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Alprazolam / benzodiazapine
Xanax
anti anxiety
- action: works on the CNS produce anxiolytic effect
- contra: hypersensitivity
- adv: dizzy, drowsiness, lethargy, confuusion, headache, mental depression
- interacts: alcohol, anti depresents, other benzos, antihistamine, opioid analgesics, increases CNS depression
- Assess: level of anxiety, orientation, mood, drowsiness,
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fluphenazine
- anti psycohotics
- action: alters dopamine in the CNS
- adverse: NMS, sedation, tardive dysknesia, hyper, hypotension, tachycardia
- inter: antiarrythmics
- asses: mood, behavior, bp,
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haloperidol
haldol
- antipsychotic
- action: alters effect of dopamine in the CNS
- contra: hypersensitivity, cns depression
- adverse: siezures, confusiion, drowsiness, tardive dyskinesea, NMS
- interactions:hypertensive meds, nitrates, alcohol, anticholiergics
- assess: mental status, bp, output and intake, dehydration, tardive dyskinesea
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aripiprazole
- atypical antipsycotic
- action: psychotropic activity, agonist activity of dopamine
- adverse: susicidal thoughts, drowsiness, extrapyramidal reactions, akathisia, confusion, depression, fatigue, hostility, insomnia, manic, impaired cognitive functions,NMS
- interactions: cardiac meds,
- Assess: mental status, mood, behavior, suicidal idiations, bp, RR,
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Lorazepam/benzodiazapine
Ativan
- antianxiety
- action: depresses CNS
- adverse: dizzy, drowsiness, lethargy, headache, ataxia, slurred speech, mental depression
- interactions: alcohol, other cns depressants, antihistimines, opioids
- Assess: anxiety,
- teaching: may cause drowsiness, and dizzy
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fluoxetine
prozac
- antidepressants
- action: inhibits the reuptake of serotonin in the CNS
- cont: no maoi's no thiordazine
- adverse: NMS, seizures, NMS, suicidal thoughts
- interactions: confusion, agitation, seizures, hyperpyrexia,
- assess: mood, SI,
- teaching: may cause drowsiness, dizzy, impaired judgement, blurred vision
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venlafaxiine/ Effexor
- antidepressants
- action: inhibits serotonin and norepinephrine reuptake in the CNS
- adverse: NMS, seizures, SI, abnormal dreams, anxiety, dizzy, headache, insomnia, weakness
- interactions: other MAOI's , alchohol, CNS depressants, sedativess, antihistimines
- assess: mental status, mood, SI,
- Teaching: look for SI especially early in the therapy
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phenelzine
Nardil / MAOI
- antidepressants
- action: inhibits the enzyme monoamine oxidase, resulting in an accumulation, of various neurotransmittters, dopamine, epinephrine
- contra: liver disease, renal disease, heart failure, ecessive caffine, tyamine
- adverse: seizures, dizzy, drowsiness, fatigue, headache, hyperflexia insomnia, tremor, twitiching, weakness, euphoria
- Interactions: SSRI's, heart medsother mental health drugns
- assess: mental status, mood, anxiety levels, SI, bp, HR
- Teaching: no alcohol, do not ubruptly stop using , avoid other CNS depresents, dizzy, drowsiness
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Lithium
- mood stabilizer
- action: alters cation transport in nerve and muscle( decreases manic episodes)
- contra: cardiovascular or renal disease, brugada syndrome
- adverse: si=seizures, fatigue, headache, impaired memory, ataxia, sedation, confusion, dizzy, drowsy, psychootor retardation, restless
- interaction: haloperidol, diuretics, ace inhibitors
- assess: mental status, initiate SI precautions, monitor intake ond output rations, min fluid 2000-3000 mL per day.
- treaching: dizzy, drowsiness, caution driving, low sodium levels
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amitriptyline
elavil
- antidepressant
- action: potetiates, the effect of serotonin in norepinephrine in the CNS
- contra: angle closure glaucoma, MI or Heart failure
- adverse: SI, lethargy, sedation, arrhythmias, torsade de pointes, hypotension,
- Interactions:
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alendronate / bisphosphonate
- bone resorption inhibitors
- action: inhibits resorption of bone by inhibiting osteoclast activity
- contra: renal insufficiency, esophagus abnormalities
- adverse: headache, blurred vision, conjuctivitis, eye pain, atrial fib, GI issues
- Interactions: calcium, antacids, levothyroxine, ranitidine
- assess: osteoporosis,pagett's disease,
- teaching: take with 6-8 oz of water, exercise, use sunscreen,
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conjugated estrogen replacement
- hormone
- action: agonist, effects on the endometrium of the uterus, effects are tissue specific
- contra: hypersensitivity, abnormal genital bleeding, cancer, hx of dvt, pe, mi or stroke, concurrent use with other estrogens
- adverse: Stroke, DVT, endometrial cancer, hot flush,muscle spasms, angioedema
- asses: pain during intercourse, bp,
- teaching: report ss of unusual vaginal bleeding, new severe headaches, sob, weakness or fatigue, contact provider
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testosterone
- hormone
- action: responsible for growth and development of male sex organs
- contra: hypersensitivity, breast or prostate cancer, severe liver, renal or cardiac disease
- adverse: deepening voice, MI, stroke, venous thromboembolism, edema, jaundice, gynecomastia,
- interactions: warfarin, oral hypoglycemeic and insulin or concurrent use with corticosteroids.
