What is Ondansetron used for?
used for chemo or post op; an antiemetic
What is Ondansetron's dosage range?
2-4 mg per day
What route can you give Ondansetron?
PO, IM, and IV
What are nursing actions for Ondansetron?
do not exceed 8 mg in patients with liver diseases, monitor drowsiness, sedation and I and O
What are the labs to check on Ondansetron?
liver function
What patient teaching should be done for Ondansetron?
report difficulty breathing immediately, can cause dry mouth so use ice chips, can cause drowsiness so do not do anything that requires alertness, maintain adequate hydration
What is the trade name for Ondansetron?
Zofran
What are the side effects for Ondansetron?
hard on liver, dry mouth, drowsiness
What is the action of Ondansetron?
serotonin receptor antagonist
What is promethazine used for?
an antiemetic and antihistamine: treats perioperative vertigo (before or after operations), motion sickness, nausea and vomiting
What is the dosage range for promethazine?
12.5-50 mg
How do you administer promethazine?
very slow IV push, PO, give deep IM bc it burns
What are some side effects to promethazine?
tissue necrosis, dry mouth, can cause sedation
What is the trade name for promethazine?
Phenergan
What are nursing actions for promethazine?
never give sub-q, monitor respiratory rate, I and O, watch for drowsiness, sedation, hypotension, restlessness, confusion, and urinary retention
What are the labs to check for promethazine?
monitor CBC
What patient teaching is done for promethazine?
teach that it causes sedation so avoid activity that requires alertness, take with food or milk, causes dry mouth so use ice chips, do not drink alcohol
What are the adverse reactions for promethazine?
restlessness and jittery movement (normal effect is sedation, not jittery feeling)
What is metformin used for?
antidiabetic, used for type II diabetes
What is the mode of action for metformin?
inhibits hepatic glucose production and increases tissue sensitivity to insulin
What is the dosage range for metformin?
500-1000 mg but usually 850 is prescribed
What is the route for metformin?
PO
What are the side effects for metformin?
use caution when used in patients that have CHF, renal problems or are older than 80. Possible decrease in renal function, increase in lactic acidosis, may cause Vitamin B12 and folic acid deficiency
What nursing actions should be done before giving metformin?
check liver enzymes
What labs should be checked for metformin?
BUN/creatinine, liver function, CK, serum hemoglobin A1C, glucose
What patient teaching should be done for metformin?
adhere to ADA diet & exercise, take with food to help prevent GI side effects such as nausea, vomiting, and diarrhea. Stop 48 hours before x-rays with contrast, CT with iodinated dye. Do not crush or chew the extended form of the drug. Teach the signs and
What is the trade name for prednisone?
Prednisone Intensol or Deltasone
What is prednisone used for?
anti inflammatory (glucocorticoid steroid), anti-rejection and immune modifier (used in auto immune disease and patients with transplants)
What is the dosage range for prednisone?
2-100 mg and up
What route(s) do you give prednisone?
PO with food, IV push, IVPB (IV piggyback)
What are the side effects for prednisone?
hypokalemia, hyperkalemia, increased appetite causing weight gain, hirsutism (excessive hairiness in women, growth retardation, cataracts/glaucoma, osteoporosis (buffalo hump at T3 and T4), swelling of face called moon face, euphoria, delayed wound healin
What are the nursing actions for prednisone?
monitor B/P, glucose, weight, sleep pattern
What lab(s) do you check for prednisone?
check serum glucose, potassium, BUN/creatinine, T3 and T4
What patient teaching is done for prednisone?
report difficulty breathing immediately, stay away from ppl that are sick bc it will mask the infection, take with food because it will cause GI upset, can cause dry mouth, do not stop abruptly bc it can be fatal. Have eye exams and bone scans, increase i
What is the trade name of clonidine?
Catapres
What class is clonidine?
anti-hypertensive and adrenergic (centrally acting)
What is the dosage range for clonidine?
0.1-0.6 mcg
What are the side effects for clonidine?
decreases libido, orthostatic hypotension, dry mouth, severe hypertensive rebound
What are the nursing actions for clonidine?
check BP and pulse 1 hour before and after
What patient teaching needs to be done for clonidine?
change position slowly, do not stop taking without MD order, decrease sodium intake
What is clonidine used for?
pain relief for alcohol or drug withdrawal
What is the trade name for digoxin?
Lanoxin
What class is digoxin?
inotropic antiarrhythmic
What is the dosage range and route for digoxin?
