1. Normal value for Potassium (K) 3.5--5.

5
2. Hypokalemia <3.5 mEq
-result from k excreted from KIDNEY
-give Potassium chloride (K DUR) PO bad tste give w/ juice
3. Hyperkalemia K+ >5.0 mEq/L
Calcium Gluconate and Sodium Bircarbonate IV
Kayexalate enema if pt cant take PO
4. coumadin Warfarin give always at 4 pm
PT
5. Coumadin/warfarin and Heparin blood thinners
high pt/ptt = risk for bleeding.
low pt/ptt = risk for blood clots/ stroke
6. Drugs and their Antidotes Digoxin - Digibind
2. Heparin/Lovenox - Protamine Sulfate
3. Morphine sulfate - Naloxone Hydrochloride
4. Warfarin/Coumadin- Vitamin K
5. Acetaminophen - Acetylcysteine -mucomyst
6. Benzodiazepine - Flumazenil
7. Penicillin - Epinephrine
8. Anticholinergic poisoning - Physostigmine
9. Alcohol withdraw= Librium.
10. ammonia= lactulose
7. heparin side effect check Partial Thromboplastin Time (PTT)
s/e Hematuria
8. lasix (Furosemide) Loop Diuretic
BID give at 9am and 4-5pm
pt w/ catherer time does not matter (has a catherer)
9. nitroglycerine (Deponit, Nitrostat) s/e headache
10. tuberculosis TB medications Isoniazide (INH)
Rifampin (rifadin)
11. Isoniazide (INH) Taken for 6 to 9 months
Liver function tests (LFTs or LFs)
Administer with (pyridoxine) vitamin B6 to prevent peripheral neuritis
12. Rifadin Rifampin trade name
Red orange tears and urine, also contraceptives don't work as well
s/e hematuria
13. streptomycin Aminoglycoside (30S)
s/e shut daown renal system
-check urine, creatinine and BUN
-dont give more than 4 days pt ended in dyalasis
14. ANTIINFLAMMATORY MEDICATIONS divide in 2 corticosteroids and non corticosteroids NSAID's
-both have in common GI BLEEDING
-best time to give after FOOD
15. corticosteroids lide predisone , ...sone / ...lone
16. NSAID -Non-Steroidal Anti-inflammatory drug
aspirin ASA BIG ONE-no kids reyes syndrome
ibuprofen (Motrin),
naproxen (Aleve, Naprosyn),
17. Anticonvulsants drugs used to manage seizure disorders
meds
Study online at quizlet.com/_qm8u3
18. Anticonvulsants categories Hydantoins
Carboxylic acid derivatives
Succinimides
Oxazolidinediones
Barbiturates
Benzodiazepines
19. Anticonvulsants Lorazepam
(Ativan)
Lorazepam (Ativan), is the drug of choice for status epilepticus
20. Adverse Reactions of
Anticonvulsants
CNS:somnolence (sleepiness), nystagmus
GI: gingival hyperplasia (gum tissue overgrowth)
21. benzodiazepines are used cautiously during pregnancy
22. Hydantoins Include: ethotoin (Peganone), fosphenytoin (Cerebyx), and **phenytoin (Dilantin)
s/e hypotension,drowsiness, sedation,gingival hyperplasia (Dilantin only),blood dyscrasias,
elevated glucose
23. Phenytoin (Dilantin) most commonly prescribed anticonvulsant
-orally w/ meals and parenterally by IV route;
-IM route may cause pain and muscle damage
-IV diluted in NS b/c dextrose causes medication to crystalize (precipitate)
-Rapid IV administration cause hypotension and dysrhythmias
-decreases the effectiveness of some birth control pills
tube feedings may interfere w/ the absorption of orally administered
-if on continuous tube feedings higher doses of the drug may be necessary
-soft bristled toothbrush (may have bleeding due to gingivitis and gingival hyperplasia)
-urine to turn a harmless pinkish-red or reddish-brown color
-monitor serum glucose levels often in clients with diabetes mellitus
24. Succinimides Include: ethosuximide (Zarontin), and methsuximide (Celontin)
Used for partial seizures and absence seizures
CBC and liver function tests should be monitored
