Med Surg Exam #6 Medications

Cataracts can occur due to long term use of:

Corticosteroids, beta blockers, or miotic medications

Cataracts What is used pre-operatively to dilate pupil and paralyze the ciliary muscles? (sedative)

anticholinergic eye drops

Glaucoma -Constrict pupil, allows better circulation of aqueous humor-Can blur vision

pilocarpine (Isopto)

Glaucoma -Reduces aqueous humor production

timolol (Timoptic)

Glaucoma-Osmotic diuretic for emergent treatment of primary angle-closure-Surgical intervention

IV mannitol

Medications used to manage Meniere's Disease:

antiemetics, antihistamines, anticholinergics, diuretics

Carbon monoxide poisoning is treated with:(will flush carbon monoxide)

100% humidified oxygen

Types of fluids used for burn pts during fluid therapy:

Isotonic crystalloid solutions, 0.9% sodium chloride (NS) or lactated Ringers

Drug therapy for burn pts- analgesics and sedatives

-Morphine -Hydromorphone (Dilaudid)-Haloperidol (Haldol)-Lorazopam (Ativan)-Midazolam (Versed)

Drug therapy for burn pts- topical agents

-Silver sulfadiazine (Silvadene)-Mafenide acetate (Sulfamylon)-Silver nitrate 0.5%-Bacitracin

Drug therapy for burn pts- other

-Tetanus immunization -antibiotics if infection presents

Pain management for burn pts- continuous background pain

around the clock analgesics (long acting po or continuous IV)

Pain management for burn pts- treatment induced pain

-potent, short acting analgesics and/or benzodiazepine-nonpharmacological strategies

TIA treatment- antiplatelet drugs

-aspirin-ticlopidine (Ticlid)-clopidogrel (Plavix)-dipyridamole (Persantine)-dipyridamole/aspirin (Aggrenox)-warfarin (Coumadin)- anticoagulant long term anticoagulant therapy

Herpes Simplex Virus treatment -aimed at decreasing outbreaks and minimizing the severity

-acyclovir (Zovirax) -famciclovir (Famvir)-valacyclovir (Valtrex)vir= antiviral

Herpes Zoster treatment- antivirals -shortens the clinical course

-acyclovir (Zovirax) -famciclovir (Famvir)-valacyclovir (Valtrex)

Herpes Zoster treatment- pain meds

NSAIDs, narcotics

why are corticosteroids contraindicated for treating herpes zoster?

they suppress the immune system so if someone is already immunosuppressed, theyre not a good option.

antihistamines are used in the treatment of herpes zoster for:

itching

Post-herpetic neuralgia treatment:

TCAs- nerve painTENS unitCapsaicin creamGanglion nerve block

Shingles Vaccine

zoster vaccine recombinant (Shingrix)-FDA approved in 2017 (replaces Zostavax)-90% effective -indicated for the 50yrs or older -2 doses, 2-6 months apartContraindicated if:-currently have shingles -pregnant or breastfeeding

Treatment of Psoriasis- topical

-tar preparations: help with inflammation -corticosteroids: triamcinolone, betamethasone -vitamin D analogs, vitamin A (tazarotene)

Treatment of Psoriasis- systemic-biologic agents

-alefacept (Amevive)-adalimumab (Humira)-infliximab (Remicade)

Treatment of Psoriasis- systemic

-methotrexate -cyclosporine

Psoriasis Arthritis treatment meds

methotrexate, biologic agents

Actinic keratoses treatment

cryosurgery, 5-fluorouracil cream, surgery

basal cell carcinoma- topical chemo

5-fluorouracil cream (5-FU)

cryosurgery

topical liquid nitrogen

Mild to moderate headache

aspirin, acetaminophen, or ibuprofen

Migraines- Serotonin receptor agonists

Triptans": sumatriptan (Imitrex), zolmitriptan (Zomig), almotriptan (Axert)•Taken at the first symptom•Reduce the inflammation of the cerebral vessels and produce vasoconstriction•NOT for use in patients with cardiac, cerebrovascular, or peripheral vascular problems

Migraine- combination therapy

sumaptriptan/naproxen (Treximet)

Preventive Therapy for Migraines: Alpha-adrenergic blockers

clonidine (Catapres)

Preventive Therapy for Migraines: Beta-adrenergic blockers

propanolol (Inderal)

Preventive Therapy for Migraines: Tricyclic antidepressants

amytriptyline (Elavil), imipramine (Tofranil)

Preventive Therapy for Migraines: Calcium channel blockers

verapamil (Isoptin), nifedipine (Procardia)

Preventive Therapy for Migraines: Antiseizure drugs

topiramate (Topamax), divalproex (Depakote), gabapentin (Neurontin), valproic acid (Depakene)

older drugs for seizures/epilepsy -(need to monitor serum drug levels to avoid toxicity)

