitivity, metabolic acidosis, dehydration, kidney dysfunction, diagnostic procedures using IV contrast, HF, alcohol abuse Adverse effects: Abdominal bloating, diarrhea, nausea, vomiting, lactic acidosis, hypoglycemia |
Interactions: acute alcohol ingestion and IV contrast increase risk of lactic acidosis, digoxin, morphine, calcium channel blockers may compete for elimination pathways, furosemide may increase effects
Safe Dose: 500 mg BID up to 2000mg/day |
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Glucophage
Assessment: Observe for S/S of hypoglycemic reactions, assess for ketoacidosis or lactic acidosis in previously controlled patients who develop illness, monitor serum glucose, glycosylated hemoglobin periodically, BUN and creatinine, serum folic acid vitamin B12 |
Administration: Patients exposed to stress (surgery) may require insulin, administer with meals
Teaching: Follow prescribed diet, know S/S of hypoglycemia and hyperglycemia, test blood glucose, may cause unpleasant metallic taste, report stomach pain, diarrhea, nausea and vomiting to professional, carry a form of sugar and identification |
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Norvasc
Ther. Class: Antihypertensive (Ca Channel Blocker [-dipine]) - Ther. Effects: Systemic vasodilation (decreased bp), coronary vasodilation (decrease frequency and severity of anginal attacks. Used for Prinzmetals Angina. - Half-life: 30-50hr - Route: PO - Onset: Unknown - Peak: 6-9hr - Duration: 24hr - AR/SE: headache, peripheral edema |
- Implementation: May be administered without food.
- Pt./Fam. Teaching: Take as directed. Do not skip or double doses. Avoid large amounts of grapefruit juice (6-8 glasses/day). Monitor pulse correctly and contact HCP if <50bpm. Change position slowly. May cause drowsiness. Good dental hygiene important to prevent tenderness, bleeding, and gum enlargement. Wear sunscreen to prevent photosensitivity rxns. Can continue to take if on nitrate or beta blocker. Continue with other antihypertensive therapy such as diet and exercise and monitor bp if used for HTN. |
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Norvasc
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- Contraindications: Systolic BP <90, hx HF
- Interactions: Grapefruit juice increases effect - Dose: 2.5mg QD. This is a normal starting dose. Can take up to 10mg/day. - Assess: Monitor bp and pulse before therapy, during dose titration, and periodically during therapy. Monitor ECG periodically. Monitor I&O and daily wt. Assess for s/s of HF (peripheral edema, rales/crackles, dyspnea, wt. gain, jugular venous distention). Assess location, duration, intensity, and precipitating factors to anginal pain. - Labs: Total serum Ca concen. is not affected by Ca channel blockers. |
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Lipitor
Ther. Class: Lipid lowering agent (-statin) - Ther. Effects: Lowering of total cholesterol, LDL, and triglycerides (reducing risk of MI and stroke). Slightly increases HDL. Slows progression of coronary atherosclerosis. - Half-life: 14hr - Route: PO - Onset: Unknown - Peak: Unknown - Duration: 20-30hr following discontinuation |
- AR/SE: Abd. cramps, constipation, diarrhea, flatus, heartburn, rash, RHABDOMYOLYSIS, HYPERSENSITIVITY RXNS (ANGIONEUROTIC EDEMA), MUSCLE TENDERNESS.
- Dose: 20mg QD is a safe dose - Contraindications: Acute liver disease - Interactions: May slightly increase dig. levels. Grapefruit juice increases levels and risk of rhabdomyolysis. - Assess: Diet hx especially fat consumption |
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Lipitor
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- Labs: Serum cholesterol and triglycerides before therapy, 2-4wks after therapy begins, and periodically throughout therapy. Monitor AST and ALT prior to initiation. If muscle tenderness occurs, CPK levels should be monitored.
Implementation: May be given w/o food. Avoid grapefruit juice to decrease risk of tox. - Pt./Fam. Teaching: Take as directed. Do not skip dose or double dose. Avoid drinking more than 1 qt. of grapefruit juice/day. Should be used with exercise and diet restrictions and smoking cessation. Notify HCP if muscle pain, weakness, or tenderness occurs (esp. if with fever or malaise). |
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Lasix: Ther. Class: Diuretic (loop diuretic)
- Ther. Effects: Diuresis and subsequent mobilization of excess fluid (edema, pleural effusions). Decreased bp. - Half-life: 30-60min, Route: PO, Onset: 30-60min - Peak: 1-2hr, Duration: 6-8hr - AR/SE: STEVENS-JOHNSON SYNDROME, TOXIC EPIDERMAL NECROLYSIS, dehydration, hypocalcemia, hypochloremia, hypokalemia, hypomagnesemia, hyponatremia, hypovolemia, metabolic akalosis, APLASTIC ANEMIA, AGRANULOCYTOSIS. |
- Dose: 30mg BID Recommended as 20-80 mg/day which may be repeated 6-8hr later. 30mg BID for a total of 60mg daily is a safe dose.
