Major Medication Classification

8/6/2019 Major Medication Classification

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Major Medication classification

AdrenergicsActions:

Stimulate the sympathetic nervous system: increase inperipheral resistance, increase blood flow to heart,bronchodilation, increase blood flow to skeletal muscle, increaseblood flow to uterus Stimulate beta-2 receptors in lungs Use for cardiac arrest and COPD Adrenergic Medications Levophed Dopamine

Adrenalin Dobutrex Adrenergics Side effects: Dysrhythmias Tremors Anticholinergic effectsAdrenergics Nursing Considerations: Monitor BP Monitor peripheral pulses Check output

Anti-AnxietyAction: Affect neurotransmittersUsed for: Anxiety disorders, manic episodes, panic attacks Anti-AnxietyMedications: Librium, Xanax, Ativan, Vistaril, EquanilAnti-AnxietySide effects: Sedation Confusion


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Hepatic dysfunctionAnti-AnxietyNursing Considerations: Potention for addiction/overdose Avoid alcohol Monitor Liver Function AST/ALT Dont discontinue abruptly, wean off Smoking/caffeine decreases effectiveness

AntacidsActions: Neutralize gastric acidsUsed for: Peptic ulcer

Indigestion, reflex esophagitis Antacids Medications Amphojel Milk of Magnesia Maalox AntacidsSide effects: Constipation Diarrhea Acid rebound

AntacidsNursing Considerations: Interferes with absorption of antibiotics, iron preps, INH, Oralcontraceptives Monitor bowel function Give 1-2 hours after other medications


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1-3 hours after meals and at HS Take with fluids

AntiarrhythmicsAction: Interfere with electrical excitability of heartUsed for: Atrial fibrillation and flutter Tachycardia PVCs AntiarrhythmicsMedications: Atropine sulfate Lidocaine Pronestyl Quinidine Isuprel AntiarrhythmicsSide effects: Lightheadedness Hypotension

Urinary retentionAntiarrhythmicsNursing Considerations: Monitor vital signs Monitor cardiac rhythm

Aminoglycosides (Antibiotics)Action:

Inhibits protein synthesis in gram-negative bacteriaUsed for: Pseudomonas, E.Coli Aminoglycosides (Antibiotics)Medications: Gentamycin Neomycin


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Streptomycin Tobramycin Aminoglycosides (Antibiotics)Side effects: Ototoxicity and Nephrotoxicity Anorexia Nausea Vomiting DiarrheaAminoglycosides (Antibiotics)Nursing Considerations: Harmful to liver and kidneys Check 8th cranial nerve (hearing) Check renal function Take for 7-10 days Encourage fluids Check peak/trough level

Allergy: 1st symptom SOB

Cephalosporins (Antibiotics)Action: Inhibits synthesis of bacterial cell wallUsed for:


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Tonsillitis, otitis media, peri-operative prophylaxis Meningitis Cephalosporins (Antibiotics)Medications: Ceclor Ancef Keflex Rocephin Cefoxitin Cephalosporins (Antibiotics)Side effects: Bone marrow depression: caution with anemic,thrombocytopenic patients Superinfections RashNursing Considerations: Take with food Cross allergy with PCN Avoid alcohol Obtain C&S before first dose: to make sure medication iseffective against disease/bacteria

Can cause false-positive for proteinuria/glycosuria

Fluoroquinolones (Antibiotics)Action: Interferes with DNA replication in gram-negative bacteriaUsed for: E.Coli, Pseudomonas, S. Aureus Fluoroquinolones(Antibiotics)

Medications: Cipro Fluroquinolones(Antibiotics)Side effects: Diarrhea Decreased WBC and Hematocrit


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Elevated liver enzymes (AST, ALT) Elevated alkaline phosphataseNursing Considerations: C&S before starting therapy Encourage fluids Take 1 hour ac or 2 hour pc (food slows absorption) Dont give with antacids or iron preparation Maybe given with other medications (Probenicid: for gout)

