Mel's Nursing School Medications

Front 1

Cephalexin (Keflex)
-- Pharmacologic class
-- Therapeutic class
-- Pregnancy risk category
-- Controlled substance category

Back 1

Ph Cl: first-generation cephalosporin
Th Cl: antibiotic
PG Cl: B
CS Cl: N/A

Front 2

Cephalexin (Keflex)
-- Indications
-- Action

Back 2

Hinders or kills susceptible bacteria by inhibiting cell-wall synthesis. Broad spectrum antibiotic.

Front 3

Cephalexin (Keflex)
-- Typical dose adults

Back 3

250 mg p.o. q6hr--maximum 4 g daily.

Front 4

Cephalexin (Keflex)
-- Adverse Reactions

Back 4

anorexia, diarrhea, nausea, pseudomembranous colitis, thrombocytopenia, transient neutropenia, anaphylaxis

Front 5

Cephalexin (Keflex)
-- Nursing Process

Back 5

* to minimize GI reactions, give drug with food or milk
* instruct patient to take drug as prescribed even after he feels better

Front 6

Restoril (Temazepam) -- Pharmacologic class -- Therapeutic class -- Pregnancy risk category -- Controlled substance category

Back 6

Ph Cl: benzodiazepine
Th Cl: sedative-hypnotic
PG Cl: X
CS Cl: 4

Front 7

Restoril (Temazepam)
-- Indications -- Action

Back 7

Acts on limbic system, thalamus and hypothalamus of CNS to produce hypnotic/sleep results.

Front 8

Restoril (Temazepam)
-- Typical dose adults

Back 8

7.5 – 30 mg p.o. before bedtime

Front 9

Restoril (Temazepam)
-- Adverse Reactions / Drug Interactions

Back 9

Adverse Reactions: Daytime drowsiness, dizziness, abnormal dreams, headache
Drug Interactions: CNS depressants & opioid analgesics may increase depression—use w caution

Front 10

Restoril (Temazepam)
-- Nursing Process

Back 10

* watch patient doesn’t try to get out of bed and fall

Front 11

Zolpidem Tartrate (Ambien) -- Pharmacologic class -- Therapeutic class -- Pregnancy risk category -- Controlled substance category

Back 11

Ph Cl: imidazopyridine
Th Cl: hypnotic
PG Cl: B
CS Cl: N/A

Front 12

Zolpidem Tartrate (Ambien)
-- Indications -- Action

Back 12

Interacts w the benzodiapine receptor site on the GABA receptor to produce hypnotic effect—no muscle relaxant or anticonvulsant properties.

Front 13

Zolpidem Tartrate (Ambien)
-- Typical dose adults

Back 13

10 – 12.5 mg p.o. before bedtime

Front 14

Zolpidem Tartrate (Ambien)
-- Adverse Reactions / Drug Interactions

Back 14

Adverse Reactions: Daytime drowsiness, dizziness, abnormal dreams, headache
Drug Interactions: CNS depressants & opioid analgesics may increase CNS depression—use w caution

Front 15

Zolpidem Tartrate (Ambien)
-- Nursing Process

Back 15

* take on an empty stomach (immediately before bed) for max absorption
* short term drug
* watch patient doesn’t try to get out of bed and fall

Front 16

Ferrous Sulfate (Iron Supplement) -- Pharmacologic class -- Therapeutic class -- Pregnancy risk category -- Controlled substance category

Back 16

Ph Cl: oral iron supplement
Th Cl: hematinic
PG Cl: A
CS Cl: N/A

Front 17

Ferrous Sulfate (Iron Supplement)
-- Indications -- Action

Back 17

Binds to carrier protein (transferrin) then to bone marrow for incorporation into hemoglobin

Front 18

Ferrous Sulfate (Iron Supplement)
-- Typical dose adults

Back 18

150 -300 mg po daily in divided doses

Front 19

Ferrous Sulfate (Iron Supplement)
-- Adverse Reactions / Drug Interactions

Back 19

Adverse Reactions: Temporary staining of teeth; GI disturbance (nausea, vomiting, constipation, black stools)
Drug Interactions: Vit C increases absorption, avoid taking w dairy decreases absorption (also antacids, tetracycline)