0.75-1.25 mg PO daily
What nursing actions do you do for digoxin?
take an apical pulse for 60 seconds before giving meds, if pulse is less than 60, hold the drug and call MD
What labs should be checked for digoxin?
check potassium levels(norms are 3.5-5.3) esp if patient is on lasix and digoxin to check for toxicity. If medication is equal or greater than 2 the the patient has toxicity. Signs of toxicity are nausea, vomiting, blurry yellow hazy vision, leg cramps. I
What patient teaching should be done for digoxin?
take med same time every day and listen to apical pulse
What is the trade name for pantoprazole?
Protonix
What class is pantoprazole?
anti-ulcer agent (treat acid reflux) and proton pump inhibitor
What is the action of pantoprazole?
suppresses gastric acid secretion through binding of a certain enzyme thus inhibiting proton pump activity
What is the dosage range for pantoprazole?
20-40 mg
How is pantoprazole administered?
PO, IV
What nursing actions should be done for pantoprazole?
monitor for discomfort and acid reflux
What labs should be checked for pantoprazole?
serum glucose, ALT, AST
What patient teaching is done for pantoprazole?
Do not crush or chew the extended release
What is the trade name for gabapentin?
Neurontin
What is the use for gabapentin?
anti-convulsant (used for rest of life) or neuropathic pain (short term use)
What is the normal dosage range and route for gabapentin?
100-800 mg oral
What is/are the side effects for gabapentin?
drowsiness
What nursing actions are done for gabapentin?
renal function before and during
What labs are checked for gabapentin?
renal labs, BUN/creatinine
What patient teaching is done for gabapentin?
TAKE right BEFORE BEDTIME, avoid activity that requires alertness bc of drowsiness
What is/are the trade names for Ibuprofen?
Motrin/Advil (NSAID)
What is ibuprofen used for?
treats minor pain and anti-inflammatory
What is the normal dosage range and limit for ibuprofen?
200-800 mg per dose, NO MORE THAN 800 mg per dose and NO MORE than 3.2 grams per day
What is the route(s) for ibuprofen?
PO, IV
What are the side effects for ibuprofen?
rash, heartburn, dizziness
What contraindications are for ibuprofen?
do not give if the patient has gastric ulcers
What labs to check for ibuprofen?
renal and hepatic function
What patient teaching is done for ibuprofen?
teach drinking alcohol causes gastric bleeds. Take with food. Report increased bruising, dark tarry stools, do not take with other NSAIDS, inform doctor 5-7 days before any procedure done
What is the trade name for ketorolac?
Toradol
What class and use is ketorolac?
an NSAID to treat mainly post op pain
What is the normal dosage range for ketorolac?
10-60 mg acute short term but not for more than 5 days
What is the route for ketorolac?
IV or IM but if given IM, give it deep because it hurts and apply pressure to reduce pain at site, also PO
What are some contraindications for ketorolac?
do not give if the patient has renal problems (bc its hard on kidneys), and do not give it patient has GI bleed or GI upset. Do not give with ASA
What are nursing actions to be take with ketorolac?
use caution in the elderly and check for renal function issues. If given PO, take with food
What is the trade name for aspirin?
Bufferin
What is the classification for aspirin?
a NSAID, salicylate, anti-inflammatory, ANTI-PLATELET AGGREGATE
What are some uses for aspirin?
fever, mild pain, inflammatory pain, stroke, MI (inhibits prostaglandin and other substances)
What is the normal dosage range for aspirin?
75-650 mg Q4H but if it's low dose and enteric coated it is being used for platelet aggregation
What labs are checked for aspirin?
long term therapy: check salicylate level. PT, PTT, and INR
What are the nursing considerations for aspirin?
give with food, watch for tinnitus which is showing toxicity levels, acidosis, seizures, watch for increased bruising, do not give to patients that have history of GI bleed or thrombocytopenia, and know that caffeine may increase drug absorption
What patient teaching is done for aspirin?
take with food to decrease GI distress, stop taking 7 days before surgery, report bloody emesis or black tarry stools, do not chew enteric coated tablets and DO NOT take gingko
What is the trade name for clopidogrel?
Plavix
What classification is clopidogrel?
anti-platelet aggregate
What is the use for clopidogrel?
decreases incidence of MI's, stroke, and acute coronary syndrome
What is the normal dose for clopidogrel?
75 mg daily
What labs are checked for clopidogrel?
platelet counts before and after
What nursing considerations are appropriate for clopidogrel?
do not give to patients with history of GI bleeding and give with food to decrease GI upset, check BP and pulse before and after
What patient teaching should be done for clopidogrel?
do not take with aspirin or other NSAIDS, take with food, report increased GI upset, report increased bleeding and bruising, stop before having surgery, brush with soft toothbrush
What are the side effects of clopidogrel?
decreased libido, orthostatic hypotension, dry mouth, severe hypertensive rebound
What is the trade name for enoxaparin?
