MedMaster Show (Nursing Podcast: Pharmacology and Medications for Nurses and Nursing Students by NRSNG)

Visit: https://nursing.com/140meds to request your free copy of "140 Must Know Meds" Generic Name lactulose Trade Name Kristalose Indication Constipation, portal-systemic encephalopathy Action draws water into the stool and softens stool, inhibits ammonia passing into the colon Therapeutic Class laxative Pharmacologic Class osmotic Nursing Considerations • use caution with DM • may cause cramps, abdominal distention, hyperglycemia • assess mental status, ammonia levels, abdominal distention • patient should average 2-3 bowel movements per day

Visit: https://nursing.com/140meds to request your free copy of "140 Must Know Meds" Generic Name ketorolac Trade Name Toradol Indication pain Action pain relief due to prostaglandin inhibition by blocking of the enzyme cyclooxygenase (COX) Therapeutic Class nonsteroidal anti-inflammatory agents, nonopioid analgesics Pharmacologic Class pyrroziline carboxylic acid Nursing Considerations • may cause GI bleeding, Stevens-Johnson Syndrome, anaphylaxis, drowsiness • should not exceed 5 days of therapy • bleeding risk increased with garlic, ginger, and ginkgo • may decrease effectiveness of hypertensive medications and diuretics

Visit: https://nursing.com/140meds to request your free copy of "140 Must Know Meds" Generic Name isoniazide Trade Name INH Indication tuberculosis Action Inhibits synthesis of mycobacterial cell wall Therapeutic Class Antitubercular Pharmacologic Class none Nursing Considerations • can cause jaundice • may cause peripheral neuropathy, seizures, hepatitis • patient should avoid high amounts of tyramine (pickled meats, aged/smoked meats, alcohol, exotic/aged cheese) • monitor liver function tests • complete full course of therapy (6-12 months) • often used in combination with Rifampin

Visit: https://nursing.com/140meds to request your free copy of "140 Must Know Meds" Generic Name radioactive iodine Trade Name none Indication thyroidectomy pretreatment, thyrotoxic crisis, radiation exposure Action inhibits the release of thyroid hormones Therapeutic Class Antithyroid Agent, control of hyperthyroidism Pharmacologic Class none Nursing Considerations • may cause GI bleeding, diarrhea, hypothyroidism, goiter • monitor for hypersensitivity

Visit: https://nursing.com/140meds to request your free copy of "140 Must Know Meds" Generic Name Insulin Regular Trade Name Humulin R/Novolin R Indication hyperglycemia with diabetes type 1 and 2, diabetic ketoacidosis Action stimulates uptake of glucose into muscle and fat cells, inhibits production of glucose in the liver, prevents breakdown of fat and protein Route Onset Peak Duration Subcutaneous 30-45 min 1-5 4.5-6h   Therapeutic Class antidiabetics, hormones Pharmacologic Class pancreatics Nursing Considerations • assess for symptoms of hypoglycemia or hyperglycemia • monitor body weight over time • may cause decreased inorganic phosphates, potassium, and magnesium • monitor blood sugars every 6 hours, monitor A1C every 3-6 months

Visit: https://nursing.com/140meds to request your free copy of "140 Must Know Meds" Generic Name Aspart, Lispro, Glulisine Trade Name Novolog, Humalog, Apidra Indication hyperglycemia with diabetes type 1 and 2, diabetic ketoacidosis Action stimulates uptake of glucose into muscle and fat cells, inhibits production of glucose in the liver, prevents breakdown of fat and protein Route  Onset Peak Duration Aspart 10-20 min 1-3 hr 3-5 hr Glulisine 15 min 1 hr 2-4 hr Lispro 15 min 1-1.5 hr 3-4 hr Therapeutic Class antidiabetics, hormones Pharmacologic Class pancreatics Nursing Considerations • assess for symptoms of hypoglycemia or hyperglycemia • monitor body weight over time • may cause decreased inorganic phosphates, potassium, and magnesium • monitor blood sugars every 6 hours, monitor A1C every 3-6 months

Visit: https://nursing.com/140meds to request your free copy of "140 Must Know Meds" Generic Name Insulin detemir, Insulin glargine Trade Name Levemir, Lantus Indication hyperglycemia with diabetes type 1 and 2, diabetic ketoacidosis Action stimulates uptake of glucose into muscle and fat cells, inhibits production of glucose in the liver, prevents breakdown of fat and protein Route Onset Peak Duration Detemir 3-4 hr 3-14 hr 24 hr Glargine 3-4 hr none 24 hr   Therapeutic Class antidiabetics, hormones Pharmacologic Class pancreatics Nursing Considerations • assess for symptoms of hypoglycemia or hyperglycemia • monitor body weight over time • may cause decreased inorganic phosphates, potassium, and magnesium • monitor blood sugars every 6 hours, monitor A1C every 3-6 months

