Post on 17-Oct-2014
transcript
ATI Final
Classification Prototype Action Uses Side effects Interactions NI AffectingNSAIDS NSAIDS: Asprin2nd Gen: Celecoxib (celebrex) decrease
inflammation, pain, and fever
Inflammation, Analgesia, fever reduction, dysmenorrhea
GI discomfort, gastric ulcers, bleeding, renal dysfunction, Salicylism, Reye Syndrome
Warfarin, Glucocorticoids, Alcohol, Ibuprofen
Take with food, milk, or fully glass of water
Pain and inflammation
Antigout Colchicine decrease inflammation
Gout GI toxicity Warfarin Pain and inflammation
Migraine Medications Ergot alkaloids: Ergotamine (ergostat) Serotonin receptor agonists (Triptains): Sumatripitan (Imitrex)
prevent inflammation and dilation to intracranial blood vessels
abort acute migraine attack, prevent migraines
Ergot: GI discomfort; Ergotism, physical dependence, abortionTriptans: Chest symptoms, angina, teratogenic
Triptains with MAOI's
Avoid trigger factors.
Pain and inflammation
Opioid Antagonist Naloxone (Narcan) interfere with the action of opioids
opioid overdose, reverse effects of opioids, reversal of resp. depression in infants
tachycardia, tachypnea, abstinence syndrome
Pain andinflammation
Neuromuscular BlockingAgents
Nondepolarizing: Tubocurarine (Tubarine) Depolarizing: succinylcholine (Anecitine)
Block ACh at neuromuscular junction
adjuncts to general anesthesia, diagnosis myasthenia gravis, seizure control, endotracheal intubation, endoscopy
Respiratory arrest, hypotentionSuccinylcholine: apnea, malignant hypertension, hyperkalemia
General anesthetics, Aminoglycosides, tetracyclines, Cholinesterase inhibitors
continuous cardiac monitoring
Nervous system
Anti Parkinsons Dopaminergic: Levodopa (Dopar, Larodopa) Dopamine agonists: pramipexole (Mirapex) Centrally acting anticholengerics: Benztropine (congentin) Dopamine releaser (Antiviral): Amantadine (symmetrel)
block receptors Parkinsons Levodopa: N/V, Dyskinesias, ortho hypo, cardio effects, psychosis, discoloration of sweat and urine, activation of malignant melanoma Mirapex: sleep attacks, daytime sleepiness, ortho hypo, psychosis, dyskinesias, NauseaCogentin: N/V, Atropine effects.
Levodopa: Protients, conventional antipsychotic agents, pyridoxine, MAOIs. Mirapex: Levodopa
effects may not be noticeable for several weeks to months
Nervous system
AEDs Barbiturates: phenobarbital (Luminal) Hydantoins: phenytoin (Dilantin) Benzodiazepines: diazepam (valium), lorazepam (Ativan) Carbamazepine (Tegretol), ethosuximide (zaronin), valproic acid (Depakote), gabapentin (Neurontin)
slow entrance of Na and Ca, suppress neuronal firing, inhibit GABA
generalized seizures, partial seizures
CNS effects, skin rash, toxicity, Cardio effects, teratogenisis, GI effects, respiratory depression
Dilantin: OC, warfarin, glucocorticoids, alcohol, valium. Tegretol: OC, warfarin, grapefruit juice, phenytoin, phenobarbital.
