Pharm Test 1
ANALGESICS:
OPIOIDS (1-5)
#1. Codeine Sulfate
pharm class: Opioid analgesic
therapeutic class: pain reliever, antitussive
Indications & Why: mild to moderate pain and cough suppression
Major Side Effects: Resp. depression, drowsiness, nausea, constipation, hypotension
Nsg Considerations & Pt Ed: Avoid alcohol. Take w/ food if GI upset occurs. Monitor respiratory status, BP, and bowel function
Labs to Monitor: N/A
Impact on Other Diseases: can exacerbate respiratory issue (COPD & asthma pts) and may worsen GI motility disorders
#2. Hydrocodone/APAP (acetaminophen)
trade: Norco
pharm class: Opioid analgesic
therapeutic class: pain reliever
Indications & Why: Treats moderate to severe pain
Major Side Effects: Resp. depression, drowsiness, nausea, constipation
Nsg Considerations & Pt Ed: Monitor RR, caution with CNS depressants. Take with food if GI upset occurs.
Labs to Monitor: Liver function (APAP component), renal function
Impact on Other Diseases: Caution in pts w/ a h/o substance abuse, resp. disorders, or liver disease
#3. Hydromorphone
trade: Dilaudid
pharm class: Opioid analgesic
therapeutic class: Pain reliever
Indications& Why: Used for moderate to severe pain management
Major Side Effects: Resp. depression, sedation, nausea, constipation, hypotension
Nsg Considerations & Pt Education: Monitor resp. status. Avoid alcohol and CNS depressants. Use stool softeners to prevent constipation.
Labs to Monitor: N/A
Impact on Other Diseases: can exacerbate resp. depression in pts w/ COPD or asthma
#4. Morphine Sulfate
pharm class: Opioid analgesic
therapeutic class: Pain reliever
Indication & Why: Used for severe pain management (especially cancer and post-op)
Major Side Effects: Respiratory depression, hypotension, constipation, sedation.
Nsg Considerations & Pt Education: Monitor RR and BP. Educate about addiction risk. Encourage fluids and fiber intake.
Labs to Monitor: N/A
Impact on Other Diseases: can exacerbate resp. conditions and worsen GI motility disorders
#5. Naloxone
trade: Narcan
pharm class: Opioid analgesic
therapeutic class: Antidote for opioid overdose
Indications& Why: Used for opioid overdose and resp. depression reversal
Major Side Effects: Withdrawal symptoms (pain, tachycardia, hypertension), nausea, vomiting
Nsg Considerations & Pt Education: Monitor RR and BP. Reassess for resp. depression after administration (short half-life).
Labs to Monitor: N/A
Impact on Other Diseases: N/A
NONSTEROIDAL ANTI-INFLAMMATORY DRUGS (NSAIDs) (1-3)
#1. Aspirin
trade: Ecotrin
pharm class: Salicylate
therapeutic class: Antiplatelet, NSAID, antipyretic
Indications& Why: Used for pain, fever, inflammation, and prevention of cardiovascular events (MI, stroke)
Major Side Effects: GI bleeding, tinnitus, Reye’s syndrome (in children), bleeding risk
Nsg Considerations & Pt Education: Take with food to reduce GI irritation. Monitor for signs of bleeding. Avoid in children with viral infections
Labs to Monitor: Platelet, Hgb, & Hct count, liver function tests (ALT, AST), kidney enzymes (BUN, creatinine)
Impact on Other Diseases: can increase the risk of GI bleeding and worsen renal function in pts w/ kidney disease
#2. Celecoxib
pharm class: COX-2 inhibitor
therapeutic class: NSAID
Indications& Why: Used for pain, osteoarthritis, and rheumatoid arthritis
Major Side Effects: GI bleeding, cardiovascular events, renal impairment
Nsg Considerations & Pt Education: Take with food. Avoid with other NSAIDs. Caution in pt w/ HTN
Labs to Monitor: Renal function, liver enzymes