Visit: https://nursing.com/140meds to request your free copy of "140 Must Know Meds" Generic Name Insulin NPH Trade Name Humulin N, Novolin N Indication hyperglycemia with diabetes type 1 and 2, diabetic ketoacidosis Action stimulates uptake of glucose into muscle and fat cells, inhibits production of glucose in the liver, prevents breakdown of fat and protein Route Onset Peak Duration Subcutaneous 1-2 hr 4-12hr 18-24hr   Therapeutic Class antidiabetics, hormones Pharmacologic Class pancreatics Nursing Considerations • assess for symptoms of hypoglycemia or hyperglycemia • monitor body weight over time • may cause decreased inorganic phosphates, potassium, and magnesium • monitor blood sugars every 6 hours, monitor A1C every 3-6 months

Visit: https://nursing.com/140meds to request your free copy of "140 Must Know Meds" Generic Name indomethacin Trade Name Indocin Indication Inflammatory disorders when patients do not respond to other medications Action Decreases pain and inflammation by inhibiting prostaglandin synthesis Therapeutic Class antirheumatics, ductus arteriosus patency adjuncts (IV only), nonsteroidal anti-inflammatory agents Pharmacologic Class none Nursing Considerations • monitor for hepatitis and GI bleeding • monitor for dizziness, drowsiness, and headache • assess for anaphylactic reaction • aspirin may decrease effectiveness • monitor renal labs • shake suspension before administration • patient should wear sunscreen and protective clothing to protect against photosensitivity

Hi NURSING.com family.   You can now prep for the NCLEX Anywhere!   We just released a new Podcast show, “NCLEX Flash Notes.”  This is the perfect NCLEX review, and as ALWAYS, we have pulled out the MOST important info that you need to become an Amazing nurse! Listen in each week while we review the critical topics you need to pass the NCLEX Exam.  Each episode will cover different MUST-know nursing topics, with a perfect overview of all you need to know. Our new show is NCLEX Flash Notes.   Just click the link below for a direct link to the show on either iTunes OR Spotify!   https://nursing.com/flashnotes 

Visit: https://nursing.com/140meds to request your free copy of "140 Must Know Meds" Generic Name ibuprofen Trade Name Advil / Motrin Indication Mild to moderate pain, inflammatory states Action Decreases pain and inflammation by inhibiting prostaglandins Therapeutic Class antipyretics, antirheumatics, nonopioid analgesics, nonsteroidal anti-inflammatory agents Pharmacologic Class nonopioid analgesics Nursing Considerations • may cause GI bleeding, hepatitis, Stevens-Johnson Syndrome • may cause anaphylaxis • monitor for headache, nausea, vomiting, constipation • therapy should be discontinued after first sign of rash • monitor renal and liver labs • patient should avoid using alcohol

Visit: https://nursing.com/140meds to request your free copy of "140 Must Know Meds" Generic Name hydromorphone Trade Name Dilaudid Indication moderate to severe pain Action alters the perception and reaction to pain by binding to opiate receptors in the CNS, also suppresses the cough reflex Therapeutic Class Opioid Analgesic, allergy, cold and cough remedies, antitussive Pharmacologic Class opioid agonist Nursing Considerations • Assess BP, respirations, and pulse before and during administration – medication causes general CNS depression • Narcan (nalaxone) is the antidote for overdose • use caution with concurrent use of MAOI – avoid use within 14 days of each other • may be used as an antitussive • advised to dilute with NS prior to administration and to administer slowly to decrease CNS depression

Hi NURSING.com family.  Are you getting ready for the NCLEX??   This show is the perfect NCLEX review, and as ALWAYS, we have pulled out the MOST important info that you need to become an Amazing nurse! Listen in each week while we review 77 critical topics you need to pass the NCLEX-RN Exam.  Each episode will cover these MUST-know nursing topics with a perfect overview.   Our new show is NCLEX Flash Notes.  You can search that in Apple podcasts or Spotify and pull up the SHOW.   NCLEX Flash Notes NCLEX Flash Notes is your go-to last-minute refresher for the NCLEX exam. Cut through the fluff and get straight to the essential information with this free resource.  

