Ace Inhibitors
PRIL" Captopril, Enalapril, Afosiopril
Decreases BP, Sodium and fluid loss.
Check BP before giving (hypotension)
Avoid salt substitutes (hyperkalemia)
Take on empty stomach
*Orthostatic Hypotension
Beta Blockers
***
DO NOT give with ASTHMA, BRONCHIAL CONSTRICTIVE DISEASE!!!
*** EXCEPTION: CAN USE METOPROLOL
"LOL" Antenolol, metoprolol. labetolol
Antihypertensive. Lowers BP.
Check BP before giving (hypotension)
*Orthostatic Hypotension
* Do not D/C abruptly (2wks)
Calcium Channel Blocker
CA" Calan, Procardia, Cardizem, Nifedipine
Slow the HR and decrease BP (check HR and BP before).
SE: Constipation
Procardia sometimes causes peripheral edema
A-fib
Dofetilide
Cardiac meds used for shock
Intropin, dopamine
Hydralazine hydrochloride
Used to tx autonomic dysreflexia
Diuretics
-K+ and NA+ follows the walter --> electrolytes imbalances
-Thiazide/Loop: Watch for hypokalemia.
-Loop diuretics CI with use with digoxin and vancomycin (furosemide, bumetanide, torsemide)
Furosemide
AE: Ototoxic
Potassium Chloride
Check labs before giving, Never give IV PUSH
No faster than 10 mEq/hr through central venous line
Avoid adding lidocaine
Give with FOOD (GI distresss))
Extreme caution if pt. receiving potassium-sparing diuretic.
NOT for pts with RENAL DISEASE.
Antiemetics
Pro" Prochlorperazine, promethazine, trimethobenzamide
Morphine
IV for chest pain
Check Respirations
Other narcotics
Butorphanol, meperidine
Methadone
Used for pain/detox in narcotic addicts
Naloxone
Counteracts Morphine - opioid narcotics.
Atropine (Caridiac Use)
Tx Heart Blocks (increase HR), reduce secretions
4D's:
Dry Mouth, Dry Stool, Dilated Pupils, Dilated Bladder (urinary retention)
Digoxin
Strengthens cardiac muscle contraction
Antiarrhythmic
CANT MIX WITH ANYTHING
TOXICITY:
Pulse (slows - Check Apical Pulse before giving)
Photosensitivity
Puke (vomiting, nausea)
Yellow-Green Halos
Light Flashes
Lidocaine
Decrease cardiac irritability
Titate IV
Use with V. TACH
Nitro
Vasodilator
Angina (1 tab 3x, 5 min apart)
Keep med dry, cool, only effective for 6 mo. (Tingling under tongue = good)
Hold when BP <90/60
ORTHOSTATIC HYPOTENSION
Aminophylline
Bronchodilator - Decreases SOB
Therapeutic levels 10-20 mcg/dl
TOXIC > 20
CANT MIX WITH ANYTHING
Amphotericin B
Antifungal
IVPB SLOW - 2+ hrs
Hydrate pt - very toxic to kidneys, monitor BUN.
Check Hearing
Check K+ levels (causes hypokalemia)
Aminoglycosides
Gentamycin, Kanamycin sulfate, Neomycin sulate, Steptomycin Sulfate; Everything _mycin except erythromycin
OTOTOXICITY
KIDNEY DAMAGE
Bronchodilators
Epinephrine (adrenalin)
Careful with Cardiac Pts
Anticoagulants
Heparin (Antecdote - Protamine Sulfate)
Warfarin (Antecdote - Vit K.); avoid foods high in K (spinach, pork)
Bleeding precautions
PPT - Heparin
PT/INR - Warfarin
Cholesterol meds
-Gemfibrozil, atorvostatin, lovastatin
-Monitor LFTs
-Use alt protection (contraceptives < effective)
-Avoid grapefruit juice/colchicine
Cholestyramine
Interacts with digoxin and hydrochlorothiazide
Anticholinergics
Atropine, benztropine, antihistamines
"red as a beet, mad as a hatter, dry as bones, blind as a bat, hot as a hare"
GI - Slows motility, spasm
Eyes - Dilates pupils
DO NOT GIVE TO GLAUCOMA PTS
Heart - Increase HR
Resp - bronchodilator (Atrovent)
Cancer Drugs
Wear gloves, mask when preparing or giving. Can be absorbed throught skin
Sulfa Drugs
Drink lots of fluids
Can cause blood dyscrasias - REPORT SORE THROAT, RASH IMMEDIATELY.
