Pharmacology Meds exam

Anti-infectives

Kill bacteria

Anti-infectives mycotic

Treat fungal (mycosis) infections

Analgesics

Relieve pain

NSAIDs

Relieve pain and decrease inflammation

Cephalosporin and penicillins

Beta-lactams

Cephalosporin (anti-infective)

Kills bacteria (bactericidal)

Cephalosporin generic (brand) names

Cephalexin (Keflex), Cefalozin (Ancef), Ceftriaxone (Rocephin)

Cephalosporin side effects

GI upset/Diarrhea, secondary infections, colitis, and seizures

Cephalosporin Nursing Considerations

• Obtain any specimen cultures before giving first dose

• Can give w/wo food

• Assess for allergic response

• Determine allergy to penicillin, as there is risk for cross sensitivity to PCN

• Continue to assess for response to infection

• Observe, educate, report S&S of secondary infections

• Finish the full Rx to prevent resistance

Penicillins (anti-infective)

Kills bacteria (bactericidal)

Penicillins generic (brand) names

Amoxicillin, Ampicillin, Piperacillin

Penicillins side effects

GI upset/Diarrhea, rash, secondary infections, allergic reactions, colitis, and seizures

Penicillins Nursing Considerations

• Obtain any specimen cultures before giving first dose

• Can give w/wo food

• Assess for allergic response

• Cross sensitivity to cephalosporins

• Continue to assess for response to infection

• Observe, educate, report S&S of secondary infections

• Finish the full Rx to prevent resistance

Sulfonamides (anti-infective)

Kills bacteria (bactericidal)

Sulfonamide generic (brand) names

Sulfamethoxazole (w/ trimethoprim)(bactrim)

Sulfonamide side effects

Allergic response, crystalluria, and hyperkalemia

Sulfonamide Nursing Considerations

• Primarily treats E. Coli (UTI)

• Assess for Sulfa allergy

• Give wo food

• Given together to prevent resistance

• Encourage fluids/ Monitor Urine output

• Monitor Electrolytes, BUN/Creat.

• Obtain any specimen cultures before giving first dose

• Observe, educate, report S&S of secondary infections

• Finish the full Rx to prevent resistance

Tetracyclines (anti-infective)

Kills bacteria (bactericidal)

Tetracyclines generic (brand) names

Doxycycline, Tetracycline

Tetracyclines side effects

GI upset/Diarrhea, secondary infections, photosensitivity, esophageal ulceration, and tooth discoloration

Tetracyclines Nursing Considerations

• Obtain any specimen cultures before giving first dose

• Give wo food, w/8 oz. water, NO dairy

• NOT during pregnancy

• Not to children under 8 y.o.

• Cause tooth discoloration

• Observe, educate, report S&S of secondary infections

• Monitor kidney and liver function

• Finish the full Rx to prevent resistance

Macrolides (anti-infective)

Kills bacteria (bactericidal)

Macrolides generic (brand) names

Erythromycin, Azithromycin, Clarithromycin

Macrolides side effects

GI upset/Diarrhea, secondary infections, dysthymias, and ototoxicity

Macrolides Nursing Considerations

• Obtain any specimen cultures before giving first dose

• Can give w/wo food

• Observe, educate, report S&S of secondary infections

• Finish the full Rx to prevent resistance

Fluroquinolones (anti-infective)

Kills bacteria (bactericidal)

Fluroquinolones generic (brand) names

Ciprofloxacin

Fluroquinolones side effects

GI upset/Diarrhea, secondary infection, Achilles tendinitis, and Achilles rupture

Fluroquinolones Nursing Considerations

• Obtain any specimen cultures before giving first dose

• Can give w/wo food, NO dairy

• Observe, educate and report pain in the Achilles site

• Observe, educate, report S&S of secondary infections

• Finish the full Rx to prevent resistance

Anti-fungal (anti-infective)

Treat Fungal (mycosis) infections

Anti-fungal generic (brand) names

Fluconazole (Diflucan), Nystatin (Mycostatin)

Anti-fungal side effects

Liver toxicity

Anti-fungal Nursing Considerations

• Obtain any specimen cultures before giving first dose

• Excreted by kidneys so monitor renal function (creatinine) closely

General anti-infective side effects

GI upset/Diarrhea and secondary infections

General anti-infective Nursing Considerations

• Obtain any specimen cultures before giving first dose

• Observe, educate, report S&S of secondary infections

• Finish the full Rx to prevent resistance

Opioids (narcotics) (analgesic)

Relieve pain

Opioids (narcotics) generic (brand) names

Fentanyl, Hydromorphone (Dilaudid), Morphine (MS Cotin), Oxycodone (Oxycotin), Codeine