- Contraindications: Cross sensitivity with thiazides and sulfonamides. - Interactions: Hypokalemia may increase risk of dig toxicity and arrhythmia. NSAIDs decrease effects. - Assess: Assess fluid status (monitor daily wt, I&O, edema, lung sounds, skin turgor, mucous membranes). Notify HCP if thirst, dry mouth, lethargy, weakness, hypotension, or oliguria occur. Monitor bp and pulse before and during admin. |
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Lasix
- Pt./Fam. Teaching: Take as directed. Do not double doses. Change positions slowly. High K diet. Contact HCP if weight gain of more than 3lbs/day. Use sunscreen to prevent photosensitivity rxns. **Contact HCP immediately if rash, muscle weakness, cramps, nausea, dizziness, numbness, or tingling extremities occurs. Diabetics should monitor glucose levels closely bc it may increase. |
**Assess pts. on dig. for anorexia, nausea, vomiting, muscle cramps, paresthesia, and confusion (dig toxicity bc of hypokalemia). Assess for tinnitus and hearing loss. **Assess for skin rash frequently. May be life threatening.
- Labs: Monitor for decreased electrolytes, renal and hepatic function (increased BUN, creatinine, and uric acid), and monitor for increased serum glucose. - Implementation: Give 2nd dose no later than 5pm to minimize disruption of sleep cycle. May be taken with food or milk. Tabs may be crushed. |
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Heparin -Ther. Class: Anticoagulant
- Ther. Effects: Prevention of thrombus formation and prevention of extension of existing thrombi. - Half-Life: 1-2hr, Route: SQ, Onset: 20-60min - Peak: 2hr, Duration: 8-12hr - AR/SE: BLEEDING, HEPARIN INDUCED THROMBOCYTOPENIA, anemia - Dose: 8.000 Units Q12h should really be given q8h. 1200 Units Q12h is a very low dose and not therapeutic. - Contraindications: Uncontrolled bleeding, severe thrombocytopenia, open wounds. |
- Interactions: Concurrent use of thrombolytic increases bleeding. Dig, tetracyclines, nicotine, antihistamines decrease effects.
- Assess: Signs of bleeding and hemorrhage (bleeding gums, nose bleed, bruising, black tarry stools, decreased hct or bp). Assess for thrombosis. Monitor pt. for chills, fever, urticaria. Observe inject site for hematomas, ecchymosis, or inflammation. - Labs: Monitor aPTT (30 min before each dose) and hct. Monitor platelet count every 2-3 days. - Implementation: Administer as deep tissue. Alternate sites btw arm |
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Lantus U100 Insulin - Ther. Class: Hormones
- Ther. Effects: Control of hyperglycemia in diabetics - Half-life: 5-6min, Route: SQ, Onset: 3-4hr - Peak: No peak (relatively constant effect over time) - Duration: 24hr - AR/SE: HYPOGLYCEMIA, ALLERGIC RXNS (ANAPHYLAXIS) - Dose: range is 2-100 units/day so dose of 6 units Qam is safe dosage. - Contraindications: Hypoglycemia |
- Interactions: Beta blockers mask s/s of hypoglycemia. Corticosteroids, thyroid supplements, estrogen may increase insulin requirements. Alc., Ace inhibitors (-prils), MAOIs may decrease insulin requirements.
- Assess: Symptoms of hypoglycemia include restlessness, tingling in hands and feet, chills, cold sweats, confusion, difficulty concentrating, drowsiness, nightmares, tremor, weakness. Symptoms of hyperglycemia include confusion, drowsiness, flushed dry skin, polyuria, unusual thirst. Monitor body weight periodically. |
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Lantus U100 Insulin
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- Pt./Fam. Teaching: Instruct proper administration and selection of injection site. Therapy is long term. Instruct proper glucose testing. Emphasize diet and exercise guidelines. Carry source of sugar and ID card.
