copy of classes of drugs (study guide)

8/8/2019 Copy of Classes of Drugs (Study Guide)

1/25

1

CLASS

USE ASSESSMENT INTERVENTIONS MISC/SIDE

EFFECTS

Narcotics

1.) Morphine

2.) Codeine

3.) Dilaudid

4.) Demerol

Works in CNS

Mod-severe pain,

depress resp &cough

Mild-moderate

pain, coughsuppress

7-10 xs more

potent thandemeral. shorteracting than

morphine

No anti-cough

properties, usedduring labor, short-

term use only

Monitor VS,

output, bowelsounds, assess

allergies,respirations


2/25

2

CLASS


EFFECTS

3.) Nubain Relieve mod to

severe pain

Obtain drug hx,

baseline vsUse cautiously for

pts w/ hx of drugabuse or

emotionalinstability,

impairedrepirations, head

injury, increasedintracranial

pressure, MI,biliary tract

surgery, renal or

hepaticdysfunction.

Monitor vs, bowel

sounds, I&Os

SE: Dizziness,

confusion,hallucinations,

blurred vision,HA, flushing,

sedation,nervousness,

restlessness,euphoria,

depression,crying, dysphor

unusual dreamsdry mouth, bitte

taste, n/v,

abdominalcramps, clammskin, urinary

urgency

NSAIDs, Salicylate

1.) aspirinASA

(acetylsalicylic acid)ASA falls under

multiple classes

2.) ibuprofen (Motrin,Advil, Nuprin,

Medipren)

Analgesic,

antipyreticantiplatelet

Anti-inflammatorymenstrual pain

AnalgesicAnti-inflammatory

Antipyretic

Check for ASA

allergies.Assess for hx of

GI upset,bleeding & liver

disease

Check for allergyto NSAIDs.

Check medical hxfor severe renal or

liver disease,peptic ulcer, or

bleeding disorder,GI upset and

peripheral edema.

Take with food or full

glass of water

Admin PPI to reducerisk of ulcer

Take with food or fullglass of water

Observe client forbleeding gums, black

(tarry) stools, GIdiscomfort.

Dont take last

trimester,w/alcohol, othe

NSAIDS andkids w/flu like

(ReyesSyndrome)

SE: GI upsetbleeding, renal

failure, tinnitus

SE: anorexiaN/V, diarrhea,

edema, rash,purpura, tinnitu

fatigue, dizzinelightheadednes

anxiety,confusion, GI

bleeding,nephrotoxicity


3/25

3

CLASS


EFFECTS

3.) ketorolac

(Toradol)

(2nd

generationNSAID)

4.) cox 2 inhibitor:celecoxib (Celebrex)

5.) anti-gout/inflammatory:

Colchicine

Analgesic

Intraocular anti-inflammatory

Tx of osteoarthritis& rheumatoid

arthritisMenstral

discomfortLong term use

Tx of acute gout &prophylaxis of

recurrent goutyarthritis

Assess for hx ofrenal or hepatic

dysfunction,hypertension,

fluid retention,heart failure,

infection, GIbleeding or

ulceration,concurrentanticoagulant

therapy, steroids,or alcohol use

Assess medical

hx for any gastric,renal (sufficient

renal functionneeded), cardiac,

Monitor renal/hepatic

functionObserve client for

signs of bleeding

Increase fluid intakeMonitor renal

function

Increase fluid intake.

Monitor GI sx,gastric pain, n/v, or

diarrhea (take w/food)

First injectable

NSAIDShort-term tx o

painOphthalmic--

relieve itchingcaused by allerg

conjunctivitisSE: HA, nausea

abdominaldiscomfort, pep

ulcer, GI

bleeding,gastritis, severehepatic reaction

nephrotoxicity pts w/ preexisti

renal impairme

SE: HA,dizziness,

sinusitis, nauseflatulence,

diarrhea, rash,peripheral edem

GI upset/bleed

SE: anorexia, ndiarrhea,

stomatitis,dizziness, rash,


4/25

4

CLASS


EFFECTS

or liver disorders.

Assess serum uricacid & urine

output.

