-
Antacids
- Actions: They contain magnesium, aluminum, calcium and a
- combination of these compounds. They slow down the rate of gastric
- emptying and neutralize gastric acidity.
- Uses: Gastritis, peptic ulcer, hiatal hernia and reflux esophagitis.
- Adverse Reactions and Side Effects: Constipation, diarrhea, flatus,
- abdominal distention, alkaluria.
- Contraindications: Allergy and sensitivity
- Implications: Assess epigastric pain, GI symptoms and renal problems
- and electrolytes.
- Examples of Medications in This Classification:
- • aluminum carbonate
- • calcium carbonate
-
-
This classification is further divided into:
- • nitrates,
- • calcium channel blockers, and
- • b-adrenergic blockers.
- Actions:
- Nitrates - dilate coronary arteries, decrease preload and afterload.
- Calcium channel blockers- also dilate coronary arteries, but they also
- decrease SA/AV node conduction
- β -Adrenergic blockers- slow the heart rate, thus decreasing O2 use.
- Uses: Angina. Calcium channel blockers and β-blockers can also be
- used for hypertension and dysrhythmias.
- Adverse Reactions and Side Effects: Postural hypotension, fatigue,
- dysrhythmias, headache, edema, dizziness.
- Contraindications: Increased intracranial pressure, cerebral
- hemorrhage and sensitivity.
- Implications: Monitor for side effects and orthostatic B/P. Continue to
- assess angina pain.
- Examples of Medications in This Classification:
- • propranolol
- • verapamil hydrochloride
- • nitroglycerine
-
-
Actions: Inhibit acetylcholine (autonomic nervous system)
- Uses: Many uses- some decrease GI, urinary and billiary motility;
- others decrease GI secretions, decrease involuntary movement, and
- relieve nausea, and vomiting.
- Adverse Reactions and Side Effects: Dryness of the mouth, paralytic
- ileus, constipation, urinary problems (retention and hesitancy)
- dizziness and headache.
- Contraindications: GI or urinary obstruction, narrow-angle glaucoma,
- and myasthenia gravis.
- Implications: Monitor urinary and bowel function as well as vital signs.
- Keep the patient in bed for one hour after parenteral dose.
- Examples of Medications in This Classification:
- • atropine sulfate
- • scopolamine
-
-
Actions: Prevent clot formation.
- Uses: MI, pulmonary embolus, deep vein thrombosis, disseminated
- intravascular clotting syndrome (DIC), and atrial fibrillation. It is also
- used with dialysis.
- Adverse Reactions and Side Effects: Hemorrhage, diarrhea, fever, rash
- and blood disorders (leukopenia, thrombocytopenia, etc.) depending
- on the specific drug.
- Contraindications: Bleeding disorders, such as hemophilia and
- leukemia, ulcers, blood dyscrasias, nephritis, endocarditis and
- thrombocytopenia purpura.
- Implications: Observe for bleeding (oral, black stools, stool occult
- blood, ecchymosis, etc.). Monitor blood and BP (hypertension may
- occur).
- Examples of Medications in This Classification:
- • warfarin sodium
- • heparin
-
-
This classification is further divided into:
- • barbiturates,
- • hydantoins,
- • succinimides,
- • benzodiazepines and
- • others.
- Actions: Act to prevent seizures.
- Uses: Depending on the specific drug, they prevent tonic-clonic
- seizures, psychomotor seizures, status epilepticus, petit mal seizures
- and cortical focal seizures.
- Adverse Reactions and Side Effects:
- Bone marrow depression, which can be life-threatening, GI problems,
- CNS effects like confusion, ataxia and slurring of speech.
- Contraindications: Sensitivity
- Implications: Monitor hepatic and renal function, blood, mental status,
- blood dyscrasias, and toxicity (ataxia, bone marrow depression,
- nausea, vomiting, cardiovascular problems, Stevens-Johnson
- syndrome)
- Examples of Medications in This Classification:
- • phenytoin
- • diazepam
-
-
Actions:
- MAOIs- inhibit MAO and thus they increase epinephrine,
- norepinephrine, serotonin, and dopamine.
- Tricyclics- block the reuptake of serotonin and norepinephrine in the
- nerve endings, thus increasing the actions of both in the nerve cells.