Impact on Other Diseases: can increase the risk of heart attack, stroke, and GI bleeding. It can also worsen renal function in pts w/ kidney issues
#3. Ibuprofen
trade: Advil, Motrin
pharm class: NSAID
therapeutic class: Anti-inflammatory, analgesic, antipyretic
Indications& Why: Used for pain, inflammation, and fever
Major Side Effects: GI bleeding, renal impairment, increased cardiovascular risk
Nsg Considerations & Pt Education: Take with food. Avoid with anticoagulants and prolonged use
Labs to Monitor: Renal function, liver function tests
Impact on Other Diseases: Can worsen kidney function and increase the risk of cardiovascular events, particularly in long-term use
ANTIBIOTICS:
Beta-Lactam Antibiotics (1-2)
#1. Ampicillin/Sulbactam
pharm class: Penicillin-beta-lactamase inhibitor
therapeutic class: Antibiotic
Indications& Why: Treats bacterial infections, including skin, respiratory, and intra-abdominal infections (ex. UTI)
Major Side Effects: Allergic reactions, diarrhea, superinfection, nausea
Nsg Considerations & Pt Education: Assess for penicillin allergy. Monitor for signs of superinfection (e.g., oral thrush, unusual vaginal discharge)
Labs to Monitor: CBC, renal function, liver function tests
Impact on Other Diseases: can cause an overgrowth of non-susceptible organisms (e.g., C. difficile), leading to secondary infections
#2. Cefazolin
pharm class: Cephalosporin antibiotic
therapeutic class: Antibiotic
Indications& Why: Treats bacterial infections (ex. UTI), surgical prophylaxis
Major Side Effects: Allergic reactions, diarrhea, superinfection
Nsg Considerations & Pt Education: Screen for penicillin allergy. Monitor for C. difficile infection
Labs to Monitor: Renal function, WBC count, liver enzymes
Impact on Other Diseases: can cause or worsen GI infections (e.g., C. difficile) and may increase the risk of nephrotoxicity in pts w/ pre-existing kidney conditions
Fluoroquinolones (1)
#1. Levofloxacin
pharm class: Fluoroquinolone antibiotic
therapeutic class: Antibiotic
Indications& Why: Treats bacterial infections (respiratory, UTI, skin)
Major Side Effects: Tendon rupture, QT prolongation, C. difficile infection
Nsg Considerations & Pt Education: Avoid excessive sun exposure. Take with plenty of water. Caution in those with renal impairment or a history of seizures.
Labs to Monitor: renal function and electrolytes
Impact on Other Diseases: can increase the risk of tendon rupture, especially in older adults. It can cause QT prolongation, which can be dangerous in pts w/ cardiac conditions
Rifamycins (1)
#1. Rifampin
pharm class: Rifamycin antibiotic
therapeutic class: Anti-tuberculosis agent
Indications& Why: Treats tuberculosis
Major Side Effects: Hepatotoxicity, red/orange body fluids, GI upset
Nsg Considerations & Pt Education: Take on an empty stomach. Avoid alcohol. Caution is advised in pts w/ HIV or those taking other medications that affect liver enzymes
Labs to Monitor: liver function tests
Impact on Other Diseases: may interact with other medications, including antiretrovirals for HIV, and can lower the effectiveness of oral contraceptives
ANTIDEPRESSANTS:
Selective Serotonin Reuptake Inhibitors (SSRIs) (1)
#1. Sertraline
trade: Zoloft
pharm class: SSRI
therapeutic class: Antidepressant
Indications& Why: Used for depression, anxiety, OCD, PTSD
Major Side Effects: Sexual dysfunction, weight changes, serotonin syndrome, insomnia
Nsg Considerations & Pt Education: Takes weeks for full effect. Do not stop abruptly. Monitor for suicidal ideation. It may take a few weeks for full effects to be seen. Avoid alcohol.