Visit: https://nursing.com/140meds to request your free copy of "140 Must Know Meds" Generic Name hydrocodone/acetaminophen Trade Name Vicodin, Lortab, Norco Indication management of moderate to severe pain Action alters the perception and reaction to pain by binding to opiate receptors in the CNS, also suppresses the cough reflex Therapeutic Class opioid Analgesic, allergy, cold and cough remedies, antitussive Pharmacologic Class opioid agonists, nonopioid analgesic combinations Nursing Considerations • use caution with concurrent use of MAOI – avoid use within 14 days of each other • hypotension – monitor hemodynamics and respirations after administering • may increase ICP use caution with head trauma • Narcan (nalaxone) is the antidote for overdose • DO NOT exceed 4g of acetaminophen per day

Visit: https://nursing.com/140meds to request your free copy of "140 Must Know Meds" Generic Name hydralazine Trade Name Apresoline Indication hypertension Action arterial vasodilation by unclarified mechanism Therapeutic Class anti-hypertensive Pharmacologic Class vasodilator Nursing Considerations • may cause tachycardia, sodium retention, arrhythmias, angina • use caution with MAOIs • monitor blood pressure • instruct patient on how to take blood pressure

Visit: https://nursing.com/140meds to request your free copy of "140 Must Know Meds" Generic Name haloperidol Trade Name Haldol Indication Schizophrenia, mania, aggressive and agitated patient Action Alters the effect of dopamine Therapeutic Class Antipsychotic Pharmacologic Class butyrophenones Nursing Considerations • extrapyramidal symptoms, tardive dyskinesia • use caution in QT prolongation • may cause seizures, constipation, dry mouth, agranulosytosis • assess for hallucinations • monitor hemodynamics • monitor for neuroleptic malignant syndrome (fever, muscular rigidity, altered mental status, and autonomic dysfunction) • monitor CBC with differential

Visit: https://nursing.com/140meds to request your free copy of "140 Must Know Meds" Generic Name guaifenesin Trade Name Mucinex Indication Cough suppression, expectorant Action Decreases viscosity of and mobilizes secretions Therapeutic Class allergy, cold and cough remedies, expectorant Pharmacologic Class none Nursing Considerations • patient should avoid over the counter cold medications • assess lung sounds • maintain adequate fluid intake

Visit: https://nursing.com/140meds to request your free copy of "140 Must Know Meds" Generic Name Glipizide Trade Name Glucotrol Indication Type 2 diabetes mellitus Action Stimulates release of insulin from the beta cells in the pancreases and leads to increased sensitivity to insulin Therapeutic Class Anti-diabetic Pharmacologic Class Sulfonylureas Nursing Considerations • May cause aplastic anemias, hypoglycemia, photosensitivity, dizziness, drowsiness, headache, diarrhea • Monitor CBC, assess for allergy to sulfonamides • Beta blockers may increase signs of hypoglycemia • Instruct patient on how to check blood sugars and • Instruct patient on importance of carrying source of sugar in case of hypoglycemia

Visit: https://nursing.com/140meds to request your free copy of "140 Must Know Meds" Generic Name Gentamicin Trade Name Cidomycin Indication Treatment of gram negative infections when penicillin is ineffective Action Inhibits bacterial protein synthesis Therapeutic Class Anti-infectives Pharmacologic Class Aminoglycoside Nursing Considerations • Causes tinnitus-hearing loss/do not administer with penicillin • Use caution in renal impairment • Assess for infection • Obtain cultures prior to therapy • Monitor liver function tests • Monitor blood levels of drug

Visit: https://nursing.com/140meds to request your free copy of "140 Must Know Meds" Generic Name Gabapentin Trade Name Neurontin Indication Seizures, peripheral neuropathy, neuropathic pain, prevention of migraines Action Exact method of action unknown, may play a role in stabilizing neural membranes Therapeutic Class Analgesic adjuncts, anticonvulsants, mood stabilizers Pharmacologic Class None Nursing Considerations • May cause suicidal thoughts, confusion, depression, drowsiness, ataxia, facial edema, hypertension • Monitor pt closely for changes in behavior and depression • Assess seizure activity • Assess pain level • Patient should take medications exactly as prescribed

Visit: https://nursing.com/140meds to request your free copy of "140 Must Know Meds" Generic Name Furosemide Trade Name Lasix Indication Edema, hypertension Action Prevents reabsorption of sodium and chloride in the kidneys, increase excretion of water, sodium, chloride, magnesium, potassium Therapeutic Class Diuretics Pharmacologic Class Loop diuretics Nursing Considerations • Use caution with liver disease • May cause hypotension, dry mouth, excessive urination, dehydration, electrolyte abnormalities, metabolic alkalosis • Hypokalemia may lead to increase risk of digoxin toxicity • Monitor renal panel • Use caution with other antihypertensives • Causes arthritic symptoms/do not administer with aminoglycosides due to ototoxicity

