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Exam 3 Medications
| Term | Definition |
|---|---|
| Antitussives drugs | Dextromethorphan (non-opioid) codiene/hydrocodone (opioid) |
| antitussives action | act on the medullary cough center of the brain to depress cough reflex |
| antitussives uses | control nonproductive cough |
| antitussives adverse effects | AE: dry mucous membranes, GI effects, CNS effects |
| antitussives nursing considerations | assess respirations & adventitious lung sounds do not give to patients who need to cough to maintain airway do not give to patients with a CNS injury do not give with MAOI's |
| decongestants drugs | oxymetazoline (topical for rosacea) pseudoephedrine/phenylephrine (oral) fluticasone (nasal) |
| decongestants action | sympathetic nervous system causes vasoconstriction causing less inflammation in nasal membrane; oral allows for increased air flow |
| decongestants uses | nasal congestion that accompanies a common cold, sinusitis, and allergies |
| decongestants adverse effects | AE: cardiac effects (oral), rebound congestion (nasal), steroids decrease immune function, local stinging/burning (topical) |
| decongestants nursing considerations | do not use in patients with lesions in mucous membranes do not take with other medication containing the same active ingredients medication can raise blood pressure only use fluticasone for a couple of weeks; not meant for long term use |
| antihistamines drugs | diphenhydramine (Benadryl) - 1st Generation cetirizine (Zyrtec), loratadine (Claritin) - 2nd Generation |
| antihistamines action | block the effects of histamine at the histamine-1 receptor sites to decrease allergic response |
| antihistamines uses | seasonal allergies, conjunctivitis, uncomplicated urticaria |
| antihistamines adverse effects | AE: drowsiness, sedation for 1st generation, anticholinergic effects, CNS effects |
| antihistamines nursing considerations | assess for drowsiness/sedation use caution in patients with renal or hepatic impairment 1st generation = drowsy |
| expectorants drugs | guaifenesin (Mucinex) |
| expectorants action | increase the output of respiratory tract fluids by decreasing the adhesiveness and surface tension of these fluids causing easier movement of the less viscous secretions |
| expectorants uses | increase productive cough to clear the airways and symptomatic relief of respiratory conditions by non productive cough |
| expectorants adverse effects | AE: GI effects, CNS effects, mild rash |
| expectorants nursing considerations | prolonged use may mask serious underlying disorder do not give in the evening do not give to patients with persistent cough makes it easier to cough up mucous |
| mucolytics drugs | acetylcystine (Mucomyst) |
| mucolytics action | break down the mucous to aid the high risk respiratory patient in coughing up thick, tenacious secretions |
| mucolytics uses | patients with difficulty coughing up secretions, patients with atelectasis, patients undergoing bronchoscopy, postoperative patients, patients with tracheostomies |
| mucolytics adverse effects | AE: GI effects (stomatitis), bronchospasms, mild rash |
| mucolytics route | nebulization or direct inhalation into trachea |
| mucolytics nursing considerations | caution in patients with history of bronchospasms and peptic ulcers medication makes it easier to break up thick secretions |
| beta 2 adrenergic agonists drug ending | "terol" |
| beta 2 adrenergic agonists drugs | albuterol (short acting or rescue) salmeterol (long acting) |
| beta 2 adrenergic agonists action | open and dilate the bronchi to increase the rate and depth of respirations |
| beta 2 adrenergic agonists uses | COPD, bronchospasm, prevent asthma attack, treat attack with short acting |
| beta 2 adrenergic agonists adverse effects | AE: tachycardia, palpitations, cardiac arrhythmia, nervousness, anxiety |
| beta 2 adrenergic agonists nursing considerations | use cation in patients with cardiac arrhythmias use bronchodilator before corticosteroid (B before C) inhaled |
| anticholinergics drug ending | "opium" |
| anticholinergics drugs | ipratropium ( Atrovent) Tiotropium (Spiriva) |
| anticholinergics action | acetylcholine agonist via blocking muscarinic cholinergic receptors |
| anticholinergics uses | COPD maintenance, bronchospasms |
| anticholinergics adverse effects | AE: anticholinergic effects - dry mouth, blurred vision, dry eyes, CNS effects, constipation, skin flushing, unable to sweat, urine retention, tachycardia |
