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Adrenergic Vasopressor Inotrope Vasoactive Agent

MoA: Stimulates beta-1, alpha, and dopamine receptors. Induces (+) inotropic activity.

• Beta-1 receptors increase the force of myocardial contraction, raise heart rate, and stimulate electrical conduction via SA and AV nodes.
• Alpha receptors stimulate the CNS, constrict blood vessels, decrease gastric motility, and dilate pupils.
• Dopamine receptors dilate renal, mesenteric, coronary, and cerebral vessels.
• (+) Inotropic Effect: Increases cardiac output and stroke volume through stronger myocardial contraction.

Indications: Shock, Heart Failure, Hypotension, Bradycardia

Side Effects: Headache, GI Distress

Nursing Implications:

• Monitor ECG for abnormalities.
• Simultaneous administration of two or more adrenergic drugs may precipitate tachycardia or hypertension.

Stimulant Amphetamine

MoA: Increases alertness and focus by stimulating the CNS to release norepinephrine. Additionally, it causes euphoria by increasing dopamine and serotonin release.

Indications: ADHD, Narcolepsy

Side Effects: Palpitations, Tachycardia, Hypertension, Nervousness, Irritability, Anxiety, Insomnia, Loss of Appetite

Nursing Implications:

• Refrain from administering close to bedtime as it can cause insomnia.
• Instruct the client to develop a dietary regimen consisting of small and frequent high-calorie meals.
• Avoid excessive caffeine consumption.
• Monitor for delayed growth in children.

Vitamin Fat-Soluble

Sources: Liver, Fish, Dairy, Eggs, Dark Leafy Greens, Yellow-Orange Vegetables and Fruits

Functions: Develops bones and teeth, increases production of rhodopsin for vision, and synthesizes cholesterol and steroid hormones.

Indications: Nutrient Deficiency

Antimigraine Selective Serotonin Agonist

MoA: Releases into the cerebrovascular system and binds to 5-HT receptors. From there, triptans exert their effect by causing vasoconstriction and decreasing inflammatory neuropeptide production.

Indications: Migraine

Contraindications: Coronary Artery Disease, Uncontrolled Hypertension

Side Effects: Dizziness, Headache, Tingling, Flushing

Nursing Implications:

• Take medication when symptoms start.
• Teach patients to lie down in a dark room to reduce visual stimulation.
• Recommend the patient keep a migraine diary that notes the severity, duration, and frequency.

Antimigraine Selective Serotonin Agonist

MoA: Releases into the cerebrovascular system and binds to 5-HT receptors. From there, triptans exert their effect by causing vasoconstriction and decreasing inflammatory neuropeptide production.

Indications: Migraine

Contraindications: Coronary Artery Disease, Uncontrolled Hypertension

Side Effects: Dizziness, Headache, Tingling, Flushing

Nursing Implications:

• Take medication when symptoms start.
• Teach patients to lie down in a dark room to reduce visual stimulation.
• Recommend the patient keep a migraine diary that notes the severity, duration, and frequency.

Antimigraine Selective Serotonin Agonist

MoA: Releases into the cerebrovascular system and binds to 5-HT receptors. From there, triptans exert their effect by causing vasoconstriction and decreasing inflammatory neuropeptide production.

Indications: Migraine

Contraindications: Coronary Artery Disease, Uncontrolled Hypertension

Side Effects: Dizziness, Headache, Tingling, Flushing

Nursing Implications:

• Take medication when symptoms start.
• Teach patients to lie down in a dark room to reduce visual stimulation.
• Recommend the patient keep a migraine diary that notes the severity, duration, and frequency.

Antimigraine Selective Serotonin Agonist

MoA: Releases into the cerebrovascular system and binds to 5-HT receptors. From there, triptans exert their effect by causing vasoconstriction and decreasing inflammatory neuropeptide production.

Indications: Migraine

Contraindications: Coronary Artery Disease, Uncontrolled Hypertension

Side Effects: Dizziness, Headache, Tingling, Flushing

Nursing Implications:

• Take medication when symptoms start.
• Teach patients to lie down in a dark room to reduce visual stimulation.
• Recommend the patient keep a migraine diary that notes the severity, duration, and frequency.

Antimigraine Selective Serotonin Agonist

MoA: Releases into the cerebrovascular system and binds to 5-HT receptors. From there, triptans exert their effect by causing vasoconstriction and decreasing inflammatory neuropeptide production.

Indications: Migraine

Contraindications: Coronary Artery Disease, Uncontrolled Hypertension

Side Effects: Dizziness, Headache, Tingling, Flushing

Nursing Implications:

• Take medication when symptoms start.
• Teach patients to lie down in a dark room to reduce visual stimulation.
• Recommend the patient keep a migraine diary that notes the severity, duration, and frequency.

Antimigraine Selective Serotonin Agonist

MoA: Releases into the cerebrovascular system and binds to 5-HT receptors. From there, triptans exert their effect by causing vasoconstriction and decreasing inflammatory neuropeptide production.

Indications: Migraine

Contraindications: Coronary Artery Disease, Uncontrolled Hypertension

Side Effects: Dizziness, Headache, Tingling, Flushing

Nursing Implications:

• Take medication when symptoms start.
• Teach patients to lie down in a dark room to reduce visual stimulation.
• Recommend the patient keep a migraine diary that notes the severity, duration, and frequency.

CNS Depressant Anxiolytic Benzodiazepine

MoA: Depresses hypothalamic, thalamic, and limbic systems by binding to GABA and benzodiazepine receptors.

Indications: Sedation, Muscle Relaxation, Anxiety, Seizures, Alcohol Withdrawal

Side Effects: Drowsiness, Dizziness, Orthostatic Hypotension

Nursing Implications:

• Implement fall risk precautions.
• Monitor for toxicity: neutropenia and respiratory depression. Romazicon (Flumazenil) is an antidote for Benzodiazepine toxicity.
• Educate patients about avoiding tasks that require high attention span such as driving or operating heavy equipment.
• Do not stop this medication abruptly during long-term use. It can precipitate withdrawal symptoms.
• Teach the client to take this medication at bedtime when possible.

CNS Depressant Anxiolytic Benzodiazepine

MoA: Depresses hypothalamic, thalamic, and limbic systems by binding to GABA and benzodiazepine receptors.

Indications: Sedation, Muscle Relaxation, Anxiety, Seizures, Alcohol Withdrawal

Side Effects: Drowsiness, Dizziness, Orthostatic Hypotension

Nursing Implications:

• Implement fall risk precautions.
• Monitor for toxicity: neutropenia and respiratory depression. Romazicon (Flumazenil) is an antidote for Benzodiazepine toxicity.
• Educate patients about avoiding tasks that require high attention span such as driving or operating heavy equipment.
• Do not stop this medication abruptly during long-term use. It can precipitate withdrawal symptoms.
• Teach the client to take this medication at bedtime when possible.

CNS Depressant Anxiolytic Benzodiazepine

MoA: Depresses hypothalamic, thalamic, and limbic systems by binding to GABA and benzodiazepine receptors.

Indications: Sedation, Muscle Relaxation, Anxiety, Seizures, Alcohol Withdrawal

Side Effects: Drowsiness, Dizziness, Orthostatic Hypotension

Nursing Implications:

• Implement fall risk precautions.
• Monitor for toxicity: neutropenia and respiratory depression. Romazicon (Flumazenil) is an antidote for Benzodiazepine toxicity.
• Educate patients about avoiding tasks that require high attention span such as driving or operating heavy equipment.
• Do not stop this medication abruptly during long-term use. It can precipitate withdrawal symptoms.
• Teach the client to take this medication at bedtime when possible.

CNS Depressant Anxiolytic Benzodiazepine

MoA: Depresses hypothalamic, thalamic, and limbic systems by binding to GABA and benzodiazepine receptors.

Indications: Sedation, Muscle Relaxation, Anxiety, Seizures, Alcohol Withdrawal

Side Effects: Drowsiness, Dizziness, Orthostatic Hypotension

Nursing Implications:

• Implement fall risk precautions.
• Monitor for toxicity: neutropenia and respiratory depression. Romazicon (Flumazenil) is an antidote for Benzodiazepine toxicity.
• Educate patients about avoiding tasks that require high attention span such as driving or operating heavy equipment.
• Do not stop this medication abruptly during long-term use. It can precipitate withdrawal symptoms.
• Teach the client to take this medication at bedtime when possible.

CNS Depressant Anxiolytic Benzodiazepine

MoA: Depresses hypothalamic, thalamic, and limbic systems by binding to GABA and benzodiazepine receptors.

Indications: Sedation, Muscle Relaxation, Anxiety, Seizures, Alcohol Withdrawal

Side Effects: Drowsiness, Dizziness, Orthostatic Hypotension

Nursing Implications:

• Implement fall risk precautions.
• Monitor for toxicity: neutropenia and respiratory depression. Romazicon (Flumazenil) is an antidote for Benzodiazepine toxicity.
• Educate patients about avoiding tasks that require high attention span such as driving or operating heavy equipment.
• Do not stop this medication abruptly during long-term use. It can precipitate withdrawal symptoms.
• Teach the client to take this medication at bedtime when possible.

CNS Depressant Anxiolytic Benzodiazepine

MoA: Depresses hypothalamic, thalamic, and limbic systems by binding to GABA and benzodiazepine receptors.

Indications: Sedation, Muscle Relaxation, Anxiety, Seizures, Alcohol Withdrawal

Side Effects: Drowsiness, Dizziness, Orthostatic Hypotension

Nursing Implications:

• Implement fall risk precautions.
• Monitor for toxicity: neutropenia and respiratory depression. Romazicon (Flumazenil) is an antidote for Benzodiazepine toxicity.
• Educate patients about avoiding tasks that require high attention span such as driving or operating heavy equipment.
• Do not stop this medication abruptly during long-term use. It can precipitate withdrawal symptoms.
• Teach the client to take this medication at bedtime when possible.

CNS Depressant Sedative

MoA: Depresses hypothalamic, thalamic, and limbic systems by binding to GABA and other neurological receptors.

Indications: Sleep Impairment

Side Effects: Somnambulation

Nursing Implications:

• Instruct patient to take this medication when they can sleep a minimum of 8hrs.
• This medication can be taken during the night when there is more than 4hrs until they need to awaken.
• Educate patients about avoiding tasks that require high attention span such as driving or operating heavy equipment.

CNS Depressant Sedative

MoA: Depresses hypothalamic, thalamic, and limbic systems by binding to GABA and other neurological receptors.

Indications: Sleep Impairment

Side Effects: Dizziness, Drowsiness

Nursing Implications:

• Instruct patient to take this medication when they can sleep a minimum of 8hrs.
• This medication can be taken during the night when there is at least 4hrs until they need to awaken.
• Educate patients about avoiding tasks that require high attention span such as driving or operating heavy equipment.

CNS Depressant Sedative

MoA: Depresses hypothalamic, thalamic, and limbic systems by binding to GABA and other neurological receptors.

Indications: Sleep Impairment

Side Effects: Somnambulation

Nursing Implications:

• Instruct patient to take this medication when they can sleep a minimum of 8hrs.
• This medication can be taken during the night when there is at least 4hrs until they need to awaken.
• Educate patients about avoiding tasks that require high attention span such as driving or operating heavy equipment.

CNS Depressant Barbiturate

MoA: Stimulates GABA receptors to depress cerebral cortex and brainstem function.

Indications: Sedation, Seizures, Anesthesia

Contraindications: Porphyria, Renal Impairment, Liver Impairment

Side Effects: Drowsiness, Dizziness, Lethargy

Nursing Implications:

• Barbiturates have a Narrow Therapeutic Index which increases the potential for habituation.
• Monitor respiratory function with high doses of Barbiturates.
• Educate patients about avoiding tasks that require high attention span such as driving or operating heavy equipment.

CNS Depressant Barbiturate

MoA: Stimulates GABA receptors to depress cerebral cortex and brainstem function.

Indications: Sedation, Seizures, Anesthesia

Contraindications: Porphyria, Renal Impairment, Liver Impairment

Side Effects: Drowsiness, Dizziness, Lethargy

Nursing Implications:

• Barbiturates have a Narrow Therapeutic Index which increases the potential for habituation.
• Monitor respiratory function with high doses of Barbiturates.
• Educate patients about avoiding tasks that require high attention span such as driving or operating heavy equipment.

CNS Depressant Barbiturate

MoA: Stimulates GABA receptors to depress cerebral cortex and brainstem function.

Indications: Sedation, Seizures, Anesthesia

Contraindications: Porphyria, Renal Impairment, Liver Impairment

Side Effects: Drowsiness, Dizziness, Lethargy

Nursing Implications:

• Barbiturates have a Narrow Therapeutic Index which increases the potential for habituation.
• Monitor respiratory function with high doses of Barbiturates.
• Educate patients about avoiding tasks that require high attention span such as driving or operating heavy equipment.

CNS Depressant Anticonvulsant Barbiturate

MoA: Stimulates GABA receptors to depress cerebral cortex and brainstem function.

Indications: Sedation, Seizures, Anesthesia

Contraindications: Porphyria, Renal Impairment, Liver Impairment

Side Effects: Drowsiness, Dizziness, Lethargy

Nursing Implications:

• Monitor for possible suicidal ideation.
• Barbiturates have a Narrow Therapeutic Index which increases the potential for habituation.
• Monitor respiratory function with high doses of Barbiturates.
• Educate patients about avoiding tasks that require high attention span such as driving or operating heavy equipment.

Muscle Relaxant

MoA: Acts on GABA receptors at the synapse of skeletal muscles to decrease the frequency of neurotransmitter response.

Indications: Muscle Pain, Muscle Spasms, Spasticity

Side Effects: Dizziness, Drowsiness, Muscle Weakness, Seizures, Constipation

Nursing Implications:

• Monitor for signs of constipation.
• Educate patients about avoiding tasks that require high attention span such as driving or operating heavy equipment.

Muscle Relaxant

MoA: Depresses the CNS to reduce muscle activity.

Indications: Muscle Pain, Muscle Spasms, Spasticity

Side Effects: Dizziness, Muscle Weakness

Nursing Implications:

• Monitor for therapeutic effects.

Muscle Relaxant

MoA: Depresses the CNS to reduce muscle activity.

Indications: Muscle Pain, Muscle Spasms, Spasticity

Side Effects: Dizziness, Drowsiness, Muscle Weakness, GI Distress

Nursing Implications:

• Educate patients about avoiding tasks that require high attention span such as driving or operating heavy equipment.

Antiviral Dermatologic Drug

MoA: Blocks polymerase to inhibit nucleic acid synthesis and growth of viral genomes.

Indications: Herpes Simplex Virus 1-2, Varicella Zoster Virus

Side Effects: GI Distress, Headache

Nursing Implications:

• Educate patient on proper contraceptive measures for sexual activity.
• Monitor for Nephrotoxicity: assess renal panel and urinary tract abnormalities.
• Inform the patient that this medication is not a cure but helps to manage symptoms.

Antiviral

MoA: Blocks polymerase to inhibit nucleic acid synthesis and growth of viral genomes.

Indications: Cytomegalovirus

Side Effects: Fever, Tremors, GI Distress

Nursing Implications:

• Monitor for Bone Marrow Suppression: anemia, leukocytosis, thrombocytopenia, mouth sores, and fever.
• Inform the patient that this medication is not a cure but helps to manage symptoms.

Antiviral

MoA: Blocks polymerase to inhibit nucleic acid synthesis and growth of viral genomes.

Indications: Influenza A-B Prophylaxis

Side Effects: GI Distress

Nursing Implications:

• Inform the patient that this medication is not a cure but helps to manage symptoms.

Antiviral

MoA: Blocks polymerase to inhibit nucleic acid synthesis and growth of viral genomes.

Indications: Active Influenza A-B

Side Effects: GI Distress

Nursing Implications:

• Inform the patient that this medication is not a cure but helps to manage symptoms.

Antiviral

MoA: Blocks polymerase to inhibit nucleic acid synthesis and growth of viral genomes.

Indications: Respiratory Syncytial Virus, Hepatitis C

Contraindications: Pregnant Women

Side Effects: GI Distress, Loss of Appetite

Nursing Implications:

• This medication can induce teratogenic effects in pregnant women.
• Inform the patient that this medication is not a cure but helps to manage symptoms.

Antiretroviral

MoA: Blocks reverse transcriptase during the viral replication cycle.

Indications: Acute HIV Infection, HIV Prophylaxis

Side Effects: Abdominal Pain, Fever, Fatigue, Loss of Appetite

Nursing Implications:

• Monitor for Bone Marrow Suppression: anemia, leukocytosis, thrombocytopenia, mouth sores, and fever.
• Inform the patient that this medication is not a cure but helps to manage symptoms.

Antibiotic Antitubercular

MoA: Inhibts ATP Synthase production to prevent mycobacterium replication.

Indications: MDR-Tuberculosis

Side Effects: GI Distress, Chest Pain, Headache

Drug Interactions: Alcohol

Nursing Implications:

• This medication can cause a prolonged QT segment on an ECG.
• Educate patient on reporting sudden dizziness and irregular heartbeats.
• It is important that the patient completes the full drug regimen to prevent antibiotic resistance.
• Patients are encouraged to take this medication at the same time everyday. Some therapies may require greater than 6 months of antitubercular treatment.
• Teach the patient about proper PPE use as patients with active tuberculosis are contagious in the initial stages of illness.

Antibiotic Antitubercular

MoA: Hydrolyzes enzymes inside mycobacterium to prevent replication.

Indications: Tuberculosis

Side Effects: Fever, GI Distress, Loss of Appetite

Drug Interactions: Alcohol, Aluminium Hydroxide (Maalox)

Nursing Implications:

• Monitor for Neuropathy: numbness, tingling, paralysis, and pain in extremities.
• Educate patient to include Vitamin B6 (Pyridoxine) supplements to prevent peripheral neuropathy.
• Monitor for Hepatotoxicity: elevated liver enzymes, jaundice, dark urine, and vomiting.
• Take this medication at the same time everyday.
• Educate about proper PPE use as patients with active tuberculosis are contagious in the initial stages of illness.

Antibiotic Antitubercular

MoA: Destroys the cell wall by inhibiting lipid and protein synthesis.

Indications: Tuberculosis

Side Effects: Arthralgia, Headache, GI Distress, Loss of Appetite

Drug Interactions: Alcohol

Nursing Implications:

• Patients taking Ethambutol are at high risk of ocular neuritis and blindness.
• Monitor for Vision Changes: blurred vision and color blindness. Teach clients to attend regular ophthalmologic appointments.
• It is important that the patient completes the full drug regimen to prevent antibiotic resistance.
• Take this medication at the same time everyday.
• Educate about proper PPE use as patients with active tuberculosis are contagious in the initial stages of illness.

Anticoagulant

MoA: Inhibits production of Vitamin K-dependent clotting factors synthesized in the liver.

Indications: Treatment and Prophylactic for DVT, Atrial Fibrillation

Contraindications: Pregnant Women

Side Effects: Bleeding, Bruising

Drug Interactions: NSAIDs, Ginger, Garlic, Ginkgo

Nursing Implications:

• Antidote for Warfarin is Vitamin K.
• Monitor PT level for therapeutic effects: Normal PT Range: 11-13.5 seconds.
• Monitor INR level for therapeutic effects: Normal INR Range: 0.8-1.1 seconds. Therapeutic Range: 2.0-3.0 seconds.
• Avoid foods high in Vitamin K such as tomatoes and dark leafy vegetables.
• Monitor for Bleeding: black tarry stools, bleeding gums, hematuria, and bruising.

Antibiotic Antitubercular

MoA: Inhibts mycobacterium replication.

Indications: Tuberculosis

Side Effects: Reddish-Orange Urine or other Body Fluids, Headache, Dizziness

Drug Interactions: Oral Contraceptives, Warfarin, Hypoglycemics, Alcohol

Nursing Implications:

• Monitor for Hepatotoxicity: elevated liver enzymes, jaundice, dark urine, and vomiting.
• Suggest that the client wear glasses to avoid discoloration of contact lenses.
• Take this medication at the same time everyday.
• Educate about proper PPE use as patients with active tuberculosis are contagious in the initial stages of illness.
• Clients should use non-hormonal forms of birth control while taking this medication.

Antiparkinsonian Dopamine Replacement

MoA: Crosses the blood brain barrier and converts to dopamine by migrating to the presynapse and absorbing into the dopaminergic terminal.

Indications: Parkinson's Disease

Side Effects: Dizziness, Orthostatic Hypotension, Involuntary Movements

Drug Interactions: MAOIs

Nursing Implications:

• Monitor clients for cardiac dysrhythmias.
• Taking Levodopa in conjunction with MAOIs may precipitate a hypertensive crisis.
• The client may develop orthostatic hypotension. Implement Fall Risk precuations as necessary.

Antiparkinsonian Dopamine Replacement

MoA: Releases into the body to prevent Levodopa breakdown.

Indications: Parkinson's Disease

Side Effects: Dizziness, GI Distress

Nursing Implications:

• Teach the client about the difference between Levodopa and Carbidopa.

Antiparkinsonian Dopamine Replacement

MoA: Increases dopamine release and prevents dopamine breakdown in the periphery.

Indications: Parkinson's Disease

Side Effects: Chorea, GI Distress, Orthostatic Hypotension

Nursing Implications:

• Encourage clients to take this medication on an empty stomach to avoid GI distress, however, it can be taken with food.
• Carbidopa-Levodopa (Sinemet) can trigger reactivation of melanoma. It can also cause discoloration of bodily-fluids
• This medication can take weeks to see therapeutic effects.
• Do not stop this medicaiton abruptly.
• Avoid eating high protein meals.
• Monitor for toxicity: grimacing, eye twitching, tongue protrusion, or other forms of dyskinsesia.

Anticholinergic Antimuscarinic

MoA: Stimulates (+) chronotropic activity in the heart. Inhibits parasympathetic activity by binding to muscarinic receptors to block the effects of acetylcholine.

• (+) Chronotropic Effect: Increases heart rate by speeding up electrical activity.

Indications: Bradycardia, Anticholinesterase Inhibitor Toxicity

Contraindications: Glaucoma

Side Effects: Mydriasis, Xerostomia, Blurred Vision

Drug Interactions: CNS Depressants, Alcohol

Nursing Implications:

• Monitor for Anticholinergic toxicity: urinary hesitancy, tremors, confusion, and hallucinations.
• Physostigmine is an antidote for Anticholinergic toxicity.
• Teach older patients to limit physical exertion and avoid high temperatures due to risk for heatstroke.
• Educate patient to wear dark glasses due to light sensitivity and use caution when driving due to risk for blurred vision.
• Suggest sugarless gum or hard candy for episodes of dry mouth.

Anticholinesterase

MoA: Blocks acetylcholinesterase from breaking down acetylcholine and increases acetylcholine levels.

Indications: Anticholinergic Toxicity, Atropine Overdose

Side Effects: Bronchospasm, Diaphoresis, Salivation, Miosis

Nursing Implications:

• Patient is at risk for Cholinergic Crisis. Monitor for salivation, lacrimation, urinary incontinence, diarrhea, GI cramps, and emesis (SLUDGE).
• Atropine should be readily available for a cholinergic crisis.

Anticholinergic

MoA: Blocks effects of acetylcholine to suppress cholinergic activity.

• Cholinergic receptors stimulate urinary and gastrointestinal activity, constrict pupils, increase salivation, constrict bronchioles, and decrease heart rate.

Indications: Parkinson's Disease, Extrapyramidal Symptoms (e.g. Pseudoparkinsonism, Dystonia)

Contraindications: Glaucoma

Side Effects: Confusion, Tachycardia, Urinary Retention, GI Distress

Drug Interactions: Alcohol

Nursing Implications:

• Educate patients to avoid extremely hot temperatures due to increased risk for hyperthermia.
• Monitor for Urinary Tract abnormalities: difficulty starting and stopping, urinating minimal amounts, feelings of incomplete urination, and frequent urges to urinate.
• Monitor for Anticholinergic toxicity: urinary hesitancy, tremors, confusion, and hallucinations.
• Physostigmine is an antidote for Anticholinergic toxicity.

Antihistamine Antiemetic Antipruritic H1 Antagonist

MoA: Blocks histamine-1 receptors from binding histamine.

• Histamine-1 receptors constrict respiratory tract vessels, induce hypotension, and increase capillary permeability.

Indications: Parkinson's Disease, Urticaria, Pruritus, Motion Sickness, Non-Productive Cough, Allergy Symptoms

Contraindications: Alcohol

Side Effects: Dizziness, Drowsiness, Xerostomia

Nursing Implications:

• It is important to monitor for sedation in high doses of Diphenhydramine. Sedative effects can contribute to increased Fall Risk.
• Monitor for changes in vision as Diphenhydramine can increase the risk of Glaucoma.
• Educate patients about driving carefully and avoiding hazardous tasks due to increased drowsiness.

Antimalarial Aminoquinoline

MoA: Disrupts protein synthesis and hemoglobin use to prevent parasite replication.

Indications: Protozoa Infection (e.g. Malaria, Giardiasis, Trichomoniasis), Rheumatoid Arthritis, Systemic Lupus Erythematosus

Side Effects: GI Distress, Weight Loss

Nursing Implications:

• Take weekly with water.
• Monitor for Ototoxicity: tinnitus and decreased hearing.

Antimalarial DMARD Aminoquinoline

MoA: Disrupts protein synthesis and hemoglobin use to prevent parasite replication. Inhibits immune and inflammatory response.