s/e gingival hyperplasia (gum overgrowth)
25. Barbiturates phenobarbital (Luminal), amobarbital (Amytal), mephobarbital (Mebaral)
Use with extreme caution with valproic acid, may cause phenobarbital toxicity
s/e somnolence, respiratory depression,
26. Carboxylic Acid Derivatives acid (Depakene, Depacon), divalproex sodium (Depakote)
-Also referred to as valproates
-Used for epilepsy, migraine headache, mania
-Use with extreme caution with phenobarbital (Luminal) may cause phenobarbital toxicity
-s/e blood dyscrasias, hepatotoxicity (monitor CBC & liver enzymes)
27. Oxazolidinediones trimethadione (Tridone), paramethadione (Paradione)
28. Benzodiazepines lonazepam (Klonopin), clorazepate (Tranxene), diazepam (Valium, Diastat), lorazepam (Ativan)
-sedation, drowsiness,blood dyscrasias
29. Carbamazepine (Tegretol) for epilepsy, bipolar disorder, trigeminal and postherpetic neuralgia
30. Gabapentin (Neurontin) - used for partial seizures (adults) and postherpetic neuralgia
31. Nursing Considerations started low and gradually increased over a few weeks
-Plasma serum levels of anticonvulsants are measured regularly to monitor for toxicity
-taken for life
-Status epilepticus may result from abrupt discontinuation
-orazepam (Ativan) or diazepam (Valium) may cause respiratory depression
-avoid alcohol and over the counter medications
-caution when driving or performing activities that require alertness
-follow-up healthcare visits w/ periodic blood studies related to determining toxicity
-report symptoms of bruising, and nosebleeds, which may indicate a blood dyscrasia
-may cause nausea and vomiting so stress importance of adequate nutritional intake
32. Therapeutic Serum Range for Common
Anticonvulsants
Carbamezepine (Tegretol): 3-14 mcg/mL
Clonazepam (Klonopin): 20-80 ng/mL
Ethosuximide (Zarontin): 40-100 mcg/mL
Phenobarbital (Luminal): 15-40 mcg/mL
Phenytoin (Dilantin): 10-20 mcg/mL
33. Monitor for signs and symptoms of liver
dysfunction for clients on carbamazepine
(Tegretol)
dark urine, clay colored stools, unusual bleeding,
34. Parkinsonism tremors, rigidity, and bradykinesia (slow movement)
35. Antiparkinsonism Drugs either supplement the dopamine in the brain or block excess acetylcholine (ACh) so
that better transmission of nerve impulses occur
36. Antiparkinsonism drugs include Dopaminergic agents
Cholinergic blocking drugs
Catechol-O-methyltransferase inhibitors
Non-ergot dopamine receptor agonists
37. Dopaminergic Drugs affect the dopamine content in the blood
levodopa, carbidopa (Lodosyn), amantadine (Symmetrel), and carbidopa/levodopa
combination (Sinemet)
38. Dopaminergic Drugs AKA MAOIs MAOIs, selegiline (Eldepryl, Zelapar) and rasagiline (Azilect) should not be used with
the opioid meperidine (Demerol) because of antimetabolite conversion stupor,
rigidity, and hyperthermia
39. Amantadine (Symmetrel) lightheadedness, dizziness,orthostatic hypotension ( B/P and P),
40. Carbidopa/levodopa (Sinemet, Parcopa,
Carbilev)
dizziness, dark sweat or urine,
41. Rasagiline (Azilect) Do not administer with demerol
42. Selegeline (Eldepryl, Emsam, Zelapar) - agonist (helper) for levodopa/carbidopa in the treatment of PD
Do not administer with demerol
43. Adverse Reactions of Cholinergic
Blocking Drugs (Anticholinergics)
dry mouth, blurred vision, dizziness, orthostatic hypotension ( B/P and pulse),urinary
retention,
44. Cholinergic Blocking Drugs
(Anticholinergics)
glaucoma,prostatic hypertrophy,myasthenia gravis,
45. Cholinergic Blocking Drugs
(Anticholinergics)