- Uses: Depression. Nocturnal enuresis in children.
- Adverse Reactions and Side Effects: Orthostatic hypotension, mouth
- dryness, dizziness, drowsiness, urinary retention, hypertension, renal
- failure and paralytic ileus.
- Contraindications: Hypertrophy of the prostate, seizure disorders,
- renal, hepatic and cardiac disease.
- Implications: Monitor standing and lying BP, blood, mental status,
- hepatic function. Observe for extrapyramidal symptoms and urinary
- retention. Withdrawal symptoms occur with abrupt cessation.
- Examples of Medications in This Classification:
- • sertraline
- • amitriptylyline
- • bupropion
- • phenelzine
-
-
Antidiabetics are also subdivided into the following groups:
- • insulins of varying kinds, and
- • oral hypoglycemic agents.
- Actions:
- Insulin- lowers blood sugar, potassium and phosphate
- Oral hypoglycemic agents- stimulate the β -cells of the pancreas to
- release insulin.
- Uses: Diabetes and ketoacidosis
- Adverse Reactions and Side Effects: Hypoglycemia, hepatotoxicity,
- allergic responses
- Contraindications: Sensitivity. Oral agents are contraindicated for
- juvenile diabetes and ketoacidosis.
- Implications: Monitor blood glucose, assess for hypoglycemia, rotate
- insulin injection sites, and use human insulin with pork or beef
- sensitivity.
- Examples of Medications in This Classification:
- • insulin
- • glyburide
-
-
Actions: Varying. Come decrease water content of stool, some slow
- down GI peristalsis.
- Uses: Diarrhea
- Adverse Reactions and Side Effects: Constipation, paralytic ileus,
- abdominal pain.
- Contraindications: Colitis
- Implications: Used for short term therapy (48 hours or less). Monitor
- electrolytes and bowel response.
- Examples of Medications in This Classification:
- • bismuth subgallate
- • kaolin and pectin mixtures
-
-
Uses: Atrial and ventricular arrhythmias (atrial fibrillation, PVCs, and
- tachycardia), hypertension, and angina
- Adverse Reactions and Side Effects: Hypotension, bradycardia, other
- arrhythmias and various other wide ranging side effects.
- Contraindications: Various. Check each medication.
- Implications: Monitor rate and rhythm, blood pressure, potassium,
- dependent edema and I & O
- Examples of Medications in This Classification:
- • digoxin
- • procainamide
- • quinidine
- • acebutolol
- • bretylium
- • verapamil
-
-
Actions: Decreases sodium, potassium and nutrients in the cell and
- increases cell permeability.
- Uses: Fungal infections such as cryptococcosis, aspergillosis,
- histoplasmosis, blastomycosis, coccidiomycosis, , phycomycosis, and
- candidiasis
- Adverse Reactions and Side Effects: Renal, liver damage and failure,
- gastroenteritis, hypokalemia, anorexia, nausea and vomiting.
- Contraindications: Sensitivity and bone marrow depression.
- Implications: For IV administration, use a filter, check for
- extravasation and protect from light (cover with foil). Monitor vital
- signs, I & O, blood, weight, renal and hepatic function, hypokalemia
- and ototoxicity.
- Examples of Medications in This Classification:
- • nystatin
- • amphoteracin B
-
-
Actions: Antagonists of histamine.
- Uses: Allergies, pruritus and rhinitis.
- Adverse Reactions and Side Effects: Most cause drowsiness, headache,
- urinary retention, blood dyscrasias, thickened bronchial secretions and
- GI effects
- Contraindications: Sensitivity, asthma, peptic ulcer, narrow angle
- glaucoma.
- Implications: Monitor urinary, respiratory and cardiac status. Also
- monitor for blood dyscrasias.
- Examples of Medications in This Classification:
- • diphenhydramine hydrochloride
- • chlorpheniramine maleate
-
-
This classification is further divided into:
- • angiotensin-converting enzyme (ACE) inhibitors,
- • b-adrenergic blockers,
- • calcium channel blockers,
- • centrally acting adrenergics,
- • diuretics,
- • peripherally acting antiadrenergics, and
- • vasodilators.