use for control not cure, seizure frequency chart
Nervous system
Muscle relaxants and Antispasmodics
dantrolene (Dantrium) acts directly on spastic muscles
relief of spasticity CNS depression, hepatic toxicity, physical dependence
CNS depressants don’t stop taking medication
Local Anesthetics Amide: lidocaine (xylocaine)"cain" decrease conduction of pain impulses
minor procedures... CNS excitation, Hypotension, Allergic reactions, Spinal headache, urinary retention
Nervous system
General InhalationAnesthetics
Halothane (fluothane)"ane" loss of sensation, consciousness, memory loss
Surgery, diagnostic procedures, analgesia, muscle relaxation
hypotension, resp and cardio depression, malignant hyperthermia, hepatotoxicity
CNS depressants, CNS stimulants, morphine sulfate, succinylcholine
NPO 6-8 hrs. before
Nervous system
Antipsychotics-Conventional Low: Chlorpromazine (thorazine) High: Haloperidol (haldol)
inhibit psychotic symptoms
schizo, bipolar, tourettes, delusions, dementia, Huntington’s chorea
EPS, TD, Neuroleptic malignant syndrome, Anticholinergic effects, ortho hypo, sedation, seizures, sexual dysfunction, skin effects
Anticholinergic agents, CNS depressants, Levodopa
Nervous system
Antipsychotics-atypical clozapine (clozaril) blocks serotonin and dopamine
severe schizo, psychosis Agranulocytosis, seizures, weight gain, inflammation of heart muscle
Immunosuppressive meds
Nervous system
TCA amitriptyline (Elavil) block reuptake of norepi and serotonin--intensify effects
Depression, bipolar ortho hypo, anticholinergic effects, sedation, cardiac toxicity,
MAOIs, Antihistamines, Epinephrine, NE, Ephedrine, amphetamine, CNS depressants
effects not experienced until 1-3 weeks
Nervous system
SSRIs Fluoxetine (prozac) block reuptake of serotonin
Depression, OCD, bulimia, panic disorders, PTSD
Sexual dysfunction, wt. gain, mental confusion, agitation, anxiety, withdrawal syndrome, hyonatremia, rash, sleepiness
MAOIs, warfarin, Tricyclic antidepressants, NSAIDS anticoagulants,
take with food Nervous system
MAOIs Phenelzine (Lardil) increase amount of NE and serotonin avaliable
atypical depression, bulimia, OCD
CNS stimulation, ortho hypo, hypertensive crisistrycyclic
antidepressants, SSRIs, Antihypertensives, Mepridine(Demerol), Tyramine rich foods, Vasopressors
Nervous system
Atypical Antidepressants bupropion HCL (Wellbutrin) Inhibit dopamine uptake
depression, aid to quit smoking H/A, dry mouth, contipation, tachycardia, nausea, wt.loss, seizures
MAOIs take daily nervous system
Mood stabilizers Litium: Valproic acid(depakote), carbamazepine (tegretol)
serotonin blockade bipolar, alcoholism, bulimia, schizo
GI effects, tremors, polyuria, renal toxicity, goiter, teratogenesis,
Diuretics, NSAIDS, Anticholinergics
monitor litium levels
Nervous system
Benzodiazepines diazepam (Valium) enhance GABA in CNS
Anxiety, seizure, insomnia, muscle sapsm, alcohol withdrawal, panic disorder
CNS depressions, paradoxical response, respiratory depression, teratogenesis, acute toxicity
CNS depressants taper dose when D/C
Nervous system
Non Benzo zolpidem (Ambien) do ot function as muscle relaxant
insomnia daytime sleepiness and lightheadedness
CNS depressants, food take before bedtime
Nervous system
Anxiolytic-Non-Barbiturate buspirone(BuSpar) binds to serotoinin and dopamine receptors
GAD CNS effects Erythromycin, ketoconazole, grapefruit juice
take with meals Nervous system
CNS Stimulant Methylphenidate (ritalin,Concerta) Release NE and dopamine
ADHD, Narcolepsy, Obesity CNS stimulation, wt.loss, Cardioeffects,
MAOIs, Caffeine, Phenytoin, warfarin, OTC cold meds
