POPULARITY
“Transfusion safety is really a registered nurse activity, and I just continue to reiterate the blessing of nursing assessment, getting those vitals before the transfusion, and then monitoring them closely and stopping the transfusion if they have a reaction, because that's really an assessment, and we can't delegate that to nonlicensed staff. And so that's really why we just celebrate that nurses have such a great role in transfusion safety,” Renee LeBlanc, BSN, RN, manager of the infusion services office at Fred Hutchinson Cancer Center in Seattle, WA, told Lenise Taylor, MN, RN, AOCNS®, BMTCN®, oncology clinical specialist at ONS, during a conversation about administration of plasma and cryoprecipitate. Music Credit: “Fireflies and Stardust” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 Earn 0.25 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at myoutcomes.ons.org by May 31, 2026. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of NCPD by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: Learners will report an increase in knowledge related to plasma and cryoprecipitate administration. Episode Notes Complete this evaluation for free NCPD. Oncology Nursing Podcast episodes: Episode 234: Oncologic Emergencies 101: Thrombotic Thrombocytopenia Purpura Episode 228: Oncologic Emergencies 101: Disseminated Intravascular Coagulation Episode 196: Oncologic Emergencies 101: Bleeding and Thrombosis Episode 176: Oncologic Emergencies 101: Cytokine Release Syndrome ONS Voice articles: Nursing Considerations for Adverse Events From CAR T-Cell Therapy Manage Thrombosis in Patients With Cancer ONS courses: Essentials in Oncologic Emergencies for the Advanced Practice Provider Oncologic Emergencies ONS book: Understanding and Managing Oncologic Emergencies: A Resource for Nurses (third edition) Clinical Journal of Oncology Nursing article: STAT: Cytokine Release Syndrome ONS Huddle Cards Cytokine Release Syndrome Disseminated Intravascular Coagulation AABB (Association for the Advancement of Blood and Biotherapies, formerly American Association of Blood Banks) American Association of Clinical Oncology Blood Bank Guy (Joe Chaffin, MD) Joint Commission: Patient Blood Management Certification Review Process Guide 2021 To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From This Episode “Plasma is indicated for massive transfusions and emergent reversal of warfarin therapy–related intracranial hemorrhage. Nurses may also see plasma ordered pre-op for multiple coagulation deficiencies or factor XI deficiency.” TS 2:58 “Surgical centers performing procedures with large-volume blood loss would be a prime location for staff to be experts in transfusing plasma and cryo. Nurses caring for patients with cytokine release syndrome may be familiar with monitoring for hypofibrinogenemia. Cryoprecipitate in this setting may be given more prophylactically than for a patient who's actively bleeding or having a procedure.” TS 6:48 “Plasma coagulation factors have a short half-life. Transfusing as close to the procedure will ensure the highest level of factor activity at the time of the procedure. Nurses can ensure best outcomes through care coordination and timing the transfusions as close to the procedure as possible. So we don't want to start transfusing plasma at midnight if the factors are going to be expiring and their procedure isn't until 9:00 in the morning.” TS 10:40 “One of the questions that I get sometimes, especially with plasma, is, ‘I don't have time to be at the bedside for 15 minutes for four units.' Remember that each unit is a different donor, and what they eat, what kind of antibodies they have, whether they were pregnant—it's all part of that experience. It's not the same plasma product given four different times or three different times. And so just really drawing nurses into the value of being at the bedside for that first 15 minutes of that final determination of acceptability and tolerance.” TS 14:20
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
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 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
Join us as we engage in an enlightening conversation with retired Army Colonel Kim Biever, a seasoned medical professional with vast experience in critical care nursing. Listen in as Kim discusses the emerging need for large-scale combat operations preparation in the current operational environment. She shares invaluable insights on the importance of readying medical personnel for the future and the urgency to tailor training to the right level of provider. We also touch on the necessity of reflecting on past events and experiences for lessons learned and innovative ways to simplify tasks for medical professionals on the battlefield. Later, Kim highlights the weight of kindness and flexibility when leading others and sheds light on the various roles in nursing, emphasizing that there's something