Top Drugs.txt

Opioid agonist

Binds to opiate receptors in the CNS—decreases moderate pain. Suppresses cough reflex

confusion, sedation, hypotension, constipation HEPATOTOXICITY. various GI symptoms

Monitor respiratory status. Should not exceed 4 grams of acetaminophen in 24 hrs.Typical opioid precautions. should be taken with food

Opioid agonist

Controlled release for moderate to severe pain Not for PRN

confusion, sedation, constipation RESPIRATORY DEPRESSION. various GI symptoms

Administer q12 hours for Chronic pain.Typical opioid precautions. Do not crush or chew. should be taken with food

Potassium supplement

Transmit nerve impulses; contraction of cardiac, skeletal, and smooth muscle; gastric secretion; renal function; tissue synthesis; and CHO metabolism.

• ARRHYTHMIAS, ECG changes
• oral—abdominal pain, diarrhea, flatulence, nausea & vomiting. various GI symptoms

(IV rate should generally not exceed 20 mEq/hr, unless closely monitored.) s/s hypokalemia/hyperkalemia. should be taken with food

NSAIDs, COX-2 inhibitor

Analgesic, anti-inflammatory, & antipyretic

GI BLEEDING, dermal rash. various GI symptoms

Assess pain, ROM and swelling. Do not give if allergic to sulfonamides, aspirin or NSAIDs. Watch for tarry stools.

Antiulcer agents; proton pump inhibitors

Decrease acid accumulation in the gastric lumen which decreases GI reflex Healing of duodenal ulcers

Headache, constipation, dry mouth, various GI symptoms

Give 1hr before meals Do not crush or chew pellets Assess for epigastric/abdominal pain, blood in stool, emesis, or gastric aspirate Give slow IVP over 5-6 minutes, diluted with 0.9% NS

Histamine (H2) Antagonist Antiulcer

inhibits the action of histamine at H2-receptor site (gastric parietal cells), decreases gastric acid

ARRHYTHMIAS, APLASTIC ANEMIA, AGRANULOCYTOSIS, confusion, dizziness, headache, nausea, black tongue, diarrhea

Monitor CBC, Dilute IV, rapid administration may cause hypotension. should be taken with food

Lipid-Lowering agent

LDL/VLDL/Triglyceride. HDL (slightly)

RHABDOMYOLYSIS = muscle cell lysis, toxins into circulation, rashes, constipation, flatus. various GI symptoms

Avoid grapefruit & grapefruit juice.With unexplained muscle pain/tenderness-monitor CPK --if it increases, d/c med = life threatening. LFTs

Lipid-Lowering agent Eze = inhibits intestinal absorption of CHOLS im = inhibits CHOL synthesis

Lowers Total and LDL CHOL and triglycerides with slight increase in HDL

Abdominal pain, diarrhea, epigastric pain, HA, dizziness, anemia, alopecia

Administer once daily in the evening, without regard to food.Wear sunscreen to prevent rare photosensitivity reaction. LFTs

Antidepressant Smoking deterrent

Diminished depression Decreased craving for cigarettes

SEIZURES, agitation, HA, drymouth, nausea, vomiting, tremor

Monitor mood changes. Assess for suicidal tendencies. Monitor hepatic and renal function in pts with liver or kidney impairments to prevent increased serum levels.

Antidepressant SSRI

Decreases panic attacks, OCD, intense fear and helplessness

Dizziness, drowsiness, fatigue, HA, insomnia, dry mouth, tremor, sweating, Avoid use with any MAO Inhibitors/ various GI symptoms

Monitor weight, mood changes, and suicide risk. No alcohol or other CNS depressants Do not D/C abruptly Wear sunscreen to prevent photosensitivity reaction.

Thyroid preparation

Restoration of hormonal balance, suppression of cancer

Insomnia, arrhythmias, tachycardia, wt. loss Avoid use in thyrotoxicity

Assess apical pulse and BP prior to admin & during therapy, & for chest pain, tachyarrhythmias Monitor T3 and TSH Important drug interactions

Antiinfective, 3rd generation cephalosporin

Bactericidal for bone & joint and lower resp. tract infections; skin infections, some STDs and UTIs

PSEUDOMEMBRANOUS COLITIS, SEIZURES, phlebitis at IV site, pain at IM site. various GI symptoms

Monitor for super infections Obtain specimens for culture and sensitivity before starting. Instruct patient to notify MD if fever and diarrhea develop, especially if stool contains blood, pus, or mucus.