Visit: https://nursing.com/140meds to request your free copy of "140 Must Know Meds" Generic Name Fluticasone Trade Name Flovent, Flonase Indication prophylactic asthma treatment Action locally acting anti-inflammatory Therapeutic Class antiasthmatics, anti-inflammatory (steroid) Pharmacologic Class Corticosteroids, Inhalation Nursing Considerations • use cautiously with untreated infections and suppressed immune function • may cause headache, insomnia, bronchospasm, nasal congestion, adrenal suppression • monitor patient's respiratory status • may lead to decreased bone density • instruct patients using corticosteroids and bronchodilators that they need to use bronchodilators first. • instruct patient to stop smoking

Visit: https://nursing.com/140meds to request your free copy of "140 Must Know Meds" Generic Name Fluoxetine Trade Name Prozac Indication Depressive disorder, OCD, bulimia, panic disorder, bipolar, anorexia, ADHD, DM neuropathy, obesity Action Inhibits reuptake of serotonin allowing it to persist longer in the synaptic cleft Therapeutic Class Antidepressant Pharmacologic Class SSRI Nursing Considerations • Do not use while taking MAOIs • May cause suicidal thoughts, drowsiness, anxiety, sexual dysfunction, insomnia, palpitations • Monitor closely for serotonin syndrome • Concurrent use with certain medications may lead to QT prolongation • Monitor mood changes and assess for suicidal ideation • Monitor nutrition status • May cause elevated liver enzymes • Instruct pt to maintain good oral hygiene

Visit: https://nursing.com/140meds to request your free copy of "140 Must Know Meds" Generic Name Ferrous sulfate Trade Name Feosol Indication Prevention and treatment of iron-deficiency anemia Action Iron is essential for hemoglobin, myoglobin and enzymes, it is transported to organs where it becomes part of iron stores Therapeutic Class Antianemics Pharmacologic Class Iron supplements Nursing Considerations • May cause seizures, hypotension, constipation, epigastric pain, diarrhea, skin staining, anaphylaxis • Assess nutritional status, bowel function • Monitor hemoglobin, hematocrit, iron levels • May cause elevated liver enzymes • Take on an empty stomach to increase absorption/vitamin c helps with absorption • Use z-track for IM injections

Visit: https://nursing.com/140meds to request your free copy of "140 Must Know Meds" Generic Name Fentanyl Trade Name Sublimaze Indication Supplement to general anesthesia, continuous IV infusion for purpose of analgesia Action Binds to opiate receptors in CNS altering perception of pain, producing CNS depression Therapeutic Class Opioid Analgesic Pharmacologic Class Opioid agonists Nursing Considerations • Use caution with increased ICP, head trauma, adrenal insufficiency • Avoid use with MAOIs • May cause apnea, laryngospasm, decreased respirations, bradycardia, hypotension • Do not consume grapefruit while taking this medication • Monitor hemodynamics during administration • Assess patient pain scale frequently

Visit: https://nursing.com/140meds to request your free copy of "140 Must Know Meds" Generic Name Famotidine Trade Name Pepcid Indication Short term treatment of active ulcer, GERD, treatment of heartburn, indigestion, management of Zollinger Ellison syndrome, prevention of GI bleeding in critically ill patients, management of symptoms associated with overuse of NSAIDs Action Blocks action of histamine located in gastric parietal cells, inhibits gastric acid secretion Therapeutic Class Antiulcer agent Pharmacologic Class Histamine H2 antagonist Nursing Considerations • May cause arrhythmias, agranulocytosis, aplastic anemias • Assess for abdominal pain and occult blood • Monitor CBC • Instruct pt to increase fluid and fiber intake to prevent constipation

Visit: https://nursing.com/140meds to request your free copy of "140 Must Know Meds" Generic Name Escitalopram Trade Name Lexapro Indication Major depressive disorder, anxiety disorder, PCD, PTSD, social phobia Action Increases the extracellular levels of serotonin in the synaptic cleft by selectively inhibiting its reuptake Therapeutic Class Antidepressant Pharmacologic Class SSRI Nursing Considerations • Contraindicated with MAOI • May cause suicidal thoughts, insomnia, drowsiness, diarrhea, nausea, serotonin syndrome • May cause QT prolongation with certain medications • Assess for sexual dysfunction • May take 4-6 weeks for full affect to take place • Monitor for serotonin syndrome (mental changes, NV, tachycardia, hyperthermia)

