Jules ***printed 9/9 Cards***

Front 1

Vistaril
Generic name-Hydroxyzine Trade names-Apo-Hydroxyzine, Atarax, Hyzine-50, Multipax, Novohydroxyzin
Classification-Therapeutic: antianxiety agents, antihistamines, sedative/hypnotics

Back 1

Indications: Treatment of anxiety. Preoperative sedation. Antiemetic. May be combined with opioid analgesics.
Route/Dosage: PO: Antianxiety-25-100 mg qid, not to exceed 600 mg/day. Preoperative sedation-50-100 mg single dose. Anti-pruritic-25 mg 3-4 times daily. IM- Preoperative Sedation-25-100 mg single dose. Antiemetic, adjunct to opioid analgesics-25-100 q 4-6 hr as needed.
Nursing Indications-Assess pt. for profound sedation and provide safety precautions (side rails up, etc.) Older pts.more sensitive to CNS and delirium, acute confusion, dizziness, tachycardia, dry mouth, urinary retention, constipation. Assess mental status. Assess degree of nausea and freq. and amnt. of emesis. Assess degree of itching. May cause false negative results of allergen extracts.Tablets can be crushed and capsules can be opened. IM injection is extremely painful. Inject into well developed muscle.
Side Effects/Toxic Effects: Drowsiness, agitation, wheezing, pain and abscesses at IM site, chest tightness. CNS depression with other CNS depressants. Can antagonize the effects of Epinephrine.

Front 2

Aldomet (Trade and Generic Names: Methyldopa, Apo-Methyldopa, Dopamet, Novamedopa, NuMedopa
Classification-Therapeutic: Antihypertensives
Pharmacologic: Centrally acting antidrenergics

Back 2

Indications-Management of moderate to severe hypertension (w/ other agents).
Route/Dosage-PO: 25-500 mg 2-3 times daily (not to exceed 500 mg/day if used with other agents); may be increased q 2 days as needed; usual maintenance dose is 500 mg-2g/day ( not toe exceed 3 g/day)
IV: 250-500 mg q 6 hr ( up to 1 g q 6 hr)
Nursing Indications: Monitor BP and pulse frequently. Monitor frequency of prescription refills to monitor compliance. Monitor intake and output ratios and assess for edema daily. Assess for depression or other changes in mental status. Monitor temp. during therapy. Monitor hepatic function if unexplained fever. Monitor renal, hepatic and CBC labs before and during therapy. Monitor direct Coombs test. May cause prolonged prothrombin time.
Side or Toxic Effects: Sedation, decreased mental acuity, depression, nasal stuffiness, bradycardia, edema, orthostatic hypotension, diarrhea, dry mouth, erectile dysfunction, drug induced hepatitis, anemia, fever

Front 3

Aspirin (Generic and Trade Names: ApoASA, ApoASEN, Arthrinol, Arthrisin, Artria S.R., ASA, Asaphen, Ascriptin, Aspercin, Aspergum, Aspirtab, Astrin, Bayer Aspirin, Bufferin, Coryphen, Easprin, Ecotrin, Entrophen, Genacote, Halfprin, Headache tablets, Healthprin, Novasen, PMS-ASA, Rivasa, St. Joseph Adult Chewawble Aspirin, ZORprin
Classification: Therapeutic-antipyretics, nonopioid analgesics
Pharmacologic- salicylates