Labs to Monitor: N/A
Impact on Other Diseases: can worsen conditions like bipolar disorder if not properly monitored. It may also interact with other medications, such as blood thinners, increasing the risk of bleeding
Norepinephrine-Dopamine Reuptake Inhibitors (NDRIs) (1)
#1. Bupropion
trade: Wellbutrin
pharm class: Atypical antidepressant
therapeutic class: Antidepressant, smoking cessation aid
Indications& Why: Used for depression and smoking cessation
Major Side Effects: Seizures (especially in high doses), insomnia, dry mouth, mania
Nsg Considerations & Pt Education: Avoid alcohol. Do not crush or chew extended-release tablets. Monitor for psychiatric side effects, particularly mood changes or seizures. Assess for any signs of suicidal ideation or psychosis.
Labs to Monitor: N/A
Impact on Other Diseases: may lower the seizure threshold and can increase the risk of manic episodes in patients with bipolar disorder
ANTIEMETICS
Antihistamines (1)
#1. Hydroxyzine
trade: Vistaril
pharm class: Antihistamine
therapeutic class: Anxiolytic, anti-allergy
Indications& Why: Used for anxiety, nausea, itching, sleep problems, and preoperative sedation (adjunct to anesthesia)
Major Side Effects: Drowsiness, dry mouth, dizziness
Nsg Considerations & Pt Education: Avoid alcohol and other CNS depressants. Take with food to minimize GI upset. Monitor for sedation, dry mouth, and urinary retention. Assess mental status and level of sedation. Be cautious in older adults and those with a history of respiratory issues. Can worsen glaucoma.
Labs to Monitor: N/A
Impact on Other Diseases: Can worsen glaucoma, urinary retention, and may cause sedation in patients with respiratory conditions.
ANTIEPILEPTICS
Benzodiazepines (1)
#1. Diazepam
trade: Valium
pharm class: Benzodiazepine
therapeutic class: Anxiolytic, muscle relaxant, anticonvulsant, antiepileptic, sedative/hypnotic
Indications& Why: Used for anxiety, muscle spasms, seizures, and alcohol withdrawal.
Major Side Effects: Sedation, respiratory depression, dizziness, dependence, severe liver disease, hypotension
Nsg Considerations & Pt Education: Avoid alcohol. Monitor for falls in elderly patients. Do not stop abruptly, as this can precipitate withdrawal symptoms. Be cautious when driving or operating machinery.
Labs to Monitor: N/A
Impact on Other Diseases: may exacerbate respiratory depression in patients with COPD or sleep apnea. It can also increase the risk of falls and confusion in elderly patients.
ANTIGOUT AGENTS
Xanthine Oxidase Inhibitors (1)
#1. Allopurinol
pharm class: Xanthine Oxidase Inhibitors
therapeutic class: Anti-gout agent
Indications& Why: Prevents gout attacks by reducing uric acid production, treats kidney stones, and reduces uric acid levels in conditions like hyperuricemia
Major Side Effects: Rash (including Stevens-Johnson syndrome), nausea, kidney stones, liver toxicity, diarrhea
Nsg Considerations & Pt Education: Encourage hydration to prevent kidney stones. Monitor for rash and liver/kidney function
Labs to Monitor: Uric acid levels, renal and liver function tests
Impact on Other Diseases: can affect renal function, especially in those with pre-existing kidney disease. It should be used cautiously in patients with liver disease. Additionally, it may interact with other drugs like anticoagulants, increasing the risk of bleeding
Microtubule Inhibitors (1)
#1. Colchicine
pharm class: Anti-gout agent
therapeutic class: Anti-inflammatory
Indications & Why: Used for gout flares and prevention
Major Side Effects: Diarrhea, nausea, myelosuppression (bone marrow suppression), abdominal cramping, muscle pain, and neuropathy
Nsg Considerations & Pt Education: Take with food to minimize GI upset. Avoid grapefruit juice.
Labs to Monitor: CBC, renal function
Impact on Other Diseases: can cause GI upset and may worsen renal function, especially in pts w/ pre-existing kidney disease
ANTIHISTAMINES
Second-Generation Antihistamines (1)
#1. Fexofenadine
trade: Allegra
pharm class: Antihistamine
therapeutic class: Allergy relief agent
Indications& Why: Treats seasonal allergies, urticaria (hives), treats allergic conditions such as hay fever
Major Side Effects: Drowsiness, dry mouth, headache, dizziness, swelling
Nsg Considerations & Pt Education: Avoid alcohol and CNS depressants. Can be taken with food to decrease GI upset. Avoid grapefruit juice
Labs to Monitor: N/A
Impact on Other Diseases: should be used cautiously in pts w/ kidney disease as the drug is excreted via the kidneys
HYDROZYZINE IS ALSO AN ANTIHISTAMINE!!!!!!!!!!!
