furosemide
class- Loop diuretic
suffix- semide
uses- Pulmonary edema, hypertension
max dose- Oral: 600 mg/day
IV: 1000-2000 mg/day
side effects- electrolyte imbalance, hypotension,
complication- ototoxicity
contraindication- hypersensitivity, hypovolemia, electrolyte depletion
mode of action- rapid diuresis
drug interaction- ACE inhibitors, ahminoglycosides, digoxin
pt education- consume foods high in potassium
nursing consideration- admin several hours before bed, infuse at 20 mg/min, weigh pt daily, monitors I&O’s
heparin
class- Anticoagulant
suffix: -parin
uses- prevent and treat thromboembolic disorders
max dose- varies
side effects- bleeding
complication- heparin induced thrombocytopenia(HIT)
contraindication- active bleeding, present complications
mode of action- prevents new clot formation
drug interaction- NSAID’s and anticoagulants/platelets
pt education- reg. blood test, reports signs of bleeding
nursing consideration- antidote is protamine sulfate, monitor aPTT(activated Partial Thromboplastin Time)
warfarin
class: Anticoagulants
suffix: -arin
uses: prevent and treat thromboembolic disorders, prevent complication after MI
max dose: varies
side effects: Gi upset, hepatitis
complication: life-threatening bleeding
contraindication: pregnant, liver disease, bleeding
mode of action: antagonizes Vit K»_space;>prevent several cloning factors
drug interaction: NSAIDs, antibiotics, antiplatelets
pt education: consistent dietary intake of Vitamin K, Educate on s/s bleeding
nursing consideration: antidote is Vit K, monitor PT(Prothrombin Time)/INR(International Normalized Ratio)
enoxaparin
prophylaxis of blood blots(bed bound pts)
EVERYTHING ELSE SAME AS HEPRIN
atorvastatin
class-statins
suffix:-statin
uses- Hypercholesterolemia, Reduce risk of cardiovascular disease
max dose- 80 mg/day
side effects- muscle pain, Gi disturbance
complication- hepatoxicity, Rhabdomyolysis(damaged muscle fibers) (rare but serious)
contraindication- liver disease, pregnant ,hypersensitivity
mode of action-↓LDL production, ↑ HDL production
drug interaction-Niacin, Fibrates
pt education- avoid alcohol, grapefruit juice, report muscle pain, cola-colored urine, take in evening
nursing consideration- monitor liver, CK(Creatine Kinase) levels
Digoxin
class- Cardiac Glycosides
suffix:-oxin
uses- HF, atrial fibrillation/ flutter
max dose- 0.5-2 ng/mL
side effects- Visual disturbance, nausea, headache
complication- Cardiac arrhythmias, digoxin toxicity
contraindication- hypersensitivity, cardiac arrhythmias
mode of action- ↓HR, and ↑ contraction of heart
drug interaction- potassium-depleting diuretics, calcium channel blockers
pt education-reports signs of toxicity, maintain potassium intake, DO NOT stop abruptly
nursing consideration- DO NOT give is pule is <60bpm, monitor levels and toxicity
spironolactone
class- potassium-sparing diuretics
suffix: -one
uses- HF, hypertension
max dose-400mg/day
side effects- hyperkalemia, menstrual irregularities
complication-severe hyperkalemia
contraindication-severe kidney failure , pregnant, hyperkalemia
mode of action- excretions of water and sodium, but not potassium
drug interaction- ACE inhibitors, similar meds
pt education- avoid salt substitutes w/ potassium
nursing consideration- monitor potassium levels and EKG
diphenhydramine
class- antihistamines
suffix:-ine
uses- allergies, motions sickness, hives
max dose-300mg/day
side effects- sedation, anticholinergic effects(dry mucous membranes)
complication-Anticholinergic toxicity
contraindication- glaucoma
mode of action- blocks histamines
drug interaction- CNS depressants, Anticholinergic drugs, MAO inhibitors
pt education- don’t drive, standup slowly(orthostatic hypotension), no alcohol
nursing consideration-implement fall precautions
nitroglycerin
class- Nitrate
suffix:-in
uses- angina( heart muscle not getting enough oxygen-rich blood»chest pain)
max dose- 3 doses max»1 dose/5min
side effects- orthostatic hypotension, headache
complication- severe hypotension
contraindication- severe anemia, hypersensitivity
mode of action- vasodilation
drug interaction-alcohol, other vasodilators
pt education- keep in dark glass bottle, Sublingual:onset of angina( dose 1»5min»no reflief, call 911» dose 2»5 min»no relief» dose 3
Topical: wear gloves, apply with paper
nursing consideration- monitor BP, ≤10min IV
Guaifenesin
class- expectorant
suffix-N/A
uses- cough»respiratory infection
max dose-2,400 mg/day
side effects- Gi upset, dizziness
complication- allergic reaction, kidney stone(prolonged use)
contraindication- pregnant, hypersensitivity
mode of action- makes cough more productive
drug interaction-N/A
pt education- ↑fluid intake, safe O-T-C usage
nursing consideration- minister side effects assess sputum
Benzonatate
class- Antitussives
suffix:-onatate
uses- Dry cough
max dose- 600 mg/day
side effects- sedation, constipation, Gi upset
complication- Severe hypersensitivity reaction, CNS toxicity
contraindication- Hypersensitivity, Children under 10 years old
mode of action- cough suppression
drug interaction- CNS depressants
pt education- use measuring spoon to measure dose, instruct patient on proper administration technique.