Lovenox
What is the class for enoxaparin?
anti-coagulant, a low molecular weight heparin BUT NOT interchangeable with heparin
What is the normal dosage range for enoxaparin?
30-80 mg/ml, can be up to 150 mg/ml (prefilled syringe)
What is the route for enoxaparin?
ALWAYS GIVE SUB-Q!! NEVER IM. do not expel bubbles out of syringe, and know it will burn
What nursing actions are appropriate for enoxaparin?
Do not give with other NSAIDS or aspirin
What lab(s) are checked for enoxaparin?
hemoglobin, hematocrit, and know platelet values. If values are under 20,000 probably bleeding out. If values are 50,000 or less watch patient closely. If values are 150,000-400,000, it is normal
What patient teaching is done for enoxaparin?
do not use NSAIDS, especially aspirin. use herbal meds like gingko with caution, report excessive bruising or bleeding. do NOT expel bubbles out of syringe it seals the medication in. do NOT rub the site of injection
What is the use for enoxaparin?
to prevent deep vein thrombosis, pulmonary embolism, acute S-T elevation MI, prevents fibrin formation
What is the trade name for acetaminophen?
Tylenol, APAP
What is the class and use for acetaminophen?
treats mild fever and pain and is an non-opioid analgesic, antipyretic
What is the action for acetaminophen?
works through hypothalamus to reduce fever, has some prostaglandin effects on pain
What is the normal and max dosage range for acetaminophen?
325-650 mg, max dose is 4 g/day. long term therapy do not exceed 2.6 g/day. if it it low dose and enteric coated, being used for platelet aggregation
What are the routes of administration for acetaminophen?
PO, IV, IM
What side effects are for acetaminophen?
liver damage (most of the time it's permanent)
What nursing action is done for acetaminophen?
if you overdose, give acetylcysteine
What labs are checked for acetaminophen?
liver enzymes
What patient teaching is appropriate for acetaminophen?
use short term only 10 days max, read labels so pt does not overdose
What is the trade name for morphine?
MS-Contin
What is the class and use for morphine?
opioid analgesic (used for severe pain and MI)
What is the normal dosage range for morphine?
PO 15-60 mg tablets, IV 1-15 mg every 4 hours (works in 30 min)
What are the side effects to morphine?
urinary retention, slows consciousness, constipation, orthostatic hypotension, dizziness
What are the contraindications to morphine?
Do NOT give if patient has renal problems (hard on kidneys), GI bleed, or GI upset
What are the nursing actions for morphine?
only give it respiratory rate is 12 or more, monitor bowel sounds to check for constipation, check respirations, BP, assess and check for pain 30 minutes after, assess lung sounds, and in the elderly watch their I and O
What patient teaching is appropriate for morphine?
turn and cough, deep breathing, be careful getting up due to orthostatic hypotension and dizziness, increase fluid and fiber intake, take stool softener, teach elderly it may cause urinary retention
What is the trade name for hydromorphone?
Dilaudid
What is the class for hydromorphone?
opioiod narcotic analgesic
What is the normal dosage range for hydromorphone?
dosage is individualized but normally 2-8 mg
What is the route of administration for hydromorphone?
IV or IM
What are the side effects to hydromorphone?
respiratory depression, dizziness, sedation, impaired vision, slurred speech
What nursing actions are appropriate for hydromorphone?
monitor respiration, BP, O2 sats, assess pain 30 minutes after giving. If long term chronic use, check liver, respirations and do not give if below 8
What patient teaching is appropriate for hydromorphone?
call MD if short of breath, DO NOT TAKE ANTIHISTAMINES with this drug. Avoid alcohol, sedatives, antihistamines. May cause dizziness, nausea, sedation, or impaired vision. Best when taken with food.
What is the trade name for nalaxone?
Narcan
What is the classification for nalaxone?
opiate antagonist only
What is the use for naloxone?
reverse respiratory depression of opioid drugs
What is the normal dosage range and route for nalaxone?
0.02-0.04 mg/ml IM or IV
What nursings actions are appropriate for nalaxone?
monitor respiratory rate and depth, check O2 sats, monitor for return of pain and increased BP
What is the trade name for hydro-chlorothiazide (HCTZ)?
Hydro Diuril
What is the class for HCTZ?
diuretic
Why is HCTZ used?
hypertension and excess fluid retention
What is the normal dosage range and route for HCTZ?
25-100 mg daily PO
What labs are checked for HCTZ?
serum K+ and Na, renal function, and glucose in diabetics
What nursing considerations are appropriate for HCTZ?
monitor B/P, I and O, weight, K+ levels, and know it may increase risk of Digoxin toxicity
What patient teaching is done for HCTZ?
change positions slowly, weigh daily same conditions, take in morning with food to decrease GI upset
What is the trade name for furosemide?
