Medications

What is the therapeutic use for aspirin?

Antiplatelet agent to reduce risk of stroke, MI, and blood clots.

What is the mechanism of actuion for aspirin?

Prevents platelet aggregation

What are some nursing considerations for aspirin?

Monitor for signs of bleeding (e.g., GI bleeding, bruising), take with food to minimize gastric irritation.

What are some adverse effects of aspirin?

GI ulcers and bleeding, tinnitus, increased bleeding risk.

What is the therapeutic use for Rivaroxaban (Xarelto)?

Prevention and treatment of DVT/PE, stroke prevention in A-Fib

What is the mechanism of action for rivaroxoban (xarelto)?

Direct Factor Xa inhibitor, preventing thrombin formation and clot development.

What are some nursing considerations for rivaroxaban (xarelto)?

No routine coagulation monitoring required, avoid in patients with renal/hepatic impairment, administer with food to improve absorption.

What is the reversal agent for rivaroxaban (xarelto)?

Andexanet alfa

What are some adverse effects for rivaroxaban (xarelto)?

Bleeding, elevated liver enzymes.

What is the therapeutic use for Apixaban (Eliquis)?

Stroke prevention in A-Fib, prevention and treatment of DVT/PE.

What is the mechanism of action for apixaban (eliquis)?

Direct Factor Xa inhibitor, preventing clot formation.

What are some nursing considerations for apixaban (eliquis)?

No routine coagulation monitoring needed, lower bleeding risk, take consistently at the same time each day.

What is the reversal agent for apixaban (eliquis)?

Andexanet alfa

What are some adverse effects of apixaban (eliquis)?

Bleeding risk, nausea, anemia.

What is the mechanism of action for ondanestron (zofran)?

Prevention and treatment of CINV

What is the mechanism of action for ondanestron (zofran)?

Selective serotonin receptor antagonist, blocking nausea signals in the brain.

What are some nursing consideratians for ondanestron (zofran)?

Monitor for QT prolongation, Administer 30 minutes before chemotherapy or surgery.

What are some adverse effects of ondanestron (zofran)?

Headache, dizziness, constipation or diarrhea, QT prolongation

What is the therapeutic use of filgrastim (neupogen)?

Stimulates neutrophil production in neutropenic patients

What is the mechanism of action for filgrastim?

Granulocyte colony-stimulating factor that promotes neutrophil proliferation and differentiation.

What are some nursing considerations for filgrastim (neupogen)?

Monitor Absolute Neutrophil Count (ANC) levels, administer at least 24 hours after chemotherapy; store in the refrigerator, do not shake vial.

What are some adverse effects of filgrastim (neupogen)?

Bone pain, leukocytosis if overused.

What is the therapeutic use of epoeitin alfa (epogen)?

Stimulates RBC production for chemotherapy-induced anemia

What is the mechanism of action for epoetin alfa (epogen)?

Synthetic erythropoietin that stimulates bone marrow RBC production.

What are some nursing considerations for epoeitin alfa (epogen)?

Monitor hemoglobin (Hgb) levels—should not exceed 11 g/dL (risk of thrombosis); contraindicated in uncontrolled hypertension; do not shake vial (protein denaturation).

What are some adverse effects of epoetin alfa (epogen)?

Hypertension, increased risk of thromboembolism

What is the therapeutic use of ferrous sulfate?

Prevention and treatment of iron-deficiency anemia.

What is the mechanism of action for ferrous sulate?

Provides elemental iron for hemoglobin and RBC synthesis.

What are some nursing considerations for ferrous sulfate?

Best absorbed on an empty stomach with vitamin C (avoid dairy), causes black stools, take 2 hours apart from antacids, calcium, or tetracyclines

What are some adverse effects of ferrous sulfate?

Constipation, GI upset, nausea.

What is the therapeutic use of iron dextran?

Treatment of severe iron deficiency anemia (when oral iron is ineffective or not tolerated).

What is the mechanism of action for iron dextran?

Restores iron stores for hemoglobin production.

What are some nursing considerations for iron dextran?

Administer test dose before full infusion, monitor for hypotension and allergic reactions.

What are some adverse effects for iron dextran?

Hypotension, flushing, anaphylaxis

What is the therapeutic use of cyanacobalamin (vitamin B12)

Treatment of Vitamin B12 deficiency anemia

What is the mechanism of action for cyanocobalamin (vitamin B12)?

Essential for RBC production, DNA synthesis, and nerve function.

What are some nursing considerations for cyanocobalamin (vitamin B12)?

IM injection required for pernicious anemia (lifelong therapy), monitor for hypokalemia after initiating treatment.

What are some adverse effects of cyanocobalamin (vitamin B12)?

Hypokalemia, injection site pain.

What is the therapeutic use for heparin sodium (unfractionated heparin)?

Prevention and treatment of thromboembolic disorders (DVT, PE, MI, stroke).

What is the mechanism of action for heparin sodium (unfractionated heparin)?

Binds to antithrombin III, inactivating Factor Xa and thrombin, preventing clot formation.

What are some nursing considerations for heparin sodium (unfractionated heparin)?

Monitor aPTT levels, given IV or subcutaneously (not IM), do not aspirate or massage injection sites (prevents hematoma), rotate injection sites

What is the reversal agent for heparin sodium (unfractionated heparin)?

Protamine sulfate

What are important lab values to monitor when giving heparin sodium (unfractionated heparin)?

aPTT: 30-40 sec (normal), 45-80 sec (therapeutic), platelets: Monitor for heparin-induced thrombocytopenia (HIT).

What are some adverse effects of heparin sodium (unfractionated heparin)?

Bleeding, hemorrhage, HIT, osteoporosis

What is the therapeutic use for lovenox (low molecular weight heparin)?

Prevention and treatment of DVT/PE

What is the mechanism of action for lovenox (low molecular weight heparin)?

More selective inhibition of Factor Xa than unfractionated heparin.

What are some nursing considerations for lovenox (low molecular weight heparin)?

Administer subcutaneously, monitor for bleeding, hematoma at injection site, less need for lab monitoring

What is the reversal agent for lovenox (low molecular weight heparin)?

Protamine sulfate (only partially reverses LMWH effects).

What are important lab values to monitor for lovenox (low molecular weight heparin)?

Anti-Xa levels, platelet count

What are some adverse effects for lovenox (low molecular weight heparin)?

Bleeding, injection site hematoma, HIT

What is the therapeutic use for coumadin (warfarin)?

Long-term prevention of thromboembolic events

What is the mechanism of action for coumadin (warfarin)?

Inhibits Vitamin K-dependent clotting factors in the liver.

What are some nursing considerations for coumadin (warfarin)?

Takes 3-5 days to become therapeutic, consistent Vitamin K intake, monitor for bleeding, bruising, many drug interactions

What is the reversal agent for coumadin (warfarin)?

Vitamin K, Fresh Frozen Plasma (FFP), Prothrombin Complex Concentrate (PCC)

What are some important lab values to monitor for coumadin (warfarin)?

INR: 0.8-1.1 (normal), 2.0-3.0 (therapeutic for most indications), 2.5-3.5 (mechanical heart valves), PT (Prothrombin Time): 11-12.5 sec (normal).

What are some adverse effects of coumadin (warfarin)?

Bleeding, hemorrhage, warfarin-induced skin necrosis, teratogenic