Front 20

Ferrous Sulfate (Iron Supplement)
-- Nursing Process

Back 20

* Patient Ed: black stools & GI disturbance common
* Do not give with milk or antacids
*Vit C may increase absorption
* Best absorbed on an empty stomach but give w food b/c of GI disturbance

Front 21

Acetaminophen (Tylenol, APAP) -- Pharmacologic class -- Therapeutic class -- Pregnancy risk category -- Controlled substance category

Back 21

Ph Cl: para-aminophenol deriv
Th Cl: non-opioid analgesic; anti-pyretic

PG Cl: B
CS Cl: N/A

Front 22

Acetaminophen (Tylenol, APAP)
-- Indications -- Action

Back 22

Analgesia by inhibiting prostaglandin syn; anti-pyretic effect by acting on hypothalamic heat reg. center

Front 23

Acetaminophen (Tylenol, APAP)
-- Typical dose adults

Back 23

40 – 650 mg q 4-6 h prn
po or pr

Front 24

Acetaminophen (Tylenol, APAP)
-- Adverse Reactions / Drug Interactions

Back 24

Adverse Reactions: Liver damage; hypoglycemia, blood cell damage
Drug Interactions: warfarin increased risk of bleeding;

Front 25

Acetaminophen (Tylenol, APAP)
-- Nursing Process

Back 25

* Tell patient for short term use only (od or lt use can cause liver damage)
* Not for fever over 103.1, lasting longer than 3 days or recurring

Front 26

Acetylsalicylic Acid (aspirin) Pharmacologic class -- Therapeutic class -- Pregnancy risk category -- Controlled substance category

Back 26

Ph Cl: salicylate
Th Cl: non-opioid analgesic; antiplatelet drug; anti-pyretic;anti-inflammatory

PG Cl: C / D in 3rd Trimester
CS Cl: N/A

Front 27

Acetylsalicylic Acid (aspirin)
-- Indications -- Action

Back 27

Analgesia and anti-inflammatory effects by inhibiting prostaglandin syn; anti-pyretic effect by acting on hypothalamus to cause vasodilation

Front 28

Acetylsalicylic Acid (aspirin)
-- Typical dose adults

Back 28

325 – 650 mg q 4-6 h prn
po or pr (80 mg prophylaxis)

Front 29

Acetylsalicylic Acid (aspirin)
-- Adverse Reactions / Drug Interactions

Back 29

Adverse Reactions: GI bleeding, GI distress, tinnitus (hearing loss), Reyes Syndrome, angioedema, anaphylaxis, thrombocytopenia
Drug Interactions: warfarin and heparin increased risk of bleeding;

Front 30

Acetylsalicylic Acid (aspirin)
-- Nursing Process

Back 30

* Give with food, milk, antacid or large glass H20 to minimize GI disturbance
* Best absorbed on an empty stomach but give w food b/c of GI disturbance

Front 31

Nitroglycerin
Pharmacologic class -- Therapeutic class -- Pregnancy risk category -- Controlled substance category

Back 31

Ph Cl: nitrate
Th Cl: antianginal; vasodilator
PG Cl: C
CS Cl: N/A

Front 32

Nitroglycerin
-- Indications -- Action

Back 32

Acts on vascular smooth muscle tissue of VEINS; decreases cardiac oxygen demand by decreasing diastolic pressure; increases blood flow through CORONARY vessels increasing oxygen supply

Front 33

Nitroglycerin
-- Typical dose adults

Back 33

SL 0.3 – 0.6 mg q5 min for up to 15 min.