•phenytoin (Dilantin)- can cause gingival hyperplasia•phenobarbital•carbamazepine (Tegretol)•divalproex (Depakote)

newer drugs for seizures/epilepsy -(no need for serum levels as they have a wide therapeutic range)

•gabapentin (Neurontin)•lamotrigine (Lamictal)•topiramate (Topamax)•tiagabine (Gabitril)•zonisamide (Zonegran)•levetiracetam (Keppra)

Status Epilepticus meds

diazepam (Valium) or lorazepam (Ativan) intravenously

Multiple Sclerosis- Immunomodulator drugs-modify the disease progression and reduces # of relapses

beta-interferon (Betaseron, Avonex)

Multiple Sclerosis- Immunosuppressants

mitoxantrone (Novatrone)

Multiple Sclerosis- Corticosteroid therapy

dexamethasone,methylprednisolone (Solu-Medrol), prednisone

Multiple Sclerosis- Muscle relaxants

for spasticity

multiple sclerosis- Anticonvulsants or antidepressants

...

Multiple Sclerosis drug used to treat cognitive impairment

donezepil hydrochloride (Aricept)

Multiple Sclerosis- Anticholinergics

for bladder symptoms

Multiple Sclerosis- Nerve Conduction enhancer-may cause seizures, esp. in higher doses

dalfampridine (Ampyra)

Multiple Sclerosis drug -prevents lymphocytes from reaching CNS and causing damage.

fingolimod (Gilenya)

Amyotrophic Lateral Sclerosis (ALS) (Lou Gehrig's Disease)-does not cure, but slows progression of disease. -It decreases glutamate - excitatory neurotransmitter in the brain

riluzole (Rilutek)

Amyotrophic Lateral Sclerosis (ALS) (Lou Gehrig's Disease)-new treatment in May 2017 - first time in 20 years

edaravone (Radicava)

Parkinson's disease- Dopaminergics

carbidopa-levodopa (Sinemet)•Dopamine cannot cross blood-brain barrier, levodopa can. Carbidopa stops dopa-decarboxylase.•Also available as Parcopa - tablet that dissolves quickly in the mouth•Over time, may have "on/off" periods

Parkinson's disease- Dopamine agonists-activate dopamine receptors in the brain

bromocriptine (Parlodel), pramipexole (Mirapex)*bromocriptine (Parlodel) - pt may become dizzy due to orthostatic hypotension following the first initial dose

Parkinson's disease- anticholinergics

trihexyphenidyl (Artane), benztropine (Cogentin)

Osteoporosis Treatment- Bisphosphonates

alendronate (Fosamax), risendronate (Actonel), ibandronate (Boniva)

Osteoporosis Treatment- Selective Estrogen Receptor Modulator (SERM)

raloxifene (Evista)

Osteoporosis Treatment- Thyroid Hormone

calcitonin (Miacalcin) (nasal spray)

Osteoporosis Treatment- Parathyroid Hormone

teriparatide (Forteo)-sub-q injection daily for 2 yrs

Osteoarthritis (OA) medications

-Analgesics-NSAIDs-Intra-articular injections (steroids or viscosupplements: hyaluronic acid- (Synvisc)-Glucosamine Chondroiton Sulfate

Rheumatoid Arthritis- NSAIDs or COX-2 inhibitors

celecoxib (Celebrex)

Rheumatoid Arthritis- Disease Modifying Antirheumatic Drugs (DMARDs)

hydroxychloroquine (Plaquenil), methotrexate, sulfasalazine (Azulfidine)

Rheumatoid Arthritis- corticosteroids

po or intraarticular

Rheumatoid Arthritis- Biologic Response Modifiers

adalimumab (Humira), infliximab (Remicade), etanercept(Enbrel)

Gout- NSAIDs

naproxen, indomethacin (Indocin)

Gout- Anti-inflammatory agent

colchicine During treatment of the patient with an acute attack of gout, the nurse would expect to administer colchicine

Gout- steroids

po or injected

Gout- preventative meds

-allopurinol (Zyloprim)-febuxostat (Uloric)-probenecid

Systemic Lupus Erythematosus: SLE- NSAIDs

control arthritic symptoms

Systemic Lupus Erythematosus: SLE- Antimalarial drugs

hydroxychloroquine (Plaquenil)

Systemic Lupus Erythematosus: SLE- Corticosteroids

For immunosupression, reduce inflammation

Systemic Lupus Erythematosus: SLE- Immunosuppressant agents

methotrexate, azathioprine (Imuran)

Fibromyalgia Treatment: multi-disciplinary

acetaminophen, tramadol (Ultram), amitriptyline (Elavil), SSRIs

During treatment of the patient with an acute attack of gout, the nurse would expect to administer

colchicine