- assess: intake and output monitor,
- teaching: report, painful erections, monitor blood glucose levels,
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sildenafil
viagra
- erectile dysfunction agent
- action: enhances effects of nitric oxide released during sexual stimulation.
- contra: hypersensitivity, concurrent use with other nitrates, pulmonary veno occlusive disease
- adverse: headache, dizzy, insomnia, epistaxis, hearing loss, nasal congestion vision loss, MI, sudden death hypotension, vaso occlusive crisis.
- interactions: concurrent use with other nitrates
- teaching: take as directed, no alpha adrenergic blockers, if decreased hearing ringing in ears or dizziness contact doctor
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tamsulosin
Flomax
- alpha blocker
- action: decreases contractions in smooth muscle of the prostatic hyperplasia BPH
- contra: hypersensitivity
- adverse: dizzy, headache, floppy iris syndrome, rhinitis, ortho hypotension
- interactions: cietidine, anti adrenergics, erectile medications
- asses: for symtoms of bph, (urinary hesitancy)
- teaching: no double dose if missed, may cause dizzy, avoid driving, caution changing positioins
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Lispro
Humalog
- antidiabetics/ hormone
- action: lowers blood glucose by stimulating glucose uptake in skeletal muscle and fat
- contra: hypoglycemia, allergy or hypersensitivity to lispro
- adverse: hypokalemia, pruritus, erythema,swelling,
- interactions: beta blockers, clonidine, reserpine, corticosteroids, tyroid supplements estrogens alcohol, ace inhibitors
- asses: symptoms of hypoglycemia, anxiety, restlessness, tingling in hands and feet, lips or toungue, chills, cold sweats, confusion, cool pale skin concentration, drowsiness, nightmares, sleeping problems, excessive hunger, weakness, unsteady gait
- teaching: instruct on proper technique, use of equipment, how to mix insulins,
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regular insulin
humulin r
novolin r
- antidiabetics
- action: lowers blood glucose by uptake in skeletal muscle fat, inhibiting hepatic glucose production
- contra: hypoglycemia, allergy or hypersensitivity to a particular type of insulin
- adverse: hypoglycemia, hypokalemia, pruritus, erythmia, swelling
- interactions: beta blockers, clonidine, reserpine, corticosteroids, alcohol, octreotide
- asses: for symptoms of hypoglycemia, monitor body weight
- teaching: how to use equipment, mixing,
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insulin isophane
NPH
intermediate acting insulin
- antidiabetic
- action: lowers blood glucose, inhibits hepatic glucose production
- contra: hypoglycemia, allergy or hypesensitivity
- adverse: hypoglycemia
- interactions: beta blockers, clonidine, reserpine, corticosteroids, alcohol, ace inhibitors, maoi's,
- assess: for symptoms of hypoglycemia
- teaching: proper use of equipment,
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isuline glargine
Lantus
- anti diabetic/ hormone
- action: lowers blood glucose by inhibiting hepatic glucose production
- cont: hypoglycemia, allergy and hypersensitivity
- adverse: hypoglycemia, hypokalemia
- interactions: beta blockers, clonidine, resrpine, corticosteroids, thyroid supp, estrogens, alcohol, ace inhibitors, maoi's
- asses: hypoglycemia, monitor body weight
- teaching: proper technique of equiptment, and injection
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exenatide
- antidiabetic
- action: mimics the action of incretin which promotes endogenous insulin secretion, and promotes other mechanisms of glucose lowering
- contra: hypersensitivity, type 1 diabetes or diabetic keto acidosis, renal impairment, severe gi disease
- adverse: dizzy, headache, jitteriness, weakness, diarrhea, nausea, vomiting dyspepsia, gi reflux, tyroid c cell tumors, hypoglycemia, renal failure
- interactions: concurrent use with sulfonylureas or insulin
- assess: signs and symptoms of hypoglycemia, pancreatitis, ab pain,
- teaching: take within 60 min of a meal do not take after a meal, no extra doses
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glipizide
Glucotrol
- antidiabetic
- action: lowers blood sugar by stimulating the release of insulin from the pancreas and increasing the sensitivity to insulin receptors
- contra: hypersensitivity, insulin dependent diabetics, diabetic coma or keto acidosis
- adverse: dizzy drowsiness, headache, weakness, constipation, cramps, diarrhea, hepatitis, dyspepsia, photosensitivity, hypoglycemia
- interactions: alcohol, diuretics, corticosteroids, contraceptives, estrogens tyroid prep, phenytoin,nicotinic acid, maoi's , warfarin, nsaids, salicylates, fluconazole, beta blockers
- asess, signs and symptoms of hypoglycemia,
- teaching, take as directed same time everyday
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metformin
glucophage
- antidiabetic
- action: decreases hepatic glucose production, increases sensitivity to insulin
- cont: hypersensitivity, mettobolic acidosis, dehydration, sepsis, hypoxemia, hepatic impairment,
- adverse: ab bloating, diarrhea, nausea, vomiting, unpleasant metallic taste
- interactions: alcohol, iodine contrast media, cardiac meds, furosemide, increase effects, nifedepine absorbs effect
- asses: hypoglycemic reactions, ab pain sweating, hunger, weakness, dizzy, headache, tremor, tachycardia, anxiety
- teaching: take at same time everyday, encourage to follow prescribed diet.