Front 34

Nitroglycerin
-- Adverse Reactions / Drug Interactions

Back 34

Adverse Reactions: GI bleeding, GI distress, tinnitus (hearing loss), Reyes Syndrome, angioedema, anaphylaxis, thrombocytopenia
Drug Interactions: interactions w other hypertensives can decrease bp too much

Front 35

Nitroglycerin
-- Nursing Process

Back 35

* monitor vital signs & drug response (esp bp—excessive hypotension may worsen MI)
* take drug regularly, keep handy, do not abruptly stop
* use lowest dose to avoid building up tolerance to drug

Front 36

Digoxin (Lanoxin)
Pharmacologic class -- Therapeutic class -- Pregnancy risk category -- Controlled substance category

Back 36

Ph Cl: cardiac glycoside
Th Cl: anti-arrhytmic; inotropic
PG Cl: C
CS Cl: N/A

Front 37

Digoxin (Lanoxin)
-- Indications -- Action

Back 37

Strengthens myocardial contractions by acting on CNS to enhance vagal tone (slowing through SA / AV nodes, resulting in an anti-arrythmic effect

Front 38

Digoxin (Lanoxin)
-- Typical dose adults

Back 38

p.o. 0.05 – 0.5 mg for slow effect; 0.75 – 1.25 mg for rapid effect

Front 39

Digoxin (Lanoxin)
-- Adverse Reactions / Drug Interactions

Back 39

Adverse Reactions: nausea, vomiting, anorexia, visual disturbances
Drug Interactions: avoid antacids (decrease absorption), avoid diuretics and corticosteroids that lower K level (precipitating toxicity)

Front 40

Digoxin (Lanoxin)
-- Nursing Process

Back 40

* monitor vital signs & drug response (must check apical pulse: ok between 60 – 100 bpm)
* blood serum level of digoxin 0.5-2 ng/ml
* low K levels can precipitate toxicity: instruct patient to eat foods high in K

Front 41

Furosemide (Lasix)
Pharmacologic class -- Therapeutic class -- Pregnancy risk category -- Controlled substance category

Back 41

Ph Cl: loop diuretic
Th Cl: diuretic; anti-hypertensive
PG Cl: C
CS Cl: N/A

Front 42

Furosemide (Lasix)
-- Indications -- Action

Back 42

Inhibits NaCl reabsorption (at the loop of henle) & promotes H20 and NaCl excretion (also K, Ca, Mg)

Front 43

Furosemide (Lasix)
-- Typical dose adults

Back 43

p.o, iv or im usual initial 20 – 80 mg bid

Front 44

Furosemide (Lasix)
-- Adverse Reactions / Drug Interactions

Back 44

Adverse Reactions: hyperglycemia, hypotension, hypokalemia,
Drug Interactions: may intensify other hypotensive therapies, decreases hypoglycemic effects of antidiabetics, effects blunted by NSAIDS

Front 45

Furosemide (Lasix)
-- Nursing Process

Back 45

* avoid giving at night--nocturia
* encourage foods high in K

Front 46

Enalaprilat (Vasotec)
Pharmacologic class -- Therapeutic class -- Pregnancy risk category -- Controlled substance category

Back 46

Ph Cl: ACE inhibitor
Th Cl: anti-hypertensive
PG Cl: C / D (2nd/3rd Trimester)
CS Cl: N/A

Front 47

Enalaprilat (Vasotec)
-- Indications -- Action

Back 47

Decrease of angiotensin 2 levels: vasodilation, decr blood volume Increase of bradykinin levels: vasodilation, cough, risk of angioedema

Front 48

Enalaprilat (Vasotec)
-- Typical dose adults

Back 48

Initially 5 mg po daily; usual dose 10 – 40 mg daily

Front 49

Enalaprilat (Vasotec)
-- Adverse Reactions / Drug Interactions

Back 49

Adverse Reactions: cough, angioedema, first-dose hypotension, hyperkalemia,Drug Interactions: may intensify other hypotensive therapies, decreases hypoglycemic effects of antidiabetics, effects blunted by NSAIDS