ANTIHYPERTENSIVES
Beta-Blockers (2)
#1. Atenolol
pharm class: Beta-blocker
therapeutic class: Antihypertensive, antianginal
Indications& Why: Treats hypertension, angina, and post-MI management and manages arrhythmia
Major Side Effects: Bradycardia, hypotension, fatigue, dizziness
Nsg Considerations & Pt Education: Monitor BP and HR. Do not stop abruptly (risk of rebound hypertension).
Labs to Monitor: N/A
Impact on Other Diseases: May worsen heart failure in pts w/ poorly controlled heart conditions. Can mask symptoms of hypoglycemia in diabetic pts
#2. Timolol
pharm class: Beta-blocker
therapeutic class: Anti-glaucoma agent
Indications& Why: Eye drops: used to treat IOP inside the eye such as ocular hypertension and glaucoma
Major Side Effects: Eye irritation, bradycardia, hypotension
Nsg Considerations & Pt Education: Do not touch dropper to eye. Hold nasolacrimal duct to prevent systemic absorption.
Labs to Monitor: N/A
Impact on Other Diseases: can exacerbate respiratory conditions such as asthma and can also cause bradycardia and hypotension
Calcium Channel Blockers (1)
#1. Amlodipine
pharm class: Calcium channel blocker
therapeutic class: Antihypertensive
Indications& Why: Treats hypertension and angina
Major Side Effects: Edema, dizziness, hypotension, flushing, arrythmia
Nsg Considerations & Pt Education: Monitor BP, avoid grapefruit juice,
Labs to Monitor: N/A
Impact on Other Diseases: can lower blood pressure significantly, so caution is required in patients with hypotension or dehydration. It may also exacerbate heart failure and renal impairment in some individuals
ANTIRETROVIRALS (HIV & AIDS)
Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs) (1)
#1. Nevirapine
pharm class: NNRTI
therapeutic class: Antiretroviral
Indications& Why: Used for HIV treatment
Major Side Effects: fatigue, nausea, hepatotoxicity, rash (Stevens-Johnson syndrome), immune reconstitution syndrome.
Nsg Considerations & Pt Education: Monitor for liver damage and rashes. Adherence to regimen is crucial.
Labs to Monitor: Liver function tests, CD4 count, viral load
Impact on Other Diseases: can worsen liver disease in patients with pre-existing liver conditions. It may also interact with other medications, such as hormonal contraceptives, reducing their effectiveness
Nucleoside Reverse Transcriptase Inhibitors (NRTIs) (1)
#1. Zidovudine
pharm class: NRTI
therapeutic class: Antiretroviral
Indications& Why: Used for HIV treatment and prevention of maternal-fetal HIV transmission.
Major Side Effects: Bone marrow suppression (anemia, neutropenia), lactic acidosis, hepatomegaly, myopathy
Nsg Considerations & Pt Education: Monitor for signs of infection or anemia. Adherence to medication regimen is crucial for effectiveness
Labs to Monitor: CBC, liver function tests, lactic acid levels
Impact on Other Diseases: can worsen bone marrow suppression and may increase the risk of infections. It may also interact with other medications, including those that affect liver enzymes
ANXIOLYTICS
Benzodiazepines (2)
#1. Alprazolam
trade: Xanax
pharm class: Benzodiazepine
therapeutic class: Anxiolytic (reduces anxiety)
Indications& Why: Treats anxiety, panic disorders
Major Side Effects: Drowsiness, dizziness, dependence, respiratory depression
Nsg Considerations & Pt Education: Avoid alcohol. Do not stop abruptly (risk of withdrawal). Monitor for signs of abuse
Labs to Monitor: N/A
Impact on Other Diseases: Can worsen resp. depression in pts w/ COPD or obstructive sleep apnea. In pts w/ depression, may exacerbate symptoms, especially if used long-term.
