Norepinephrine (Levophed)

Dopamine (Intropin)

Epinephrine (Adrenalin)

Isoproterenol (Isuprel)

Phenylephrine (Neo-Synephrine)

Dobutamine hydrocholoride (Dobutrex)

Milirone (Primacor)

Sodium nitroprusside (Nitropress)

Diphenhydramine HCl (Benedryl)

Tx:  shock, cardiac arest, and anaphylaxis

SE:  serious rebound effect may occur, balance between unerdosing and overdosing

Nursing considerations: monitor VS, measure urine output, assess for extravasation, observe extremities for color and perfusion

Chlordiazepoxide (Librium)

Diasepam (Valium)

Alprazolam (Xanax)

Clonazepam (Klonopin)

Lorazepam (Ativan)

Oxazepam (Serax)

Midazalam (Versed)

Benzodiazepine Derivitaves-affect neurotransmitters

Tx: anxiety, insomnia, petit mal seizures, panic attacks, acutic manic episodes, musicle relazants, sedatives, hypnotics

SE:  Sedation, depression, confusion, anger, hostility, H/A, dry mouth, constipation, bradycardia, urinary retention

NC:  monitor liver function, monitor for therapeutic blood levels, avoid alcohol, caution when performing tasks requiring alertmess,

Buspirone (BuSpar)

Hydroxyzine (Vistaril) (Atarax)

Nonbenzodiazepine antianxiety agents

Kava

herbal antianxiey agent

SE:  impaired thinking, judgement, motor reflexes, vision, decreased plasma proteins, thronbocytopenia, leukocytopenia, dyspnea, and pulmonary hypertension

NC:  suppresses emotional excitability and produces mild euphoria, do not take with CNS depressants, do not take if pregnant, lactating, or under age 12

SE:  sedation, confusion, H/A, and tachycardia

NC:  influences sleep-wake cycles (high levels during sleep), used to prevente and treat "jet lag" and insomnia, use caution with benzodiazepine and CNS depressants, contraindicated in hepatic insufficiency, hx of cerebrovascular disease, depression, and neurologic disorders

Aluminum hydroxide gel (Amphojel)

Calcium carbonate (Titralac)

Aluminum hydroxide + magnesium trisilicate

Magnesiumm hydroxide (Milk of mag)

Aluminum hydroxide + magnesium hydroxide (Maalox)

Tx: peptic ulcer, indigestion, reflex esphagitis, prevent stress ulcers

SE:  constipation, diarrhea, acid rebound between doses, metabolic acidosis

NC:  use meds with sodium content cautionsly for clients with cardiac and renal diseas, absorption of tetracyclines, quinolones, phenothiazades, iron preparations, isoniazid reduced when given with antacids, effectiveness of oral contraceptives and salicylates may decrease when given with antacids

Procainamide (Pronestyl)

Disopyramine (Norpace)

Class Ia antidysrhythmic

SE:  hypotension, heart failure

NC:  monitor BP, monitor for widening of the PR, QRS, or QT intervals

Propanolol (Inderal)

Acebutolol (Sectral)

Esmolol hydrochloride (Brevibloc)

Sotalol hydrocloride (Betapace)

Class II antidysrhythmics

SE:  bradycardia, hypotension, bronchospasm, increase in heart failure, fatigue and sleep disturbancs

NC:  Monitor apical heart rate, cardiac rhythm and BP, assess for shortness of breath and wheezing, assess for fatigue, sleep disturbances, assess apical heart rate for 1 minute before administration

Lidocaine (xylocaine)

Mexiletine hydrochloride (Mexitil)

Tocainide hydrochloride (Tonocard)

Class Ib antidysrhythmics

SE:  CNS-slured speech, confusion, drowsiness, confusion, seizures, hypotension and bradycardia

NC:  Monitor for CNS SEs, Monitor BP and heart rate and cardiac rhythm

Flecainide (Tambocor)

Propafenone hydrochloride (Rythmol)

Class Ic antidysrhythmics

SE:  bradycardia, hypotension, dysrhythmias, CNS-anxiety, insomnia, confusion, seizures

NC:  Monitor for increasing dysrhythmias, monitor heart rate and BP, monitor for CNS effects

