Common name, not capitalized

Name used for marketing and followed by symbol (R). Name is registered and its use is restricted to the owner of the drug.

Chemical constitution of the drug

drug is transferred from its site of entry into the body to the circulating fluid (blood, lymph)

ways in which drugs are transported by the circulating body fluid to the sites of action, metabolism, and excretion

"biotransformation"- process by which body inactivates drugs

elimination of metabolites of drugs, and sometimes the active drug, in urine, feces, sweat, tears.

inhalation, sublingual, topical

when adverse side effects are severe

a severe, life-threatening reaction that causes respiratory distress and cardiovascular collapse. It is a medical emergency and requires immediate attention.

When one drug is chemically incompatible with another drug causing deterioration when the two drugs are mixed. Signs: cloudiness, haziness, precipitation, color changes

Ex: ampicillin + gentamicin= ampicillin inactivated gentamicin

Two drugs with similar actions are taken for a doubled effect

Ex: propoxyphene + aspirin= added analgesic effects

The amount of time required for half of the drug to be eliminated from the body. Drugs with short half lives must be given more frequently than drugs with long half-lives.

Ex: Aspirin half-life: 5 hours-give frequently, Digoxin half-life: 36 hours-give daily

Hypersensitivity reaction-occurs in 6-10% of patients taking medications. Occur in patients previously exposed to a drug and have developed antibodies. Most drug allergies are mild. Urticaria is a possible warning to an anaphylactic reaction.

Agonists: drugs that interact with a receptor to stimulate a response.

Antagonists: drugs that attach to a receptor, but DO NOT stimulate a response

Begins with patient admission and ends with discharge. Subjective (what client says) and Objective (what nurse observes)

Gathering and compiling data obtained from assessment to prioritize patient's needs.

Develop goals (client will), prioritize goals, nursing interventions, and client outcomes

Process of carrying out established plan of care

Determine effectiveness of goals

Drug, Time, Dose, Patient, Route, Documentation

Relieves severe pain without loss of consciousness. Opiate agonists. Acts at the same opiate receptors in CNS as morphine to stimulate analgesic effects.

PO, SC, IM (Duration 2-4 hours), IV (give very slowly)

Stimulates opiate receptors to block pain without loss of consciousness
Depresses CNS-reflexes, gag, cough, respirations, can cause euphoria and slows GI motility

can occur after 3-6 weeks of continuous use

Respiratory Depression, Urinary Retention

Morphine-like derivatives, meperidine-like derivatives, methadone-like derivatives, and other.

Naloxene (Narcan)
Competes for and blocks agonists from attaching to the receptor
It is a pure opiate antagonist and its only effect is to reverse the effects of opiate agonists, opiate partial agonists, and propoxyphene.

a contraction of the iris muscle (pupil narrows)-parasympathetic nerve fibers.
Mitotic agents cause contraction and are used to treat acute angle closure glaucoma.
ex. pilocarpine

dilation of pupil-sympathetic motor nerve fibers. Mydriatic agents cause pupil dilation.

parasympathomimetic
wet and slow
decreased HR, increased GI motility and secretions, increase contractions of bladder, sweating, miosis of eye (decreased IOP), increased force fo contraction of skeletal muscle

post-op N/V, motion sickness, pregnancy, psychogenic, chemotherapy-induced N/V, anticipatory (sight/smell causes) delayed emesis, radiation-induced N/V

Treat nausea BEFORE vomiting occurs

Decreased WBC count, Risk for infection, risk for injury (bleeding)
Suppression of bone marrow production of blood cells.
Causes: Leukocytopenia, thrombocytopenia, neutropenia

(doxorubicin),Adriamycin

to cure gram negative infections-inhibit protein synthesis-treatment of chronic UTIs and meningitis, life-threatening septicemia. Wound infections

ototoxicity, nephrotoxicity

end in -mycin, (NOT vancomycin), Tobrmycin and Gentamycin

Acne, rickettsial, allergies to penicillins, UTI, Upper respiratory tract infections, pneumonis, meningitis, Rocky Mountain Fever, Lime disease

Nausea, vomiting, anorexia, abdominal cramps, diarrhea, photosensitivity, permanent staining of teeth during last half of pregnancy up to eight years