for everyone in this noble field. Learn from her experiences of creating positive outcomes through the simple act of being kind to people and gain insights into the diverse opportunities available in the nursing field. Chapters: (0:00:00) - Preparing for Large-Scale Medical Operations (0:11:31) - Leadership Lessons and Nursing Advice Chapter Summaries: (0:00:00) - Preparing for Large-Scale Medical Operations (12 Minutes) We hear from retired Army Colonel Kim Biever, a Critical Care Nurse, Nurse Practitioner, and Clinical Nurse Specialist. We discuss the current operational environment and the need to prepare for large-scale combat operations. Kim shares her insights on the importance of preparing medical personnel for the future and the need to bring training to the right level of provider. We also explore the need to look back at past events and experiences to apply lessons learned and how to innovate and make things easier for medical professionals on the battlefield. (0:11:31) - Leadership Lessons and Nursing Advice (6 Minutes) Kim found her passion in nursing. She realized that taking a moment to be kind to people can be highly beneficial in creating positive outcomes. Kim shares the importance of kindness and flexibility when leading others. She also explains the variety of nursing roles and how there is something for everyone in the nursing field. Episode Keywords: Medical Operations, Combat Operations, Training, Provider Proficiency, Past Experiences, Lessons Learned, Innovations, Kindness, Flexibility, Nursing Roles, Army Colonel, Critical Care Nurse, Nurse Practitioner, Clinical Nurse Specialist Hashtags: #wardocs #military #medicine #podcast #CombatMedicine #MilitaryNursing #BattlefieldInsights #PowerOfKindness #NursingLeadership #OperationalMedicine #RetiredMilitary #HealthcareHeroes #ArmyMedics Honoring the Legacy and Preserving the History of Military Medicine The WarDocs Mission is to honor the legacy, preserve the oral history, and showcase career opportunities, unique expeditionary experiences, and achievements of Military Medicine. We foster patriotism and pride in Who we are, What we do, and, most importantly, How we serve Our Patients, the DoD, and Our Nation. Find out more and join Team WarDocs at https://www.wardocspodcast.com/ Check our list of previous guest episodes at https://www.wardocspodcast.com/episodes Listen to the “What We Are For” Episode 47. https://bit.ly/3r87Afm WarDocs- The Military Medicine Podcast is a Non-Profit, Tax-exempt-501(c)(3) Veteran Run Organization run by volunteers. All donations are tax-deductible and go to honoring and preserving the history, experiences, successes, and lessons learned in Military Medicine. A tax receipt will be sent to you. WARDOCS documents the experiences, contributions, and innovations of all military medicine Services, ranks, and Corps who are affectionately called "Docs" as a sign of respect, trust, and confidence on and off the battlefield, demonstrating dedication to the medical care of fellow comrades in arms. Follow Us on Social Media Twitter: @wardocspodcast Facebook: WarDocs Podcast Instagram: @wardocspodcast LinkedIn: WarDocs-The Military Medicine Podcast
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
“I think the take-home message here, though, is to have very specific guidelines at your institution to manage both CRS and ICANS. The protocols should be readily available to all practitioners who may participate in the care of these patients,” ONS member Phyllis McKiernan, MSN, APN, OCN®, advanced practice provider at the John Theurer Cancer Center at Hackensack University Medical Center in New Jersey, told Lenise Taylor, MN, RN, AOCNS®, BMTCN®, oncology clinical specialist at ONS. McKiernan's and Taylor's conversation centered around the nurse's role in recognizing and managing toxicities related to CAR T-cell therapy for hematologic malignancies, specifically ICANS and CRS, which was an educational priority that ONS members identified during two ONS focus groups on the topic in March 2023. McKiernan was one of the content experts for those focus groups. This podcast episode is produced by ONS and supported by funding from Janssen Oncology/Legend Biotech. ONS is solely responsible for the criteria, objectives, content, quality, and scientific integrity of its programs and publications. Music Credit: “Fireflies and Stardust” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 Episode Notes NCPD contact hours are not available for this episode. Oncology Nursing Podcast episodes: Oncologic Emergencies 101 series Episode 261: CAR T-Cell Therapy for Hematologic Malignancies Requires Education and Navigation Episode 139: How CAR and Other T Cells Are Revolutionizing Cancer Treatment Episode 1: Experiences With CAR T-Cell Therapy ONS Clinical Practice Resources: Chimeric Antigen Receptor T-Cell Therapy: A Timeline of Events and Adverse Events Cytokine Release Syndrome ONS Clinical Update: Focus on