drugs cards exam 1

Heparin

Generic Name: Heparin | Drug Classification: Anticoagulant | Therapeutic Use: Prevents/treats DVT, PE, MI, atrial fibrillation, clot formation | Mechanism of Action: Enhances antithrombin III to inactivate thrombin (Factor IIa) and Factor Xa, preventing fibrin clot formation | Adverse Effects: Bleeding, HIT, anemia, injection-site irritation, osteoporosis (long-term) | Nursing Actions: Monitor aPTT (1.5–2.5× control), monitor platelets, assess for bleeding, do not massage injection site, keep protamine sulfate available | Interactions: Aspirin, NSAIDs, warfarin, clopidogrel, thrombolytics, garlic, ginkgo | Contraindications: Active bleeding, severe thrombocytopenia, history of HIT, recent brain/spinal surgery | Patient Teaching: Use soft toothbrush/electric razor, avoid injury, report bruising or black stools, avoid aspirin unless prescribed.

Enoxaparin (Lovenox)

Generic Name: Enoxaparin | Drug Classification: Low-Molecular-Weight Heparin (LMWH) | Therapeutic Use: Prevents DVT, PE, acute coronary syndrome | Mechanism of Action: Inhibits Factor Xa more than thrombin | Adverse Effects: Bleeding, bruising, HIT (rare) | Nursing Actions: Inject into abdomen, do not expel air bubble, do not massage site, monitor CBC/platelets, assess for bleeding | Interactions: Aspirin, NSAIDs, anticoagulants, clopidogrel | Contraindications: Active bleeding, HIT, severe thrombocytopenia | Patient Teaching: Rotate injection sites, avoid NSAIDs, report bleeding.

Acetaminophen (Tylenol)

Generic Name: Acetaminophen | Drug Classification: Non-opioid analgesic; antipyretic | Therapeutic Use: Mild-moderate pain, fever | Mechanism of Action: Inhibits prostaglandin synthesis in CNS | Adverse Effects: Hepatotoxicity, rash, kidney damage (rare) | Nursing Actions: Monitor liver function, assess pain/temp, maximum 4 g/day (many providers recommend ≤3 g/day) | Interactions: Alcohol, warfarin | Contraindications: Severe liver disease | Patient Teaching: Avoid alcohol, check OTC products, do not exceed daily dose.

Aspirin (Salicylate)

Generic Name: Aspirin | Drug Classification: Salicylate; NSAID; Antiplatelet | Therapeutic Use: Pain, fever, inflammation, MI/stroke prevention | Mechanism of Action: Irreversibly inhibits COX-1 & COX-2 to reduce prostaglandins and platelet aggregation | Adverse Effects: GI bleeding, ulcers, tinnitus, Reye syndrome | Nursing Actions: Give with food, monitor GI bleeding and platelets, stop before surgery if ordered | Interactions: Anticoagulants, NSAIDs, alcohol, corticosteroids | Contraindications: Active bleeding, peptic ulcer disease, children with viral illness | Patient Teaching: Take with food, report ringing in ears, avoid alcohol, never give to children with viral illness.

Advil, Motrin)

Generic Name: Ibuprofen | Drug Classification: NSAID | Therapeutic Use: Pain, fever, inflammation | Mechanism of Action: Reversibly inhibits COX-1 & COX-2 to decrease prostaglandins | Adverse Effects: GI bleeding, kidney injury, hypertension, fluid retention | Nursing Actions: Give with food, monitor renal function, BP, GI bleeding | Interactions: Aspirin, anticoagulants, corticosteroids, alcohol | Contraindications: Active GI bleed, severe kidney disease, NSAID allergy | Patient Teaching: Take with meals, avoid alcohol, stay hydrated, report black stools.

(Mobic)

Generic Name: Meloxicam | Drug Classification: NSAID | Therapeutic Use: Osteoarthritis, rheumatoid arthritis, chronic pain | Mechanism of Action: Preferential COX-2 inhibition decreases prostaglandins | Adverse Effects: GI bleeding, kidney impairment, hypertension, edema | Nursing Actions: Monitor renal function, BP, GI bleeding, give with food | Interactions: NSAIDs, anticoagulants, ACE inhibitors, diuretics | Contraindications: NSAID allergy, active ulcer, severe kidney disease | Patient Teaching: Avoid other NSAIDs, report bloody stools, stay hydrated.