Antitubercular drug that is combined with other antitubercular agents to prevent resistance

nausea, vomiting, anorexia, abdominal cramps. REPORT confusion, hallucinations, blurred vision, color blindness (red/green)

Antitubercular drug used for prophylaxis and treatment, used in combination with Rifampin. Inhibits metabolism of phenytoin.

tingling, numbness, nausea, vomiting, dizziness, ataxia, hepatotoxicity

antitubercular drug used for treatment in combination with isoniazide; treats meningitis and tuberculosis

reddish-orange secretions interferes with oral contraceptives
Use an alternative form of birth control

colitis; glycopeptide antibiotic; Red Mans Syndrome

Amoxicillin + Potassium clavulanate; penicillinase (beta-lactamase) destroys beta-lactam ring of penicillin and makes bacteria resistant. Adding another structure to the penicillin that binds the penicillinase allows the penicillin molecule to inhibit cell wall synthesis. Potassium is added to amoxicillin to bind to the penicillinase.

Example is acyclovir (Zovirax): Used for herpes genitalis, herpes simplex viral infections; it inhibits viral cell wall replication
the side effects are rash, hives, nephrotoxicity, hypotension, diaphoresis, confusion

selectively toxic when cell is in a specific phase of growth-thereofre schedule dependent-best if malignancy that proliferates rapidly

active throughout cell cycle-may be more effective against slowly proliferation neoplastic tissue

cancers of soft tissue, osteogenic and miscelaneous sarcomas, Hodgkins/NonHodgkins disease, breast carcinoma, leukemias

nausea, red urine, bone marrow suppression, cardiotoxicity, alopecia (hair loss), stomatitis

Monitor vital signs and CBC, red urine is not hematuria, stomatitis (oral hygiene)

Anticholinergic- fast and dry, sympathetic-norephinephrine- "fight or flight"
Alpha: Vasoconstriction "Fight or Flight"

increased heart rate and blood pressure, dilated pupils (mydriasis)-screen for open-angle glaucoma due to decrease in IOP, decreased GI motility, decreased secretions, urinary retention, bronchodilation

wet and slow
Cholinergic agent-acetylcholine-"Rest-Replenish-Reproduction"
Side effects: decrease heart rate and BP, pupil constriction (miosis): Increased IOP;screen for closed-angle glaucoma, increased GI motility, bronchoconstriction, increased constriction of urinary bladder, diaphoresis

Increased Heart rate and blood pressure; treats allergic reactions, vasoconstrictor, bronchodilator, cardiac stimulant

Side effects are dysrhythmias, chest pain, hypotension, angina, nausea, vomiting, orthostatic hypotension

reduces saliva and bronchial secretions (pre-op), minimizes bradycardia during intubation (antidote), treats pylorospasm, and spastic conditions of Gi tract, urethral and biliary colic
Antidote to Cholinergics
Side effects: constipation, dryness of mucosa, urinary hesitancy

quiets the patient and gives a feeling of rest and relaxation

produces sleep

Can be the same drug only in different doses. Primarily used to treat insomnia, decrease anxiety and increase sleep/relaxation prior to procedure

Used primarily for sedative and hypnotic effects. The long-acting barbituate Phenobarbital is also used as an anticonvulsant. The ultra-short acting agents (methohexital, thiopental) may be administered as a general anesthetic.

Seek information regarding prior use of sedatives/hypnotic medications
Obtain information related to baseline neurological function
Assess respirations before giving medication (long half-life)

symptoms similar to alcohol withdrawal

Expect hangover, lethargy, and sedation
REPORT: excessive use/abuse, paradox response, hypersensitivity, blood dyscrasias

Drugs that increase toxic effects: antihistamines, alcohol, analgesics, anesthetics, tranquilizers, valproic acid, chlormaphenicol, monoamine oxidase inhibitors, and other sedatives
Drugs that decrease toxic effects: Warfarin, digoxin, doxycycline, antidepressants, quinidine, and chlorpromazine

most commonly used as sedative-hypnotic
Used as pre-op sedative (IM) and consious sedation (IV) for induction of general anesthesia

Benzodiazepine used for antianxiety, ethanol withdrawal symptoms, skeletal muscle relaxant, treatment of convulsive disorders

When therapy starts, patient feels a sense of deep/refreshing sleep. With chronic use, the amount of REM sleep gradually increases as tolerance develops to the REM suppressant effects. It is important to use for short periods of therapy.