Indications: Protozoa Infection (e.g. Malaria, Giardiasis, Trichomoniasis), Rheumatoid Arthritis, Systemic Lupus Erythematosus

Side Effects: GI Distress, Weight Loss

Nursing Implications:

• Take with water or with food to decrase GI distress.
• Monitor for Retinopathy: blurred vision and double vision. Educate patient to schedule regular ophthalmologic exams.
• Monitor for Ototoxicity: tinnitus and decreased hearing.

Antimalarial

MoA: Disrupts protein synthesis to prevent parasite replication by increasing pH levels.

Indications: Protozoa Infection (e.g. Malaria, Giardiasis, Trichomoniasis)

Contraindications: Pregnant Women

Side Effects: Dizziness, GI Distress, Tinnitus

Nursing Implications:

• Take weekly with water.
• Monitor for Ototoxicity: tinnitus and decreased hearing.

Antimalarial

MoA: Disrupts protein synthesis to prevent parasite replication by increasing pH levels.

Indications: Protozoa Infection (e.g. Malaria, Giardiasis, Trichomoniasis)

Contraindications: Pregnant Women

Side Effects: GI Distress

Nursing Implications:

• Take this medication with water.
• Monitor for Ototoxicity: tinnitus and decreased hearing.

Antigout

MoA: Decreases production of uric acid by inhibiting xanthine oxidase activity.

Indications: Gout, Tumor Lysis Syndrome

Side Effects: Rash, GI Distress

Nursing Implications:

• Take medication with water and increase daily fluid intake to prevent Kidney Stone formation.
• Educate Patient on severe complications such as Exfoliative Dermatitis, Stevens-Johnson Syndrome, and Toxic Epidermal Necrolysis.

Antigout

MoA: Mitigates inflammation by decreasing tissue response to urate crystals in joints.

Indications: Acute Gout, Gout Prophylaxis

Side Effects: Weakness, Numbness, Tingling, Melena, GI Distress

Nursing Implications:

• Monitor for leukopenia and bleeding in GI tract.

Antigout

MoA: Increases uric acid excretion by blocking kidney reabsorption.

Indications: Gout

Side Effects: Mouth Sores, GI Distress, Loss of Appetite

Nursing Implications:

• Take medication with water and increase daily fluid intake to prevent Kidney Stone formation.

Antifungal Polyene

MoA: Destroys fungal cells by binding to sterols in the cell membrane of fungi.

Indications: Systemic Fungal Infection, Topical Fungal Infection

Side Effects: Fever, Chills, Anemia, Headache, GI Distress

Nursing Implications:

• Monitor for Pulmonary Infiltration, Renal Toxicity (Hypokalemia, Hypomagnesemia), and Cardiac Dysrhythmias.
• Monitor for Neurotoxicity: tinnitus, visual disturbances, numbness, tingling, pain, and seizures.
• Assess liver and renal function tests, I/O, and vital sign changes.

Antifungal Polyene

MoA: Destroys fungal cells by binding to sterols in the cell membrane of fungi.

Indications: Systemic Fungal Infection, Topical Fungal Infection

Side Effects: Rash

Nursing Implications:

• For PO consumption, teach the patient to either allow the medication to completely dissolve in mouth or swish the medication thoroughly before swallowing.
• Assess liver and renal function tests, I/O, and vital sign changes.
• Prevent harboring of fungi by removing dentures prior to consumption.

Antifungal Triazole

MoA: Manipulates cell metabolism in fungi by destroying enzymes that regulate replication.

Indications: Systemic Fungal Infections, Topical Fungal Infections, Cryptococcal Meningitis

Side Effects: GI Distress, Headache, Light Colored Stools, Dizziness, Rash

Nursing Implications:

• Assess liver and renal function tests, I/O, and vital sign changes.

Anticonvulsant Hydantoin

MoA: Suppresses transmission of nerve impulses by blocking sodium transport.

Indications: Seizures

Contraindications: Pregnant Women

Side Effects: Confusion, Nervousness

Drug Interactions: Warfarin

Nursing Implications:

• This medication can induce teratogenic effects in pregnant women.
• Therapeutic range of this medication: 10-20 mcg/mL.
• Monitor for toxicity: gait disturbances, nystagmus, and slurred speech.
• This medication can cause Acne, Hirsutism, Dilantin Facies, Folic Acid Deficiency, and Osteoporosis.
• Educate patient on dental visits and performing good oral hygiene for Gingival Hyperplasia.

Anticonvulsant

MoA: Suppresses transmission of nerve impulses by blocking sodium transport and increasing GABA release.

Indications: Generalized Seizures, Partial Seizures, Bipolar Disorder

Contraindications: Liver Impairment, Urea Cycle Disorder

Side Effects: Dizziness, Alopecia, GI Distress

Drug Interactions: Barbiturates

Nursing Implications:

• Monitor for possible suicidal ideation.
• Therapeutic range of this medication: 50-125 mcg/mL.
• Educate Patient on complications that include but are not limited to: Pancreatitis and Hepatotoxicity.

Anticonvulsant

MoA: Increases release of GABA into the synapse.

Indications: Seizures

Side Effects: Fatigue, Xerostomia, Dizziness

Drug Interactions: Antacids

Nursing Implications:

• Monitor for possible suicidal ideation.
• Educate Patient on reporting changes in vision, hallucinations, and fever to their healthcare provider.

Anticonvulsant

MoA: Increases GABA transmission and regulates neurotransmitter release.

Indications: Partial Seizures

Side Effects: Irritability, Dizziness, Somnolence, Weakness

Nursing Implications:

• Monitor for possible suicidal ideation.
• Monitor for Steven Johnson Syndrome: rash, blisters, muscle and joint pain.
• Monitor renal panel.

Anticonvulsant

MoA: Alters calcium channels to decrease glutamate release.

• Calcium plays a role in generating and propagating electrical impulses.

Indications: Partial Seizures, Neuropathic Pain, Neuralgia, Fibromyalgia

Side Effects: Dizziness, Drowsiness, Headache

Nursing Implications:

• Monitor for possible suicidal ideation.
• Teach the client to notify the provider if encountering vision changes such as blurriness or double vision.

Antibiotic Sulfonamide

MoA: Disrupts folic acid synthesis which impacts bacterial replication.

Indications: Gram(+,-) Bacteria, UTI, HIV-associated Pneumonia, Staphylococcus Infections, MRSA

Contraindications: Pregnant Women, Infants

Side Effects: Headache, Dizziness

Drug Interactions: Celebrex, Alcohol

Nursing Implications:

• Educate the patient on complications such as: Hemolytic Anemia, Aplastic Anemia, Agranulocytosis, Thrombocytopenia, Photosensitivity, Exfoliative Dermatitis, Stevens-Johnson Syndrome, and Epidermal Necrolysis.
• Take medication with water, increase daily water intake, and take this medication with food.
• Ensure the patient understands to take the full antibiotic course to decrease risk of antibiotic resistance.

Antibiotic Sulfonamide

MoA: Disrupts folic acid synthesis to prevent bacterial replication.

Indications: Gram(+,-) Bacteria, UTI, HIV-associated Pneumonia, Staphylococcus Infections, MRSA

Contraindications: Pregnant Women, Infants

Side Effects: Headache, GI Distress

Drug Interactions: Celebrex, Alcohol

Nursing Implications:

• Educate the patient on complications such as: Hemolytic Anemia, Aplastic Anemia, Agranulocytosis, Thrombocytopenia, Photosensitivity, Exfoliative Dermatitis, Stevens-Johnson Syndrome, and Epidermal Necrolysis.
• Take medication with water, increase daily water intake, and take this medication with food.
• Ensure the patient understands to take the full antibiotic course to decrease risk of antibiotic resistance.

Antibiotic DMARD Sulfonamide

MoA: Disrupts folic acid synthesis to prevent bacterial replication. Inhibits immune and inflammatory response.

Indications: Gram(+,-) Bacteria, UTI, HIV-associated Pneumonia, Staphylococcus Infections, MRSA

Contraindications: Pregnant Women, Infants

Side Effects: Headache, GI Distress

Drug Interactions: Celebrex, Alcohol

Nursing Implications:

• Educate the patient on complications such as: Hemolytic Anemia, Aplastic Anemia, Agranulocytosis, Thrombocytopenia, Photosensitivity, Exfoliative Dermatitis, Stevens-Johnson Syndrome, and Epidermal Necrolysis.
• Take medication with water, increase daily water intake, and take this medication with food.
• Ensure the patient understands to take the full antibiotic course to decrease risk of antibiotic resistance.

Antibiotic Penicillin

MoA: Inhibits bacterial enzymes that synthesize cellular walls.

Indications: Gram(+) Bacteria, Syphilis

Contraindications: Cephalosporin Allergy

Side Effects: Headache, GI Distress

Drug Interactions: Oral Contraceptives, Warfarin, Orange Juice, Grapefruit Juice, Alcohol

Nursing Implications:

• Take medication with water, increase daily water intake, and take this medication with food.
• Monitor for GI distress as Clostridium Difficile (C.diff) can occur when taking antibiotics.
• Take the full antibiotic course to decrease risk of antibiotic resistance.

Antibiotic Penicillin Aminopenicillin

MoA: Inhibits bacterial enzymes that synthesize cellular walls.

Indications: Gram(+,-) Bacteria, ENT Infection, Skin Infection

Contraindications: Cephalosporin Allergy

Side Effects: Headache, GI Distress

Drug Interactions: Oral Contraceptives, Warfarin, Orange Juice, Grapefruit Juice, Alcohol

Nursing Implications:

• Take medication with water, increase daily water intake, and take this medication with food.
• Monitor for GI distress as Clostridium Difficile (C.diff) can occur when taking antibiotics.
• Take the full antibiotic course to decrease risk of antibiotic resistance.

Antibiotic Aminopenicillin

MoA: Inhibits bacterial enzymes that synthesize cellular walls.

Indications: Gram(+,-) Bacteria, UTI, Meningitis, Pneumonia, ENT Infection, Bronchitis

Contraindications: Cephalosporin Allergy

Side Effects: Headache, GI Distress

Drug Interactions: Oral Contraceptives, Warfarin, Orange Juice, Grapefruit Juice, Alcohol

Nursing Implications:

• Take medication with water, increase daily water intake, and take this medication with food.
• Monitor for GI distress as Clostridium Difficile (C.diff) can occur when taking antibiotics.
• Take the full antibiotic course to decrease risk of antibiotic resistance.

Antibiotic Pencillin Extended Spectrum-Resistant

MoA: Inhibits bacterial enzymes involved with synthesizing cellular walls.

Indications: Gram(+,-) Bacteria, Anaerobic Bacteria, Pneumonia, Skin Infection

Contraindications: Cephalosporin Allergy

Side Effects: Headache, GI Distress

Drug Interactions: Oral Contraceptives, Warfarin, Orange Juice, Grapefruit Juice, Alcohol

Nursing Implications:

• Take medication with water, increase daily water intake, and take this medication with food.
• Monitor for GI distress as Clostridium Difficile (C.diff) can occur when taking antibiotics.
• Take the full antibiotic course to decrease risk of antibiotic resistance.

Psych Agent

MoA: Triggers an alcohol sensitivity reaction by blocking the metabolism of acetaldehyde.

Indications: Alcoholism

Contraindications: Pregnant Women

Side Effects: Drowsiness, Blurred Vision

Nursing Implications:

• This medication should not be taken with alcoholic beverages or other products that contain alcohol.
• Educate patient to take this medication at bedtime to avoid day time drowsiness

Antibiotic 1st Gen. Cephalosporin

MoA: Induces bactericidal effects by binding to bacteria with a beta-lactam ring. Resists beta-lactamase destruction.

Indications: Gram(+) Bacteria, Pneumonia, Surgery Prophylaxis, Staphylococcus Infection

Contraindications: Penicillin Allergy

Side Effects: Headache, GI Distress

Drug Interactions: Orange Juice, Grapefruit Juice, Alcohol

Nursing Implications:

• Take medication with water, increase daily water intake, and take this medication with food.
• Educate the patient to avoid alcohol consumption due to increased risk of Disulfiram (Antabuse) Reaction.
• Monitor for GI distress as Clostridium Difficile (C.diff) can occur when taking antibiotics.
• Take the full antibiotic course to decrease risk of antibiotic resistance.

Antibiotic 1st Gen. Cephalosporin

MoA: Induces bactericidal effects by binding to bacteria with a beta-lactam ring. Resists beta-lactamase destruction.

Indications: Gram(+) Bacteria, Surgery Prophylaxis, Staphylococcus Infection

Contraindications: Penicillin Allergy

Side Effects: Headache, GI Distress

Drug Interactions: Orange Juice, Grapefruit Juice, Alcohol

Nursing Implications:

• Take medication with water, increase daily water intake, and take this medication with food.
• Educate the patient to avoid alcohol consumption due to increased risk of Disulfiram (Antabuse) Reaction.
• Monitor for GI distress as Clostridium Difficile (C.diff) can occur when taking antibiotics.
• Take the full antibiotic course to decrease risk of antibiotic resistance.

Antibiotic 2nd Gen. Cephalosporin

MoA: Induces bactericidal effects by binding to bacteria with a beta-lactam ring. Resists beta-lactamase destruction.

Indications: Gram(+,-) Bacteria, Pneumonia, Anaerobic Bacteria, Surgery Prophylaxis

Contraindications: Penicillin Allergy

Side Effects: Headache, GI Distress

Drug Interactions: Orange Juice, Grapefruit Juice, Alcohol

Nursing Implications:

• Take medication with water, increase daily water intake, and take this medication with food.
• Educate the patient to avoid alcohol consumption due to increased risk of Disulfiram (Antabuse) Reaction.
• Monitor for GI distress as Clostridium Difficile (C.diff) can occur when taking antibiotics.
• Take the full antibiotic course to decrease risk of antibiotic resistance.

Antibiotic 2nd Gen. Cephalosporin

MoA: Induces bactericidal effects by binding to bacteria with a beta-lactam ring. Resists beta-lactamase destruction.

Indications: Gram(+,-) Bacteria, Pneumonia, Surgery Prophylaxis, Hib Infection

Contraindications: Penicillin Allergy

Side Effects: Headache, GI Distress

Drug Interactions: Orange Juice, Grapefruit Juice, Alcohol

Nursing Implications:

• Take medication with water, increase daily water intake, and take this medication with food.
• Educate the patient to avoid alcohol consumption due to increased risk of Disulfiram (Antabuse) Reaction.
• Monitor for GI distress as Clostridium Difficile (C.diff) can occur when taking antibiotics.
• Take the full antibiotic course to decrease risk of antibiotic resistance.

Antibiotic 3rd Gen. Cephalosporin

MoA: Induces bactericidal effects by binding to bacteria with a beta-lactam ring. Resists beta-lactamase destruction.

Indications: Bacterial Meningitis, Pneumonia, Hib Infection

Contraindications: Penicillin Allergy, Liver Impairment

Side Effects: Headache, GI Distress

Drug Interactions: Orange Juice, Grapefruit Juice, Alcohol

Nursing Implications:

• Take medication with water, increase daily water intake, and take this medication with food.
• Educate the patient to avoid alcohol consumption due to increased risk of Disulfiram (Antabuse) Reaction.
• Monitor for GI distress as Clostridium Difficile (C.diff) can occur when taking antibiotics.
• Take the full antibiotic course to decrease risk of antibiotic resistance.

Antibiotic 3rd Gen. Cephalosporin

MoA: Induces bactericidal effects by binding to bacteria with a beta-lactam ring. Resists beta-lactamase destruction.

Indications: Gram(-) Bacteria, Pneumonia

Contraindications: Penicillin Allergy

Side Effects: Headache, GI Distress

Drug Interactions: Orange Juice, Grapefruit Juice, Alcohol

Nursing Implications:

• Take medication with water, increase daily water intake, and take this medication with food.
• Educate the patient to avoid alcohol consumption due to increased risk of Disulfiram (Antabuse) Reaction.
• Monitor for GI distress as Clostridium Difficile (C.diff) can occur when taking antibiotics.
• Take the full antibiotic course to decrease risk of antibiotic resistance.

Antibiotic 4th Gen. Cephalosporin

MoA: Induces bactericidal effects by binding to bacteria with a beta-lactam ring. Resists beta-lactamase destruction.

Indications: Urinary Tract Infection, Pneumonia

Contraindications: Penicillin Allergy

Side Effects: Headache, GI Distress

Drug Interactions: Orange Juice, Grapefruit Juice, Alcohol

Nursing Implications:

• Take medication with water, increase daily water intake, and take this medication with food.
• Educate the patient to avoid alcohol consumption due to increased risk of Disulfiram (Antabuse) Reaction.
• Monitor for GI distress as Clostridium Difficile (C.diff) can occur when taking antibiotics.
• Take the full antibiotic course to decrease risk of antibiotic resistance.

Antibiotic 5th Gen. Cephalosporin

MoA: Induces bactericidal effects by binding to bacteria with a beta-lactam ring. Resists beta-lactamase destruction.

Indications: MRSA, Pneumonia

Contraindications: Penicillin Allergy

Side Effects: Headache, GI Distress

Drug Interactions: Orange Juice, Grapefruit Juice, Alcohol

Nursing Implications:

• Take medication with water, increase daily water intake, and take this medication with food.
• Educate the patient to avoid alcohol consumption due to increased risk of Disulfiram (Antabuse) Reaction.
• Monitor for GI distress as Clostridium Difficile (C.diff) can occur when taking antibiotics.
• Take the full antibiotic course to decrease risk of antibiotic resistance.

Antibiotic Carbapenem

MoA: Uses a beta-lactam ring to bind to the cellular wall and induce bactericidal effects.

Indications: Abdominal Infection, UTI, Pneumonia

Side Effects: Pruritus, Rash

Drug Interactions: Alcohol

Nursing Implications:

• This drug increases the risk of seizures. Educate the patient about seizure precautions.
• Monitor for GI distress as Clostridium Difficile (C.diff) can occur when taking antibiotics.
• Take the full antibiotic course to decrease risk of antibiotic resistance.

Antibiotic Carbapenem

MoA: Use a beta-lactam ring to bind to the cellular wall and induce bactericidal effects.

Indications: Bacterial Meningitis

Side Effects: Pruritus, Rash

Drug Interactions: Alcohol

Nursing Implications:

• This drug increases the risk of seizures. Educate the patient about seizure precautions.
• Monitor for GI distress as Clostridium Difficile (C.diff) can occur when taking antibiotics.
• Take the full antibiotic course to decrease risk of antibiotic resistance.

Antacid H2 Antagonist

MoA: Block histamine-2 receptors on parietal cells to decrease release of hydrogen ions.

Indications: Peptic Ulcer Disease, GERD, Esophagitis, Upper GI Bleed

Side Effects: GI Distress, Headache, Dizziness

Drug Interactions: Alcohol

Nursing Implications:

• Monitor this patient for signs of thrombocytopenia in addition to assessing renal and liver function labs.
• Take H2 Antagonists 1-2hrs prior to antacids.
• Educate patient on smoking cessation.

Antibiotic Fluoroquinolone

MoA: Alters DNA synthesis to induce bactericidal effects.

Indications: Anthrax, Gram(-) Bacteria, Urinary Tract Infection, Respiratory Infection, Musculoskeletal Infection, GI Infection, Skin Infection

Side Effects: Dizziness, GI Distress, Thrush

Drug Interactions: Sucralfate, Antacids, Iron Salts, Dairy Products, Probenecid, Nitrofurantoin, Anticoagulants, Alcohol

Nursing Implications:

• This medication can cause ruptured tendons and tendinitis.
• Take this medication with water.
• Drugs that negatively interact with quinolones may be consumed 1hr before or 1hr after quinolone intake.
• Monitor ECG for Prolonged QT interval.
• Assess for signs of Thrush: white patches in the mouth, cheilitis, and loss of taste.
• Monitor for GI distress as Clostridium Difficile (C.diff) can occur when taking antibiotics.
• Take the full antibiotic course to decrease risk of antibiotic resistance.

Bronchodilator Xanthine Derivative

MoA: Stimulates the CNS and relax bronchiole smooth muscle to dilate airway.

Indications: Asthma, Chronic Bronchitis, Emphysema

Side Effects: GI Distress, Dizziness, Hyperglycemia

Drug Interactions: Cimetidine, Ciprofloxacin, Caffeine, Phenobarbital, Phenytoin

Nursing Implications:

• Educate the patient about avoiding caffeine.
• This medication is not for management of an acute attack.
• Therapeutic range of this medication: 10-20 mcg/mL.
• Monitor for toxicity: seizures and arrhythmias.
• For respiratory indications, use bronchodilators before corticosteroids.

Immunosuppressant

MoA: Inhibits immune cell activation to prevent tissue rejection and autoimmune flare up.

Indications: Organ Transplant, Autoimmune Disorders

Side Effects: Hypertension, Hirsutism, Tremors

Drug Interactions: Milk, St. John's Wort

Nursing Implications:

• Monitor for Renal Impairment, Liver Impairment, Seizures, and Skin Cancer.
• Do not mix this medication in a styrofoam cup as it can decrease effectiveness.
• Monitor WBC counts throughout therapy as patients have an increased risk for infection.
• When indicated for transplantation, this is a lifelong medication.

Anticonvulsant

MoA: Suppresses transmission of nerve impulses.

Indications: Generalized Seizures, Partial Seizures, Bipolar Disorder

Side Effects: Drowsiness, Nystagmus, Diplopia

Drug Interactions: Warfarin, Grapefruit Juice

Nursing Implications:

• Monitor for altered blood counts: thrombocytopenia, anemia, and leukopenia.
• Monitor for SIADH: weight gain, hyponatremia, seizures, and altered mental status.

Antibiotic Macrolide

MoA: Induces bacteriostatic and bactericidal effects by binding to 50S ribosomal subunits and inhibiting protein synthesis.

Indications: Streptococcal Infection, Upper and Lower Respiratory Tract Infection, Syphilis, Lyme Disease, Gonorrhea, Chlamydia, Mycoplasma Infection

Side Effects: GI Distress

Drug Interactions: Oral Contraceptives, Carbamazepine, Cyclosporine, Theophylline, Warfarin, Alcohol

Nursing Implications:

• Take this medication with food to decrease GI distress.
• Assess ECG for QT prolongation.
• Monitor for Hepatotoxicity: elevated liver enzymes, jaundice, dark urine, and vomiting.
• Monitor for GI distress as Clostridium Difficile (C.diff) can occur when taking antibiotics.
• Take the full antibiotic course to decrease risk of antibiotic resistance.

Antibiotic Macrolide

MoA: Induces bacteriostatic and bactericidal effects by binding to 50S ribosomal subunits and inhibiting protein synthesis.

Indications: Streptococcal Infection, Upper and Lower Respiratory Tract Infection, Syphilis, Lyme Disease, Gonorrhea, Chlamydia, Mycoplasma Infection

Side Effects: GI Distress

Drug Interactions: Oral Contraceptives, Carbamazepine, Cyclosporine Theophylline, Warfarin, Alcohol

Nursing Implications:

• Take this medication with food to decrease GI distress.
• Assess ECG for QT prolongation.
• Monitor for Hepatotoxicity: elevated liver enzymes, jaundice, dark urine, and vomiting.
• Monitor for GI distress as Clostridium Difficile (C.diff) can occur when taking antibiotics.
• Take the full antibiotic course to decrease risk of antibiotic resistance.

Antibiotic Macrolide

MoA: Induces bacteriostatic and bactericidal effects by binding to 50S ribosomal subunits and inhibiting protein synthesis.

Indications: Streptococcal Infection, Upper and Lower Respiratory Tract Infection, Syphilis, Lyme Disease, Gonorrhea, Chlamydia, Mycoplasma Infection

Side Effects: GI Distress

Drug Interactions: Oral Contraceptives, Carbamazepine, Cyclosporine, Theophylline, Warfarin, Alcohol

Nursing Implications:

• Take this medication with food to decrease GI distress.
• Assess ECG for QT prolongation.
• Monitor for Hepatotoxicity: elevated liver enzymes, jaundice, dark urine, and vomiting.
• Monitor for GI distress as Clostridium Difficile (C.diff) can occur when taking antibiotics.
• Take the full antibiotic course to decrease risk of antibiotic resistance.

Antibiotic Tetracycline

MoA: Induces bacteriostatic activity by inhibiting protein synthesis.

Indications: Gram(+,-) Bacteria, Protozoa Infection, Chlamydia, Syphilis, Lyme Disease, Acne

Contraindications: Pregnant Women, Children, Nursing Infants

Side Effects: Dizziness, Headache, Loss of Appetite, GI Distress

Drug Interactions: Dairy Products, Antacids, Iron Salts, Oral Contraceptives, Alcohol

Nursing Implications:

• Take this medication with water, on an empty stomach, and not with other medications.
• This drug can cause photosensitivity. Educate patient to use skin protection to prevent sunburns.
• Monitor for GI distress as Clostridium Difficile (C.diff) can occur when taking antibiotics.
• Take the full antibiotic course to decrease risk of antibiotic resistance.

Antibiotic Tetracycline

MoA: Induces bacteriostatic activity by inhibiting protein synthesis.

Indications: Gram(+,-) Bacteria, Protozoa Infection, Chlamydia, Syphilis, Lyme Disease, Acne

Contraindications: Pregnant Women, Children, Nursing Infants

Side Effects: GI Distress

Drug Interactions: Dairy Products, Antacids, Iron Salts, Oral Contraceptives, Alcohol

Nursing Implications:

• Take this medication with water, on an empty stomach, and not with other medications.
• This drug can cause photosensitivity. Educate patient to use skin protection to prevent sunburns.
• Monitor for GI distress as Clostridium Difficile (C.diff) can occur when taking antibiotics.
• Take the full antibiotic course to decrease risk of antibiotic resistance.