Monitor urine output

and watch forpossible kidney

stones.

pruritus, metall

taste, GIupset/bleed

Antigout

1.) colchicine(see above)

1.) Allopurinol

Acute gout

Low serum uric

acid levels,prevents attacks

Assess Uric acid

levels, CBCUric acid foods:wine, alcohol,

organ meats,sardines, salmon,

gravy

I&Os, increase fluid

intakeTake after mealsYearly eye exams

disease of kingunwalkable

diseaseInflammation

condition, attacjoints & tendon

Caused by exceUric acid

(overproduction

or underelimination)SE: anorexia, n

diarrhea,stomatitis,

dizziness, rash,pruritus, metall

taste, HA,malaise.

Penicillins

1.) Dicioxacillin

2.) Carbenicillin

3.) Bicillin

4.) Amoxicillin

Tx of infection

PCN V: po, mild-

mod inf

PCN G: IV/IM,

mod-severe infProcaine PCN G:

IM, decrease pain

Check allergies toPCN & Cephs

Send culture tolab

Labs: BUN,creatinine

Monitor VS,urine output

Increase fluid intakeFood may decrease

absorptionTake 1 h ac & 2 h pc

Have epinephriavailable

Sulfonamides

UTI, baby eye

prophylaxis,

Assess renal

function, BUN,

Administer w/full

glass of water.

Dont take w/

antacids


5/25

5

CLASS


EFFECTS

1.) Bactrim

2.) Septra

3.) Silvadene Cream

Chlamydia,

pneumocystiscarinii pneumonia,

absorbed by GItract. po, IV

Treats UTIs

burns

CBC &

creatinine. Checkfor allergies

Check I&Os

Push fluids

Avoid during la

2 mo pregnancySE: Steven

JohnsonSyndrome,

crystalluria,photosensitivity

Tetracycline

1.) Doxycycline

Broad spectrum,bacteriostatic

po/IV, never IM(too painful)txs acne & tick-

born illnesses

Labs: BUN,creatinine.

Culture before

starting therapy

Take on emptystomach

Dont take w/ milk,

forms complexAdmin 1 h ac & 2 hpc

Dont take w/ antacid

Dont take whilpregnant

BC pills less

effectiveSE:photosensitivity

tertogenic, grayteeth,

nephrotoxicity

Aminoglycosides

mycin

1.) Gentamycin

2.) Neomycin

3.) Streptomycin

4.) Amikacin

5.) Tobramycin

Gram

For seriousinfections

IM/IV, exceptNeomycin (po)

Neomycindecreases ammonia

level

Assess vitals,

urine output. Maydecrease K+ &

Mg+Renal & Hearing

baselineCheck for

Nephrotoxicity &Ototoxicity


IV dilute & infuse

30-60 minsCulture before

starting therapyMonitor I&Os,

hearing, labs.Push fluids

Peak & thru levels(narrow TI)

SE:

nephrotoxicity,ototoxicity

Cephalosporine-

Cef/Ceph

1.) Cephalexin

2.) Cefadroxil3.) Cefaclor

Resistance to

penicillinase

Superinfection

Allergies (ifallergic to PCN,

may be also to

Cephs)Labs: BUN,creatinine

Monitor VS, I&Os

Culture beforestarting therapy

SE: nausea,

vomiting,diarrhea,

nephrotoxicity,

increasedbleeding

Fluoroquinolones

1.) Ciprofloxacin2.) Levofoxacin

3.) Gatifloxacin

Broad spectrumInterferes w/ the

enzyme DNAgyrase.

Treats anthrax,

BUN, creatinine Increase fluid intakeDont take while

pregnantMonitor I&Os

Antacids & ironlower absorptio

SE: nausea,vomiting,

diarrhea,


6/25

6

CLASS


EFFECTS

UTI, resp inf, skin

inf

abdominal

cramps, HA,flatulence,

photosensitivitytinnitus

Macrolides

1.) Erythromycin

2.) Dirithromycin

3.) Clindamycin

Tx of respiratory

infections, skininfections

PCN substitute

Lab: liver

enzymes (AST 0-35 & ALT 4-36)

Send sample tolab

Give w/ full glass of

waterIV: dilute, infuse

slowlyNever give IM-too

painful

Low dose:

bacteriostaticHigh dose:

bacteriocidalSE: hepatoxi

GI disturbances

Vancomycin

Treats MRSA Labs: BUN 10-

20, creatinine 05-1.2

Baseline hearingGet peak and thru

levelsGet culture before

starting therapy

Drink lots of fluids SE: nephroto

ototoxicity, givtoo fast pt will

develop red masyndrome due t

vasodilation

Antitubercular

1.) Isoniazid (INH)