UTI (Sulamethoxazole/Trimethoprim, sulfisoxazole)
Ulcerative colitis (Sulfasalazine)
Urinary Antispasmodics
Phenazopyridine (cystitis) - Orange/Red urine
Penicillins
Take all 10 days
Cortisone (Steroids)
Wt gain, Na+ retention, K+ Loss
NEVER STOP SUDDENLY
Phenytoin
Anti-convolsant
Therapeutic level 10-20 (same as amminophylline)
Toxicity > 20
Causes hyperplasia of gums - bleeding gums
Give extra VIT. D
Tylenol
Bad for Liver - DO NOT GIVE TO ALCOHOLICS
Conjugated estrogen
1. Hormone Replacement - Estrogen
Tx Menopause Sxs, Vascular Headaches
Periods continue
2. Conjugated estrogens/medroxyprogesterone acetate
No periods
Allupurinol
G - Gulp 3L fluid per day
O - (NO) Organ Meats
U - Output up to 2 L/day
T - Teach
Miotics
CONSTRICT (Pilocarpine)
For glaucoma - eyedrops
Mydriatics
DILATES (Atropine)
Dont use in pts with gaucoma (build up IOP)
Timolol
Eyedrops to tx glaucoma
Acetazolamid
Glaucoma
CI in sulfa allergies
Antacids
Aluminum - Causes Constipation
Magnesium - Causes diarrhea Diarrhea
Lithium
Bipolar Disorder
Decrease Na+ (hyponatremia - risk of toxicity)
Increase Na+ levels (causes sodium diuresis)
Toxic Level > 2 mEq/L
Chloriazepoxide and Diazepam
To prevent DT's in acute alcohol withdrwal
Can produce physical dependency.
Direct - Acting Vasodilator
Hydralazine
Relaxes smooth muscle of blood vessels, lowing peripheral resistance.
Teach pt to check pulse d/t change in C.O.
If HR <60 Contact physician.
Clozapine
Atypical antipsychotic
AE: Agranulocytosis - need WBC checked; discontinue if <2000
Caridopa-Levodopa
Parkinson disease
CI: Glaucoma
Avoid vitamin B6 and MAOIs
Chlorpromazine
Schizophrenia
AE: Leukopenia - lab work needed
Otoxic NSAIDs
Indomethacin, aspirin
Aspirin
Avoid if allergy to tartrazine
Bismuth subsalicylate
Diarrhea med
Affects absorption of PO meds - sep administration
Ranitidine
Histamine blocker
May cause false negatives on allergy tests
Avoid all NSAIDs
Aluminum hydroxide suspension
Antacid
Take 1-3 hours after meal
Cimetidine
Antacid
Careful with use in elderly
Interacts w/ a lot of foods/meds
Take 1 hr apart from other antacids
Pentamidine Isethionate
Anti-protozoal prevent PCP
AE: Leukemia, thrombocytopenia
Oseltamivir
Tx flu
Capsules may be opened/mixed w/ food
Take w/ food
Zidovudine
HIV med
AE: Bone marrow suppression and anemia - check CBC
Rimantadine, Zanamivir
Antivirals
CI to receive flu vaccine. OK w/ acyclovir
TB drugs
Isoniazid, rifampicin, pyrazinamide, ethambutol, streptomycin
SE: Red/orange tears/urine; contraceptives don't work well
Liver toxicity (avoid in Hep B pts)
Ciprofloxacin
Ab
Increase fluid intake
Avoid milk/yogurt, multivitamin (w/in 6 hrs)
Cephalexin
Ab
Yogurt ad acidophilus milk help maintain normal flora
Neostigmine
Myasthenia Gravis
Take 45 mins before eating
Succinylcholine
Used for intubation/ECT
Gout meds
Allopurinol, colchicine, probenecid
No Vit C w/ allopurinol
Antidote tylenol
n-Acetylcysteine
Antidote magnesium sulfate
Calcium gluconate
Antidote TPA
Aminocaproic acid
Antidote pancuronium bromide
Neostigmine/atropine
Antidote dig toxicity
Digoxin immube fab
Antidote iron
Deferoxamine
Antidote ammonia
Lactulose
Alendronate
Oral biphosphate
Take in AM 30 mins before anything on empty stomach followed by 8 oz water. Wait 30 mins to eat anything
Sit upright/ambulate for 30 mins after taking
Vincristine
Leaukemia
IV ony
Asparaginase
ALL, AML, non-HL
Test for hypersensitivity before admin
Cyclophosphamide
Leukemia/lymphoma
SE: Alopecia
Diabetes meds
-Surgery: Hold rapid-acting/intermediate morning of surgery. Provide regular on sliding scale.