Antibiotic Tetracycline

MoA: Induces bacteriostatic activity by inhibiting protein synthesis.

Indications: Gram(+,-) Bacteria, Protozoa Infection, Chlamydia, Syphilis, Lyme Disease, Acne

Contraindications: Pregnant Women, Children, Nursing Infants

Side Effects: Dizziness, Headache, GI Distress

Drug Interactions: Dairy Products, Antacids, Iron Salts, Oral Contraceptives, Alcohol

Nursing Implications:

• Take this medication with water, on an empty stomach, and not with other medications.
• This drug can cause photosensitivity. Educate patient to use skin protection to prevent sunburns.
• Monitor for GI distress as Clostridium Difficile (C.diff) can occur when taking antibiotics.
• Take the full antibiotic course to decrease risk of antibiotic resistance.

Antibiotic Tetracycline

MoA: Induces bacteriostatic activity by inhibiting protein synthesis.

Indications: Gram(+,-) Bacteria, Protozoa Infection, Chlamydia, Syphilis, Lyme Disease, Acne

Contraindications: Pregnant Women, Children, Nursing Infants

Side Effects: Dizziness, Loss of Appetite, GI Distress

Drug Interactions: Dairy Products, Antacids, Iron Salts, Oral Contraceptives, Alcohol

Nursing Implications:

• Take this medication with water, on an empty stomach, and not with other medications.
• This drug can cause photosensitivity. Educate patient to use skin protection to prevent sunburns.
• Monitor for GI distress as Clostridium Difficile (C.diff) can occur when taking antibiotics.
• Take the full antibiotic course to decrease risk of antibiotic resistance.

Antibiotic Glycycline

MoA: Induces bacteriostatic activity by inhibiting protein synthesis.

Indications: MRSA, Abdominal Infections

Contraindications: Pregnant Women, Children, Nursing Infants

Side Effects: GI Distress

Drug Interactions: Dairy Products, Antacids, Iron Salts, Oral Contraceptives, Alcohol

Nursing Implications:

• This medication is an injection only medication.
• This drug can cause photosensitivity. Educate patient to use skin protection to prevent sunburns.
• Monitor for GI distress as Clostridium Difficile (C.diff) can occur when taking antibiotics.
• Take the full antibiotic course to decrease risk of antibiotic resistance.

Antibiotic Aminoglycoside

MoA: Induces bactericidal effects by binding to ribosomal subunits.

Indications: Gram(+,-) Bacteria

Contraindications: Pregnant Women

Side Effects: GI Distress

Drug Interactions: Alcohol

Nursing Implications:

• Take this medication with water.
• Monitor for Nephrotoxicity: assess renal panel and urinary tract abnormalities.
• Monitor for Ototoxicity: tinnitus and decreased hearing.
• Ensure the patient understands to take the full antibiotic course to decrease risk of antibiotic resistance.

Antibiotic Aminoglycoside

MoA: Induces bactericidal effects by binding to ribosomal subunits.

Indications: Gram(+,-) Bacteria

Contraindications: Pregnant Women

Side Effects: GI Distress

Drug Interactions: Alcohol

Nursing Implications:

• Take this medication with water.
• Monitor for Nephrotoxicity: assess renal panel and urinary tract abnormalities.
• Monitor for Ototoxicity: tinnitus and decreased hearing.
• Ensure the patient understands to take the full antibiotic course to decrease risk of antibiotic resistance.

Antibiotic Aminoglycoside

MoA: Induces bactericidal effects by binding to ribosomal subunits.

Indications: Gram(+,-) Bacteria

Contraindications: Pregnant Women

Side Effects: GI Distress

Drug Interactions: Alcohol

Nursing Implications:

• Take this medication with water.
• Monitor for Nephrotoxicity: assess renal panel and urinary tract abnormalities.
• Monitor for Ototoxicity: tinnitus and decreased hearing.
• Ensure the patient understands to take the full antibiotic course to decrease risk of antibiotic resistance.

Antibiotic Aminoglycoside

MoA: Induces bactericidal effects by binding to ribosomal subunits.

Indications: Gram(+,-) Bacteria

Contraindications: Pregnant Women

Side Effects: GI Distress

Drug Interactions: Alcohol

Nursing Implications:

• Take this medication with water.
• Monitor for Nephrotoxicity: assess renal panel and urinary tract abnormalities.
• Monitor for Ototoxicity: tinnitus and decreased hearing.
• Ensure the patient understands to take the full antibiotic course to decrease risk of antibiotic resistance.

Antibiotic

MoA: Induces bactericidal effects to disrupt nucleic acid synthesis.

Indications: Uncomplicated UTI

Side Effects: Dizziness, Headache

Drug Interactions: Alcohol

Nursing Implications:

• It is important to monitor liver and renal function by assessing the patient and reviewing appropriate lab results.
• Monitor for Hepatotoxicity: elevated liver enzymes, jaundice, dark urine, and vomiting.
• Take this medication with water.
• Monitor for GI distress as Clostridium Difficile (C.diff) can occur when taking antibiotics.
• Take the full antibiotic course to decrease risk of antibiotic resistance.

Acid Controlling Drug

MoA: Binds to the base of ulcers to form a protective barrier against pepsin.

Indications: Stress Ulcer, Peptic Ulcer Disease, Chronic Renal Failure

Side Effects: GI Distress

Nursing Implications:

• Take this medication with water, on an empty stomach, and not with other medications.

Antibiotic Fluoroquinolone

MoA: Alters DNA synthesis to induce bactericidal effects.

Indications: Gram(-) Bacteria, Urinary Tract Infection, Respiratory Infection, Musculoskeletal Infection, GI Infection, Skin Infection

Side Effects: GI Distress

Drug Interactions: Sucralfate, Antacids, Iron Salts, Dairy Products, Probenecid, Nitrofurantoin, Anticoagulants, Alcohol

Nursing Implications:

• This medication can cause ruptured tendons and tendinitis.
• Take this medication with water.
• Drugs that negatively interact with quinolones may be consumed 1hr before or 1hr after quinolone intake.
• Monitor ECG for Prolonged QT interval.
• Assess for signs of Thrush: white patches in the mouth, cheilitis, and loss of taste.
• Monitor for GI distress as Clostridium Difficile (C.diff) can occur when taking antibiotics.
• Take the full antibiotic course to decrease risk of antibiotic resistance.

Anticholinesterase

MoA: Blocks acetylcholinesterase from breaking down acetylcholine.

Indications: Myasthenia Gravis, Neuromuscular Blocker Toxicity

Side Effects: Dizziness, Bronchospasm, Diaphoresis, Blurred Vision

Nursing Implications:

• Take 30-minutes before eating to improve chewing and swallowing.
• Do not stop this medication abruptly.
• Patient is at risk for Cholinergic Crisis. Monitor for salivation, lacrimation, urinary incontinence, diarrhea, GI cramps, and emesis (SLUDGE).
• Atropine should be readily available for a cholinergic crisis.

Neuromusclar Blocker Non-Depolarizing Drug

MoA: Induces muscle paralysis by binding to nicotinic receptors to block acetylcholine and inhibit nerve transmission at the neruomuscular junction.

• Cholinergic receptors stimulate urinary and gastrointestinal activity, constrict pupils, increase salivation, constrict bronchioles, and decrease heart rate.
• Nicotinic receptors are a type of cholinergic receptor that promote nerve transmission.

Indications: Endotracheal Intubation, Surgery

Side Effects: Muscle Weakness

Nursing Implications:

• Long term use of this medication can result in prolonged paralysis and difficulty weaning from mechanical ventilation.
• A common antidote used to reverse toxic effects of neuromuscular blockers is Neostigmine (Prostigmin).
• If the patient is Pre-Op, educate the patient about turning, coughing, and deep breathing after surgery.

Antibiotic Antiacne Lincosamide

MoA: Binds to ribosomal subunits in bacteria to inhibit protein synthesis.

Indications: Ear Infection, Peritonitis, Abscess, Abdominal Infection, Acne

Side Effects: Arthralgia, GI Distress, Pruritus

Drug Interactions: Vecuronium, Alcohol

Nursing Implications:

• Take this medication with water.
• Monitor for GI distress as Clostridium Difficile (C.diff) can occur when taking antibiotics.
• Take the full antibiotic course to decrease risk of antibiotic resistance.

Antibiotic Glycopeptide

MoA: Binds to the cellular wall to block bacterial replication.

Indications: MRSA, Gram(+) Bacteria, Clostridium Difficile, Staphylococcus Enterocolitis

Side Effects: GI Distress

Drug Interactions: Neuromuscular Blockers, Alcohol

Nursing Implications:

• This medication must be administered over 1hr or greater. Draw trough levels prior to next IV dose. Therapeutic range: 10-20 mg/L.
• Monitor for Nephrotoxicity: assess renal panel and urinary tract abnormalities.
• Monitor for Ototoxicity: tinnitus and decreased hearing.
• Administering too quickly can cause Red Man Syndrome: facial flushing, rash, and pruritus.
• Take this medication with water.
• Take the full antibiotic course to decrease risk of antibiotic resistance.

Antibiotic Oxazolidinones

MoA: Binds to ribosomal subunits in bacteria to inhibit protein synthesis.

Indications: Vancomycin Resistant Enterococcus Faecium, Hospital Associated Infections, Skin Infection, MRSA

Side Effects: GI Distress, Dizziness

Drug Interactions: Alcohol

Nursing Implications:

• Educate patient on tyramine-restricted diet. Avoid foods such as cheese, sherry, pickled foods, stimulants, and cured meats due to increased risk for serotonin syndrome.
• Take this medication with water.
• Monitor for GI distress as Clostridium Difficile (C.diff) can occur when taking antibiotics.
• Take the full antibiotic course to decrease risk of antibiotic resistance.

Analgesic Antitussive Opioid Agonist

MoA: Binds directly to opioid receptors to decrease pain response. Supresses the cough reflex in the medulla. Increases viscosity of respiratory secretions and dries mucosa of respiratory tract.

Indications: Acute Pain, Chronic Pain, Non-Productive Cough

Contraindications: Asthma

Side Effects: Constipation, Diaphoresis, Flushing, Pruritus

Drug Interactinos: Alcohol, Antihistamines, Barbiturates, Benzodiazepines, MAOIs

Nursing Implications:

• Opioids are a Schedule 2 Controlled Substance.
• Assess pain and respiratory status before and after administration. Patient is at risk for respiratory depression.
• Instruct patients to change positions slowly due to risk of falls.
• Monitor the patient for bowel movements as opioid usage can induce constipation.
• This medication can increase intracranial pressure or exacerbate COPD.
• Understand that Opioid Agonists have a no ceiling effect.

Analgesic Antitussive Opioid Agonist

MoA: Binds directly to opioid receptors to decrease pain response. Supresses the cough reflex in the medulla. Increases viscosity of respiratory secretions and dries mucosa of respiratory tract.

Indications: Acute Pain, Chronic Pain, Non-Productive Cough

Contraindications: Asthma

Side Effects: Constipation, Diaphoresis, Pruritus

Drug Interactinos: Alcohol, Antihistamines, Barbiturates, Benzodiazepines, MAOIs

Nursing Implications:

• Opioids are a Schedule 2 Controlled Substance.
• Assess pain and respiratory status before and after administration. Patient is at risk for respiratory depression.
• Instruct patients to change positions slowly due to risk of falls.
• Monitor the patient for bowel movements as opioid usage can induce constipation.
• Monitor for elevated intracranial pressure.
• Understand that Opioid Agonists have a no ceiling effect.

Analgesic Opioid Agonist

MoA: Binds directly to opioid receptors to decrease pain response.

Indications: Acute Pain, Chronic Pain

Contraindications: Asthma

Side Effects: Constipation, Diaphoresis, Pruritus

Drug Interactinos: Alcohol, Antihistamines, Barbiturates, Benzodiazepines, MAOIs

Nursing Implications:

• Opioids are a Schedule 2 Controlled Substance.
• Assess pain and respiratory status before and after administration. Patient is at risk for respiratory depression.
• Instruct patients to change positions slowly due to risk of falls.
• Monitor the patient for bowel movements as opioid usage can induce constipation.
• Monitor for elevated intracranial pressure.
• Understand that Opioid Agonists have a no ceiling effect.

Analgesic Opioid Agonist

MoA: Binds directly to opioid receptors to decrease pain response.

Indications: Acute Pain, Chronic Pain, Myocardial Infarction

Contraindications: Asthma

Side Effects: Constipation, Flushing

Drug Interactinos: Alcohol, Antihistamines, Barbiturates, Benzodiazepines, MAOI

Nursing Implications:

• Opioids are a Schedule 2 Controlled Substance.
• Assess pain and respiratory status before and after administration. Patient is at risk for respiratory depression.
• Instruct patients to change positions slowly due to risk of falls.
• Monitor the patient for bowel movements as opioid usage can induce constipation.
• Monitor for elevated intracranial pressure.
• Understand that Opioid Agonists have a no ceiling effect.

Analgesic Opioid Agonist

MoA: Binds directly to opioid receptors to decrease pain response.

Indications: Acute Pain, Chronic Pain

Contraindications: Asthma

Side Effects: Constipation, Dizziness

Drug Interactinos: Alcohol, Antihistamines, Barbiturates, Benzodiazepines, MAOIs

Nursing Implications:

• Opioids are a Schedule 2 Controlled Substance.
• Assess pain and respiratory status before and after administration. Patient is at risk for respiratory depression.
• Instruct patients to change positions slowly due to risk of falls.
• Monitor the patient for bowel movements as opioid usage can induce constipation.
• Monitor for elevated intracranial pressure.
• Understand that Opioid Agonists have a no ceiling effect.

Analgesic Opioid Agonist

MoA: Binds directly to opioid receptors to decrease pain response.

Indications: Acute Pain, Chronic Pain

Contraindications: Asthma

Side Effects: Constipation, Diaphoresis

Drug Interactinos: Alcohol, Antihistamines, Barbiturates, Benzodiazepines, MAOIs

Nursing Implications:

• Opioids are a Schedule 2 Controlled Substance.
• Assess pain and respiratory status before and after administration. Patient is at risk for respiratory depression.
• Instruct patients to change positions slowly due to risk of falls.
• Monitor the patient for bowel movements as opioid usage can induce constipation.
• Monitor for elevated intracranial pressure.
• Understand that Opioid Agonists have a no ceiling effect.

Analgesic Opioid Agonist

MoA: Binds directly to opioid receptors to decrease pain response.

Indications: Acute Pain, Chronic Pain

Contraindications: Asthma

Side Effects: Constipation, Diaphoresis, Flushing, Pruritus

Drug Interactinos: Alcohol, Antihistamines, Barbiturates, Benzodiazepines, MAOIs

Nursing Implications:

• Opioids are a Schedule 2 Controlled Substance.
• Assess pain and respiratory status before and after administration. Patient is at risk for respiratory depression.
• Instruct patients to change positions slowly due to risk of falls.
• Monitor the patient for bowel movements as opioid usage can induce constipation.
• Monitor for elevated intracranial pressure.
• Understand that Opioid Agonists have a no ceiling effect.

Analgesic Opioid Mixed Agonist-Antagonist

MoA: Binds and blocks separate opioid receptors to induce pain relieving effects.

Indications: Obstetric Pain

Contraindications: Asthma

Side Effects: Constipation, Diaphoresis, Drowsiness

Drug Interactinos: Alcohol, Antihistamines, Barbiturates, Benzodiazepines, MAOIs

Nursing Implications:

• Opioids are a Schedule 2 Controlled Substance.
• Assess pain and respiratory status before and after administration. Patient is at risk for respiratory depression.
• Instruct patients to change positions slowly due to risk of falls.
• Monitor the patient for bowel movements as opioid usage can induce constipation.
• Monitor for elevated intracranial pressure.
• Understand that Opioid Agonists have a no ceiling effect.

Analgesic Opioid Mixed Agonist-Antagonist

MoA: Bind and block separate opioid receptors to induce pain relieving effects.

Indications: Obstetric Pain

Contraindications: Asthma

Side Effects: Constipation, Diaphoresis, Flushing

Drug Interactinos: Alcohol, Antihistamines, Barbiturates, Benzodiazepines, MAOIs

Nursing Implications:

• Opioids are a Schedule 2 Controlled Substance.
• Assess pain and respiratory status before and after administration. Patient is at risk for respiratory depression.
• Instruct patients to change positions slowly due to risk of falls.
• Monitor the patient for bowel movements as opioid usage can induce constipation.
• Monitor for elevated intracranial pressure.
• Understand that Opioid Agonists have a no ceiling effect.

Analgesic Opioid Antagonist

MoA: Competes for opioid receptors to reduce opiate inducing effects.

Indications: Opiate Overdose

Side Effects: Aching, Irritability

Nursing Implications:

• This medication should be readily available in case of severe respiratory or CNS depression indicating overdose.

Analgesic Opioid Antagonist

MoA: Competes for opioid receptors to reduce opiate inducing effects.

Indications: Opiate Overdose

Side Effects: Aching, Irritability, Diaphoresis

Nursing Implications:

• This medication can reverse severe respiratory or CNS system depression.
• Naloxone (Narcan) has a short half-life and may require a second dose.

Analgesic

MoA: Inhibits prostaglandin production to reduce fever and induce pain relieving effects.

Indications: Mild-Moderate Pain, Fever

Contraindications: Liver Impairment

Side Effects: GI Distress, Loss of Appetite, Clay-Colored Stools, Pruritus

Nursing Implications:

• The antidote to Acetaminophen (Tylenol) overdose is Acetylcysteine (Mucomyst).
• Monitor renal panel.
• Monitor for Hepatotoxicity: elevated liver enzymes, jaundice, dark urine, and vomiting.
• Educate patients about consuming a maximum of 3000mg per day. For patients with liver impairment, they should be instructed to consume a maximum of 2000mg per day.

Blood Product

Indications: Hemorrhage Prevention, Thrombocytopenia

Transfusion Reaction:

• Immune Hemolytic Reaction: Monitor for chills, shortness of breath, flank pain, chest pain, tachycardia, and flushing.
• Non-Immune Hemolytic Reaction: Monitor for fever, chills, hives, and pruritus.
• Transfusion Related Acute Lung Injury: Monitor for hypoxemia, dyspnea, cyanosis, hypotension, and crackles.
• Anaphylactic Reaction: Monitor for hypotension, dyspnea, wheezing, hives, and pruritus.

Nursing Implications:

• Vitals are obtained 15-minutes before infusion, 15-minutes after the start of infusion, every hour during transfusion process, and after transfusion has completed.
• Obtain a patient informed consent form that was signed, acknowledged, and approved.
• Monitor for signs of fluid overload such as respiratory distress, weight gain, edema, hypertension, and tachycardia.
• It is important to check hospital policy regarding transfusion protocols. Common procedures include a 2-RN verification, maximum of a 4hr blood product hang time, administering product within 30-minutes of reception, following standard medication rights, and more.

Analgesic Antipyreitc Antiplatelet Anti-inflammatory NSAID - Saliycylate

MoA: Acts as an irreversible inhibitor of cycloxygenase-1 and thromboxane-2 to decrease platelet aggregation and block prostaglandin synthesis for fever or inflammation.

Indications: Headache, Neuralgia, Myalgia, Arthralgia, Arthritis, Rheumatic Fever, Pericarditis, Systemic Lupus Erythematosus

Contraindications: Asthma, Liver Impairment, Renal Impairment, Bleeding, Peptic Ulcer Disease, Anemia

Side Effects: GI Distress, Loss of Appetite, Light-Colored Stools

Drug Interactions: Anticoagulants, Diuretics

Nursing Implications:

• NSAIDs are commonly taken with food, milk, or an antacid to decrease GI irritation and increase absorption.
• This medication increases the risk for bleeding. Signs of bleeding include: black tarry stools, bleeding gums, hematuria, and bruising.
• Hold this medication if platelet level is under 150,000/μL.
• Monitor for toxicity: tachycardia, tinnitus, hearing loss, confusion, drowsiness, and hyperventilation.
• Activated charcoal and IV Sodium Bicarbonate can be used to reverse Salicyclate poisoning.
• Long term use of this medication can lead to Chronic Kidney Disease, Stomach Ulcers.
• Monitor for Reye's Syndrome in children.
• This medication can trigger bronchospasms in asthmatic clients.

Analgesic NSAID - Acetic Acid Derivative

MoA: Inhibits prostaglandin synthesis by blocking cyclooxygenase-1 and cyclooxygenase-2.

Indications: Rheumatoid Arthritis, Osteoarthritis, Acute Bursitis, Tendonitis, Ankylosing Spondylitis, Gout, Patent Ductus Arteriosus

Contraindications: Asthma, Liver Impairment, Renal Impairment, Bleeding, Peptic Ulcer Disease, Anemia

Side Effects: Heartburn, Ulcers, Headache

Drug Interactions: Anticoagulants, Diuretics

Nursing Implications:

• This medication increases the risk of thrombotic events, myocardial infaraction, and stroke.
• NSAIDs are commonly taken with food, milk, or an antacid to decrease GI irritation and increase absorption.
• Risk for complications include but are not limited to Acute Renal Failure, Pulmonary Edema, Hepatotoxicity, and Ototoxicity.
• Long term use of this medication can lead to Chronic Kidney Disease, Stomach Ulcers.

Analgesic NSAID - Acetic Acid Derivative

MoA: Inhibits prostaglandin synthesis by blocking cyclooxygenase-1 and cyclooxygenase-2.

Indications: Moderate-Severe Pain

Contraindications: Asthma, Liver Impairment, Renal Impairment, Bleeding, Peptic Ulcer Disease, Anemia

Side Effects: Heartburn, Ulcers, Headache

Drug Interactions: Anticoagulants, Diuretics

Nursing Implications:

• This medication increases the risk of thrombotic events, myocardial infaraction, and stroke.
• NSAIDs are commonly taken with food, milk, or an antacid to decrease GI irritation and increase absorption.
• Risk for complications include but are not limited to Acute Renal Failure, Pulmonary Edema, Hepatotoxicity, and Ototoxicity.
• Long term use of this medication can lead to Chronic Kidney Disease, Stomach Ulcers.

Analgesic NSAID - Propionic Acid Derivative

MoA: Inhibits prostaglandin synthesis by blocking cyclooxygenase-1 and cyclooxygenase-2.

Indications: Rheumatoid Arthritis, Osteoarthritis, Primary Dysmenorrhea, Gout, Dental Pain, Fever

Contraindications: Asthma, Liver Impairment, Renal Impairment, Bleeding, Peptic Ulcer Disease, Anemia

Side Effects: GI Distress, Ulcers

Drug Interactions: Anticoagulants, Diuretics

Nursing Implications:

• This medication increases the risk of thrombotic events, myocardial infaraction, and stroke.
• NSAIDs are commonly taken with food, milk, or an antacid to decrease GI irritation and increase absorption.
• This medication can trigger bronchospasms in asthmatic clients.
• Risk for complications include but are not limited to Acute Renal Failure, Pulmonary Edema, Hepatotoxicity, and Ototoxicity.
• Long term use of this medication can lead to Chronic Kidney Disease, Stomach Ulcers.

Analgesic NSAID - Propionic Acid Derivative

MoA: Inhibits prostaglandin synthesis by blocking cyclooxygenase-1 and cyclooxygenase-2.

Indications: Rheumatoid Arthritis, Osteoarthritis, Ankylosing Spondylitis, Tendinitis, Bursitis, Primary Dysmenorrhea

Contraindications: Asthma, Liver Impairment, Renal Impairment, Bleeding, Peptic Ulcer Disease, Anemia

Side Effects: Heartburn, Ulcers, Headache, Rash

Drug Interactions: Anticoagulants, Diuretics

Nursing Implications:

• This medication increases the risk of thrombotic events, myocardial infaraction, and stroke.
• NSAIDs are commonly taken with food, milk, or an antacid to decrease GI irritation and increase absorption.
• Risk for complications include but are not limited to Acute Renal Failure, Pulmonary Edema, Hepatotoxicity, and Ototoxicity.
• Long term use of this medication can lead to Chronic Kidney Disease, Stomach Ulcers.

Analgesic COX-2 Inhibitor

MoA: Inhibits prostaglandin synthesis by binding to cyclooxygenase-2.

Indications: Osteoarthritis, Rheumatoid Arthritis, Acute Pain, Ankylosing Spondylitis, Primary Dysmenorrhea, GI Ulcer Prevention

Contraindications: Sulfonamide Allergy, Asthma, Liver Impairment, Renal Impairment, Bleeding, Peptic Ulcer Disease, Anemia

Side Effects: Heartburn, Ulcers

Drug Interactions: Anticoagulants, Diuretics

Nursing Implications:

• This medication increases the risk of thrombotic events, myocardial infaraction, and stroke.
• NSAIDs are commonly taken with food, milk, or an antacid to decrease GI irritation and increase absorption.
• Risk for complications include but are not limited to Acute Renal Failure, Pulmonary Edema, Hepatotoxicity, and Ototoxicity.
• Long term use of this medication can lead to Chronic Kidney Disease, Stomach Ulcers.

Adrenergic Blocker Alpha Blocker

MoA: Binds to alpha receptors to inhibit sympathetic activity, relax smooth muscle, and induce vasodilation.

• Alpha receptors stimulate the CNS, constrict blood vessels, decrease gastric motility, and dilate pupils.