Take baseline vitals, check history for blood dyscrasias, hepatic disease, or 1st trimester of pregnancy

drowsiness, hangover, sedation, lethargy

Block the dopamine receptors in the brain. They work at different sites in the brain so the side effects are observed on different systems throughout the body

tardive dyskinesia or extrapyramidal effects, blocks cholinergic, antihistamines, and nicotine

digitalis glycosides

moderate to severe systolic heart failure not responding to diuretics and ACE inhibitors, atrial fibrillation, atrial flutter, and paroxysmal tachycardia. NOT used to treat diastolic heart failure (may worsen condition).

loading doses of digoxin over a period of hours/days to produce desired effect (usually 24-48 hours)

take apical pulse for 1 full minute, withhold drug if pulse is less than 60 or greater than 100. Witals, weight, labs, monitor for toxicity, hypokalemia, or sudden increase in pulse rate.

hypokalemia

Give over 1 minute (IV) and (orally) after meals to minimize gastric irritation

pulse defecit, bradycardia, tachycardia,bigeminy, nausea, vomiting, diarrhea, weakness of arms/legs, extreme fatigue, anorexia, hazy, or blurred vision can signify digitalis toxicity

Digibind (digoxin immune FAB)

Treat major diseases affecting the cardiovascular system; heart failure (remove excess sodium and water to relieve symptoms associated with edema and pulmonary congestion) and hypertension

Mannitol

spironolactone (Aldactone)

It is a diuretic and can be used to treat hypercalcemia. It should be taken in the morning.

It is the most potent type of diuretics. It treats severe fluid volume overload. Watch out for ototoxicity and hypokalemia. Patient should eat potassium rich foods.

acetazolamide

angina pectoris

Assess pain level, location, duration, intensity. Ask about last dose of nitrates and effectiveness.

prolonged headache, hypotension, tolerance

alcohol, smoking (can cause vasoconstriction), calcium ion antagonists, beta adrenergic blockers

patch, place anywhere without hair

change position slowly because patient may experience postural hypotension

antiarrythmic

ventricular arrythmias, convert arrythmia to normal sinus rhythm

obtain data relating to the 6 cardinal signs of CV disease to be used as a baseline; Assess and record data relating to the patient's basic mental status

light headedness, muscle twitching, hallucinations, agitation, euphoria, respiratory depression

phenytoin, cimetidine, procainamide, tocainide, and beta adrenergic blockers (-lol) will enhance the therapeutic and toxic effects

neuromuscular blocking agent

relieve angina pectoris (chest pain) by inducing relaxation of peripheral vascular smooth muscles resulting in dilation of arteries and veins. They increase myocardial oxygen supply by dilating large coronary arteries and redistributing blood flow.

sublingual, transmucosal, translingual, topically, sustained release tablets, transdermal disk, and IV

hypotension, headache, tolerance

cholestyramine (Questran)

used in conjunction with dietary therapy (low fat and cholesterol) and exercise to decrease elevated cholesterol concentration in type 2 hyperlipidemia and to reduce the risk of atherosclerosis leading to CHD (coronary heart disease)

Serum triglyceride and cholesterol levels
Obtain any data related to GI alterations

constipation, bloating, fullness, nausea, flatulence

reduces the effectiveness of Digitoxin, Warfarin, thyroxine, thiazide diuretics, phenobarbital, NSAIDS, tetracycline, amiodarone, beta blockers, fat soluble vitamins (ADEK), folic acid

Decreases blood viscosity and improves blood flow by decreasing concentration of fibrinogen in blood, and preventing aggregation of RBC and platelets.

intermittent claudication

Dry, nonproductive cough, remove mucus plugs from respiratory tract. Combined with bronchodilators, decongestants, antihistamines, or antitussives to aid in making nonproductive cough more productive. Effective if patient is well hydrated.

thins bronchial secretions to increase flow by decreasing mucus viscosity

suppress cough center in brain

used for dry, hacking nonproductive cough (decreases frequency and nocturnal spams)

Teach them to rise slowly due to orthostatic hypotension. Tell them to administer Lasix with food or milk to decrease GI irritation. If they are allergic to sulfonamides they may also be allergic to Lasix. It should be taken in the morning to prevent nocturia.