Visit: https://nursing.com/140meds to request your free copy of "140 Must Know Meds" Generic Name Erythromycin Trade Name E-Mycin Indication Useful in place of penicillin when patient cannot take penicillin, upper and lower respiratory tract infections, otitis media, skin infections, pertussis, syphilis, rheumatic fever Action Bacteriostatic: suppresses bacterial protein synthesis Therapeutic Class Anti-infective Pharmacologic Class Macrolide Nursing Considerations • Causes QT prolongation, ventricular arrhythmias • Diarrhea • Asses infection • Monitor liver function tests • Instruct patient to finish medication dosage even if they are feeling better • Medication should not be shared

Visit: https://nursing.com/140meds to request your free copy of "140 Must Know Meds" Generic Name Epoetin Trade Name Epogen Indication Anemia Action Stimulates erythropoiesis (production of RBCs) Therapeutic Class Antianemic Pharmacologic Class Hormones Nursing Considerations Assess dialysis shunts Contraindicated in albumin hypersensitivity May cause Seizures CHF MI CVA Hypertension Do not shake vial Initiate seizure precautions Monitor Bleeding times Signs of anemia

Visit: https://nursing.com/140meds to request your free copy of "140 Must Know Meds" Generic Name Epinephrine Trade Name Adrenalin, EpiPen Indication Asthma and COPD exacerbations, allergic reactions, cardiac arrest, anesthesia adjunct Action Affects both beta1 and beta2 also has alpha agonist properties resulting in bron- chodilation and increases in HR and BP. Inhibits hypersensitivity reactions. Therapeutic Class Antiasthmatic, bronchodilator, vasopressor Pharmacologic Class Adrenergic agonist Nursing Considerations • Side effects include: angina, tachycardia, hypertension, restlessness, nervousness, hyperglycemia • Use with MAOI may lead to hypertensive crisis • Patients should not use stimulants (caffeine, guarana, etc) • Excessive use may cause bronchospasm • Assess lung sounds, pulse, BP, and other hemodynamic parameters • Monitor for chest pain • Instruct patient to use as directed • Patient should insure adequate fluid intake to liquefy secretions • Mouth should be rinsed after inhalation • Beta blockers may negate effects • May increase blood glucose levels

Visit: https://nursing.com/140meds to request your free copy of "140 Must Know Meds" Generic Name Enoxaparin Trade Name Lovenox Indication Prevention of VTE, DVT, and PE Action Prevents thrombus formation by potentiating the inhibitory effect of antithrom- bin on factor Xa and thrombin. Enoxaparin is a low molecular weight heparin. Therapeutic Class Anticoagulant Pharmacologic Class Antithrombotic Nursing Considerations • Contraindicated in pork hypersensitivity • Monitor for signs of bleeding • Administer in subcutaneous tissue • DO NOT eject air bubble prior to injection • DO NOT aspirate or massage site

Visit: https://nursing.com/140meds to request your free copy of "140 Must Know Meds" Generic Name Enalapril Trade Name Vasotec Indication hypertension, management of CHF Action Block conversion of angiotensin I to angiotensin II, increases renin levels and decreases aldosterone leading to vasodilation Therapeutic Class Antihypertensives Pharmacologic Class ACE Inhibitor Nursing Considerations • May cause hypersensitivity (allergic) reactions and angioedema (swelling of face, lips, tongue, throat) • Can cause neutropenia – check WBCs regularly • Use cautiously with potassium supplements and potassium sparing diuretics. • Use cautiously with diuretic therapy • Administer 1 hour before meals • Monitor blood pressure often • Monitor weight and fluid status • Monitor renal profile • Monitor CBC frequently • Dry cough

Visit: https://nursing.com/140meds to request your free copy of "140 Must Know Meds" Generic Name dopamine Trade Name Inotropin What is the indication for Dopamine? used to improve blood pressure, cardiac output, and urine output Action Smaller doses result in renal vasodilation Doses 2-10mcg/kg/min result in cardiac stimulation by acting on beta1 receptors Doses >10mcg/kg/min stimulate alpha receptors leading to vasoconstriction (↑SVR) What is the therapeutic class for Dopamine? inotropic, vasopressor Pharmacologic Class adrenergic Nursing Considerations for Dopamine (Inotropin) • Monitor hemodynamics closely: BP, HR, EKG, CVP, and PAOP if available • Obtain parameters for hemodynamic values • Titrate to obtain appropriate BP (more potent vasoconstrictors may be required) • Irritation may occur at IV site • Beta blockers may counteract therapeutic effects Dopamine Audio Lecture

