treat HTN by blocking conversion of

angiotensin I to angiotensin II
ACE inhibitors (lisinoPRIL)
treat HTN by blocking the binding of
angiotensin II to recetors in tiss!es
AR"# (lo#ARTAN)
$lisinoPRIL ACE inhibitors
$lo#ARTAN AR"#
%hat to &onitor %hen taking ACE (lisinoPRIL)
'AR"# ( lo#ARTAN)
&onitor () levels* blood ress!re and
angiode&a (give ei s!b+)
sto di!retics ,-$-. hrs before starting ACE inhibitors (lisinoPRIL)
ACE (lisinoPRIL) &ay ca!se/ ersistent non rod!ctive co!gh
side e0ects incl!de/ angiode&a (ad&inister ei
s!b+) and hyotension $ sho!ld not be !sed in
the ,nd'1rd tri&ester of regnancy
ACE inhib(lisinoPRIL) ' AR"s (lo#ARTAN)
AR" that sho!ld be taken 2 ho!r before &eals catoPRIL
slo%s &ove&ent of calci!& into s&ooth
&!scle cells ca!sing arterial dilation and
decreased "P
calci!& channel blockers (CC"s)
a&lo3IPINE* veraa&il* cardi4e& CC"s
!sed to treat angina and HTN CC"s/ a&lo3IPINE* veraa&il* cardi4e&
&ay be !sed to treat a5b* a6!tter or #7T veraa&il and dilta4e&
reca!tions'interactions in CC"s/ a&lo3IPINE*
veraa&il* cardi4e&
ts taking digo8in and beta$blockers9
heart fail!re* heart block or bradycardia9
do not cons!&e graefr!it :!ice
side e0ects' advrse e0ects of CC"s
(a&lo3IPINE* veraa&il* cardi4e&)
constiation* re6e8 tachycardia*
eriheral ede&a* and to8icity
in:ect I7 CC"s (a&lo3IPINE* veraa&il*
cardi4e&) over ;;;; to ;;;; &in
, $ 1
ho% to 3'C CC"s (a&lo3IPINE* veraa&il*
cardi4e&)
slo%ly taer
%hat to &onitor in ts taking CC"s
(a&lo3IPINE* veraa&il* cardi4e&)
heart rate and "P
another na&e for alha adrenergic blockers
(ra<=#IN)
sy&atholitics (ra<=#IN)
decreases "P by inhibting alha$2 adrenergic
recetors ca!sing arterial and veno!s dilation
sy&atholitics (ra<=#IN)
&ay be !sed in the treat&ent of "PH do8a<=#IN
%hat dr!gs &ay decrease the e0ect of
ra<=#IN
N#AI3s
side e0ects of sy&atholitics (ra<=#IN) di44iness* fainting* hyotension
%hat ti&e sho!ld sy&atholitics (ra<=#IN) be
taken and %hy>
at bedti&e to &ini&i4e e0ects of
hyotension
decrease eriheral vasc!lar resistance by
sti&!lating alha adrenergic recetors
alha$, agonists (catares* tene8*
aldo&et)
antiHTN dr!gs that &ay be !sed in severe
cancer ain
alha$, agonists (catares* tene8*
aldo&et)
%hen are alha$, agonists (catares* tene8*
aldo&et) contraindicated
in ts taking anticoag!lants'?A=Is * ts
%ith heatic fail!re'C7A* ?I* diabetes*
dression or chronic renal fail!re
do not ad&inister ;;;;;;;; thro!gh I7 line %ith alha$, agonists (catares* tene8*
barbit!ates or s!lfona&ides aldo&et)
lactating &others sho!ld not !se these
antihyertensives
alha$, agonists (catares* tene8*
aldo&et)
dry &o!th* dro%siness'sedation* rebo!nd HTN*
black'sore tong!e* le!koenia
side e0ects of alha$, agonists (catares*
tene8* aldo&et)
ts sho!ld notify the hysician of this %hen
taking alha$, agonists (catares* tene8*
aldo&et)
invol!ntary :erky &ove&ent* rolonged
di44iness* rash* yello%ing of the skin
decrease/ cardiac e8citability* cardiac o!t!t*
and &yocardial o8ygen de&and9 lo%er "P by
decrease release of renin in the kidney
beta$blockers (&etor=L=L)
beta$blockers (&etor=L=L) are
contraindicated in ts %ith
A7 block* or chronic resiratory diseases
;;;;;;; (beta$blocker) &ay &aks signs of
hyoglyce&ia in diabetics
roan=L=L
do not ad&inister labet=L=L in the sa&e line
%ith >
f!rose&ide
side e0ects of beta$blockers (&etor=L=L) bradycardia* nasal st!@ness* A7 block*
bronchosas&
hold beta$blockers (&etor=L=L) %hen #"P A
;;;; or HR A ;;;;;
#"P A2BB ' HR A CB
nitro* nicardIPINE* vasotec I7* es&olol are> vasodilators