| anticholinergics nursing considerations | use caution in patients who are sensitive to anticholinergic effects route: inhaled |
| methylxanthine drug ending | "phylline" |
| methylxanthine drug | theophylline (Theophylline) |
| methylxanthine action | effects smooth muscles of the respiratory tract in bronchi and vessels |
| methylxanthine uses | symptom relief in asthma, reverse bronchospasm in COPD |
| methylxanthine adverse effects | AE: theophylline toxicity - GI upset, nausea, vomiting, irritability, tachycardia, seizure, life-threatening arrhythmias, comatose, death |
| methylxanthine nursing considerations | medication interacts with substances in cigarettes (nicotine) watch blood levels - Therapeutic level : 10-20 mg/L route: oral |
| anti-inflammatory (steroids) drug ending | "sone or olone" |
| anti-inflammatory drugs | beclomethasone & fluticasone - nasal/inhales prednisone - oral solumedrol - IV |
| anti-inflammatory action | decrease inflammation in the airway |
| anti-inflammatory uses | prevent or treat asthma, COPD |
| anti-inflammatory adverse effects | AE: dry mouth, fungal infections, sore throat/hoarse |
| anti-inflammatory nursing considerations | do not use during an attack - use rescue inhaler rinse out mouth after use give hard candy or ice for dry mouth |
| leukotriene modifier/inhibitor drug ending | "lukast" |
| leukotriene modifier/inhibitor drug | montelukast (Singulair) |
| leukotriene modifier/inhibitor action | block leukotriene production |
| leukotriene modifier/inhibitor uses | asthma maintenance, prevent inflammation before attack |
| leukotriene modifier/inhibitor adverse effects | AE: headache, dizziness, GI effects (N/V), elevated liver concentrations |
| leukotriene modifier/inhibitor nursing considerations | use caution in patients with hepatic or renal impairments takes 1-2 weeks to reach therapeutic effect route: oral |
| mast cell stabilizers drug | cromolyn sodium |
| mast cell stabilizers action | inhibits release of histamine and SRSA |
| mast cell stabilizers uses | maintenance COPD |
| mast cell stabilizers adverse effects | AE: hypotension, GI effects, headache, dizziness |
| mast cell stabilizers nursing considerations | use caution in patients with hepatic or renal impairment often taken in combination with bronchodilators added after other medication aren't working |
| benzodiazepines drug ending | "lam or pam" |
| benzodiazepines drugs | diazepam (Valium) alprazolam (Xanax) lorazepam (Ativan) |
| benzodiazepines action | act in the limbic system and the RAS, make GABA more effective, causes interference with neurons firing |
| benzodiazepines uses | anxiety disorders (short term), alcohol withdraw, hyperexcitability, aggitation, preoperative relief, aid in balanced anesthesia, seizures |
| benzodiazepines adverse effects | AE: sedation, blurred vision, confusion, cholinergic effects, GI upset, hypotension, depression, drowsiness |
| benzodiazepines nursing considerations | contraindications: psychosis, coma, shock, aute alcohol intoxication, acute narrow angle glaucoma long term use leads to drug dependence and tolerance taper off medication when quitting withdrawal symptoms avoid hazardous task and alcohol |
| benzodiazepine toxicity signs and symptoms | sedation, respiratory distress, coma |
| benzodiazepines antidote | Flumazenil (Romazicon) |
| Flumazenil adverse effects | aggitation, confusion, seizures, benzo withdraws s/sx |
| alcohol withdrawal s/sx | shaking, sweating, nervousness, N/V, confusion, sedation |
| benzo withdrawal s/sx | increased anxiety, concentration difficulties, tremors, photophobia, insomnia, metallic taste |
| benzo teaching | take drug as directed, avoid performing hazardous tasks and alcohol, do not stop drugs abruptly, do not take OTC drugs or supplements without consulting HCP, inform dentists, physicians, and HCP of your therapy |
| barbiturates ending | "barbital" |
| barbiturates drugs | phenobarbital, phentobarbital |
| barbiturates action | inhibit neuronal impulse conduction in the ascending RAS, depress cerebral cortex and motor output, causes sedation, hypnosis, anesthesia, and coma |
| barbiturates uses | anxiety, sedation, insomnia, pre-anesthesia, seizures |
| barbiturates adverse effects | AE: CNS depression, drowsiness, somnolence, lethargy, ataxia, physical dependency, N/V, constipation, vertigo |
| barbiturates nursing considerations | contraindications: previous history of addiction to sedative or hypnotic drugs, latent or manifest porphyria, hepatic impairment or nephritis, respiratory distress or severe dysfunction |