Macrolide (Antibiotics)Action: Binds to cell membrane and changes protein functionUsed for: Acute infections Acne URI Prophylaxis before dental procedures if allergic to PCN Macrolide(Antibiotics)Medications:

Erythromycin Clindamycin Macrolide (Antibiotics)Side effects: Diarrhea Confusion Hepatotoxicity SuperinfectionsNursing Considerations:

Take 1hr ac or 2-3 hr pc Monitor liver function Take with water (no fruit juice) May increase effectiveness of: Coumadin and Theophylline(bronchodilator)


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PenicillinAction: Inhibits synthesis of cell wallUsed for: Moderate to severe infections Syphilis Gonococcal infections Lyme disease PenicillinMedications: Amoxicillin Ampicillin Augmentin PenicillinSide effects: Stomatitis Diarrhea Allergic reactions Renal and Hepatic changesNursing Considerations: Check for hypersensitivity

Give 1-2 hr ac or 2-3 hr pc Cross allergy with cephalosporins

Sulfonamides (Antibiotics)Action: Antagonize essential component of folic acid synthesisUsed for: Ulcerative colitis

Crohns disease Otitis media UTIs Sulfonamides (Antibiotics)Medications: Gantrisin Bactrim


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Take 1 hr ac or 2-3 hr pc Do not take with antacids, milk, iron Note expiration date Monitor renal function Avoid sunlight

AnticholinergicsAction: Inhibits action of acethylcholine and blocks parasympatheticnerves (affects heart, eyes, respiratory tract, GI tract and thebladder) Dilates pupil, causes bronchodilation and decreased secretions

Decrease GI motility secretionsUsed for: Opthalmic exam Motion sickness Pre-operative Anticholinergic Medications: Pro-Banthine Atropine Scopolamine AnticholinergicSide Effects: Blurred vision Dry mouth Urinary retention Chage in heart rateNursing Consideration: Monitor output Contraindicated with glaucoma Give 30 min ac, hs, or 2hr pc Contraindicated: paralytic ileus, BPH

AnticoagulantsAction:


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Blocks conversion of prothrombin to thrombinUsed for: Pulmonary embolism Venous thrombosis Prophylaxis after acute MI AnticoagulantsMedications: Heparin Anticoagulants (Heparin)Side Effects: Hematuria Tissue irritationNursing Considerations: Monitor clotting time or Partial Thromboplastin Time (PTT) Normal 20-45 sec Therapeutic level 1.5-2.5 times control AntagonistProtamine Sulfate Give SC or IV

AnticoagulantAction:

Interferes with synthesis of vitamin K-dependent clottingfactorsUsed for: Pulmonary embolism Venous thrombosis Prophylaxis after acute MI AnticoagulantMedication: Coumadin Anticoagulant (Coumadin)

Side Effects: Hemorrhage, AlopeciaNursing Considerations: Monitor Prothrombin Test (PT) Normal 9-12 sec Therapeutic level 1.5 times control


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AntagonistVitamin K (AquaMEPHYTON) Monitor for bleeding Give PO

AnticonvulsantsAction: Decreases flow of calcium and sodium across neuronalmembranesUsed for: Seizures AnticonvulsantMedications: Dilantin Luminal Depakote Tegretol

Klonopin AnticonvulsantSide effects: Respiratory depression Aplastic anemia Gingival hypertrophy AtaxiaNursing Considerations: Dont discontinue abruptly

Monitor I&O Caution with use of medications that lower seizure threshold:MAO inhibitors & anti-psychotics Good mouth care Take with food May turn urine pinkish-red/pinkish-brown


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Bulimia Anti-DepressantsSelective Serontonin Reuptake Inhibitors (SSRI)Medications: Paxil Prozac Zoloft Anti-DepressantsSelective Serontonin Reuptake Inhibitors (SSRI)Side effects: Anxiety GI upset Change in appetite and bowel function Urinary retentionNursing Considerations: Suicide precautions Takes 4 weeks for full effect Take in a.m. May urine to pinkish-red or Pinkish-brown Can be taken with mealsAnti-Depressants (Tricyclics)