Front 50

Enalaprilat (Vasotec)
-- Nursing Process

Back 50

* obtain bp history before starting therapy; monitor K intake and serum K level
* educate patient about signs of angioedema (breathing difficulty, swollen lips & tongue)

Front 51

Nifedipine (Procardia)
Pharmacologic class -- Therapeutic class -- Pregnancy risk category -- Controlled substance category

Back 51

Ph Cl: calcium channel blocker
Th Cl: anti-anginal
PG Cl: C
CS Cl: N/A

Front 52

Nifedipine (Procardia)
-- Indications -- Action

Back 52

Reduces B.P. and prevents angina by blocking calcium channels in peripheral arterioles lowering arterial pressure. Decreases myocardial contractility and O2 demand.

Front 53

Nifedipine (Procardia)
-- Typical dose adults

Back 53

p.o. 10 – 60 mg daily

Front 54

Nifedipine (Procardia)
-- Adverse Reactions / Drug Interactions

Back 54

Adverse Reactions: dizziness, headache, light-headedness, flushing, heart failure, MI, hypokalemia, pulmonary edema
Drug Interactions: quinidine, betablockers: cause hypotension DO NOT USE WITH magnesium sulfate

Front 55

Nifedipine (Procardia)
-- Nursing Process

Back 55

* monitor bp regularly; monitor K levels
* when quick response to drug needed: have patient bite and swallow capsule: monitor bp and ekg
* temporary worsening of angina may occur at onset of therapy
* ghost capsule may appear in stools

Front 56

Aluminum Hydroxide (Amphojel)
-- Pharmacologic class -- Therapeutic class -- Pregnancy risk category -- Controlled substance category

Back 56

Ph Cl: aluminum salt
Th Cl: antacid
PG Cl: C
CS Cl: N/A

Front 57

Aluminum Hydroxide (Amphojel)
-- Indications -- Action

Back 57

Relieves GI discomfort by reducing total acid load in GI tract, elevation in pH reduces pepsin activity; relief from peptic ulcer

Front 58

Aluminum Hydroxide (Amphojel)
-- Typical dose adults

Back 58

p.o. 300 – 600 mg DO NOT GIVE WITH OTHER ORAL DRUGS

Front 59

Aluminum Hydroxide (Amphojel)
-- Adverse Reactions / Drug Interactions

Back 59

Adverse Reactions: Anorexia, constipation, intestinal obstruction
Drug Interactions: interferes with absorption

Front 60

Aluminum Hydroxide (Amphojel)
-- Nursing Process

Back 60

* assess patient comfort before and after
* do not give w/in 2 hours of another drug
* patient education: stools might have white streaks, shake suspension well and follow with a drink, how to avoid constipation
* patients on low sodium diets need to use cautiously

Front 61

SIDE EFFECTS OF INSULIN: describe the signs/symptoms of hypoglycemia

Back 61

* blood glucose under 50 mg/dL
* rapid drop in blood sugar may include: tachycardia, palpitations, sweating, nervousness
* more gradual decrease in blood sugar may include: confusion, fatigue, drowsiness, headache, excessive hunger

Front 62

SIDE EFFECTS OF INSULIN: describe the signs/symptoms of hyperglycemia

Back 62

* polyuria
* polydipsia
* ketonuria
* weight loss

Front 63

SHORT ACTING: REGULAR/SEMILENTE INSULIN
1) Time of Onset
2) Peak time
3) Duration

Back 63

1) Time of Onset: 30 - 60 min.
2) Peak time: 1 - 5 hours
3) Duration: 6 - 10 hours

Front 64

INTERMEDIATE ACTING (NPH/LENTE) INSULIN
1) Time of Onset
2) Peak time
3) Duration

Back 64

1) Time of Onset 1 - 2 hours
2) Peak time: 6-14 hours
3) Duration: 16 - 24 hours

Front 65

LONG ACTING (PZI/ULTRA LENTE)INSULIN
1) Time of Onset
2) Peak time
3) Duration

Back 65

1) Time of Onset: over 1 hour
2) Peak time: None
3) Duration 24 hours