(Phenergan)

Generic Name: Promethazine | Drug Classification: First-generation antihistamine; antiemetic | Therapeutic Use: Nausea, vomiting, motion sickness, allergies, sedation | Mechanism of Action: Blocks H1 and dopamine receptors in CTZ | Adverse Effects: Drowsiness, dizziness, dry mouth, hypotension, respiratory depression, tissue necrosis with IV extravasation | Nursing Actions: Monitor respirations, BP, sedation, use deep IM if injectable, fall precautions | Interactions: Alcohol, opioids, benzodiazepines, CNS depressants | Contraindications: Children <2 years, coma, severe respiratory depression | Patient Teaching: Avoid alcohol and driving, change positions slowly, report breathing problems.

(Vistaril)

Generic Name: Hydroxyzine | Drug Classification: Antihistamine; anxiolytic; antiemetic | Therapeutic Use: Anxiety, nausea, allergies, pre-op sedation | Mechanism of Action: Blocks H1 receptors causing sedation and antiemetic effects | Adverse Effects: Drowsiness, dry mouth, blurred vision, constipation | Nursing Actions: Monitor sedation, anxiety, fall precautions | Interactions: Alcohol, opioids, benzodiazepines | Contraindications: Early pregnancy, hypersensitivity | Patient Teaching: Avoid alcohol, rise slowly, avoid driving.

(Zofran)

Generic Name: Ondansetron | Drug Classification: 5-HT3 serotonin antagonist | Therapeutic Use: Prevents nausea/vomiting | Mechanism of Action: Blocks serotonin receptors in GI tract and CTZ | Adverse Effects: Headache, constipation, QT prolongation, dizziness | Nursing Actions: Monitor ECG if high risk, assess nausea, monitor bowel function | Interactions: SSRIs, QT-prolonging drugs | Contraindications: Congenital long QT syndrome, hypersensitivity | Patient Teaching: Increase fluids, eat small meals, report irregular heartbeat.

Morphine Sulfate

Generic Name: Morphine | Drug Classification: Opioid agonist | Therapeutic Use: Moderate-severe pain, MI pain, pulmonary edema | Mechanism of Action: Binds opioid receptors in CNS altering pain perception | Adverse Effects: Respiratory depression, sedation, constipation, hypotension, urinary retention | Nursing Actions: Assess pain, monitor respirations (hold if RR <12 unless otherwise ordered), monitor BP, keep naloxone available, monitor bowel function | Interactions: Alcohol, benzodiazepines, sedatives | Contraindications: Respiratory depression, paralytic ileus, severe asthma | Patient Teaching: Avoid alcohol, increase fluids/fiber, don't drive, rise slowly.

Fentanyl

Generic Name: Fentanyl | Drug Classification: Opioid agonist | Therapeutic Use: Severe pain, anesthesia, chronic cancer pain | Mechanism of Action: Stimulates opioid receptors producing analgesia | Adverse Effects: Respiratory depression, bradycardia, sedation, constipation | Nursing Actions: Monitor respirations and oxygen saturation, remove old patch before new one, avoid heat over patch | Interactions: Alcohol, benzodiazepines, CNS depressants | Contraindications: Respiratory depression, acute asthma | Patient Teaching: Do not cut patches, avoid heat, fold patches before disposal, keep away from children.

Hydrocodone

Generic Name: Hydrocodone | Drug Classification: Opioid analgesic | Therapeutic Use: Moderate pain | Mechanism of Action: Activates opioid receptors in CNS | Adverse Effects: Sedation, constipation, respiratory depression, dizziness | Nursing Actions: Monitor respirations, assess pain, encourage fluids, monitor bowel function | Interactions: Alcohol, benzodiazepines, CNS depressants | Contraindications: Severe respiratory depression, paralytic ileus | Patient Teaching: Avoid alcohol, increase fiber, don't drive, take exactly as prescribed.

(Dilaudid)

Generic Name: Hydromorphone | Drug Classification: Opioid analgesic | Therapeutic Use: Severe pain | Mechanism of Action: Binds opioid receptors to block pain perception | Adverse Effects: Respiratory depression, sedation, constipation, hypotension | Nursing Actions: Assess pain, monitor respirations and BP, keep naloxone available | Interactions: Alcohol, sedatives, benzodiazepines | Contraindications: Respiratory depression, paralytic ileus | Patient Teaching: Avoid alcohol, increase fluids, prevent constipation, don't drive.