Action: Inhibits reuptake of neurotransmittersUsed for: Depression Sleep apnea Anti-Depressants (Tricyclics)Medications: Norpramin Elavil

Tofranil Anti-Depressants (Tricyclics)Side Effects: Sedation/Confusion Anticholinergics affects Postural Hypotension Urinary retention


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Nursing Considerations: Suicide precautions/2-6 weeks to work Take at hs/Dont abruptly halt Avoid alcohol/OTC /Photosensitivity

Antidiabetic AgentsAction: Stimulates insulin release from beta cells in pancreasUsed for: Type 2 diabetes (NIDDM) Antidiabetic AgentsMedications: Diabinese

Orinase Dymelor Micronase Antidiabetic AgentsSide Effects: Hypoglycemia Allergic skin reactions GI upsetNursing Considerations: Take before breakfast Monitor glucose levels Avoid alcohol, sulfonamides, Oral Contraceptives, (MAO),aspirin because they help to make drug work better

Hypoglycemic AgentAction: Stimulates liver to change glycogen to glucoseUsed for: Hypoglycemia Hypoglycemic AgentMedication: Glucagon Hypoglycemic AgentSide Effects:


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Hypotension BronchospasmNursing Considerations: May repeat in 15min Give carbohydrates orally to prevent secondary hypoglycemicreactions

AntidiarrhealsAction: Slows peristalsis Increases tone of sphinctersUsed for: Diarrhea AntidiarrhealsMedications: Kaopectate Lomotil Imodium Paregoric AntidiarrhealsSide Effects:

Constipation Anticholinergic effects (urinary retention, dry mouth)Nursing Considerations: Do not use with abdominal pain Monitor for urinary retention Give 2hr before or 3 hr after other meds


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AntiemeticsAction: Increases GI motility Blocks effect of dopamine in chemoreceptor trigger zoneUsed for: Vomiting AntiemeticsMedications: Tigan Compazine Torecan Reglan Antivert Dramamine AntiemeticsSide Effects: Sedation Anticholinergic effectsNursing Considerations: Used before chemotherapy

When used with viral infections may cause Reyes syndrome(Toxic Encephalopathy)

AntifungalsAction: Impairs cell membraneUsed for: Candidiasis

Oral thrush Histoplasmosis AntifungalsMedications: Amphotericin B Nystatin AntifungalsSide Effects:


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Hepatotoxicity Thrombocytopenia Leukopenia PruritisNursing Considerations: Give with food Monitor liver function Good oral hygiene

Antigout AgentsAction: Decreases production and resorption of uric acidUsed for: Gout Antigout AgentsMedications: Colchicine Probenecid Zyloprim Antigout AgentsSide Effects:

Agranulocytosis GI upset Renal calculiNursing Considerations: Monitor for renal calculi Give with food, milk, antacids

Antihistamines

Action: Block effects of histamineUsed for: Allergic rhinitis Allergic reactions to blood AntihistaminesMedications:


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Chlor-Trimeton Benadryl Phenergan AntihistaminesSide Effects: Drowsiness Dry mouth PhotosensitivityNursing Considerations: Give with food Use sunscreen Avoid alcohol

Antihyperlipidemic AgentsAction: Inhibits cholesterol and triglyceride synthesisUsed For: Elevated cholesterol Reduce incidence of cardiovascular disease AntihyperlipidemicAgents

Medications: Questran Lipid Antihyperlipidemic AgentsSide Effects: Constipation Fat-soluble vitamin deficiencyNursing Considerations: Take at hs or 30 min ac