!sed in HTN e&ergencies b'c they directly
dilate arteries and veins res!lting in decreased
reload and afterload
vasodilators (nitro* nicardIPINE* vasotec
I7* es&olol)
vasodilators (nitro* nicardIPINE* vasotec I7*
es&olol) sho!ld not be !sed in ts %ith>
heatic'renal disease* old age* electrolyte
i&balances
side e0ects of vasodilators (nitro* nicardIPINE*
vasotec I7* es&olol)
di44iness* HA* rofo!nd hyotension*
cyanide to8icity*
nitror!sside &ay not be &i8ed %ith ;;; any other &eds
cardiac glycosides digo8in
increases the force in velocity of heart
contractions to i&rove stroke vol!&e (DB&L)
and cardiac o!t!t and slo% cond!ction rate
digo8in
!sed to treat heart fail!re and a5b digo8in
;;;;;;;;; &eds increase risk of hyokale&ia
and reciitate digo8in to8icity
thia4ide' loo di!retics* AR"s
(lo#ARTAN) 'ACE inhibitors (lisinoPRIL)
signs of digo8in to8icity E Early signs of to8icity/ FI !set/
Anore8ia* N'7'3*
E Late signs of to8icity/ HA* vis!al
dist!rbances* HR abnor&alities
nor&al ser!& digo8in level BG. $ ,
ad&inister ;;;; for digo8in overdose digibind
in digo8in to8icity %hat sho!ld dysryhth&ias be
treated %ith %hen digo8in is stoed
dilantin
slo%s cond!ction ti&e thro!gh the A7 node*
interr!ts A7 node ath%ays to restore N#R
adenosine
rolongs reolari4ation* rela8es s&ooth
&!scles* decreases vasc!lar resistance
a&iodorone
increases 5ring of the #A node and cond!ction atroine
thro!gh the A7 node$ ooses action of the
vag!s nerve
convert s!raventric!lar tachycardia (#7T) to
N#R
adenosine
treat 7$Hib* !nstable ventriv!lar tachycardia a&iodarone
treat asystole* bradycardia atroine
anti$hyerliide&ia &eds statins
;;;; &ay ca!se rolonged bleeding in ts take
co!&adin
statins
do not ad&inister statins %ith ;;;;;> graefr!it :!ice
inhibits the absortion of cholesterol 4etia
%hen sho!ld 4etia be taken 2 ho!rs before or - ho!rs after statins
short$acting inhaler for ac!te bronchosas& alb!terol
long acting inhaler for for long$ter& control of
asth&a
foradil* serevent
oral* long acting beta$, adrenergic agonists
(bronchodilator) !sed for long$ter& control of
asth&a
terb!taline
;;;;;; &eds that %ill increases the e0ect of
bronchodilators
?A=Is
ca!ses rela8ation of bronchial s&ooth &!scle
ca!sing bronchodilation !sed for long ter&
control of asth&a
theoPHILLINE
;;;;;; and ;;;;;; decrease theoPHILLIN levels henobarbitol and henytoin
therae!tic level of theoPHILLINE 2B$,B &cg'&L
treat&ents of theoPHILLINE to8icity activated charcoal to decrease
absortion* lidocaine for dysrhyth&ias
and dia4ea& for sei4!res
inhaled anticholinergics ca!sing
bronchodilation
iratr=PIJ?
iratr=PIJ? is contraindicated in ts %ith a
;;;;;; allergy
ean!t
!se iratr=PIJ? %ith e8tre&e ca!tion in
atients %ith ;;;;;; and ;;;;;;
ac!te angle gla!co&e and "PH
side e0ects of iratr=PIJ? dry &o!th'eyes and !rinary retention
do not take gl!cocorticoids %ith ;;;;;;; N#AI3s
revents e0ects of le!kotrienes ca!sing
decreased/ in6a&&ation* bronchoconstriction*
air%ay ede&a* and &!c!s rod!ction
sing!lair* 4y6o
;;;;;;;; %ill decrease the circ!lating e0ects of
sing!lar
henobarbital
side e0ects of sing!lair and 4y6o elevated LHTs* %arfarin and theohylline
to8icity
slo%s carb absortion and digestion*
contraindicated in ts %ith intestinal disease
Precose* Flyset
red!ces gl!coneogeneis* increases gl!cose
!take by &!scles
&etfor&in
ro&otes release of ins!lin* lo%ers gl!cagon
secretions and slo%s gastric e&tying
Kan!via
Kan!via dose sho!ld be red!ced in atients %ith i&aired renal f!nction
diabetes &ed that sho!ld be %ithheld for -.