Back 3

Indications: Inflammatory disorders including: Rheumatoid Arthritis, Osteoarthritis, Mild to moderate pain, fever, Prophylaxis of transient ischemic attacks and MI.
Route/Dosage: Pain/Fever-PO, Rect: 325-1000 mg q 4-6 hr (not to exceed 4 g/day). Extended-release tablet-650 mg q 8 hr or 800 mg q 12 hr.
Inflammation: PO- 2.4 g/day initially; increased to maintenance dose of 3.6-5.4 g/day in divided doses (up to 7.8 g/day for acute rheumatic fever).
Prevention of Transient Ischemic Attacks: PO- 50-325 mg once daily
Prevention of Myocardial Infarction: PO- 80-325 mg once daily.
Special Nursing Implications: Pts. who have asthma, allergies, and nasal polyps or who are allergic to tartrazine are at increased risk for develping hypersensitive reactions. Assess pain and limitation of movement, assess fever, monitor hepatic function before antirheumatic therapy, if severe abnormalities or active liver disease occur discontinue use. Monitor serum salicylate levels. Prolongs bleeding time and may cause prolonged prothrombin time. Assess for GI blood loss. Monitor for onset of tinnitus, headache, hyperventilation, agitation, mental confusion, lethargy, diarrhea, and sweating (signs of overdose)
Side Effects/Toxic Effects: Above named as well as dyspepsia, anorexia, exfoliative dermatitis, stevens-johnson syndrome, anemia, hemolysis, increased bleeding time, laryngeal edema and alaphylaxis

Front 4

Digoxin (Generic and Trade Names: Digitek, Lanoxicaps, Lanoxin
Classification: Therapeutic- antiarrythmics, inotropics
Pharmacologic: Digitalis glycosides

Back 4

Indications: Treatment of CHF. Tachyarrythmias: Atrial fibrillation and atrial flutter, Paroxysmal atrial tachycardia.
Route/Dosage: IV: Digitalizing dose-0.5-1mg given as 50% of the dose initially and one quarter of the initial dose in each of two subsequent doses at 6-12 hr intervals.
PO: Digitalizing dose-0.75-1,5 mg given as 50% of the dose intially and one quarter of the initial dose in each of 2 subsequent doses at 6-12 hr intervals. Maintenance dose-0.125-0.5 mg/day as tablets or 0.350-0.5 mg/day as tablets or 0.350-0.5 mg/day as gelatin capsules, depending on pts lean body weight, renal function and serum level.
PO (Geriatric)-Daily dosage should not exceed 0.125 mg except when treating atrial fibrilation.
Special Nursing Indications: Monitor apical pulse for full minute before administering. Withhold dose and notify physician if bpm is <60. Monitor ECG throughout IV administration and 6 hours after each dose, observe IV site for redness or infiltration, extravasation can lead to tissue irriation and sloughing, monitor intake and output ratios and daily weight, assess for peripheral edema and auscultate lungs for rales and crackles, before administering initial dose determine if pt. has taken any digitalis precautions in preceding 2-3 wks. Assess for fall risk in elderly as this can increase risk of falls, evaluate serum electrolyte levels, notify health care professional before giving dose if pt. is hypokalemic.
Side Effects/Toxic Effects: fatigue, headache, weakness, blurred vision, yellow or green vision, bradycardia, ECG changes, A-V block, S-A block, anorexia, nausea, vomiting, diarrhea, gynecomastia, thrombocytopenia,, electrolyte imbalances with acute digoxin toxicity.

Front 5

Vitamin B12 (Generic and Trade Names: Cyanocobalamin, Nascobal, Rubramin PC Hydroxocobalamin, Cyanokit
Classification: Therapeutic- antianemics, vitamins
Pharmacologic- water soluble vitamins