| buspirone action | impacts the neurotransmitters in the brain |
| buspirone uses | reduce the s/sx of anxiety |
| buspirone adverse effects | AE: CNS effects, can progress to severe AE such as MI, CHF, PID, and hallucinations; not as common to have severe AE |
| buspirone nursing considerations | added onto other drugs to treat anxiety and depression do not take with grapefruit juice |
| hypnotic drugs | Eszopiclone (Lunesta), zolpidem (Ambien) |
| hypnotics action | slows down the activity in the CNS |
| hypnotics uses | insomnia |
| hypnotics adverse effects | AE: sleep walking, memory loss, CNS depression, s/sx of cold, s/sx of depression |
| hypnotics nursing considerations | can be dangerous for older adults with sleep walking and memory loss |
| selective serotonin reuptake inhibitors (SSRI's) drugs | sertraline (Zoloft) escitalopram (Lexapro) fluoxetine (Prozac) |
| selective serotonin reuptake inhibitors (SSRI's) action | block the reuptake of 5HT with little to no known effect on NE inhibits CNS neuronal reuptake of serotonin with little effect on NE |
| selective serotonin reuptake inhibitors (SSRI's) uses | depression, OCD, panic attack, bulimia, PMDD, PTSD, social phobias, social anxiety disorders |
| selective serotonin reuptake inhibitors (SSRI's) adverse effects | serotonin syndrome, headache, drowsiness, dizziness, insomnia, anxiety, tumor, agitation |
| selective serotonin reuptake inhibitors (SSRI's) nursing considerations | contraindications: impaired renal or hepatic function, MAOI's, TCA's increase risk of therapeutic and toxic effects safest drug - used 1st |
| serotonin norepinephrine reuptake inhibitors (SNRI's) drugs | venlafaxine (Effexor) duloxetine (Cymbalta) |
| serotonin norepinephrine reuptake inhibitors (SNRI's) action | decrease neuronal reuptake of both serotonin and norepinephrine and more weakly inhibit dopamine |
| serotonin norepinephrine reuptake inhibitors (SNRI's) uses | nerve pain, depression, OCD, panic attack, PMDD, PTSD, social anxiety disorders |
| serotonin norepinephrine reuptake inhibitors (SNRI's) adverse effects | AE: N/V, constipation, tachycardia, hypertension, palpitations, abnormal bleeding, serotonin syndrome, urinary retention, erectile dysfunction, angle closure glaucoma |
| serotonin norepinephrine reuptake inhibitors (SNRI's) nursing considerations | more cardiac effects 2nd step drug contraindications: severe depression, bipolar disorders, seizures, MAOI's & TCA's, anti platelet drugs |
| tricyclic antidepressants (TCA's) drugs | imipramine (Trofanil) amitriptyline (Elavil) |
| tricyclic antidepressants (TCA's) action | reduce the reuptake of 5HT and NE into nerves |
| tricyclic antidepressants (TCA's) uses | depression, sleep disorders, enuresis, nerve and chronic pain |
| tricyclic antidepressants (TCA's) adverse effects | AE: N/V, constipation, sleep disturbances, sedation, fatigue, dry mouth, ataxia, hallucinations |
| tricyclic antidepressants (TCA's) nursing considerations | must have a 14 day window between TCA's and MAOI's contraindications: severe depression, urinary retention, CV disease, MAOI's, anticoagulant drugs, angle closure glaucoma |
| Monoamine Oxidase Inhibitors (MAOI's) drugs | phenelzine (Nardil) isocarboxazid (Marplan) |
| Monoamine Oxidase Inhibitors (MAOI's) action | irreversibly inhibits MAO, allowing NE, serotonin, and dopamine to accumulate in the synaptic cleft |
| Monoamine Oxidase Inhibitors (MAOI's) uses | major depressive disorder, individuals who are not responding to other medications |
| Monoamine Oxidase Inhibitors (MAOI's) adverse effects | dizziness, nervousness, tremors, confusion, agitation, mania, GI effects, weight gain, insomnia, dry mouth, hyperreflexia, liver toxicity |
| Monoamine Oxidase Inhibitors (MAOI's) nursing considerations | used as a last resort contraindications: pheochromocytoma, headaches, renal or hepatic impairment, CV disease, TCA's, insulin or anti diabetic medications, tyramine (increase stroke risk and HTN crisis) |
| hydantoins drug ending | "toin" |
| hydantoins drugs | phenytoin (Dilantin) |
| hydantoins action | stabilize nerve membranes, influence ionic channels in cell membrane, decrease excitability to stimulation |
| hydantoins uses | maintenance and prevention of seizures |
| hydantoins adverse effects | AE: CNS effects, urinary retention, dry mouth, GI effects, cardiac arrhythmia's, anorexia, loss of libido |
| hydantoins nursing considerations | take with meals reoccurrence of seizures can happen when a dose is missed at risk of pancytopenia avoid alcohol given with Ativan during status epileptics therapeutic level: 10-20 mcg/ml |