hrs rior to and after contrast
&etfor&in
&etfor&in is contraindicated in atients %ith severe infection* shock* hyo8ic
conditions
red!ces rod!ction of gl!cose and sho!ld not
be !sed %ith NPH
randin* starli8
ro&otes release of ins!lin fro& the ancreas glii4ide* glyb!ride
these diabetes &eds ca!se high risk for
hyoglyce&ia in ts %ith renal* heatic or
adrenal disorders
glii4ide* glyb!ride
oral &edications that decreases ins!lin
resistance
Avandia* Actos
oral diabetes &edications that have a high risk
for CHH d!e to 6!id retention
Avandia* Actos
onset of h!&alog less than 2C &in
eak of h!&alog 1B$LB &in
d!ration of h!&alog 1$- ho!rs
onsent of reg!lar ins!lin 1B$LB &in
eak of reg!lar ins!lin ,$1 ho!rs
d!ration of reg!lar ins!lin C$D ho!rs
onset of NPH 2$, ho!rs
eak of NPH -$2, ho!rs
d!ration of NPH 2.$,- ho!rs
onset of lant!s 2 ho!r
eak of lant!s none
d!ration of lant!s 2B$,- ho!rs
3ra%ing$! reg!lar and NPH ins!lin N$R$R$N
2G In:ect air into NPH
,G In:ect air into reg!lar
1G 3ra% ! reg!lar ins!lin
-G 3ra% ! NPH
%hen sho!ld lant!s be ad&inistered at bedti&e
do not &i8 other ins!lins %ith h!&alog* lant!s or co&bination ins!lins
the only ins!lin given I7 reg!lar
glyce&ic agent that breaksdo%n glycogen into
gl!cose in the liver
gl!cagon
gl!cagon sho!ld not be &i8ed %ith ;;;;; and
;;;; sol!tions
sodi!& or de8trose
sti&!lates the &etabolis& of all body syste&s
acclerating the rate of cell!lar o8ygenation
synthroid
side e0ects of synthroid' signs of
hyerthyroidis&
tachycardia* restlessness* diarrhea* %t
loss* decrease bone density* heat
intolerance* inso&nia
inhibits synthesis of thyroid hor&one Taa4ole
increases rod!ction of ins!lin$like gro%th
factor
so&at=TR=PIN
avoid !se of ;;;;; %hen taking so&at=TR=PIN gl!ccocorticoids
so&at=TR=PIN is ad&inistered s!b+
ro&otes reabsortion of %ater %ith the
kidneys9 vasocontriction of vasc!lar s&ooth
&!scle
des&oPRE##IN
des&oPRE##IN is !sed to T8 diabetes insiid!s* cardiac arrest and
noct!rnal en!resis
side e0ects of des&oPRE##IN hyonatre&ia* sei4!res and co&a
blood rod!ct !sed to relace vol!&e %hole blood (,$- hr)
blood rod!ct !sed to T8 severe ane&ia*
he&olytic ane&ia* erythroblastosis
acked R"Cs (,$- hr)
blood rod!ct to T8 active bleeding* alastic
ane&ia* and bone &arro% s!oression
latelets (2C$1B &in)
blood rod!ct !sed to T8 he&orrhage* b!rns*
shock* TTP* and reverse e0ects of %arfain
HHP
sti&!lates R"C rod!ction Procrit
sti&!lates M"C rod!ction &ay ca!se bone
ain or le!kocytosis
Ne!ogen* Ne!lasta
sti&!lates latelet rod!ction Ne!&ega
hold digo8in if an infants !lse is less than NB
hold digo8in if a childOs !lse is less than DB
%hen to delay He " va8 allergy to bakerOs yeast* liver disease
%hen to delay 3TaP va8 1B days after i&&!nos!ression
%hen to delay Hib va8 if child is ill
delay all va8 if te& P > 2B2GBH
%hen to delay ??R va8 allergy to eggs* neo&ycin* gelatin $
regancy
%hen to delay 7aricella 7a8 allergy to neo&ycin* gelatin
%hen to delay ne!&ococcal va8 sensitivity to ditheria
%hen to delay &eningococcal (?C7) va8 regnancy
In bacterial &eningitis ;;;;;;; Q ;;;;;; are
elevated and ;;;;;;;;; is decreased
M"C'rotein R elevated
gl!cose R decreased
ab8 class !sed to T8 sesis* &eningitis*
ne!&onia
a&inoglycosides (a&akin* vanco?ICIN)
this class of ab8 are ototo8ic* nehroto8ic*
"JN'creat sho!ld be &onitored
a&inoglycosides (a&akin* vanco?ICIN)
therae!tic level of vanco?ICIN ,B$-B&cg'dL
ab8 class !sed to treat JRIs* skin and JTI* cehalosorins (cehale8in* CEHaclor)
this class of ab8 have a cross sensitivity %ith
PCN and yo! sho!ld &onitor for CGdi0
cehalosorins (cehale8in* CEHaclor)