Indications: Hypertension, Pheochromocytoma, Raynaud's Disease, BPH

Contraindications: COPD, Arrhythmias, Heart Failure

Side Effects: Orthostatic Hypotension, Dizziness, Fatigue

Drug Interactions: Antacids, Antimuscarinics, Anticholinergics, Diuretics, Neuromuscular Blockers, Oral Hypoglycemics

Nursing Implications:

• Educate patients to change positions slowly.
• Do not stop this medication abruptly.
• Hold this medication if the patient is experiencing hypotension.
• Teach the patient about reporting constipation, urinary hesitancy, or bladder distention immediately.

Adrenergic Blocker Alpha Blocker

MoA: Binds to alpha receptors to inhibit sympathetic activity, relax smooth muscle, and induce vasodilation.

• Alpha receptors stimulate the CNS, constrict blood vessels, decrease gastric motility, and dilate pupils.

Indications: Hypertension, Pheochromocytoma, Raynaud's Disease, BPH

Side Effects: Orthostatic Hypotension, Dizziness

Drug Interactions: Antacids, Antimuscarinics, Anticholinergics, Diuretics, Neuromuscular Blockers, Oral Hypoglycemics

Nursing Implications:

• Educate patients to change positions slowly.
• Do not stop this medication abruptly.
• Hold this medication if the patient is experiencing hypotension.
• Teach the patient about reporting constipation, urinary hesitancy, or bladder distention immediately.

Adrenergic Blocker Antihypertenisve Alpha Blocker

MoA: Binds to alpha receptors to inhibit sympathetic activity, relax smooth muscle, and induce vasodilation.

• Alpha receptors stimulate the CNS, constrict blood vessels, decrease gastric motility, and dilate pupils.

Indications: Hypertension, Pheochromocytoma, Raynaud's Disease, BPH

Side Effects: Orthostatic Hypotension, Dizziness

Drug Interactions: Antacids, Antimuscarinics, Anticholinergics, Diuretics, Neuromuscular Blockers, Oral Hypoglycemics

Nursing Implications:

• Educate patients to change positions slowly.
• Do not stop this medication abruptly.
• Hold this medication if the patient is experiencing hypotension.
• Teach the patient about reporting constipation, urinary hesitancy, or bladder distention immediately.

Adrenergic Blocker Alpha Blocker

MoA: Binds to alpha receptors to inhibit sympathetic activity, relax smooth muscle, and induce vasodilation.

• Alpha receptors stimulate the CNS, constrict blood vessels, decrease gastric motility, and dilate pupils.

Indications: Hypertension, Pheochromocytoma, Raynaud's Disease, BPH

Side Effects: Orthostatic Hypotension, Dizziness

Drug Interactions: Antacids, Antimuscarinics, Anticholinergics, Diuretics, Neuromuscular Blockers, Oral Hypoglycemics

Nursing Implications:

• Educate patients to change positions slowly.
• Do not stop this medication abruptly.
• Hold this medication if the patient is experiencing hypotension.
• Teach the patient about reporting constipation, urinary hesitancy, or bladder distention immediately.

Adrenergic Vasopressor Inotrope Chronotrope Vasoactive Agent

MoA: Stimulates alpha, beta-1, and beta-2 receptors. Induces (+) inotropic activity.

• Alpha receptors stimulate the CNS, constrict blood vessels, decrease gastric motility, and dilate pupils.
• Beta-1 receptors increase the force of myocardial contraction, raise heart rate, and stimulate electrical conduction via SA and AV nodes.
• Beta-2 receptors dilate bronchioles, relax the uterus, decrease gastric motility, and increase renin secretion.
• (+) Inotropic Effect: Increases cardiac output and stroke volume through stronger myocardial contraction.
• (+) Chronotropic Effect: Increases heart rate by speeding up electrical activity.

Indications: Anaphylaxis, Septic Shock, Asthma, Croup, Open-Angle Glaucoma, Asystole, PEA

Side Effects: Tremors, Headache, Dizziness, Diaphoresis

Nursing Implications:

• Store this medication in a dark place and at room temperature.
• Administer injections at 90 degrees in the outher thigh.
• Simultaneous administration of two or more adrenergic drugs may precipitate tachycardia or hypertension.

Adrenergic Vasopressor Inotrope Chronotrope Vasoactive Agent

MoA: Stimulates alpha and beta-1 receptors to cause (+) inotropic, (+) chronotropic, and vasoconstrictive effects.

• Alpha receptors stimulate the CNS, constrict blood vessels, decrease gastric motility, and dilate pupils.
• Beta-1 receptors increase the force of myocardial contraction, raise heart rate, and stimulate electrical conduction via SA and AV nodes.
• (+) Inotropic Effect: Increases cardiac output and stroke volume through stronger myocardial contraction.
• (+) Chronotropic Effect: Increases heart rate by speeding up electrical activity.

Indications: Hypotension, Shock

Side Effects: Headache, Dizziness, Diaphoresis, Fatigue

Nursing Implications:

• Simultaneous administration of two or more adrenergic drugs may precipitate tachycardia or hypertension.

Adrenergic Blocker Alpha Blocker

MoA: Binds to alpha receptors to inhibit sympathetic activity, relax smooth muscle, and induce vasodilation.

• Alpha receptors stimulate the CNS, constrict blood vessels, decrease gastric motility, and dilate pupils.

Indications: Hypertension, Pheochromocytoma, Raynaud's Disease, BPH

Contraindications: COPD, Arrhythmias, Heart Failure

Side Effects: Orthostatic Hypotension, Dizziness

Drug Interactions: Antacids, Antimuscarinics, Anticholinergics, Diuretics, Neuromuscular Blockers, Oral Hypoglycemics

Nursing Implications:

• Educate patients to change positions slowly.
• Do not stop this medication abruptly.
• Hold this medication if the patient is experiencing hypotension.
• Teach the patient about reporting constipation, urinary hesitancy, or bladder distention immediately.

Adrenergic Blocker Alpha Blocker

MoA: Binds to alpha receptors to inhibit sympathetic activity, relax smooth muscle, and induce vasodilation.

• Alpha receptors stimulate the CNS, constrict blood vessels, decrease gastric motility, and dilate pupils.

Indications: Benign Prostatic Hyperplasia

Contraindications: COPD, Arrhythmias, Heart Failure

Side Effects: Dizziness, Abnormal Ejaculation

Drug Interactions: Erectile Dysfunction Drugs

Nursing Implications:

• Educate patients to change positions slowly.
• Do not stop this medication abruptly.
• Hold this medication if the patient is experiencing hypotension.
• Teach the patient about reporting constipation, urinary hesitancy, or bladder distention immediately.

Adrenergic Blocker Antihypertenisve Antianginal Antiarrhythmic Beta Blocker

MoA: Reduces sympathetic stimulation by blocking beta-1 receptors. This is a cardioselective beta blocker because it acts on beta-1 receptors only.

• Beta-1 receptors increase the force of myocardial contraction, raise heart rate, and stimulate electrical conduction via SA and AV nodes.

Indications: Myocardial Infarction, Hypertension, Heart Failure, Angina, Thyrotoxicosis

Contraindications: Asthma, COPD

Side Effects: Bradycardia, Hypotension, Dizziness, Fatigue

Drug Interactions: Antacids, Antimuscarinics, Anticholinergics, Diuretics, Neuromuscular Blockers, Oral Hypoglycemics

Nursing Implications:

• Educate patients to change positions slowly.
• Do not stop this medication abruptly. It can precipitate rebound hypertension.
• Hold this medication if the patient is experiencing hypotension and/or bradycardia.
• Teach the patient about reporting constipation, urinary hesitancy, or bladder distention immediately. Other signs that need to be reported include edema, weight gain, shortness of breath, and syncope.

Adrenergic Blocker Antihypertenisve Antianginal Antiarrhythmic Beta Blocker

MoA: Reduces sympathetic stimulation of the heart by blocking beta-1 and beta-2 receptors. This is a non-selective beta blocker because it acts on both beta receptors.

• Beta-1 receptors increase the force of myocardial contraction, raise heart rate, and stimulate electrical conduction via SA and AV nodes.
• Beta-2 receptors dilate bronchioles, relax the uterus, decrease gastric motility, and increase renin secretion.

Indications: Myocardial Infarction, Hypertension, Heart Failure, Angina, Arrhythmias

Contraindications: Asthma, COPD

Side Effects: Bradycardia, Hypotension, Fatigue

Drug Interactions: Antacids, Antimuscarinics, Anticholinergics, Diuretics, Neuromuscular Blockers, Oral Hypoglycemics

Nursing Implications:

• Educate patients to change positions slowly.
• Do not stop this medication abruptly. It can precipitate rebound hypertension.
• Hold this medication if the patient is experiencing hypotension and/or bradycardia.
• Teach the patient about reporting constipation, urinary hesitancy, or bladder distention immediately. Other signs that need to be reported include edema, weight gain, shortness of breath, and syncope.
• This medication can trigger bronchoconstriction in asthmatic clients.

Adrenergic Blocker Antihypertenisve Antianginal Antiarrhythmic Beta Blocker

MoA: Reduces sympathetic stimulation of the heart by blocking beta-1 and beta-2 receptors. This is a non-selective beta blocker because it acts on both beta receptors.

• Beta-1 receptors increase the force of myocardial contraction, raise heart rate, and stimulate electrical conduction via SA and AV nodes.
• Beta-2 receptors dilate bronchioles, relax the uterus, decrease gastric motility, and increase renin secretion.

Indications: Hypertension, Angina, Heart Failure

Contraindications: Asthma, COPD

Side Effects: Bradycardia, Hypotension, Dizziness, Bradycardia

Drug Interactions: Antacids, Antimuscarinics, Anticholinergics, Diuretics, Neuromuscular Blockers, Oral Hypoglycemics

Nursing Implications:

• Educate patients to change positions slowly.
• Do not stop this medication abruptly. It can precipitate rebound hypertension.
• Hold this medication if the patient is experiencing hypotension and/or bradycardia.
• Teach the patient about reporting constipation, urinary hesitancy, or bladder distention immediately. Other signs that need to be reported include edema, weight gain, shortness of breath, and syncope.

Adrenergic Blocker Antiarrhythmic Beta Blocker

MoA: Reduces sympathetic stimulation of the heart by blocking beta-1 receptors. This is a cardioselective beta blocker because it acts on beta-1 receptors only.

• Beta-1 receptors increase the force of myocardial contraction, raise heart rate, and stimulate electrical conduction via SA and AV nodes.

Indications: Supraventricular Tachycardia

Contraindications: COPD

Side Effects: Bradycardia, Hypotension, Dizziness

Drug Interactions: Antacids, Antimuscarinics, Anticholinergics, Diuretics, Neuromuscular Blockers, Oral Hypoglycemics

Nursing Implications:

• Avoid giving this medication with high fiber foods.
• Educate patients to change positions slowly.
• Do not stop this medication abruptly. It can precipitate rebound hypertension.
• Hold this medication if the patient is experiencing hypotension and/or bradycardia.
• Teach the patient about reporting constipation, urinary hesitancy, or bladder distention immediately. Other signs that need to be reported include edema, weight gain, shortness of breath, and syncope.

Cardiac Glycoside Inotrope

MoA: Induces (+) inotropic activity by increasing the flow of sodium and calcium. Stimulates (-) chronotropic activity.

• (+) Inotropic Effect: Increases cardiac output and stroke volume through stronger myocardial contraction.
• (-) Chronotropic Effect: Decreases heart rate by slowing electrical activity.

Indications: Heart Failure, A-Fib, Atrial Flutter

Side Effects: Dizziness, Halo Vision, GI Distress

Drug Interactions: Antacids, Antimuscarinics, Anticholinergics, Diuretics, Neuromuscular Blockers, Oral Hypoglycemics

Nursing Implications:

• Therapeutic range: 0.5-2 ng/mL. Serum levels should be drawn ~6 hours after last dose.
• Monitor for Digoxin toxicity: altered mental status and hyperkalemia.
• Digibind is an antidote for digoxin toxicity.
• Patients with hypokalemia and renal disease increase the risk of digoxin toxicity.
• Monitor for Nephrotoxicity: assess renal panel and urinary tract abnormalities.
• Assess apical pulse for a full minute before administration. Hold this medication if the patient is experiencing bradycardia.

Crystalloid

Overview: This solution contains fluids and electrolytes normally found in the body. Crystalloid fluids do not contain proteins (colloids).

Indications: Dehydration, Maintenance Fluid

Concentration: Isotonic

Nursing Implications:

• Viral transmission, anaphylaxis, and altered coagulation profiles do not pose as risks for this fluid.
• Monitor for fluid overload: respiratory distress, weight gain, edema, hypertension, and tachycardia.

Crystalloid

Overview: This solution contains fluids and electrolytes normally found in the body. Crystalloid fluids do not contain proteins (colloids).

Indications: Dehydration, Hypovolemia/p>

Concentration: Hypotonic

Nursing Implications:

• Viral transmission, anaphylaxis, and altered coagulation profiles do not pose as risks for this fluid.
• Monitor for fluid overload: respiratory distress, weight gain, edema, hypertension, and tachycardia.

Crystalloid

Overview: This solution contains fluids and electrolytes normally found in the body. Crystalloid fluids do not contain proteins (colloids).

Indications: Hyponatremia, Increased ICP

Concentration: Hypertonic

Nursing Implications:

• Viral transmission, anaphylaxis, and altered coagulation profiles do not pose as risks for this fluid.
• Monitor for fluid overload: respiratory distress, weight gain, edema, hypertension, and tachycardia.

Crystalloid

Overview: This solution contains fluids and electrolytes normally found in the body. Crystalloid fluids do not contain proteins (colloids).

Indications: Hypovolemia, Hemorrhage, Burns

Concentration: Isotonic

Nursing Implications:

• Viral transmission, anaphylaxis, and altered coagulation profiles do not pose as risks for this fluid.
• Monitor for fluid overload: respiratory distress, weight gain, edema, hypertension, and tachycardia.

Crystalloid

Overview: This solution contains fluids and electrolytes normally found in the body. Crystalloid fluids do not contain proteins (colloids).

Indications: Dehydration, Hypoglycemia

Concentration: Isotonic

Nursing Implications:

• Viral transmission, anaphylaxis, and altered coagulation profiles do not pose as risks for this fluid.
• Monitor for fluid overload: respiratory distress, weight gain, edema, hypertension, and tachycardia.

Crystalloid

Overview: This solution contains fluids and electrolytes normally found in the body. Crystalloid fluids do not contain proteins (colloids).

Indications: Dehydration, Maintenance Fluid

Concentration: Hypertonic

Nursing Implications:

• Viral transmission, anaphylaxis, and altered coagulation profiles do not pose as risks for this fluid.
• Monitor for fluid overload: respiratory distress, weight gain, edema, hypertension, and tachycardia.

Colloid

Overview: Colloids contain protein substances that increase oncotic pressure in the intravascular space by shifting fluid from the interstitium. This product does not have oxygen-carrying capacity or clotting factors.

Indications: Edema, Hypovolemia

Nursing Implications:

• Albumin is considered both a colloid and blood product.
• Monitor for fluid overload: respiratory distress, weight gain, edema, hypertension, and tachycardia.

Colloid

Overview: Colloids contain protein substances that increase oncotic pressure in the intravascular space by shifting fluid from the interstitium. This product does not have oxygen-carrying capacity or clotting factors.

Indications: Edema, Hypovolemia

Nursing Implications:

• Monitor for anaphylaxis and signs of acute renal failure.
• Monitor for fluid overload: respiratory distress, weight gain, edema, hypertension, and tachycardia.

Blood Product

Indications: Clotting Factor Deficiency, Hemorrhage, Anticoagulation Reversal

Transfusion Reaction:

• Immune Hemolytic Reaction: Monitor for chills, shortness of breath, flank pain, chest pain, tachycardia, and flushing.
• Non-Immune Hemolytic Reaction: Monitor for fever, chills, hives, and pruritus.
• Transfusion Related Acute Lung Injury: Monitor for hypoxemia, dyspnea, cyanosis, hypotension, and crackles.
• Anaphylactic Reaction: Monitor for hypotension, dyspnea, wheezing, hives, and pruritus.

Nursing Implications:

• Vitals are obtained 15-minutes before infusion, 15-minutes after the start of infusion, every hour during transfusion process, and after transfusion has completed.
• Obtain a patient informed consent form that was signed, acknowledged, and approved.
• Monitor for fluid overload: respiratory distress, weight gain, edema, hypertension, and tachycardia.
• It is important to check hospital policy regarding transfusion protocols. Common procedures include a 2-RN verification, maximum of a 4hr blood product hang time, administering product within 30-minutes of reception, following standard medication rights, and more.

Blood Product

Indications: Von Willebrand Disease, Hypofibrinogenemia

Transfusion Reaction:

• Immune Hemolytic Reaction: Monitor for chills, shortness of breath, flank pain, chest pain, tachycardia, and flushing.
• Non-Immune Hemolytic Reaction: Monitor for fever, chills, hives, and pruritus.
• Transfusion Related Acute Lung Injury: Monitor for hypoxemia, dyspnea, cyanosis, hypotension, and crackles.
• Anaphylactic Reaction: Monitor for hypotension, dyspnea, wheezing, hives, and pruritus.

Nursing Implications:

• Vitals are obtained 15-minutes before infusion, 15-minutes after the start of infusion, every hour during transfusion process, and after transfusion has completed.
• Obtain a patient informed consent form that was signed, acknowledged, and approved.
• Monitor for fluid overload: respiratory distress, weight gain, edema, hypertension, and tachycardia.
• It is important to check hospital policy regarding transfusion protocols. Common procedures include a 2-RN verification, maximum of a 4hr blood product hang time, administering product within 30-minutes of reception, following standard medication rights, and more.

Blood Product

Indications: Hemorrhage, Anemia, Cancer Patients

Transfusion Reaction:

• Immune Hemolytic Reaction: Monitor for chills, shortness of breath, flank pain, chest pain, tachycardia, and flushing.
• Non-Immune Hemolytic Reaction: Monitor for fever, chills, hives, and pruritus.
• Transfusion Related Acute Lung Injury: Monitor for hypoxemia, dyspnea, cyanosis, hypotension, and crackles.
• Anaphylactic Reaction: Monitor for hypotension, dyspnea, wheezing, hives, and pruritus.

Nursing Implications:

• Vitals are obtained 15-minutes before infusion, 15-minutes after the start of infusion, every hour during transfusion process, and after transfusion has completed.
• Obtain a patient informed consent form that was signed, acknowledged, and approved.
• Monitor for fluid overload: respiratory distress, weight gain, edema, hypertension, and tachycardia.
• It is important to check hospital policy regarding transfusion protocols. Common procedures include a 2-RN verification, maximum of a 4hr blood product hang time, administering product within 30-minutes of reception, following standard medication rights, and more.

Blood Product

Indications: >25% Blood Loss

Transfusion Reaction:

• Immune Hemolytic Reaction: Monitor for chills, shortness of breath, flank pain, chest pain, tachycardia, and flushing.
• Non-Immune Hemolytic Reaction: Monitor for fever, chills, hives, and pruritus.
• Transfusion Related Acute Lung Injury: Monitor for hypoxemia, dyspnea, cyanosis, hypotension, and crackles.
• Anaphylactic Reaction: Monitor for hypotension, dyspnea, wheezing, hives, and pruritus.

Nursing Implications:

• Vitals are obtained 15-minutes before infusion, 15-minutes after the start of infusion, every hour during transfusion process, and after transfusion has completed.
• Obtain a patient informed consent form that was signed, acknowledged, and approved.
• Monitor for fluid overload: respiratory distress, weight gain, edema, hypertension, and tachycardia.
• It is important to check hospital policy regarding transfusion protocols. Common procedures include a 2-RN verification, maximum of a 4hr blood product hang time, administering product within 30-minutes of reception, following standard medication rights, and more.

Supplement

MoA: Increases intracellular concentration of potassium to contract muscles, transmit nerve impulses, regulate heart rate, and maintain acid-base balance.

Indications: Nutrient Deficiency, Irregular Heartbeats, Tachydysrhythmias

Side Effects: GI Distress, Phlebitis

Nursing Implications:

• Never give potassium IV push. Administer via infusion at no more than 5-10 mEq/hr.
• If the patient is on telemetry, assess ECG prior to administration.
• Take PO forms with water or fruit juice, during or after meals, and remain upright after consumption.
• Monitor for signs of hyperkalemia such as lab values, muscle weakness, paralysis, dysrhythmias, and tingling. Normal Potassium level is 3.5-5.0 mmol/L.

Diuretic Carbonic Anhydrase Inhibitor

MoA: Blocks carbonic anhydrase activity to increase the elimination of sodium, potassium, and water in renal tubules.

Indications: Diuretic Resistance, Open Angle Glaucoma, Increased IOP, High Altitude Sickness

Contraindications: Hyponatremia, Hypokalemia, Renal Impairment, Liver Impairment

Side Effects: Polyuria, GI Distress, Paresthesia

Drug Interactions: NSAIDs, Digoxin

Nursing Implications:

• Diuretics administered with digoxin increase the risk of digoxin toxicity. Monitor for digoxin toxicity: confusion, irregular pulse, and vision changes is pertinent.
• Educate patient to change positions slowly.
• Monitor I/O, daily weights, and electrolytes to assess for therapeutic effects.

Diuretic Loop Diuretic

MoA: Inhibits sodium and chloride resorption in the kidney.

Indications: Edema, Heart Failure, Liver Disease, Renal Disease

Side Effects: Hypokalemia, Polyuria, Dizziness, GI Distress

Drug Interactions: NSAIDs, Digoxin

Nursing Implications:

• Loop diuretics increase urinary excretion of potassium. Monitor for hypokalemia: paresthesia, muscle cramps, and muscle weakness.
• Diuretics administered with digoxin increase the risk of digoxin toxicity. Monitor for digoxin toxicity: confusion, irregular pulse, and vision changes is pertinent.
• Educate patient to change positions slowly.
• Monitor I/O, daily weights, and electrolytes to assess for therapeutic effects.

Diuretic Loop Diuretic

MoA: Inhibits sodium and chloride resorption in the kidney. Additionally, it increases renal prostaglandin release to dilate blood vessels.

Indications: Edema, Heart Failure, Liver Disease, Renal Disease

Side Effects: Hypokalemia, Polyuria, Dizziness, GI Distress

Drug Interactions: NSAIDs, Digoxin

Nursing Implications:

• Monitor for Steven Johnson Syndrome: rash, blisters, muscle and joint pain.
• Loop diuretics increase urinary excretion of potassium. Monitor for hypokalemia: paresthesia, muscle cramps, and muscle weakness.
• Diuretics administered with digoxin increase the risk of digoxin toxicity. Monitor for digoxin toxicity: confusion, irregular pulse, and vision changes is pertinent.
• Educate patient to change positions slowly.
• This medication can cause Ototoxicity if administered at high infusion rates.
• Monitor I/O, daily weights, and electrolytes to assess for therapeutic effects.

Diuretic Loop Diuretic

MoA: Inhibits sodium and chloride resorption in the kidney.

Indications: Edema, Heart Failure, Liver Disease, Renal Disease

Side Effects: Polyuria, Dizziness, GI Distress

Drug Interactions: NSAIDs, Digoxin

Nursing Implications:

• Loop diuretics increase urinary excretion of potassium. Monitor for hypokalemia: paresthesia, muscle cramps, and muscle weakness.
• Diuretics administered with digoxin increase the risk of digoxin toxicity. Monitor for digoxin toxicity: confusion, irregular pulse, and vision changes is pertinent.
• Educate patient to change positions slowly.
• Monitor I/O, daily weights, and electrolytes to assess for therapeutic effects.

Diuretic Osmotic Diuretic

MoA: Induces an osmotic effect into renal tubules by pulling water from tissues.

Indications: Cerebral Edema

Side Effects: Headache, Cough

Drug Interactions: NSAIDs

Nursing Implications:

• Mannitol is IV only and requires a special filter for infusion.
• This medication must be kept away from low temperatures as it can crystallize.
• Diuretics administered with digoxin increase the risk of digoxin toxicity. Monitor for digoxin toxicity: confusion, irregular pulse, and vision changes is pertinent.
• Educate patient to change positions slowly.
• Monitor I/O, daily weights, and electrolytes to assess for therapeutic effects.

Diuretic Potassium Sparing Diuretic

MoA: Blocks aldosterone to retain potassium, excrete sodium, and excrete water.

Indications: Hyperaldosteronism, Hypertension, Heart Failure

Contraindications: Renal Impairment

Side Effects: Hyperkalemia, Gynecomastia, Amenorrhea, Post-Menopausal Bleeding

Drug Interactions: NSAIDs, Digoxin

Nursing Implications:

• Diuretics administered with digoxin increase the risk of digoxin toxicity. Monitor for digoxin toxicity: confusion, irregular pulse, and vision changes is pertinent.
• Educate patient to change positions slowly.
• Monitor I/O, daily weights, and potassium to assess for therapeutic effects.

Diuretic Potassium Sparing Diuretic

MoA: Blocks aldosterone to retain potassium, excrete sodium, and excrete water.

Indications: Edema, Hypertension

Side Effects: Hyperkalemia, GI Distress, Polyuria

Drug Interactions: NSAIDs, Digoxin

Nursing Implications:

• Diuretics administered with digoxin increase the risk of digoxin toxicity. Monitor for digoxin toxicity: confusion, irregular pulse, and vision changes is pertinent.
• Educate patient to change positions slowly.
• Monitor I/O, daily weights, and potassium to assess for therapeutic effects.