- Antidote: IV glucose, glucagon, or epinephrine. - Precautions: High alert med BE CAREFUL. Do not mix with other insulins. Prior to withdrawing, rotate vial between palms. Store in cool place up to 28 days. - Labs: Monitor blood glucose every 6hr. A1C can be monitored every 3-6 months. |
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Imodium - Ther. Class: Antidiarrheals
- Ther. Effects: Relief of diarrhea. - Half-Life: 10.8hr - Route: PO - Onset: 1hr - Peak: 2.5-5hr - Duration: 10hr - AR/SE: drowsiness, constipation - Dose: 2mg after each loose stool is a safe dose - Contraindications: Abd. pain of unknown cause, alc. intolerance. - Interactions: Kava-kava, valeria, skullcap, chamomile, hops all increase CNS depression. |
- Assess: Frequency and consistency of stools and bowel sounds. Fluid and electrolyte balance. Skin turgor.
- Implementation: Administer with clear fluids to prevent dehydration. - Pt./Fam. Teaching: Frequent mouth rinses, good oral hygiene, sugarless gum/candy may relieve dry mouth. Avoid using alc. |
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Lopressor -Ther. Class: Antianginal, antihypertensive (beta blocker [metaprolol])
- Ther. Effects: Decreases bp and hr. Decreases frequency of angina pectoris. Decreases rate of cardiovascular mortality and hospitalization in pts. w/ heart failure. - Half-life: 3-7hr, Route: PO (max effects on bp may not occur for 1 week) - Onset: 15min, Peak: Unknown - Duration: 6-12hr - AR/SE: fatigue, weakness, BRADYCARDIA, HF, PULMONARY EDEMA, erectile dysfunction - Dose: 50mg QD this is a safe dosage. |
- Pt./Fam. Teaching: Instruct to take med at same time each day. Do not skip or double up on doses. Abrupt withdrawal may cause arrhythmias, hypertension, and myocardial ischemia. Check pulse daily and bp biweekly. May cause drowsiness. Change position slowly. Diabetics should monitor blood glucose more closely (med will not block sweating as a sign of hypoglycemia). Carry ID card. Continue additional therapies for hypertension (diet and exercise).
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Lopressor
Assess: Monitor bp, ECG, and pulse frequently. If hr is <40 administer atropine IV. Monitor I&O and daily wts. Assess routinely for s/s of HF (dyspnea, rales/crackles, wt gain, peripheral edema, jugular venous distention). Assess frequency and characteristics of anginal attacks. |
- Contraindications: Uncompensated HF, pulmonary edema, cardiogenic shock, bradycardia, heart block
- Interactions: Anesthesia, phenytoin, verapamil may increase myocardial depression. Concurrent admin of thyroid may decrease effectiveness. May alter effectiveness of insulin. - Labs: May increase BUN, K, blood glucose, AST, ALT, LDH, triglycerides, and uric acid. - Implementation: Take apical impulse before admin. If <50bpm or arrhythmic, withhold med and notify HCP. Admin with meals or directly after eating. ER tabs must be taken whole. |
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Morphine - Ther. Class: Opiod agonist
- Ther. Effects: Decrease in severity of pain. - Half-life: 2-4hr (adults), Route: IM or IV - Onset: 10-30min (IM) or rapid (IV) - Peak: 30-60min (IM) or 20min (IV) - Duration: 4-5hr for both routes - AR/SE: Confusion, sedation, RESPIRATORY DEPRESSION, hypotension, constipation - Dose: 4mg Q4h is a safe dose. Usual dose is 4-10mg Q3-4hr. - Contraindications: Use cautiously in head trauma, seizure, hypothyroidism, hx of substance abuse. |
- Interactions: Use with extreme caution in pts. receiving MAOIs w/i 14 days prior. Kava-kava, valerian, chamomile can increase CNS depression.
- Assess: Assess type, location, and intensity of pain prior to and 1hr (IM) or 20 (IV) following admin. **Assess level of consciousness, bp, pulse, and respirations before and periodically during admin. If RR is <10/min assess level of sedation. Prolonged use may lead to tolerance. Assess bowel function routinely. |
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Morphine
- Implementation: Do not confuse with hydromorphone. Have 2nd HCP check order, dosage calc, and infusion pump settings. Coadmin with nonopiod analgesics may permit lower dosing. |
- IV admin: solution should be colorless. dilute with at least 5mL of sterile water or 0.9% NaCl. Concentration is 0.5-5mg/mL. Administer 2.5-15mg over 5min. May be administered via PCA.