- Actions:
- Angiotensin-converting enzyme inhibitors- dilatation of the arterial and
- venous systems occur through the suppression of renin-angiotensin I
- to angiotensin II conversion
- Centrally acting adrenergics- inhibit impulses in the CNS and the
- sympathetic nervous system, decreases cardiac output, blood pressure
- and pulse rate
- Peripherally acting antiadrenergics- inhibit the release of
- norepinephrine thus decreasing sympathetic vasoconstriction
- Vasodilators- reduce blood pressure, cardiac rate and cardiac output
- because these medications relax and dilate the smooth muscle of the
- arteries
- b-Blockers, calcium channel blockers, and diuretics are discussed in
- another section below.
- Uses: Hypertension, heart failure, angina and some dysrhythmias
- Adverse Reactions and Side Effects: Hypotension, tachycardia,
- bradycardia, nausea, vomiting and headache.
- Contraindications: Heart block, hypersensitivity
- Implications: Check for edema, monitor renal function, blood and for
- symptoms of congestive heart failure.
- Examples of Medications in This Classification:
- • captopril
- • propranolol hydrochloride
- • reserpine
- • nitroprusside sodium
-
-
Antiinfectives are divided further into the following groups:
- • penicillins,
- • cephalosporins,
- • aminoglycosides,
- • sulfonamides,
- • tetracyclines,
- • monobactam,
- • erythromycins, and
- • quinolones.
- Actions: Inhibit the growth and/or replication of susceptible bacteria
- Uses: Infection
- Adverse Reactions and Side Effects: Diarrhea, nausea, vomiting, bone
- marrow depression and anaphylaxis (life threatening)
- Contraindications: Hypersensitivity. Most people allergic to penicillins
- are also allergic to the cephalosporins.
- Implications: Observe bowel pattern and urinary output. Monitor renal
- function, blood and for signs of a superinfection and bleeding.
- Examples of Medications in This Classification:
- • penicillin
- • tetracycline
-
-
This classification is further divided into:
- • cholinergics and
- • dopamine antagonists.
- Actions:
- Cholinergics- block acetylcholine receptors
- Dopamine antagonists- activate dopamine receptors
- Uses: Parkinson’s disease
- Adverse Reactions and Side Effects: Involuntary movement, insomnia,
- nausea, vomiting, orthostatic hypotension, dry mouth, numbness and
- headache
- Contraindications: Sensitivity and narrow angle glaucoma
- Implications: Monitor respirations, blood pressure and changes in
- mental and behavioral status
- Examples of Medications in This Classification:
- • levodopa
- • entacapone
-
ANTIPSYCHOTIC AND NEUROLEPTIC AGENTS
-
Again, this classification is subdivided. The groups are:
- • phenothiazines,
- • thioxanthenes,
- • butyrophenones,
- • dibenzoxazepines,
- • dibenzodiazepines,
- • indolones and
- • other heterocyclic compounds.
- Actions: All of these pharmacological agents block the dopamine
- receptors in the brain, the area that involves psychotic behavior
- Uses: Schizophrenia, mania, paranoia, and anxiety. They are also
- sometimes used for unrelieved hiccups, nausea, vomiting, and
- pediatric behavioral problems as well as pre-operative relaxation.
- Adverse Reactions and Side Effects: Some symptoms (EPS, dystonia,
- akathisia and tardive dyskinesia) can be controlled with
- antiparkinsonian medications. Others side effects include dry mouth,
- photosensitivity, agranulocytosis, hypotension, and life threatening
- cardiac problems and laryngospasm.
- Contraindications: Coronary disease, severe hypertension, severe
- depression, bone marrow depression, blood dyscrasias, parkinsonism,
- cerebral arteriosclerosis, narrow angle glaucoma and children less than
- 12 years of age. Cautiously used with the elderly.
- Implications: Monitor CBC, liver function, I & O, blood pressure lying
- and standing (orthostatic hypotension), EPS (antiparkinsonian agents
- should be used for this). Observe for dizziness, palpations,
- tachycardia, changes in affect, level of consciousness, gait and sleep
- patterns.
- Examples of Medications in This Classification:
- • haloperidol
- • chlorpromazine
-
ANTITUSSIVES and EXPECTORANTS
-
Actions:
- Antitussives- suppression of the cough reflex
- Expectorants- decrease the viscosity of thick, tenacious secretions
- Uses: The expectorants are used with a cough associated with
- bronchitis, TB, pneumonia, cystic fibrosis and COPD. Antitussives are
- used for nonproductive coughs.