Diuretic Thiazide Diuretic

MoA: Increases fluid excretion by blocking sodium and water reabsorption in the renal tubules.

Indications: Hypertension, Edema, Heart Failure

Side Effects: Dizziness, Headache, GI Distress, Photosensitivity

Drug Interactions: NSAIDs, Digoxin, Licorice

Nursing Implications:

• Diabetic patients taking Thiazide Diuretics are at risk for hyperglycemia. Monitor for manifestations of hyperglycemia and check blood glucose levels as applicable.
• Excessive consumption of licorice with thiazides can lead to hypokalemia.
• Diuretics in combination with digoxin increases the risk of digoxin toxicity. Monitoring for signs of digoxin toxicity such as confusion, irregular pulse, and vision changes is pertinent.
• Educate patient to change positions slowly.
• Monitor I/O, daily weights, and electrolytes to assess for therapeutic effects.

Diuretic Thiazide-Like Diuretic

MoA: Blocks sodium and water reabsorption in the renal tubules.

Indications: Hypertension, Edema, Diabetes Insipidus, Heart Failure

Side Effects: Dizziness, Headache, GI Distress, Photosensitivity

Drug Interactions: NSAIDs, Digoxin

Nursing Implications:

• Diuretics in combination with digoxin increases the risk of digoxin toxicity. Monitoring for signs of digoxin toxicity such as confusion, irregular pulse, and vision changes is pertinent.
• Educate patient to change positions slowly.
• Monitor I/O, daily weights, and electrolytes to assess for therapeutic effects.

Anticoagulant Unfractionated

MoA: Inhibits clotting factors IIa and Xa involved in thrombin formation.

Indications: Thromboembolic Prophylactic

Contraindications: Acute Bleeding, Indwelling Epidural Catheter, Risk for Epidural Hematoma

Side Effects: GI Distress, Bruising

Drug Interactions: NSAIDs, Ginger, Garlic, Ginkgo

Nursing Implications:

• Antidote for heparin derived anticoagulants is Protamine Sulfate.
• Monitor aPTT level for therapeutic effects: Normal Range: 25-35seconds. Therapeutic Range: 45-70 seconds.
• This medication increases the risk for bleeding. Signs of bleeding include: black tarry stools, bleeding gums, hematuria, and bruising.
• Monitor for Heparin-Induced Thrombocytopenia.

Anticoagulant LMWH

MoA: Stimulates antithrombin III and inhibits clotting factors involved in thrombin formation.

Indications: Thromboembolic Prophylactic

Contraindications: Acute Bleeding, Indwelling Epidural Catheter, Risk for Epidural Hematoma

Side Effects: GI Distress, Bruising

Drug Interactions: NSAIDs, Ginger, Garlic, Ginkgo

Nursing Implications:

• Antidote for heparin derived anticoagulants is Protamine Sulfate.
• Monitor aPTT level for therapeutic effects: Normal Range: 25-30 seconds. Therapeutic Range: 45-70 seconds.
• This medication increases the risk for bleeding. Signs of bleeding include: black tarry stools, bleeding gums, hematuria, and bruising.

Anticoagulant Direct Thrombin Inhibitor

MoA: Inhibits clotting factor IIa to prevent thrombin formation.

Indications: Thromboembolic Prophylactic

Side Effects: GI Distress, Bruising

Drug Interactions: NSAIDs, Ginger, Garlic, Ginkgo

Nursing Implications:

• This medication increases the risk for bleeding. Signs of bleeding include: black tarry stools, bleeding gums, hematuria, and bruising.
• Take this medication with water and keep in original container.

Anticoagulant Direct Thrombin Inhibitor

MoA: Inhibits clotting factor IIa to prevent thrombin formation.

Indications: Thromboembolic Prophylactic

Side Effects: GI Distress, Bruising

Drug Interactions: NSAIDs, Ginger, Garlic, Ginkgo

Nursing Implications:

• This medication increases the risk for bleeding. Signs of bleeding include: black tarry stools, bleeding gums, hematuria, and bruising.
• Take this medication with water and keep in original container.

Anticoagulant Factor Xa Inhibitor

MoA: Inhibits clotting factor Xa to prevent thrombin formation.

Indications: Thromboembolic Prophylactic

Side Effects: GI Distress, Bruising

Drug Interactions: NSAIDs, Ginger, Garlic, Ginkgo

Nursing Implications:

• Do not administer this medication in clients with an epidural catheter.
• This medication increases the risk for bleeding. Signs of bleeding include: black tarry stools, bleeding gums, hematuria, and bruising.

Anticoagulant Factor Xa Inhibitor

MoA: Inhibits clotting factor Xa to prevent thrombin formation.

Indications: Thromboembolic Prophylactic

Side Effects: GI Distress, Bruising

Drug Interactions: NSAIDs, Ginger, Garlic, Ginkgo

Nursing Implications:

• This medication increases the risk for bleeding. Signs of bleeding include: black tarry stools, bleeding gums, hematuria, and bruising.

Anticoagulant Factor Xa Inhibitor

MoA: Inhibits clotting factor Xa to prevent thrombin formation.

Indications: Thromboembolic Prophylactic

Side Effects: GI Distress, Bruising

Drug Interactions: NSAIDs, Ginger, Garlic, Ginkgo

Nursing Implications:

• This medication increases the risk for bleeding. Signs of bleeding include: black tarry stools, bleeding gums, hematuria, and bruising.

Antiplatelet

MoA: Binds to ADP receptors to prevent platelet formation and aggregation.

Indications: Coronary Artery Disease, Myocardial Infarction, Angina, Stroke, Transient Ischemic Attack, Peripheral Artery Disease

Contraindications: Active Bleeding, Thrombocytopenia

Side Effects: GI Distress

Drug Interactions: NSAIDs, Heparin, Herbal Products

Nursing Implications:

• This medication increases the risk for bleeding. Signs of bleeding include: black tarry stools, bleeding gums, hematuria, and bruising.
• Clopidogrel (Plavix) may be held if platelets are under 150,000/μL.

Thrombolytic

MoA: Breaks down clots by covnerting plasminogen to plasmin which lyses fibrin found in clots.

Indications: Myocardial Infarction, Deep Vein Thrombosis, Shunt or Catheter Occlusion, Embolus, Acute Ischemic Stroke

Contraindications: Hemorrhage, Aneurysm, Ischemic Stroke, Aortic Dissection, Head Injury

Side Effects: GI Distress, Hypotension

Nursing Implications:

• Monitor ECG for possible cardiac dysrhythmias.
• This medication increases the risk for bleeding. Signs of bleeding include: black tarry stools, bleeding gums, hematuria, and bruising.

Antifibrinolytic

MoA: Prevents fibrin clot breakdown by binding to plasminogen to prevent the formation of plasmin.

Indications: Excessive Bleeding, Hemophilia, Von Willebrand's Disease

Side Effects: GI Distress, Dizziness

Nursing Implications:

• Monitor for therapeutic effects.

Cholinergic

MoA: Mimics acetylcholine effects by binding directly to cholinergic receptors

• Cholinergic receptors stimulate urinary and gastrointestinal activity, constrict pupils, increase salivation, constrict bronchioles, and decrease heart rate.

Indications: Decrease Intraocular Pressure, Glaucoma, Intraocular Surgery

Side Effects: Burning Pain, Blurred Vision

Nursing Implications:

• Do not stop this medication abruptly.

Cholinergic

MoA: Mimics acetylcholine effects by binding directly to muscarinic receptors

• Cholinergic receptors stimulate urinary and gastrointestinal activity, constrict pupils, increase salivation, constrict bronchioles, and decrease heart rate.
• Muscarinic receptors are a type of cholinergic receptor that act on smooth muscle.

Indications: Decrease Intraocular Pressure, Glaucoma, Intraocular Surgery

Side Effects: Headache, Miosis

Nursing Implications:

• Do not stop this medication abruptly.
• Patient is at risk for Cholinergic Crisis. Monitor for salivation, lacrimation, urinary incontinence, diarrhea, GI cramps, and emesis (SLUDGE).
• The antidote for cholinergic medication is atropine and should be readily available for emergent use.

Cholinergic

MoA: Mimics acetylcholine effects by binding directly to muscarinic receptors

• Cholinergic receptors stimulate urinary and gastrointestinal activity, constrict pupils, increase salivation, constrict bronchioles, and decrease heart rate.
• Muscarinic receptors are a type of cholinergic receptor that act on smooth muscle.

Indications: Decrease Intraocular Pressure, Glaucoma, Intraocular Surgery

Side Effects: Bronchospasm, Diaphoresis, Salivation

Nursing Implications:

• Do not stop this medication abruptly.
• Patient is at risk for Cholinergic Crisis. Monitor for salivation, lacrimation, urinary incontinence, diarrhea, GI cramps, and emesis (SLUDGE).
• The antidote for cholinergic medication is atropine and should be readily available for emergent use.

Cholinergic

MoA: Mimics acetylcholine effects by binding directly to muscarinic receptors

• Cholinergic receptors stimulate urinary and gastrointestinal activity, constrict pupils, increase salivation, constrict bronchioles, and decrease heart rate.
• Muscarinic receptors are a type of cholinergic receptor that act on smooth muscle.

Indications: Xerostomia from Sjögren’s Syndrome

Side Effects: Headache, Dizziness, Bronchospasm, Diaphoresis

Nursing Implications:

• Do not stop this medication abruptly.
• Patient is at risk for Cholinergic Crisis. Monitor for salivation, lacrimation, urinary incontinence, diarrhea, GI cramps, and emesis (SLUDGE).
• The antidote for cholinergic medication is atropine and should be readily available for emergent use.

Neuromuscular Blocker

MoA: Binds directly to cholinergic receptors to depolarize membranes and induce muscle paralysis.

• Cholinergic receptors stimulate urinary and gastrointestinal activity, constrict pupils, increase salivation, constrict bronchioles, and decrease heart rate.

Indications: General Anesthesia

Contraindications: Hyperkalemia, Rhabdomyolysis

Side Effects: Muscle Weakness

Nursing Implications:

• Monitor for malignant hypethermia. Signs include > 104 degree temperature, tachypnea, tachycardia, and muscle rigidity. Antidote for Succinylcholine hyperthermia is Dantrolene (Dantrium).
• Do not stop this medication abruptly.

Cholinergic

MoA: Mimics acetylcholine effects by binding directly to muscarinic receptors

• Cholinergic receptors stimulate urinary and gastrointestinal activity, constrict pupils, increase salivation, constrict bronchioles, and decrease heart rate.
• Muscarinic receptors are a type of cholinergic receptor that act on smooth muscle.

Indications: Post-Op or Postpartum Non-Obstructive Urinary Retention, Neurogenic Bladder

Side Effects: Headache, Dizziness, Abdominal Cramps, Bronchospasm

Nursing Implications:

• Monitor for urination within 1hr of administration.
• Do not stop this medication abruptly.
• Patient is at risk for Cholinergic Crisis. Monitor for salivation, lacrimation, urinary incontinence, diarrhea, GI cramps, and emesis (SLUDGE).
• The antidote for cholinergic medication is atropine and should be readily available for emergent use.

Anticholinesterase

MoA: Blocks acetylcholinesterase from breaking down acetylcholine.

Indications: Alzheimer's Disease

Side Effects: Headache, Dizziness, Abdominal Cramps, Bronchospasm

Nursing Implications:

• Ensure the patient understands that this medication manages symptoms but is not a cure for Alzheimer’s Disease.
• Do not stop this medication abruptly.
• Patient is at risk for Cholinergic Crisis. Monitor for salivation, lacrimation, urinary incontinence, diarrhea, GI cramps, and emesis (SLUDGE).
• Atropine should be readily available for a cholinergic crisis.

Anticholinesterase

MoA: Blocks acetylcholinesterase from breaking down acetylcholine.

Indications: Alzheimer's Disease

Side Effects: Headache, Dizziness, Abdominal Cramps

Nursing Implications:

• Ensure the patient understands that this medication manages symptoms but is not a cure for Alzheimer’s Disease.
• Do not stop this medication abruptly.
• Patient is at risk for Cholinergic Crisis. Monitor for salivation, lacrimation, urinary incontinence, diarrhea, GI cramps, and emesis (SLUDGE).
• Atropine should be readily available for a cholinergic crisis.

Anticholinesterase

MoA: Blocks acetylcholinesterase from breaking down acetylcholine.

Indications: Alzheimer's Disease

Side Effects: GI Distress

Nursing Implications:

• Ensure the patient understands that this medication manages symptoms but is not a cure for Alzheimer’s Disease.
• Do not stop this medication abruptly.
• Patient is at risk for Cholinergic Crisis. Monitor for salivation, lacrimation, urinary incontinence, diarrhea, GI cramps, and emesis (SLUDGE).
• Atropine should be readily available for a cholinergic crisis.

Anticholinesterase

MoA: Blocks acetylcholinesterase from breaking down acetylcholine and increases acetylcholine levels.

Indications: Myasthenia Gravis

Side Effects: Abdominal Cramps

Nursing Implications:

• Take 30-minutes before eating to improve chewing and swallowing.
• Do not stop this medication abruptly.
• Patient is at risk for Cholinergic Crisis. Monitor for salivation, lacrimation, urinary incontinence, diarrhea, GI cramps, and emesis (SLUDGE).
• Atropine should be readily available for a cholinergic crisis.

Antilipemic HMG-CoA Reductase Inhibitor

MoA: Inhibits HMG-CoA reductase activity in the liver to decrease cholesterol production.

Indications: Hyperlipidemia, Cardiovascular Disease

Side Effects: GI Distress, Loss of Appetite, Muscle Cramps

Nursing Implications:

• Monitor for Rhabdomyolysis: muscle pain, muscle cramps, weakness.
• Monitor for Hepatotoxicity: elevated liver enzymes, jaundice, dark urine, and vomiting.
• Take this medication in the evening or at bedtime.

Antilipemic HMG-CoA Reductase Inhibitor

MoA: Inhibits HMG-CoA reductase activity in the liver to decrease cholesterol production.

Indications: Hyperlipidemia, Cardiovascular Disease

Side Effects: GI Distress, Loss of Appetite, Muscle Cramps

Nursing Implications:

• Monitor for Rhabdomyolysis: muscle pain, muscle cramps, weakness.
• Monitor for Hepatotoxicity: elevated liver enzymes, jaundice, dark urine, and vomiting.
• Take this medication in the evening or at bedtime.

Antilipemic HMG-CoA Reductase Inhibitor

MoA: Inhibits HMG-CoA reductase activity in the liver to decrease cholesterol production.

Indications: Hyperlipidemia, Cardiovascular Disease

Side Effects: GI Distress, Loss of Appetite, Muscle Cramps

Nursing Implications:

• Monitor for Rhabdomyolysis: muscle pain, muscle cramps, weakness.
• Monitor for Hepatotoxicity: elevated liver enzymes, jaundice, dark urine, and vomiting.
• Take this medication in the evening or at bedtime.

Antilipemic Bile Acid Sequestrant

MoA: Increases excretion of bile acids in stool by binding to them in the intestines.

Indications: Hypercholesterolemia

Side Effects: GI Distress

Nursing Implications:

• Take adjunct drugs 1hr before or 4-6hrs after consuming bile acid sequestrants.
• High doses of this medication decrease the absorption of fat-soluble vitamins. Educate patient on need for Vitamin A, D, E and K supplements.

Antilipemic Bile Acid Sequestrant

MoA: Increases excretion of bile acids in stool by binding to them in the intestines.

Indications: Hypercholesterolemia

Side Effects: GI Distress

Nursing Implications:

• Take adjunct drugs 1hr before or 4-6hrs after consuming bile acid sequestrants.
• High doses of this medication decrease the absorption of fat-soluble vitamins. Educate patient on need for Vitamin A, D, E and K supplements.

Antilipemic Bile Acid Sequestrant

MoA: Increases excretion of bile acids in stool by binding to them in the intestines.

Indications: Hypercholesterolemia, Pruritus

Side Effects: GI Distress

Nursing Implications:

• Take adjunct drugs 1hr before or 4-6hrs after consuming bile acid sequestrants.
• High doses of this medication decrease the absorption of fat-soluble vitamins. Educate patient on need for Vitamin A, D, E and K supplements.

Antilipemic

MoA: Increases activity of lipase which decreases the metabolism and catabolism of cholesterol and triglycerides.

Indications: Hyperlipidemia, Mixed Dyslipidemia

Side Effects: Flushing, Pruritus, GI Distress

Nursing Implications:

• Consuming aspirin or NSAIDs 30-minutes prior can minimize flushing effect.

Antilipemic Fibric Acid Derivative

MoA: Disrupts fatty acid synthesis pathways by increasing lipase activity to breakdown VLDL.

Indications: Hypertriglyceridemia

Side Effects: GI Distress, Gallstones

Nursing Implications:

• Give this medication at least 30-minutes before eating.
• Monitor liver function tests.

Antilipemic Fibric Acid Derivative

MoA: Disrupts fatty acid synthesis pathways by increasing lipase activity.

Indications: Hypertriglyceridemia

Side Effects: GI Distress

Nursing Implications:

• Monitor for therapeutic effects.

Antilipemic Cholesterol Absorption Inhibitor

MoA: Inhibits absorption of cholesterol and related sterols in the small intestine.

Indications: Hypercholesterolemia

Contraindications: Pregnant Women, Liver Impairment

Side Effects: GI Distress, Muscle Aches

Nursing Implications:

• This medication can act as an adjunct with Statins.

Antihypertensive Antianginal Vasodilator

MoA: Increases oxygen delivery to myocardial tissue, dilates arteries to reduce afterload, and dilates veins to reduce preload.

Indications: Angina, Hypertension, Myocardial Infarction

Contraindications: Anemia, Hypotension, Head Injury

Side Effects: Headache, Dizziness

Drug Interactions: Erectile Dysfunction Drugs

Nursing Implications:

• Educate patient that a burning or tingling sensation with sublingual nitrates indicates effectiveness.
• Nitroglycerin patches should be applied once per day while rotating sites.
• Store this medication in a dark environment, away from heat, and in the original container.
• Teach patient to stop activity and take a prescribed tablet if experiencing angina at home. If no pain relief in 5-minutes, call 911 and take a second tablet. If pain continues after 5-minutes, take a third tablet.

Antihypertensive Antianginal Antiarrhythmic Calcium Channel Blocker

MoA: Blocks the flow of calcium in the heart. Additionally, it reduces cardiac workload and AV node conduction, decreases myocardial oxygen demand, and decreases systemic vascular resistance by dilating coronary and peripheral arteries.

• Calcium plays a role in generating and propagating electrical impulses.

Indications: Angina, Hypertension, A-Fib, Atrial Flutter

Contraindications: Myocardial Infarction, Heart Block, Hypotension, Cardiogenic Shock, Bradycardia

Side Effects: Bradycardia, Hypotension, Headache, Dizziness, Constipation

Drug Interactions: Grapefruit Juice, Beta Blockers

Nursing Implications:

• Do not consume this medication with grapefruit. It can precipitate hypotension.
• Instruct patient to increase fiber intake to reduce effects of constipation.

Antiarrhythmic Sodium Channel Blocker

MoA: Stabilizes the cell membrane by preventing sodium transport.

• Sodium plays a role in generating action potentials and depolarizing cell membranes.

Indications: A-Fib, Atrial Flutter

Side Effects: GI Distress

Nursing Implications:

• Monitor for Cinchonism: blurred vision, tinnitus, and digitalis toxicity
• Assess ECG rhythm before, during, and after therapy along with heart rate, blood pressure, skin color, and temperature.

Antiarrhythmic Sodium Channel Blocker

MoA: Stabilizes the cell membrane by preventing sodium transport.

• Sodium plays a role in generating action potentials and depolarizing cell membranes.

Indications: A-Fib, Atrial Flutter, SVT, VTACH

Side Effects: Dizziness, Xerostomia, GI Distress

Nursing Implications:

• Monitor for lupus-like syndrome: muscle and joint pain, swelling, fatigue, and fever.
• Assess ECG rhythm before, during, and after therapy along with heart rate, blood pressure, skin color, and temperature.

Antiarrhythmic Anesthetic Sodium Channel Blocker Local Anesthetic

MoA: Stabilizes the cell membrane by preventing sodium transport and inhibiting nerve impulses.

• Sodium plays a role in generating action potentials and depolarizing cell membranes.

Indications: VTACH, PVC, Surgery, Procedures, Pregnant Women, Chronic Pain

Side Effects: Pruritus, Dizziness, Chest Pain, SOB

Nursing Implications:

• Assess ECG rhythm before, during, and after therapy along with heart rate, blood pressure, skin color, and temperature.
• Assess proper response to anesthesia.

Antiarrhythmic Sodium Channel Blocker

MoA: Stabilizes the cell membrane by preventing sodium transport.

• Sodium plays a role in generating action potentials and depolarizing cell membranes.

Indications: SVT, VTACH

Side Effects: Dizziness, Chest Pain, SOB

Nursing Implications:

• Assess ECG rhythm before, during, and after therapy along with heart rate, blood pressure, skin color, and temperature.

Antiarrhythmic Potassium Channel Blocker

MoA: Blocks potassium channels to slow membrane repolarization and increase the refractory period.

Indications: VTACH, V-Fib, A-Fib

Contraindications: Heart Block

Side Effects: Dizziness

Drug Interactions: Digoxin, Warfarin

Nursing Implications:

• Assess ECG rhythm before, during, and after therapy along with heart rate, blood pressure, skin color, and temperature.
• Educate patient about reporting signs of Corneal Microdeposits such as halos, photophobia, and dryness.
• Monitor for Hypothyroidism: weight gain, weakness, dry skin, and fatigue.
• Monitor for Pulmonary Toxicity: dry cough, pleruitis, and dyspnea.
• Monitor for Hepatotoxicity: elevated liver enzymes, jaundice, dark urine, and vomiting.

Antiarrhythmic

MoA: Slows cardiac electrical activity by decreasing the rate of conduction in the AV node.

Indications: SVT

Side Effects: Dizziness, Chest Pain

Nursing Implications:

• This medication may cause short term asystole.
• Medication route is usually via IV push followed by a saline flush.
• Assess ECG rhythm before, during, and after therapy along with heart rate, blood pressure, skin color, and temperature.

Antitubercular

MoA: Inhibits mycobacterium replication.

Indications: Tuberculosis

Side Effects: Light-Colored Stools, Reddish-Orange Body Fluids

Drug Interactions: Oral Contraceptives, Warfarin, Hypoglycemics, Alcohol

Nursing Implications:

• Monitor for Hepatotoxicity: elevated liver enzymes, jaundice, dark urine, and vomiting.
• Suggest that the client wear glasses to avoid discoloration of contact lenses.
• It is important that the patient completes the full drug regimen to prevent antibiotic resistance.
• Patients are encouraged to take this medication at the same time everyday as some therapies may require greater than 6 months of antitubercular treatment.
• Teach the patient about proper PPE use as patients with active tuberculosis are contagious in the initial stages of illness.
• Clients should use non-hormonal forms of birth control while taking this medication.

Antihypertensive Alpha-2 Agonist

MoA: Binds to alpha-2 receptors to inhibit sympathetic activity and decrease blood pressure.

• Alpha receptors stimulate the CNS, constrict blood vessels, decrease gastric motility, and dilate pupils.

Indications: Hypertension, Alcoholism, Withdrawal

Side Effects: Drowsiness, Dizziness, Depression, Impotence

Nursing Implications:

• Do not stop this medication abruptly. It can precipitate rebound hypertension.
• Educate client about tracking blood pressure via a journal and implementing healthy behavior strategies.
• Report signs of depression to the healthcare provider.
• Suggest sugarless gum or hard candy for episodes of dry mouth.

Antihypertensive Alpha-2 Agonist

MoA: Binds to alpha-2 receptors to inhibit sympathetic activity and decrease blood pressure.

• Alpha receptors stimulate the CNS, constrict blood vessels, decrease gastric motility, and dilate pupils.

Indications: Hypertension, Alcoholism, Withdrawal

Side Effects: Edema, Depression, Impotence

Nursing Implications:

• Do not stop this medication abruptly. It can precipitate rebound hypertension.
• Educate client about tracking blood pressure via a journal and implementing healthy behavior strategies.
• Report signs of depression to the healthcare provider.
• Suggest sugarless gum or hard candy for episodes of dry mouth.

Antihypertensive ACE Inhibitor

MoA: Inhibits ACE activity to block angiotensin II formation. Triggers vasodilation and decreases glomerular filtration pressure.

Indications: Hypertension, Heart Failure, Left Ventricular Hypertrophy, Renal Protection

Contraindications: Pregnant Women

Side Effects: Dry Cough, Angioedema, Dizziness

Drug Interactions: NSAIDs

Nursing Implications:

• This medication can induce teratogenic effects in pregnant women.
• Hold this medication if the patient is displaying severe hypotension.
• This medication may increase the risk of hyperkalemia.
• Notify the healthcare provider if the patient is experiencing angioedema.
• Patient is at risk for falls due to orthostatic hypotension.

Antihypertensive ACE Inhibitor

MoA: Inhibits ACE activity to block angiotensin II formation. This activity results in vasodilation which decreases glomerular filtration pressure.

