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Med Class NC

Tricyclic glycopeptide (1) Red-Man/red-neck syndrome - sudden release of histamine caused by too-rapid IV administration. Life-threatening Symptoms: flushing and/or and a red rash that affects the face, neck and upper torso, hypotension and angioedema may also occur.
Tricyclic glycopeptide (2) Tx: Antihistamines. Always administer Vanco over at least 60 to 90 minutes using an IV pump.
Histamine H2 antagonists Give with meals to prolong drug effect. Do not give with antacids because antacids block absorption of H2 antagonists (give antacids 1 hr before or after the drug). May have to stop drug if diarrhea occurs.
Proton pump inhibitors Give on empty stomach. May have to stop drug if diarrhea occurs.
Subcutaneous anticoagulants (1) Remember that enoxaparin does not require that the PTT be monitored since it maintains more consistent blood levels than heparin does. For both meds, monitor platelet count, Hct, and occult blood in stools.
Subcutaneous anticoagulants (2) Do not give med if platelet count is decreasing. Administration of sq anticoagulants: Give in the abdomen at a 90 ° angle. Do not aspirate. Do not massage. Use an air lock when administering enoxaparin.
Insulin Know onset and peak times of action for the following insulins and when they should be given in relation to meals; Know the procedure for mixing two insulins.
Beta Blockers (1) Use with caution in people with asthma and diabetes. Can cause bronchospasm in people with asthma. Can mask symptoms of hypoglycemia in diabetics. Monitor these patients closely and teach them about those things.
Beta Blockers (2) Do not withdraw abruptly. Taper over a 2 week period. Rebound hypertension and rebound tachycardia will occur. Angina could also occur.
ACE inhibitors (1) May have to stop drug if dry cough does not go away after a few weeks. Watch potassium levels closely, especially if patient is taking potassium-sparing diuretics. Monitor renal function closely (BUN and creatinine).
ACE inhibitors (2) Must discontinue drug if edema of the face and hands occurs (angioedema). This is a medical emergency because the airway can become blocked.
Calcium Channel Blockers Teach patient to notify health care provider if peripheral edema occurs because the edema can strain the heart. A change in drug dosage or drug class may be necessary.
Loop diuretic (1) Monitor potassium levels closely, teach patient to eat high-potassium foods, teach patient to weigh themselves daily to check fluid status,
Loop diuretic (2) hearing loss can occur when furosemide is given at high doses for extended periods, monitor renal status (BUN and creatinine) since the drug is nephrotoxic.
Cardiac Glycoside ↓ potassium levels ↑ digoxin toxicity. Potassium level must be within normal range. Apical pulse for one minute prior to giving drug. If <60, recheck pulse in one hour. If still <60, hold drug and call prescriber. Therapeutic level: 0.5-2
Narcotics (1) ↑ risk: Life threatening side effects in “opioid naïve” (pt new to narcotics; i.e. just being started on a narcotic). ↑ risk: first two weeks of narcotic therapy. Physical tolerance may develop; higher doses require for relief.
Narcotics (2) IV effect peak: 10 to 20 mins after given. Po effects: depend on if it’s short or long-acting. Short peak: one hour. Long peak: longer. Best used for long-term, chronic pain. Teach patients to increase fluids and fiber to prevent constipation.
Systemic Corticosteroids Take with food, Do not take with grapefruit juice, Never stop abruptly.
Created by: Slacker