Visit: https://nursing.com/140meds to request your free copy of "140 Must Know Meds" Generic Name Dobutamine Trade Name Dobutrex Indication Short term management of heart failure Action Dobutamine has a positive inotropic effect (increases cardiac output) with very little effect on heart rate. Stimulates Beta1 receptors in the heart. Therapeutic Class Inotropic Pharmacologic Class Beta-adrenergic agonist Nursing Considerations • Monitor hemodynamics: hypertension, ↑HR, PVCs • Skin reactions may occur with hypersensitivity • Beta blockers may negate therapeutic effects of dobutamine • Monitor cardiac output • Monitor peripheral pulses before, during, and after therapy • DO NOT confuse dobutamine with dopamine

Visit: https://nursing.com/140meds to request your free copy of "140 Must Know Meds" Generic Name Divalproex Trade Name Depakote Indication Seizures, manic episodes, prevention of headache Action Increases the level of GABA (inhibitory neurotransmitter) in CNS Therapeutic Class Anticonvulsant, vascular headache suppressants Pharmacologic Class None Nursing Considerations • May cause suicidal thoughts, agitation, dizziness, insomnia, hepatotoxicity, pancreatitis • Increases risk for bleeding with Warfarin • Use caution with MAOIs • Monitor liver function tests

Visit: https://nursing.com/140meds to request your free copy of "140 Must Know Meds" Generic Name Diphenoxylate/atropine Trade Name Lomotil Indication Treatment for diarrhea Action Inhibits GI motility via anticholinergic effects Therapeutic Class Antidiarrheal Pharmacologic Class Anticholinergic Nursing Considerations • Contraindicated with angle-closure glaucoma, dehydration • Structurally related to opioids so use caution with patients that have allergies to opioids • May cause constipation, tachycardia, dizziness, ileus • Monitor liver function as the medication is excreted by the liver • Ensure that client is taking medication as prescribed and not double dosing

Visit: https://nursing.com/140meds to request your free copy of "140 Must Know Meds" Generic Name Diphenhydramine Trade Name Benadryl Indication Allergy, anaphylaxis, sedation, motion sickness, antitussive Action Antagonizes effects of histamine, CNS depression Therapeutic Class Allergy, cold and cough remedy, antihistamine, antitussive Pharmacologic Class Antihistamine Nursing Considerations • May cause drowsiness, anorexia, dry mouth, nausea, chest tightness, thick secretions, hypotension, blurred vision, headache • Anticholinergic effects (dry mouth, blurred vision, constipation, sedation) • Assess purpose of medication prior to giving it • Assess allergies, sleep patterns, cough and lung sounds • Patient should avoid other over-the-counter cough and cold remedies

Visit: https://nursing.com/140meds to request your free copy of "140 Must Know Meds" Generic Name Diltiazem Trade Name Cardizem Indication Hypertension, angina, SVT, AFib, aflutter Action Inhibits calcium transport resulting in inhibition of excitation and contraction, leads to depression of AV and SA node leading to decreased HR, leads to vasodi- latation and decreased blood pressure. Therapeutic Class Antianginals, antiarrhythmics, antihypertensive Pharmacologic Class Ca Channel Blocker (Benzothiazepine) Nursing Considerations • Contraindicated in 2nd and 3rd AV block • May cause arrhythmias, CHF, bradycardia, peripheral edema, gingival hyperplasia • Increases digoxin levels • Don't drink grapefruit juice • Assess for signs of CHF • Monitor EKG continuously • Tell patient to change positions slowly • Monitor serum potassium • Instruct pt on how to take blood pressure

Visit: https://nursing.com/140meds to request your free copy of "140 Must Know Meds" Generic Name Digoxin Trade Name Lanoxin Indication CHF, AFib, A-flutter Action Positive inotropic effect (increases force of myocardial contraction), prolongs refractory period, ↓ conduction through SA and AV nodes. Essentially digoxin is given to increase cardiac output and slow the rate. Therapeutic Class Antiarrhythmic, inotropics Pharmacologic Class Digitalis glycosides Nursing Considerations • Excreted by kidneys • Assess patient for hypersensitivity • Contraindicated with uncontrolled ventricular arrhythmias • Hypokalemia increase risk for toxicity • Hypercalcemia ↑ risk for toxicity • Use caution with diuretic use as they may cause electrolyte abnormalities that can lead to toxicity • Assess patient for cardiac arrhythmias including bradycardia • Signs of toxicity include vision changes (blurred vision, yellow, green vision disturbances) • Monitor pulse rate for 1 full minute prior to dosing patient (hold for pulse

