NCLEX MEDS
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| ACE INHIBITORS (pril) lisinopril (Zestril, Prinivil) benazepril (Lotensin) catopril (Capoten) enalipril (Vasotec) quinapril (accupril) ramipril (Altace) | 1. n/v/d 2. persistant dry hacking cough (ACE only) 3. hypotension 4. hyperkalemia 5. tachycardia 6. headache/dizziness 7. insomnia 8. bruising, petechiae, bleeding 9. diminished taste (ACE only) | show 🗑
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| show | 1. headache 2. hypotension 3. dizziness/weakness/faintess 4. flushing or pallor 5. tachycardia | 1. caution pt to make position changes slowly to minimize orthostatic hypotension
2. inform pt headache is a common s/e
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| ANGIOTENSIN RECEPTOR BLOCKERS (sartan) *losartan (Cozaar)* candesartan (Atacand) eprosartan (Teveten) irbesartan (Avapro) olmesartan (Benicar) telmisartan (Micardis) valsartan (Diovan) | show | 1. instruct pt how to take BP
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| BETA BLOCKERS (olol) *carvedilol (Coreg)* *propranolol (Inderal)* sotalol (Betaspace) timolol (Blocadren) *atenolol (Tenormin)* metoprolol (Lopressor, Toprol-XL) | show | 1. hold meds if pulse or BP is not within prescribed parameters
2. monitor signs or worsening of HF
3. advise pt taking insulin that beta blockers can mask early signs of hypoglycemia- tachycardia/nervousness
4. rise slowly to prevent hypotension
5.
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| show | 1. hypokalemia, hyponatremia, hypocalcemia, hypomagnesemia, hypochloremia 2. thrombocytopenia 3. hyperuricemia 4. ototoxicity and deafness 5. dehydration 6. orthostatic hypotension | 1. monitor I&O, weight
2. check peripheral for edema
3. instruct pt to take meds in the AM to avoid nocturia
4. instruct pt to eat foods high in potassium
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| show | 1. hyperkalemia | 1. instruct pt to avoid foods high in potassium
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| THIAZIDE DIURETICS (thiazide) chlorothiazide (Diuril) chlorothalidone (Hygroton, Thalitone) hydrochlorothiazide (HydroDIURIL) quinethazone (Hydromox) | 1. hypokalemia and hyponatremia 2. hypotension | show 🗑
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| show | 1. fluid and electrolyte imbalance 2. transient plasma volume increase 3. pulmonary edema 4. cellular dehydration | 1. monitor v/s including CVP hourly
2. insert foley, record urine output
3. monitor weight, I&O, sodium and potassium levels
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| OSMOTIC DIURETICS acetazolamide (Diamox)= EYES, tx glaucoma | 1. hyperglycemia, hyperurecemia, hypercalcemia, hypokalemia 2. orthostatic hypotension 3. renal calculi 4. hemolytic anemia | show 🗑
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| show | 1. hemorrhage | 1. monitor PT/INR
2. avoid salicylates
3. observe for any bleeding
4. teach pt of use soft toothbrush and electric razor
5. avoid foods high in vitamin K such as green leafy vegetables
6. ANTIDOTE: Vitamin K (phytonadione, aquaMEPHYTON)
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| ANTICOGULANTS (in OR arin) heparin (Lovenox)= IV, SUBQ argatroban (Acova) bivalirudin (Angiomax) dalteparin (Fragmin) desirudin (Ipravask) enoxaparin (Lovenox) fondaparinux (Atrixta) lepirudin (Refludan) tinzaparin (Innohep) | show | 1. monitor aPTT
2. avoid salicylates
3. observe for any bleeding
4. avoid foods high in vitamin K such as green leafy vegetables
5. ANTIDOTE: Protamine Sulfate
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| show | 1. orthostatic hypotension 2. restlessness 3. insomnia (Parnate) 4. dizziness, weakness, lethargy 5. dry mouth 6. anticholinergic effects 7. CNS= anxiety, agitation, severe depression 8. erection/orgasm difficulty; delay in ejaculation | AVOID foods that contain TYRAMINE: avocados, bananas, beef or chicken liver, brewer's yeast, broad beans, no caffeine such as coffee, tea, chocolate, cheese, figs (fruit), overripe fruit, meat extracts, papaya, pickled herring, raisins, red wine, beer...