(Narcan)

Generic Name: Naloxone | Drug Classification: Opioid antagonist | Therapeutic Use: Reversal of opioid overdose | Mechanism of Action: Competitively blocks opioid receptors, reversing respiratory depression | Adverse Effects: Hypertension, tachycardia, sweating, withdrawal symptoms, agitation | Nursing Actions: Maintain airway, monitor respirations, repeat doses may be needed, monitor for recurrent respiratory depression | Interactions: Opioids | Contraindications: Hypersensitivity (use cautiously in opioid-dependent patients) | Patient Teaching: Call 911 after administration, remain with the patient because symptoms may return.

Isoflurane

Generic Name: Isoflurane | Drug Classification: Inhaled general anesthetic | Therapeutic Use: Maintenance of general anesthesia | Mechanism of Action: Produces CNS depression causing unconsciousness | Adverse Effects: Hypotension, respiratory depression, malignant hyperthermia | Nursing Actions: Monitor airway, BP, ECG, oxygenation; keep dantrolene available | Interactions: Other CNS depressants | Contraindications: Malignant hyperthermia history | Patient Teaching: Expect drowsiness after anesthesia.

Nitrous Oxide

Generic Name: Nitrous Oxide | Drug Classification: Inhaled anesthetic | Therapeutic Use: Procedural sedation, adjunct to anesthesia | Mechanism of Action: CNS depression with analgesia | Adverse Effects: Nausea, dizziness, diffusion hypoxia | Nursing Actions: Monitor oxygenation; administer oxygen after discontinuation | Interactions: CNS depressants | Contraindications: Pneumothorax, bowel obstruction, middle ear surgery | Patient Teaching: Temporary dizziness may occur.

Vecuronium

Generic Name: Vecuronium | Drug Classification: Nondepolarizing neuromuscular blocker | Therapeutic Use: Skeletal muscle paralysis during surgery/intubation | Mechanism of Action: Blocks acetylcholine at neuromuscular junction | Adverse Effects: Apnea, prolonged paralysis | Nursing Actions: Mechanical ventilation required; monitor TOF and airway | Interactions: Anesthetics, aminoglycosides | Contraindications: Hypersensitivity | Patient Teaching: Used only while closely monitored.

Propofol

Generic Name: Propofol | Drug Classification: IV general anesthetic | Therapeutic Use: Induction/maintenance of anesthesia, procedural sedation | Mechanism of Action: Enhances GABA activity | Adverse Effects: Hypotension, respiratory depression, bradycardia | Nursing Actions: Monitor airway, BP, ECG; use aseptic technique | Interactions: CNS depressants | Contraindications: Hypersensitivity to components | Patient Teaching: Causes rapid sleepiness.

Dantrolene

Generic Name: Dantrolene Sodium | Drug Classification: Skeletal muscle relaxant | Therapeutic Use: Malignant hyperthermia, severe spasticity | Mechanism of Action: Reduces calcium release from skeletal muscle | Adverse Effects: Muscle weakness, drowsiness, hepatotoxicity | Nursing Actions: Monitor liver enzymes; assess muscle strength | Interactions: CNS depressants | Contraindications: Active liver disease | Patient Teaching: Avoid alcohol; report jaundice.

Benzodiazepines

Drug Classification: CNS depressants/anxiolytics | Therapeutic Use: Anxiety, seizures, insomnia, sedation | Mechanism of Action: Enhance GABA | Adverse Effects: Sedation, respiratory depression, dependence | Nursing Actions: Monitor respirations, fall precautions | Interactions: Alcohol, opioids | Contraindications: Acute narrow-angle glaucoma, severe respiratory insufficiency | Patient Teaching: Do not stop abruptly; avoid alcohol.

Diazepam

Generic Name: Diazepam | Drug Classification: Benzodiazepine | Therapeutic Use: Anxiety, seizures, muscle spasms | Mechanism of Action: Enhances GABA | Adverse Effects: Sedation, respiratory depression | Nursing Actions: Monitor respirations and sedation | Interactions: Alcohol/opioids | Contraindications: Myasthenia gravis | Patient Teaching: Avoid driving/alcohol.