Back 5

Indications: Vitamin B12 deficiency (perenteral product or nasal spray should be used when deficiency is due to malabsorption. Pernicious anemia (only parenteral products should be used for initial therapy), Part of the Schilling test (Vit. B12 absorption test) (diagnostic). Cyanide poisoning (Cyanokit only).
Route/Dosage: Oral products usually not recommended due to poor absorption, should be used if pt. refuses other routes.
PO: Vit. B12 deficiency-amnt. depends on deficiency (up to 1000 mcg/day have been used), Pernicious Anemia--1000-2000 mcg/day
IM, Subcut: Vit.B12 deficiency-30 mcg a day for 5-10 days then 100-200 mcg/month, Pernicious Anemia-100 mcg/day for 6-7 days, if improvement give same for every other day for 7 doses, then every 3-4 days for 2-3 weeks, once remission occurs can give maintenance dose of 100/mcg a month or up to 1000 mcg a month, Schilling test-flushing dose is 1000 mcg.
Intranasal: Vit. b12 deficiency-500 mcg (one spray) in once nostril once weekly, Pernicious anemia- 500 mcg (one spray) in one nostril once weekly.
Hydroxocobalamin-IM: Vitamin B12 deficiency-30 mcg/day for 5-10 days, then 100-200 mcg/month, Pernicious anemia-100 mcg/day for 6-7 days, if improvement give same dose every other dose for 7 doses, then every 3-4 days for 2-3 wks, once remission occurs give maintenance dose of 100 mcg/mnth, Schilling test-flushing dose is 1000 mcg.
IV (cyanide poisoning)-(cyanokit only)-5g over 15 min.,another 5 g dose may be infused over 15-120 min. depending upon severity of poisoning (max. cumulative dose=10 g).
Special Nursing Indications: Assess pts. for signs of Vit. B12 deficiency (pallor, neuropathy, psychosis, red inflamed tongue) before and during therapy. Monitor plasma, folic acid, Vit. B12 and Iron levels, hemoglobin, hematocrit and reticulocyte count before treatment.
Side Effects/Toxic Effects: headache, heartfailure (Cyanokit: dizziness, memory impairment and restlessness, hypertension, chest pain, tachycardia, dry throat, nausea, vomiting, rash, red urine, dyspnea), diarrhea and itching, hypokalemia, thrombocytosis and pulmonary edema.

Front 6

Doxyciline (Generic and Trade names: Adoxa, Apo-Doxy, Doryx, Doxy, Doxycin, Doxytab, Monodox, Novodoxylin, Nu-Doxycycline, PMS-Doxycycline, Ratio-Doxycycline, Vibramycin, Vibra-tabs
Classification: Therapeutic- anti-infectives

Back 6

Indications: Treatment of various infections caused by unusual organisms, including : Mycoplasma, Chlamydia, Rickettsia, Borellia burgdorferi. Treatment of gonorrhea and syphilis in penicillin-allergic patients. Prevention of exacerbations of chronic bronchitis. Treatment of inhalational anthrax (postexposure) and cutaneous anthrax (doxycycline only). Treatment of acne.
Route/Dosage: PO-most infections-100 mg q 12 hr on the 1st day, then 100-200 mg once daily or 50-100 mg q 12 hr. Gonorrhea-100 mg q 12 hr for 7 days or 300 mg followed 1 hr later by another 300 mg dose. Malaria prophylaxis-100 mg once daily. Lyme disease-100 mg twice daily. Periodontis-20 mg twice daily. Anthrax-100 mg twice daliy for 60 days.
IV-200 mg once daily or 100 mg q 12 hrs on the 1st day, then 100-200 mg once daily or 50-100 mg q 12 hours. Anthrax-100 mg q 12 hrs change to oral when appropriate for 60 days.
Nursing Indications: Assess for infection at beginning and throughout therapy (vital signs, appearance of wound, urine, stool, wbc), obtain specimens for culture before initiating therapy, assess IV site frequently, monitor renal and hepatic function and CBC periodically.
Side Effects/Toxic Effects: Benign intracranial hypertension, diarrhea, nausea, vomiting, esophagitis, hepatotoxicity, pancreatitis, photosensitivity, rashes, blood dyscrasias, phlebitis at IV site, hypersensitivity reaction, superinfection.

Front 7

Tagamet (Generic and Trade Names: Cimetidine, Apo-Cimetidine, Dom-Cimetidine, Gen-Cimetidine, Novo-Cimetidine, Nu-Cimet, PMS-Cimetidine,Tagamet HB
Classification: Therapeutic- antiulcer agents
Pharmacologic: histamine H2 antagonists