Administer 1hr before or 4-6 hr after other meds

Antihypertensives


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Types: ACE InhibitorsAction: Blocks ACE in lungsUsed for: Hypertension CHF Antihypertensives(ACE Inhibitors)Medications: Capoten Vasotec Antihypertensives(ACE Inhibitors)Side Effects: GI upset Orthostatic hypotension DizzinessNursing Considerations: Give 1hr ac or 3hr pc Change position slowly

AntihypertensivesType: Beta-Adrenergic BlockersAction: Blocks Beta-Adrenergic Receptors Decrease excitability/workload of heart, oxygen consumption DecreaseUsed for: Hypertension

Angina SVT AntihypertensivesType: Beta-AdrenergicMedications; Nadolol Propranolol


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Tenormin Timoptic AntihypertensivesType: Beta-AdrenergicSide Effects: Changes in heart rate Hypotension BronchospasmNursing Considerations: Masks signs of shock and hypoglycemia Take with meals Do not discontinue abruptly

AntihypertensivesType: Calcium Channel BlockersAction: Inhibits movement of calcium across cell membranes Slow impulse conduction and depresses myocardial contractility Causes dilation of coronary arteries and decreases cardiacworkload and energy consumption

Used for: Angina Hypertension Interstitial cystitis AntihypertensivesType: Calcium Channel BlockersMedications: Procardia Calan

Cardizem AntihypertensivesType: Calcium Channel BlockersSide Effects: Hypotension Dizziness GI distress


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Nursing Consideration: Monitor vital signs Do not chew or divide sustained-release tablets

AntihypertensivesType: Centrally acting alpha-adrenergicsAction: Stimulates alpha receptors in medulla which causes a reductionin sympathetic in the heartUsed for: Hypertension AntihypertensivesType: Centrally acting alpha-adrenergicsMedications: Aldomet Catapres AntihypertensivesType: Centrally acting alpha-adrenergicsSide Effects: Sedation Orthostatic Hypotension

Nursing Considerations: Dont discontinue abruptly Monitor for fluid retention Change position slowlyAntihypertensivesType: Direct-acting vasodilatorsAction: Relaxes smooth muscle

Used for: Hypertension AntihypertensivesMedications Hydralazine Minoxidil AntihypertensivesSide Effects:


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PolyuriaNursing Considerations: Monitor serum levels Give with meals Increase fluid intake

Antineoplastic AgentsType: Alkylating AgentsAction: Interferes with rapidly reproducing DNAUsed for: Leukemia Multiple myeloma Antineoplastic AgentsMedications: Cisplatin Myleran Cytoxan Antineoplastic AgentsSide Effects: Hepatotoxicity

Ecchymosis Alopecia Epitaxis Infertility Bone Marrow Suppression Stomatitis GI disturbances: Anorexic, N/V, diarrheaNursing Considerations:

Check hematopoietic (reproduction of RBCs by bone marrow)function Force fluids Good mouth care

Antineoplastic Agents


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Type: AntimetabolitesAction: Inhibits DNA polymeraseUsed for: Acute lymphatic leukemia Cancer of colon, breast, pancreas Antineoplastic AgentsAntimetabolites Medications: 5-FU Methotrexate Hydrea Antineoplastic AgentsAntimetabolitesSide Effects: Nausea Vomiting Oral ulceration Bone marrow suppression AlopeciaNursing Considerations: Monitor hematopoietic function

Good mouth care Discuss body image changes

Antineoplastic AgentsType: Antitumor AntibioticsAction: Interferes with DNA and RNA synthesisUsed for:

Cancer Antineoplastic AgentsAntitumor AntibioticsMedications: Adriamycin Actinomycin D Bleomycin Antineoplastic Agents


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Antitumor AntibioticsSide Effects: Bone marrow suppression Alopecia StomatitisNursing Considerations: Monitor vital signs Give antiemetic medications before therapy

Antineoplastic AgentsType: Hormonal AgentsAction: Changes hormone input into sensitive cellsUsed for: Cancer Antineoplastic AgentsType: Hormonal AgentsMedications: Diethylstilbestrol Tamoxifen