Benztropine (Cogentin)
Biperiden (Akineton)
Diphenhydramine (Benadryl)
46. COMT Inhibitors Tolcapone is a potent COMT inhibitor associated with liver damage and liver failure
Tolcapone (Tasmar) -liver failure
47. Dopamine Receptor Agonists Apomorphine (Apokyn) is used for "on-off" phenomenon; antiemetic therapy must be
initiated with this drug due to vomiting
-nausea, vomiting,postural hypotension, abnormal involuntary movements,
Apomorphine (Apokyn)profound hypotension, nausea, vomiting
48. Antiparkinsonism Drugs
Nursing Considerations
Antiparkinsonism drugs if effective should severity of symptoms
-Parlodel interferes with oral contraceptives, another method of birth control should be used
Offer frequent sips of water, ice chips, or hard candy
- chronic constipation
-diet high in fiber and fluids
-Monitor liver function tests:persistent nausea, fatigue, lethargy, anorexia, jaundice, dark urine, clay
colored stools, unusual bleeding, pruritus, and RUQ tenderness
-rise slowly from a sitting or lying position,
-neuroleptic malignant-like syndrome may occur: muscular rigidity, elevated body temperature, and
mental changes
-Avoid the use of alcohol
Instruct the client taking levodopa to avoid vitamin B6 (pyridoxine), this vitamin may interfere with the
action of levodopa (found in whole grains, fortified cereals, liver, and green vegetables)
49. "On-Off" Phenomenon is when the therapeutic effects of the drug have decreased and the adverse effects have increased
-associated with long term levodopa treatment
-Low doses of the drug, reserving the drug for severe cases, or the use of a drug holiday (off drug for 5-14
days) may be prescribed
50. nystatin Mycostatin
Anti-fungal,
for thrush (oral infection)
51. digoxin 1. lanoxin
take apical pulse
Do not administer if pulse is less than 60 bpm
Antidote : Digoxin Immune FAB
52. phenyton Dilantin
Antiarrhythmia/anticonvulsan
abruply discontinuation makes seizures worse
53. before starting antibiotic
tx
culture and sensitivity test
54. Expectorant Expect to see increase of sputum production
55. Antitussive drug used to relieve nonproductive (dry)coughing
56. Acetylcysteine (Mucomyst) Helps to loose bronchial secretions
57. Expectorants: guaifenesin Instruct client to fluids to help thin and loosen secretions
58. Naturally help pt to loose
secretions
Advice pt to drink plenty of fluids
59. Cetirizine (Zyrtec) -
benadryl
Common Antihistamines (block effect of histamine) for allergies rhinitis, urticaria.
60. Commun antihistamine Antihistamines block most of the effects of histamine.
Diphenhydramine (Benadryl) - allergy symptoms, may be used as sleep aid
Loratadine (Claritin,allergic rhinitis
61. Oxymetazoline (Afrin,
Dristan,Vicks Sinex)
nasal congestion-
Overuse of the topical decongestants may cause rebound congestion;
advise the client to use topical decongests for 3-5 days only
62. Albuterol
(Proventil,Ventolin)
acute bronchospasm, pt with asthma.
(rescuer) Short Acting 2 Adrenergic Bronchodilator
S/E Nervousness, tachycardia, insomnia
63. Aminophylline
(Truphilline)
rectal suppository. Tachycardia
64. Cromolyn (Intal, Mast Cell
Stabilizers.
anti-inflammatory,
65. How to use
inhalator
Shake canister for 5-10 seconds prior to use
Wait one minute between inhalations from the same inhaler
Wait 2-3 minutes between inhalations from different inhalers
Wait 2 minutes between inhalations of Metaproterenol (Alupent)
66. Isoniazid
(INH,
First line drug for active TB and for prophylaxis of TB;
only drug can be prescribe alone.