orthostatic hypotension (rise slowly), oral irritation (oral hygiene), dry mouth (ice chips, hard candy)

Daily weight; need to watch for fluid and electrolyte imbalance

Do not take Potassium supplements or use salt substitutes
Should be administered with food
Don't administer at night (nocturia)

It is used to treat edema and ascites that doesn't respond to other diuretics. It has been shown to reduce morbidity and mortality for patients with heart failure.

mental confusion, headache, diarrhea, dehydration, gynecomastia, decreased libido, breast tenderness

Loop diuretics

Work on Loop of Henle and sometimes proximal and distal tubules to inhibit sodium chloride reabsorption. Water follows sodium so more water is excreted

severe fluid volume overload (excessive fluid accumulation), hypertension, edema, heart failure

Loop diuretics and aminoglycosides
Loop diuretics and Cisplatin
Note if patient speaks more loudly, asks for statements to be repeated, or plays the TV or radio louder

Decrease intraocular pressure (IOP) to treat closed angle glaucoma (decreases amount of intraocular fluid). Elevates osmotic pressure of the plasma, causing fluid from the extravascular spaces ro be drawn into the blood reducing IOP.

GOUT

acts on distal tubules of kidneys to block reabsorption of sodium and chloride ions from the tubule. The plasma uric acid is frequently elevated by thiazides, which inhibit uric acid excretion

Add a uricosuric agent or allopurinol to patient's medication regimen.

They need to comply with the prescribed regimen and the need for lab data to determine the correct maintenance dose. Tell the patient to resume a regular schedule if one dose is missed. If two doses or more are missed, the patient should consult the physician.

PT/INR

PTT, hemoglobin, platelet count; monitor for bleeding

Vitamin K

protamine sulfate

(anticoagulant)platelet inhibitor that causes the platelet to lose its ability to aggregate and form clots. Used for patients at risk for TIA and stroke.

Acts as a catalyst to accelerate the rate of action of naturally occurring inhibitor of thrombin, anti-thrombin 3 (heparin cofactor). In the presence of heparin, antithrombin 3 rapidly neutralizes thrombin, activated factors IXa, Xa, XI, and XII, and plasmin.

given Subcutaneous

Regular

Subcutaneous

Subcutaneous

Inhalation powder

Beta-adrenergic bronchodilating agent

relaxes smooth muscles of tracheobronchial tree to open bronchioles and alveolar ducts to greater air volume

asthma, bronchitis, emphysema, acute bronchospasms-RESCUE INHALER

baseline VS, presence of palpitations/arrhythmias, baseline mental status

tachycardia, palpitations, nervousness, tremors, anxiety, restlessness, headache, nausea, vomiting, dizziness

ticlopidine, tricyclic antidepressants, monoamine oxidase inhibitor, and other sympathetic agents enhance toxic effects
beta-adrenergic blocking agents decrease therapeutic effects

treat iron deficiency anemias (patients should also increase iron intake (green leafy veggies, whole grains, meat, eggs, raisins)

Use Z-track, so as not to stain the skin

May cause black, tarry stools

needed for the heart, acid-base balance, nerve conduction, body water balance, muscle contractions, most abundant intracellular mineral

citrus fruits, meat, milk, bananas, liver

Specific set of chemical molecules that regulate human metabolism and necessary to maintain health
13 Vitamins: 9 water soluble, 4 fat soluble (ADEK)

Use Z-track Method (Not to stain SC tissue or clothing). Inject deep in dorsal gluteal site 2-3 inches with 19-20 gauge needle. Give small amount and check for allergic reaction before giving complete dose.