Back 7

Indications: Short-term treatment of active duodenal ulcers and benign gastric ulcers. Maintenance therapy for duodenal and gastric ulcers after healing of active ulcers. Management of GERD. Treatment of heartburn, acid indigestion and sour stomach (OTC use). Management of gastric hypersecretory states, prevention and treatment of stress induced upper GI bleeding in critically ill pts, management of GI symptoms associated with the use of NSAIDs, prevention of acid inactivation of supplemental pancreatic enzymes in pts with pancreatic insufficiency. Management of urticaria.
Route/Dosage: PO-Short term treatment of active ulcers: 300 mg 4 times dally or 800 mg at bedtime or 400-600 mg twice daily (not to exceed 2.4 g/day) for up to 8 wk. Duodenal ulcer prophylaxis-300 mg twice daily or 400 mg at bedtime, GERD-400 mg q 6 hr or 800 mg twice daily for 12 wk. Gastric hypersecretory conditions-300-600 mg q 6 hr ( up to 2400 mg a day) OTC use-up to 200 mg may be taken twice daily for not more than 2 wk.
IM/IV: Short term treatment of active ulcers-300 mg q 6 hr ( not to exceed 2.4 g/day), Continuous IV Infusion-900 mg infused over 24 hrs (37.5 mg/hr), may be preceded by a 150-mg bolus dose. Gastric hypersecretory conditions-300-600 mq 6 hr (not to exceed 2.4 g/day). Prevention of upper GI bleeding in crit. ill pts.-50 mg/hr.
Renal Impairment-IV, PO-CCr 10-50 ml/min-administer 50% of normal dose, CCr <10 ml/min-administer 25% of normal dose, Prevention of upper GI bleeding in crit. ill pts if CCr is <30 ml/min-25 mg/hr.
Nursing Indications: Assess for epigastric or abdominal pain, frank or occult blood in the stool, emisis of gastric aspirate, assess Geriatric and debilitated pts routinely for confusion, monitor CBC with differential periodically throughout therapy, may cause false neg. results in skin tests using allergen extracts, administer with meals or immediately after to prolong effect.
Side Effects/Toxic Effects- Confusion, dizziness, drowsiness, hallucinations, headaches, arrythmias, constipation, diarrhea, drug-induced hepatitis, nausea, decreased sperm count, erectile dysfunction, gynecomastia, anemia, neutropenia, thrombocytopenia, pain at IM site, hypersensitivity reactions and vasculitis.

Front 8

Procainamide (Pronestyl)
Classification: Therapeutic- antirrhythmics (class 1A)

Back 8

Indications: Treatment of a wide variety of ventricular and atrial arrhythmias, including: ATrial premature contractions, Premature ventricular contractions, Ventricular tachycardia, Paroxysmal atrial tachycardia. Maintenance of normal sinus rhythm after conversion from atrial fibrilation or flutter.
Route/Dosage: IM-50 mg/kgday in divided doses q 3-6 hrs
IV-100 mg q 5 min until arrhythmia is abolished or 1000 mg have been given; wait at least ten minutes until further dosing or loading infusion of 500-600 mg over 30-60 min followed by maintenance infusion of 1-4 mg/min.
Nursing Indications: Monitor ECG, pulse and BP continuously throughout IV administration. IV admin. is discontinued usually if arrhythmia is resolved, QRS complex widens by 50%, PR interval is prolonged, BP drops >15mm Hg or toxic side effects develop. Pt. should remain suppine throughout admin. to minimize hypotension. Monitor CBC every two weeks. May cause low leukocyte, neutrophil and platelet counts. Monitor ANA periodically or if lupus like reaction occurs.
Side Effects/Toxic Effects: SIgns of toxicity are confusion, drowsiness, decreased urination, nausea, vomiting and tachyarrhthmias. Side effects include seizures, confusion, dizziness, heart block, asystole, hypotension, diarrhea, anorexia, bitter taste, nausea, vomiting, rashes, chills, drug induced systemic lupus, fever, leukopenia, thrombocytopenia and eosinophilia.

Front 9

Empirin Compound (Aspirin, Paracetamol, Caffeine)

Back 9

Indications: For symptomatic relief of pain, fever associated with acute & chronic rheumatism, dysmenorrhoea, neuralgia, tonsillitis, influenza, coryza, headaches.
Route/Dosage: PO-1-2 tabs four times a day