!se ca!tion in atients %ith heatic* renal or
sei4!re disorder %ith these ab8
6!roS!inolones (ciroHL=TACIN)
!sed for clients %ith a PCN allergy and
ad&inister %ith &eals
4$ak* e$&ycin* bia8in
a broad sectr!& ab8 contraindicated in ts
%ith renal dysf!nction !sed to T8 JTI
&acrodantin
%arn ts taking &acrodantin that> GGGGG !rine %ill t!rn bro%n
%hen taking "actri& and #etra> cons!&e at least 1L of %ater* !se back$
! contracetives* avoid s!n e8os!re
%hen taking tetraCICLINEs cons!&e at least 1L of %ater* !se back$
! contracetives* avoid s!n e8os!re
do not give ;;;;;; to children less than . d!e to
er&anent teeth discoloration
tetraCICLINEs
;;;;;;;; ca!ses gingivitis* gingival hyerlasia 3ilantin
%hat 7a8 are needed by age L 3Ta* IP7* ??R* 7aricella*
&onitor heatic'renal f!nction* refrigerate
s!sensions* increased risk - bleeding in ts
taking anticoag!lants
3i6!can
&onitor for dr!g ind!ced retinoathy in ts
taking
laS!enil* S!inine
!sed for revention and T8 of T" INH* rifa&in
recations %hen taking ;;;;;;; incl!de/
risk of ne!roathies'heatoto8icity
cons!&e "L
avoid alcholol
INH
avoid eating ;;;;; and taking ;;;;;; %hen on
INH
tyra&ine ' dilantin
;;;;;;;; %ill ca!se discoloration of !rine* saliva*
s%eat and tears
rifa&in
ad&inister this antiretroviral on an e&ty
sto&ach
A<T* retrovir
ad&inister these antiretrovirals %ith food acyclovir
%hen taking any antiretroviral
2G>
,G>
increase 6!id intake
begin theray %ith 5rst onset of
sy&to&s
osteoorosis &eds (boniva* 4o&eta) absortion
is decreased %hen taken %ithGGGGGG
calci!&* =K* antacids* ca0eine
osteoorosis &eds (boniva* 4o&eta) sho!ld be
ad&inistered
in the A? on an e&ty sto&ach
this &ed !sed to T8 rhe!&atoid arthritis is
contraindicated in regnancy* renal'liver fail!re*
soriasis* blood disorders
3?AR3s
this &ed (3?AR3) !sed to T8 rhe!&atoid
arthritis &ay ca!se increased risk for infection*
bone &arro% s!ression* FI !lceration
&ethotre8ate
laS!enil &ay ca!se retinal da&age (blindness)
go!t &ed that inhibits !rac acid rod!ction
!sed to treat ACJTE go!t
allo!rinol
go!t &ed that inhibits rocesses to revent
le!kocytes fro& invading :oints !sed to treat
CHR=NIC go!t
colchine
go!t &eds are contraindicated in ts %ith>>>> renal* cardiac and FI dysf!nction
avoid ;;;;; %hen taking &eds for go!t A#A
na&e - antian8iety &eds lora<EPA?* 8ana8* libri!&* "!#ar
do not give ;;;;;; and ;;;;;; to ts %ith
s!bstance ab!se and liver disease
7ali!& and "!#ar
;;;;;;; is contraindicated fo clients taking "!#ar
?A=Is
%hich antian8iety &ed %ill not ca!se
%ithdra%al #8
"!#ar
treat overdose of antian8iety &eds %ith ;;;;;; Ro&a4icon
%hat antideressants are contraindicated for
clients %ith sei4!re disorder
tricyclics (Elavil* ToHRANIL* do8ein)
do not ad&inister ;;;;;; %ith ?A=Is or #tGKohns
%ort
tricyclics (Elavil* ToHRANIL* do8ein)
&onitor for anticholinergic e0ects* sedation*
to8icity and decreased sei4!re threshold in ts
taking
tricyclics (Elavil* ToHRANIL* do8ein)
the follo%ing are #8 of ;;;;;;;;
agitation* conf!sion* hall!cinations and sho!ld
be &onitored for the 5rst ;;;; hr %hen taking
;;;;;;
serotonin syndro&e* D, ho!rs* ##RIs
(aroTETINE* le8aro* l!vo8* 4oloft)
side e0ects of ##RIs (aroTETINE* le8aro*
l!vo8* 4oloft) incl!de
%eight gain
se8!al dysf!nction
fatig!e
dro%siness
?A=is incl!de &arlan* Parnate
do not take ?A=Is %hen taking ;;;;;;; antihyertensives
;;;;;; are contraindicated in ts taking ##RIs*
tricyclics* and %ho have heart fail!re* C7A*
renal ins!@ciency
?A=Is
side e0ects of ?A=Is incl!de CN# sti&!lation* orthostatic hyotension
instr!ct client to take ;;;;;;; antideressants in
the A?