nursing consideration-Assess cough before and after administration, assess for signs toxicity
Albuterol
class- beta-2 adrenergic agonists
suffix- -ol
uses-Asthma, COPD
Duration: 3-4 hrs
side effects- chest pain, tremors, ↑HR
complication- Paradoxical bronchospasm
contraindication-Cardiovascular disorders, hypersensitivity
mode of action- bronchodilation
drug interaction-beta-blockers, similar meds, diuretics
pt education- only used for acute asthma attacks, proper inhaler technique
nursing consideration- monitor HR and BP, assess RR before and after, monitor complication signs
Bronchodilators
class- Beta Agonist (Mimics “Flight or Flight”)
suffix: -ol
uses- COPD, asthma, bronchospasm
max dose-varies
side effects-↑HR. hypokalemia
complication- Cardiac distress, bronchospasm
contraindication- hypersensitivity, cardiac disorders
mode of action- dilates airway
drug interaction- Antidepressants, beta-blockers, similar meds
pt education- inhaler technique, don’t use more that instructed
nursing consideration- check respiratory status before and after, monitor vitals, watch caffeine intake
NSAID’s
class- NSAID’s
suffix: nonspecific (-profen)
uses- pain, inflammation
max dose- 3.2g/day
side effects-Gi upset
complication- Nephrotoxicity, Gi upset, cardiovascular risk
contraindication- pregnancy, bleeding disorder
mode of action- ↓ inflammation
drug interaction- corticosteroids, alcohol
pt education- take w/ food/milk, no alcohol, report black stool
nursing consideration- monitor Gi bleeding, renal function, lowest dose»shortest duration
Thiazide Diuretics
class- Diuretic
suffix: -thiazide
uses-hypertension, edema,HF
max dose-N/A
side effects- hypokalemia, hyponatremia, dehydration
complication-severe electrolyte imbalance
contraindication- hypersensitivity, liver/kidney impairment
mode of action-block reabsorption of salt and water
drug interaction-NSAID’s and digoxin
pt education-potassium rich foods
nursing consideration- give hr’s before bed, weigh pt daily
Beta-blockers
class- beta blocker
suffix:-olol
uses-hypertension, cardiac disorders
max dose-varies
side effects-bronchospasm, hypersensitivity,↓HR
complication- bronchoconstriction, HF
contraindication - asthma
mode of action- ↓BP and HR
drug interaction- calcium channel blockers
pt education- don’t stop abruptly and no heavy lifting
nursing consideration- monitor BP and HR
Inhaled Glucocorticoids
class-Glucocorticoids
suffix: -sone, -one
uses- asthma, COPD
max dose-VARIES
side effects- fluid gain, hypokalemia, infection
complication- bone loss, PUD(peptic ulcer disease)
contraindication- hypersensitivity, respiratory infection
mode of action- ↓ inflammation, suppress immune response
drug interaction-NSAIDS
pt education- don’t stop suddenly, calcium & Vitamin D supplements
nursing consideration- monitor infections, PUD»coffee ground vomit and black stool
Which is important client education about nasal decongestants?
Should be used no more than three days
Clients use expectorants to help with which symptoms?
-Loosen congested bronchial secretions
-Increase productive cough
Why do client administer Antitussives
cough suppress
Alcohol + Antitussives = _______________ .
increased sedation
Corticosteroids help with COPD by doing which? (Double Points!)
reducing inflammation therefore making air flow easier in the lungs
Which causes the symptoms of COPD?
Hyperinflation of alveoli and destruction of alveolar walls
MDI Stands for which?
Metered Dose Inhaler