Opioids (narcotics) side effects

Confusion, sedation, constipation, respiratory depression, and hypotension

Opioids (narcotics) Nursing Considerations

• Assess Before: Vitals (Resp) and pain level before

• Evaluate After: LOC, Vitals/Resp, Pain, safety

• Reversal: Naloxone

• Monitor bowel activity

• Encourage fluids

Opioid-Nonopioid combo (analgesic)

Relieve pain

Opioid-Nonopioid combo generic (brand) names

Oxycodone/APAP (Percocet), Hydrocodone/APAP (Vicodin), Codeine/APAP (Tylenol #3)

Opioid-Nonopioid combo side effects

Confusion, sedation, constipation, respiratory depression, and hypotension

Opioid-Nonopioid combo Nursing Considerations

• Assess Before: Vitals (Resp) and pain level before

• Evaluate After: LOC, Vitals/Resp, Pain

• Monitor for safety

• Monitor bowel activity

• Encourage fluids

NonOpioid analgesic (analgesic)

Relieve pain

NonOpioid analgesic generic (brand) names

Acetaminophen (Tylenol)

NonOpioid analgesic side effects

Toxicity, liver failure, and GI bleeding

NonOpioid analgesic Nursing Considerations

• Assess Before: Vitals and pain level

• Evaluate After: Vitals, Pain

Tylenol (APAP):

• Max Dose (for Adults) 4000 mg/Day

• Monitor liver enzymes

• Reversal: Acetylcysteine (oral)

Nonsteroidal anti-inflammatory (NSAID) (analgesic)

Relieve pain, decrease inflammation

Nonsteroidal anti-inflammatory (NSAID) generic (brand) names

Ibuprofen (Advil, Motrin), Naproxen (Aleve), Ketorolac (Toradol)

Nonsteroidal anti-inflammatory (NSAID) side effects

GI upset, GI bleeding, and nephrotoxicity

Nonsteroidal anti-inflammatory (NSAID) Nursing Considerations

• Assess Before: Vitals and Pain

• Evaluate After: Vitals and Pain

• Encourage Fluids

• Give w/food

• Monitor for bleeding

• Monitor kidney and liver function

Antigout agents (analgesic, anti-inflammatory, Antigout)

Relieve pain, reduce inflammation, block/inhibit uric acid

Antigout agents generic (brand) names

Allopurinol (inhibit production), Colchicine (Stop inflammation)

Antigout agents side effects

GI upset

Antigout agent Nursing Considerations

• Encourage Fluids

• Avoid Purines

General analgesic Nursing Considerations

• Assess Before: Vitals and Pain

• Evaluate After: Vitals and Pain

• Encourage Fluids

ACE inhibitors (anti-hypertensives)

Vasodilator

ACE inhibitors generic (brand) names

Captopril (Capoten), Enalapril (Vasotec), Lisinopril (Prinivil)

ACE inhibitors side effects

Hypotension, Dry Cough, Hyperkalemia, angioedema, agranulocytosis

ACE inhibitors Nursing Considerations

• Obtain BP before administering

(hold typically if SBP <90)

• Continue lifestyle modification

• Change position slowly-especially with elderly

to prevent orthostatic changes

• Monitor for:

-decreased WBC count, Hyperkalemia, liver function & kidney function

Angiotensin II Receptor Blockers (ARBS-Anti-hypertensives)

Vasodilator

Angiotensin II Receptor Blockers generic (brand) names

Losartan, Valsartan, Irbesartan

Angiotensin II Receptor Blockers side effects

Hypotension, Hyperkalemia, angioedema, agranulocytosis

Angiotensin II Receptor Blockers Nursing Considerations

• Obtain BP before administering

(hold typically if SBP <90)

• Continue lifestyle modification

• Change position slowly-especially with elderly

to prevent orthostatic changes

• Monitor for:

-decreased WBC count, Hyperkalemia, liver function & kidney function

Beta adrenergic antagonists (beta blockers-ant-hypertensives/antianginals)

Blocks beta 1 or beta 1 and 2, vasodilator, slows conduction (HR)

Beta adrenergic antagonists generic (brand) names

(Cardioselective-Block Beta-1): Atenolol (Tenormin), Metoprolol (Lopressor)

(Nonselective-Block Beta-1 & 2):

Propranolol (Inderal), Labetalol

Beta adrenergic antagonists side effects

Hypotension, Bradycardia, Fatigue, weakness, Worsening HF, Pulmonary Edema

Beta adrenergic antagonist Nursing Considerations

• Obtain BP and HR before administering (hold

typically if SBP <90. HR <60)

• Assess Pulmonary non-selective can cause bronchospasms, bronchoconstriction (lungs sounds and oxygenation, SOB)