Antiinfective, Aminoglycoside

Treatment for enterococcal infections

Ototoxicity and nephrotoxicity

Do peak and trough levels, report to MD for dose adjusting Assess hearing periodically throughout TX Monitor for superinfections

Antiinfective Fluoroquinolone

Broad spectrum against gram positive and gram negative

Dizziness, drowsiness, headaches, various GI symptoms

Watch for anaphylactic rxn Do not administer <4 hr before or 2 hr after giving an Al/Mg/ Fe or Zn preparation Monitor for superinfections

Antiinfective, antiulcer, Antiprotozoal

Treatment of anaerobic and parasitic infections

SEIZURES, dizziness, HA, anorexia, nausea. various GI symptoms

Monitor WBC, neurological status, and I/Os. should be taken with food

Antihypertensive ACE inhibitor

Lowers BP, decreases afterload in CHF & LV remodeling & mortality

Cough, proteinuria, taste impairment, clinically significant hyperkalemia, ANGIOEDEMA

Monitor BP, pulse, fluid retention, dry persistent cough, rash, mouth sores, swelling of face, dizziness

Antianginal

Relief or prevention of anginal attacks; increase cardiac output; decrease blood pressure

dizziness, headache, restlessness, syncope, hypotension, contact dermatitis, blurred vision

-Wear gloves during removal/application- Remove patches before cardioversion or defibrillation- D/C if low BP Rotate sites of application to prevent skin irritation

Antianginal Nitrate

Increases coronary bloodflow to decrease angina attacks. Decrease BP. Increase cardiac output.

Dizziness. HA. Blurred Vision. Hypotension. Tachycardia. Flushing. various GI symptoms

Tablets should be kept in original container & cotton should be removed. Do not open bottle frequently or handle tablets. Replace q 6 months after opening

Beta blocker

Antihypertensive Antianginal, Prev & decr mortality in recent MI pts

BRADYCARDIA, PULMONARY EDEMA, CHF. fatigue, weakness, impotence

Hold HR <60. Monitor I & O, daily weight. Assess for HF, bronchospasm

2nd generation (nonsedating) Antihistamine

Relief of seasonal and perennial allergic rhinitis

Dizziness, fatigue, dry mouth

Administer once daily without regard to food

Bronchodilator Beta 2 agonist

Bronchodilation for asthma, COPD, acute bronchospasm

Nervousness, restlessness, tremor, chest pain, palpitations.

Observe for paradoxical bronchospasm (wheezing). Consider aerochamber. Monitor K+ and glucose.

Antianginal antiarrhythimics (classIV) antihypertensive. CA++ channel blocker

Decreased blood pressure.Coronary vasodilation Antiarrhythmic

Arrhythmias CHF Peripheral edema, Postural hypotension

Assess for signs of CHF Monitor BP &P, notify < 50 bpm. May cause drowsiness or dizziness. Caution patient to avoid driving until response to medication is known Gingival hyperplasia-teach good oral care

Angiotensin II receptor blocker

Antihypertensive. Decreases risk of stroke.

Orthostatic hypotension, diarrhea Dizziness, ANGIOEDEMA Use cautiously in CHF

Assess orthostatic blood pressures. Use care when changing positions to prevent orthostatic hypotension. Monitor BUN/Creatinine for possible early renal failure.

Antiarrhythmic Anticholinergic

TX for symptomatic bradycardia & heart block. Decrease GI & respiratory secretions

Dry mouth, urinary hesitancy, blurred vision, tachycardia

Monitor urinary output esp. in BPH. Assess VS and EKG

Antiarrhythmic, cardiotonic andinotropic agent

TX of CHF, tachyarrhythmia Antidote immune Fab (Digibind)

NARROW THERAPUETIC RANGE visual disturbances and fatigue, blurred vision, ECG changes. various GI symptoms

Monitor apical pulse for one full minute. Hold if pulse is <60. Second person check calculations in IV & Peds Monitor drug levels

Antihypertensive Non K+ sparing diuretic

Decrease Blood Pressure Increase in Urine output

Hypokalemia Drowsiness Digoxin toxicity Increased glucose levels

Monitor blood pressure, I & O, daily wt, Monitor lytes. Administer in am. Change positions slowly to minimize orthostatic hypotension.