Clinical Experiences With CAR T-Cell Therapy ONS course: Nursing Considerations for CAR T-Cell Therapy for Patients With Hematologic Malignancies: Patient Education and Symptom Management ONS Huddle Card™️: Cytokine Release Syndrome ONS Immuno-Oncology Learning Library ONS videos: CAR T-Cell Therapy Cytokine Release Syndrome American Cancer Society American Society for Transplantation and Cellular Therapy Grading Scale for CRS and ICANS Leukemia and Lymphoma Society Multiple Myeloma Research Foundation National Institutes of Health's National Cancer Institute Risk Evaluation and Mitigation Strategies To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From Today's Episode “All symptoms need to be investigated fully to determine their cause and thus the best management strategy and not just simply assume that they're related to CAR T.” Timestamp (TS) 9:21 “Accurate grading is really crucial to ensure that the toxicities are identified and managed consistently across the institution.” TS 10:52 “Once the patient shows signs and symptoms of neurotoxicity, they should have a comprehensive neurologic examine, and that should include, a neurology consult, maybe imaging, such as an MRI or CT, and perhaps even a lumbar puncture.” TS 14:12 “Letting patients and their families know what next steps are can alleviate anxiety and give the patients the confidence that the medical team is familiar with these toxicities. And let them know that these toxicities are expected and that there are protocols in place to manage these symptoms.” TS 22:56 “I think that some patients, and even healthcare professionals, who aren't familiar with CAR T believe that the toxicities are always severe and always irreversible. When, in reality, most of the toxicities are mild and managed with minimal intervention or even just supportive care.” TS 23:55 “Early detection, consistent grading, vigilant monitoring, and standardized care plans are crucial to the success of any CAR T program and can also help reduce the risk of the severe adverse effects and hopefully improve outcomes for our patients.” TS 30:26
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
“Just like with anything we do in oncology, a lot of education is required. Nurses and coordinators are critical to start the education and provide effective resources that are reinforced throughout the treatment,” ONS member Beth Faiman, PhD, MSN, APN-BC, AOCN®, BMTCN®, FAAN, FAPO, advanced practice provider at Cleveland Clinic in Ohio, told Lenise Taylor, MN, RN, AOCNS®, BMTCN®, oncology clinical specialist at ONS, during a conversation about how to address knowledge gaps and barriers to practice regarding patients who are preparing for or who have received CAR T-cell therapy for hematologic malignancies. Faiman was one of the content experts for two ONS focus groups on the topic in March 2023. This podcast episode is produced by ONS and supported by funding from Janssen Oncology and Legend Biotech. ONS is solely responsible for the criteria, objectives, content, quality, and scientific integrity of its programs and publications. Music Credit: “Fireflies and Stardust” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 Episode Notes NCPD contact hours are not available for this episode. Oncology Nursing Podcast episodes: Episode 1: Experiences With CAR T-Cell Therapy Episode 139: How CAR and Other T Cells Are Revolutionizing Cancer Treatment Episode 176: Oncologic Emergencies 101: Cytokine Release Syndrome ONS Voice articles: Studies Show Best Practices to Manage CAR T-Cell Therapies' irAEs and Improve Outcomes CAR T-Cell Therapy Programs: Essential Elements to Establish a Successful System A Body of Evidence Helps Nurses Manage CAR T-Cell Therapy Toxicities Clinical Journal of Oncology Nursing articles: CAR T-Cell Therapy: Updates in Nursing Management Building a Program: Implications for Infrastructure, Nursing Education, and Training for CAR T-Cell Therapy Management Across Settings: An Ambulatory and Community Perspective for Patients Undergoing CAR T-Cell Therapy in Multiple Care Settings ONS clinical practice resources: Chimeric Antigen Receptor T-Cell Therapy: A Timeline of Events and Adverse Events Cytokine Release Syndrome ONS course: Nursing Considerations for CAR T-Cell Therapy for Patients With Hematologic Malignancies: Patient Education and Symptom Management ONS videos: CAR T-Cell Therapy Cytokine Release Syndrome American Society for Transplantation and Cellular Therapy Consensus Grading for Cytokine Release Syndrome and Neurologic Toxicity Associated With Immune Effector Cells International Myeloma Foundation Leukemia and Lymphoma Society Multiple Myeloma Research Foundation New England Journal of Medicine article: Ide-cel or Standard Regimens in Relapsed and Refractory Multiple Myeloma Transplantation and Cellular Therapy article: Overcoming Barriers to Referral for Chimeric Antigen Receptor T Cell Therapy in Patients With Relapsed/Refractory