2.) Rifampin3.) Ethambutol

4.) PZA

Treats tuberculosis

Prophylaxis

Collect early am

sputum for AcidFast Bacillus x3

s & sx: nightsweats, fever,

productive cough

Give 1 h ac or 2 h pc

DOTS tx: directlyobserved tx

Prevent peripheralneuropathy w/

vitamin B6(pyridoxine) (INH)

Eye exams

Dont takeantacids

SE: hepatotojaundice

Brown rustdiscolor(rifamp

Acetaminophen

1.) Tylenol

Fever, pain,headache

Monitor forhepatotoxicity

AST 0-35 & ALT

Check for jaundiceand bleeding

Antidote:mucomyst

Causes little to


7/25

7

CLASS


EFFECTS

2.) Excedrin

3.) Goodys4.) Midol

4-36, pain GI disturbances

Antifungalszole drugs

1.) Amphotericin B

2.) Nystatin

3.) Mycostatin

4.) Azole drugs

Yeast, fungalpneumonia,

ringworm, jockitch, athletes foot

Amphoterrible:IV(slowly) only,

life threateningfungal infections

Swish & swallow

for thrush

Powder, topical

Monistat,Fluconazole

(Diflucan),Clotrimazole

Labs: liverenzymes

(nephrotoxic),BUN, creatinine,

bilirubin

Culture for fungusProtect medicine

from lightMonitor output, labs,

VSAvoid alcohol

give Nystatin last

IV sitethrombophlebit

Nausea/vomitinAvoid hazardou

equipmentHypokalemia

Shake & bake

(fever, chills)premedicate

w/Tylenol &

benedryl

Antimalarials

1.) Quinine Sulfate

2.) Aralen

For nocturnal legcramps, malaria

Prophylaxis

(before, during,after trip)

Signs & sx:fevers, chills,

sweats.Assess hearing &

visual changes

Take w/ foodAvoid alcohol

Monitor output

Caused byparasitic

protozoal (bite infected

mosquito)Destroys RBC,

impairs O2delivery

SE: GI upsetcranial nerve 8

(hearing)

involvement,renal impairme

Antiparasitic

1.)Metronidazole

(Flagyl)

4 organisms of GI

tract (H-pylori,Giardia,

trichomonis, C-Diff)

Used prior to GI

Assess for

bleeding

Inhibits

metabolism ofanticoagulant in

liverNo alcohol-pt w

get antabuse


8/25

8

CLASS


EFFECTS

surgery

Inhibits metabolismof anticoagulant in

liver

effect:

nausea/vomitintachycardia,

circulatorycollapse

SE: metallic tasdiscolor urine

HIV Antivirals

1.) zidovudine (AZT)

2.) Retrovir

3.)Pentamidine(Pentam)

Wont allow RNAto convert to DNA

Treats

HIV(decreasematernal

transmission)

Prophlaxis foraccidental needle

sticks

Pneumocystiscarinii pneumonia

SE: neutopeniabone marrow

suppression,anemia,

neurologicalproblems,

confusion

Low everythinghypotension,

hypoglycemia

Anti-anemics

1.) Iron (Fe)

Hemoglobinregeneration

Treats anemia

Hgb lab

Bleeding outsomewhere

Inj: Z-track methodLiquid: drink thru

strawDrink lots of water

Vit C increasesabsorption

Pt could need bloodtransfusion and O2

therapy

Iron foods:spinach, fruits,

veg, liver, eggyolks

SE: Black/grstool, constipat

For urinary tract

infection

1.)Nitrofurantoin(Macrodantin)

2.) Bactrim

E. Coli

Tx of acute andchronic UTIs

Hx of UTI orother urinary tract

disorders.

CBC w/ longterm therapyAssess renal and

hepatic function

Monitor output.Before therapy obtain

culture

SE: anorexian/v, rust/brown

discoloration of

urine, diarrhea,rash, pruritus,dizziness, HA,

drowsiness,superinfection,

hepatotoxicity.


9/25

9

CLASS


EFFECTS

3.) Fluroquinolones

4.) analgesic:

Pyridium

Relieves pain,

burning sensation,and the frequency

and urgency.