• Change position slowly-especially with elderly to prevent orthostatic changes

• Contraindicated in worsening CHF, bradycardia of heart block...use with caution in diabetes, liver disease

Calcium channel blockers (anti-hypertensive/antianginal)

Vasodilator and slows conduction (HR)

Calcium channel blockers generic (brand) names

Amlodipine (Norvasc), Diltiazem (Cardizem), Nifedipine (Procardia), Verapamil (Calan)

Calcium channel blockers side effects

Hypotension, Bradycardia, Peripheral Edema, Cardiac Dysrhythmia, Worsening HF

Calcium channel blockers Nursing Considerations

• Obtain BP and HR before administering (hold typically if SBP <90. HR <60)

• Resp/Lung assessment

• Change position slowly-especially with elderly to prevent orthostatic changes

• Measure I&O closely and fluid status due to potential for edema

• Monitor liver and kidney function

Alpha Adrenergic Blockers (Sympatholytics)(anti-hypertensive)

Block Alpha-1, vasodilator

Alpha Adrenergic Blockers generic (brand) names

Prazosin, Doxazosin

Alpha adrenergic blockers side effects

Hypotension, Dizziness

Alpha adrenergic blockers Nursing Considerations

Obtain BP before administering

(hold typically if SBP <90)

Doxazosin also used for BPH

Continue lifestyle modification

Change position slowly-especially with elderly to prevent orthostatic changes

Central acting alpha agonists (anti-hypertensive)

Stimulate alpha 2, vasodilator

Central acting alpha agonists generic (brand) names

Clonidine, Guanfacine, Methyldopa

Central acting alpha agonists side effects

Hypotension, Dizziness

Central acting alpha agonists Nursing Considerations

• Obtain BP before administering

(hold typically if SBP <90)

• Continue lifestyle modification

• Change position slowly-especially with elderly to prevent orthostatic changes

Nitrates (antianginal)

Direct vasodilator, antianginal

Nitrates generic (brand) names

Isosorbide (Isordil), Nitroglycerin (Nitrostat, Tridil, Nitrodur), Nitro patch, Nitroprusside

Nitrates side effects

Hypotension, Tachycardia, Headache, Dizziness

Nitrates Nursing Considerations

• Obtain BP before administering

(hold typically if SBP <90)

• Nitro SL: 1-tab q5min x3 tabs, call 911 if no relief after 1st tab

• Patches must be taken off at night and then reapplied in the morning

• Contraindicated if client taking any erectile dysfunction meds (Viagra

Cardiac Glycoside (HF)

Increase Contractility, Decrease Conduction, Improve SV and

CO

Cardiac Glycoside generic (brand) names

Digoxin (Lanoxin)

Cardiac Glycoside side effects

Hypotension, Bradycardia, Toxicity

Cardiac Glycoside Nursing Considerations

• Obtain BP and HR before administering (hold typically if SBP <90. HR <60)

• Evaluate BP and HR AFTER

• Assessment for green/yellow halos

• Monitor Dig Level

• Monitor K+ Levels (low K+ increased risk of toxicity)

Antidysrhythmics

Decrease or Increase Conduction

Antidysrhythmics generic (brand) names

Decrease Conduction:

(Slow HR) Adenosine, Amiodarone

Increase Conduction:

(Increase HR) Atropine

Antidysrhythmics side effects

Bradycardia

Cardiogenic Shock

Dry mouth

Urinary

Retention

Tachycardia

Antidysrhythmics Nursing Considerations

• Adenosine: Rapid IV push

Beta-2 Adrenergic Agonists (Respiratory-Inhaled/ Oral)

Stimulate Beta-2, Bronchodilation, Relieve Bronchospasms

Beta-2 adrenergic agonists generic (brand) names

Short-Acting (SABA): Albuterol

Long-Acting (LABA): Formoterol (Inhaled), Terbutaline (Oral)

Beta-2 adrenergic agonists side effects

Restlessness, Tachycardia, Palpitations, Tremors

Beta-2 adrenergic agonists Nursing Considerations

• SABAs used for RESCUE (for acute bronchospasms)

• LABAs for maintenance/asthma control

• Avoid other stimulants

Methylxanthines (Respiratory-Oral/ IV)

Relax Smooth muscles, Bronchodilation, Relieve Bronchospasms

Methylxanthines generic (brand) names

Aminophylline, Theophylline

Methylxanthines side effects

Restlessness, Irritability

Toxicity: Tachycardia, Seizures

Methylxanthines Nursing Considerations

• Monitor Ther. Levels/ Toxicity

• Maintenance/long-term asthma control

• Avoid other stimulants (Caffeine)