| hydantoins toxicity s/sx | slurred speech, ataxia, N/V, dizziness |
| pancytopenia s/sx | sore throat, fever, malaise, bleeding of mucous membranes |
| partial seizures drugs | carbamazepine (Tegretol) |
| carbamazepine action | directly: alter sodium and calcium channels indirectly: increase the activity of GABA (inhibitory neurotransmitter) |
| carbamazepine uses | maintenance and prevention of partial seizures |
| carbamazepine adverse effects | AE: CNS effects, liver toxicity and failure, potential for increased suicidality, vision changes |
| carbamazepine nursing considerations | half life of 25-65 hours drug interactions: MAOI's & alcohol - do not give within 14 days |
| anticonvulsant drug | gabapentin (Neurontin) |
| gabapentin action | GABA decreases the excitability of nerve cells in the brain, which play a role in seizures and the transmission of pain signals and mirrors the effects of GABA calming excited neurons |
| gabapentin uses | maintenance and prevention of partial seizures, nerve pain |
| gabapentin adverse effects | AE: cos effects, mood changes, cyanosis, unexpected muscle pain |
| gabapentin nursing considerations | drug interactions: alcohol and certain antidepressants |
| barbitautes (seizures) action | stabilize nerve membranes through the CNS directly by influencing ionic channels in the cell membrane, thereby decreasing excitability and hyper excitability to stimulation |
| benzo (seizure) action | when a patient feels a seizure coming on, this medication can increase the seizure threshold and delay the electrical activity in the brain |
| absent seizure drugs | ethosuximiden (zarontin) methsuximide (celontin) |
| melatonin use | improve sleep |
| melatonin adverse effects | drowsiness, night terrors, dependence |
| melatonin nursing considerations | use caution in patients with mental illness use caution in daytime due to drowsiness do not operate machinery or drive |
| St. John's Wort uses | mild depression, mild pain, inflammation |
| St. John's Wort adverse effects | dry mouth, lightheadedness, GI upset |
| St. John's Wort nursing considerations | can cause serotonin syndrome decrease effectiveness of oral contraceptives, warfarin, and digoxin avoid prolonged sun exposure due to potential skin rash |
| valerian action | increase GABA |
| valerian uses | prevent insomnia, reduce anxiety |
| valerian adverse effects | AE: drowsiness, lightheadedness, depression, dependence |
| valerian nursing considerations | use caution in patients with mental illness or history of depression avoid if pregnant |
| saw palmetto uses | decrease enlarged prostate |
| saw palmetto adverse effects | AE: mild GI reaction, fetal defects if taken while pregnant |
| saw palmetto nursing considerations | additive effects with Finasteride bleeding risk pregnancy? |
| anti-infectives drugs | monurol (Fosfomyocin) nitrofurantoin (Macrobid) trimethiorim sulfamethoxazole (Bactrum) ciprofloxacin (Cipro) |
| anti-infectives action | act in urinary tract to destroy bacteria (antibiotic or acidification effect) |
| anti-infectives uses | chronic UTI's, acute cystitis, pyelonephritis |
| anti-infectives adverse effects | GI effects, CNS effects (headache, dizziness, blurred vision), urticaria |
| anti-infectives nursing considerations | report worsening painful urination to HCP use caution with liver or renal dysfunction avoid calcium containing antacids because they interfere by making the urine alkaline |
| antispasmodics drugs | oxybutymin (Ditropan) |
| antispasmodics action | block parasympathetic activity to block spams and relax bladder muscles |
| antispasmodics uses | bladder spasms and dysuria |
| antispasmodics adverse effects | anticholinergic effects, tachycardia, blurred vision, drowsiness |
| antispasmodics nursing considerations | drug interaction: Haloperidol use caution in patients with: obstructive urinary tract, glaucoma, acute hemorrhage, renal or liver dysfunction |
| urinary tract analgesics drugs | phenazipyridine (Pyridium) |
| urinary tract analgesics action | excreted in urine, direct topical analgesic effect of urinary mucosa |
| urinary tract analgesics uses | urinary tract pain and urinary retention |
| urinary tract analgesics adverse effects | GI effects, dermatological effects |
| urinary tract analgesics nursing considerations | medication turns skin and urine orange take medication after meals use caution in patients with renal or liver dysfunction drug interaction: antibacterial agents |