Indications: Hypertension, Heart Failure, Left Ventricular Hypertrophy, Renal Protection

Contraindications: Pregnant Women

Side Effects: Dry Cough, Angioedema, Dizziness

Drug Interactions: Alcohol

Nursing Implications:

• This medication can induce teratogenic effects in pregnant women.
• Hold this medication if the patient is displaying severe hypotension.
• This medication may increase the risk of hyperkalemia.
• Notify the healthcare provider if the patient is experiencing angioedema.
• Patient is at risk for falls due to orthostatic hypotension.

Antihypertensive Angiotensin Receptor Blocker

MoA: Blocks angiotensin receptors to trigger vasodilation and reduce fluid volume.

Indications: Hypertension, Heart Failure

Contraindications: Pregnant Women

Side Effects: Dizziness, Headache

Drug Interactions: NSAIDs, Aspirin

Nursing Implications:

• Concurrent use with Fluconazole (Diflucan) may increase antihypertensive effects.
• Hold this medication if the patient is displaying severe hypotension.
• This medication may increase the risk of hyperkalemia.
• Patient is at risk for falls due to orthostatic hypotension.

Antihypertensive Angiotensin Receptor Blocker

MoA: Blocks angiotensin receptors to trigger vasodilation and reduce fluid volume.

Indications: Hypertension, Heart Failure

Contraindications: Pregnant Women

Side Effects: Dizziness, Headache

Drug Interactions: NSAIDs, Aspirin

Nursing Implications:

• Concurrent use with Fluconazole (Diflucan) may increase antihypertensive effects.
• Hold this medication if the patient is displaying severe hypotension.
• This medication may increase the risk of hyperkalemia.
• Patient is at risk for falls due to orthostatic hypotension.

Antihypertensive Vasodilator

MoA: Relaxes arteriolar smooth muscle to decrease systemic vascular resistance.

Indications: Hypertension, Heart Failure

Side Effects: Dizziness, Headache, Hypotension

Nursing Implications:

• Assess daily weights.
• Take this medication with food.
• Monitor for Lupus-Like Syndrome: muscle and joint pain, swelling, fatigue, and fever
• Patient is at risk for falls due to orthostatic hypotension.

Antihypertensive Vasodilator

MoA: Dilates arteries to reduce afterload and dilates veins to reduce preload.

Indications: Hypertension, Myocardial Infarction, Heart Failure

Side Effects: Dizziness, Headache, Hypotension

Nursing Implications:

• Protect this medication from light, heat, and moist environments.
• This medication should be administered with foil around tubing and the IV bag covered.
• Nitroprusside appears light brown in color, discard any medication that does not resemble this characteristic.
• Sodium Thiosulfate may be administered to decrease the risk of cyanide toxicity.
• Patient is at risk for falls due to orthostatic hypotension.

Anticholinergic Antispasmodic

MoA: Binds to muscarinic receptors to block effects of acetylcholine and inhibit parasympathetic activity.

• Cholinergic receptors stimulate urinary and gastrointestinal activity, constrict pupils, increase salivation, constrict bronchioles, and decrease heart rate.
• Muscarinic receptors are a type of cholinergic receptor that act on smooth muscle.

Indications: Irritable Bowel Syndrome

Contraindications: Glaucoma

Side Effects: Xerostomia, Dizziness, Tachycardia, Blurred Vision

Drug Interactions: CNS Depressants, Alcohol

Nursing Implications:

• Monitor for Anticholinergic toxicity: urinary hesitancy, tremors, confusion, and hallucinations.
• Physostigmine is an antidote for Anticholinergic toxicity.
• Teach older patients to limit physical exertion and avoid high temperatures due to risk for heatstroke.
• Educate patient to wear dark glasses due to light sensitivity and use caution when driving due to risk for blurred vision.
• Suggest sugarless gum or hard candy for episodes of dry mouth.

Anticholinergic

MoA: Binds to muscarinic receptors to block effects of acetylcholine and inhibit parasympathetic activity.

• Cholinergic receptors stimulate urinary and gastrointestinal activity, constrict pupils, increase salivation, constrict bronchioles, and decrease heart rate.
• Muscarinic receptors are a type of cholinergic receptor that act on smooth muscle.

Indications: Overactive Bladder, Neurogenic Bladder

Contraindications: Glaucoma

Side Effects: Constipation, Urinary Retention, Drowsiness, Blurred Vision

Drug Interactions: CNS Depressants, Alcohol

Nursing Implications:

• Monitor for Anticholingergic toxicity: urinary hesitancy, tremors, confusion, and hallucinations.
• Physostigmine is an antidote for Anticholinergic toxicity.
• Teach older patients to limit physical exertion and avoid high temperatures due to risk for heatstroke.
• Educate patient to wear dark glasses due to light sensitivity and use caution when driving due to risk for blurred vision.
• Suggest sugarless gum or hard candy for episodes of dry mouth.

Anticholinergic Antiemetic

MoA: Binds to muscarinic receptors to block effects of acetylcholine and inhibit parasympathetic activity.

• Cholinergic receptors stimulate urinary and gastrointestinal activity, constrict pupils, increase salivation, constrict bronchioles, and decrease heart rate.
• Muscarinic receptors are a type of cholinergic receptor that act on smooth muscle.

Indications: Motion Sickness, GI Distress

Contraindications: Glaucoma

Side Effects: Dizziness, Xerostomia, Blurred Vision

Drug Interactions: CNS Depressants, Alcohol

Nursing Implications:

• Educate client to apply patches >4hrs prior to traveling.
• Monitor for Anticholinergic toxicity: urinary hesitancy, tremors, confusion, and hallucinations.
• Physostigmine is an antidote for Anticholinergic toxicity.
• Teach older patients to limit physical exertion and avoid high temperatures due to risk for heatstroke.
• Educate patient to wear dark glasses due to light sensitivity and use caution when driving due to risk for blurred vision.
• Suggest sugarless gum or hard candy for episodes of dry mouth.

Adrenergic Inotrope Vasoactive Agent

MoA: Stimulates beta-1 receptors and induces (+) inotropic activity.

• Beta-1 receptors increase the force of myocardial contraction, raise heart rate, and stimulate electrical conduction via SA and AV nodes.
• (+) Inotropic Effect: Increases cardiac output and stroke volume through stronger myocardial contraction.

Indications: Cardiogenic Shock, Heart Failure

Side Effects: Dizziness, Chest Pain, Tachycardia, SOB

Nursing Implications:

• Simultaneous administration of two or more adrenergic drugs may precipitate tachycardia or hypertension.

Adrenergic Vasopressor Decongestant Vasoactive Agent

MoA: Stimulates alpha receptors to provide a short acting increase in blood pressure.

• Alpha receptors stimulate the CNS, constrict blood vessels, decrease gastric motility, and dilate pupils.

Indications: Hypotension, Shock, SVT, Nasal Congestion

Side Effects: Tremors, Headache, Dizziness, Diaphoresis, Muscle Cramps

Nursing Implications:

• Educate patient about avoiding caffeine.
• If fever, cough, and other flu-like symptoms last longer than 1-week, report findings to the healthcare provider.
• Simultaneous administration of two or more adrenergic drugs may precipitate tachycardia or hypertension.

Vitamin Fat-Soluble

Sources: Fish and Liver Oils, Saltwater Fish, Milk, Orange Juice, Fortified Cereals, Animal Liver, Eggs, Butter, Dairy, Sunlight

Functions: Acts with PTH to regulate calcium and phosphorous absorption. Calcifies bones and teeth.

Indications: Rickets, Tetany, Osteomalacia, Osteoporosis, Osteodystrophy, Hypocalcemia, Hypoparathyroidism, Hypophosphatemia, Nutrient Deficiency

Vitamin Fat-Soluble

Sources: Fruits, Grains, Fortified Cereals, Vegetable Oil, Wheat Germ, Nuts, Eggs, Chicken, Red Meats, Fish

Functions: Antioxidant properties, maintains immune system, and stimulates erythropoiesis.

Indications: Nutrient Deficiency

Vitamin Fat-Soluble

Sources: Broccoli, Cabbage, Spinach, Kale, Cheese, Soybean Oils

Functions: Synthesizes blood coagulation factors in the liver.

Indications: Prophylaxis for Newborns, Warfarin Antidote, Nutrient Deficiency

Vitamin Water-Soluble

Sources: Whole Grains, Liver, Beans, Yeast

Functions: Regulates carbohydrate metabolism, participates in the citric acid cycle, and maintains integrity of peripheral, cardiovascular, and GI systems.

Indications: Wernicke’s Encephalopathy, Beriberi, Nutrient Deficiency

Vitamin Water-Soluble

Sources: Green Leafy Vegetables, Eggs, Dairy, Nutes, Legumes, Meats, Liver, Yeast, Whole Grains

Functions: Converts nutrients into energy.

Indications: Microcytic Anemia, Acne, Migraines, Nutrient Deficiency

Vitamin Water-Soluble

Sources: Beans, Turkey, Tuna, Liver, Yeast, Whole Grains, Wheat Germ, Tryptophan

Functions: Supports nervous system function and maintains skin integrity.

Indications: Hyperlipidemia, Nutrient Deficiency

Side Effects: Flushing, Pruritus

Vitamin Water-Soluble

Sources: Whole Grains, Wheat Germ, Yeast, Fish, Liver, Poultry, Eggs, Nuts, Vegetables, Bananas

Functions: Manages macronnutrients, converts trpytophan into niacin, and maintains integrity of peripheral nervous, integumentary, and hematopoietic systems.

Indications: Seizures, Morning Sickness, Nutrient Deficiency, Microcytic Anemia

Vitamin Water-Soluble

Sources: Liver, Fish, Shellfish, Poultry, Milk, Eggs, Blue Cheese, Fortified Cereals

Functions: Synthesizes coenzymes needed for metabolic pathways.

Indications: Pernicious Anemia, Nutrient Deficiency, Macrocytic Anemia

Vitamin Water-Soluble

Sources: Oranges, Grapefruit, Peppers, Broccoli, Brussel Sprouts, Tomatoes

Functions: Regulates oxidation-reduction activity in metabolic pathways.

Indications: Scurvy, Nutrient Deficiency

Thyroid Drug

MoA: Synthetically increases Thyroxine (T4) levels to increase thyroid activity.

Indications: Goiter, Hypothyroidism, Thyroidectomy

Side Effects: Headache, GI Distress, Weight Loss, Hair Loss, Heat Intolerance

Nursing Implications:

• Take in the morning, at the same time everyday, on an empty stomach, and not with other medications.
• This medication can take weeks to see therapeutic effects. Levothyroxine treatment is lifelong.
• Monitor for toxicity: cardiac dysrhythmias, tremors, weight loss, palpitations, and insomnia.
• Levothyroxine (Synthroid) is safe to use during pregnancy.

Antithyroid

MoA: Decrease production of thyroid hormones.

Indications: Hyperthyroidism, Grave's Disease

Side Effects: Headache, Alopecia, GI Distress

Nursing Implications:

• This medication is well tolerated when consumed with food.
• Take this medication at the same time each day.
• Avoid foods high in iodine such as seafood, soy sauce, tofu, and salt.
• Monitor for Hepatotoxicity: elevated liver enzymes, jaundice, dark urine, and vomiting.

Antithyroid

MoA: Decreases production of thyroid hormones.

Indications: Hyperthyroidism, Grave's Disease

Side Effects: Black Tarry Stool, Fatigue

Nursing Implications:

• This medication is well tolerated when consumed with food.
• Take this medication at the same time each day.
• Propylthiouracil (PTU) is safe to use during pregnancy.
• Avoid foods high in iodine such as seafood, soy sauce, tofu, and salt.
• Monitor for Hepatotoxicity: elevated liver enzymes, jaundice, dark urine, and vomiting.

Bronchodilator Beta-Adrenergic Agonist

MoA: A short-acting agent that binds to beta-2 receptors.

• Beta-2 receptors dilate bronchioles, relax the uterus, decrease gastric motility, and increase renin secretion.

Indications: Asthma, Bronchitis, Respiratory Disease

Contraindications Uncontrolled Hypertension, Arrhythmias

Side Effects: Tremor, Tachycardia

Nursing Implications:

• This medication should not be used frequently and is only intended for acute measures.
• For respiratory indications, use bronchodilators before corticosteroids and use spacers to deliver successful inhalations.
• When using a Metered-Dose Inhaler, shake medication before use, hold inhalation for 10-seconds, and wait 1-minute between inhalations.

Bronchodilator Beta-Adrenergic Agonist

MoA: A long-acting agent that binds to beta-2 receptors.

• Beta-2 receptors dilate bronchioles, relax the uterus, decrease gastric motility, and increase renin secretion.

Indications: Asthma, Bronchitis, Respiratory Disease

Contraindications Uncontrolled Hypertension, Arrhythmias

Side Effects: Headache, Rhinorrhea

Nursing Implications:

• Often, Salmeterol is co-administered with an inhaled corticosteroid for long-term asthma control.
• Use in emergency situations is not recommended.
• This medication is used to maintain current condition and prevent future exacerbations
• Do not give more than the maximum daily dose or more than twice daily.
• For respiratory indications, use bronchodilators before corticosteroids and use spacers to deliver successful inhalations.
• When using a Metered-Dose Inhaler, shake medication before use, hold inhalation for 10-seconds, and wait 1-minute between inhalations.

Anticholinergic Bronchodilator

MoA: Block cholinergic activity to decrease respiratory secretions and prevent bronchial constriction.

• Cholinergic receptors stimulate urinary and gastrointestinal activity, constrict pupils, increase salivation, constrict bronchioles, and decrease heart rate.

Indications: COPD

Contraindications: Glaucoma

Side Effects: Dizziness, Nausea, Xerostomia

Nursing Implications:

• Monitor for Anticholinergic toxicity: urinary hesitancy, tremors, confusion, and hallucinations.
• Physostigmine is an antidote for Anticholinergic toxicity.
• This medication is meant for prevention of bronchospasms, not symptom management.
• For respiratory indications, use bronchodilators before corticosteroids and use spacers to deliver successful inhalations.

Non-Bronchodilator Leukotriene Receptor Antagonist

MoA: Affects immune pathways by blocking inflammation, decreasing mucus secretion, reducing vascular permeability, and blocking neutrophil and leukocyte infiltration.

Indications: Chronic Asthma, Allergic Rhinitis

Side Effects: Headache, Dizziness, GI Distress

Nursing Implications:

• This medication is intended to prevent asthma attacks. Use in emergency situations is not recommended.
• Teach the patient to allow for at least 1-week before seeing symptom improvement.
• Take this medication every night on a continuous schedule, even if symptoms improve.

Adrenal Drug Corticosteroid Glucocorticoid

MoA: Stimulates beta-adrenergic receptors to relax bronchial smooth muscle. Additionally, this medication inhibits inflammatory and immune responses by increasing cortisol levels.

Indications: Asthma, Cerebral Edema, Systemic Lupus Erythematosus, Cancer, Meningitis, Fetal Lung Maturity

Contraindications: Fungal Infection

Side Effects: Xerostomia, Cough, Weight Gain, Menstrual Irregularities, Muscle Loss

Drug Interactions: NSAIDs

Nursing Implications:

• Do not stop this medication abruptly. It can precipitate an adrenal crisis.
• Corticosteroids can suppress the immune system and cause infection. Educate the patient to gargle and rinse mouth with water to prevent oral infections in addition to avoiding large crowds.
• If fever, cough, and other flu-like symptoms last longer than 1-week, report findings to the healthcare provider.
• Monitor for hyperglycemia and hyperkalemia.

Adrenal Drug Corticosteroid Decongestant Glucocorticoid

MoA: Stimulates beta-adrenergic receptors to relax bronchial smooth muscle. Additionally, this medication inhibits inflammatory and immune responses by increasing cortisol levels.

Indications: Psoriasis, Systemic Lupus Erythematosus, Dermatitis, Nephrotic Syndrome, Fetal Lung Maturity

Contraindications: Fungal Infection

Side Effects: Xerostomia, Cough, Weight Gain, Menstrual Irregularities, Muscle Loss

Drug Interactions: NSAIDs

Nursing Implications:

• Do not stop this medication abruptly. It can precipitate an adrenal crisis.
• Corticosteroids can suppress the immune system and cause infection. Educate the patient to gargle and rinse mouth with water to prevent oral infections in addition to avoiding large crowds.
• If fever, cough, and other flu-like symptoms last longer than 1-week, report findings to the healthcare provider.
• Monitor for hyperglycemia and hyperkalemia.

Adrenal Drug Corticosteroid Glucocorticoid

MoA: Stimulates beta-adrenergic receptors to relax bronchial smooth muscle. Additionally, this medication inhibits inflammatory and immune responses by increasing cortisol levels.

Indications: Asthma, Cerebral Edema, Dermatitis, Systemic Lupus Erythematosus, Cancer, Meningitis

Contraindications: Fungal Infection

Side Effects: Xerostomia, Cough, Weight Gain, Menstrual Irregularities, Muscle Loss

Drug Interactions: NSAIDs

Nursing Implications:

• Do not stop this medication abruptly. It can precipitate an adrenal crisis.
• Corticosteroids can suppress the immune system and cause infection. Educate the patient to gargle and rinse mouth with water to prevent oral infections in addition to avoiding large crowds.
• If fever, cough, and other flu-like symptoms last longer than 1-week, report findings to the healthcare provider.
• Monitor for hyperglycemia and hyperkalemia.

Adrenal Drug Corticosteroid Bronchodilator Glucocorticoid

MoA: Stimulates beta-adrenergic receptors to relax bronchial smooth muscle. Additionally, this medication inhibits inflammatory and immune responses by increasing cortisol levels.

Indications: Asthma, Cerebral Edema, Systemic Lupus Erythematosus, Cancer

Contraindications: Fungal Infection

Side Effects: Xerostomia, Cough, Weight Gain, Menstrual Irregularities, Muscle Loss

Drug Interactions: NSAIDs

Nursing Implications:

• Do not stop this medication abruptly. It can precipitate an adrenal crisis.
• Corticosteroids can suppress the immune system and cause infection. Educate the patient to gargle and rinse mouth with water to prevent oral infections in addition to avoiding large crowds.
• If fever, cough, and other flu-like symptoms last longer than 1-week, report findings to the healthcare provider.
• Monitor for hyperglycemia and hyperkalemia.

Adrenal Drug Corticosteroid Bronchodilator Decongestant Glucocorticoid

MoA: Stimulates beta-adrenergic receptors to relax bronchial smooth muscle. Additionally, this medication inhibits inflammatory and immune responses by increasing cortisol levels.

Indications: Asthma, COPD

Contraindications: Fungal Infection

Side Effects: Xerostomia, Cough

Drug Interactions: NSAIDs

Nursing Implications:

• Corticosteroids can suppress the immune system and cause infection. Educate the patient to gargle and rinse mouth with water to prevent oral infections in addition to avoiding large crowds.
• If fever, cough, and other flu-like symptoms last longer than 1-week, report findings to the healthcare provider.
• For respiratory indications, use bronchodilators before corticosteroids and use spacers to deliver successful inhalations.
• When using a Metered-Dose Inhaler, shake medication before use, hold inhalation for 10-seconds, and wait 1-minute between inhalations.

Adrenal Drug Corticosteroid Non-Bronchodilator Decongestant Glucocorticoid

MoA: Stimulates beta-adrenergic receptors to relax bronchial smooth muscle. Additionally, this medication inhibits inflammatory and immune responses by increasing cortisol levels.

Indications: Asthma, COPD, Nasal Congestion

Contraindications: Fungal Infection

Side Effects: Xerostomia, Cough, Skin Irritation

Drug Interactions: NSAIDs

Nursing Implications:

• Corticosteroids can suppress the immune system and cause infection. Educate the patient to gargle and rinse mouth with water to prevent oral infections in addition to avoiding large crowds.
• For respiratory indications, use bronchodilators before corticosteroids and use spacers to deliver successful inhalations.
• When using a Metered-Dose Inhaler, shake medication before use, hold inhalation for 10-seconds, and wait 1-minute between inhalations.

Pituitary Drug Ant. Pituitary

MoA: Increases release of cortisol from adrenal cortex and induces anti-inflammatory effects.

Indications: Adrenocortical Insufficiency, HIV Wasting

Side Effects: Hypertension, Weight Gain, Rash

Nursing Implications:

• Monitor for edema and hypertension.

Pituitary Drug Ant. Pituitary

MoA: Mimics effects of growth hormone to stimulate skeletal, muscle, and cellular growth.

Indications: Hypopituitary Dwarfism, Growth Hormone Deficiency

Side Effects: GI Distress, Muscle Pain

Nursing Implications:

• For children, educate parents to keep a journal to track growth.
• This medication can take weeks to see therapeutic effects.

Octapeptide

MoA: Reduces gastrointestinal activity by constricting blood vessels and slowing motility.

Indications: Carcinoid Syndrome, GI Bleed

Side Effects: GI Distress

Nursing Implications:

• This medication may impair gallbladder function, instruct patient to report RUQ pain.
• Monitor glucose levels in patients with diabetes taking this medication.

Vasopressor Pituitary Drug Post. Pituitary

MoA: Induces vasoconstrictive effects in the arteries. Mimics ADH by increasing water resorption in the kidneys.

Indications: Diabetes Insipidus, Septic Shock, Cardiac Arrest, Esophageal Varices

Side Effects: Flushing, GI Distress

Nursing Implications:

• Monitor for therapeutic effects.

Pituitary Drug

MoA: Acts on the vasopressin receptors to mimic ADH and increase water resorption in the kidneys. Stimulates release of platelet factors to control bleeding.

Indications: Diabetes Insipidus, Nocturnal Enuresis, Hemophilia, Von Willebrand Disease

Side Effects: Flushing, GI Distress

Nursing Implications:

• Monitor for therapeutic effects: decreased urinary output and increased urine specific gravity.
• Monitor for Water Intoxication and Hyponatremia: headache, muscle weakness, altered level of consciousness.

Overview:

• Peripheral: Short term nutritional replacement with 10% Dextrose that is delivered via peripheral IV sites.
• Central: Long term nutritional replacement with 25-35% Dextrose that is delivered via jugular or subclavian vein.

Indications:

• Peripheral: NPO, Anorexia from Chemotherapy, GI Illness, Post-Op
• Central: Hypermetabolism, Metabolic Stress

Side Effects: Flushing, GI Distress

Nursing Implications:

• Consult a dietician to ensure the proper TPN is administered. Verify TPN protocol by reviewing hospital procedures.
• Assess protein, albumin, BUN, RBC, WBC, and cholesterol labs for irregularities.
• Monitor for signs of Lactose Intolerance: cramping, diarrhea, bloating, and flatulence.
• Monitor for fluid volume overload.
• Do not stop this therapy abruptly. It can precipitate hypoglycemia. Keep 5-10% dextrose at bedside.

Sedative

MoA: Binds to alpha-2 receptors to reduce consciousness and reflex acitivity.

• Alpha receptors stimulate the CNS, constrict blood vessels, decrease gastric motility, and dilate pupils.

Indications: Procedural Sedation, Ventilation

Side Effects: Hypotension, Bradycardia, Xerostomia, Dizziness

Nursing Implications:

• Assess proper response to anesthesia.
• Educate the patient during Pre-Op about turning, coughing, and deep breathing after surgery.
• This medication has a short half-life; therefore, the patient may awaken quickly.
• Monitor for toxicity by assessing for cardiac and respiratory arrest.

Anesthetic

MoA: Depresses the CNS to reduce consciousness and reflex acitivity.

Indications: Surgery, ECT

Side Effects: GI Distress, Dizziness

Nursing Implications:

• This medication can induce psychomimetic effects such as hallucinations.
• Assess proper response to anesthesia.
• Educate the patient during Pre-Op about turning, coughing, and deep breathing after surgery.
• Monitor for toxicity by assessing for cardiac and respiratory arrest.

Sedative

MoA: Depresses the CNS to reduce consciousness and reflex acitivity.

Indications: Dental Surgery

Side Effects: GI Distress, Dizziness

Nursing Implications:

• Commonly known as ‘Laughing Gas’.
• Assess proper response to anesthesia.
• Monitor for toxicity by assessing for cardiac and respiratory arrest.

Anesthetic

MoA: Depresses the CNS to reduce consciousness and reflex acitivity.

Indications: Surgery, Ventilation, Moderate Sedation

Side Effects: Hypotension, Fatigue, Dizziness

Nursing Implications:

• Monitor triglycerides.
• Assess proper response to anesthesia.
• Educate the patient during Pre-Op about turning, coughing, and deep breathing after surgery.
• Monitor for toxicity by assessing for cardiac and respiratory arrest.

Anesthetic

MoA: Inhibits nerve impulses to reduce consciousness and reflex acitivity.

Indications: Surgery, ECT

Side Effects: GI Distress, Muscle Aches, Xerostomia, Dizziness

Nursing Implications:

• Assess proper response to anesthesia.
• Educate the patient during Pre-Op about turning, coughing, and deep breathing after surgery.
• Monitor for toxicity by assessing for cardiac and respiratory arrest.

Anesthetic Local Anesthetic

Routes: Topical, IV, Spinal (e.g. Epidural, Intrathecal), Infiltration, Nerve Block

MoA: Blocks nerve impulses from communicating pain signals. Does not depress respiratory function.

Indications: Surgery, Dental Procedures, Diagnostic Procedures, Pregnant Women, Chronic Pain

Side Effects: Pruritus, GI Distress

Nursing Implications:

• Manage spinal headaches with bed rest, analgesics, and caffeine.
• Assess proper response to anesthesia.

Neuromuscular Blocker Non-Depolarizing Drug

MoA: Induces muscle paralysis by binding to nicotinic receptors to block acetylcholine and inhibit nerve transmission at the neruomuscular junction.