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glucagon
- hormones
- action: stimulates hepatic production of glucose from glycogen stores
- cont: hypersensitivity, pheochromacytoma,
- adverse: hypotension, nausea, vomiting, hypersensitivity
- interactions: warfarin, phenytoin, ephinephrine
- asses: for signs of hypoglycemia, neurologic status, nutritional status
- teach: signs and symptoms of hypoglycemia,
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levothyroxine
synthroid
- hormones
- action: replacement for endogenous thyroid hormones
- cont: hypersensitivity, recent MI, Hyperthyroidism
- adverse: headache, insomnia, irritibility, angina pectoris, arrhythmias, tachycardia
- interactions: bile acid sequestrats, warfarin
- asses: bp, hr, arrythmias, chest pain
- teaching: take meds at the same time everyday, as directed, do not discontinue without consulting your pcp
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propylthiouracil
- anti-thyroid agent
- action: inhibits synthesis of thyroid hormone
- cont: hypersensitivity
- adverse: drowsiness, headache paresthesia, vertigo, edema vasculitis, hepatotoxiciy, nausea vomiting, stevens johnson syndrome
- interact: anti-neoplastics, litium, phenothiazines
- asses: responses of hyperthyroidism, tacky, palpitatiois, nervousness, insomnia
- teach: take as directed
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calcitriol
- vitimans: management of hypocalcemia
- action: active form of vitiman d
- cont: hypersensitivity, hypercalcimia
- adverse: headache, somnolence, photophobia, rhinorrhea, HTN
- interaction; mineral oil, corticosteroids, digoxin
- asses: symptoms of vitiman deficiancy, patient bone pain and weakness
- teach: take as directed, review diet modifications
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prednisone
- anti inflammatory, steroidal
- action: suppresses inflammation and the normal immune response
- contra: active untreated infections
- adverse: epression, euphoria, headache, psychoses, restlessness, HTN
- interactions: loop diuretics, digoxin, phontoin
- asses: signs of renal insufficiency HTN
- teach: no double doses if missed,
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fludrocortisone
- hormone
- action: causes sodium reabsorption
- contra: hypersensitivity
- adverse: dizzy, headache, arhythmias, edema, HTN,
- interaction: thiazide, diuretics, digoxin
- asses: bp, fluid retention
- teaching: life long therapy, no abrupt discontinued use
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epoetin alpha
- antianemics
- hormones
- action: stimulates erythropoiesis
- contra: hypersensitivity to albumin, uncontrolled htn
- adverse: seizures, hf, mi, stroke, thromboembolic events,
- interactions: heparin
- asses: bp, monitor for symptoms of anemia
- teaching: risk for seizures
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filgrastim
- colony stimulating factors
- action: glycoprotein filgrastim binds to and stimulates immature neutrophils to divde and differentiate
- contra: hypersensitivity to filgrastim
- adverse: vasculitis, splenic rupture, spelenomegaly, hemoptysis, acute respirtory distress syndrome
- interactions: antineoplastics
- asses: hr, bp and respiratory status
- teach: explain purpose of filgrastim to patient
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oprelvekin
- colony stimulating factors
- action; stimulates production of megakaryocytes and platelets
- contra: hypersensitivity
- adverse: dizzy, headache, insomnia, nervousness,weakness, cough, dyspnea, pleural effusions, syncope
- assess: fluid retention, peripheral edema
- teaching: instruct in proper tech for preparation and admin of meds
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allopurinol
- antigout agent
- action: inhibits production of uric acid
- contra: hypersensitivity
- adverse: hypotension, flushing, htn, bradycardia, heart failure drowsiness
- interactions: amoxicillin, azathioprine(bone marrow depressent
- asses: intake and output, kidney function,
- teaching: take as directed, take nsaid along with meds to relieve acute attack of gout
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