Top 50 Drugs-Nursing

Classification: Bronchodilator Beta 2 agonist Therapeutic Effects: Bronchodilation for asthma, COPD, acute bronchospasm Adverse Reactions & side effects: Nervousness, restlessness, tremor, chest pain, palpitations. Nursing Implications & teaching: Assess lung sound before & after TX. Observe for paradoxical bronchospasm (wheezing). Consider aerochamber.

Monitor K+ and glucose. Rinse mouth with water to minimize dry mouth.

Classification: Sedative / hypnotic Therapeutic Effects: Sedation and induction of sleep Adverse Reactions & side effects: Amnesia, daytime drowsiness, drugged feeling, physical & psychological dependence, tolerance, GI effects Nursing Implications & teaching: Assess sleep, mental status, potential for dependence. Don't use more than 7-10 days. Avoid ETOH & other CNS depressants

Classification: Antianxiety Sedative / hypnotic.

Benzodiazepine. Therapeutic Effects:Management of anxiety, insomnia, Status Epilepticus. Preoperative sedation. Postoperative amnesia Adverse Reactions & side effects: Dizziness, drowsiness, lethargy, APNEA, CARDIAC ARREST with rapid IVP Nursing Implications & teaching: Assess anxiety, mental status,. Avoid ETOH & other CNS depressants

Classification: Antidiabetic. Thiazolidinediones Therapeutic Effects: Decrease insulin resistance Adverse Reactions & side effects: Edema, anemia, wt gain, increased cholesterol Nursing Implications & teaching: Monitor for fluid retention, hypoglycemia.

Check PLFTs & CBC High Alert Medication!

Classification: Antianginal antiarrhythimics (class IV) antihypertensive. CA++ channel blocker Therapeutic Effects: Decreased blood pressure. Coronary vasodilation. Antiarrhythimic Adverse Reactions & side effects: Arrhythmias.

CHF. Peripheral edema, Postural hypotension Nursing Implications & teaching: Assess for signs of CHF. Monitor BP , notify < 50 bpm. May cause drowsiness of dizziness. Caution patient to avoid driving until response to medication is known.

Gingival hyperplasia-teach good oral care

Classification:NSAIDs, COX-2 inhibitor Therapeutic Effects: Analgesic, anti- inflammatory, & anti- pyretic Adverse Reactions & side effects: GI BLEEDING, dermal rash, GI effects Nursing Implications & teaching: Assess pain, ROM and swelling. Do not give if allergic to sulfonamides, aspirin or NSAIDs. Watch for tarry stools.

Classification: Angiotensin II receptor blocker Therapeutic Effects: Antihypertensive. Decreases risk of stroke.

Adverse Reactions & side effects: Orthostatic hypotension, diarrhea. Dizziness, ANGIOEDEMA. Use cautiously in CHF Nursing Implications & teaching: Assess orthostatic blood pressures. Use care when changing positions to prevent orthostatic hypotension. Monitor BUN/Creatinine for possible early renal failure.

Classification:Anticoagulant.

Interferes with hepative syntheses of Vitamin K- dependant clotting factors Therapeutic Effects: Prophylaxis/Treatment of venous &/or pulmonary embolism (PE) and atrial fibrillation w/ embolization. Antidote = Vitamin K Adverse Reactions & side effects: Bleeding. Numerous drugs and natural products affect the activity of warfarin! Nursing Implications & teaching: Asses for bleeding, or increased thrombosis. Check INR/PT before administration and regularly. PT may be 1.3-1.

5 times greater than control. INR goal dependent on medical diagnosis. Maintain consistent vitamin K, Take in evening. Avoid ETOH & OTC medications. High Alert Medication

Classification:Anti-inflammatory.