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| RAPID/FAST ACTING INSULIN lispro (Humolog) aspart (NovoLog) glulisine (Aprida) | show | 1. given with food during breakfast
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| show | ONSET: 0.5 PEAK: 2.4 hours DURATION: 6-8 hours; 8hrs only for Novolin R and Velosulin BR |
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| INTERMEDIATE INSULIN NPH (Neutral Protamine Hagedorn) Lente | show |
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| show | ONSET: 4-6 hours; Lantus immediate PEAK: 18+ hours; Lantus constant DURATION: 30-36 hours; Lantus 24 hours | 1. contraindicated for children under 6 y/o
2. given @ BEDTIME
3. cannot be given IV, cannot be mixed with other insulin
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| COMBINATION INSULIN 70 NPH _________ 30 regular | show |
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| HERBAL kava kava | show | TX for gonorrhea
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| HERBAL ginger | show |
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| NARCOTIC/OPIOID ANALGESICS codeine, meperidine hydrochloride (Demerol) morphine sulfate | 1. respiratory depression 2. hypotension 3. bradycardia 4. sedation, drowsiness 5. n/v 6. constipation, urinary retention 7. tremors | show 🗑
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| ORAL HYPOGLYCEMICS; BIGUANIDES metformin (Glucophage) | show | 1. it suppresses hepatic production of glucose and increases insulin sensitivity
2. if hypoglycemia occurs, advise pt to take glass of orange juice or 2-3 tsp of sugar, honey or corn syrup dissolved in water
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| show | 1. given with 1st bite of meal @ breakfast**
2. will not cause hypoglycemia when given alone
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| ANTIANEMICS; IRON DEFICIENCY ANEMIA ferrous sulfate (Feosol) | show | 1. absorption best if given between meals
2. GI upset, give w/ meals or orange juice
3. Vitamin C may increase absorption
4. teach pt to increase fiber, fluids, exercise
5. LIQUID P.O- use straw to prevent staining teeth
6. PARENTERAL-Ztrack air lock
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| HERBAL Saw Palmetto (antiestrogen activity) | show | BPH & UTI
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| MANIC/BIPOLAR DISORDER lithium carbonate (Eskalith, Lithobid) NORMAL LEVELS: 0.5-1.2 1.5=TOXICITY!!! | 1. polyuria, polydipsia (dry mouth) 2. anorexia, nausea 3. weight gain, ABD bloating 4. fine hand tremors, muscle weakness 5. inability to concentrate 6. lethargy, fatigue, headache 7. hair loss, hypothyroidism | show 🗑
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| LITHIUM TOXICITY | MILD 1.5 mEq/L 1. apathy 2. lethargy 3. diminished concentration 4. ataxia 5. coarse hand tremors 6. slight muscle weakness | show 🗑
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| PROTON PUMP INHIBITORS (prazole) omeprazole (Prilosec)* esomeprazole (Nexium) lansoprazole (Prevacid) pantoprazole (Protonix) rabeprazole (Aciphex) | common s/e 1. headache 2. diarrhea 3. ABD pain 4. nausea other: confusion, arrhythmias, agranulocytosis, aplastic anemia | show 🗑
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| H2 INHIBITOR (tidine) cimetidine (Tagamet)* famotidine (Pepcid) nizatidine (Axid) ranitidine (Zantac)* | 1. drowsiness 2. dizziness 3. blurred vision | show 🗑
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| HERBAL Echinacea | show |
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| show | 1. dizziness 2. headache 3. ABD pain 4. anorexia, nausea s/s of alcohol deterrent: flushing, n/v, palpitations, and tachycardia >>> | 1. urine may turn brownish/black
2. teach pt NOT to apply cologne after shave lotion, bath splashes, ingest ETOH products (anything containing alcohol) to avoid disulfiram (Anatabuse) type reaction
3. *cough drops contain alcohol*
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| show | 1. hepatotoxicity & peripheral neuropathy* 2. n/v 3. dry mouth 4. dizziness 5. hyperglycemia 6. vision changes (color, disturbances)* 7. hepatitis | 1. MONITOR LIVER FUNCTION TESTS*
2. notify MD for loss of appetite, fatigue, malaise, jaundice, & dark urine
3. give pyridoxine (Vitamin B6) to prevent peripheral neuropathy**
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| ANTITUBERCULAR; pulmonary tuberculosis ethambutol (Myambutol) | 1. vision loss and loss of color discrimination* | show 🗑
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| ANTITUBERCULAR: pulmonary tuberculosis rifampin (Rifadin)* | show | 1. monitor liver function tests
2. may require ^doses of warfarin, corticosteroids, and hypoglycemic
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| ANTIVIRAL (vir) acyclovir (Zovirax) *tx of: genital herpes, infections of localized cutaneous herpes Zoster, shingles, and chicken pox (Varicella) | 1. seizures 2. dizziness 3. headache 4. hallucinations 5. trembling 6. renal failure | show 🗑
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| ANTIVIRAL; prevents HIV cells from multiplying in your body ritonivir (Norvir) | 1. n/v/d/anorexia 2. asthenia, parathesia 3. taste changes 4. dizziness 5. vasodilation | show 🗑
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| show | 1. bradycardia 2. hypotension 3. headache 4. dizziness/lightheadedness 5. peripheral edema 6. constipation 7. flushing of the skin | 1. monitor: v/s, HF, kidney function, live enzymes
2. instruct how to take pulse
3. encourage pt to change positions or get up slowly to avoid orthostatic hypotension
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