Blood test to

monitor glucoselevels

Monitor glucose

levelsMonitor for GI

disturbances,hemolytic anemia,

nephrotoxicity, andhepatotoxicity.

SE: GI

disturbances,hemolytic

anemia,nephrotoxicity,

hepatotoxicity,urine becomes

reddish orange.

Potassium (K+)

1.) K-Dur

2.) Micro-K3.) Kaochlor

Excreted by the

kidneys whenleaked from the

cells into the

intravascular fluid.Treats hypokalemia

which causesirregular heartbeat

Levels should be

3.5 to 5.3 mEq/L

Assess for K+

depleting meds(Lasix)

Foods: OJ, raisins,

bananas, potatoes,dehydrated fruits.


Tab, cap or powdertake w/ full glass (6-8

oz) of water

IV: dilute, neverbolus-will stop heart

(can give IVPB)

Necessary for

transmission &conduction of

nerve impulses

for contraction skeletal, cardiacand smooth

muscles.

SE: nausea,vomiting,

diarrhea, abdcramps, rash

Flu/herpes

Antivirals

1.) Tamiflu

2.) Relenza3.) Symmetrel

(also antiparkinsons)

4.) Acyclovir(Zovirax)

Flu shot inactive

Nasal is live virus(live virus not for

young, pregnant orimmunocompromis

ed)

Take wi 48 h ofonset

Treats influenza A

Treats HSV ,shingles.

VS, urine output Flu shot yearly unless

allergic to eggs or hxof Guilliane-Barre

IV: slowDrink lots of water

Used w/ elderly

po 5xd

SE: nephroto

ototoxicity

Orthohypotensi


10/25

10

CLASS


EFFECTS

5.) Valtrex po bid

CNS Stimulants

1.) Ritalin

2.) Provigil

To correct

hyperactivitycaused by ADHD,

increase attentionspan, treat fatigue,

and controlnarcolepsy

To correct ADHD& Narcolepsy

Determine if there

is a hx of heartdisease,

hypertension,hyperthyroidism,

parkinsonism, orglaucoma.

Baseline vsCBC, WBC,

platelets before

and duringtherapy

Give morning &

lunchShould take a break

form the medMonitor vs

Record ht, wt, andgrowth of children

Observe forwithdrawal sx (n/v,

weakness, HA)

Monitor for sideeffects

Avoid alcohol &

caffeineMonitor wt

SE: anorexia

(reducesappetite),

vomiting,diarrhea,

insomnia,

dizziness,nervousness,restlessness,

irrtability

SE: HA, nauseadiarrhea, and

nervousness

CNS Depressants

Benzodiazepines

lam & pam

1.) flurazepam

(Dalmane)

2.) temazepam(Restoril)

Short term use

for insomnia

to treat insomnia &to decrease

nocturnal

Baseline vs

Obtain drug hx

Give bedtime

Monitor vs

Check for sign ofrespiratory distress

Observe client forside effects

Avoid alcohol &

other CNSdepressants

SE: hangover,light-headednes

dizziness, orconfusion

Overdose:administer an

emetic and follow/ activated

charcoal/conscus pt or gastric

lavage/unconsc

us pt administerromazicon ifrequired

Has sedativeeffect


11/25

11

CLASS


EFFECTS

3.) triazolam

(Halcion)

Anxiolytic(antianxiety drugs)

4.) Ativan

5.) diazepam(valium)

6.) alpraxolam(Xanax)

7.) Librium

Nonbenzodiazepine

1.) Zolpidem(Ambien)

awakenings

For management of

insomnia

A preoperative

sedative & toreduce anxiety,

Stops seizures

Anxiety, stopsseizures

For alleviating

anxiety that maycause sleeplessness

Effective for

alcohol withdrawalsyndrome (DTs),

anxiety, andtension.