Visit: https://nursing.com/140meds to request your free copy of "140 Must Know Meds" Generic Name Diazepam Trade Name Valium Indication Anxiety, pre-op sedation, conscious sedation, treatment of seizures, insomnia, management of alcohol withdrawal Action Decreases the effects of voltage gated sodium channels to depresses the CNS Therapeutic Class Antianxiety agents, anticonvulsants, sedative/hypnotics, skeletal muscle relax- ants (centrally acting) Pharmacologic Class Benzodiazepine Nursing Considerations • Contraindicated in hepatic dysfunction • Use caution with renal impairment • Can cause dizziness, drowsiness, lethargy, hypotension, physical depen- dence, tolerance • Instruct patient to take as directed • Caution to avoid alcohol use • Flumazenil (Romazicon) is the reversal agent

Visit: https://nursing.com/140meds to request your free copy of "140 Must Know Meds" Generic Name Dexamethasone Trade Name Decadron Indication Manage cerebral edema, assess for Cushing's Disease Action Suppress inflammation and normal immune response. Used in inflammatory states to decrease inflammation. Therapeutic Class Antiasthmatics, corticosteroids Pharmacologic Class Corticosteroids Nursing Considerations • Excreted by the liver – monitor liver profile • Avoid in active untreated infections • May cause CNS alterations • May cause peptic ulcers • May cause Cushingoid appearance (buffalo hump, moon face) • Weight gain • Osteoporosis • Decrease wound healing • May elevate blood sugars • May increase cholesterol and lipid values

Visit: https://nursing.com/140meds to request your free copy of "140 Must Know Meds" Generic Name Cyclosporine Trade Name Sandimmune Indication Prevention of rejection in transplantation, treatment of severe RA, management of ulcerative colitis Action Inhibits normal immune response primarily by decreasing the activity of T cells Therapeutic Class Immunosuppressant, antirheumatics (DMARD) Pharmacologic Class Polypeptides (cyclic) Nursing Considerations • May cause seizures, tremors, hypertension, hepatotoxicity, diarrhea, N/V, gingival hyperplasia • Increases immune suppression with corticosteroids • Avoid grapefruit juice while taking this medications • Assess for signs of organ rejection • Monitor renal panel, liver enzymes • Take medication as directed • Lifelong therapy required for transplant patients • Instruct pt on how to take blood pressure

Join us for our FREE Test-Taking Webinar to boost your exam scores: https://bit.ly/nursingtesttaking I am excited to bring to you the NURSING.com SOCK Method, with proven tips to help you master pharmacology.   When I surveyed 200 nursing students, 66% said that their most difficult subject was nursing pharmacology.  However, the issue is often overlooked. There are a lot of schools that don't have dedicated pharmacology courses and instead roll it up into other parts of the program.  But that is devastating to me because the one thing we do more than almost anything else in our careers as nurses is give medication. So today I'm gonna introduce you to something called the SOCK Method for mastering nursing pharmacology.  We are doubling down on our focus on pharmacology in this podcast.  After listening to this, I am confident that you will be able to become a master of nursing pharmacology. SOCK Method S – Side Effects O – Organs C – Class/Considerations/Cards K – Know (or Must Know) The Correct Order

Visit: https://nursing.com/140meds to request your free copy of "140 Must Know Meds" Generic Name Cortisone Trade Name Cortone Indication Management of adrenocortical insufficiency (Addison's Disease). Replace cortisol in states of deficiency, suppress inflammation and normal immune response. Action The adrenal glands sit on top of the kidneys. The adrenal glands excrete steroid hormones, including cortisol that play a role in increasing blood sugars, immune suppression, and metabolism of fat, protein, and carbohydrates, as well as decreasing bone formation. Therapeutic Class Antiasthmatics, corticosteroids Pharmacologic Class Corticosteroids Nursing Considerations • Excreted by the liver – monitor liver profile • Avoid in active untreated infections • May cause CNS alterations • May cause peptic ulcers • May cause Cushingoid appearance (buffalo hump, moon face) • Weight gain • Osteoporosis • Decrease wound healing • May elevate blood sugars • May increase cholesterol and lipid values

Visit: https://nursing.com/140meds to request your free copy of "140 Must Know Meds" Generic Name Codeine Trade Name Paveral Indication Management of pain, diarrhea, cough suppressant Action Binds to opiate receptors in the CNS and alters perception of pain while producing a general depression of the CNS. This depression also causes a decrease in the cough reflex and GI motility. Therapeutic Class Allergy, cold, cough remedy, antitussive, opioid analgesic Pharmacologic Class Opioid agonist Nursing Considerations • May cause alterations in mentation, hypotension, constipation, nausea, vomiting • Assess BP, pulse, and respiratory rate prior to administration and frequently during administration • Use caution if patient is receiving MAO Inhibitors • Narcan (naloxone) is the antidote for opioid agonists