- Pt./Fam. Teaching: May cause drowsiness and dizziness. Change positions slowly. Avoid concurrent use with alc. or other CNS depressants. Turn, couch, breathe deeply every 2hr. - Antidote: Naloxone (Narcan) |
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Nitro Derm Patch- Ther. Class: Antianginals
- Ther. Effects: Relief or prevention of anginal attacks. Increase cardiac output. Reduced bp. - Half-life: 1-4min, Route: Patch, Onset: 40-60min - Peak: Unknown, Duration: 8-24hr - AR/SE: Dizziness, hypotension, tachycardia - Dose: 0.3mg/hr QD is a safe dose. Patch should be worn 12-14hr/day and taken off for 10-12hr/day. - Contraindications: Severe anemia, pericardial tamponade, constrictive peridcarditis. |
- Assess: Assess location, duration, intensity, and precipitating factors of anginal pain. Monitor bp and pulse before and after admin.
- Implementation: Rotate sites to prevent skin irritation. Remove patch and clean site before next application. Apply to any hairless site with firm pressure especially around edges. Apply a new does if the patch becomes loose or falls off. They are waterproof. Do not alternate brands between patches bc dosing may not be equal. Remove patch before MRI, cardioversion, or defibrillation to prevent burns. |
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Nitro Derm Patch
- Interactions: Concurrent use of nitrates in any form with sildenafil, taladafil, and vardenafil increase risk of potentially fatal hypotension. |
- Pt./Fam. Teaching: Take as directed. Take missed dose asap unless next dose is scheduled within 2hr. Do not discontinue abruptly. Change positions slowly. First dose should be taken while sitting. Avoid concurrent use of alc. Headache is common side effect and can take aspirin or acetaminophen. Notify HCP if headache is severe or persistent or if dry mouth or blurred vision occurs.
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NPH Insulin- Ther. Class: Antidiabetics, Hormones
Ther Effects: Control of hyperglycemia in diabetics - Half-life: Unknown, Route: SQ, Onset: 2-4hr - Peak: 4-10hr, Duration: 10-16hr - AR/SE: HYPOGLYCEMIA, ALLERGIES (ANAPHYLAXIS) - Contraindications: Hypoglycemia - Interactions: Beta blockers, clonidine, and reserpine may mask s/s of hypoglycemia. Coticosteroids, thyroid supplements, estrogens, may increase insulin requirements. Alc, ACE (-pril) inhibitors, MAOIs may decrease insulin requirements. |
- Labs: Monitor blood glucose every 6hr during therapy. A1C may be monitored every 3-6mo.
- Antidote: IV glucose, glucagon, or epinephrine - Implementation: Check type, dose, expiry with another licensed nurse. Do not confuse Humulin with Humalog or Novolin with Novolog. Rotate vial before withdrawing. **Administer within 30-60min before a meal. - Pt./Fam. Teaching: proper tech for administration. Discuss importance of not changing brands or sharing pens. Therapy is long term. Instruct proper blood glucose test and ketones. Importance of diet. Carry a source of sugar and ID card |
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NPH Insulin
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- Dose: 15 units Qam. Safe dosage is 0.5-1 unit total insulin/kg/day (dosing depends on wt. of pt.)
- Assess: Assess for s/s of hypoglycemia (restlessness, tingling, chills, cold sweats, confusion, difficulty concentrating, drowsiness, nightmares, tremors, weakness) and hyperglycemia (confusion, drowsiness, flushed dry skin, fruit like breath, polyuria, unusual thirst). Monitor body wt. |
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Potassium Chloride, Prendisone, Prilosec, Regular U100 Insulin, Rocephin, Synthroid, Toradol, Trivelent inactivated influenza vaccine, vancomycin, zithromax
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See Nursing Central 23-32
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Advil, Amoxicillin, Cardizem, Colace, Coumadin, Depakene, Dyazide, Digoxin, Percocet, Gentamicin sulfate, Glucophage
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See Nursing Central 1-11
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Heparin, Imodium, Lantis U100 Insulin, Lasix, Lipitor, Lopressor, Morphine, Nitro Derm Patch, Norvasc, NPH Insulin
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See Nursing Cental 12-22
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Heparin
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- Pt./Fam. Teaching: Report any unusual bleeding or bruising immediately. Do not take aspirin or NSAIDs while on heparin. Avoid activities leading to injury. Use soft tooth brush, and an electric razor.
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