-Oral hypoglycemics: AE - rash, photosensitivity
Rapid acting insulin
Lispro, aspart, glulisine
Onset: 10-30 mins
Peak: 30-3 hrs
Short acting insulin
Regular
Onset: 30-60 mins
Peak: 2-5 hrs
Intermediate acting insulin
NPH
Onset: 2-4 hrs
Peak: 6-12 hrs
Long-acting insulin
Glargine
Continuous effect w/ no peak
Herbal meds
St John's wort: CI with digoxin, nifedipine, simvastatin, escitalopram (SSRI). OK w/ hydrochlorothiazide and metformin
Gingko: Antiplatelet. Avoid w/ NSAIDs. OK w/ digoxin.
Epoetin
Anemia w/ CKD
SE: Hypokalemia, HTN, DVT
Hydroxyurea
Sickle cell disease
Report GI symptoms immediately
Cyclosporine
Immunosuppressive drug
Stored at room temp in closed container
Take w/ meals
Avoid grape fruit juice
Rhogam
Rh- mother, negative Coombs test
28 weeks, 72 hrs PP
Terbutaline
Tocolytic/bronchodilator use din preg breathing problems
Hold if pulse high
Ritodrine HCl
Reduce intensity/freq of contrations
Onabotulinumtoxina
Nystagmus in peds
Patch good eye so weaker eye gets strog
Radioactive iodine
-3-4 L/day x 2 days
-Flush toilet 2x after use for 2 ays
-Contact only 30 mins/day
-No preg people or kids
Ace Inhibitors
PRIL" Captopril, Enalapril, Afosiopril
Decreases BP, Sodium and fluid loss.
Check BP before giving (hypotension)
Avoid salt substitutes (hyperkalemia)
Take on empty stomach
*Orthostatic Hypotension
Beta Blockers
***
DO NOT give with ASTHMA, BRONCHIAL CONSTRICTIVE DISEASE!!!
*** EXCEPTION: CAN USE METOPROLOL
"LOL" Antenolol, metoprolol. labetolol
Antihypertensive. Lowers BP.
Check BP before giving (hypotension)
*Orthostatic Hypotension
* Do not D/C abruptly (2wks)
Calcium Channel Blocker
CA" Calan, Procardia, Cardizem, Nifedipine
Slow the HR and decrease BP (check HR and BP before).
SE: Constipation
Procardia sometimes causes peripheral edema
A-fib
Dofetilide
Cardiac meds used for shock
Intropin, dopamine
Hydralazine hydrochloride
Used to tx autonomic dysreflexia
Diuretics
-K+ and NA+ follows the walter --> electrolytes imbalances
-Thiazide/Loop: Watch for hypokalemia.
-Loop diuretics CI with use with digoxin and vancomycin (furosemide, bumetanide, torsemide)
Furosemide
AE: Ototoxic
Potassium Chloride
Check labs before giving, Never give IV PUSH
No faster than 10 mEq/hr through central venous line
Avoid adding lidocaine
Give with FOOD (GI distresss))
Extreme caution if pt. receiving potassium-sparing diuretic.
NOT for pts with RENAL DISEASE.
Antiemetics
Pro" Prochlorperazine, promethazine, trimethobenzamide
Morphine
IV for chest pain
Check Respirations
Other narcotics
Butorphanol, meperidine
Methadone
Used for pain/detox in narcotic addicts
Naloxone
Counteracts Morphine - opioid narcotics.