To treat insomnia

Do not use longer

than 7-10 d at atime

Avoid alcohol &

smoking

SE: Drowsines

lethargy,hangover,

irritability,dizziness,

anxiety, n/v,confusion,

disorientation

Anesthesia & Spinal

anesthesia

Inhalation

Intravenous

Baseline vs

Drug hx

Monitor

postoperative state

SE: respiratory

distress


12/25

12

CLASS


EFFECTS

Topical

Local

Spinal-3rd

lumbar

Monitor urine output

Record vs

Pt must lay flat for 6h to reduce

possibility of HAfrom fluid leaking

Encourage fluidintake

SE: HA

Anticonvulsants

Phenytoin (Dilantin)

Suppress CNS

To prevent grand

mal & complexpartial seizures

Stop seizures withIV Valium or IV

Ativan

Obtain drug hx

Check urinaryoutputBun, creatinine

IV give w/ NS

Monitor serum drug

levels (10-20) (toxicdont give)Protect client from

hazards in theenvironment

Adequate nutrientsfor the client

Good oral care

SE: HA, diplop

confusion,dizziness,sluggishness,

decreasedcoordination,

ataxia, slurredspeech, rash,

anorexia, n/v,hypotension,

pink-red/browndiscoloration of

urine, increaseglucose levels f

diabetics, reducplatelets

Adrenergic agonists

1.) adrenalin(epinephrine) non-

selective (Beta 1-

heart, Beta 2-lungs,Alpha 1-vessels-vasoconstriction)

Stimulate thesympathetic

nervous system

Treats allergicreaction,

anaphylaxis,

bronchospasm,cardiac arrest

Baseline vsDrug hx (no beta-

blockers)

Health hx(contradicted ifclient has cardiac

dysrhythmias,narrow-angle

glaucoma, orcardiogenic

shock.

Record vsObserve urinary

output

Offer food to avoidn/vBlood glucose may

increase

Increases B/P &heart rate

Dilates bronchi

tubesSE: anorexia, nnervousness,

tremors, agitatiHA, pallor,

insomnia,syncope,

dizziness,


13/25

13

CLASS


EFFECTS

2.) Albuterol

(Proventil) selective-beta 2

Treats

bronchospasm,asthma, bronchitis,

& other COPD

Labs

palpitations,

tachycardia,dyspnea,

ventricularfibrillation,

pulmonary edem

SE: tremor,

dizziness,nervousness,

restlessness,

palpitations,reflextachycardia,

hallucinations,cardiac

dysrhythmias

Adrenergic

BlockersBeta

Blockers

olol

1.) Propranolol(inderal) non-

selective

2.) metoprolol(Lopressor) selective

Treats cardiacdysrhythmias, mild

hypertension, mildtachycardia, and

angina pectoris

Treats cardiacdysrhythmias, mild

hypertension, mildtachycardia, and

angina pectoris

Obtain health hxuse extreme

caution withclients w/ COPD

& asthmaObtain drug hx

Safe forrespiratory pts

Hold meds for


14/25

14

CLASS


EFFECTS

emptying of

stomach)

Anticholinergic

Atropine

Reduces salivation,

increases heart rate,dilates pupils

Evaluate for renal

or hepaticdisorders, COPD,

congestive heartfailure

SE: dry mouth,

nausea, HA,constipation, ra

dry skin, flush,blurred vision,

photophobia,tachycardia,

hypotension,papillary dilatio

abdominal

distention,palpitations, nacongestion

Parkinsons disease

Dopaminergic

Agent:

1.)carbidopa-

levadopa

2.) Sinemet

Caused by animbalance of the

neurotransmittersdopamine and

acetylcholine.degeneration of

neurons

Stimulate the

dopamine receptors

Treats

parkinsonism;relieves tremors

and rigidity

Baseline vs

Assess for s & sxor parkinsonism

(stooped forwardposture, shuffling

gait, masked face

and restingtremors)

Monitor vs and ekg

Watch for orthostatichypotension

(weakness, dizziness,or syncope)

Give w/ low protein

foods to avoidinterference w/ drugtransport to the CNS

Avoid foods

containing vit B6

SE: anorexia, n

dysphagia,fatigue, dizzine

HA, dry mouthbitter taste,

twitching, blurr

vision, insomni


15/25

15

CLASS


EFFECTS

Anticholinergic

Agent:

1.) Cogentin

Inhibit the releaseof acetylcholine.