(intermediate acting) corticosteroid Therapeutic Effects: inflammation & modification of the normal immune response; replacement therapy in adrenal insufficiency. Management of cerebral edema. Potentiates anti-N/V action of Zofran. Adverse Reactions & side effects: PEPTIC ULCERATION, THROMBOEMBOLISM, mood changes, hypertension, anorexia, nausea, acne, decreased wound healing, ecchymosis, fragility, hirsutism, petechiae, adrenal suppression, muscle wasting, osteoporosis, cushingoid appearance, GI effects Nursing Implications & teaching:Monitor for fluid retention, hyperglycemia, infections, bleeding, steady weight gain, crackles, dyspnea. Do not D/C abruptly.

Monitor serum electrolytes, cholesterol/lipids. avoid people w/contagious illnesses, TAKE WITH FOOD

Classification: Anti-inflammatory (long acting) corticosteroid Therapeutic Effects: inflammation & modification of the normal immune response; replacement therapy in adrenal insufficiency. Management of cerebral edema. Potentiates anti-N/V action of Zofran. Adverse Reactions & side effects: PEPTIC ULCERATION, THROMBOEMBOLISM, mood changes, hypertension, anorexia, nausea, acne, decreased wound healing, ecchymosis, fragility, hirsutism, petechiae, adrenal suppression, muscle wasting, osteoporosis, cushingoid appearance, GI effects Nursing Implications & teaching:Monitor for fluid retention, hyperglycemia, infections, bleeding, steady weight gain, crackles, dyspnea. Do not D/C abruptly.

Monitor serum electrolytes, cholesterol/lipids. avoid people w/contagious illnesses, TAKE WITH FOOD

Classification: Antiarrhythmic, Anticonvulsant Therapeutic Effects: Decrease seizures, control arrhythmias; Decrease pain Adverse Reactions & side effects: Aganulocytosis, aplastic anemia, Stevens-Johnson syndrome. diplopia, nystagmus, hypotension, gingival hyperplasia, nausea, rashes Nursing Implications & teaching: Assess for hypersensitivity syndrome; monitor CBC, platelet count, avoid driving till MD ok; avoid ETOH & OTC meds; maintain oral hygiene; urine can be pink/red; diabetic-monitor glucose closely; avoid taking within 2-3hr of antacids/antidiarrheals; decrease contraceptive(hormonal), TAKE WITH FOOD

Classification: Antiinfective, antiulcer, Antiprotozoal Therapeutic Effects: Treatment of anaerobic and parasitic infections Adverse Reactions & side effects: SEIZURES, dizziness, HA, anorexia, nausea, GI effects Nursing Implications & teaching:Monitor WBC, neurological status, and I/Os, TAKE WITH FOOD

Classification: Peripherally acting anti-adrenergic. Therapeutic Effects: Decreased symptoms of prostatic hyperplasia, i.

e. male urinary outflow obstruction Adverse Reactions & side effects: Dizziness, headache, orthostatic hypotension, retrograde/ diminished ejaculation. Cautious in patients at risk for prostate carcinoma Nursing Implications & teaching: Monitor for dizziness, hypotension. Have patient change positions slowly to minimize symptoms.

Classification: Bone resorption inhibitor. Bisphosphonate Therapeutic Effects: TX and prevention of post-menopausal and cortico-steroid-induced osteoporosis, Adverse Reactions & side effects: Altered taste, photosensitivity, rash, musculoskeletal pain, fluid overload, esophagitis. Common upset stomach & heartburn, GI effects Nursing Implications & teaching:Take first thing in the AM, before eating anything; then pt MUST remain upright for at least 30 mins! Take only with plain water. Monitor for GI side effects.

Use sunscreen to prevent photosensitivity reactions.

Classification: Antiinfective, Aminoglycoside Therapeutic Effects: Treatment for enterococcal infections Adverse Reactions & side effects: Ototoxicity and nephrotoxicity Nursing Implications & teaching: Do peak and trough levels, report to MD for dose adjusting. Assess hearing periodically throughout TX. Monitor for superinfections

Classification: Anti-diabetic.

Biguanides Therapeutic Effects: Decrease hepatic glucose production & intestinal absorption, increased receptor site sensitivity, GI effects Adverse Reactions & side effects: Abdominal bloating. Lactic acidosis. Metallic taste Nursing Implications & teaching: Educate about lactic acidosis when food or fluid is decreased. (S/S - chills, diarrhea, dizziness, low BP, weakness, muscle pain, slow HR. Notify MD IMMEDIATELY). Stop drug before dye based studies.