Do not administer isoniazid with foods containing tyramine, such as aged cheese, processed meats and fish,
bananas, dried fruits, yeast products (bread), soy sauce, and red wine
S/E peripheral neuropathy,
-monitor liver function tests,
Administer pyridoxine (vitamin B6) as prescribed to reduce the risk of neurotoxicity
-vit c
-give it as prescribed
67. Pyrazinamide
(PZA)
First line drug for active TB
S/E photosensitivity,
68. Rifampin
(Rifadin)
First line drug for active TB
May cause urine, feces, saliva, sputum, sweat, and tears to be colored reddish orange
-May cause fatigue, gout
Evaluate CBC (blood dyscrasias), uric acid, and liver function tests
69. Pt w/ upset
stomach
Even if medication states w/o food give it in meal time
70. Streptomycin Tinnitus
71. Directly
Observed
Therapy (DOT)
is taken in the presence of the nurse, for tb drugs
72. Pt w/
pneumonia
Give O2L via nasal cannula
73. Antitubercular
Drugs
The drugs used to treat TB do not "cure" the disease, but they do render the client noninfectious to others
-anti-infectives
-bacteriostatic against the Mycobacterium tuberculosis bacterium
74. Tx for TB Minium 6 months. 4-7 months. Usually is combination of 3+ meds except INH
75. acyclovir
(zovirax)
an oral antiviral drug (trade name Zovirax) used to treat genital herpes available as a topical : Burning, rash
,pruritus,stinging. Systemic: Headache ,seizures renal toxicity, phlebitis at iv site. Nursing Implications; Topical use:
use glove to apply: cover lesion completely. Systemic; ensure adequate hydration to prevent crystallization in kidneys;
administer IV dose for at least 1 hr.
76. alpha keri Emollient;local irritations allergix reactions;external use only;can slip in bathtub
SIDE EFFECTS; local irritation,allergic reactions
NURSING IMPLICATIONS; For external use only ;exercise caution when using in the tube to avoid slipping.
77. Aluminum
acetate
solution
(Burows
solutions)
astringent; local irritations; do not use with occlusive dressing
78. Antihistamines
(benadryl)
Antihistamines block the effects of histamine at the H1 receptor. They do not block histamine release, antibody
production, or antigen-antibody reactions. Can cause sedations
ACTION: Blocks histamine @ H1 receptor site, inhibiting many allergic reactions.
SIDE EFFECTS: Drowsiness,dizziness,confusion, dry mouth urinary retention
NURSING IMPLICATIONS: If drowsiness occurs avoid activities that require concentration; avoid using with alcohol
or other CNS deppresents.
79. Benzoyl Peroxide ACTION: antiacne agent
SIDE EFFECTS: EXCESSIVE DRYING OF THE SKIN ALLERGIC REACTIONS
NURSING IMPLICATIONS: Discontinue use if excessive drying or peeling occurs avoid contact w/ hair or fabric.
80. Chlorhexidine
gluconate
(Hibiciens)
ACTION:Antimicrobal skin cleanser
SIDE EFFECTS: Irritation, dermatitis, allergic reactions NURSING IMPLICATIONS:external use onlydo not use
on broken skin unless directed by a Physician.
81. Calamine lotion ACTION:calamine astringent
SIDE EFFECTS: Local irritation
NURSING IMPLICATIONS: For external use only
82. Coal Tar ( Estar
gel, psorigel,
other)
ACTION:Coal tar is used to treat psoriasis and other chronic disorders of the skin.
SIDE EFFECTS: PHOTOSENSITIVITY ,dermatitis, allergic reactions.