Visit: https://nursing.com/140meds to request your free copy of "140 Must Know Meds" Generic Name Clopidogrel Trade Name Plavix Indication Atherosclerotic events, MI, CVA, PVD, acute coronary syndrome Action Inhibits platelet aggregation Therapeutic Class Antiplatelet agent Pharmacologic Class Platelet aggregation inhibitors Nursing Considerations • May cause GI bleeding, neutropenia, hypercholesterolemia • May increase risk for bleeding in warfarin, aspirin, heparin • Can increase risk for bleeding with garlic, ginkgo, ginger • Monitor for signs of bleeding • Monitor bleeding times • Monitor CBC and platelet count • Discontinue use 5-7 days before surgery

Visit: https://nursing.com/140meds to request your free copy of "140 Must Know Meds" Generic Name Clindamycin Trade Name Cleocin Indication Skin infections, respiratory tract infections, septicemia, intra-abdominal infections, osteomyelitis Action Bacteriostatic: inhibits protein synthesis Therapeutic Class Anti-infectives Pharmacologic Class Lincosamide Nursing Considerations • Arrhythmias, pseudomembranous colitis, diarrhea, phlebitis • Monitor bowel function • Assess for infection, obtain cultures prior to therapy • Monitor liver function tests • Monitor CBC

Visit: https://nursing.com/140meds to request your free copy of "140 Must Know Meds" Generic Name Ciprofloxacin Trade Name Cipro Indication Urinary tract infections, gonorrhea, respiratory tract infections, bronchitis, pneumonia, skin and bone infections, infectious diarrhea, abdominal infections Action Inhibits bacterial DNA synthesis Therapeutic Class Anti-infectives Pharmacologic Class Fluoroquinolone Nursing Considerations • Contraindicated in allergies • May cause QT prolongation, avoid use with other drugs that can cause QT prolongation • Can cause seizures, arrhythmias, pseudomembranous colitis, anaphylaxis, Stevens Johnson syndrome • May decrease effects of phenytoin • Monitor renal panel • Assess for infection, obtain cultures prior to therapy • Monitor liver function tests

Visit: https://nursing.com/140meds to request your free copy of "140 Must Know Meds" Generic Name Cimetidine Trade Name Tagamet Indication Treatment of duodenal ulcers, GERD, heartburn, Zollinger Ellison syndrome, prevention of GI bleeding in critical patients. Action Inhibits action of histamine leading to inhibition of gastric acid secretion Therapeutic Class Antiulcer agent Pharmacologic Class Histamine H2 antagonist Nursing Considerations • Increases serum level of warfarin • Can lead to respiratory infection (green sputum) • Monitor for arrhythmias • May cause agranulocytosis, aplastic anemia • Monitor CBC during therapy • Take medication as directed • Instruct patient to increase fluid and fiber intake to decrease constipation

Visit: https://nursing.com/140meds to request your free copy of "140 Must Know Meds" Generic Name Chlorpromazine Trade Name Thorazine Indication Second line treatment of schizophrenia and psychosis, nausea/vomiting, pre-op sedation, acute intermittent porphyria, headache, bipolar Action Exhibits anticholinergic activity, alters effects of dopamine in CNS Therapeutic Class Antipsychotic, antiemetic Pharmacologic Class Phenothiazines (dopamine D2 receptor antagonist) Nursing Considerations • May cause neuroleptic malignant syndrome, sedation, tardive dyskinesia, hypotension, agranulocytosis • Assess mental status prior to and during treatment • Monitor blood pressure • Ensure patient is taking medication • Monitor CBC and liver function tests • Instruct patient not to skip doses or double dose.

Visit: https://nursing.com/140meds to request your free copy of "140 Must Know Meds" Generic Name Cephalexin Trade Name Keflex Indication Skin infections, pneumonia, UTI, otitis media Action Bactericidal: binds to bacterial cell wall leading to cell death Therapeutic Class Anti-infectives Pharmacologic Class Cephalosporin 1st generation Nursing Considerations • Contraindicated with cephalosporin and serious penicillin allergies. • May need lead to seizures, pseudomembranous colitis, diarrhea, phlebitis at IV site, anaphylaxis • Assess infection and allergies • Obtain cultures prior to therapy • Monitor bowel function • May lead to superinfection • May cause elevated liver enzymes