Loop Diuretic

Diuresis. lowering of blood pressure

Dehydration, hypochloremia, hypokalemia, hypomagnesaemia, hyponatremia, hypovolemia, metabolic alkalosis

Monitor for thirst, dry mouth, lethargy, weakness, hypotension, oliguria and notify physician. Monitor K+, Ca++, Mg. Can increase BUN, glucose and creatinine. should be taken with food

Anticoagulant. Interferes with hepative syntheses of Vitamin Kdependant clotting factors

Prophylaxis/Treatment of venous &/or pulmonary embolism (PE) and atrial fibrillation w/embolization

Bleeding. Numerous drugs and natural products affect the activity of warfarin!

Asses for bleeding, or Ç thrombosis Check INR/PT before administration and regularly PT may be 1. 3-1.5 times greater than control. INR goal dependent on medical diagnosis Maintain consistent vitamin K , Take in evening Avoid ETOH & OTC medications High Alert Medication

Anticoagulant Causes the inhibitory effect of anti-thrombin on factor Xa and thrombin

Prevention of deep vein thrombosis (DVT) and PE Antidote = protamine sulfate.

Bleeding, anemia,,thrombocytopenia, erythema at injection site, pain. Use only 1 heparin product at a time

Assess for bleeding, CBC, platelet count, neurological impairment.Note pkg info for prefilled syringe- keep air lock. “Lovenoxin the love handles”-no aspiration or massage High Alert Medication

Anticoagulant

Antithrombotic. Prevention of extension of existing thrombi. Antidote = protaminesulfate

BLEEDING. Thrombocytopenia, anemia. Has multiple drug reactions

Assess for bleeding (nose, gums, urine, stool), anemia, thrombocytopenia Closely monitor aPTT. High Alert Medication. Use heparin nomogram/protocol. Immediate onset when given IV

Anti-platelet

atherosclerotic events

GI bleed, neutropenia, thrombotic thrombocytopenic purpura

Monitor for bleeding, CBC, diff, platelet count, Do not double dose, Avoid NSAIDs. Watch for fever, chills, sore throat, bleeding/bruising. Caution in brushing/flossing teeth

Sedative/hypnotic

Sedation and induction of sleep

Amnesia, daytime drowsiness, drugged feeling, physical & psychological dependence, tolerance. various GI symptoms

Assess sleep, mental status, potential for dependence. Don’t use more than 7-10 days. Avoid ETOH & other CNS depressants

Antianxiety Sedative/hypnotic Benzodiazepine

Management of anxiety, insomnia, Status Epilepticus Preoperative sedation Postoperative amnesia

Dizziness, drowsiness, lethargy, APNEA, CARDIAC ARREST with rapid IVP

Assess anxiety, mental status, Avoid ETOH & other CNS depressants

Opioid analgesic Opioid agonist

pain, pulmonary edema, pain with MI

Respiratory depression, confusion, sedation, hypotension, constipation

Typical opioid precautions. Dilute for IV push and give over 4-5 minutes

Antiemetic Antihistamine (H1) Sedative/hypnotic Phenothiazine

symptoms of excess histamine, sedation, N/V

neuroleptic malignant syndrome, confusion, disorientation, sedation, dizziness

Monitor for extrapyramidal side effects; educate on techniques to help dry mouth; oral care, photosensitivity; orthostatic hypotension risk; avoid ETOH & other CNS depressants; monitor sedation. A known Vesicant always dilute before IV administration!!

Analgesic adjunct Anticonvulsant

seizures, neuralgias, chronic pain

Drowsiness, ataxia. Avoid in pregnancy/breastfeeding

TID dosing should not exceed 12 hr between doses. Do not D/C abruptly; do not take within 2hr of antacid. avoid driving–till MD OK; Avoid use with other CNS depressants

Antiarrhythmic, Anticonvulsant

seizures, control arrhythmias; pain

Agranulocytosis, aplastic anemia, Stevens-Johnson syndrome diplopia, nystagmus,hypotension, gingival hyperplasia, nausea, rashes

Assess for hypersensitivity syndrome; monitor CBC, platelet count, avoid driving till MD ok; avoid ETOH & OTC meds; maintain oral hygiene; urine can be pink/red; diabetic-monitor glucose closely; avoid taking within 2-3 hr of antacids/antidiarrheals;↓contraceptive (hormonal). should be taken with food

