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1. Normal value for Potassium (K) 3.5--5.5

2. Hypokalemia 5.0 mEq/L

Calcium Gluconate and Sodium Bircarbonate IVKayexalate 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

medsStudy online at quizlet.com/_qm8u3

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18.Anticonvulsants categories Hydantoins

Carboxylic acid derivatives

Succinimides

Oxazolidinediones

Barbiturates

Benzodiazepines

19.Anticonvulsants Lorazepam

(Ativan)

Lorazepam (Ativan), is the drug of choice for s tatus 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 toxicitys/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 (Ativa

-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

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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 withthe 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),urina

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

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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 crystalliza tion 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 alcoh

or other CNS deppresents.

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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 astringentSIDE 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 sever

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 only86.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 gi

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.

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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: antifungalSIDE EFFECTS: Pruritus, loca l 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 escha

pain on application.

102.NITROFURAZONE

( FURACIN)

ADVANTAGES: Inhibits enzymes necessary for bacterial metabolism broad spectrum of activity effective again

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.

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104.NEOMYCIN ADVANTAGES: broad antimicrobial activity causes miscoding in the messenger RNA of bacteri

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 actio

facilitates removal of eschar and purulent drainage.

DISADVANTAGES: Mild, transient pain on application paresthesia, bleeding, dermatitis

dressing must be kept moist at all times.