##RIs (aroTETINE* le8aro* l!vo8* 4oloft)
;;;;;; and ;;;;; %ill increase lithi!& levels N#AI3s and A#A
&onitor ser!& ;;;;; levels %hen taking lithi!& sodi!&
therae!tic level of lithi!& BG- $ 2&ES'L
therae!tic e0ects of lithi!& begin in ;;; to ;;;
days
D to 2-
%hat is the lithi!& to8icity level>
#8/ FI distress* &ental conf!sion* oor
coordination* coarse tre&ors
2GC to ,/ &oderate to advanced
%hat is the lithi!& to8icity level>
#8/ ata8ia* conf!sion* increased dil!te !rine
o!t!t* bl!rred vision* clonic &ove&ents*
sei4!res* st!or* severe hyotension* and
co&a* !l&onary co&lications &ay lead to
death $ !se ;;;;;;; to increase rate of e8cretion
P ,/ severe $ &annitol
ac!te dyskinesias and dystonic reactions*
tardive dyskinesia* Parkinsonis&* akinesia*
akathisia* and ne!roletic &alignant syndro&e
are>>>
e8trayra&idal e0ects of conventional
(haldol* thora4ine* nacene) antisychotics
a disorder res!lting in invol!ntary* reetitive
body &ove&ents
tardive dyskinesia
Co&&on sy&to&s incl!de/
E3ecrease in facial e8ressions
E3i@c!lty starting and controlling &ove&ent
ELoss or %eakness of &ove&ent (aralysis)
E#oft voice
E#ti0ness of the tr!nk* ar&s* or legs
Parkinsonis&
ETre&or
absence* overty* or loss of control of vol!ntary
&!scle &ove&ents
akinesia
a disorder in %hich there is an !rge or need to
&ove the legs to sto !nleasant sensations
akathisia
#y&to&s incl!de high fever* s%eating*
!nstable blood ress!re* st!or* &!sc!lar
rigidity* and a!tono&ic dysf!nctionG
ne!roletic &alignant syndro&e
#y&to&s occ!r %ithin &in!tes to ho!rs of
taking (aroTETINE* le8aro* l!vo8* 4oloft)* and
&ay incl!de/
E Agitation or restlessness
E 3iarrhea
E Hast heart beat
E Hall!cinations
E Increased body te&erat!re
E Loss of coordination
E Na!sea
E =veractive re6e8es
E Raid changes in blood ress!re
E 7o&iting
serotonin syndro&e
!sed to &aintain sobriety in T8 of alcoholis& antab!se
do not give antab!se %ithin ;;;; days of
drinking alcohol
2- days
&edications !sed to treat &ysasthenia gravis Prostg&in* ?ytelase* Tensilon
do not ad&inister &yasthenia gravis &eds if
systolic "P is belo%
NB
"L decreases the e0ects of this arkinsonOs
&ed
levodoa
;;;;;;; ca!ses increased e8cretion of digo8in*
%arfarin* and =CP
3ilantin
therae!tic range for 3ilantin 2B$,B
do not take Ti&otic %hen !sing CC"s and beta$blockers
;;;;;; oiod is contraindicated after biliary
tract s!rgery
&orhine
;;;;;;; oiod is contraindicated in clients %ith
renal fail!re
3e&erol
therae!tic level of &agnesi!& s!lfate -$.