Testosterone Antineoplastic AgentsType: Hormonal AgentsSide Effects: Leukpenia Bone pain HypercalcemiaNursing Considerations: Check CBC

Monitor serum calcium

Antineoplastic AgentsType: Vinca AlkaloidsAction: Interferes with cell division


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Used for: Cancer Antineoplastic AgentsType: Vinca AlkaloidsMedications: Oncovin Velban Antineoplastic AgentsType: Vinca AlkaloidsSide Effects: Stomatitis Alopecia Loss of reflexes Bone marrow suppressionNursing Considerations: Give antiemetic before administration Check reflexes Given with Zyloprim to decrease uric acid

Antiparkinson AgentsAction:

Converted to Dopamine Stimulates postsynaptic Dopamine receptorsUsed for: Parkinsons disease Antiparkinson AgentsMedications: Artane Cogentin L-Dopa

Parlodel Sinemet Symmetrel Antiparkinson AgentsSide Effects: Dizziness Ataxia


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Atropine-like effects: dry mouth, urinary retentionNursing Considerations: Monitor for urinary retention Large doses of vitamin B6 reverse effects Avoid use of CNS depressantsAntiplatelet AgentsAction: Interferes with platelet aggregationUsed for: Venous thrombosis Pulmonary embolism Antiplatelet AgentsMedications: Aspirin Persantine Antiplatelet AgentsSide Effects: Hemorrhage ThrombocytopeniaNursing Considerations: Check for signs of bleeding

Give with food or milk

Antipsychotic AgentsAction: Blocks dopamine receptors in basal gangliaUsed for: Acute and Chronic psychoses Antipsychotic AgentsMedications:

Haldol Thorazine Mellaril Stelazine Antipsychotic AgentsSide Effects: Akathisia (inability to sit still)


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Dyskinesia Dystonias Parkinsons syndrome Tardive dyskinesias LeukopeniaNursing Considerations: Check CBC Monitor vital signs Avoid alcohol and caffeine

Atypical Antipsychotic AgentsAction: Interferes with binding of dopamine in the brainUsed for: Acute and Chronic psychoses Atypical AntipsychoticMedications: Clozaril Risperdal Atypical AntipsychoticSide Effects:

Extrapyramidal effects Anticholinergic Sedative Orthostatic hypotensionNursing Considerations: Monitor blood Change positions slowly Use sunscreen

Antipyretic AgentsAction: Antiprostaglandin activity in hypothalamusUsed for: Fever Antipyretic Agents


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Medications: Tylenol (Acetaminophen) Antipyretic AgentsSide Effects: GI irritationNursing Considerations: Monitor liver function Aspirin contraindicated for younger than 21 years old due torisk of Reyes syndrome

Antithyroid AgentsAction: Reduce vascularity of thyroid Inhibits release of thyroid into circulationUsed for: Hyperthyroidism Antithyroid AgentsMedications: Tapazole SSKI Antithyroid AgentsSide Effects:

Leukopenia Rash ThrombocytopeniaNursing Considerations: Bitter taste May cause burning in mouth Give with meals Check CBC


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Thyroid Replacement AgentsAction: Increases metabolic rateUsed for: Hypothyroidism Thyroid ReplacementMedications Synthroid Cytomel Thyroid ReplacementSide Effects: Nervousness Tachycardia Weight lossNursing Considerations: Monitor pulse and BP Monitor weight Take in a.m. Enhance action of anticoagulants, antidepressants, decreaseaction of insulin and digitalis

Antitubercular AgentsAction: Inhibits cell and protein synthesisUsed for: Tuberculosis To prevent disease in person exposed to organismAntitubercular AgentsMedications:

INH Ethambutol Streptomycin PAS PYZ Antitubercular AgentsSide Effects:


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Hepatitis Peripheral NeuritisNursing Considerations: Check liver function tests Vitamin B6 given for peripheral neuritis (Pyridoxine) Used in combinationAntiviralsAction: Inhibits DNA and RNA replicationUsed for: Recurrent HSV HIV infection AntiviralsMedications: Zovirax AZT Videx Famvir Cytovene AntiviralsSide Effects:

Headache Dizziness GI symptomsNursing Considerations: Encourage fluids Not a cure, but relieves symptoms

Attention Disorder Agents

Action: Increases level of catecholaminesUsed for: ADDH Narcolepsy Attention Disorder AgentsMedications:


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Ritalin Cylert Dexedrine Attention Disorder AgentsSide Effects: Restlessness Insomnia Tachycardia PalpitationsNursing Considerations: Monitor growth rate Monitor liver enzymes Give in A.M.

BronchodilatorsAction: Decreases activity of phosphodiesteraseUsed for: COPD Preterm labor (Terbutaline) Bronchodilators

Medications: Aminophylline Atrovent Brethine Proventil Primatene Bronchodilators


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Side Effects: Tachcyardia Dysrhythmias Palpitations Anticholinergic effectsNursing Considerations: Monitor BP and HR When used with steroid inhaler, use bronchodilator first May aggravate diabetes

Cardiac GlycosidesAction: Increases force of myocardial contraction, slows rateUsed for: Left-sided CHF Cardiac GlycosidesMedication: Lanoxin(Digoxin) Cardiac GlycosidesSide Effects:

Bradycardia Nausea Vomiting Visual disturbancesNursing Considerations: Take apical pulse Notify physician if adult


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Hygroton DiureticsSide Effects: Dizziness Orthostatic Hypotension LeukopeniaNursing Considerations: Take with food or milk Take in a.m. Monitor fluid and electrolytes

Iron: Imferon/Feosol, use straw if liquid form, no milk/antacids,take on empty stomach, tachycardiGlucocorticoidsAction: Stimulates formation of glucose Alters immune responseUsed for: Addisons disease Crohns disease

COPD Leukemias GlucocorticoidsMedications: Solu-Cortef Decadron Deltasone GlucocorticoidsSide Effects: Psychoses

Depression Hypokalemia Stunted growth Buffalo HumpNursing Considerations: Monitor fluid and electrolyte balance


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Dont discontinue abruptly Monitor for signs of infection

MineralocorticoidsAction: Increases sodium reabsorption Potassium and hydrogen ion secretion in kidneyUsed for: Adrenal insufficiency MineralocorticoidsMedications: Florinef MineralocorticoidsSide Effects: Hypertension Edema HypokalemiaNursing Considerations: Monitor BP, I&O, Weight, and Electrolytes Give with food Low-sodium, High-protein, High-potassium diet

Heavy Metal AntagonistsAction: Forms stable complexes with metalsUsed for: Gold and arsenic poisoning Acute lead encephalopathy Heavy Metal AntagonistsMedications:

Desferal mesylate BAL in Oil EDTA Heavy Metal AntagonistsSide Effects: Tachycardia Pain and induration at injection site (conjunct with Procaine in


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syringe)Nursing Considerations: Monitor I&O and kidney function Administered with local anesthetic Seizure precautions

H2 Receptor BlockersAction: Inhibits action of histamine and gastric acid secretionUsed for: Ulcers Gastroesophageal reflux H2 Receptor BlockersMedications: Tagamet Zantac H2 Receptor BlockersSide Effects: Dizziness Confusion Hypotension

ImpotenceNursing Considerations: Take with meals and hs Smoking decreases effectiveness Monitor liver function and CBC

ImmunosuppressantsAction: Prevents production of T cells and their response to interleukin-2Used for: Prevents rejection for transplanted organs Immunosuppressants


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Medications: Sandimmune ImmunosuppressantsSide Effects: Hepatotoxicity Nephrotoxicity LeuKopenia ThrombocytopeniaNursing Considerations: Take once daily in a.m. Used with adrenal corticosteroids Monitor renal and liver function tests