Reduce involuntary

muscle contractions

Health hx

(contraindicatedfor pts w/ hx of

glaucoma, GI

dysfunction,urinary retention,angina pectoris,

myasthenia gravisDrug hx

Baseline vsBaseline urinary

output

Monitor vs, urine

output, bowel soundsObserve for

involuntary

movements

SE: increased

pulse rate, urinaretention,

constipation

Myasthenia Gravis

(autoimmune

disease)

1.) Neostigmine

(Prostigmin)

Opposite of

ParkinsonsLack of nerve

impulses andmuscle responses at

the nerves inmuscle endings

Causes fatigue andmuscular weakness

of the respiratorysystem

Inadequatesecretion of

acetylcholine orloss because of an

increase in theenzyme

acetylcholinesterase

Contols MG

Short acting

Give q 2-4 h to

S & SX:

Weakness andfatigue of the

skeletal musclemuscle weakne

dysphagia,dysarthria,and

respiratorymuscle weakne

eyelid droop(ptosis) and

double vision(diplopia)

SE: muscle

weakness if not


16/25

16

CLASS


EFFECTS

2.) Mestinon

3.) Mytelase

4.) edrophonium Cl(Tensilon)

Control & treat MGPrevents the

destruction ofacetylcholine

MG-used when ptscannot take

Prostigmin orMestinon

Used to diagnoseMG

Drug hxBaseline vs

Assess for s & sxof myasthenia

crisis (muscleweakness w/

difficultybreathing &

swallowing)

Drug hx-can betaken w/

glucocorticoiddrugs

prevent muscle

weakness

Monitoreffectiveness, muscle

strength, depth andrate of respirations

Administer IVundiluted

Observe for s & sx ofoverdosing (muscle

weakness, increased

salivation, sweating,tearing, miosis(constricted pupil of

the eye)

given on time

Antidote forcholinergic

crisisatropine

SE: recurrence sx of MG, n/v,

diarrhea, HA,dizziness,

abdominal

cramps, sweatinrash, miosis

Long actingacetylcholine

inhibitor

Ultra shortduration of 5 to

20 min increasemuscle strength

immediately ancorrects ptosis

(droopy eyelidsimmediately aftadministrated

SkeletalMuscle

Relaxants

Centrally acting:

1.) Carisoprodol(Soma)

To relax skeletalmuscles (for acute

or severe)

Medical hx(contraindicated

for pts withsevere renal or

liver disease,

Monitor serum liverenzyme

Record vsObserve for CNS side

effects (dizziness)

SE: n/v,dizziness,

weakness,insomnia,

asthmatic attack


17/25

17

CLASS


EFFECTS

2.) Flexeril

Peripherally Acting:

1.) dantrolene(Dantrium)

Short term tx of

muscle spasms

For chronicneurologic

disorders causingspasms such as

spinal cord injuries,stroke, MS

glaucoma or

myastheniagravis)

Baseline vsHealth hx to

identify cause(acute or chronic)

Drug hx

Offer w/ food to

avoid GI upset

tachycardia,

hypotension,diplopia (doubl

vision)

SE: GI upset

Avoid taking walcohol & CNS

depressants

Upper respiratory

disorders

Antihistamines: H1

Blockers

1.) Diphendydramine

(Benedryl)

Blocks the H1

receptordecreases

nasopharyngealsecretions

Treats allergic

rhinitis, itching;prevents motion

sickness; sleep aid;antitussive

Assess cardiac &respiratory status

Baseline vs

Drug hxAssess for s & sx

urinarydysfunction

(retention,dysuria, &

frequency)CBC

Cardiac &repiratory status

Give w/ food to

decrease gastricdistress

IM in large muscle(no sub Q inj)

SE: drowsiness

dizziness, fatigun/v, urinary

retention,constipation,

blurred vision,dry mouth and

troat, reducedsecretions,

hypotension,epigastric

distress, hearing


18/25

18

CLASS


EFFECTS

2nd

generationantihistamines:

2.) Allegra

3.) Claritin

4.) Zyrtec

Decongestants:

1.) pseudoephedrine(Sudafed)

2.) nasal sprays

Treats allergic

rhinitis andrhinorrhea

Relief of allergic

rhinitis & urticaria

For allergic rhinitis& urticaria

Allergic rhinitis

Stimulate the alpha-adrenergic

receptors, thusproducing vascular

constriction(vasoconstriction)

of the capillarieswithin the nasal

mucosa (shrinks thenasal mucous

membranes andreduces fluid

Drug hxHealth hx

(contraindicatedor use w/ caution

in pts w/hypertension,

cardiac disease,hyperthyroidism,

and diabetes

disturbances,

excitation inchildren,

photosensitivity

Has less sedativ

effect

Long acting

Has fewanticholinergic

effects

SE: jittery,nervous,

restlessness,hypertension,

increased bloodglucose levels

Frequent use caresult in toleran

and rebound nacongestion

(reboundvasodilatation

instead ofvasoconstrictio


19/25

19

CLASS


EFFECTS

Expectorants:

1.) guaifenesin

Antitussive:

1.) codine narcotic

2.)Dextromethormphan non-narcotic

secretion)

For dry,unproductive cough

Suppresses thecough reflex

Suppresses thecough reflex

Used in OTC coldremedies (temp

suppression of anonproductive

cough; reducesviscosity of

tenacious secretions

Take w/ glass ofwater to loosen

mucus

Drug hxDontraindicated

with COPD,pulmonary

disease, chronicproductive cough,

hypersensitivity,MAOIs

SE: n/v

Do not usealcohol

SE: nausea,dizziness,

drowsiness,sedation

Broncholdilators:

Xanthine Class:

1.) Theophylline (po)

Promotesbronchodilation

Treats asthma &COPD

Monitortheophylline

serum frequently(10 to 20)

Pt should avoidcaffeinated products

and increase fluidintake

SE: anorexia, ngastric pain,

intestinalbleeding,

nervousness,dizziness, HA,

irritability,cardiac

dysrhythmias,tachycardia,

palpitations,


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CLASS


EFFECTS

2.) aminophilline(IV)

1st

theophyllinepreparation

produced in 1936

Rapid IVadministration

can causedizziness,

flushing,hypotension,

sever bradycardia,palpitations

Administer slow viainfusion pump

marked

hypotension,hyperreflexia,

seizures, adversCNS reactions

Mucolytics:

1.) mucomyst

Act like detergents

by liquefying &loosening thickmucous secretions

Do not mix w/ other

drugs

SE: n/v,

stomatitis (oralulcers), runny

nose

Cromolyn (Intal)

Leukotriene

modifiers:

1.) Accolate

For chronic asthma

& prophylactic use.Suppresses

inflammation in thebronchial tube;

does not havebronchodilating

effects. Prevents therelease of histamine

For prophylaxis &

maintenancetherapy for chronicasthma. Reduces

inflammationwithin the bronchial

tubes & airways.

Administer by

inhalation

Obtain medical &

drug hxBaseline vsAssess for

wheezing,decreased breath

sounds, cough,sputum

production

Must be taken daily

Provide adequate

hydrationmonitor vsblood pressure &

heart rate canincrease greatly

administermedication pc to

decrease GI distress

SE: cough, bad

taste


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CLASS


EFFECTS

2.) Singulair

Prevention &maintenance tx of

asthma

Assess for

confusion &restlessness

caused byhypoxia &

hypercapniaDetermine

hydration

Health hx(caution in pts w/

severe liverdisease)

Check liver

function labs

SE: HA,dizziness, fatigu

nasal congestiocough, sorethro

dental pain,

influenze,dyspepsia,abdominal pain

rash

Cardiac Gylcoside

1.) Lanoxin(Digoxin)

Treats CHF, atrialtachycardia, flutter,

or fibrillation

Obtain drug hxBaseline pulse

rateAssess for s & sx

of digitalistoxicity (anorexia,

n/v, bradycardia,cardiac

dysrhythmias,visual

disturbances)

Check apical pulse


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CLASS


EFFECTS

Antidysrhythmnic:

Beta blocker class

olol

Calcium channelblocker class:

1.) verapamil (Calan)

2.) nifedipine(Procardia)

3.) diltiazem(Cardizem)

Disturbed heartrhythm

Antidysrhythmnic& adrengergic

blockers (seeabove)

Health & drug hx

Baseline vs &ECG

Check cardiacenzyme results

hypotension)

Monitor vs

(hypotension canoccur

IV push or bolusadministered over 2

to 3 mins.Monitor ECG

SE: dizziness,

nausea, HA,hypotension,

diaphoresis,fatigue,

constipation ordiarrhea,

occasionallyimpotence

Diuretics:

Thiazide class

Loop diuretic class:

Decreaseshypertension &

decrease edema

Increase urine

output; treathypertension,

edema from CHF,hepatic cirrhosis,

renal dysfunction

Assess vs, wt,

urine output,serum chemistry

values forbaseline

Check peripheralextremities for

edemaDrug hx

Monitor vs, serum

electrolytes (K,glucose, uric acid,

cholesterol levels)S & sx of

hypokalemia (muscleweakness, leg

cramps, cardiacdysrhythmias

Producesincreased urine

flow (inhibits N& water

reabsorption frothe kidney

tubules)

SE: orthostatichypotension,

dizziness,photosensitivity

electrolyteimbalances


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CLASS


EFFECTS

1.) furosemide(Lasix)

Duration:Po-6-8 h

IV-2h

Osmotic Diuretics:

1.) mannitol

K sparing class:

1.) sprionolactone(Aldactone)

To treat fluidretention/fluid

overload caused byCHF, renal

dysfunction,cirrhosis;

hypertension,; acutepulmonary edema

Prevents kidney

failure, decreasesintracranial

pressure (ICP),decreases

intraocular pressure(IOP)

Used in emergencysituations such ashead injuries

Reduce body fluid

& sodium

Drug hxBaseline vs,

serumelectrolytes, wt,

urine outputCheck for

hypersensitive tosulfonamides

Drug hxespecially K

supplements orsalt substitute

baseline vs,serum

One given IV, urineoutput should

increase in 5 to 20mins. (watch for

possible severe renaldisorder)

Monitor urinaryoutput

Check wt (2.2-2.5lbs= 1 liter of fluid loss)

Monitor vsAdminister IV slowly

to prevent hearing

loss (give no morethan 20mg IVpush/min)

S & sx ofhypokalemia (< 3.5)

Monitor serumpotassium levels

Monitor urinaryoutput

Monitor vsObserve for s & sx of

hyperkalemia

SE: n/v, diarrhe

electrolyteimbalances,

vertigo,cramping, rash,

HA, weakness,ECG changes,

blurred vision,photosensitivity

Potent diuretic

SE: fluid &electrolyte

imbalance,pulmonary edem

from rapid shiftof fluids, n/v,tachycardia fro

rapid fluid loss,acidosis

SE:

photosensitivityrash, dizziness,

weakness


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CLASS


EFFECTS

electrolytes, wt,

urinary output

Antihypertensives:

Can use diuretics

Beta blockers

Calcium channel

blockers

Ace inhibitor class:

pril

1.) captopril(Capoten)

2.) lisinopril

3.) monopril

Reduces B/PNothing to pulse

Anticoagulants

1.) Heparin

2.) Enoxaprin

(Lovenox)

Inhibits clotformation

Prevents blood

clotting

For

thromboembolism

Prevents & treatsDVT & pulmonaryembolism

Health hx

Drug hxBaseline labs

(PTT 60-70 &aPTT 30-40)

Monitor vs (increased

pulse rate followedby a decreased

systolic pressure canindicate a fluid

volume deficitexternal or internal

bleeding)Antidote--Protamine

No alcohol

SE: bleeding,itching, burning

SE: bleeding


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CLASS


EFFECTS

3.) Warfarin

(Coumadin)

Prevents blood

clotting

Baseline labs (PT

11-12.5 & INR 2-3)

AntidoteVit K

Foods: green leafyvegs

SE: anorexia, n

diarrhea,abdominal

cramps, rash,fever, bleeding

Antilipemics/Anticho

lesterol

Statin class:

1.) atorvastatin

(Lipitor)

Bile acid

sequestrants:

1.) cholestyramine

(Questran)

Toxic to liver

Decreases

cholesterol levels &decrease serum

lipids especially

LDL &triglycerides

Binds w bile acids

in the intestine

Baseline vs,

serum chemistryvalues

Medical hx

(contraindicatedfor pts w/ liverdisorder)

Monitor pts blood

lipid levels(cholesterol < 200,

triglyceride < 150,

LDL 60)Monitor liver

function labsTake with sufficient

water or w/ eveningmeal to prevent GI

discomfort

Powder form that is

mixed thoroughly inwater or juice

SE: HA,

rash/pruritus,constipation/dia

hea, sinusitis,

pharynitis

Cholesterol

excreted througfeces

SE: GI upset,constipation

Steroids

inflammation Health hxDrug hx

Use w caution indiabetic pts

SE: increaseglucose, sodium

Decreasepotassium,

Buffalo hump,

Face swelling

copy of classes of drugs (study guide)

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