Lorazepam

Generic Name: Lorazepam | Drug Classification: Benzodiazepine | Therapeutic Use: Anxiety, status epilepticus, sedation | Mechanism of Action: Enhances GABA | Adverse Effects: Sedation, hypotension, respiratory depression | Nursing Actions: Monitor airway and sedation | Interactions: CNS depressants | Contraindications: Acute narrow-angle glaucoma | Patient Teaching: Do not stop suddenly.

Alprazolam

Generic Name: Alprazolam | Drug Classification: Benzodiazepine | Therapeutic Use: Anxiety, panic disorder | Mechanism of Action: Enhances GABA | Adverse Effects: Drowsiness, dependence | Nursing Actions: Monitor mental status and respirations | Interactions: Alcohol, opioids | Contraindications: Concurrent strong CYP3A4 inhibitors | Patient Teaching: Avoid alcohol; taper slowly.

Metformin

Generic Name: Metformin | Drug Classification: Biguanide | Therapeutic Use: Type 2 diabetes | Mechanism of Action: Decreases hepatic glucose production and improves insulin sensitivity | Adverse Effects: GI upset, lactic acidosis (rare) | Nursing Actions: Monitor renal function; hold before iodinated contrast if indicated | Interactions: Alcohol, contrast dye | Contraindications: Severe renal impairment | Patient Teaching: Take with meals.

Glipizide

Generic Name: Glipizide | Drug Classification: Sulfonylurea | Therapeutic Use: Type 2 diabetes | Mechanism of Action: Stimulates insulin release | Adverse Effects: Hypoglycemia, weight gain | Nursing Actions: Monitor glucose | Interactions: Alcohol | Contraindications: Type 1 diabetes | Patient Teaching: Eat regularly.

Glyburide

Generic Name: Glyburide | Drug Classification: Sulfonylurea | Therapeutic Use: Type 2 diabetes | Mechanism of Action: Stimulates insulin release | Adverse Effects: Hypoglycemia | Nursing Actions: Monitor glucose | Interactions: Alcohol | Contraindications: Type 1 diabetes | Patient Teaching: Recognize hypoglycemia.

Acarbose

Generic Name: Acarbose | Drug Classification: Alpha-glucosidase inhibitor | Therapeutic Use: Type 2 diabetes | Mechanism of Action: Delays carbohydrate absorption | Adverse Effects: Flatulence, diarrhea | Nursing Actions: Give with first bite of meal | Interactions: Digestive enzymes | Contraindications: Bowel disease | Patient Teaching: Treat hypoglycemia with glucose tablets, not sucrose.

Repaglinide

Generic Name: Repaglinide | Drug Classification: Meglitinide | Therapeutic Use: Type 2 diabetes | Mechanism of Action: Stimulates rapid insulin release | Adverse Effects: Hypoglycemia | Nursing Actions: Give before meals; skip if meal skipped | Patient Teaching: Do not take without eating.

Sitagliptin

Generic Name: Sitagliptin | Drug Classification: DPP-4 inhibitor | Therapeutic Use: Type 2 diabetes | Mechanism of Action: Increases incretin levels | Adverse Effects: Pancreatitis, URI | Nursing Actions: Monitor glucose | Patient Teaching: Report severe abdominal pain.

Exenatide

Generic Name: Exenatide | Drug Classification: GLP-1 receptor agonist | Therapeutic Use: Type 2 diabetes | Mechanism of Action: Increases insulin secretion, slows gastric emptying | Adverse Effects: Nausea, pancreatitis | Nursing Actions: Inject as directed; monitor glucose | Patient Teaching: Report severe abdominal pain.

Rosiglitazone

Generic Name: Rosiglitazone | Drug Classification: Thiazolidinedione | Therapeutic Use: Type 2 diabetes | Mechanism of Action: Improves insulin sensitivity | Adverse Effects: Edema, heart failure risk | Nursing Actions: Monitor for fluid retention | Contraindications: NYHA III/IV heart failure | Patient Teaching: Report swelling or shortness of breath.

Insulins

Classification: Antidiabetic hormone | Therapeutic Use: Type 1 & 2 diabetes | MOA: Replaces/supplements insulin to lower blood glucose | Adverse Effects: Hypoglycemia, hypokalemia | Nursing Actions: Monitor glucose, rotate injection sites, know onset/peak/duration | Patient Teaching: Recognize and treat hypoglycemia; carry fast-acting glucose.