don’t chew or crush
Nervous system
Adrenergic Agonists epinephirne (Adrenaline)Dopamine (Intropin)Dobutamine(Dobutrex)
increase HR, Contractility, rate of conduction
Tx of AV block and cardiac arrest, HF, shock, hypertenstion
Hypertensive crisis, dysrhythmias, necrosis, increase HR
MAOIs, Tricyclic antidepresants, general anthetics, alpha-adrenergic blocking agents, beta adrenergic blocking agents, diuretics
IV continuous infusion
Cardiovascular system
Alpha Adrenergic blockers (sympatholytic)
Prazosin(minipress) venous and arterial dilation, smooth muscle relaxation
hypertension, BPH First dose hypertension Antihypertensive meds
BP,HR, take w/food, inital dose at bedtime
Cardio
Centrally Acting Alpha2 agonists
Clonidine(Catapress) decrease sympathetic outflow
HTN,sever CA pain Drowsiness, sedation, dry mouth rebound hypertension
anti HTN meds, praxosin, MAOIs, tricyclic antidepressants, CNS depressants
Cardio
Beta Adrenergic Blockers (sympatholytic)
Cardio selective: metoprolol (lopressor) nonselective: Propranolol (Inderal)"lol"
block beta1 adrenergic receptors
angina, HTN, dysrhythmias, MI, HF
Bradycardia, decrease CO, AV block, ortho hypo, rebound myocardium excitation,
CCB, Antihypertensive meds, insulin
don’t d/c med with out dr. orders, don’t crush or chew
cardio
bronchoconstriction, glycogenolysis inhibited
ACE inhibitors Captopril(capoten)"pril" block the production of Ang II (vasodilation, excretion of Na and H2o and retention of K)
HF, HTN,MI, nephropathy first dose ortho hypo, cough, hyperkalemia, rash, angioedema, neutropenia
Diuretics, antiHTN meds, K supplements, lithium, NSAIDS
1hr before meals cardio
ARBs lorsartan (Cozaar)"artan" blocks action of ang II
HTN, HF, MI, Stroke,nephropathy
angioedema, fetal injury anti HTN meds taken with or with out food
cardio
CCB nifedipine (Adalat,Procradia)"ipine"verapamil (calan), diltiazem (cardizem)
vasodilation Angina, HTN,Verapamil:dysrhythmias
reflex tachy, peripheral edema, acute toxicityverapamil: ortho hypo, constipation, suppression of cardiac function, dysrhythmias
beta blockers, grapefruit juiceverapamil: plus digoxin
IV 2-3 min cardio
Hypertensive crisis Sodium nitroprusside direct vasodilation hypertensive emergencies, decrease bleeding
excessive hypotention, cyanie poisoning, thiocyanate poisoning,
don’t mix with other medications
cardio
Organic Nitrates nitroglycerine (Nitrol, Nitrostat) angina angina H/A, ortho hypo, reflex tachycardia, tolerance
Alcohol, antihypertensive meds, viagra
Cardio
Cardiac Glycosides digoxin (Lanoxin, lanoxicaps, digitek) increase force of contraction, decrease HR
HF, dysrhythmias(A fib) Dysrhythmias, bradycardia, GI effects(anorexia, N/V, abd pain) CNS effects(fatigue, weakness, vision changes)
Thiazide, ACE, ARBs, sympathomimetic meds, quinidine, verapamil
check apical pulse, same time daily,
cardio
Statins atorvastatin (Lipitor) Cholesterol hyperohlesterolemia, prevent coronary events, protect MI, raise HDL levels
hepatotoxicity, myopathy, peripheral neuropathy
fibrates, erythromycin, grapefruit juice
take with evening meal
Cardio
Antilipemics: fibrates gemfibrozil (Lopid) increase VLDL excretion, increase HDL levels
Reduction of VLDLs, increase HDL
Gall stones, myopathy,hepatotoxicity
Warfarin, statins, cholestyramine
obtain baseline cholesterol levels, take 30 min prior to meals
Cardio
Antilipemics-Cholesterol Absorption Inhibitor
ezetimibe (zetia) absorb cholesterol lower LDL NONE Cholestyramine, statins, fibrates, cyclosporine,
baseline cholesterol levels, no reguard to food
cardio
Antilipemics-bile-acid-sequestrants