| benign prostate hyperplasia drug | doxazosin (Cardura) |
| benign prostate hyperplasia action | blocks alpha adrenergic receptors to relax the bladder and urinary tract |
| benign prostate hyperplasia uses | enlarged prostate, difficulty urinating, cystitis results |
| benign prostate hyperplasia adverse effects | hypotension, tachycardia, decreased libido, sexual dysfunction, headache, postural dizziness |
| benign prostate hyperplasia nursing considerations | finasteride (Proscar) is hazardous risk to female production - wear gloves when giving medication caution in patients with liver and renal dysfunction |
| bladder protectant | pentosan polysulfate sodium (Elmiron) |
| pentosan polysulfate sodium action | coat or adhere to the bladder mucosal wall and protect it from irritation related to solutes in urine (heparin like compound) |
| pentosan polysulfate sodium uses | interstitial cystitis |
| pentosan polysulfate sodium adverse effects | anticoagulant effect, GI effects, headache, alopecia |
| pentosan polysulfate sodium nursing considerations | drug interactions: anticoagulants, NSAIDS, aspirin use caution in patients with a bleeding risk or heparin induced thrombocytopenia |
| chemical stimulates drug | biscodyl (Dulcolax) Senna (Senokat) Castor Oil |
| chemical stimulates action | begin working at small intestine and increase motility throughout the rest of the GI tract by irritating the nerve plexus |
| chemical stimulates uses | promote bowel movement, bowel prep, remove ingested toxins |
| chemical stimulates adverse effects | diarrhea, CNS effects, sweating, heart palpitations |
| chemical stimulates nursing considerations | contact HCP if you have diarrhea for more than 48 hours castor oil blocks absorption of fats and fat soluble vitamins Dulcolax given in PM for a bowel movement in the AM |
| Bulk Stimulates drug | psyllium (Metamucil) polycarbophil (Fibercon) methylcellulose (Citrucel) |
| Bulk Stimulates action | increase fluid into the GI tract to increase motility of the fecal mass |
| Bulk Stimulates uses | promote bowel movement, bowel prep |
| Bulk Stimulates adverse effects | diarrhea, CNS effects, sweating, heart palpitations |
| Bulk Stimulates nursing considerations | added to 8oz of water for administration |
| osmotic stimulates drug | magnesium citrate lactulose polyethylene (Miralax) |
| osmotic stimulates action | increase fluid into the GI tract to increase motility of the fecal mass (oral, suppository, or IV) |
| osmotic stimulates uses | promote bowel movement, bowel prep |
| osmotic stimulates adverse effects | rectal irritation, diarrhea, CNS effects, sweating, heart palpitations |
| osmotic stimulates nursing considerations | lactulose rids the body of high ammonia levels |
| lubricants drug | mineral oil glycerin suppositories |
| lubricants action | forms a slippery coat on the contents of the intestinal tract |
| lubricants uses | short term relief of constipation, prevent straining, remove ingested poisons |
| lubricants adverse effects | diarrhea, sweating, heart palpitations, CNS effects |
| lubricants nursing considerations | suppositories for kids can be used for eating disorders (caution) |
| gastrointestinal stimulants drug | metoclopramide (Reglan) |
| gastrointestinal stimulants action | blocks dopamine receptors and makes the GI cells more sensitive to acetylcholine; stimulates parasympathetic activity within the GI tract |
| gastrointestinal stimulants uses | increase GI activity and motility, GERD, gastroparesis, stimulates gastric emptying |
| gastrointestinal stimulants adverse effects | GI effects, spasms, hypotension, bradycardia, extrapyramidal symptoms (uncontrolled movement) |
| gastrointestinal stimulants nursing considerations | do not take with alcohol contact PCP if you have extrapyramidal symptoms because it can lead to tardive dyskinesia which involves the tongue and cannot be treated EPS + fever = Neruoeptic malignant syndrome |
| antidiarrheal drugs | loperamide (Imodium) Bismuth Subsalicylate (Peptio Bismol) |
| antidiarrheals action | slow the motility of the GI tract through direct action of the lining of the GI tract; loperamide affects the muscle layers of the GI tract |
| antidiarrheals uses | relief of diarrhea, reduction of volume of discharge from ileostomies, prevention of traveler's diarrhea |
| antidiarrheal adverse effects | dry mouth, toxic megacolon, constipation, abdominal distention, nausea |
| antidiarrheal nursing considerations | can lead to bowel obstruction |
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