act on !terine &!scle to sto contractions tocolytics (brethine* rocardia* &ag
s!lfate)
signs of &agnesi!& s!lfate to8icity 3eressed 3TR (dee tendon re6e8)
$ Resiratory deression
$ Co&a
$ Cardiac arrest
$ 3eathG
if yo! s!sect &ag to8icity > ad&inister Calci!& Fl!conateG
3ecreased a&&onia level R i&rove&ent in ts %ith heatic
encehaloathy
?!scle sas&s indicate hyo or
hyercalcae&ia
hyocalcae&ia
#8 of hyo or hyer calce&ia
Lethargy* %eakness* fatig!e* conf!sion* %t loss*
bone ain* cardiac dysrhyth&ias and kidney
stone
hyercalce&ia
;;;;;;;;%ill be elevated in bone or liver disease
and is also raised by alcohol and heatoto8ic
FFT
dr!gs
A 6atted T %ave is indicated of > hyokale&ia
a&inoglycosides (genta?ICIN* vanco?ICIN)
are ad&inistered I7 over ;;;;;;;; (ti&e)
2 ho!r
a vasoressor !sed in the T8 of shock and
heart fail!reG
increases cardiac o!t!t by increasing
&yocardial contractility
Ualso dilates renal blood vessels* %hich increase
renal rof!sion leading to increased !rine
o!t!t
doa&ine
therae!tic e0ect of doa&ine increased !rine o!t!t d!e to dilated
renal blood vessles and increased renal
erf!sion
side e0ects of doa&ine increased !lse
HTN
dysrhyth&ias
!sed to correct hyotension that is
!nresonsive to adeS!ate 6!id vol!&e
relace&ent or occ!rs as art of shock
syndro&e ca!sed by bactere&ia* chronic
cardiac deco&ensation* dr!g overdose* ?I*
oen$heart s!rgery* renal fail!re* tra!&a* or
other &a:or syste&ic illnesses9 to i&rove lo%
cardiac o!t!t
vasoressors (doa&ine)
Mhere is Penicillin F ad&inistered> PCN F is very irritating and sho!ld be
in:ected into a large &!scle (ventral
gl!teal ' vast!s lateralis) !sing a ,,$,CF 2
$2 2',V needle and sho!ld be
ad&inistered dee
%hy is ?ag s!lfate is ad&inistered to re$ to revent sei4!res
ecla&sia ts>
the best evidence of therae!tic resonse to
Plavi8 is
absence of angina* neck':a% ain and
absence of di@c!lty s%allo%ing
ts %ith an allergy to PCNs &ay also have an
allergy to this ab8 class
CEPH'Halosorins
N#AI3s ;;;;;;; di!retic e0ects red!ce
to8ic levels of ;;;;;;;; can ca!se
diloia'do!ble vision* HA* and vertigoG #er!&
sodi!& levels can be i&acted and !rine
o!t!t decreased
?edication !sed for alcohol %ithdra% are Libri!&
Elavil* is a antideressant* the side e0ects are =rthostatic hyotension* di44iness* get !
Q &ove slo%ly* ?onitor "P* Q heart rate
before* and 2 ho!r after ad&inistering* if
decrease in heart rate* hold &eds Q notify
3octorG
Elavil* Theray Relief can take 2 to 1 %eeks* and ossibly
, to 1 &onths for f!ll bene5tG
Elavil* also e0ects Jrinary retention* dry &o!th* bl!rred
vision* hotohobia* constiation*
tachycardia
Proranolol* as Inderal* is a "eta "locker 3o not sto ab!rtly* client sho!ld &onitor
heart* and "lood Press!re daily* Treats*
hyerthyroidis&* &igraine* and gla!co&a
Proranolol* Inderal #ide E0ect "radycardia* !lse rate belo% LB* hold
&edication Q call 3octor* 3iabetics can
&ask tachycardia* &onitor gl!cose to
detect hyoglyce&ia* 3ecreased cardiac
o!t!t signs* are shortness of breath*
ede&a* fatig!e* =rthostatic hyotension*
faintness* Avoid in client %ith asth&a
Lisinoril* as Prinivil is a Ace Inhibitor
for "lood Press!re
Treats* Hyotension* heart fail!re*
&yocardial infraction* it decreases the left
ventric!lar dysf!nction
Lisinoril* side e0ects are Ca!ses a 3ry co!gh* sto &edsG* notify
3octor*
hyerkale&ia* &onitor otassi!&*
e8ected range 1GC to C* Rash Q
dysge!sia* as altered taste*
Angioede&a is a s%ollen tong!e* and oral
haryn8* side e0ects are treated %ith
in:ection of Einehrine
3ystonia #as& #!stained* invol!ntary &!scle
contractions