DIAZEPAM (VALIUM) IS ALSO AN ANXIOLYTIC!!!!!!!!!!!!!!!!!
BRONCHODILATORS
Leukotriene Receptor Antagonists (1)
#1. Montelukast
trade: Singulair
pharm class: Leukotriene receptor antagonist
therapeutic class: Anti-asthmatic, anti-allergy
Indications& Why: Used for asthma maintenance and allergic rhinitis
Major Side Effects: Mood changes (depression, suicidal thoughts), headache, GI upset, anaphylaxis
Nsg Considerations & Pt Education: For long-term control, not for acute asthma attacks. Take at bedtime for best results.
Labs to Monitor: N/A
Impact on Other Diseases: generally well-tolerated but can exacerbate psychiatric disorders in vulnerable pts
CORTICOSTEROIDS
Systemic Corticosteroids (3)
#1. Dexamethasone
trade: Decadron
pharm class: Corticosteroid
therapeutic class: Anti-inflammatory, immunosuppressant
Indications& Why: Treats inflammation, cerebral edema, allergies, and autoimmune conditions and manages symptoms of certain cancers
Major Side Effects: Hyperglycemia, osteoporosis, weight gain, mood changes, immunosuppression, GI ulcers, insomnia
Nsg Considerations & Pt Education: Taper gradually when discontinuing. Monitor blood glucose and infection signs.
Labs to Monitor: Blood glucose, WBC count, electrolytes
Impact on Other Diseases: can exacerbate diabetes, cause fluid retention, and increase the risk of infections. Long-term use can lead to osteoporosis and cataracts.
#2. Methylprednisolone
trade: Medrol
pharm class: Corticosteroid
therapeutic class: Anti-inflammatory, immunosuppressant
Indications& Why: Treats inflammatory and autoimmune conditions (e.g., asthma, rheumatoid arthritis, allergic reactions, lupus).
Major Side Effects: Hyperglycemia, osteoporosis, fluid retention, mood changes, immunosuppression
Nsg Considerations & Pt Education: Do not stop abruptly (risk of adrenal insufficiency). Monitor blood glucose and infection signs. Take with food to prevent GI upset
Labs to Monitor: Blood glucose, WBC count, electrolytes.
Impact on Other Diseases: Long-term use can exacerbate diabetes and osteoporosis. It can also increase the risk of infection due to immune suppression.
#3. Hydrocortisone
pharm class: Corticosteroid
therapeutic class: Anti-inflammatory
Indications& Why: Treats adrenal insufficiency, inflammation, certain autoimmune diseases, and allergic reactions (calms down immune response)
Major Side Effects: Hyperglycemia, osteoporosis, Cushing’s syndrome, mood changes
Nsg Considerations & Pt Education: Do not stop abruptly. Monitor blood glucose in diabetic patients. Take with food to prevent GI upset
Labs to Monitor: Blood glucose, electrolytes, WBC count
Impact on Other Diseases: Can worsen diabetes and hypertension. It can also suppress the immune system, making infections harder to fight. Prolonged use can lead to osteoporosis and adrenal insufficiency.
ELECTROLYTE SUPPLEMENTS
Iron Supplements (1)
#1. Ferrous sulfate
pharm class: Iron supplement
therapeutic class: Antianemic
Indications& Why: Treats iron deficiency anemia
Major Side Effects: Constipation, black/tarry stools, GI upset
Nsg Considerations & Pt Education: Take on an empty stomach with vitamin C for better absorption; avoid dairy and antacids
Labs to Monitor: Hemoglobin, hematocrit, ferritin, total iron-binding capacity (TIBC)
Impact on Other Diseases: may worsen conditions like hemochromatosis or liver disease
GASTROINTESTINAL AGENTS
H2 Receptor Antagonists (1)
#1. Famotidine
trade: Pepcid
pharm class: Histamine-2 receptor antagonist (H2 blocker)
therapeutic class: Anti-ulcer agent
Indications& Why: Used for GERD, peptic ulcers, and acid reflux by reducing stomach acid production.