cholestyramine (Questran) lower LDL Lower LDL Constipation digoxin, warfarin, thiazides, tetracyclines
disolve in 4oz of H2O
Cardio
Anticoagulants/parenteral Heparin prevents bleeding DVT, DIC Hemmorrhage, hypersensitivity reactions
anti-platelet agents baseline vitals, monitor CBC,monitor aPPT (60-80sec)
Blood
Tx of Heparin overdose Protamine Sulfate antidote reversal of heparin administration
IV administered slowly
Blood
Anticoag/Oral Warfarin (coumadin) prevent synthesis of coagulation factors
thrombosis hemorrhage heparin, aspirin, glucocorticoids, acetaminophen, foods high in vit K
vitals, monitor PT, CBC, platelet count, Hct levels
Blood
Warfarin overdose Vit K(phytonadione, Aquamephyton) promotes synthesis of coag factors
reversal of bleeding, Vit k deficiency
anaphylactoid-type reaction (flushing, hypotension, urticaria, cardio collapse)
small doses orally
Blood
Antiplatelets Asprin (ecotrin) prevent platelets from clumping together by
MI, stroke, coronary syndromes
GI effects (bleeding), Hemorrhagic stroke
NSAIDs, Heparin, warfarin
Blood
inhibiting enzymesThrombolytic medications Streptokinase (streptase) "ase" dissolves clots that
have already formedMI, DVT, PE, ischemic stroke bleeding, hypotension,
allergic reactionNSAIDs, Heparin, Warfarin
Blood
Iron Preparations Ferrous sulfate (feosol)Iron dextran (INFeD) provide iron iron deficiency GI distress, Teeth staining, Anaphylaxis
antacids, vit c take on empty stomach, green blackish stool
blood
Hematopoietic growth factors epoetin alfa (Epogen, Procrit) increase production of RBC
anemia, HIV HTN, increased risk for cardiovascular event
monitor iron levels, BP, Hgb and Hct
blood
Beta2-Adrenergic agonists Albuterol (proventil, Ventolin) activate the beta receptorsin the bronchial smooth muscle
asthma Tachycardia, angina, tremors
beta blockers, MAOIs, tricyclic antidepressants
Respiratory
Methylxanthines theophylline (Theolair) bronchodilation asthma GI distress, restlessness, seizures
caffeine Respiratory
Inhaled Anticholinergic ipratropium (Atrovent) brochodilation brochospasm, asthma local anticholingergic effects RespiratoryGlucocorticoids belcomethasone dipropionate (QVAR) prevent
inflammation, suppression of airway mucus,
prophylaxis of asthma, oral therapy, replacement therapy
difficulty speaking, hoarsness, candidiasis, bone loss, hyperglycemia, myopathy, peptic ulcer disease, infection,
k-depleting diuretics, NSAID
fixed schedule Respiratory
Mast Cell Stabilizers cromolyn sodium (Intal) Anti-inflammation chronic asthma, exercised and allergen induced asthma
take 15 min before exercise or exposure to allergen
Respiratory
Leukotriene Modifiers montelukast (singulair) suppresses inflammation, bronchoconstriction, edema, mucous production
Long term asthma liver injury warfarin,Theophylline
Respiratory
Antitussive-Opioids Codiene Cough suppression for non-productive cough CNS effects, GI distress, potiential for abuse
Respiratory
Mucolytics acetylcysteine (Mucomyst) enhance the flow of secretions in respiratory passaes
pulmonary disorders, cystic fibrosis
Aspiration, bronchospasm odor that smells like rotten eggs, dilute medication in fruit juice
Respiratory
Decongestants phenylephrine cause reduction in inflammation
rhinitis, sinusitis Rebound congestion, CNS stimulation, Vasoconstricion
lateral head low position when taking
Respiratory
High Ceiling Loop Diuretics furosemide (Lasix) prevent reaborption of H2O
Pulmonary edema, renal impairment
Dehydration, hypotension, ototoxicity, hypokalemia
Digoxin, Antihypertensives, litium, NSAIDS
daily wts Fluids