- Adverse Reactions and Side Effects: Dizziness, drowsiness and nausea
- Contraindications: Iodine sensitivity, pregnancy, lactation and
- hypothyroidism. Caution with the elderly and those with asthma
- Implications: Monitor the cough and the sputum. Increase fluid intake
- and humidification to thin secretions.
- Examples of Medications in This Classification:
- • guaifenesin
- • codeine
-
-
Actions: Interferes with the DNA needed for viral replication
- Uses: HIV infections, herpes (herpes simplex virus and herpes
- genitalis), encephalitis (herpes simplex) and varicella zoster
- encephomyelitis
- Adverse Reactions and Side Effects: Nausea, vomiting, diarrhea,
- headache, anorexia, vaginitis, moniliasis, blood dyscrasias, renal
- failure and metabolic encephalopathy which could be fatal
- Contraindications: Immunosuppressed patients with herpes zoster and
- hypersensitivity. Caution with pregnancy, lactation, renal and liver
- disease and dehydration
- Implications: Assess for renal and liver problems. Observe for signs of
- infection and allergic reactions (itching, rash, urticaria). Monitor the
- blood for dyscrasias.
- Examples of Medications in This Classification:
- • acyclovir sodium
- • cidofovir
-
-
Actions: Decreases impulse transmission to the cerebral cortex
- Uses: Epilepsy, sedation, insomnia, anesthesia, cholestasis with some
- medications in this classification.
- Adverse Reactions and Side Effects: Drowsiness, nausea, blood
- dyscrasias and Stevens-Johnson syndrome
- Contraindications: Allergy, poor liver function, porphyria, pregnancy
- (category D). Caution with the elderly renal or hepatic disease (slowed
- metabolism)
- Implications: Monitor seizure control, blood, hepatic and renal
- function. Observe for toxicity (insomnia, hallucinations, hypotension,
- pulmonary constriction; cold, clammy skin; cyanosis of lips, nausea,
- vomiting, delirium, weakness)
- Examples of Medications in This Classification:
- • phenobarbital
- • secobarbital
-
-
Actions: Decreases anxiety by potentiating g-aminobutyric acid and
- other CNS inhibitory transmitters
- Uses: Anxiety secondary to phobic disorders and other conditions,
- acute alcohol withdrawal and pre-operative relaxation.
- Adverse Reactions and Side Effects: Physical dependence and abuse,
- dizziness, drowsiness, orthostatic hypotension, and blurred vision
- Contraindications: Narrow angle glaucoma, infants less than 6 months
- old, hypersensitivity, lactation (diazepam) and liver disease
- (clonazepam). Caution with the elderly as well as those with renal
- and/or hepatic disease
- Implications: Monitor lying and standing blood pressure (notify MD if
- B/P drops 20 mm Hg or more), pulse, hepatic and renal function and
- signs of dependency. Administer with milk or food to prevent GI
- symptoms.
- Examples of Medications in This Classification:
- • diazepam
- • clonazepam
-
-
β-Blockers are divided into two categories:
- • selective blockers and
- • nonselective blockers.
- Actions:
- Selective blockers- block the stimulation of b1-receptors in the cardiac
- smooth muscle with chronotropic and inotropic effects.
- Nonselective blockers- lowers blood pressure (plasma renins are
- reduced) without a reduction in heart rate or reflex tachycardia.
- Uses: Hypertension, angina prophylaxis and ventricular dysrhythmias
- Adverse Reactions and Side Effects: Orthostatic hypotension, diarrhea,
- nausea, vomiting, bradycardia, blood dyscrasias, CHF and
- bronchospasm
- Contraindications: Heart block, cardiogenic shock and CHF. Cautious
- use with the elderly and those patients with COPD, coronary artery
- disease, asthma, renal disease, thyroid disease, pregnancy.
- Implications: Monitor blood pressure, I&O, daily weights, pulse and
- renal function. Observe for edema and take the apical and radial pulse
- before administration in order to determine if significant changes have
- occurred.
- Examples of Medications in This Classification:
- • metroprolol
- • propranolol
-
-
This classification is further subdivided into:
- • anticholinergics,
- • α/β -adrenergic agonists,
- • β -adrenergic agonists, and
- • phosphodiesterase inhibitors.