NURSING IMPLICATIONS: Avoid exposure to sunlight at least 72 hrs after use ; may stain clothes and bathtub;
for external use only
83. Corticosteroids
(topical)
including:
Fluocinonide
(lidex)
Triamcinolome
(kenalog)
Betamethasone (
valisone)
ACTION: antiinflammatory agent
SIDE EFFECTS: Local irritation ,maceration,superinfection, atrophy, itching, and drying of the skin( more severe
local reactions and systemic effects possible w/higher3 doses and potency or when used with occlusive dressings)\
NURSING IMPLICATIONS: do not use occlusive dressings unless directed by a physician; washing or soaking
area before application increases drug penetration.
84. crotamiton (
eurax)
ACTION: Scabicidal and antipruritic
SIDE EFFECTS: Local irritation, allergic reactions
NURSING IMPLICATIONS; For external use only ; do not apply yo severly irritated skin.
85. Curel, EUCERIN,
Lubriderm
ACTION: EMOLLIENT
SIDE EFECTS: Local irritation, allergic reactions
NURSING IMPLICATIONS: For external use only
86. Fluconazole
(Diflucan)
ACTION: ANTIFUNGAL
SIDE EFFECTS: headache, nausea, vomiting, diarrhea
NURSING IMPLICATIONS: May elevate liver function test; monitor BUN ,creatine
87. Griseofulvin
(fulvicin,grisactin,
grifulvin,others)
ACTION: ANTIFUNGAL AGENT
SIDE EFFECTS: HYPERSENSITIVITY reactions, photosensitivity, nausea, fatigue, mental confusion
NURSING IMPLICATIONS: avoid exposure to sunlight; drug absorption when given w/meals; clinical responce
may appear only after full course of theraphy.
88. Isotretinoin (
Accutane)
ACTION; antiacne agent
SIDE EFFECTS: SEVERE DRYNESS OF SKIN ,mouth, eyes,mucous membranes, nose and nails, skin fragility,
epistaxis, joint and muscle pain ,nausea,abdominal pain
NURSING IMPLICATIONS: Absolutely contraindicated in pregnant women or women contemplating pregnancy;
women of childbering age must practice contraception during theraphy and 1 month before and after theraphy give
drug w/meals do not give vitamins supplements containing vitamin A avoid exposure to sunlight.
89. itraconazole
(sporanox)
ACTION: antifungal agent
SIDE EFFECTS: HYPERTENSION, HEADACHE , NAUSEA, ANOREXIA
NURSING IMPLICATIONS: give w/food check hepatic function can increase PT level.
90. Lindane (kwell) ACTION: Scabicide ,ovicide
SIDE EFFECTS: Local irritation,dizziness, seizures (rare)
NURSING IMPLICATIONS: for external use only avoid applying to open skin lesions.
91. Lubriderm ACTION: EMOLLIENT
SIDE EFFECTS: Local irritation, allergic reactions
NURSING IMPLICATIONS: For external use only exercise caution when using in tub to avoid slipping.
92. Methoxsalen
(oxsoralen,
oxsoralen-ultra 8-
MOP)
ACTION: Skin pigmentation agent
SIDE EFFECTS; SEVERE PHOTOSENSITIVITY , NAUSEA, NERVOUSNESS, INSOMNIA, HEADACHE,
HYPOPIGMENTATION.
NURSING IMPLICATIONS:
93. povidone -iodine
(betadine)
ACTION: TOPICAL ANTIMICROBIAL AGENT
SIDE EFFECTS: LOCAL IRRITATION
NURSING IMPLICATIONS: FOR EXTERNAL USE ONLY MAY STAIN SKIN AND CLOTHING.
94. PYRENTHRIN (
RID OTHERS)
ACTION: Pediculicide
SIDE EFFECTS: LOCAL IRRITATION
NURSING IMPLICATIONS: For external use only do not use for infestations, eyebrows or eyelashes.
95. SALICYLIC ACID ACTION; Keratolytic agent
SIDE EFFECTS; Local irritation , erythema, scaling
NURSING IMPLICATIONS: For external use only may damage clothing, plastic, wood, and other materials on
contact
96. TERBINAFINE (
LAMISIL)
ACTION: antifungal
SIDE EFFECTS: Pruritus, local burning, erythema
NURSING IMPLICATIONS: For external use only do not use occlusive dressings unless directed by physician.