Thiazide Diuretic hydrochlorothiazide(HydroDIURIL) block reabsorbtion of Na and Cl
essential HTN, mild-mod HF, liver and kidney disease
dehydration, hypokalemia, hyperglycemia
Digoxin, Antihypertensives, litium,
k levels, daily wts
fluids
K sparing diuretics spironolactone (Aldactone) block action of aldosterone
k sparing effects, HF hyperkalemia, endocrine effects
ACE, K supplements k levels, daily wts
fluids
osmotic diuretics mannitol (Osmitrol) increases blood osmolality
Renal failure, decrease ICP, IOP
HF, pulmonary edema, Renal failure, fluid and electrolyte imblalances
Fluids
K supplements potassium chloride (K-Dur) supplys K hypokalemia GI distress, local GI ulceration, hyperkalemia
ACE, spironolactone NEVER GIVE IV PUSH
Fluids
Histamine ReceptorsAntagonists
ranitidine hydrochloride (Zantac) suppress secretion of gastric acid
GERD, H.pylori, Heart burn, sour stomach
decrease libido, CNS effects warfarin, antacids eat 6 small meals
GI
Proton Pump Inhibitor omeprazole (Prilosec) reduce gastric acid seretion by irreversibly
peptic ulcers, GERD, hypersecretory contitions
Ampicillin, digoxin, iron
don’t crush or chew
GI
inhibiting enzymeAntacids aluminum hydroxide gel (Amphojel) neutralize gastric
acid and inactivate pepsin
PUD, GERD constipation, hypophosphatemia,
warfarin, tetracycline chew tablets then drink 8 oz of H2O or milk
GI
Prostaglandin E Analog misoprostol (cytotec) decreases acid production
long term NSAID use prevent ulcers, pregnant
diarrhea, abd pain, dysmenorrhea
GI
laxatives psyllium(Metamucil)docusate sodium (Colace)bisacodyl (Dulcolax)magnesium hydroxide
softens fecal mass constipation GI irritation, Rectal burning sensation
milk, antacids GI
Prokinetic agents metoclopramide (Reglan) suppress emeisis GERD, chemo enduced Nasuea,
EPS, sedation, Diarrhea opioids monitor for CNS depressant
GI
Oral hypoglycemics-sulfonylureastolbutamide (orinase) glipizide (Glucotrol, Glucotrol XL)
promote insulin release
type 2 diabetes hypoglycemia alcohol, NSAIDs, beta blockers
exercise Endocrine
Oral hypoglycemics-Biguanides
metformin HCl (Glucophage) reduce production of glucose within liver
type 2 diabetes PCOS GI effects, Vit B12 deficiency, lactic acidosis
Alcohol with breakfast and dinner
Endocrine
Insulin Overdose Glucagon increases breakdown of glycogen into glucose
hypoglycemia GI distress Endocrine
Thyroid hormones levothyroxine(Synthroid,levothriod) synthetic form of T4 hypothyroidism, emergency tx of myxedema coma
overmedication binding agents, antiseizure and anti depressant, warfarin
vitals, TSH levels
Endocrine
Antithyroid Medications propylthiouracil (PTU) block synthesis of thyroid hormoones
grave's disease overmedication, agranulocytosis
increase anticoag effects
Endocrine
posterior pituitary hormone vasopressin (pitressin synthetic) promotes reabsorption of H20 within kidneys
diabetes insipidus, used during cardiac arrest
reabsorption of too much water
Endocrine
Uterine stimulants oxytocin(pitocin, syntocinon) stimulates uterus induction of labor, fetal stress test
uterine rupture, HTN crisis Vasopresssors use infusion pump, monitor for hyperstimulaion
Reproductive
Tocolytic medications terbutaline sulfate (brethine) uterine smooth muscle relaxation
delay preterm labor tachycardia, tremors adrenergic agonists, MAOIs, betablockers
monitor BP, frequency and duration of contractions, fetal distress
Reproductive
Androgens Testosterone enanthate (Delatestryl) promotes skeletal muscle growth
hypogonadism, delayed puberty
hepatotoxicity, cardio risk, Virilism effects
warfarin, glucocorticoids, hepatotoxic drugs
report wt. gain of >2lbs.