- Actions:
- Anticholinergics- inhibit the interaction of acetylcholine at receptor
- sites on bronchial smooth muscle
- α/β −adrenergic agonists- increase the diameter of nasal passages and
- relax bronchial smooth muscle
- β-adrenergic agonists- relax the smooth muscle of the bronchii
- Phosphodiesterase inhibitors- increased smooth muscle relaxation in
- the respiratory system
- Uses: Asthma, bronchospasm, COPD, emphysema, Cheyne-Stokes
- respirations
- Adverse Reactions and Side Effects: Dyspnea, bronchospasm, anxiety,
- tremors, throat irritation, nausea and vomiting.
- Contraindications: Narrow angle glaucoma, severe cardiac disease,
- tachydysrhythmias and sensitivity. Cautious use with hypertension,
- seizure disorders, pregnancy and lactation, hyperthyroidism and
- prostatic hypertrophy
- Implications: Assess for a therapeutic response (absence of dyspnea
- and/or wheezing) and patient/family education about the use of the
- inhaler
- Examples of Medications in This Classification:
- • albuterol
- • aminophylline
-
-
Actions: Inhibits the flow of calcium ions across the cell membrane of
- cardiac and vascular smooth muscle, thus relaxing the coronary
- vascular smooth muscle, dilating the coronary arteries, slowing SA/AV
- node conduction, and dilating peripheral arteries.
- Uses: Angina, hypertension, and dysrhythmias.
- Adverse Reactions and Side Effects: Dysrhythmias, edema, fatigue,
- headache, and drowsiness.
- Contraindications: Systolic blood pressure of less than 90 mm HG,
- Wolff-Parkinson-White syndrome, 2nd or 3rd degree heart block, sick
- sinus syndrome, and cardiogenic shock. CHF may get worse in the
- presence of edema. Cautious use with hepatic and renal disease.
- Implications: Monitor blood pressure, pulse and respirations.
- Administer at bedtime and before meals.
- Examples of Medications in This Classification:
- • verapamil
- • felodipine
-
-
Actions: Cardiac output and cardiac contractility are enhanced by
- making more calcium available.
- Uses: CHF and tachycardia
- Adverse Reactions and Side Effects: Cardiac changes, hypotension, GI
- symptoms, blurred vision, yellowish-green halos and headache.
- Contraindications: Hypersensitivity, ventricular fibrillation, ventricular
- tachycardia and carotid sinus syndrome. Caution among patients with
- imbalances of potassium, magnesium and/or calcium, acute MI, severe
- respiratory disease, AV block, renal or liver disease, hypothyroid and
- the elderly.
- Implications: Assess vital signs, check apical rate for one full minute
- prior to administration (if less than 60, hold the dose and notify the
- MD), electrolytes (sodium, potassium, chloride and magnesium), renal
- and hepatic function. Monitor I & O. If K level is less than 3mg/dl,
- potassium supplements may be ordered.
- Examples of Medications in This Classification:
- • digitoxin
- • digoxin
-
-
Actions: These medications prevent the destruction of acetylcholine,
- thus increasing its concentration, which enhances the transmission of
- impulses.
- Uses: Myasthenia gravis, bladder distention, urinary distention, and
- postoperative paralytic ileus
- Adverse Reactions and Side Effects: Bronchospasm, laryngospasm,
- respiratory depression, convulsion, paralysis, respiratory arrest,
- nausea, vomiting and diarrhea
- Contraindications: Renal or intestinal obstruction. Cautious use with
- children, lactation, bradycardia, hypotension, seizure disorders,
- bronchial asthma, coronary occlusion, and hyperthyroidism
- Implications: Monitor vital signs, I & O. Assess for urinary retention,
- bradycardia, bronchospasm, hypotension, respiratory depression.
- Examples of Medications in This Classification:
- • neostigmine
- • bethanechol
-
-
Actions: Blocks the autonomic nervous system’s acetylcholine
- Uses: Prevention of surgical secretions, to decrease the motility of the
- urinary, biliary and GI tracts, reverses neuromuscular blockade. Some
- are used for parkinsonian symptoms secondary to the use of
- neuroleptic medications
- Adverse Reactions and Side Effects: Constipation and dryness of the
- mouth.