Antiparkinson agent Dopamine agonist

Relief of tremor & rigidity in Parkinson’s

Involuntary movements, Avoid with MAO inhibitors, narrow angle glaucoma. various GI symptoms

Monitor CBC, hepatic & renal function; avoid driving-till MD OK; orthostatic hypotension; oral hygiene-dry mouth; skin lesions-changes; avoid OTC meds. should be taken with food

Bone resorption inhibitor Bisphosphonate

TX and prevention of postmenopausal and corticosteroid-induced osteoporosis,

Altered taste, photosensitivity, rash, musculoskeletal pain, fluid overload, esophagitis. various GI symptoms

Take first thing in the AM, before eating anything; then pt must remain upright for at least 30 mins! Take only with plain water. Monitor for GI side effects.Use sunscreen to prevent photosensitivity reactions.

Immunosuppressant

Prevent renal transplant rejection. Treat Rheumatoid arthritis and Crohn’s

Blood dyscryasias, hepatotoxicity. various GI symptoms

CBC, LFT Assess for infection, fluid retention, bleeding. Contraception and teratogenic concerns. Do not d/c abruptly

Anti-diabetic Biguanide

Decrease hepatic glucose production & intestinal absorption, ↑ receptor site sensitivity

Abdominal bloating. Lactic acidosis. Metallic taste. various GI symptoms

Educate about lactic acidosis when food or fluid is decreased. (S/S – chills, diarrhea, dizziness, low BP, weakness, muscle pain, slow HR. Notify MD IMMEDIATELY) Stop drug before dye based studies. Renal function. should be taken with food

AntidiabeticThiazolidinediones

Decrease insulin resistance

Edema, anemia, wt gain, increased cholesterol

Monitor for fluid retention, hypoglycemia. LFTs & CBC High Alert Medication

Antidiabetic sulfonylurea

Stimulates release of insulin from the pancreas,↑receptor site sensitivity

Photosensitivity, hypoglycemia. APLASTIC ANEMIA

Observe s/s of hypoglycemia. High Alert Medication. Do not take glyburide if you are unable to eat. Avoid alcohol.

Antidiabetic; pancreatic hormone. Long acting 24 hours

Lowers blood glucose by increasing transport into cells and promoting conversion of glucose to glycogen. Inhibits release of free fatty acids.

HYPOGYCEMIA, lipodystrophy, anaphylaxis

For all insulins: typical diabetic teaching and concerns.Watch for interactions with beta blockers, thiazide diuretics, corticosteroids. Know peaks, onsets, durations High Alert Medications

Anti-diabetic; pancreatic hormone. Onset 30 minutes

Lowers blood glucose by increasing transport into cells and promoting conversion of glucose to glycogen. Inhibits release of free fatty acids.

HYPOGYCEMIA, lipodystrophy, anaphylaxis

For all insulins: typical diabetic teaching and concerns.Watch for interactions with beta blockers, thiazide diuretics, corticosteroid. Humulin 70/30: 2 Peaks. Know peaks, onsets, durations. High Alert Medications

Anti-diabetic pancreatic hormone Onset < 15 minutes

Lowers blood glucose by increasing transport into cells and promoting conversion of glucose to glycogen. Inhibits release of free fatty acids.

HYPOGYCEMIA, lipodystrophy, anaphylaxis

For all insulins: typical diabetic teaching and concerns.Watch for interactions with beta blockers, thiazidediuretics, corticosteroids Lispro: Do not give sooner than 15 minutes before a meal. Know peaks, onsets, durations. High Alert Medications

Peripherally acting antiadrenergic

Decreased symptoms of prostatic hyperplasia, i.e. male urinary outflow obstruction

Dizziness, headache, orthostatic hypotension, retrograde/diminished ejaculation. Cautious in patients at risk for prostate carcinoma

Monitor for dizziness, hypotension. Have patient change positions slowly to minimize symptoms.

Anti-inflammatory (intermediate acting) corticosteroid

Suppression of inflammation & modification of the normal immune response; replacement therapy in adrenal insufficiency. Management of cerebral edema. Potentiates anti-N/V action of Zofran.