Major Side Effects: Headache, dizziness, constipation, diarrhea, confusion (especially in elderly patients)
Nsg Considerations & Pt Education: Take with or without food. Avoid alcohol and NSAIDs to prevent irritation. Monitor for signs of GI bleeding
Labs to Monitor: Monitor renal function (serum creatinine) in patients with renal impairment, as the drug is excreted through the kidneys
Impact on Other Diseases: can reduce stomach acid and may affect the absorption of other medications that require an acidic environment for absorption (e.g., certain antifungals, iron)
Laxatives (2)
#1. Docusate Sodium
trade: Colace
pharm class: Stool softener
therapeutic class: Laxative
Indications& Why: Used for constipation
Major Side Effects: Abdominal cramping, diarrhea
Nsg Considerations & Pt Education: Encourage fluid intake. Do not use long-term. Assess for abdominal distension, bowel sounds, and usual patterns of bowel function.
Labs to Monitor: N/A
Impact on Other Diseases: excessive use may cause electrolyte imbalance, particularly in pts w/ kidney disease or heart conditions
#2. Lactulose
trade: Kristalose
pharm class: Osmotic laxative
therapeutic class: Laxative, ammonia reducer
Indications& Why: Used for constipation and hepatic encephalopathy
Major Side Effects: Diarrhea, electrolyte imbalance, bloating
Nsg Considerations & Pt Education: Monitor bowel movements and electrolyte levels
Labs to Monitor: Ammonia levels (in liver disease pts) and monitor electrolyte levels (particularly potassium), as prolonged diarrhea can lead to imbalances
Impact on Other Diseases: Caution in pts w/ DM (d/t high sugar content) and in those with GI obstructions. May exacerbate electrolyte imbalances in pts w/ kidney disease and can cause dehydration if used excessively
HEMATOPOIETIC AGENTS
Colony-Stimulating Factors (1)
#1. Filgrastim
pharm class: Colony-stimulating factor
therapeutic class: Hematopoietic agent
Indications& Why: Increases WBCs in neutropenic pts (e.g., chemotherapy-induced, bone marrow transplantation, or certain chronic conditions (e.g., severe chronic neutropenia, HIV-associated neutropenia) neutropenia.)
Major Side Effects: Bone pain, leukocytosis, splenomegaly, fever, fatigue, nausea, headache, injection site reactions, splenic rupture, allergic reactions, ARDS, and excessive WBC production (leukocytosis).
Nsg Considerations & Pt Education: Monitor CBC, especially neutrophil count. Educate about the potential for bone pain. Watch for respiratory symptoms and signs of hypersensitivity
Labs to Monitor: liver function tests, CBC with differential, platelet count, uric acid levels
Impact on Other Diseases: can exacerbate sickle cell disease (triggering crises), may stimulate myeloid malignancies, and can worsen conditions leading to splenic rupture. It may also impact kidney function due to increased uric acid levels.
Erythropoiesis-Stimulating Agents (1)
#1. Epoetin
pharm class: Erythropoiesis-stimulating agent
therapeutic class: Antianemic
Indications& Why: used to treat anemia, particularly in patients with chronic kidney disease, cancer chemotherapy, or HIV treatment.
Major Side Effects: clot risk, seizures, HTN, headache, fever, pure red cell aplasia, joint pain, thromboembolic events
Nsg Considerations & Pt Education: Monitor BP. Ensure iron intake, monitor hgb levels closely to prevent excessive increases
Labs to Monitor: Hemoglobin, hematocrit, iron studies
Impact on Other Diseases: can exacerbate hypertension and increase the risk of clot formation, which can worsen cardiovascular conditions
MUCOLYTIC & ANTIDOTE
Mucolytic Agents (1)
#1. Acetylcysteine
trade: Mucomyst
pharm class: Mucolytic agent
therapeutic class: Antidote (for acetaminophen toxicity), mucolytic
Indications& Why: Used for acetaminophen overdose, chronic bronchopulmonary disorders, and to loosen thick mucus in conditions like COPD, and for preventing contrast-induced nephropathy
Major Side Effects: Nausea, vomiting, bronchospasm, rash, dizziness, unpleasant sulfur-like odor, hypotension
Nsg Considerations & Pt Education: Monitor respiratory function, assess for allergic reactions. Instruct the pt that the inhaled form has a strong sulfur smell. Ensure adequate hydration.