- Contraindications: GU or GI obstruction, angle closure glaucoma,
- myasthenia gravis, and hypersensitivity. Cautious use among the
- elderly and with patients who have prostatic hypertrophy or
- tachycardia
- Implications: Monitor urinary status and I & O with particular attention
- to any dysuria, frequency or retention. The medication may be
- discontinued with these signs. Observe mental status and for
- constipation. Administer oral doses with milk or food and administer
- parenteral doses slowly with the person in a recumbent position to
- prevent postural hypotension
- Examples of Medications in This Classification:
- • atropine
- • scopolamine
-
-
This classification is also subdivided. These groups are:
- • glucocorticoids and
- • mineralcorticoids.
- Actions:
- Glucocorticoids- increase capillary permeability and suppress the
- movement of fibroblasts and leukocytes, thereby decreasing
- inflammation.
- Mineralcorticoids- increase potassium and hydrogen excretion in the
- distal tubule by increasing the resorption of sodium
- Uses:
- Glucocorticoids- decrease inflammation. Some are used for adrenal
- insufficiency, allergies and cerebral edema.
- Mineralcorticoids- adrenal insufficiency
- Adverse Reactions and Side Effects: Insomnia, euphoria, behavioral
- changes, peptic ulcer (GI irritation), sodium and fluid retention,
- hypokalemia, hyperglycemia, and carbohydrate intolerance (metabolic
- reactions)
- Contraindications: Fungal infections, amebiasis, hypersensitivity, and
- lactation. Caution with the elderly, children and pregnant women,
- diabetes, seizures, peptic ulcers, glaucoma, CHF, hypertension,
- impaired renal function, myasthenia gravis and ulcerative colitis
- Implications: GI symptoms can be prevented when the dose is given
- with food or milk. Monitor blood sugar, potassium, weight, I & O,
- plasma cortisol levels, adrenal insufficiency and for any signs of
- infection. Observe for mood changes, particularly depression
- Examples of Medications in This Classification:
- • cortisone
- • dexamethasone
- • hydrocortisone
-
-
This classification of medications is subdivided into:
- • thiazides and thiazide-like diuretics,
- • loop diuretics,
- • carbonic anhydrase inhibitors,
- • osmotic diuretics, and
- • potassium-sparing diuretics.
- Actions:
- Thiazides and thiazide-like diuretics- slow resorption in the distal
- tubule, thus increasing the excretion of sodium and water
- Loop diuretics- inhibit the resorption of sodium and chloride in the loop
- of Henle.
- Carbonic anhydrase inhibitors- decrease the sodium-hydrogen ion
- exchange in the tubule, thus increasing sodium excretion
- Osmotic diuretics- decrease the absorption of sodium by increasing the
- osmotic pressure of glomerular filtrate
- Potassium-sparing diuretics- decrease potassium excretion by
- interfering with sodium resorption at the distal tubule
- Uses: Hypertension and edema with CHF
- Adverse Reactions and Side Effects: Hypokalemia, hyperglycemia and
- hyperuricemia (mostly with thiazides), blood dyscrasias, aplastic
- anemia, volume depletion, and dehydration (thiazides, loop diuretics,
- and carbonic anhydrase inhibitors)
- Contraindications: Electrolyte imbalances (K, Cl, Na), anuria,
- dehydration. Caution among the elderly as well as in the presence of
- renal or hepatic disease
- Implications: A potassium supplement may be needed. Monitor
- electrolytes, blood sugar, and lying and standing blood pressures.
- Observe for signs of hypokalemia and metabolic alkalosis. The
- medication should be given in the morning to prevent the need for
- frequent nocturnal voiding.
- Examples of Medications in This Classification:
- • furosemide
- • hydrochlorothiazide
-
-
Actions: Inhibits histamine in the parietal cells, thereby inhibiting the
- secretion of gastric acid secretion
- Uses: Gastric and duodenal ulcers, gastroesophageal reflux disease
- Adverse Reactions and Side Effects: Thrombocytopenia, neutropenia
- agranulocytosis, aplastic anemia, confusion (not ranitidine), diarrhea
- and headache.