Check renal function. TAKE WITH FOOD

Classification: Anticoagulant Therapeutic Effects: Antithrombotic. Prevention of extension of existing thrombi Antidote = protamine sulfate Adverse Reactions & side effects: BLEEDING. Thrombocytopenia, anemia. Has multiple drug reactions Nursing Implications & teaching: Assess for bleeding (nose, gums, urine, stool), anemia, thrombocytopenia. Closely monitor aPTT.

High Alert Medication. Use heparin nomogram/protocol. Immediate onset when given IV

Classification: Antihypertensive. Non K+ sparing diuretic Therapeutic Effects: Decrease Blood Pressure.

Increase in Urine output Adverse Reactions & side effects: Hypokalemia. Drowsiness. Digoxin toxicity. Increased glucose levels Nursing Implications & teaching: Monitor blood pressure, I & O, daily wt, Monitor lytes. Administer in AM.

Change positions slowly to minimize orthostatic hypotension.

Classification: Immunosuppressant Therapeutic Effects: Prevent renal transplant rejection. Treat Rheumatoid arthritis and Chron's Adverse Reactions & side effects: Blood dyscryasias, hepatotoxicity, GI effects Nursing Implications & teaching: Check CBC, LFT. Assess for infection, fluid retention, bleeding. Contraception and teratogenic concerns.

Do not d/c abruptly

Classification: Antidiabetic; pancreatic hormone. Long acting 24 hours Therapeutic Effects: Lowers blood glucose by increasing transport into cells and promoting conversion of glucose to glycogen. Inhibits release of free fatty acids. Adverse Reactions & side effects: HYPOGYCEMIA, lipodystrophy, anaphylaxis Nursing Implications & teaching: For all insulins: typical diabetic teaching and concerns. Watch for interactions with beta blockers, thiazide diuretics, corticosteroids.

Lantus: Do not mix with any other insulin. No peak. Humulin 70/30: 2 Peaks . Lispro: Do not give sooner than 15 minutes before a meal . Know peaks, onsets, durations High Alert Medications

Classification: Anti-diabetic; pancreatic hormone. Onset 30 min Therapeutic Effects: Lowers blood glucose by increasing transport into cells and promoting conversion of glucose to glycogen.

Inhibits release of free fatty acids. Adverse Reactions & side effects: HYPOGYCEMIA, lipodystrophy, anaphylaxis Nursing Implications & teaching: For all insulins: typical diabetic teaching and concerns. Watch for interactions with beta blockers, thiazide diuretics, corticosteroids. Lantus: Do not mix with any other insulin. No peak. Humulin 70/30: 2 Peaks .

Lispro: Do not give sooner than 15 minutes before a meal . Know peaks, onsets, durations High Alert Medications

Classification: Anti-diabetic pancreatic hormone Onset < 15 min Therapeutic Effects: Lowers blood glucose by increasing transport into cells and promoting conversion of glucose to glycogen. Inhibits release of free fatty acids. Adverse Reactions & side effects: HYPOGYCEMIA, lipodystrophy, anaphylaxis Nursing Implications & teaching: For all insulins: typical diabetic teaching and concerns.

Watch for interactions with beta blockers, thiazide diuretics, corticosteroids. Lantus: Do not mix with any other insulin. No peak. Humulin 70/30: 2 Peaks .