Miotics (Constricts Pupil)Action: Causes constriction of sphincter muscles of irisUsed for: Ocular surgery Open-angle glaucoma MioticsMedications:

Isopto-Carpine Eserine Carbacel MioticsSide Effects: Headache Photophobia Hypotension Bronchoconstriction

Nursing Considerations: Apply pressure on lacrimal sac for 1min Avoid sunlight May experience transient brow pain and myopia

Mydriatics (Dilates Pupil)


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Action: Anticholinergic actions leaves pupil under unopposed adrenergicinfluenceUsed for: Diagnostic procedures Acute iritis Uveitis MydriaticsMedications: Atropine sulfate Cyclogyl MydriaticsSide Effects: Tachycardia Blurred vision Photophobia Dry mouthNursing Considerations: Contraindicated with glaucoma Apply pressure on lacrimal sac for 1min. Wear dark glasses

NarcoticsAction: Acts on CNS receptor cellsUsed for: Moderate to severe pain Preoperative Postoperative Narcotics

Medications: Morphine Sulfate Codeine Demerol Dilaudid Percodan Narcotics


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Side Effects: Dizziness Sedation Respiratory depression Hypotension ConstipationNursing Considerations: Safety precautions Avoid alcohol Monitor vital signs Use narcotic antagonist if necessary (Narcan)

AntianginalsAction: Relaxes smooth muscle Decreases venous returnUsed for: Angina

Peri-operative hypertension CHF AntianginalsMedications: Nitroglycerine Isosorbide AntianginalsSide Effects: Hypotension Tachycardia

Headache DizzinessNursing Considerations: Check expiration date Teach when to take medication May take Q5min x3 doses


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Wet with saliva and place under tongue

NSAIDSAction: Inhibits prostaglandin synthesisUsed for: Arthritis Mild to moderate pain Fever NSAIDSMedications: Motrin Indocin Naprosyn NSAIDSSide Effects: GI upset Dizziness Headache Bleeding Fluid retention

Nursing Considerations: Take with food or after meals Monitor liver and renal function Use cautiously with aspirin allergy Check for bleeding

ThrombolyticsAction:

Dissolves or lyses blood clotsUsed for: Acute Pulmonary Emboli Thrombosis MI Contraindicated in: hemophilia, CVA, Trauma, not used in


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patients over 75 years old, not used in patients takinganticoagulants ThrombolyticsMedications: Streptokinase Urokinase Tissue Plasminogen Activator ThrombolyticsSide Effects: Bleeding Bradycardia DysrhythmiasNursing Considerations: Monitor for bleeding Have Amino Caproic Acid Available Check pulse, color, sensation of extremities Monitor EKG

Anaphylaxis Symptomso Hives

o Rasho Difficulty breathing (first sign)o Diaphoresis Nursing careo Epinephrine 0.3 ml of 1:1000 solution SQo Massage siteo May repeat in 15-20 min.

Delayed Allergic Reaction Symptoms:o Rash, Hives, Swollen Joints Nursing Careo Discontinue medicationo Topical Antihistamines


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o Corticosteroidso Comfort measures

Bone Marrow DepressionSymptoms:Fever, Chills, Sore ThroatBack pain, Dark urineAnemia, Thrombocytopenia, LeukopeniaNursing Care:Monitor CBCProtect from infectionsAvoid injuryLiver impairment: light stools and dark urine

Renal Impairment: decrease Hematocrit

Anticholinergic Effects Symptoms:o Dry mouth, Dysphagia, Nasal Congestion

o Urinary retention, Impotence Nursing Care:o Sugarless lozengeso Good mouth careo Void before taking medication

Parkinsons-like effects Symptoms:

o Akinesia (temporarily paralysis of muscles)o Tremorso Droolingo Changes in gaito Rigidityo Akathisia (Extreme restlessness)


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o Dyskinesia (Spasms) Nursing Care:o Anticholinergic and Antiparkinsonian medicationso Safety measures for gait

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Major Medication Classification