Used for hyperkalemia (removes potassium by exchanging sodium ions for potassium ions in the intestines)

immunosuppressive, anti-inflammatory

have anti-inflammatory and antiallergenic effect used to relieve symptoms of Rheumatoid Arthritis (RA), adrenal insufficiency (Addison's), severe psoriasis, urticaria, chronic eczema, multiple myeloma, Hodgkins disease, leukemias, and collagen disease

Erythromcin (Ilotycin): antibiotic used prophylactically to prevent opthalmia neonatorum, which is caused by N. gonorrhoeae. Also effective against C. trachomatis.
Prevention of postpartum gonorrhea or chlamydia eye infections

nausea, weight gain, spotting, changed menstrual flow, missed periods, depression, mood changes, chloasma, headaches, Consult doctor if symptoms don't resolve in 3 months

vaginal Discharge, breakthrough bleeding, yeast infection, blurred vision, severe headaches, dizziness, leg pain (increased risk of DVT), shortness of breath, acute abdominal pain

Oral contraceptive, taken daily, that contains ONLY progestin (Nor-QD, Ovrette)

Urinary analgesic; Excreted through urinary tract and produces a local anesthetic effect on mucosa of the ureters and bladder. It acts within 30 minutes after oral administration.

Relieves burning, pain, urgency, and frequency associated with UTIs. Also relieves bladder spasms which relieves resulting urinary retention

will stain urine orange; stains anything urine touches

Blocks the terminal steps in uric acid formation by inhibiting the enzyme xanthing oxidase

treatment of primary gout or gout secondary to antineoplastic (chemo, cell death)therapy. Is NOT effective in the treatment of acute attacks by gouty arthritis.

acts as a stool softener by pulling water into the colon. Decreases ammonia levels

Hepatic encephalopathy (reduces formaton of ammonia in gut), laxative

Use in diabetics with caution (Contains some free lactose, galactose, and other sugars)

Antihypertensives; -lol; side effects: bradycardia, peripheral vasoconstriction, bronchospasms, wheezing, heart failure

Antihypertensives; -pril; side effects: nausea, fatigue, headache, diarrhea, orthostatic hypotension, swelling of face, eyes, lips, tongue, difficulty breathing, dry cough
Prevents angiotensin I from converting to angiotensin II

Antihypertensives; -pine; side effects: hypotension and syncope

Antihypertensives; -zosin; Side effects: drowsiness, headache, dizziness, weakness, lethargy, tachycardia, fainting

Antihypertensives; Ex: Clonidine;side effects: drowsiness, dry mouth, dizziness, depression

Antihypertensive;(Menoxadil/Rogain): Side effects:nausea, palpitations, tachycardia, numbness and tingling in the legs, nasal congestion, orthostatic hypotension, fever, chills, joint and muscle pain, skin eruptions

cholinergic

anticholinergic

heparin

Tagamet

hypothyroidism

atropine

mannitol (Osmitrol) (Drug Class: osmotic diuretic)

(PTU, Propacil) propylthiouracil and (Tapazole) methimazole

acetylcysteine (Mucomyst)

sucrafate (Carafate) (Drug Class: coating agent)

Iodine 131

Regular

NPH

Rhogam

sulfonylurea

rifampin (Rifadin)

Regular

Hypoglycemic

lol

taper it off

ACE inhibitors

"pril"

spironolactone (Aldactone)

Drug class:gastrointestinal prostaglandin
Drug: misoprostal (Cytotech)

warfarin (Coumadin)

(Narcan) naloxone

rifampin (Rifadin)

clopidogrel (Plavix)

Antacids

metroonidazole (Flagyl)take when you travel

Calcium Channel Blockers -pine

Vitamin K shot

erythromycin opthalmic ointment (Ilotycin)

zidovudine (Retrovir)-AZT, ZDV given to pregnant females so that the baby does not get HIV)

loop diuretics

Tetracyclines

warfarin or Coumadin

Daily weight

Vitamin B6 (pyridoxine)

eight (acoustic)

Super infection or secondary infection

amantadine (Symmetrel)

Drug class: macroclides ex: erythromycin, azithromycin

Quinolones (ex. Cipro, levaquin)

ethambutol (Myambutol)

griseofulvin microsize (Griseofulvin)

peaks and troughs

neuromuscular blocking agents (succinylcholine, usually paralyzing drugs)

Rogaine or minoxidil

hyperthyroidism

hypoglycemia

use an alternative form of birth control

redneck "redman redneck syndrome"

minipill

Beta-lactamase

nephrotoxicity

liver toxicity or hepatotoxicity

Aspirin

Zovirax

aminoglycosides

oxytocin (Pitocin)

Diuretics

Hyperthyroid

Barret's esophagus, esophageal varices

anaphylaxis

Amphotericin B

tetracycline

ototoxicity