- Contraindications: Hypersensitivity. Cautious use with children less
- than 16 years of age, hepatic or renal disease, organic brain
- syndrome, lactation and pregnancy
- Implications: Monitor I & O, creatinine, BUN and gastric pH. The pH
- should be maintained above 5. Give slowly IV over 30 minutes to avoid
- bradycardia and administer oral doses with meals to prolong the effect
- of the medication
- Examples of Medications in This Classification:
- • cimetidine
- • ranitidine
-
-
Action: Inhibits lymphocytes
- Uses: Prevention of organ transplant rejection
- Adverse Reactions and Side Effects: Proteinuria, renal failure,
- albuminuria, hematuria, hepatotoxicity, oral Candida, gum
- hyperplasia, headache and tremors
- Contraindications: Hypersensitivity. Caution with severe hepatic or
- renal disease and pregnancy
- Implications: Monitor liver and kidney function, and drug blood levels.
- Observe for signs of hepatotoxicity, which can include itching, light
- colored stools, jaundice and dark urine. Administer with meals to avoid
- GI symptoms
- Examples of Medications in This Classification:
- • cyclosporine
- • azathioprine
-
-
Actions:
- Bulk laxatives – absorb water thus adding bulk to the stool
- Lubricants- increase water retention in the stool
- Stimulants- speed up peristalsis
- Saline laxatives- pull water into the intestines
- Osmotics- enhance peristalsis and increase distention
- Stool softeners- reduce the surface tension of liquids within the bowel.
- Uses: Constipation, as a bowel prep and a stool softener
- Adverse Reactions and Side Effects: Cramping, diarrhea, and nausea
- Contraindications: Megacolon, abdominal pain, nausea, vomiting,
- impaction, GI obstruction or perforation, gastric retention and colitis.
- Caution with large hemorrhoids and rectal bleeding
- Implications: Monitor blood, I & O, and urine electrolytes. Administer
- only with water to enhance absorption. Do not administer within one
- hour of taking an antacid, cimetidine or drinking milk.
- Examples of Medications in This Classification:
- • psyllium
- • docusate sodium
- • magnesium hydroxide
- • mineral oil
- • bisacodyl
-
NEUROMUSCULAR BLOCKING AGENTS
-
This classification is divided into:
- • depolarizing blockers and
- • nondepolarizing blockers.
- Actions: Inhibition of nerve impulse transmission
- Uses: The facilitation of endotracheal intubation and skeletal muscle
- relaxation (surgery, general anesthesia and mechanical ventilation)
- Adverse Reactions and Side Effects: Apnea, respiratory depression,
- bronchospasm, and bradycardia
- Contraindications: Hypersensitivity. Cautious use with collagen, thyroid
- and cardiac disease, lactation, pregnancy, children less than two years
- of age, dehydration, electrolyte imbalances, and myasthenia gravis
- Implications: Monitor potassium and magnesium (imbalances may
- increase the action of this medication), vital signs every 15 minutes
- until recovery, and I & O. IV doses must be given over 1 to 2 minutes
- by a person qualified and competent to do so (usually an
- anesthesiologist)
- Examples of Medications in This Classification:
- • gallamine
- • pancuronium
-
NONSTEROIDAL ANTIINFLAMATORIES
-
Actions: Decreases prostaglandin synthesis
- Uses: Mild to moderate pain, arthritis and dysmenorrhea
- Adverse Reactions and Side Effects: Blood dyscrasias, nephrotoxicity
- (oliguria, azotemia, hematuria and dysuria), abdominal pain,
- cholestatic hepatitis, anorexia, dizziness and drowsiness.
- Contraindications: Asthma, severe liver and/or renal disease,
- hypersensitivity. Cautious use with the elderly, children, lactation,
- pregnancy and for patients with GI, cardiac and/or bleeding disorders.
- Implications: Monitor blood, renal and hepatic function. Baseline
- hearing and eye exams are recommended so that changes can be
- identified. Toxicity may be signaled with tinnitus and/or blurred vision.
- Examples of Medications in This Classification:
- • ibuprofen
- • naproxen
-
-
This classification includes:
- • opiates and
- • nonopiates.