Diffuse Large B Cell Lymphoma Learn more about CAR T-cell therapy and risk evaluation and mitigation strategies (REMS). To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From Today's Episode “Just like with anything we do in oncology, there is a lot of education that is required. The same navigators that take care of our patients through the transplant and cellular therapy process, we have similar cellular coordinators that were part of the focus group. These navigators were critical to start the education and provide effective resources that were reinforced throughout the treatment.” Timestamp (TS) 09:00 “The nurses and coordinators play a huge role during the transition of care. Not only do they help with coordinating appointments, but also the scheduling of tests and coordinating with the referring team. I heard a lot in the focus groups about the nurses communicating from inpatient to outpatient, and also coordinating from center to center.” TS 10:22 “Patients can get really nervous when they're feeling sick. I explain it to them like, “You know how you get a flu shot, and you might get a little reaction as we're training your immune system to provide immunity? Well, it's like that, but way worse.' So, you can get really sick feeling and achy from this, and so that psychosocial support is super important.” TS 18:16 “It takes a lot of burden on the patient, caregiver, and the nurse to really be astute to those symptoms and intervene. We do provide wallet cards to patients. We educate the emergency department staff. We also heard about the infection monitoring and caregiver support is absolutely critical. Fortunately, the symptom management has become quite standardized, which really affords the nurses more autonomy to intervene more efficiently.” TS 20:46 “The nurses found for education a teach-back tool to be quite useful. One of the nurses mentioned asking the patient questions such as, ‘What will you do when you have a fever? Tell me what you do,' and “What do you understand from what the doctor just told you?' And so that was just kind of a way that they could go back and forth with the educational process and really understand what the patients understood.” TS 25:46
Visit: https://nursing.com/140meds to request your free copy of "140 Must Know Meds" Generic Name calcium acetate Trade Name PhosLo Indication treatment of hypocalcemia, prevention of post-menopausal osteoporosis, treatment of hyperkalemia and hypermagnesaemia, adjunct in cardiac arrest, control of hyperphosphatemia with ESRD. Binds to phosphate in food and prevents absorption. Action calcium is essential for nervous muscular and skeletal systems, helps maintain cell membranes, aids in transmission of nerve impulses and muscle contraction, aids in blood formation and coagulation Therapeutic Class mineral and electrolyte replacements/supplements Pharmacologic Class antacids Nursing Considerations • may cause cardiac arrest and arrhythmias • phlebitis at site of insertion • monitor hemodynamics • may cause hypotension, bradycardia, and arrhythmias • hypercalcemia can increase risk for digoxin toxicity • administer slowly • instruct pt on foods that contain Vitamin D and encourage adequate intake. • monitor parathyroid hormone
Visit: https://nursing.com/140meds to request your free copy of "140 Must Know Meds" Generic Name butorphanol Trade Name Stadol Indication moderate to severe pain, labor pain, sedation Action alters perception and response to pain by binding to opiate receptors in CNS Therapeutic Class Opioid Analgesic Pharmacologic Class opioid agonists/antagonists Nursing Considerations • use caution with concurrent use of MAOIs • may cause confusion, hallucinations, sedation • monitor for CNS depression • assess blood pressure pulse and respirations during administration • administer slowly through an IV line
“Before you even get started, you have to do your checks. Just like you do with a regular systemic infusion. You're going to be doing your physical assessment prior to starting your patient, looking at your orders to make sure everything looks right, looking at the lab work,” ONS member Emoke Karonis, MSN, RN, CRNI, clinical nurse specialist fellow at Memorial Sloan Kettering Cancer Center in New York, NY, said. “You have to be absolutely sure that day that patient is presenting to you in your suite, you're definitely giving what is expected for that day.” Karonis was speaking to Jaime Weimer, MSN, RN, AGCNS-BC, AOCNS®, oncology clinical specialist at ONS, about oncology nursing considerations for intraperitoneal chemotherapy administration. You can earn free NCPD contact hours after listening to this episode and completing the evaluation linked below. Music Credit: “Fireflies and Stardust” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 Earn 0.75 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at myoutcomes.ons.org by March 24, 2025. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of NCPD by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: The learner will report an increase in knowledge related to intraperitoneal therapy for cancer. Episode Notes: Complete this evaluation to earn free NCPD. Oncology Nursing Podcast Episode 162: What Nurses Need to Know About Central Lines and Ports ONS Voice articles: Nursing Considerations for Ovarian Cancer Survivorship Care Ovarian Cancer: Prevention, Screening, Treatment, and Survivorship Recommendations ONS book: Access Device Standards of Practice for Oncology Nursing American Cancer Society: Chemotherapy for ovarian cancer American Society of Clinical Oncology guideline: Treatment of Metastatic Colorectal Cancer Cancercare.org treatment update: Ovarian cancer Centers for Disease Control and Prevention: Information on ovarian cancer National Institute of Diabetes and Digestive and Kidney Diseases: Information on peritoneal dialysis European Society for Medical Oncology Infusion Nurses Society National Comprehensive Cancer Network To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From Today's Episode “Intraperitoneal (IP) therapy is basically the administration of an agent into that space where the abdominal organs float around via an implanted port or one of those direct intraabdominal catheters. . . Patients with cancer that have metastasized to the peritoneum, who have either had a debulking surgery and have very little disease left inside or small tumors to begin with, they can be considered for IP therapy.” Timestamp (TS) 02:02 “Hyperthermic IP chemotherapy is done in the operating room right after the surgeon has done all of their tumor removal. It is hyperthermic, meaning this stuff is hot, and it gets administered via a special circulating machine that heats up the chemotherapy and circulates it throughout the abdomen. . . . They are circulated for about 90 minutes–2 hours if they are at risk of overheating.” TS 07:39 “In the infusion suite, before you even get started, you have to do your checks. Just like you do with a regular systemic infusion. You're going to be doing your physical assessment prior to starting your patient, looking at your orders to make sure everything looks right, looking at the lab work. . . If it's the first time you're seeing the patient, you want to check for catheter confirmation. It's not going to be in a vessel, it's going to be in the abdomen. You want to make sure that, especially if the person has more than one access device, you are looking for the correct confirmation.” TS 14:00 “It is necessary to repeat yourself because we're giving patients so much information at the presurgical visit, while they're going into the operating room, when they come out of the operating room, on their discharge, and then they're going to go into the clinic for their post-op visit. There's so much being thrown at these folks all the time that you do need to constantly reteach the same thing and to always be very neutral and accepting of that—that people might not retain everything you tell them the first time.” TS 22:00 “You can't emphasize enough that if there's one point where you need to slow down, take a breath, is during that independent double check. You have to be absolutely sure that day that patient is presenting to you in your suite, you're definitely giving what is expected for that day. If they're coming in multiple days, they could have a regimen that changes from day to day. . . . It's so easy to get confused, and it's very important to go back and see what has happened before that patient showed up at your suite, what's expected to happen that day, and what's going to happen the following day.” TS 31:16
Visit: https://nursing.com/140meds to request your free copy of "140 Must Know Meds" Generic Name amoxicillin Trade Name Moxatag Indication skin infections, respiratory infections, sinusitis, endocarditis prophylaxis, lyme disease Action Inhibits synthesis of bacterial cell wall leading to cell death. Therapeutic Class anti-infectives, antiulcer agent Pharmacologic Class aminopenicillins Nursing Considerations • contraindicated with penicillin allergy • may cause seizures • assess for rash, anaphylaxis • excreted by kidneys – monitor renal labs • monitor patient for diarrhea – bloody stool should be reported immediately
Visit: https://nursing.com/140meds for your free+shipping 140 Meds book What is the Generic Name Acetaminophen What is the Trade Name for Acetaminophen Tylenol What is the Indication for Acetaminophen Pain, fever What is the Action of Acetaminophen Inhibit the synthesis of prostaglandins which play a role in transmission of pain signals and fever response What is the Therapeutic Class of Acetaminophen Antipyretic, non-opioid analgesic What are the Nursing Considerations for Acetaminophen • Do not exceed 4g of acetaminophen per day to limit risk for liver, renal, and cardiac damage • Overdose will lead to hepatotoxicity • Acetadote is the antidote for overdose • May increase risk for bleed with warfarin therapy • May alter blood glucose measurements