Reproductive
Estrogens conjugated equine estrogens(Premarin) estrogen hormones Contraception, postmenopausal symptoms, treatment of prostate cancer
Endometrail and ovearin CA, embolic events, feminization
warfarin, phenytoin rotate injection sites
reproductive
Progesterones medroxyprogesterone acetate (Provera) induce favorable conditions for fetal growth
dysfunctional uterine bleeding, anmenorrhea, endometriosis
Breast CA, thromboembolic events, breakthrough bleeding, edema
tegretol, dilantin, rifampin
withdrawal bleeding
reproductive
Erectile dysfunction sildenafil(Viagra) augments effects of nitric oxide relase during sexual stimulation
erectile dysfunction MI, sudden death, Priapism organin nitrates, grapefruit juice, erthromycin
1 hr before sexual activity
Reproductive
Immune Globulin Gamma globulin, immunoglobulin G (IgG) provide passive immunity
immunodeficiency syndrome, hep a, hep b
local reaction, systemic allergic reaction
live viruses Immune
Immunostimulants Interferon Alfa,Aldesleukin (interleukin-2) enhance host immune responses
hairy cell leukemia, maligannt melanoma, AIDS-related kaposi's sarcoma
Flu like symptoms, bone marrow suppression, hypotension
Theophylline, Zidovudine, antihypertensives
store in fridge Immune
Antihistamines diphenhydramine (Benadryl),promethazine (phenegran), dimenhydrinate (Dramamine)2nd Gen: Loratadine (claritin), cetirizine (Zyrtec), fexofenadine (Allegra), desloratadine(Clarinex)
block of histamine release
mild allergic reactions, anaphylaxis, motion sickness, insomnia
sedation, anticholingergic effects, GI discomfort, acute toxicity
CNS depressants Immune
Chemotherapy agents cyclophosphamide(Cytoxan,Neosar)cisplatin(Planinol AQ)metotrexate(Rheumatrex, trexall)cytara
destroy CA cells CA Bone marrow suppression, N&V, alopecia, mucosistis,
Immune
bine(Cytosar-U) reproductive toxicity, hyperuricemia
Penicillins penicillin G (Bicillin LA) weakening the bacterial cell wall
meningitis, syphilis, prophylaxis bacterial endocarditis
Allergies, renal impairment,hyperkalemia
Aminoglycosides, OC full glass of water 1 hr before meals or 2 hr after
Infection
Cephalosporins cephalexin (Keflex)cefaclor (Ceclor)ceftriaxone(Rocephin)cefepime(maxipime
destroy bacterial cell wall
UTI, postoperative infection, pelvic infection, meningitis
Allergice, bleeding, thrombophlebitis, cross allergy
disulfiram reaction, probenecid
take with food Infection
Carbapenems imipenem (Primaxin) destroy cell wall pneumonia, peritonitis, UTI allergy, GI symptoms, Suprainfection
Infection
Monobactams Vancomycin (Vancocin) destroy cell wall serious infections ototoxicity, infusion reaction, thrombophlebitis
Infection
Tetracyclines tetracycline hydrochloride (sumycin) inhibit growth rickettsia, acne vulgaris GI discomfort, yellow/brown tooth discoloration, hepatotoxicity, photosensitivity, suprainfecrtion
Milk products, iron, magnesium,antacids, OC
don’t give with food
Infection
Bacteriostatic inhibitors erthyromycin (E-mycin) slows growth treat clients with penicillin allergy, whooping cough
GI discomfort, thrombophlebitis
Antihistamines, theophylline, warfarin
empty stomach infection