3antri!&* is a #keletal ?!scle Rela8ant Treats ?alignant hyerther&ia* sti0ness*
and sas&s* can occ!r d!ring s!rgery
%ith certain tyes of anesthesiaG
Cehalosorin* is a "road setr!& bacterial
&edG
Treats Jrinary tract infection* ost
oerative infection* Q elvic infection
Iron s!le&ent Need to take %ith 7iti&in C* olike orange
:!i8ce* to increase absortion* Avoid &ilk*
Q calci!&* it interferes %ith absortion*
!se a stra% it can stain teeth* ?ay ca!se
black stools and constiation
Nitroress is !sed to treat congestive heart fail!re*
and life threatening high blood ress!re*
as hyertensionG
?yasthenia Fravis* Treat&ent 3r!gs It e0ects the &!scles of the eyes* face*
&o!th* throat* neckG Me &ay see facial
drooing* dr!gs !sed are Neostig&ine* as
rostig&ine
3ilantin* adverse e0ects are Hyerlasia* as bleeding F!&s* RashG*
and
3ilantin #ide E0ect* is Hair loss
3ilantin* 3r!g interaction %ith =ral contracetives* Co!&adin* and
Fl!ccocorticordsG*
3ilantin are !sed to control #ei4!res
Ti&olol Is a beta blocker* that is !sed for
treat&ent of gla!co&a*
as I=P of the eyes
Probenecid* interacts %ith Anti go!t &edications* it revents re
absortion of !ric acid Fo!t* it also
inhibits the secretion of enicillin
Pinicillin Interacts %ith Asirin* and A&inoglycosides* %hen
&i8ed in the sa&e I 7 sol!tion
Co!&adin kno%n as %arfarin INR/ ,$1* a anticoag!lant* revention of
blood clotsG
?eds that interact* %ith co!&adin are
Hearin* 3ilantin* Q Aceta&inohen as
tylenol* and Asirin
Hearin* Thera!etic Range LB to .B* inhibits the clotting rocessG*
latelet !nder 2B*BBB* sto &edication
Hearin* I 7 3ri LabG 7al!e ?onitor aPTT 2GC to ,G* ad&inister slo%ly*
no &ore than ,B&g er &in!te* and
CB&g er 2B &in!teG*
3igo8in* a cardiac glycoside 7al!e are 2GC to ,GB* ?onitor otassi!&
levels*
The dr!g Lasi8* interacts %ith digo8in* and
increases to8icity
3igo8in* #ide E0ects are Anore8ia* tachycardia* bradycardia* and
heart block
Ta&o8ifen* A Cancer dr!g* a =ral ?edication Estrogen Recetor "locker* #tos gro%th
of "reast Cancer* #ide E0ect are*
Endo&etrial Cancer* abnor&al bleedingG*
Hyrecalce&ia* &ontior calci!& levelsG*
P!l&onary E&bol!s* shortness of breath*
and chest ainG
Hentanyl* is a Narcotic Analgesic It is &ore otent than &orhine* yo!
need a %ritten rescrition for& Physician
Theohylline* 3r!g A bronchodilator to treat asth&a*
bronchitis* e&hyse&a* %hich Interacts
%ith ca0eine
Cro&oly& #odi!&* as Intal Inhaler Is a anti in6a&&atory* a Long acting
control of asth&a*
Mait 2C &in!te after !se for activity* or
e8os!re to allergen
Alb!terol* is !sed for e8ercise ind!ced Asth&a Jse the Alb!terol inhaler 5rst9 then %ait
abo!t C &in!tes before !sing the steroid
inhalerG* This allo%s the Alb!terol to oen
! yo!r air%ays* so the steroid can %ork
betterG
Antihesti&ine* as "enadryl Ca!ses sleeiness
PTJ* Interacts %ith 3igo8in* ?ay increase gl!coside levels
PTJ* side e0ects Hyothyroidis&* Meight gain*
"radycardia* Anore8ia* cold intolerance*
heatic to8icityG* agran!locytosis is RARE*
b!t ca!se sore throat* Q fever
Loid Hibrates* for Cholesterol Test ?onitor "aseline Liver f!nction* Q Renal
f!nction test
"ihoshonates "oniva* adds calci!& to bones for
osteoorosis* Take on e&ty sto&achG* sit
!right for 1B &in!tes after takingG* No
food* or calci!& s!le&ents %ithin an
ho!r of taking &edicationG* Not for atient
%ith hyocale&ia* it can ca!ses cardiac
arrest
?ethotre8ate* a Rhe!&atoid Arthiritis ?ed*
interact %ith
N#AI3* Q #!lfona&ides* &ay ca!se
To8icity* &onitor levels
Rhe!&atoid Arthiritis* Hindings to Reort Patient sho!ld be tested for t!berc!losis
5rst* and any active infection* or 6!
