side effects, dose range, pt teaching, nurse asmt, MOA, classification
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| psyllium (Matamucil) | Laxative (bulk forming) | Increase size of fecal mass | Insufficient water can lead to obstruction of esophagus or intestine | Mix with 8 Oz of Water, milk, or juice. followed by 8 Oz of liquid | -Emphesize the need for 8oz of liquid. Monitor I&O, bowel fxn | 1-2 tsp with 8Oz daily prn
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| methylcellulos (Citrucel) | Laxative (bulk forming) | Increase size of fecal mass | Insufficient water can lead to obstruction of esophagus or intestine | Mix with 8 Oz of Water, milk, or juice. followed by 8 Oz of liquid | -Emphesize the need for 8oz of liquid. | 1 tbsp tid with 8-10oz of water
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| docusate (Colace) | Laxative (stool-softner/surfactant) | make more water and fat to be absorbed into the stool | abdominal cramping, diarrhea | drink clear fluid at least 2-3L/day, exercise, eat high fiber foods. | monitor for diarrhea and dehydration | PO
50-500mg/day
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| bisacodyl (Correctol, dulcolax) | Laxative (stimulant) | promote peristalsis by irritating the bowel mucosa | fluid and electrolyte loss | -expect anal or rectal burning. -not for long term use. | monitor signs of dehydration, rectal bleeding, discharge of mucous or pus, | 10-15mg/day prn
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| diphenoxylate w/ atropine (Limotil) | Antidiarrheal/ Anticholinnergic | Slows peristalsis, allowing time for additional water reabsorption from colon and more solid stool. | -Dizziness, constipation, Angle glaucoma, dry mouth, paralytic ileus w/ toxic megacolon | Avoid activiteis that require alertness. sit if light-headed, change positions gradually.chew gum. Void every 4 hrs. Drink clear liquid | Monitor for anticholinergic affects, light headedness when ambulating, urinary elimination, -recommend lowest dose | 1-2 tab tid-qid
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| loperamide (Imodium) | Antidiarrheal | Decreases the volume of ileostomy drainage. | constipation, dry mouth | Avoid activiteis that require alertness. sit if light-headed, change positions gradually.chew gum. Void every 4 hrs. Drink clear liquid | 4 mg initially, then 2 mg after each loose stool. don't exceed 16mg/day
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| camphorated tincture of opium (Paregoric) | Antidiarrheal | constipation | 5-10ml every 2hr qid prn
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| bismuth salts (Pepto-Bismol) | Antidiarrheal | constipation | 30ml prn
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| diphenhydremine (Benadryl | Antiemetic/ Antihistamine | -anorexia, dry mouth | chew gum for dry mouth | monitor ambulating, urinary retention, bowel movement, anticholinergic affects | 25-50mg tid-qid
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| dexamethasone (Decadron) | Antiemetic/ Antiasthma /corticosteroid | PEPTIC ULCERATION, THROMBOEMBOLISM, | Avoid consumption of grapefruit juice, Administer with meals, report severe abdominal pain or tarry stools occur | Monitor: I&O, electrolytes and signs of dehydration. Asses: signs of adrenal insufficiency, LOC, cohrn's disease, ulcerative colitis | 0.25-4mg bid-qid
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| Prochlorperazine (Compazine) | Antiemetic/ Antipsychotic | NEUROLEPTIC MALIGNANT SYNDROME, AGRANULOCYTOSIS |
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| ondansetron (Zofran) | Antiemetic | Blocks the effects of serotonin at 5-HT3–receptor sites | TORSADE DE POINTES | Report irregular heart beat or involuntary movement of eyes, face, or limbs occur. | Monitor ECG |
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| metformin (Glucophage) | Antidiabetic (Oral Hyproglycemic) | Suppresses gluconeogenesis, increase muscles' glucose uptake and use. | LACTIC ACIDOSIS, decreased vitamin B12 and folic acid. | discontinue med if signs of lactic acidosis occurs. | Lactic acidosis can be treated by hemodialysis. provide supplements as needed, Assess serum electrolytes, ketones, glucose | PO 500mg