Atropine (Caridiac Use)
Tx Heart Blocks (increase HR), reduce secretions
4D's:
Dry Mouth, Dry Stool, Dilated Pupils, Dilated Bladder (urinary retention)
Digoxin
Strengthens cardiac muscle contraction
Antiarrhythmic
CANT MIX WITH ANYTHING
TOXICITY:
Pulse (slows - Check Apical Pulse before giving)
Photosensitivity
Puke (vomiting, nausea)
Yellow-Green Halos
Light Flashes
Lidocaine
Decrease cardiac irritability
Titate IV
Use with V. TACH
Nitro
Vasodilator
Angina (1 tab 3x, 5 min apart)
Keep med dry, cool, only effective for 6 mo. (Tingling under tongue = good)
Hold when BP <90/60
ORTHOSTATIC HYPOTENSION
Aminophylline
Bronchodilator - Decreases SOB
Therapeutic levels 10-20 mcg/dl
TOXIC > 20
CANT MIX WITH ANYTHING
Amphotericin B
Antifungal
IVPB SLOW - 2+ hrs
Hydrate pt - very toxic to kidneys, monitor BUN.
Check Hearing
Check K+ levels (causes hypokalemia)
Aminoglycosides
Gentamycin, Kanamycin sulfate, Neomycin sulate, Steptomycin Sulfate; Everything _mycin except erythromycin
OTOTOXICITY
KIDNEY DAMAGE
Bronchodilators
Epinephrine (adrenalin)
Careful with Cardiac Pts
Anticoagulants
Heparin (Antecdote - Protamine Sulfate)
Warfarin (Antecdote - Vit K.); avoid foods high in K (spinach, pork)
Bleeding precautions
PPT - Heparin
PT/INR - Warfarin
Cholesterol meds
-Gemfibrozil, atorvostatin, lovastatin
-Monitor LFTs
-Use alt protection (contraceptives < effective)
-Avoid grapefruit juice/colchicine
Cholestyramine
Interacts with digoxin and hydrochlorothiazide
Anticholinergics
Atropine, benztropine, antihistamines
"red as a beet, mad as a hatter, dry as bones, blind as a bat, hot as a hare"
GI - Slows motility, spasm
Eyes - Dilates pupils
DO NOT GIVE TO GLAUCOMA PTS
Heart - Increase HR
Resp - bronchodilator (Atrovent)
Cancer Drugs
Wear gloves, mask when preparing or giving. Can be absorbed throught skin
Sulfa Drugs
Drink lots of fluids
Can cause blood dyscrasias - REPORT SORE THROAT, RASH IMMEDIATELY.
UTI (Sulamethoxazole/Trimethoprim, sulfisoxazole)
Ulcerative colitis (Sulfasalazine)
Urinary Antispasmodics
Phenazopyridine (cystitis) - Orange/Red urine
Penicillins
Take all 10 days
Cortisone (Steroids)
Wt gain, Na+ retention, K+ Loss
NEVER STOP SUDDENLY
Phenytoin
Anti-convolsant
Therapeutic level 10-20 (same as amminophylline)
Toxicity > 20
Causes hyperplasia of gums - bleeding gums
Give extra VIT. D
Tylenol
Bad for Liver - DO NOT GIVE TO ALCOHOLICS
Conjugated estrogen
1. Hormone Replacement - Estrogen
Tx Menopause Sxs, Vascular Headaches
Periods continue
2. Conjugated estrogens/medroxyprogesterone acetate
No periods
Allupurinol
G - Gulp 3L fluid per day
O - (NO) Organ Meats
U - Output up to 2 L/day
T - Teach
Miotics
CONSTRICT (Pilocarpine)
For glaucoma - eyedrops
Mydriatics
DILATES (Atropine)
Dont use in pts with gaucoma (build up IOP)
Timolol
Eyedrops to tx glaucoma
Acetazolamid
Glaucoma
CI in sulfa allergies
Antacids
Aluminum - Causes Constipation
Magnesium - Causes diarrhea Diarrhea
Lithium
Bipolar Disorder
Decrease Na+ (hyponatremia - risk of toxicity)
Increase Na+ levels (causes sodium diuresis)
Toxic Level > 2 mEq/L
Chloriazepoxide and Diazepam
To prevent DT's in acute alcohol withdrwal
Can produce physical dependency.
Direct - Acting Vasodilator
Hydralazine
Relaxes smooth muscle of blood vessels, lowing peripheral resistance.
Teach pt to check pulse d/t change in C.O.