Rhe!&atoid Arthiritis ?edG Adverse E0ects Are at risk for infection* fever* sore throat*
fetal death* heatic 5brosis* and sho!ld
&onitor liver f!nction
Ergostat* ?edication Treats &igraines
Ergostat* #ide E0ect are Hetal abortion* FI disco&fort* na!sea*
vo&itingG*
Ergotis&* are &!scle ainG* Paresthesias*
cold 5ngers Q toes
"yetta* is a 3iabetes ?ellit!s*
They are re5lled in:ection en
Mhich can ca!se Pancreatitis* and severe
abdo&inal ain* sto &edication* and
notify doctorG* It also ca!ses F I e0ectsG*
"yetta needs in:ected 2 ho!r rior to
&eals* NE7ER INKECT AHTER ?EAL* store
in refridgarator
Antivirals* &edications treat HI7* heres* Heatitis "* C* In6!en4a A Q
"*
#lo%s do%n viral load* and allo%s the T
cells levels to stay nor&alG* Alha
interferons inhibit sread of vir!ses to
ne% cells
Rifa&in A treat&ent given to T" atients* it is
taken in con:!nction %ith the other 5rst
line &edication* This can ca!se =RANFE
C=L=RE3 JRINE* and er&enant
discoloration of soft contact lensesG
Potassi!& Inf!sion Five no faster than 2B&ES er ho!r and*
val!e level 1GC to CGB
If there is a &edication error Check atients vital signs 5rst
Che&o 3r!gs* contraindication are Liver* kidney* %o&en regnant* and
atient that %ith i&&!nos!ression
Fara&yci&* is a Antibiotic Protien synthesis #ide E0ect* hearing lossG* Interacts %ith
&ilk* calci!&* anatcids* and iron
s!le&entsG* take 2 ho!r before &eals
on a e&ty sto&ach
Levodoa* a Anti ParkinsonOs dr!g It is converted into doa&ine in the brain*
%hich increases intraoc!lar ress!re* and
is contraindicated in closed angle
gla!co&a
Ne!rologic 3r!gs* as 3ilantin kno%n as
Phenytoin* interacts %ith
?A=Is* Co!&adin* =ral contracetives*
CN# deressants* and graefr!it :!ice
"lood Press!re ?eds* as 3e&erol* ?orhine* Q
Hentanyl* adverse e0ects
Are Resiratory deression* and
hyotension
Ca!tion of =lder atients ?edications e0ect older atients liver*
renal* F I* blood
Hearin* Adverse E0ects "r!ising* etichiae* bleeding* and
Thro&bocytoenia* lo% latelet
Hearin* in:ections are Fiven s!bc!taneo!s* , inches fro& the
!&bilic!s* aly ress!re for 2 to ,
&in!tes after in:ection* Hearin is a anti
clotting s!bstance for&ed by tiss!e cells*
esecially the liver9 a antirothro&bin
"enadryl* is a Antihista&ine H 2 Recetor #ide E0ects are #leeiness* and dry
&o!th
"acteria Cell Mall ?edications Are in:ected I ? in the b!ttlock &!scle
area* ca!tion %ith in:ecting arteries
"2, 3e5ciency* #igns Are Ne!roathy* beefy tong!e* Patients
need to adhere to Lab tests* and blood
co!nt levels
"2, 3e5ciency* Treat&ent Cyanocobala&in as cobala&in in:ection*
Teach atient to eat green leafy
vegetables
"2, 3e5ciency* ca!ses Hyokale&ia* &onitor otassi!& levels*
also ernicio!s ane&ia* gastric byass*
acid s!ression* CrohnOs* tae%or&* and
ile!& resection
Antilie&ic* as Liitor* and* <ocar Need to take half ho!r before &ealsG*
&onitor ck levelsG*
side e0ects* are &!scle ache* ain in
hands and feet* n!&bnessG* avoid
graefr!it :!ice
Probenecid Treats Chronic Fo!t* a dr!g that red!ces
the level of !ric acid in the blood
Probenecid* interacts %ith Asirin
?alignant Hyerther&ia A a hereditary condition of !ncontrolled
heat rod!ction* occ!rring %hen
s!scetible ersons receive certain
anesthetic dr!gsG
?alignant Hyerther&ia* is treated %ith 3antri!&
antihychotic dr!gs* as Haldol* Thora4ine*
#ide e0ects
Are 3ystonia* sas&* neck sas&
Che&o 3r!gs* Adverse E0ects Are Hair loss* na!sea* vo&iting*
diarrehea* and lo% %hite blood cells
3i!retics* as Lasi8* Q =s&itrol* #ide E0ects Are 3ehydration* and Hyokale&ia*
ca!ses lo% otassi!&* &onitor
otassi!&* if belo% 1G2 notify doctor
Calci!& channel "lockers* as 7eraa&il*
side E0ects
Are ede&a* hyotension* do not drink
graefr!it :!ice
=s&ostic 3i!retics* as =s&itrol treats Red!ces the intracranial ress!re of the
eye
7ita&in ( is a antidote for Patient* on co!&adin* and e8erience
bleeding
Al4hei&ers taking 3onee4il #ide E0ect Is dysnea* ca!ses bronchconstrictionG*
N!rse sho!ld notify doctor
Libri!& ?edication Prevents deliri!& tre&ors
(etrorolac Q Toradol #ide E0ects Increase risk of bleedingG* check for
bri!singG* Take %ith food
"etaace ?edication Is !sed to decrease heart rate
I&d!r #ho!ld be given* if atients blood
ress!re is less than NB
Narcan Is taking to revent hyotensionG* To %ake
! atient
Pilocar Is !sed to treat gla!co&a* the rest of the
atients life