Aminoglycosides gentamicin (Garamycin) disrupt protein syntesis
tapeworm Ototoxicity, nephrotoxicity, neuromuscular blockade
penicillin peak and trough infection
Sulfonamides and trimethoprim
trimthoprim-sulfamethoxazole(TMP-SMZ, Bactrim) inhibit bacterial growth
UTI hypersensitivity,blood dyscrasias, kernicterus(jaundice, increase bili), photosensitivity
warfarin, phenytoin, slufonylurea
empty stomach, full glass of water
Infection
Urinary Tract Antispeptics nitrofurantoin (macrodantin) damages DNA UTI GI discomfort, Hypersensitivity reactions, blood dyscrasias, peripheral neruopathy
urine will have brownish discoloration
Infection
Antimycobacterial(Antituberculosis)
isoniazid(INH) ihibits growth of mycobacteria, prevents synthesis ofmycolic acid
TB peripheral neuropathy, hepatotoxicity
phenytoin, Alcohol empty stomach Infection
Anti-hansensDisease
dapsone prevents synthesis of folic acid
treatment of hansens disease discoloration of body fluids, hepatoxicity, mild GI discomfort
warfarin, OC,protease inhibitors
complete course infection
Antiviral acyclovir(Zovirax) prevents reproduction of viral DNA
herpes simplex virus, HIV phlebitis and inflammation at site, nephrotoxicity, mild GI discomfort, Granulocytopenia and thrombocytopenia, reproductive toxicity
never administer bolus, IV over 1 hour
Infection
Fluoroquinolones ciprofloxacin(Cipro) inhibition of enzyme necessary for DNA replication
severe infections, resp, urinary, and GI infections
GI discomfort, Achilles tendon rupture, suprainfection,
Cationic compounds, theophylline, warfarin
Infection
Antiprotozoals metronidazole(flagyl) slows growth peptic ulcer disease, protozoal infections
GI discomfort, metallic taste, darkening of urine, CNS symptoms
alcohol, metronidazole
complete course infection
Antifungal amphotericin B deoxycholate(fungizone) acts on fungal cell membranes to increase cell permeability
fungal infections, dermatophytic infections
Infusion reaction, thrombophlebitis, nephrotoxicity, hypokalemia, bone marrow suppression
Aminoglycosides, flucytosine
Infection
Acetaminophen acetaminophen (Tylenol) slows production of prostaglandins
Analgesic, antipyretic Acute toxicity Alcohol, Warfarin Pain and inflammation
Opioid Agonists Morphine sulfate act of mu receptors moderate to severe pain, sedation, reduction of bowel motility, Codiene: cough suppression
Respiratory depression, constipation, orthostatic hypotention, urinary retention, sedation, biliary colic, emesis, opioid overdose triad
CNS depressants, Anticholinergic agents, MAOI's, Antihypertensives
withhold if R<12, IV slowly (4-5 min)
Pain and inflammation
Agonists-Antagonist Opioids
Pentazocine (Talwin) low potential for abuse, less respiratory depression. Antagonist to mu receptors, agonist to kappa receptors
mild to moderate pain Abstinence syndrome NONE withhold if R<12 Pain and inflammation
Cholinesterase inhibitors neostigmine (Prostigmin) "mine" increase amount of ACh available at receptor sites
Myasthenia gravis, reversal of neuromuscular blocking agents
increase GI motility and secretions; Cholinergic crisis, bradycardia, urinary urgency
Atropine, tubocuraine, Succinylcholine
medical alert bracelet
Nervous system