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| Insulin lisparo (Humalog) | Antidiabetic (rapid acting) Onset-15 min | Promote glucose uptake, convert glucose to glycogen; amino acid to protein, fatty acid to tryglycerides. moves K+ into cell along with glucose. | HYPOGLYCEMIA, ALLERGIC REACTIONS INCLUDING ANAPHYLAXIS. | check blood glucose regularly, know signs of hypoglycemia, admin. 15g of carbohydrate (4oz of juice, 8oz of milk, glucose tablet) if hypoglycemic. | Assess signs of hypoglycemia, monitor blood glucose levels, check with another nurse for dosage | 0.2-0.6 units/kg/day, duration: 3-4hrs
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| Insulin glargine (Lantus) | Antidiabetic (Long acting) onset-1hrs | Promote glucose uptake, convert glucose to glycogen; amino acid to protein, fatty acid to tryglycerides. moves K+ into cell along with glucose. | HYPOGLYCEMIA, ALLERGIC REACTIONS INCLUDING ANAPHYLAXIS. | check blood glucose regularly, know signs of hypoglycemia, admin. 15g of carbohydrate (4oz of juice, 8oz of milk, glucose tablet) if hypoglycemic. | Assess signs of hypoglycemia, monitor blood glucose levels, check with another nurse for dosage | 10units once daily, duration: 24hrs
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| Regular insulin (Humulin R) | Antidiabetic (short acting) onset 30min | Promote glucose uptake, convert glucose to glycogen; amino acid to protein, fatty acid to tryglycerides. moves K+ into cell along with glucose. | HYPOGLYCEMIA, ALLERGIC REACTIONS INCLUDING ANAPHYLAXIS. | check blood glucose regularly, know signs of hypoglycemia, admin. 15g of carbohydrate (4oz of juice, 8oz of milk, glucose tablet) if hypoglycemic. | Assess signs of hypoglycemia, monitor blood glucose levels, check with another nurse for dosage | IV- 0.1unit/hr
subq-0.5–1 unit/kg/day
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| NPH Insulin (Humulin N) | Antidiabetic (intermediate acting) onset-1-2hrs | Promote glucose uptake, convert glucose to glycogen; amino acid to protein, fatty acid to tryglycerides. moves K+ into cell along with glucose. | HYPOGLYCEMIA, ALLERGIC REACTIONS INCLUDING ANAPHYLAXIS. | check blood glucose regularly, know signs of hypoglycemia, admin. 15g of carbohydrate (4oz of juice, 8oz of milk, glucose tablet) if hypoglycemic. | Assess signs of hypoglycemia, monitor blood glucose levels, check with another nurse for dosage | 0.5–1 unit/kg/day
duration: 18-24hrs
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| Kava kava | Antianxiety/ sedative/hypnotic | HEPATIC TOXICITY | avoid: alcohol, CNS depressants, alert activities. report signs of liver dysfxn | Assess muscle spasm, perform liver fxn test | 100mg tid
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| Garlic | lipid lowering agent | ↓ hemoglobin production and lysis of RBCs, platelet dysfunction, prolonged bleeding time. | advise pt there is potential for bleeding. need to stop using garlic 2 weeks prior to surgery. |
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| Accutane | antiacne | PREGNANCY CATAGORY X, STEVENS-JOHNSON SYNDROME, TOXIC EPIDERMAL NECROLYSIS |
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| thalidomide | Immunosuppressant | PREGNANCY CATEGORY X, SEVER BIRTH DEFECTS |
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| misoprostol (cytotec) | prostaglandins |
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| omeprazole (Prilosec) | Proton Pump Inhibitor | Decrease gastric acid secretion by binding irreversibly to an enzyme | Gastric cancer (for long term use) | on an empty stomach in the morning | -Give low dose to prevent bone loss -Monitor for bone loss via bone density scanning. | 20-60mg once to twice/day
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| ranitidine (Zantac) | H2-receprtor antagonist | Decreased gastric acid secretion by blocking H2 receptors | rare: sever reduction of RBC, WBC, platelets. -AGRANULOCYTOSIS, APLASTIC ANEMIA, ARRHYTHMIAS | Do not take Antacid together -P.C. | check liver and renal fxn monitor CBC | -100-150mg bid or
-300mg at bed time
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| aluminum hydroxide (AlternalGEL) | Antacid | neutralizes the stomach by raising pH levels | -Constipation -Hypophosphotemia | Administer at least 2 hrs before/after other drugs | Monitor phosphorus and magnesium levels | 600mg tid-qid
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