- Actions: Depression of the pain impulse transmission at the level of
- the spinal cord
- Uses: Moderate to severe pain
- Adverse Reactions and Side Effects: GI (constipation, nausea,
- vomiting, anorexia, cramps), sedation, respiratory depression,
- circulatory depression and increased intracranial pressure
- Contraindications: Upper airway obstruction, bronchial asthma,
- hypersensitivity, addiction. Cautious use with renal, hepatic,
- respiratory and heart disease.
- Implications: Monitor respiratory, urinary and mental status, level of
- consciousness. An antiemetic can be used for nausea and vomiting.
- Continue to assess level of pain
- Examples of Medications in This Classification:
- • codeine
- • fentanyl
-
-
Actions: Antipyretic (inhibits the heat regulation center in the
- hypothalamus), anti-inflammatory (inhibits prostaglandin), analgesic
- (inhibits prostaglandin)
- Uses: Mild to moderate pain, inflammation (arthritis), fever, and
- thromboembolitic disorders
- Adverse Reactions and Side Effects: Rash, GI symptoms,
- hepatotoxicity, blood dyscrasias, hearing problems and tinnitus (a sign
- of possible toxicity)
- Contraindications: Frequently occurring hypersensitivity.
- Contraindicated with a vitamin K deficiency, GI bleeding, a bleeding
- disorder, children with Reye’s syndrome. Caution with Hodgkin’s
- disease, hepatic and renal failure, anemia
- Implications: Monitor renal and hepatic function, blood. Observe for
- signs of hepatotoxicity (clay colored stool, dark urine, diarrhea, yellow
- sclera and skin, itching, fever, abdominal pain) and ototoxicity (ringing
- or roaring in the ears, tinnitus)
- Examples of Medications in This Classification:
- • aspirin
- • salsalate
-
-
Actions: These medications convert plasminogen into plasmin which is
- able to break down the fibrin of clots
- Uses: Pulmonary emboli, deep vein and arterial thrombosis, with or
- after MI, arteriovenous cannula occlusion
- Adverse Reactions and Side Effects: Anaphylaxis, GI, GU, intracranial
- retroperitoneal bleeding, and anaphylaxis. The most common side
- effects are decreased Hct, urticaria, headache, and nausea.
- Contraindications: Hypersensitivity, people with CNS neoplasms,
- bleeding, renal or hepatic disease, hypertension, COPD, subacute
- bacterial endocarditis, rheumatic valvular disease, cerebral embolism
- or thrombosis or hemorrhage, and recent surgery
- Implications: Monitor vital signs and neuro signs q 4 hours, be alert for
- internal bleeding (temperature of more than 104 degrees),
- arrhythmias, retroperineal bleeding (leg weakness, back pain, and
- poor pulses), allergic responses (rash, fever, itching, chill),
- ecchymosis, hematuria, hematemesis, epistaxis. Monitor blood before
- and during therapy. Thrombolytics are not effective if the thrombi is
- more than one week old. Use 0.8 mm filter with IV administration
- Examples of Medications in This Classification:
- • streptokinase
- • urokinase
-
-
Actions: Increase metabolism cardiac output, blood volume, oxygen
- consumption, and respiratory rate
- Uses: Thyroid replacement
- Adverse Reactions and Side Effects: Palpitations, tachycardia,
- insomnia, tremors, angina, weight loss, dysrhythmias, thyroid storm.
- Contraindications: MI, adrenal insufficiency and thyrotoxicosis.
- Cautious use with the elderly, pregnant and lactating women, and for
- patients with diabetes, hypertension, angina, and cardiac disease
- Implications: Administer at the same time of day. Check the blood
- pressure before each dose. Monitor I & O, weight, cardiac status and
- for irritability, excitability and nervousness
- Examples of Medications in This Classification:
- • thyroid
- • levothyroxin
-
-
Actions: Various modes for each. Check a drug reference book for
- specifics
- Uses: Hypertension, angina, intermittent claudication, vasospasm,
- arteriosclerosis
- Adverse Reactions and Side Effects: Both hypotension and
- hypertension, changes in EKG, nausea, headache
- Contraindications: Tachycardia, acute MI and thyrotoxicosis. Cautious
- use with peptic ulcer and uncompensated heart disease
- Implications: Administer with meals to reduce any GI symptoms.
- Check bleeding times and cardiac status
- Examples of Medications in This Classification:
- • amyl nitrate
- • hydralazine
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