97. TETRACYCLINE ACTION: antibacterial agent
SIDE EFFECTS: TOPICAL: Stinging , burning, slight yelllowish of skinmay occur
SYSTEMIC: nausea, diarrhea,photosensitivity
NURSING IMPLICATIONS: TOPICAL: AVOID CONTACT W/ SUNLIGHT
SYSTEMIC: GIVE ON EMPTY STOMACH AVOID CONCOMITANT ADMINISTRATION OF DAIRY
PRODUCTS LAXATIVES,ANTAIDS, AND PRODUCTS CONTANING IRON, MAY CAUSE PERMANENT
TOOTH DISCOLORATION WHEN USED IN CHILDREN.
98. TOLNAFTATE
(TINACTIN,
AFTATE OTHERS)
ACTION: ANTIFUNGAL AGENT
SIDE EFFECTS: Local irritation
NURSING IMPLICATIONS: For external use only.
99. MAFENIDE (
SULFAMYLON)
ADVANTAGES: Bacteriostatic against gram- negative and gram -positive organism penetrates thick eschar
DISADVANTAGES: Metabolic acidosis pain on application allergic rash.
100. SILVER
SULFADIAZINE (
SILVADENE)
ADVANTAGES: Broad antimicrobial acttivity against gram- negative , gram positive and candida organisms.
no electrolytr imbalances painless and somewhat soothing not nephrotoxic.
DISADVANTAGES: With repeated application skin may develop slimy, greyish , appearance simulating an
infection despite negative cultures. prolonged use may cause skin rash and depress granulocyte formation.
101. SILVER NITRATE ADVANTAGES: bacteriostatic effect lessens pain and eliminates odor reduces evaporative water loss from
burns.
DISADVANTAGES: Electrolyte imbalances stains everything it comes incontact with does not penetrate eschar
pain on application.
102. NITROFURAZONE
( FURACIN)
ADVANTAGES: Inhibits enzymes necessary for bacterial metabolism broad spectrum of activity effective against
staphylococcus aureus, not absorbed systemically loe incidence of sensitivity.
DISADVANTAGES: CONTACT dermatitis in unaffected skin urine turns a reddish color.
103. GENTAMICIN
SULFATE
9GARAMYCIN)
ADVANTAGES: BROAD antimicrobial activity painless.
DISADVANTAGES; OTOTOXICITY, NEPHROTOCITY,DEVELOPMENT OF RESISTANT BACTERIAL
STRAINS.
104. NEOMYCIN ADVANTAGES: broad antimicrobial activity causes miscoding in the messenger RNA of bacterial
cells.
DISADVANTAGES: Serious toxic effects, ototoxicity, nephrotoxicity.
105. SCARLET RED ADVANTAGES: Non antiseptic ,drying agent, applied to donor site , promotes epithelialization.
DISADVANTAGES: NO antimicrobial effects stains and irritates skin infection may develop
beneath scarlet red gause which may have systemic effects
106. XEROFORM ADVANTAGES: NON ANTISEPTIC DEBRIDES AND PROTECTS DONOR SITE PROTECTS
GRAFT.
DISADVANTAGES: Removal may be painful, because it sometimes adheres to wound neither
antiseptic nor antimicrobial.
107. SODIUM HYPOCHLORITE (
DAKINS SOLUTION)
ADVANTAGES: chloride base solution that is bactericidal aids in debriding wounds aids
cleaning of copious drainage.
DISADVANTAGES: Dissolves blood clots may inhibit clotting may irritate the skin
108. SUTILAINS OINTMENT
(TRAVASE)
advantages: TOPICAL ENZYMATIC AGENT DISSOLVES NECROTIC tissue by proteolytic action
facilitates removal of eschar and purulent drainage.
DISADVANTAGES: Mild, transient pain on application paresthesia, bleeding, dermatitis
dressing must be kept moist at all times.