Lispro: Do not give sooner than 15 minutes before a meal . Know peaks, onsets, durations High Alert Medications

Classification: Potassium supplement Therapeutic Effects: Transmit nerve impulses; contraction of cardiac, skeletal, and smooth muscle; gastric secretion; renal function; tissue synthesis; and CHO metabolism. Adverse Reactions & side effects: ARRHYTHMIAS, ECG changes oral—abdominal pain, diarrhea, flatulence, nausea & vomiting, GI effects Nursing Implications & teaching: (IV rate should generally not exceed 20 mEq/hr, unless closely monitored.) Check for s/s hypokalemia/hyperkalemia, TAKE WITH FOOD

Classification: Antiarrhythmic, cardiotonic and inotropic agent Therapeutic Effects: TX of CHF, tachyarrhythmia. Antidote immune Fab (Digibind) Adverse Reactions & side effects: NARROW THERAPUETIC RANGE visual disturbances and fatigue, blurred vision, ECG changes, GI effects Nursing Implications & teaching: Monitor apical pulse for one full minute.

Hold if pulse is < 60. Second person check calculations in IV & Peds. Monitor drug levels

Classification: Loop Diuretic Therapeutic Effects: Diuresis. Lowering of blood pressure Adverse Reactions & side effects: Dehydration, hypochloremia, hypokalemia, hypomagnesaemia, hyponatremia, hypovolemia, metabolic alkalosis Nursing Implications & teaching: Monitor for thirst, dry mouth, lethargy, weakness, hypotension, oliguria and notify physician. Monitor K+, Ca++, Mg.

Can increase BUN, glucose and creatinine, TAKE WITH FOOD

Classification: Antiinfective, Fluoroquinolone Therapeutic Effects: Broad spectrum against gram positive and gram negative Adverse Reactions & side effects: Dizziness, drowsiness, headaches, GI effects Nursing Implications & teaching: Watch for anaphylactic rxn. Do not administer <4 hr before or 2 hr after giving an Al/Mg/ Fe or Zn preparation. Monitor for superinfections

Classification: Lipid-Lowering agent Therapeutic Effects: Decrease LDL/VLDL/Triglycer.; Increase HDL (slightly) Adverse Reactions & side effects: RHABDOMYOLYSIS = muscle cell lysis, toxins into circulation, rashes, constipation, flatus, GI effects Nursing Implications & teaching: Avoid grapefruit & grapefruit juice.

With unexplained muscle pain/tenderness-monitor CPK -- if it increases, d/c med = life threatening. Check LFTs

Classification: Anticoagulant Causes the inhibitory effect of anti-thrombin on factor Xa and thrombin Therapeutic Effects: Prevention of deep vein thrombosis (DVT) and PE. Antidote = protamine sulfate Adverse Reactions & side effects: Bleeding, anemia, thrombocytopenia, erythema at injection site, pain. Use only 1 heparin product at a time Nursing Implications & teaching: Assess for bleeding, CBC, platelet count, neurological impairment. Note pkg info for prefilled syringe- keep air lock.

"Lovenox in the love handles"-no aspiration or massage. High Alert Medication

Classification: Antidiabetic. Sulfonylurea Therapeutic Effects: Stimulates release of insulin from the pancreas, increase receptor site sensitivity Adverse Reactions & side effects: Photosensitivity, hypoglycemia. APLASTIC ANEMIA. Nursing Implications & teaching: Observe s/s of hypoglycemia. High Alert Medication.

Do not take glyburide if you are unable to eat. Avoid alcohol.

Classification: Opioid analgesic. Opioid agonist Therapeutic Effects: Decrease pain, pulmonary edema, pain with MI Adverse Reactions & side effects: Respiratory depression, confusion, sedation, hypotension, constipation Nursing Implications & teaching: Typical opioid precautions. Dilute for IV push and give over 4-5 minutes

Classification: Analgesic adjunct. Anticonvulsant.

Therapeutic Effects: Decrease seizures, neuralgias, chronic pain Adverse Reactions & side effects: Drowsiness, ataxia. Avoid in pregnancy/breastfeeding Nursing Implications & teaching: TID dosing should not exceed 12 hr between doses. Do not D/C abruptly; do not take within 2hr of antacid. avoid driving-till MD OK; Avoid use with other CNS depressants

Classification: Antiulcer agents; proton pump inhibitors Therapeutic Effects: Decrease acid accumulation in the gastric lumen which decreases GI reflex Healing of duodenal ulcers Adverse Reactions & side effects: Headache, constipation, dry mouth, GI effects Nursing Implications & teaching: Give 1hr before meals Do not crush or chew pellets Assess for epigastric/abdominal pain, blood in stool, emesis, or gastric aspirate Give slow IVP over 5-6 minutes, diluted with 0.9% NS

Classification: Antianginal, Nitrate Therapeutic Effects: Increases coronary blood flow to decrease angina attacks. Decrease BP.