Labs to Monitor: Acetaminophen levels (if treating overdose), liver function tests, renal function (BUN, creatinine) if used for nephroprotection
Impact on Other Diseases: Can worsen bronchospasms in asthma. May alter the effectiveness of activated charcoal in poisoning cases.
ANTIPLATELET AGENTS
P2Y12 Platelet Aggregation Inhibitors (1)
#1. Clopidogrel
pharm class: Antiplatelet
therapeutic class: Cardiovascular agent
Indications& Why: Prevents blood clots in stroke/MI pts and PAD and post-stent pts
Major Side Effects: Bleeding, bruising, GI upset, TTP, severe hemorrhage
Nsg Considerations & Pt Education: Avoid NSAIDs and aspirin. Report any unusual bleeding.
Labs to Monitor: Platelet count, liver function test, CBC
Impact on Other Diseases: Increases bleeding risk in conditions like peptic ulcer disease, liver disease, and stroke. Can interact with CYP2C19 inhibitors
ANTIDIARRHEALS
Opioid & Anticholinergic Combinations (1)
#1. Diphenoxylate/Atropine
pharm class: Opioid antidiarrheal
therapeutic class: Antidiarrheal
Indications& Why: Used for diarrhea by slowing intestinal motility
Major Side Effects: Drowsiness, dry mouth, constipation, dependence, toxic megacolon (if used in infectious diarrhea), CNS depression, or anticholinergic toxicity
Nsg Considerations & Pt Education: Assess for signs of dehydration and electrolyte imbalance. Monitor for CNS effects. Avoid use in infectious diarrhea. : Do not exceed prescribed dose (can cause euphoria). Avoid alcohol and CNS depressants
Labs to Monitor: liver function test and electrolytes
Impact on Other Diseases: Can worsen toxic megacolon in infectious diarrhea. May cause severe constipation in opioid-naïve patients.
IMMUNOSUPRESSANT
TNF-α Inhibitors (Monoclonal Antibodies) (1)
#1. Inflixamab
pharm class: Monoclonal antibody
therapeutic class: Immunosuppressant, anti-inflammatory
Indications& Why: Used for autoimmune diseases (Crohn’s, ulcerative colitis, rheumatoid arthritis).
Major Side Effects: infusion reactions (fever, chills), headache, nausea, and increased infection risk, TB reactivation, hepatotoxicity, lymphoma, or heart failure
Nsg Considerations & Pt Education: Screen for TB before starting treatment. Monitor for signs of infection.
Labs to Monitor: CBC, liver function tests, TB screening
Impact on Other Diseases: Can increase infection risk in immunocompromised pts, reactivate latent TB or hepatitis B, and worsen heart failure
BONE RESORPTION INHIBITORS
Bisphosphonates (1)
#1. Alendronate
pharm class: Bisphosphonate
therapeutic class: Bone resorption inhibitor
Indications& Why: Used for osteoporosis and Paget’s disease; prevents bone loss
Major Side Effects: Esophagitis, GI upset, hypocalcemia, musculoskeletal pain.
Nsg Considerations & Pt Education: Take with a full glass of water in the morning before food; remain upright for at least 30 minutes after taking. Monitor bone density
Labs to Monitor: Calcium & Vit D
Impact on Other Diseases: can worsen GERD and dysphagia, can also exacerbate hypocalcemia, Long-term use has been associated with atypical femur fractures
TIMOLOL IS ALSO AN OPTHALMIC AGENT
ALPRAZOLAM AND DIAZWEPAM ARE ALSO SEDATIVES/HYPNOTICS
BUPROPION IS ALSO A SMOKING CESSATATION AID