Download the cheat: https://bit.ly/50-meds View the lesson: Generic Name warfarin Trade Name Coumadin Indication venous thrombosis, pulmonary embolism, A-fib, myocardial infarction Action disrupts liver synthesis of Vitamin K dependent clotting factors Therapeutic Class Anticoagulant Pharmacologic Class coumarins Nursing Considerations • contraindicated with bleeding, severe hypertension • can cause bleeding • aspirin and NSAIDs can increase risk of bleeding • azole antifungals increase effects of warfarin • cimetadine(Tagamet) increases warfarin levels • obtain full history of supplements and herbs • large amounts of vitamin K may antagonize effects of warfarin • assess for signs of bleeding • therapeutic levels: PT 1.3-1.5, INR 2.5-3.5 • instruct patient to report any signs of bleeding • patient should not drink alcohol • bleeding times need to be monitored frequently • vitamin K is antidote
Download the cheat: https://bit.ly/50-meds View the lesson: Generic Name verapamil Trade Name Isoptin Indication hypertension, angina, SVT, migraine Action prevents transport of calcium, leading to decreased contraction, decreases SA and AV node conduction Therapeutic Class antianginals, antiarrhythmic, antihypertensive, vascular headache suppressants Pharmacologic Class Ca Channel Blocker Nursing Considerations • don't use with 2nd and 3rd degree heartblock • don't use with systolic BP < 90 • may cause anxiety, confusion, cough, dyspnea, arrhythmias, CHF, bradycardia, hypotension, elevated liver enzymes, Steven's Johnson syndrome, hyperglycemia, gingival hyperplasia • grapefruit juice can increase effects • can increase levels of digoxin • monitor heart rhythm, intake and output, blood pressure • assess angina
Download the cheat: https://bit.ly/50-meds View the lesson: Generic Name vasopressin Trade Name Pitressin Indication management of diabetes insipidus, VT/VF unresponsive to initial shock, GI hemorrhage Action increases water permeability of the kidney's collecting duct and distal convoluted tubule leading to water retention, also increases peripheral vascular resistance leading to increased BP Therapeutic Class hormone Pharmacologic Class antidiuretic hormone Nursing Considerations • use caution with HF and CV disease • contraindicated in renal failure and hypersensitivity to pork • monitor BP, HR, and EKG during therapy • monitor urine specific gravity and osmolality • weigh patient and assess for edema • monitor electrolyte panel • do not use with alcohol
Generic Name vancomycin Trade Name Vancocin Indication life threatening infections, sepsis Action bactericidal, inhibits cell wall synthesis Therapeutic Class anti-infectives Pharmacologic Class glycopeptides Nursing Considerations • can cause ototoxicity, nausea, vomiting, nephrotoxicity, anaphylaxis, red-man syndrome • assess for infection • obtain culture prior to initiating therapy • monitor blood pressure • dose dependent draw serum trough levels frequently • administer over at least 60 minutes to avoid skin irritation
Generic Name metoprolol Trade Name Lopressor, Toprol XL Indication tachyarrhythmias, HTN, angina, prevention of MI, heart failure management, may be used for migraine prophylaxis Action blocks the stimulation of beta1 receptors in the SNS, does not usually effect on beta2 receptors (cardioselective) Therapeutic Class antianginal, antihypertensive Pharmacologic Class beta blocker Nursing Considerations • monitor hemodynamics • may lead to bradycardia, pulmonary edema • use caution with MAOIs • assess I&Os and monitor for signs of CHF
Download the cheat: https://bit.ly/50-meds View the lesson: Generic Name tetracycline Trade Name Doxycycline Indication treatment of infection, gonorrhea and syphilis with penicillin allergy, chronic bronchitis Action bacteriostatic by inhibiting protein synthesis Therapeutic Class anti-infectives Pharmacologic Class Tetracyclines Nursing Considerations • use caution with liver impairment • may cause pseudomembranous colitis, diarrhea, nausea, vomiting, photosensitivity, rash • may increase effects of warfarin • assess for infection • obtain culture prior to initiating therapy • monitor renal and liver labs • instruct patient to complete entire dose