Amiodarone hydrochloride (Cordarone_

Ibutilide fumarate (Corvert)

Dofetilide (Tikosyn)

Class III antidysrhythmics

SE:  Hypotension, bradycardia and atrioventriculr block, muscle weakenss, tremors, photosensitivity and photophobia, liver toxicity

NC:  continuous monitoring of cardiac rhythm during IV administration, monitor QT interval during IV administration, Monitor heart rate, BP during inititiation of therapy, instruct client to wear sunglasses and sunscreen

Verapamil (Calan)

Diltiazem hydrochloride (Cardizem)

Class IV antidysrhythmics

SE:  bradycardia, hypotension, dizziness and orthostatic hypotension, heart failure

NC:  monitor apical heart rate and BP, instruct clients about orthostatic precautiohns, instruct clients to report signs nf heart failure to health care provider

Ampicillin, Penicillin G, Penicillin V, Amoxicillin, Augmentin

• Penicillins
• SE:  skin rashes, diarrhea, allergic rxns, renal, hepatic, hemotological abnormalities, N/V
• NC:  obtain C and S before first dose, take careful hx of penicillin rxn, observe for 20 min post IM injection, give 1-2h ac or 2-3 h pc to reduce gastric acid destruction of drug, monitor for loose, foul-smelling stool and change in tongue, teach to continue med for entire time prescribed, even if symptoms resolve, check for hypersensitivity to other drugs, expecially cephalosporins

antibiotic

SE:  hypersensitivity rxn, blood dyscrasias, rash

NC:  obtain C and S before first dose, IV solution must be given slowly over 60-90 minutes, never administer IM, encourage fluids to 3,000 ml/day

antibiotic

SE:  N/V, skin eruption, agranulocytosis

NC:  advise client to avoid exposure to sunlight, maintain fluid intake at 3,000 ml/day to avoid chrystal formation

Sulfisoxazole (Gantrisin)

Sulfonamide antibiotic

SE: H/A, GI disturbances, allergic rash, urinary crystallization

NC:  monitor I and O, force fluids, maintain alkaline urine, bicarbonate may be indicated to elevate pH, avoid vit C, which acidifies urine

tetracycline antibiotics

SE:  photosensitivity, GI upset, renal, hepatic, hemotological abnormalities, dental discoloration of deciduous (baby) teeth, enamel hypoplasia

NC:  given btw meals, if GI symptoms occur, administer with food EXCEPT milk products or other foods high in calcium (interfers with absorption), assess for change in bowle habits, perineal rahs, black "hairy" tongue, good oral hygiene, avoid during tooth and early dev periods (4m prenatal to 8 yo), maintain I/O, caution client to avoid sun exposure, decomposes to toxic substance with age and exposure to light

antibiotic

SE:  photosensitivity

NC:  check patient's tongue for Monilia infection

Aminogylcoside antibiotics

SE:  ototoxicity cranial nerve VIII, nephrosensitivity rxns.

NC:  check creatinine and BUN, check peak-2h after med given, check trough-at time of dose/prior to med, monitor for symptoms of bacterial overgrowth, photosensitivity, teach to immediately report tinnitus, vertigo, nystagmus, ataxia, Monitor I/O, audiograms if given long-term

antibiotic

SE:  hypersensitivity rxns

NC:  opthalmic-remove infective exudate around eyes before administration of ointment.

Fluorequinolones

SE:  seizures, GI upset, rash

NC:  contraindicated in kids less than 18 yo, give 2 h pc or 2 hours before an antacid or iron preparation, avoid caffeine, encourage fluids

Azithromycin (Zithromax)

Erythromycin (Erythrocin)

Macrolide antibiotics

SE:  pain at injection site, nausea, diarrhea

NC:  can be used in clients with compromised renal function bc excretion is primarily through  the bile

Cephalosporins

SE:  diarrhea, nausea, dizziness, abd pain, eosinophilia, superinfections, allergic rxns

NC:  can cause false-positive Coombs' test (which will complicate transfusion cross-matching procedure), cross-sensitivity with penicillins, take careful hx of penicillin rxns

