NCLEX Meds Pt2

antiepileptics, acid controlling, GI, antihypertensives, antidysrhythmics, antipsychotics, antidepressants

which antiepileptic drugs require drug levels to be drawn?

phenytoin, carbamazepine, valproic acid, phenobarbital

hydantoins antiepileptic drug names

phenytoin, fosphenytoin

hydantoins antiepileptic drug considerations

gingival hyperplasia encourage good dental hygiene, phenytoin narrow therapeutic range (10-20mcg/mL), IV push slowly

Iminostilbenes antiepileptic names

carbamazepine, oxcarbazepine

Iminostilbenes antiepileptic considerations

risk for toxicity do not take carbamazepine with grapefruit juice

GABA analog meds name

gabapentin, pregabalin

GABA analog meds considerations

sedation avoid alcohol and activities requiring alertness

lamotrigine antiepileptic considerations

if you see a rash hold the med and notify HCP (steven johnson syndrome)

valproic acid antiepileptic and mood stabilizer considerations

increased risk for hepatotoxicity and pancreatitis

topiramate antiepileptic and used for migraines can cause?

significant weight loss

Levetiracetam antiepileptic nursing considerations

increases risk for behavioral changes assess for depression or SI

what is the drug of choice for status epilepticus?

lorazepam IV

acid controlling meds used to?

relieve symptoms of GERD and Peptic ulcer disease by decreasing or neutralizing stomach acid

proton pump inhibitors names

omeprazole, pantoprazole

proton pump inhibitors considerations

take daily before the first meal, increases risk for C.Diff infection and for fractures

H2 receptor blocker names

cimetidine, famotidine

H2 receptor blocker considerations

taken daily long term symptom management, cimetidine blocks liver enzymes increasing warfarin, phenytoin, and theophylline toxicity risk

antacid names

calcium carbonate, aluminum hydroxide, magnesium hydroxide

antacid considerations

taken PRN to neutralize stomach acid, SEPARATE from other meds by more than 1hr, use with caution in patients with HTN and HF bc they contain sodium

gastric protectant sucralfate considerations

take 1hr before meals and at bedtime to enhance effectiveness

misoprostol gastric protectant contraindicated in? and why?

pregnancy because it stimulates uterine contractions

what is a common side effect of antiemetics?

sedation and dizziness monitor closely to prevent falls and injury

serotonin antagonists odansetron considerations

monitor for QT prolongation increased risk for torsades de pointes, administer 30 mins before chemo

antidopaminergic antiemetics names

promethazine, prochlorperazine

antidopaminergic antiemetic considerations

monitor for EPS, extravasation of IV promethazine causes SEVERE tissue damage

prokinetic antiemetic metoclopramide considerations

tardive dyskinesia involuntary movements lip smacking, tongue protrusion, chewing motions, DO NOT GIVE for a bowel obstruction can cause perforation and sepsis

anticholinergics and antihistamines names

diphenhydramine, hydroxyzine, scopolamine

anticholinergics and antihistamines considerations

sedation, never give hydroxyzine IV or SUBQ severe tissue damage

bulk forming laxatives methylcellulose, psyllium considerations

mix with a full glass of water or juice to prevent obstruction

stimulant laxatives senna, bisacodyl

Avoid long-term use risk for dependence and electrolyte imbalances (hypokalemia)

osmotic laxatives lactulose, polyethylene glycol considerations

Monitor for dehydration and electrolyte imbalances.

emollient laxatives docusate, mineral oil

take with full glass of water

bismuth subsalicylate antidiarrheal can cause what harmless side effect? What can it cause in children?

blackening of stools and tongue is harmless, Reye syndrome avoid use in children with viral infections

beta blocker considerations

Can mask hypoglycemia, risk for bradycardia hold and notify HCP for HR < 60 bpm, bronchoconstriction avoid use in clients with asthma or COPD.

ace inhibitor names

lisinopril, enalapril, captopril

ace inhibitor considerations

Risk for angioedema facial swelling, stinging, or itching, and prepare to give epinephrine, dry cough not dangerous but common reason for discontinuation, teratogenic

angiotensin receptor blockers ARBs names and considerations

losartan, valsartan, less likely to cause hyperkalemia and cough

calcium channel blockers antihypertensive names and considerations

amlodipine, nifedipine avoid consuming grapefruit juice

what meds can be given for IV hypertensive emergencies?

hydralazine, sodium nitroprusside

sodium channel blockers names and used for what dysrhythmias?

quinidine, lidocaine, tachydysrhythmias (A-fib, V-tach)

sodium channel blockers considerations

quinidine QT prolongation and torsades de pointes, monitor ECG, lidocaine toxicity (neuro changes like agitation, confusion, ataxia, seizures)

potassium channel blocker name and what dysrhythmia is it used for?

amiodarone, used for tachydysrhythmias (V-tach, V-fib, A-fib)

potassium channel blocker considerations

risk for pulmonary toxicity obtain a chest x rar, monitor pulmonary function tests, report dyspnea or cough

calcium channel blockers used for dysrhythmia names and what is it used for?

diltiazem, verapamil, tachydysrhythmias (A-fib, A-flutter)

CCB dysrhythmia considerations

avoid grapefruit juice, increased risk for HF (dyspnea, edema, JVD)

adenosine causes?

brief asystole to reset the heart for symptomatic SVT, admin RAPID IV push (1-2s) and flush

Digoxin given for? and considerations?

to increase force of cardiac contractions and slows HR, used for A-fib and HF, check apical pulse hold <60bpm, monitor for toxicity (nausea, vision changes, bradycardia)

atropine used for?

treats symptomatic bradycardia by increasing HR