“When I draw the interprofessional team for the management of cardio-oncology patients, I always place nurses in the center of it, besides the patient, because nurses are the eyes and ears of interprofessional care 24 hours a day,” ONS member Anecita Fadol, PhD, FNP-BC, FAANP, FAAN, FHKAN, associate professor at the University of Texas MD Anderson Cancer Center in Houston, told Jaime Weimer, MSN, RN, AGCNS-BC, AOCNS®, oncology clinical specialist at ONS, during a conversation about getting to “the heart of the matter” of symptom management for the cardiovascular complications of cancer therapies. You can earn free NCPD contact hours after listening to this episode and completing the evaluation linked below. This episode is part of a series about cancer symptom management basics. We'll add a link to future episodes in the episode notes after the next episode airs. Music Credit: “Fireflies and Stardust” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 Earn 1 contact hour of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at myoutcomes.ons.org by January 27, 2025. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of NCPD by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: The learner will report an increase in knowledge related to cardiovascular complications associated with today's cancer treatments. Episode Notes Complete this evaluation for free NCPD. Oncology Nursing Podcast Episode 193: How Social Determinants of Health Affect Cardio-Oncology Survivorship ONS Voice articles: Nursing Considerations for ICI-Related Myocarditis Advanced Practice Nurses Are at the Heart of Patient Care in Cardio-Oncology Cardio-Oncology Program Monitors Heart Toxicities Throughout Survivorship Further Research Can Help Nurses Balance Cardiovascular Conditions With Cancer Treatments Clinical Journal of Oncology Nursing articles: Immune Checkpoint Inhibitor–Related Myocarditis: Recognition, Surveillance, and Management Cardio-Oncology: A Continually Evolving Subspecialty in Oncology Nursing Cardio-Oncology Health Disparities: Social Determinants of Health and Care for Black Breast Cancer Survivors Oncology Nursing Forum article: Mitigating Cardiovascular Dysfunction Across the Cancer Continuum ONS book: Cancer Basics (Third Edition) ONS course: Cancer Basics Learn more about the 48th Annual ONS Congress®. Journal of the American Heart Association article: Immune Checkpoint Inhibitor Myocarditis: Pathophysiological Characteristics, Diagnosis, and Treatment Circulation articles: Clinical Features, Management, and Outcomes of Immune Checkpoint Inhibitor–Related Cardiotoxicity Immune Checkpoint Inhibitor–Associated Myositis Cardio-Oncology: Vascular and Metabolic Perspectives: A Scientific Statement From the American Heart Association New England Journal of Medicine article: Fulminant Myocarditis With Combination Immune Checkpoint Blockade Lancet Oncology article: Cardiovascular Toxicities Associated With Immune Checkpoint Inhibitors: An Observational, Retrospective, Pharmacovigilance Study Journal of the American College of Cardiology article: Cardiovascular Disease Risk Among Cancer Survivors: The Atherosclerosis Risk In Communities (ARIC) Study American College of Cardiology Guideline for the Management of Patients With Non–ST-Elevation Acute Coronary Syndromes Advancing the Cardiovascular Care of the Oncology Patient Heart Failure Society of America 2022 American Heart Association/American College of Cardiology/Heart Failure Society of America Guideline for the Management of Heart Failure International Cardio-Oncology Society European Society of Cardiology Guidelines on Cardio-Oncology Joint National Committee Guidelines for the Management of Hypertension in Adults Attend the Cardio-Oncology Multidisciplinary Practice Virtual Environment on February 13, 2023. To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From Today's Episode “The most commonly reported cardiovascular toxicities can be classified into five main categories: 1. Cancer treatment-induced hypertension; 2. Cardiomyopathy, left ventricular dysfunction, or heart failure; 3. Myocarditis; 4. Vascular toxicity; and 5. Arrhythmias and QTc prolongation. These cardiovascular toxicities can be caused by the different anti-cancer agents.” Timestamp (TS) 01:46 “Cardio-oncology is more complex than the straightforward cardiology practice. Because in terms of the cardiovascular complications, these symptoms can overlap. But on the other hand, it's a very interesting area of practice because, especially as a nurse, it's like you are a detective, looking into a case and trying to find out what is the main etiology.” TS 23:50 “Nurses have a critical role in identification, monitoring, and management of these treatment-related cardiovascular complications, both in the inpatient setting and the outpatient setting with our cancer survivors. So, a nurse should remember in nursing practice, before administering anticancer treatments. . . a comprehensive cardiovascular history and a full cardiovascular assessment should be performed.” TS 30:27 “When I have to draw the interprofessional team for the management of cardio-oncology patients, I always place nurses in the center of it, besides the patient. Because nurses are the eyes and the ears of the interprofessional care who is seeing the patient 24 hours a day. And early recognition—nurses can do it and monitor the response and all the other symptoms.” TS 36:42 “Nurses are very critical in the management of these patients. Nurses are the experts in terms of doing patient teaching because we have an intimate relationship with patients. In terms of the baseline cardiovascular disease in terms of patient teaching, it is very important for nurses to teach the patient aggressive management of the known cardiac risk factors. . . because these are the ones that could cause cardiovascular complications later on when patients are receiving anticancer treatments.” TS 39:05