Increase cardiac output. Adverse Reactions & side effects: Dizziness. HA. Blurred Vision. Hypotension. Tachycardia.

Flushing, GI effects. Nursing Implications & teaching: Tablets should be kept in original container & cotton should be removed. Do not open bottle frequently or handle tablets. Replace q 6 months after opening

Classification: Antianginal Therapeutic Effects: Relief or prevention of anginal attacks; increase cardiac output; decrease blood pressure Adverse Reactions & side effects: dizziness, headache, restlessness, syncope, hypotension, contact dermatitis, blurred vision Nursing Implications & teaching: Wear gloves during removal/application, Remove patches before cardioversion or defibrillation. D/C if low BP.

Rotate sites of application to prevent skin irritation

Classification: Opioid agonist Therapeutic Effects: Controlled release for moderate to severe pain, Not for PRN confusion, sedation, constipation RESPIRATORY DEPRESSION, GI effects Nursing Implications & teaching: Administer q12 hours for Chronic pain. Typical opioid precautions. Do not crush or chew. TAKE WITH FOOD

Classification: Histamine (H2) Antagonist Antiulcer Therapeutic Effects: Inhibits the action of histamine at H2-receptor site (gastric parietal cells), decreases gastric acid Adverse Reactions & side effects: ARRHYTHMIAS, APLASTIC ANEMIA, AGRANULOCYTOSIS, confusion, dizziness, headache, nausea, black tongue, diarrhea Nursing Implications & teaching: Monitor CBC, Dilute IV, rapid administration may cause hypotension. TAKE WITH FOOD

Classification: Antiemetic. Antihistamine (H1).

Sedative / hypnotic. Phenothiazine Therapeutic Effects: Decrease symptoms of excess histamine, sedation, decrease N/V Adverse Reactions & side effects: neuroleptic malignant syndrome, confusion, disorientation, sedation, dizziness Nursing Implications & teaching: Monitor for extrapyramidal side effects; educate on techniques to help dry mouth; oral care, photosensitivity; orthostatic hypotension risk; avoid ETOH & other CNS depressants; monitor sedation. A known Vesicant!

Classification: Anti-platelet Therapeutic Effects: Decrease atherosclerotic events Adverse Reactions & side effects: GI bleed, neutropenia, thrombotic thrombocytopenic purpura Nursing Implications & teaching: Monitor for bleeding, CBC, diff, platelet count, Do not double dose, Avoid NSAIDs. Watch for fever, chills, sore throat, bleeding/bruising. Caution in brushing/flossing teeth

Classification: Antiinfective, 3rd generation cephalosporin Therapeutic Effects: Bactericidal for bone & joint and lower resp. tract infections; skin infections, some STDs and UTIs Adverse Reactions & side effects: PSEUDOMEMBRANOUS COLITIS, SEIZURES, phlebitis at IV site, pain at IM site, GI effects Nursing Implications & teaching: Monitor for superinfections.

Obtain specimens for culture and sensitivity before starting. Instruct patient to notify MD if fever and diarrhea develop, especially if stool contains blood, pus, or mucus.

Classification: Antiparkinson agent. Dopamine agonist Therapeutic Effects: Relief of tremor & rigidity in Parkinson's Adverse Reactions & side effects: Involuntary movements, Avoid with MAO inhibitors, narrow angle glaucoma, GI effects Nursing Implications & teaching: Monitor CBC, hepatic & renal function; avoid driving-till MD OK; orthostatic hypotension; oral hygiene-dry mouth; skin lesions-changes; avoid OTC meds, TAKE WITH FOOD

Classification: Thyroid preparation Therapeutic Effects: Restoration of hormonal balance, suppression of cancer Adverse Reactions & side effects: Insomnia, arrhythmias, tachycardia, wt. loss.