Glycopeptides

SE:  liver damage

NC:  poor absorption orally, but IV peak 5 min, duration 12-24 hours, avoid extravasition, during therapy-may cause necrosis, give antihistamineif "red man syndrome", decreased blood pressure, flushing of face and neck, contact clinicial if signs of superinfection, sore throat, fever fatigue

Lincosamide antibiotic

SE:  nausea, vaginitis, colitis may occur 2-9 days or several weeks after starting meds

NC:  administer oral med with a full glass of water to prevent esophageal ulcers, moniitor for persistent vomiting, diarrhea, fever, or abd pain and cramping

topical antibiotic

SE:  nephrotoxicity, ototoxicity

NC:  overgrowth of nonsusceptible organisms can occur

topical antibiotic

SE:  nephrotoxicity, ototoxicity

NC:  allergic dermititis may occur

topical antibiotic

SE:  irritation

NC: don't use around eyes, may stain skin, don't use full strength on mucous membranes

Silver sulfadiazine cream (Silvadene)

topical antibiotic

SE:  neutropenia, burning

NC:  use cautiously if sensitive to sulfonamides

topical antibiotic

SE:  irritation

NC:  use small amt of med, use med for duration prescribed

topical antibiotic

SE:  contact dermatitis

NC:  do not use occlusive dressings

genitourinary drugs

SE:  diarrhea, N/V, asthma attacks

NC:  anti-infective, check CBC, give with food or milk, check I/O, Monitor pulmonary status

genitourinary drug

SE:  H/A, vertigo

NC:  urinary tract analgesic, spasmolytic, inform patient that urine will be bright orange, take with meals

Oxybutynin (Ditropan)

Hyoscyamine (Anaspaz)

Propantheline (Pro-Banthine)

Darifenacin (Enablex)

Solifenacin (VESIcare)

Tolterodin (Detrol)

Anticholinergics

SE:  drowsiness, blurred vision, dry mouth, constipation, urinary retention

NC:  used to reduce bladder spasms and treat urinary incontinence, increase fluids and fiber in diet

Sildenafil (Viagra)

Vardemafo (Levitra)

Tadalafil (Cialis)

anti-impotence meds

SE:  H/A, flushing, hypotension, priapism

NC:  tx of erectile dysfunciton, take 1 hour before sexual activity, never use with nitrates-could have fatal hypotension, do not take with alpha blockers (doxazosin (Cardura) = risk of hypotension, do not drink grapefruit juice

Finasteride (Proscar, Propecia)

testosterone inhibitors

SE:  decreased libido, impotence, breast tenderness

NC:  tx of benign prostatic hyperplasia (BPH) by Proscar; male hair loss by Propecia, pregnant women should avoid contact with crushed drug or patient's semen-may adversely affect male fetus

tx urinary incontinence and peptic ulcer disease

SE:  decreased gastric motility, decreased effect of vagus nerve

NC:  give 30 minutes ac, give hs dose at least 2h after last meal, monitor vs and I/O

anticholinergic med

SE:  dry mouth, vertigo

NC:  action peaks in 2 h

tx bradycardia/anticholinergic

SE:  tachycardia, H/A, blurred vision, insomnia, dry mouth, dizziness, urinary retention, angina, mydriasis

NC:  give PO 30 minutes before meals, check for hx of glaucoma, asthma, hypertension, Monitor I/O, orientation, when given in nonemergency situations, make certain client voids before taking drug, educate client to expect dry mouth, increased respirations and heart rate, client should avoid heat, antidote=physostigmine salicylate

blood thinner

SE:  same as heparin

NC:  less allergenic than heparin, must be given deep SQ, never IV or IM, does not require lab test monitoring

Iproproprium (Atrovent)

Tiotropium (Spiriva)

Iprotropium plus albuterol (Duoneb)

tx bronchospasm and chronic asthma

SE:  dry mouth, irritation of pharynx

NC:  administered as aerosol or neb, Tiotropium adm in powder form by HandiHaler

Benztropine (Cogentin)

Atihexyphenydil (Artane)

tx Parkinson's Disease

SE:  urinary retention, blurred vision, dry mouth, constipation, confusion and sedation

NC:  increase fluids, bulk foods, and excercise, taper before discontinuation, orthostatic hypotension precautions

tx motion sickness

SE:  urinary retention, blurred vision, dry mouth, constipation, confusion and sedation