• Cholinergic receptors stimulate urinary and gastrointestinal activity, constrict pupils, increase salivation, constrict bronchioles, and decrease heart rate.
• Nicotinic receptors are a type of cholinergic receptor that promote nerve transmission.

Indications: Endotracheal Intubation, Surgery

Side Effects: Flushing, Pruritus, Muscle Weakness

Nursing Implications:

• A common antidote used to reverse toxic effects of neuromuscular blockers is Neostigmine (Prostigmin).
• If the patient is Pre-Op, educate the patient about turning, coughing, and deep breathing after surgery.

Antacid Aluminum Salt

MoA: This medication works to neutralize acid secretions by buffering with bicarbonate, increasing mucus secretions, and preventing proton pump activation.

Indications: Peptic Ulcer Disease, Gastritis, Heartburn

Contraindications Renal Failure

Side Effects: Constipation

Nursing Implications:

• Constipation may be relieved with adjunct use of Magnesium.
• Overuse of this medication can lead to metabolic alkalosis.
• Antacids should be administered 1-2hrs prior to other medications.
• Give this medication with water to increase absorption.

Antacid Magnesium Salt

MoA: This medication works to neutralize acid secretions by buffering with bicarbonate, increasing mucus secretions, and preventing proton pump activation.

Indications: Peptic Ulcer Disease, Gastritis, Heartburn

Contraindications Renal Failure, Magnesium Imbalance

Side Effects: GI Distress

Nursing Implications:

• Overuse of this medication can lead to metabolic alkalosis.
• Antacids should be administered 1-2hrs prior to other medications.
• Give this medication with water to increase absorption.

Antacid Calcium Salt

MoA: This medication works to neutralize acid secretions by buffering with bicarbonate, increasing mucus secretions, and preventing proton pump activation.

Indications: Peptic Ulcer Disease, Gastritis, Heartburn

Contraindications Renal Failure, Calcium Imbalance

Side Effects: GI Distress

Nursing Implications:

• This medication may lead to the development of kidney stones.
• Overuse of this medication can lead to metabolic alkalosis.
• Antacids should be administered 1-2hrs prior to other medications.
• Give this medication with water to increase absorption.

Antacid

MoA: This medication works to neutralize acid secretions by buffering with bicarbonate, increasing mucus secretions, and preventing proton pump activation.

Indications: Peptic Ulcer Disease, Gastritis, Heartburn

Contraindications Renal Failure, Sodium Imbalance, Heart Failure, Hypertension

Side Effects: Headache, Muscle Spasm, Loss of Appetite

Nursing Implications:

• Overuse of this medication can lead to metabolic alkalosis.
• Antacids should be administered 1-2hrs prior to other medications.
• Give this medication with water to increase absorption.

Antacid H2 Antagonist

MoA: Block histamine-2 receptors on parietal cells to decrease secretion of hydrogen ions.

Indications: Peptic Ulcer Disease, GERD, Esophagitis, Upper GI Bleed

Side Effects: Headache, Dizziness

Drug Interactions: Alcohol

Nursing Implications:

• Monitor this patient for signs of thrombocytopenia in addition to assessing renal and liver function labs.
• Take H2 Antagonists 1-2hrs prior to antacids.
• Educate patient on smoking cessation.

Antacid H2 Antagonist

MoA: Block histamine-2 receptors on parietal cells to decrease secretion of hydrogen ions.

Indications: Peptic Ulcer Disease, GERD, Esophagitis, Upper GI Bleed

Side Effects: Headache, Dizziness, GI Distress

Drug Interactions: Alcohol

Nursing Implications:

• Monitor this patient for signs of thrombocytopenia in addition to assessing renal and liver function labs.
• Take H2 Antagonists 1-2hrs prior to antacids.
• Educate patient on smoking cessation.

Proton Pump Inhibitor

MoA: Inhibits proton pumps to decrease gastric acid secretion.

Indications: GERD, Esophagitis, Heartburn, Duodenal Ulcer, Gastric Ulcer, NSAID-induced Ulcer, Stress Ulcer, H.pylori Ulcer

Contraindications Liver Disease

Side Effects: GI Distress, Dizziness

Drug Interactions: Warfarin, Diazepam, and Phenytoin

Nursing Implications:

• Long term use of this medication increases the risk of developing osteoporosis. Educate patient to increase Calcium and Vitamin D intake.
• Monitor for complications such as Clostridium Difficile, Pneumonia, and Magnesium Depletion.

Proton Pump Inhibitor

MoA: Inhibits proton pumps to decrease gastric acid secretion.

Indications: GERD, Esophagitis, Duodenal Ulcer, Gastric Ulcer, NSAID-induced Ulcer, Stress Ulcer, H.pylori Ulcer

Contraindications Liver Disease

Side Effects: Headache, GI Distress, Dizziness

Drug Interactions: Warfarin, Diazepam, and Phenytoin

Nursing Implications:

• Long term use of this medication increases the risk of developing osteoporosis. Educate patient to increase Calcium and Vitamin D intake.
• Monitor for complications such as Clostridium Difficile, Pneumonia, and Magnesium Depletion.

Proton Pump Inhibitor

MoA: Inhibits proton pumps to decrease gastric acid secretion.

Indications: GERD, Esophagitis, Duodenal Ulcer, Gastric Ulcer, NSAID-induced Ulcer, Stress Ulcer, H.pylori Ulcer

Contraindications Liver Disease

Side Effects: Headache, GI Distress, Dizziness

Drug Interactions: Warfarin, Diazepam, and Phenytoin

Nursing Implications:

• Long term use of this medication increases the risk of developing osteoporosis. Educate patient to increase Calcium and Vitamin D intake.
• Monitor for complications such as Clostridium Difficile, Pneumonia, and Magnesium Depletion.

Acid Controlling Drug

MoA: Stimulates prostaglandin-E receptors to decrease gastric acid secretion.

Indications: NSAID-induced Ulcer Prophylaxis, Gastric Ulcer

Contraindications: Pregnant Women, Uterine Surgery, Uterine Tachysystole, Abnormal FHR

Side Effects: GI Distress

Drug Interactions: Antacids, Oxytocin

Nursing Implications:

• This medication can induce labor in pregnant women.

Antiemetic Antidopaminergic

MoA: Blocks dopamine receptors responsible for nausea and vomiting in the CNS.

Indications: Nausea, Vomiting, Psychotic Disorders

Side Effects: Drowsiness, Dizziness, Xerostomia

Nursing Implications:

• Educate patient about driving carefully and avoiding hazardous tasks due to increased drowsiness.

Antiemetic Antidopaminergic Antihistamine H1 Antagonist

MoA: Blocks dopamine receptors responsible for nausea and vomiting in the CNS. Blocks histamine-1 receptors from binding histamine.

• Histamine-1 receptors constrict respiratory tract vessels, induce hypotension, and increase capillary permeability.

Indications: Nausea, Vomiting, Pruritus, Urticaria, Psychotic Disorders

Side Effects: Drowsiness, Dizziness, Xerostomia

Nursing Implications:

• Report excessive sedation, confusion, or hypotension to the healthcare provider.
• Suggest sugarless gum or hard candy for episodes of dry mouth.
• Educate patient about driving carefully and avoiding hazardous tasks due to increased drowsiness.

Antiemetic Prokinetic

MoA: Blocks dopamine receptors responsible for nausea and vomiting in the CNS. Blocks dopamine effects to stimulate peristalsis in GI tract.

Indications: Nausea, Vomiting, GERD, Delayed Gastric Emptying

Side Effects: Drowsiness, Dizziness, Headache

Nursing Implications:

• Monitor for Tardive Dyskinesia: lip smacking, puffing cheeks, and excess blinking.
• Avoid drinking alcohol with entiemetics as it can cause CNS depression.
• Educate patient about driving carefully and avoiding hazardous tasks due to increased drowsiness.

Antiemetic Serotonin Blocker

MoA: Blocks serotonin receptors to inhibit the nausea reflex in the CNS.

Indications: Nausea, Vomiting

Side Effects: Dizziness, Headache

Nursing Implications:

• Avoid drinking alcohol with entiemetics as it can cause CNS depression.
• Educate patient about driving carefully and avoiding hazardous tasks due to increased drowsiness.
• Monitor for Serotonin Syndrome: confusion, agitation, hallucinations, and tremors.

Antidiarrheal Antimotility Adsorbent

MoA: Relieves rectal spasms and prolongs transit time through the bowel. Increases water and electrolyte absorption.

Indications: Diarrhea

Side Effects: Constipation, Headache, Dizziness

Nursing Implications:

• This medication can increase bleeding times, use carefully in patients with clotting disorders or older adutls.
• Keep track of I/O and electrolyte status.

Antidiarrheal Antimotility Adsorbent

MoA: Relieves rectal spasms and prolongs transit time through the bowel. Increases water and electrolyte absorption.

Indications: Diarrhea

Side Effects: Constipation, Headache, Dizziness

Nursing Implications:

• This medication can increase bleeding times, use carefully in patients with clotting disorders or older adutls.
• Keep track of I/O and electrolyte status.

Antidiarrheal Probiotic

MoA: Suppresses growth of diarrhea-inducing bacteria.

Indications: Antibiotic-induced Diarrhea

Side Effects: Flatulence, Bloating

Nursing Implications:

• Monitor for therapeutic effects.

Laxative Bulk Forming

MoA: Adds bulk to stool by absorbing water and fiber.

Indications: Constipation, IBS, Diverticulosis, Anorectal Conditions, Pre-Op

Side Effects: Abdominal Pain, Bloating

Nursing Implications:

• Monitor for Hypokalemia: abdominal pain, muscle weakness, cramps, and dizziness.
• Long term laxative use may cause decreased bowel tone and increased dependency.
• Take this medication with water.

Laxative Bulk Forming

MoA: Adds bulk to stool by absorbing water and fiber.

Indications: Constipation, IBS, Diverticulosis, Anorectal Conditions, Pre-Op

Side Effects: Abdominal Pain, Flatulence

Nursing Implications:

• Monitor for Hypokalemia: abdominal pain, muscle weakness, cramps, and dizziness.
• Long term laxative use may cause decreased bowel tone and increased dependency.
• Take this medication with water.

Laxative Emollient

MoA: Increases water and fat content in stool.

Indications: Constipation, IBS, Diverticulosis, Anorectal Conditions, Pre-Op

Side Effects: GI Distress

Nursing Implications:

• Monitor for Hypokalemia: abdominal pain, muscle weakness, cramps, and dizziness.
• Long term laxative use may cause decreased bowel tone and increased dependency.
• Take this medication with water.

Laxative Hyperosmotic

MoA: Increases water content in stool while stimulating peristalsis.

Indications: Constipation, IBS, Diverticulosis, Anorectal Conditions, Pre-Op

Side Effects: Bloating, GI Distress

Nursing Implications:

• Monitor for Hypokalemia: abdominal pain, muscle weakness, cramps, and dizziness.
• Long term laxative use may cause decreased bowel tone and increased dependency.
• Take this medication with water.

Laxative Hyperosmotic

MoA: Increases water content in stool while stimulating peristalsis. Can increase excretion of ammonia into stool.

Indications: Cirrhosis, Hepatic Encephalopathy, Constipation, IBS, Diverticulosis, Anorectal Conditions, Pre-Op

Side Effects: Bloating, GI Distress

Nursing Implications:

• Monitor for improvement in mentation when indicated for hepatic encephalopathy.
• Monitor for Hypokalemia: abdominal pain, muscle weakness, cramps, and dizziness.
• Long term laxative use may cause decreased bowel tone and increased dependency.
• Take this medication with water.

Laxative Laxative-Stimulant

MoA: Stimulates intestinal nerves to increase peristalsis.

Indications: Constipation, IBS, Diverticulosis, Anorectal Conditions, Pre-Op

Side Effects: GI Distress, Reddish-Brown Urine

Nursing Implications:

• Monitor for Hypokalemia: abdominal pain, muscle weakness, cramps, and dizziness.
• Long term laxative use may cause decreased bowel tone and increased dependency.
• Take this medication with water.

Laxative Laxative-Stimulant

MoA: Stimulates intestinal nerves to increase peristalsis.

Indications: Constipation, IBS, Diverticulosis, Anorectal Conditions, Pre-Op

Side Effects: GI Distress

Nursing Implications:

• Monitor for Hypokalemia: abdominal pain, muscle weakness, cramps, and dizziness.
• Long term laxative use may cause decreased bowel tone and increased dependency.
• Take this medication with water.

Antihistamine H1 Antagonist

MoA: Blocks histamine-1 receptors from binding histamine.

• Histamine-1 receptors constrict respiratory tract vessels, induce hypotension, and increase capillary permeability.

Indications: Allergy Symptoms, Pruritus, Urticaria, Motion Sickness, Parkinson's Disease, Sleep Disorders

Side Effects: Headache, Vomiting

Nursing Implications:

• Educate patient to avoid driving and hazardous tasks due to increased drowsiness.
• Report excessive sedation, confusion, or hypotension to the healthcare provider.
• Suggest sugarless gum or hard candy for episodes of dry mouth.

Antihistamine H1 Antagonist

MoA: Blocks histamine receptors from binding histamine.

• Histamine-1 receptors constrict respiratory tract vessels, induce hypotension, and increase capillary permeability.

Indications: Seasonal Allergies, Pruritus, Urticaria, Motion Sickness, Parkinson's Disease, Sleep Disorders

Side Effects: Headache, Fatigue

Nursing Implications:

• Educate patient to avoid driving and hazardous tasks due to increased drowsiness.
• Report excessive sedation, confusion, or hypotension to the healthcare provider.
• Suggest sugarless gum or hard candy for episodes of dry mouth.

Decongestant Adrenergic

MoA: Stimulates adenergic effects by constricting blood vessels and inhibiting nasal secretions in surrounding tissues.

Indications: Nasal Decongestion

Side Effects: Nervousness, Insomnia, Palpitations

Nursing Implications:

• Educate patient about avoiding caffeine.
• If fever, cough, and other flu-like symptoms last longer than 1-week, notify healthcare provider.

Decongestant Corticosteroid

MoA: Suppresses the inflammtory response in the upper and lower respiratory tracts.

Indications: Asthma, Seasonal Allergies, Nasal Decongestion

Side Effects: Aching, Rhinorrhea, Xerostomia

Drug Interactions: NSAIDs

Nursing Implications:

• For respiratory indications, use bronchodilators before corticosteroids and use spacers to deliver successful inhalations.
• When using a Metered-Dose Inhaler, shake medication before use, hold inhalation for 10-seconds, and wait 1-minute between inhalations.

Antitussive Non-Opioid

MoA: Suppresses cough reflex by acting on cough center in the medulla, increases viscosity of respiratory secretions, and dries mucosa of respiratory tract.

Indications: Non-Productive Cough

Side Effects: Dizziness, Drowsiness, GI Distress

Nursing Implications:

• Educate patient to avoid driving and operating heavy machinery.
• If headache, fever, rash, or cough last longer than 1-week, notify healthcare provider.
• Monitor for Serotonin Syndrome: confusion, agitation, hallucinations, and tremors.

Expectorant

MoA: Loosens, thins, and disintegrates respiratory secretions by decreasing the visocsity of mucus.

Indications: Productive Cough

Side Effects: GI Distress, Rash

Nursing Implications:

• Educate patient to increase fluid intake to loosen and liquify secretions.
• If fever, cough, and other flu-like symptoms last longer than 1-week, notify healthcare provider.

Diabetic Drug Rapid Acting

MoA: Regulates glycemic index by promoting cellular uptake of glucose.

• Onset: 5-15 minutes
• Peak: 1-2 hours
• Duration: 3-5 hours

Indications: Diabetes Mellitus

Side Effects: Blurred Vision, Tingling, Diaphoresis, Dizziness

Nursing Implications:

• Rapid Acting Insulin is considered clear. If combined with NPH, draw this medication first (Clear before Cloudy).
• Educate patient about eating within 15-minutes to prevent hypoglycemia.
• Administer insulin via SQ route while rotating injection sites.
• Check blood glucose prior to administration. Hold if the patient is experiencing hypoglycemia.
• Giving insulin to hypokalemic patients can precipitate dysrhythmias.

Diabetic Drug Rapid Acting

MoA: Regulates glycemic index by promoting cellular uptake of glucose.

• Onset: 5-15 minutes
• Peak: 1-2 hours
• Duration: 3-5 hours

Indications: Diabetes Mellitus

Side Effects: Blurred Vision, Tingling, Diaphoresis, Dizziness

Nursing Implications:

• Rapid Acting Insulin is considered clear. If combined with NPH, draw this medication first (Clear before Cloudy).
• Educate patient about eating within 15-minutes to prevent hypoglycemia.
• Administer insulin via SQ route while rotating injection sites.
• Check blood glucose prior to administration. Hold if the patient is experiencing hypoglycemia.
• Giving insulin to hypokalemic patients can precipitate dysrhythmias.

Diabetic Drug Short Acting

MoA: Regulates glycemic index by promoting cellular uptake of glucose.

• Onset: 30-60 minutes
• Peak: 2-5 hours
• Duration: 6-10 hours

Indications: Diabete Mellitus, Hyperkalemia, DKA

Side Effects: Blurred Vision, Tingling, Diaphoresis, Dizziness

Nursing Implications:

• Short Acting Insulin is considered clear. If combined with NPH, draw this medication first (Clear before Cloudy).
• This is the only form of insulin that can be administered via IV push.
• Administer insulin via SQ route while rotating injection sites.
• Check blood glucose prior to administration. Hold if the patient is experiencing hypoglycemia.
• Giving insulin to hypokalemic patients can precipitate dysrhythmias.

Diabetic Drug Intermediate Acting

MoA: Regulates glycemic index by promoting cellular uptake of glucose.

• Onset: 1-2 hours
• Peak: 4-8 hours
• Duration: 10-18 hours

Indications: Diabetes Mellitus

Side Effects: Blurred Vision, Tingling, Diaphoresis, Dizziness

Nursing Implications:

• Intermediate Acting Insulin is considered cloudy. If combined with Short or Rapid Acting Insulin, draw this medication last (Clear before Cloudy).
• Administer insulin via SQ route while rotating injection sites.
• Check blood glucose prior to administration. Hold if the patient is experiencing hypoglycemia.
• Giving insulin to hypokalemic patients can precipitate dysrhythmias.

Diabetic Drug Long Acting

MoA: Regulates glycemic index by promoting cellular uptake of glucose.

• Onset: 3-4 hours
• Peak: None
• Duration: 24 hours

Indications: Diabetes Mellitus

Side Effects: Blurred Vision, Tingling, Diaphoresis, Dizziness

Nursing Implications:

• Increased risk for hypoglycemia due to no peak time.
• Do not mix with other insulin. It can be given separately with sliding scale insulin.
• Administer insulin via SQ route while rotating injection sites.
• Check blood glucose prior to administration. Hold if the patient is experiencing hypoglycemia.
• Giving insulin to hypokalemic patients can precipitate dysrhythmias.

Diabetic Drug Long Acting

MoA: Regulates glycemic index by promoting cellular uptake of glucose.

• Onset: 1-2 hours
• Peak: None
• Duration: 24 hours

Indications: Diabetes Mellitus

Side Effects: Blurred Vision, Tingling, Diaphoresis, Dizziness

Nursing Implications:

• Increased risk for hypoglycemia due to no peak time.
• Do not mix with other insulin. It can be given separately with sliding scale insulin.
• Administer insulin via SQ route while rotating injection sites.
• Check blood glucose prior to administration. Hold if the patient is experiencing hypoglycemia.
• Giving insulin to hypokalemic patients can precipitate dysrhythmias.

Diabetic Drug Biguanide

MoA: Decreases glucose production by the liver, decreases intestinal absorption of glucose, and increases cellular uptake of glucose. Does not stimulate insulin release.

Indications: Diabetes

Side Effects: GI Distress, Metallic Taste, Weight Loss

Nursing Implications:

• Risk of hypoglycemia is minimal because this medication does not increase insulin release.
• If the patient is Pre-Op or receiving IV contrast for imaging, discontinue 48hrs prior and wait 48hrs after procedure before continuing.
• Educate patient to take this medication with food.
• This medication can cause lactic acidosis and/or a Vitamin B12 deficiency.
• Oral diabetic agents may be co-administered with insulin to effectively manage blood glucose.

Diabetic Drug Sulfonylurea

MoA: Stimulates insulin secretion from beta cells in the pancreas and improves insulin sensitivity in tissues.

Indications: Diabetes

Side Effects: Diaphoresis, Dizziness, Polyphagia

Nursing Implications:

Drug Interactions: Alcohol

• Monitor for Hypoglycemia: diaphoresis, fatigue, irritability, and polyphagia.
• Oral diabetic agents may be co-administered with insulin to effectively manage blood glucose.

Diabetic Drug Sulfonylurea

MoA: Stimulates insulin secretion from beta cells in the pancreas and improves insulin sensitivity in tissues.

Indications: Diabetes

Side Effects: Diaphoresis, Dizziness, Polyphagia

Drug Interactions: Alcohol

Nursing Implications:

• Monitor for Hypoglycemia: diaphoresis, fatigue, irritability, and polyphagia.
• Oral diabetic agents may be co-administered with insulin to effectively manage blood glucose.

Diabetic Drug Sulfonylurea

MoA: Stimulates insulin secretion from beta cells in pancreas and improves insulin sensitivity in tissues.

Indications: Diabetes

Side Effects: Diaphoresis, Dizziness, Polyphagia

Drug Interactions: Alcohol

Nursing Implications:

• This drug can cause photosensitivity. Educate patient to use skin protection to prevent sunburns.
• Monitor for Hypoglycemia: diaphoresis, fatigue, irritability, and polyphagia.
• Oral diabetic agents may be co-administered with insulin to effectively manage blood glucose.

Diabetic Drug Glinide

MoA: Stimulates insulin secretion from beta cells in the pancreas.

Indications: Diabetes

Side Effects: Dizziness, Diaphoresis, Polyphagia

Nursing Implications:

• Do not administer this medication if the patient skips a meal.
• Monitor for Hypoglycemia: diaphoresis, fatigue, irritability, and polyphagia.
• Oral diabetic agents may be co-administered with insulin to effectively manage blood glucose.

Diabetic Drug Glinide

MoA: Stimulates insulin secretion from beta cells in the pancreas.

Indications: Diabetes

Side Effects: Dizziness, Diaphoresis, Polyphagia

Nursing Implications:

• Do not administer this medication if the patient skips a meal.
• Monitor for Hypoglycemia: diaphoresis, fatigue, irritability, and polyphagia.
• Oral diabetic agents may be co-administered with insulin to effectively manage blood glucose.

Diabetic Drug Alpha-Glucosidase

MoA: Delays glucose absorption.

Indications: Diabetes

Side Effects: GI Distress

Nursing Implications:

• Take this medication with meals.
• Oral diabetic agents may be co-administered with insulin to effectively manage blood glucose.

Anemia Drug Colony Stimulating Factor

MoA: Stimulates EPO receptors to generate red blood cells.

Indications: End-Stage Renal Disease, Chemotherapy, Anemia

Contraindications: Uncontrolled Hypertension, Thrombosis

Side Effects: Tachycardia, Fever, Headache, Arthralgia, Rash

Nursing Implications:

• Administered via IV or SQ routes.
• Use of this medication when hemoglobin >10 g/dL can cause a thromboembolic event.

Anemia Drug Supplement

MoA: Dissociates into the blood to increase serum iron levels. After dissociation, it can synthesize and transport hemoglobin.

Indications: Iron-Deficiency Anemia

Side Effects: GI Distress, Black Tarry Stool

Drug Interactions: Antacids, Calcium Supplements, Milk

Nursing Implications:

• Take liquid iron preparation through a straw due to risk for stained teeth.
• Take this medication with either water or juice on an empty stomach
• Remain upright for 15-30 minutes after oral Iron doses to avoid reflux.

Antineoplastic Cell-Cycle Specific

MoA: Acts on specific phases of the cell cycle to block replication of cancer cells.

Indications: Leukemia, Lymphoma, Ovarian Cancer, Prostate Cancer, Stomach Cancer

Side Effects: GI Distress, Alopecia, Stomatitis, Hematuria

Nursing Implications:

• This medication is given via IV only.
• Monitor for signs of Tumor Lysis Syndrome: dark urine, seizures, and muscle cramps.
• Monitor for Bone Marrow Suppression: anemia, leukocytosis, thrombocytopenia, mouth sores, and fever.
• Educate patient on rinsing mouth multiples times per day to reduce effects of stomatitis.

Antimetabolite DMARD Cell-Cycle Specific

MoA: Acts on specific phases of the cell cycle to block replication of cancer cells and inhibits response of immune cells.

Indications: Leukemia, Lymphoma, Sarcoma, Adenoma, Psoriasis, Rheumatoid Arthritis

Contraindications: Pregnant Women

Side Effects: Stomatitis, Poor Appetite, Rash, Bleeding

Nursing Implications:

• This medication can induce teratogenic effects in pregnant women.
• Monitor for signs of Tumor Lysis Syndrome: dark urine, seizures, and muscle cramps.
• Educate patient on rinsing mouth multiples times per day to reduce effects of stomatitis.
• Monitor for Bone Marrow Suppression: anemia, leukocytosis, thrombocytopenia, mouth sores, and fever.

Antineoplastic Cell-Cycle Specific

MoA: Acts on specific phases of the cell cycle to block replication of cancer cells.