Lasix
What is the class for furosemide?
diuretic
What is the use for furosemide?
excess fluid retention, moderate to severe edema
What is the normal dosage range for furosemide?
20-80 mg
What nursing actions are appropriate for furosemide?
monitor B/P, I and O, weight and K+ levels, watch for signs and symptoms of hypokalemia (muscle cramps or weakness)
What labs are checked for furosemide?
serum K+ and Na
What patient teaching is done for furosemide?
change positions slowly, take in morning and report muscle cramps, eat a high potassium diet and weight daily under the same circumstances
What is the trade name for azithromycin?
Zithromax, Zmax
What is the class and use for azithromycin?
treats upper and lower resp. infections, STDs and skin infections, macrolide
What is the normal dosage range for azithromycin?
250-600 mg
What patient teaching is done for azithromycin?
do not take with antacids, take with food
What are the side effects for azithromycin?
diarrhea, nausea, abdominal pain, vomiting, watch for super infections
What is the trade name for metronidazole?
Flagyl
What is the class for metronizadole?
antiprotozoals, antibacterial
What is the use for metronizadole?
used for GI and vaginal infections
What is the normal dosage range for metronizadole?
325-500 mg or 750 mg SR do not chew
What are the side effects to metronizadole?
metallic taste and dark urine are normal side effects, the taste of food may change
What are the nursing actions for metronizadole?
NO IV PUSH, give IV over 1 hour. if used for Trichomoniasis, sex partner needs to take med too
What are the labs to check for metronizadole?
liver enzymes, Culture and Sensitivity before 1st dose
What patient teaching should be done for metronizadole?
may cause metallic taste and cause dark urine, take with food, do not take with alcohol bc it will cause nausea and vomiting, do not take with Zantac
What is the trade name for levofloxacin?
Levaquin
What is the class and use for levofloxacin?
antimicrobial that treats sinus, bladder, Staph, pneumonia, anthrax, H Influenza, gonorrhea infections, also a fluoroquinolone
What is the dosage range for levofloxacin?
250-750 mg
What is the route for levofloxacin?
PO
What are the side effects for levofloxacin?
can decrease glucose in the body, monitor for excessive CNS stimulation, agitation and restlessness. It is a CRYSTALIN and PEE WILL HAVE GLASS SHARDS IN IT (INCREASE WATER INTAKE)
What are the labs to check for levofloxacin?
serum glucose and C&S
What patient teaching is appropriate for levofloxacin?
report excessive CNS stimulation (like restlessness and confusion), increase fluid intake to 1.5-2 liters of water per day, do not take with antacids or milk because they decrease absorption of the medication, take all meds until done
What is the trade name for docusate sodium?
Colace
What is the class of docusate sodium?
laxative, stool softener
What is the action for docusate sodium?
works by absorbing fat and water into stool
What is the normal dosage range for docusate sodium?
diarrhea, nausea, and stomach cramps
What patient teaching is done for docusate sodium?
do not take if you already have constipation bc it PREVENTS constipation, increase fluid intake to 2-3 liters per day. It takes 1-3 days for the medicine to work. Don't take if nauseated, cramping, or vomiting. increase fiber and exercise.
What is the trade name for polyethylene glycol?
Miralax
What is the class for polyethylene glycol?
laxative, osmotic (pulls water into colon)
What is the dosage range for polyethylene glycol?
17 g in 8 oz of water
What is the route for polyethylene glycol?
PO
What nursing actions are appropriate for polyethylene glycol?
do not give if patient has cramping or distention, monitor I and O
What patient teaching is done for polyethylene glycol?
intake 2-3 L of water per day, increase fiber intake, dissolve the powder in 8 oz of water, report cramping. do not take for more than 2 weeks bc it will cause electrolyte imbalance, takes about 2-4 days to work
What is the trade name for potassium chloride (KCl)?
K-Dur
What is the classification and action for potassium chloride?
treats electrolyte imbalance by replacing potassium in the body
What is the dosage range for potassium chloride?
8-80 mEq daily
What is the route for potassium chloride?
PO
What are the side effects for potassium chloride?
MURDER-Muscle cramps/weakness, Urine (oliguria or anuria), Reflex changes, Decreased cardiac contractility, EKG or rhythm changes
What labs are checked for potassium chloride?
3.5-5.3 potassium
What patient teaching is appropriate for potassium chloride?
mix powder in water or juice and take with meals, Call dr if you have signs of hyperkalemia which are muscle cramps, urine output decreases like oliguria or anuria, have respiratory distress, or have ECG changes, numbness and tingling in the extremities