If HR <60 Contact physician.
Clozapine
Atypical antipsychotic
AE: Agranulocytosis - need WBC checked; discontinue if <2000
Caridopa-Levodopa
Parkinson disease
CI: Glaucoma
Avoid vitamin B6 and MAOIs
Chlorpromazine
Schizophrenia
AE: Leukopenia - lab work needed
Otoxic NSAIDs
Indomethacin, aspirin
Aspirin
Avoid if allergy to tartrazine
Bismuth subsalicylate
Diarrhea med
Affects absorption of PO meds - sep administration
Ranitidine
Histamine blocker
May cause false negatives on allergy tests
Avoid all NSAIDs
Aluminum hydroxide suspension
Antacid
Take 1-3 hours after meal
Cimetidine
Antacid
Careful with use in elderly
Interacts w/ a lot of foods/meds
Take 1 hr apart from other antacids
Pentamidine Isethionate
Anti-protozoal prevent PCP
AE: Leukemia, thrombocytopenia
Oseltamivir
Tx flu
Capsules may be opened/mixed w/ food
Take w/ food
Zidovudine
HIV med
AE: Bone marrow suppression and anemia - check CBC
Rimantadine, Zanamivir
Antivirals
CI to receive flu vaccine. OK w/ acyclovir
TB drugs
Isoniazid, rifampicin, pyrazinamide, ethambutol, streptomycin
SE: Red/orange tears/urine; contraceptives don't work well
Liver toxicity (avoid in Hep B pts)
Ciprofloxacin
Ab
Increase fluid intake
Avoid milk/yogurt, multivitamin (w/in 6 hrs)
Cephalexin
Ab
Yogurt ad acidophilus milk help maintain normal flora
Neostigmine
Myasthenia Gravis
Take 45 mins before eating
Succinylcholine
Used for intubation/ECT
Gout meds
Allopurinol, colchicine, probenecid
No Vit C w/ allopurinol
Antidote tylenol
n-Acetylcysteine
Antidote magnesium sulfate
Calcium gluconate
Antidote TPA
Aminocaproic acid
Antidote pancuronium bromide
Neostigmine/atropine
Antidote dig toxicity
Digoxin immube fab
Antidote iron
Deferoxamine
Antidote ammonia
Lactulose
Alendronate
Oral biphosphate
Take in AM 30 mins before anything on empty stomach followed by 8 oz water. Wait 30 mins to eat anything
Sit upright/ambulate for 30 mins after taking
Vincristine
Leaukemia
IV ony
Asparaginase
ALL, AML, non-HL
Test for hypersensitivity before admin
Cyclophosphamide
Leukemia/lymphoma
SE: Alopecia
Diabetes meds
-Surgery: Hold rapid-acting/intermediate morning of surgery. Provide regular on sliding scale.
-Oral hypoglycemics: AE - rash, photosensitivity
Rapid acting insulin
Lispro, aspart, glulisine
Onset: 10-30 mins
Peak: 30-3 hrs
Short acting insulin
Regular
Onset: 30-60 mins
Peak: 2-5 hrs
Intermediate acting insulin
NPH
Onset: 2-4 hrs
Peak: 6-12 hrs
Long-acting insulin
Glargine
Continuous effect w/ no peak
Herbal meds
St John's wort: CI with digoxin, nifedipine, simvastatin, escitalopram (SSRI). OK w/ hydrochlorothiazide and metformin
Gingko: Antiplatelet. Avoid w/ NSAIDs. OK w/ digoxin.
Epoetin
Anemia w/ CKD
SE: Hypokalemia, HTN, DVT
Hydroxyurea
Sickle cell disease
Report GI symptoms immediately
Cyclosporine
Immunosuppressive drug
Stored at room temp in closed container
Take w/ meals
Avoid grape fruit juice
Rhogam
Rh- mother, negative Coombs test
28 weeks, 72 hrs PP
Terbutaline
Tocolytic/bronchodilator use din preg breathing problems
Hold if pulse high
Ritodrine HCl
Reduce intensity/freq of contrations
Onabotulinumtoxina
Nystagmus in peds
Patch good eye so weaker eye gets strog
Radioactive iodine
-3-4 L/day x 2 days
-Flush toilet 2x after use for 2 ays
-Contact only 30 mins/day
-No preg people or kids