Indications: Solid Tumors, Kaposi Sarcoma, Acute Leukemia, Lymphoma, Testicular Cancer, Lung Cancer, Breast Cancer, Ovarian Cancer

Side Effects: Alopecia, Constipation, Bleeding, GI Distress

Nursing Implications:

• This medication increases the risk of developing peripheral neuropathy.
• This medication is given via IV only.
• Monitor for Bone Marrow Suppression: anemia, leukocytosis, thrombocytopenia, mouth sores, and fever.

Antineoplastic Cell-Cycle Non-Specific

MoA: An alkylating agent that acts on all phases of cell cycle to prevent replication of cancer cells.

Indications: Bladder Cancer, Testicular Cancer, Ovarian Cancer

Side Effects: GI Distress, Tinnitus

Nursing Implications:

• Monitor electrolytes for low levels of Magnesium, Calcium, and Potassium.
• This medication is given via IV only.
• Monitor for Bone Marrow Suppression: anemia, leukocytosis, thrombocytopenia, mouth sores, and fever.
• Monitor for Nephrotoxicity: assess renal panel and urinary tract abnormalities.
• Educate the patient to increase fluid intake, rinse mouth, and avoid vaccinations while on this medication.

Alkylating Agent Cell-Cycle Non-Specific

MoA: An alkylating agent that acts on all phases of cell cycle to prevent replication of cancer cells.

Indications: Leukemia, Lymphoma

Side Effects: Alopecia, GI Distress, Stomatitis, Difficulty Urinating

Drug Interactions: Aspirin, NSAIDs

Nursing Implications:

• This medication poses a risk for developing hemorrhagic cystitis. Educate patient to empty bladder frequently.
• Avoid giving this medication during the evening.
• Monitor for Bone Marrow Suppression: anemia, leukocytosis, thrombocytopenia, mouth sores, and fever.

Antineoplastic Cell-Cycle Non-Specific

MoA: An alkylating agent that acts on all phases of cell cycle to prevent replication of cancer cells.

Indications: Breast Cancer

Side Effects: Hot Flashes, Discharge, GI Distress, Bleeding, Menstrual Irregularities, Vaginal Dryness

Nursing Implications:

• This medication increases the risk for thromboembolic events and endometrial cancer.

Dermatologic Drug Antibacterial

MoA: Inhibits replication of bacterium.

Indications: Staphylococcus Infection, Streptococcal Infection, Impetigo

Side Effects: Burning Pain, Pruritus, Redness

Nursing Implications:

• Monitor for therapeutic effects.

Dermatologic Drug Antibacterial

MoA: Targets the cell membrane and cell wall to destroy bacteria.

Indications: Infections of 2nd and 3rd Degree Burns

Side Effects: Burning Pain, Pruritus

Nursing Implications:

• Monitor for therapeutic effects.

Dermatologic Drug Antiacne

MoA: Inhibits sebaceous gland activity.

Indications: Recalcitrant Cystic Acne

Contraindications: Pregnant Women

Side Effects: Burning Pain, Pruritus, Redness

Drug Interactions: Tetracycline, Vitamin A Supplements

Nursing Implications:

• Monitor for possible suicidal ideation.
• This medication can induce teratogenic effects in pregnant women.
• This drug can cause photosensitivity. Educate patient to use skin protection to prevent sunburns.

Hematopoietic Drug Colony Stimulating Factor

MoA: Stimulates growth of colony stimulating factors to increase granulocyte production.

• Granulocytes include basophils, neutrophils, and eosinophils.

Indications: Anemia, Neutropenia, Thrombocytopenia

Side Effects: Fever, Aching, Bone Pain

Nursing Implications:

• Monitor for therapeutic effects.

Hematopoietic Drug Colony Stimulating Factor

MoA: Stimulates growth of colony stimulating factors to increase granulocyte and macrophage production.

• Granulocytes include basophils, neutrophils, and eosinophils.

Indications: Transplantation, Leukemia, Lymphoma, Anemia, Neutropenia, Thrombocytopenia

Side Effects: Fever, Aching, Bone Pain

Nursing Implications:

• Monitor for therapeutic effects.

Immunosuppressant

MoA: Inhibits immune cell activation to prevent tissue rejection.

Indications: Organ Transplant

Contraindications: Pregnant Women

Side Effects: Tachycardia, Edema, Hyperglycemia, Hypertension

Drug Interactions: Grapefruit Juice

Nursing Implications:

• Take oral forms with food.
• Monitor WBC counts throughout therapy as patients have an increased risk for infection.
• When indicated for Transplantation, this is a lifelong medication.

Men's Health Drug Anabolic Steroid

MoA: Binds to androgen receptors to stimulate growth of muscle tissue.

Indications: Replacement Therapy, Post-Surgical Weight Gain, Anemia, Hereditary Angioedema, Breast Cancer

Contraindications: Androgen-Responsive Tumors

Side Effects: Jaundice, Edema, Gynecomastia

Nursing Implications:

• Assess renal and liver function in addition to PSA level.

Men's Health Drug Anabolic Steroid

MoA: Binds to androgen receptors to stimulate growth of muscle tissue.

Indications: Replacement Therapy, Post-Surgical Weight Gain, Anemia, Hereditary Angioedema, Breast Cancer

Contraindications: Androgen-Responsive Tumors

Side Effects: Jaundice, Edema, Gynecomastia

Nursing Implications:

• Assess renal and liver function in addition to PSA level.

Men's Health Drug Anabolic Steroid

MoA: Binds to androgen receptors to stimulate growth of muscle tissue.

Indications: Replacement Therapy, Post-Surgical Weight Gain, Anemia, Hereditary Angioedema, Breast Cancer

Contraindications: Androgen-Responsive Tumors

Side Effects: Jaundice, Edema, Gynecomastia

Nursing Implications:

• Assess renal and liver function in addition to PSA level.

Men's Health Drug Androgen Inhibitor

MoA: Increases physiological levels of testosterone to stimulate hair growth.

Indications: Male Pattern Baldness

Contraindications: Androgen-Responsive Tumors, Pregnant Women

Side Effects: Loss of Libido, Erectile Dysfunction, Gynecomastia

Nursing Implications:

• Monitor for therapeutic effects.

Vasodilator

MoA: Stimulates vasodilation to increase blood flow.

Indications: Erectile Dysfunction, Pulmonary Hypertension

Contraindications: Cardiovascular Disorders

Side Effects: Priapism, Dizziness, Flushing

Drug Interactions: Nitrates

Nursing Implications:

• Seek immediate medical attention if priapism lasts more than 4-hours.

Women's Health Drug

MoA: Maintains female reproductive system and develops secondary sex characteristics by stimulating Estrogen receptors.

Indications: Atrophic Vaginitis, Hypogonadism, Oral Contraception, Uterine Bleeding, Hot Flashes, Osteoporosis, Breast Cancer, Prostate Cancer, Castration

Contraindications: Estrogen-Dependent Cancer, Abnormal Vaginal Bleeding, Pregnant Women, Thromboembolic Disorder

Side Effects: Weight Gain, Vaginal Discharge, Headache

Nursing Implications:

• Monitor for therapeutic effects.

Women's Health Drug

MoA: Inhibits secretion of pituitary gonadotropins.

Indications: Uterine Bleeding, Secondary Amenorrhea, Endometrial Cancer, Pregnancy Prevention

Contraindications: Estrogen-Dependent Cancer, Abnormal Vaginal Bleeding, Pregnant Women, Thromboembolic Disorder

Side Effects: GI Distress, Spotting, Amenorrhea, Edema, Weight Gain

Nursing Implications:

• Monitor for therapeutic effects.

Women's Health Drug Contraceptive

MoA: Prevents ovulation by inhibiting release of gonadotropins and increasing uterine mucous viscosity. Decreases sperm movement and inhibits zygote formation.

Indications: Endometriosis, Hypermenorrhea, Cyclic Withdrawal Bleeding, Pregnancy Prevention

Contraindications: Pregnant Women, Thromboembolic Disorder

Side Effects: Spotting, Amenorrhea

Nursing Implications:

• Monitor for thromboembolic event.
• Assess lab values for altered serum hormone concentrations.

Osteoporosis Drug Bisphosphonate

MoA: Inhibits bone resorption and osteoclast breakdown.

Indications: Prevention and Treatment of Osteoporosis, Hyperparathyroidism, Hypercalcemia

Contraindications: Hypocalcemia, Esophageal Dysfunction

Side Effects: Abdominal Pain, Arthralgia

Nursing Implications:

• Long term use of this medication can cause jaw necrosis.

Osteoporosis Drug Bisphosphonate

MoA: Inhibits bone resorption and osteoclast breakdown.

Indications: Prevention and Treatment of Osteoporosis, Hyperparathyroidism, Hypercalcemia

Contraindications: Hypocalcemia, Esophageal Dysfunction

Side Effects: Headache, Hypertension, GI Distress

Nursing Implications:

• Long term use of this medication can cause jaw necrosis.

Osteoporosis Drug Bisphosphonate

MoA: Inhibits bone resorption and osteoclast breakdown.

Indications: Prevention and Treatment of Osteoporosis, Hyperparathyroidism, Hypercalcemia

Contraindications: Hypocalcemia, Esophageal Dysfunction

Side Effects: Dizziness, Fatigue, GI Distress

Nursing Implications:

• Assess the patient's renal function.
• Long term use of this medication can cause jaw necrosis.

Osteoporosis Drug SERM

MoA: Binds to estrogen receptors to increase bone density.

Indications: Prevention of Postmenopausal Osteoporosis

Contraindications: Pregnant Women, Thromboembolic Disorder

Side Effects: Hot Flashes, Leg Cramps

Nursing Implications:

• Monitor patient for development of thromboembolic event and leukopenia.

Antipsychotic Typical

MoA: Blocks dopamine receptors in the limbic system.

Indications: Positive Psychotic Symptoms, Schizophrenia

Side Effects: Constipation, Decreased Sweating, Pupil Dilation, Xerostomia, Urinary Retention

Nursing Implications:

• Monitor for Extrapyramidal Side Effects: Acute Dystonia, Pseudoparkinsonism, Akathisia, and Tardive Dyskinesia.
• Monitor for Neuroleptic Malignant Syndrome: high fever, diaphoresis, hypertension, muscular rigidity, and altered level of consciousness.

Antipsychotic Typical

MoA: Blocks dopamine receptors in the limbic system.

Indications: Positive Psychotic Symptoms, Schizophrenia

Side Effects: Constipation, Decreased Sweating, Pupil Dilation, Xerostomia, Urinary Retention

Nursing Implications:

• Monitor for Extrapyramidal Side Effects: Acute Dystonia, Pseudoparkinsonism, Akathisia, and Tardive Dyskinesia.
• Monitor for Neuroleptic Malignant Syndrome: high fever, diaphoresis, hypertension, muscular rigidity, and altered level of consciousness.

Antipsychotic Atypical

MoA: Blocks dopamine receptors in the limbic system.

Indications: Positive and Negative Psychotic Symptoms, Schizophrenia

Side Effects: Drooling, Sedation, Weight Gain

Nursing Implications:

• Gradually titrate this medication.
• Monitor for Neuroleptic Malignant Syndrome: high fever, muscle rigidity, and altered mental status.
• Monitor for Infection: fever, flu-like symptoms, sore throat, and assess WBC count for agranulocytosis.
• Monitor for Metabolic Syndrome: weight gain, hyperglycemia, and hypercholesterolemia.

Antipsychotic Atypical

MoA: Blocks dopamine receptors in the limbic system.

Indications: Positive Psychotic Symptoms, Schizophrenia

Side Effects: Weight Gain, Constipation, Pupil Dilation, Xerostomia, Urinary Retention

Nursing Implications:

• Monitor for Metabolic Syndrome: weight gain, hyperglycemia, and hypercholesterolemia.

Antipsychotic Atypical

MoA: Blocks dopamine receptors in the limbic system.

Indications: Positive Psychotic Symptoms, Schizophrenia

Side Effects: Constipation, Decreased Sweating, Pupil Dilation, Xerostomia, Urinary Retention

Nursing Implications:

• Monitor for Metabolic Syndrome: weight gain, hyperglycemia, and hypercholesterolemia.

Antipsychotic Atypical

MoA: Blocks dopamine receptors in the limbic system.

Indications: Positive Psychotic Symptoms, Schizophrenia

Side Effects: Constipation, Decreased Sweating, Pupil Dilation, Xerostomia, Urinary Retention

Nursing Implications:

• Monitor for Metabolic Syndrome: weight gain, hyperglycemia, and hypercholesterolemia.

Antidepressant Tricyclic

MoA: Blocks norepinephrine and serotonin transporters.

Indications: Depression (2nd Line Treatment), Fibromyalgia

Contraindications: Cardiac Disease

Side Effects: Sedation, Weight Gain, Hypotension

Drug Interactions: NSAIDs, Anticoagulants, St. John's Wart

Nursing Implications:

• Tricyclic Antidepressants can induce anticholinergic effects: urinary retention, xerostomia, constipation.
• Monitor for potential development of cardiac arrythmia when taking TCA medications.
• Monitor for Serotonin Syndrome: confusion, agitation, hallucinations, and tremors.
• Do not stop this medication abruptly.
• Antidepressants can increase suicide risk.

Antidepressant SSRI

MoA: Blocks reuptake of serotonin.

Indications: Depression (1st Line Treatment), Anxiety

Side Effects: Sedation, Weight Gain, Hypotension, Sexual Dysfunction, GI Distress

Drug Interactions: NSAIDs, Anticoagulants, St. John's Wart

Nursing Implications:

• Monitor for Serotonin Syndrome: confusion, agitation, hallucinations, and tremors.
• Do not stop this medication abruptly.
• Antidepressants can increase suicide risk.

Antidepressant SSRI

MoA: Blocks reuptake of serotonin.

Indications: Depression (1st Line Treatment), Anxiety

Side Effects: Sedation, Weight Gain, Hypotension, Sexual Dysfunction, GI Distress

Drug Interactions: NSAIDs, Anticoagulants, St. John's Wart

Nursing Implications:

• Monitor for Serotonin Syndrome: confusion, agitation, hallucinations, and tremors.
• Do not stop this medication abruptly.
• Antidepressants can increase suicide risk.

Antidepressant SSRI

MoA: Blocks reuptake of serotonin.

Indications: Depression (1st Line Treatment), Anxiety

Side Effects: Sedation, Weight Gain, Hypotension, Sexual Dysfunction, GI Distress

Drug Interactions: NSAIDs, Anticoagulants, St. John's Wart

Nursing Implications:

• Monitor for Serotonin Syndrome: confusion, agitation, hallucinations, and tremors.
• Do not stop this medication abruptly.
• Antidepressants can increase suicide risk.

Antidepressant SNRI

MoA: Blocks reuptake of serotonin and norepinephrine.

Indications: Depression, Anxiety (1st Line Treatment), Fibromyalgia, Diabetic Neuropathy

Side Effects: Sedation, Weight Gain, Hypotension, Sexual Dysfunction

Drug Interactions: NSAIDs, Anticoagulants, St. John's Wart

Nursing Implications:

• Monitor for Serotonin Syndrome: confusion, agitation, hallucinations, and tremors.
• Do not stop this medication abruptly.
• Antidepressants can increase suicide risk.

Antidepressant MAOI

MoA: Blocks effects of enzymes that breakdown serotonin, norepinephrine, and dopamine.

Indications: Depression (3rd Line Treatment)

Side Effects: Sedation, Weight Gain, Hypotension, Agitation

Drug Interactions: SSRI, NSAIDs, Anticoagulants, Opioids, St. John's Wart

Nursing Implications:

• Educate patient on tyramine-restricted diet. Avoid foods such as cheese, sherry, pickled foods, stimulants, and cured meats due to increased risk for hypertensive crisis.
• Monitor for Serotonin Syndrome: confusion, agitation, hallucinations, and tremors.
• Do not stop this medication abruptly.
• Antidepressants can increase suicide risk.
• Simultaneous use with SSRIs can lead to Neuroleptic Malingnant Syndrome, Serotonin Syndrome, or precipitate a hypertensive crisis.

Antimanic Mood Stabilizer

MoA: Triggers release of serotonin, GABA, and other inhibitory neurotransmitters .

Indications: Mania, Bipolar Disorder (1st Line Treatment)

Contraindications: Pregnant Women

Side Effects: GI Distress, Drowsiness, Thirst, Tremor, Polyuria, Weight Gain

Drug Interactions: NSAIDs, Diuretics, Anticholinergics, Alcohol

Nursing Implications:

• Therapeutic range of this medication: 0.6-1.2 mEq/L. Greater than 1.5 mEq/L indicates toxicity.
• Monitor for signs of toxicity: vomiting, ataxia, lethargy, tremors, and seizures.
• Educate patient to hydrate, maintain normal sodium intake, and avoid vigorous activity as this medication is excreted like a salt.
• Dehydration, Renal Impairment, and Hyponatremia can precipitate Lithium toxicity.
• Ensure the patient takes this medication at the same time every day.
• This medication can take weeks to see therapeutic effects.

Antimanic Anticonvulsant Antiepileptic Mood Stabilizer

MoA: Increases concentration of GABA in the brain.

Indications: Mania, Bipolar Disorder (2nd Line Treatment), Seizure

Contraindications: Pregnant Women

Side Effects: Weight Gain, Hair Loss, Tremors, GI Upset

Nursing Implications:

• Therapeutic range of this medication: 50-125 mcg/mL.
• Monitor liver function tests.

Antidepressant MAOI

MoA: Blocks effects of enzymes that breakdown serotonin, norepinephrine, and dopamine.

Indications: Depression (3rd Line Treatment)

Side Effects: Sedation, Weight Gain, Hypotension, Xerostomia, Constipation, Urinary Retention

Drug Interactions: SSRI, NSAIDs, Anticoagulants, Opioids, St. John's Wart

Nursing Implications:

• Educate patient on tyramine-restricted diet. Avoid foods such as cheese, sherry, pickled foods, stimulants, and cured meats due to increased risk for hypertensive crisis.
• Monitor for Serotonin Syndrome: confusion, agitation, hallucinations, and tremors.
• Do not stop this medication abruptly.
• Antidepressants can increase suicide risk.
• Simultaneous use with SSRIs can lead to Neuroleptic Malingnant Syndrome, Serotonin Syndrome, or precipitate a hypertensive crisis.

Antibiotic Antitubercular Aminoglycoside

MoA: Induces bactericidal effects by binding to ribosomal subunits.

Indications: Gram(+,-) Bacteria, Multi-Drug Resistant Tuberculosis

Contraindications: Pregnant Women

Side Effects: GI Distress

Nursing Implications:

• Take this medication with water.
• Monitor for Nephrotoxicity: assess renal panel and urinary tract abnormalities.
• Monitor for Ototoxicity: tinnitus and decreased hearing.
• Ensure the patient understands to take the full antibiotic course to decrease risk of antibiotic resistance.

Bronchodilator Corticosteroid Beta-Adrenergic Agonist

MoA: A long-acting agent that binds to Beta-2 receptors. Additionally, this medication inhibits inflammatory and immune responses by increasing cortisol levels.

• Beta-2 receptors dilate bronchioles, relax the uterus, decrease gastric motility, and increase renin secretion.

Indications: Long-term Asthma

Contraindications Uncontrolled Hypertension, Arrhythmias, Infection

Side Effects: Headache, Nausea, Xerostomia

Drug Interactions: NSAIDs

Nursing Implications:

• This medication is not indicated for acute asthma attacks.
• For respiratory indications, use bronchodilators before corticosteroids and use spacers to deliver successful inhalations.
• When using a Metered-Dose Inhaler, wait 1-minute between inhalations.

Anticholinergic Antimuscarinic

MoA: Binds to muscarinic receptors to block effects of acetylcholine and inhibit parasympathetic activity.

• Cholinergic receptors stimulate urinary and gastrointestinal activity, constrict pupils, increase salivation, constrict bronchioles, and decrease heart rate.
• Muscarinic receptors are a type of cholinergic receptor that act on smooth muscle.

Indications: Overactive Bladder, Urinary Frequency, Urge Incontinence

Contraindications: Glaucoma

Side Effects: Constipation, Urinary Retention, Xerostomia, Blurred Vision

Drug Interactions: CNS Depressants, Alcohol

Nursing Implications:

• Monitor for Anticholinergic toxicity: urinary hesitancy, tremors, confusion, and hallucinations.
• Physostigmine is an antidote for Anticholinergic toxicity.
• Teach older patients to limit physical exertion and avoid high temperatures due to risk for heatstroke.
• Educate patient to wear dark glasses due to light sensitivity and use caution when driving due to risk for blurred vision.
• Suggest sugarless gum or hard candy for episodes of dry mouth.

Thrombolytic

MoA: Breaks down clots by activating the fibrinolytic system and plasminogen which converts to plasmin.

Indications: Myocardial Infarction, Deep Vein Thrombosis, Shunt or Catheter Occlusion, Embolus, Acute Ischemic Stroke

Contraindications: Hemorrhage, Aneurysm, Ischemic Stroke, Aortic Dissection, Head Injury

Side Effects: Bleeding

Nursing Implications:

• Monitor ECG for possible cardiac dysrhythmias.
• This medication increases the risk for bleeding. Signs of bleeding include: black tarry stools, bleeding gums, hematuria, and bruising.

Thrombolytic

MoA: Breaks down clots by activating the fibrinolytic system and plasminogen which converts to plasmin.

Indications: Myocardial Infarction, Deep Vein Thrombosis, Shunt or Catheter Occlusion, Embolus, Acute Ischemic Stroke

Contraindications: Hemorrhage, Aneurysm, Ischemic Stroke, Aortic Dissection, Head Injury

Side Effects: Bleeding

Nursing Implications:

• Monitor ECG for possible cardiac dysrhythmias.
• This medication increases the risk for bleeding. Signs of bleeding include: black tarry stools, bleeding gums, hematuria, and bruising.

Antihypertensive Antianginal Antiarrhythmic Calcium Channel Blocker

MoA: Blocks the flow of calcium in the heart. Reduces cardiac workload, decreases myocardial oxygen demand, and decreases systemic vascular resistance by dilating coronary and peripheral arteries.

• Calcium plays a role in generating and propagating electrical impulses.

Indications: Angina, Hypertension

Side Effects: Bradycardia, Hypotension, Headache, Dizziness, Flushing, Constipation

Drug Interactions: Grapefruit Juice

Nursing Implications:

• Do not consume this medication with grapefruit. It can precipitate hypotension.
• Instruct patient to increase fiber intake to reduce effects of constipation.

Antihypertensive Antianginal Antiarrhythmic Calcium Channel Blocker

MoA: Blocks the flow of calcium in the heart. Reduces cardiac workload, decreases myocardial oxygen demand, and decreases systemic vascular resistance by dilating coronary and peripheral arteries.

• Calcium plays a role in generating and propagating electrical impulses.

Indications: Angina, Hypertension

Side Effects: Bradycardia, Hypotension, Headache, Dizziness, Constipation

Drug Interactions: Grapefruit Juice

Nursing Implications:

• Do not consume this medication with grapefruit. It can precipitate hypotension.
• Instruct patient to increase fiber intake to reduce effects of constipation.

Antihypertensive Antianginal Antiarrhythmic Calcium Channel Blocker

MoA: Blocks the flow of calcium in the heart. Reduces cardiac workload and AV node conduction, decreases myocardial oxygen demand, and decreases systemic vascular resistance by dilating coronary and peripheral arteries.

• Calcium plays a role in generating and propagating electrical impulses.

Indications: Angina, Hypertension, A-Fib, Atrial Flutter

Side Effects: Bradycardia, Hypotension, Headache, Constipation

Drug Interactions: Grapefruit Juice, Beta Blockers

Nursing Implications:

• Do not consume this medication with grapefruit, it can precipitate hypotension.
• Instruct patient to increase fiber intake to reduce effects of constipation.

Diabetic Drug Thiazolidinedione

MoA: Improves insulin sensitivity systemically, but does not release excess insulin.

Indications: Diabetes

Contraindications: Heart Failure, Fluid Volume Excess

Side Effects: Edema, Weight Gain

Nursing Implications:

• This medication can increase the risk for Bladder Cancer or Cardiovascular events.
• Monitor for Hypoglycemia: diaphoresis, fatigue, irritability, and polyphagia.

Diabetic Drug Thiazolidinedione

MoA: Improves insulin sensitivity systemically, but does not release excess insulin.

Indications: Diabetes

Contraindications: Heart Failure, Fluid Volume Excess

Side Effects: Edema, Weight Gain

Nursing Implications:

• This medication can increase the risk for Bladder Cancer or Cardiovascular events.
• Monitor for Hypoglycemia: diaphoresis, fatigue, irritability, and polyphagia.

Potassium Removing Agent

MoA: Removes excess systemic potassium.

Indications: Hyperkalemia

Side Effects: Constipation, Palpitations, Muscle Weakness

Nursing Implications:

• Monitor for Intestinal Necrosis: constipation, impaction, and abnormal bowel patterns.
• Monitor for Hypokalemia: muscle weakness, palpitations, fatigue, and paresthesia.

Anxiolytic

MoA: This medication exerts agonistic effects on serotonin receptors while blocking some dopamine receptors.

Indications: Anxiety

Side Effects: Dizziness, Drowsiness, Fatigue

Nursing Implications:

• Buspirone (Buspar) has low abuse potential and does not produce withdrawal symptoms or depressing CNS effects.
• This medication can take weeks to see therapeutic effects.

Analgesic

MoA: Acts as a local anesthetic on the mucosa of the urinary tract.

Indications: Urinary Pain and Burning