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Module 2 Meds
| Generic Name | Classification | Theraputic Use/MoA | Adverse Actions | Nursing Implications |
|---|---|---|---|---|
| Metoprolol | Beta-Blocker; anti-hypertensive | Beta adrenergic blocker that is selective to beta 1 receptors, primarily in cardiac muscle resulting in decreased cardiac output | Fatigue; Weakness; Bradycardia; CHF; Pulmonary edema | Contraindicated in worsening CHF, Bradycardia, or heart block--use with caution in diabetes, liver disease Obtain BP and HR before administration - hold if SBP<90 or HR<60 Change position slowly to prevent orthostatic changes |
| Lisinopril | ACE inhibitor; Anti-hypertensive | Prevents the conversion of angiotensin I to angiotensin II; prevents vasoconstriction and decreases aldosterone secretion | Cough; Hypotension; Angioedema; Agranulosytosis | Monitor decrease in WBC, hyperkalemia, liver function, and GFR/creatinine Obtain BP before administration -- hold if SBP<90 Change positions slowly to prevent orthostatic changes |
| Furosemide/Lasix | Loop Diuretic | Blocks re-absorption of Na+ and Cl- in kidney tubules causing significant diuresis | Dehydration; Hypovolemia ; Hypokalemia; Hyponatremia; Hypomagnesemia | Monitor electrolyte levels, GFR, and creatinine (K+ is the most quickly to deplete so monitor especially for hyopkakemia) |
| Atrovastatin Calcium/Lipitor | Statin | Competes selectively with HGM-CoA reductase to prevent the creation of enzymes that are precursors to cholesterol | Abdominal cramps; Constipation; Diarrhea; Heartburn; Rashes Rhabdomyolosis | Can cause liver injury/damage -- Monitor ALT/AST/alk phosphate/bili levels can cause muscle injury/damage--if CPK elevated DC use |
| Warfrin/Coumadin | Anti-Coagulant | Blocks regeneration of vit K to reduce vit K dependent clotting factors | Bleeding (GI) | Assess for bleeding: tarry black or maroon stools, nosebleeds, bruising, or hematuria Monitor Hgb, INR (theraputic range 2-3 for anti-coagulation) |
| Aspirin 81 mg | Platelet aggregation inhibitor | Blocks pain impulses; reduces inflammation by inhibiting prostaglandins; antipyretic from vasodilation of peripheral vessels; decreases platelet aggregation | Liver Failure; Toxicity w/OD or high doses | Max dose 4000mg; Liver damage can result if reaches this level or in malnourishment; abuse of ETOH more likely to be toxic Monitor liver labs (AST, ALT, bili, PT/INR) Give with food to minimize risk for GI bleed |
| Budesonide, Flucticasone or Prednisone (PO) | Glucocorticoid | Anti-inflammatory Reduces the synthesis and release of inflammatory mediators (leukotriene, histamine) | Oropharyngeal Candidiasis;Dysphonia; Cateracts/Glaucoma Adrenal insufficiency, Osteoporosis, Infection, HYPERGLYCEMIA, Growth delay | Must be tapered off; Must be increased during times of stress |
| Montelukast | Leukotriene Modifier | Anti-inflammatory Blocks leukotriene receptors causing a reduction in edema, mucus, and broncho- constriction | DEPRESSION, SUICIDAL THOUGHTS Liver Damage | Monitor behavior and mood; Monitor liver function; |
| Ipratropium | Cholinergic antagonist | Bronchodilator Blocks muscarinic receptors in bronchi causing a decrease in constriction Onset 30 Seconds 50% of max @ 3 min Duration 6 hours | DRY MOUTH & IRRITATION OF PHARYNX; visual changes; Cardiac and CNS stimulation | Not effective for acute bronchospam |
| Albuterol | Short Acting Beta Agonist | Bronchodilator Activates Beta 2 receptors of smooth muscle in lungs causing relaxation and dilation during an acute attack Peaks immediately | Few at proper dose Localized to the lungs | Excessive use may indicate poor control of asthma |
| Salmetetol | Long Acting Beta Agonist | Bronchodilator Activates Beta 2 receptors of smooth muscle in lungs causing relaxation and dilation taken as a daily fixed dose; always combined with a glucocorticoid for asthma treatment; Onset slow | Systemic: Tachycardia; angina; artery constriction; tremor | Not a rescue medication Expect a reduction in acute attacks For asthma combine with glucocorticoid |
| Filgrastim | Colony Stimulating Factor, Hematopoietic | Reduces risk of infection by promoting neutrophil production and proliferation of bone marrow Patients undergoing Chemo, Bone Marrow transplant, Harvest stem cells, Chronic neutropenia | Bone pain Leukocytosis Thrombocytopenia N/V/D splenic rupture (splenomegaly) | Monitor CBC w/ diff; Vitals pre- post- administration- hold medication if resp are low; Allergic reaction within 30 min; Upper left quadrant pain-spleen; Pregnancy/breast feeding |
| Epoetin Alfa | Erythropoietic, Hematopoietic | Stimulates the production of RBC in bone marrow Used to counter act anemia from: chemo; Renal failure; HIV treatment; Surgery | Hypertension Cardiac problems including: -Cardiac arrest; -HF -Thrombosis (DVT) -Stroke -MI Seizures | Labs: -Urinalysis - Protien -BUN -creatinine BP to monitor for the need of anti-hypertensives Watch hematocrit for seizures Teaching: chest pain, calf pain, confusion, numbness Pregnancy/Breastfeeding |
| Ondansetron | Antiemetic; Serotonin receptor antagonist | Prevents nausea during chemo/radio therapy by blocking serotonin receptors. | Headache; Dizziness, Drowsiness; Fatigue Diarrhea/Constipation Pain, Shivering, Fever | Assess other meds for interactions; Monitor ECG for prolonged QT (especially w/ electrolyte imbalance); Serotonin Syndrome Pregnancy/Breastfeeding |
Created by:
Jennwyo83
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