NC:  contraindicated in acute angle glaucoma

Heparin

Warafrin

anticoagulants, blood thinners

SE:  nausea, alopecia, urticaria, hemorrhage, bleeding/heparin-induced thrombocytopetria (HIT)

NC:  check for signs of hemorrhage, avoid IM injections, ASA-containing products, and NSAIDs, wear medical info tag, use soft toothbrush

herbs:  garlic, ginger, ginkgo-may increase bleeding when taken with warfarin, large doses of anise may interfere with anticoagulants, ginseng and alfalfa may decrease anticoagulant activity, black haw increases action of anticoagulant, chamomile may interfere with anticoagulants

anticoonvulsant

SE: drowsiness, dizziness, confusion, respiratory depression

NC:  benzodiazepine, do not discontinue suddenly, avoid activities that require alertness

antoconvolusant

SE:  drowsiness,k atazia, hypotension, tachycardia, respiratory depression

NC:  IV push dose shouldn't exceed 2 mg/min. monitor vital signs-resusitation equipment available if given IV, alcohol increases CNS depression,  after long-term use, wd leads to symptomssuch as vomiting, sweating, cramps, tremors, and convulsions

anticonvulsant

SE:  drowsiness, dizziness, confusion, leukopenia, anemia

NC:  used for tonic-clonic seizures, status epilepticus, highly protein-bound, contact healthcare provider if rash develops

anticonvulsant

SE:  dizziness, suicidal ideation

NC:  avoid alcohol, avoid driving and activities that require alertness

anticonvulsant

SE:  drowsiness, ataxia, nystagmus, blurred vision, hirsutism, lethargy, GI upset, gingival hypertrophy

NC:  give oral med with at least 1/2 glass of water or with meals to minimize GI irritation, inform client that red-brown or pink discoloration of sweat or urine may occur, Ivadministration may lead to cardeiac arrest-have resuscitation equip at hand, never mix with any other drug or dextrose IV, instruct in oral hygiene, increase vit D intake and exposure to sunlight may be necessary with long term use, alcohol increases serum levels

anticonvulsant

SE:  drowsiness, rash, GI upset, initially constricts pupils, respiratory depression, ataxia

NC:  monitor vs-resusitation equip available if given IV, drowsiness diminishes after initial weeks of therapy, nystagmus may indicate earl toxicity, sudden discontinuation may lead to withdrawal, tolerance and dependence result from long-term use, folic acid supplements indicated for long term use

anticonvulsant

SE:  flushing, sweating, extreme thirst, hypotension, sedation, confusion

NC:  don't discontinue use abruptly, full therapeuti response may take 2 weeks, shake liquid suspension well, take with food if experiencing GI distress

anticonvulsant

SE:  flushing, sweating, extreme thirst, hypotension, sedation, confusion

NC:  monitor intake and output, before each dose, knee jerks shoiuld be tested, VS should bve monitored often during drug administration, used for pregnancy-induced hypertension

anticonvulsant

SE:  sedation, tremor, ataxia, nausea, vomiting, prolonged bleeding time

NC:  agent of choice in many seizure disorders of young children, do not take with carbonated beverage, take with food, monitor platelets, bleeding time, and liver function

anticonvulsant

SE:  myelosuppression, dizziness, drowsiness, ataxia, dipolpia, rash

NC:  monitor intake and output, supervise ambulation, monitor CBC, take with meals, wear protective clothing due to photosensitivity

anticonvulsant

SE:  GI symptoms, drowsiness, ataxia, dizziness

NC:  Monitor for behavioral changes, monitor weight weekly

anticonvulsant

SE:  increased appetite, ataxia, irritability, dizziness, fatigue

NC:  montitor for behavioral changes, monitor weight weekly, can be used to tx postherpetic neuralgia

anticonvulsant

SE:  diplopia, H/A, dizziness, drowsiness, ataxia, nausea, vomiting, life-threatening rash when given with valproic acid

NC:  take divided doses with meals or just afterward to decrease adverse effects

anticonvulsant

SE:  ataxia, confusion, dizziness, fatigue, vision problems

NC:  adjust therapy for intractable partial seizures, increased risk for renal calculi, ston drug immediately if eye problems-could lead to permanent damage