PEPTIC ULCERATION, THROMBOEMBOLISM, mood changes, hypertension, anorexia, nausea, acne, decreased wound healing, ecchymosis, fragility, hirsutism, petechiae, adrenal suppression, muscle wasting, osteoporosis, cushingoid appearance. various GI symptoms

Monitor for fluid retention, hyperglycemia, infections, bleeding, steady weight gain, crackles, dyspnea. Do not D/C abruptly. Monitor serum electrolytes, cholesterol/lipids. avoid people w/contagious illnesses, should be taken with food

Anti-inflammatory (long acting) corticosteroid

Suppression of inflammation & modification of the normal immune response; replacement therapy in adrenal insufficiency. Management of cerebral edema. Potentiates anti-N/V action of Zofran.

PEPTIC ULCERATION, THROMBOEMBOLISM, mood changes, hypertension, anorexia, nausea, acne, decreased wound healing, ecchymosis, fragility, hirsutism, petechiae, adrenal suppression, muscle wasting, osteoporosis, cushingoid appearance. various GI symptoms

Monitor for fluid retention, hyperglycemia, infections, bleeding, steady weight gain, crackles, dyspnea. Do not D/C abruptly. Monitor serum electrolytes, cholesterol/lipids. avoid people w/contagious illnesses, should be taken with food

Antiemetic 5-HT3 receptors antagonist

Prevention of nausea & vomiting associated with chemotherapy or radiation therapy. Prevention/treatment of postop nausea/vomiting.

HA, dizziness, diarrhea

Advise patient to notify MD for involuntary movement of eyes, face, or limbs.

Antiviral

Inhibition of viral replication against genital herpes, cold sores, & chickenpox. Does not eradicate the latent herpes virus.

Headaches, lightheadness, phlebitis, diarrhea, nausea, vomiting. Use cautiously with lactating mothers. RENAL FAILURE, SEIZURES and dehydration. Adjust dose in obesity

Monitor for infiltration and/or tissue damage; maintain hydration (esp. x 2hrs. after infusion) to prevent precipitation of drug in renal tubules; monitor baseline renal functioning

Antiarrhythmic

Slows conduction through the AV node. Restores sinus rhythm inpatients with PSVT.

Contraindicated in 2nd and 3rd degree. AV heart blocks. Headache, lightheadness, dizziness, SOB, transient facial flushing & nausea.

Monitor for S/S of bronchospasms in asthma patients, use hemodynamic system while administering; Do not confuse with Adenosine Phosphate. Monitor for orthostatic hypotension.

Antiarrhythmic

↑ VFib threshold. Management of supraventricular & life-threatening ventricular tachyarrhythmias.

Bradycardia, hypotension, CHF, ARDS, blurred vision, nausea & vomiting, ataxia.

Monitor ECG, BP, HR, RR carefully during infusion & until drug response has stabilized. Periodic labs should be checked, esp. liver & thyroid function.

Antiemetic 5-HT3 receptor antagonist

Decreased incidence & severity of N/V associated with chemotherapeutic and postop pts.

Fever, fatigue, headache, dizziness, diarrhea, urinary retention.

Hypokalemia and hypomagnesemia should be corrected before initiating therapy. Monitor cardiac status with electrolyte imbalance. Monitor ECGs for prolonged QT interval.

Adrenergic agonist Vasopressor + Inotrope

Increases cardiac output, + BP. Utilized in low dosages to possibly improve renal perfusion. High dosage – similar effects of epinephrine

High dose-VASCULAR COLLAPSE, arrhythmias, hypotension

Monitor cardiac pressures, BP & urinary output. Administer into a large vein. Usually titrated & must be on a pump.

Vasopressor Bronchodilator Cardiac stimulant

Used for VFib and decreased BP. Severe allergic reactions & anaphylactic shock, acute asthma

Tachycardia, HTN, bronchospasm Arrhythmias, restlessness, tremors

Can be given SQ, IV, inhalation, intracardiac, endotracheal. Monitor HR, BP, ECG, and resp rate

Opioid Analgesic

Pre- & postop analgesia. Supplement in general anesthesia induction/maintenance. 80-100 X more potent than Morphine.

APNEA, LARYNGOSPASM. CNS and Respiratory depression. Facial, esp. Nasal itching, hypotension, constipation.

Monitor respiratory rate and BP closely and frequently. Resp. depression may last longer than analgesia. Direct IV route, undiluted. Have Narcan readily available.

Combo drug Corticosteroid/Bronchodilator

Treatment of COPD and asthma

Because it is a combination drug, you need to make sure that you watch for side effects from both drugs such as chest pain arrhythmia, N/V, diarrhea, and dry mouth.

Make sure patient understands how to use this unusual inhaler. Monitor lung function. Rinse mouth after use.