Avoid use in thyrotoxicity Nursing Implications & teaching: Assess apical pulse and BP prior to admin & during therapy, & for chest pain, tachyarrhythmia. Give prior to breakfast. Monitor T3 and TSH. Important drug interactions

Classification: Beta blocker Therapeutic Effects: Antihypertensive Antianginal, Prev & decr mortality in recent MI pts Adverse Reactions & side effects: BRADYCARDIA, PULMONARY EDEMA, CHF. fatigue, weakness, impotence Nursing Implications & teaching: Hold HR <60.

Monitor I & O, daily weight. Assess for HF, bronchospasm

Classification: Opioid agonist Therapeutic Effects: Binds to opiate receptors in the CNS—decreases moderate pain. Suppresses cough reflex Adverse Reactions & side effects: confusion, sedation, hypotension, constipation, HEPATOTOXICITY, GI effects Nursing Implications & teaching: Monitor respiratory status. Should not exceed 4 grams of acetaminophen in 24 hrs.

Typical opioid precautions. TAKE WITH FOOD

Classification: Lipid-Lowering agent Eze = inhibits intestinal absorption of CHOL Sim = inhibits CHOL synthesis Therapeutic Effects: Lowers Total and LDL CHOL and triglycerides with slight increase in HDL Adverse Reactions & side effects: Abdominal pain, diarrhea, epigastric pain, HA, dizziness, anemia, alopecia Nursing Implications & teaching: Administer once daily in the evening, without regard to food. Wear sunscreen to prevent rare photosensitivity reaction. Check LFTs

Classification: Antidepressant Smoking deterrent Therapeutic Effects: Diminished depression Decreased craving for cigarettes Adverse Reactions & side effects: SEIZURES, agitation, HA, dry mouth, nausea, vomiting, tremor Nursing Implications & teaching: Monitor mood changes.

Assess for suicidal tendencies. Monitor hepatic and renal function in pts with liver or kidney impairments to prevent increased serum levels.

Classification: Antihypertensive, ACE inhibitor Therapeutic Effects: Lowers BP, decreases afterload in CHF & LV remodeling & mortality Adverse Reactions & side effects: Cough, proteinuria, taste impairment, clinically significant hyperkalemia, ANGIOEDEMA Nursing Implications & teaching: Monitor BP, pulse, fluid retention, dry persistent cough, rash, mouth sores, swelling of face, dizziness

Classification: Antiemetic. 5-HT3 receptors antagonist Therapeutic Effects: Prevention of nausea & vomiting associated with chemotherapy or radiation therapy.. Prevention/treatment of postop nausea/vomiting.

Adverse Reactions & side effects: HA, dizziness, diarrhea Nursing Implications & teaching: Advise patient to notify MD for involuntary movement of eyes, face, or limbs.

Classification: Antidepressant SSRI Therapeutic Effects: Decreases panic attacks, OCD, intense fear and helplessness Adverse Reactions & side effects: Dizziness, drowsiness, fatigue, HA, insomnia, dry mouth, tremor, sweating, Avoid use with any MAO Inhibitors, GI effects Nursing Implications & teaching: Monitor weight, mood changes, and suicide risk. No alcohol or other CNS depressants. Do not D/C abruptly.

Wear sunscreen to prevent photosensitivity reaction.

Classification: 2nd generation (non-sedating) Antihistamine Therapeutic Effects: Relief of seasonal and perennial allergic rhinitis Adverse Reactions & side effects: Dizziness, fatigue, dry mouth Nursing Implications & teaching: Administer once daily without regard to food

Classification: Antiarrhythmic. Anticholinergic Therapeutic Effects: TX for symptomatic bradycardia & heart block. Decrease GI & respiratory secretions Adverse Reactions & side effects: Dry mouth, urinary hesitancy, blurred vision, tachycardia Nursing Implications & teaching: Monitor urinary output esp.

in BPH. Assess VS and EKG