Generic Name terbutaline Trade Name Brethine, Brethaire Indication asthma, COPD, preterm labor Action produces smooth muscle relaxation, bronchodilator, and inhibits hypersensitivity reactions Therapeutic Class bronchodilators Pharmacologic Class adrenergics tocolytics Nursing Considerations • may cause nervousness, restlessness, tremors • beta blockers can reduce effect • assess respiratory status • monitor maternal/fetal vital signs if using for preterm labor • monitor for hypoglycemia • may cause decreased potassium level
Download the cheat: https://bit.ly/50-meds View the lesson: 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
Generic Name trimethoprim/sulfamethoxazole Trade Name Bactrim/TMP-SMZ Indication bronchitis, UTI, diarrhea, pneumonia, multiple types of infection Action bacteriacidal by preventing metabolism of folic acid Therapeutic Class anti-infectives, antiprotozoals Pharmacologic Class folate antagonists, sulfonamides Nursing Considerations • may cause renal damage, Steven Johnsons Syndrome – rash, pseudomembranous colitis, nausea, vomiting, diarrhea, rash, agranulocytosis, aplastic anemia, phlebitis • contraindicated with sulfa allergies • monitor CBC • obtain cultures prior to initiating therapy • monitor intake and output • instruct patient to complete dose • drink 8-10 glasses of water
Download the cheat: https://bit.ly/50-meds View the lesson: Generic Name sucralfate Trade Name Carafate Indication management of GI ulcers, GI injury prevention from high dose aspirin and NSAID treatment Action reacts with gastric acid to form a paste that adheres to ulcer Therapeutic Class antiulcer agent Pharmacologic Class GI protectant Nursing Considerations • use caution in renal failure patients • concurrent use of antacids may decrease the effect of sucralfate – administer 30 min before or after • administer on empty stomach 1 hour before meals
Download the cheat: https://bit.ly/50-meds View the lesson: Generic Name streptokinase Trade Name Streptase Indication pulmonary embolism, DVT, occluded lines, arterial thrombus Action converts plasminogen to plasmin which degrades fibrin clots Therapeutic Class Thrombolytic Pharmacologic Class plasminogen activators Nursing Considerations • contraindicated with active bleeding, hypersensitivity, bronchospasm, intracranial hemorrhage, hypotension • begin therapy as soon as possible • monitor vital signs continuously • monitor closely for bleeding • monitor hemodynamics • avoid invasive procedures
Download the cheat: https://bit.ly/50-meds View the lesson: Generic Name spironolactone Trade Name Aldactone Indication potassium loss, hypertension, edema, CHF Action inhibits sodium reabsorption while sparing potassium and hydrogen Therapeutic Class Diuretics Pharmacologic Class potassium sparing diuretics Nursing Considerations • contraindicated with hyperkalemia • monitor intake and output • monitor blood pressure • monitor potassium levels and renal panel
Download the cheat: https://bit.ly/50-meds View the lesson: Generic Name sertraline Trade Name Zoloft Indication major depressive disorder, OCD, anxiety Action inhibits uptake of serotonin allowing for higher quantities available within synaptic cleft Therapeutic Class Antidepressant Pharmacologic Class SSRI Nursing Considerations • do not use with MAOIs • can cause neurolyptic malignant syndrome, suicidal thoughts, drowsiness, insomnia, diarrhea, dry mouth, tremors, serotonin syndrome, sexual dysfunction • monitor mood changes in patient • takes 1-4 weeks for therapy to be effective.
Download the cheat: https://bit.ly/50-meds View the lesson: Generic Name salmeterol Trade Name Serevent Indication reversible airway obstruction, exercise induced asthma Action bronchodilation through stimulation of beta 2 adrenergic receptors Therapeutic Class bronchodilators Pharmacologic Class adrenergics Nursing Considerations • instruct patient to avoid excessive use • can cause headache palpitations tachycardia, abdominal pain, paradoxical bronchospasm • beta blockers and decrease effectiveness • assess respiratory status • may increase glucose levels • always take bronchodialtor first
Download the cheat: https://bit.ly/50-meds View the lesson: Generic Name rifampin Trade Name Rimactane Indication tuberculosis Action inhibits RNA synthesis Therapeutic Class Antitubercular Pharmacologic Class rifamycins Nursing Considerations • can turn body fluids red • may cause diarrhea, nausea, vomiting, confusion • assess lung sounds and sputum characteristics • evaluate renal and liver function tests • instruct patient not to skip or double dose • must complete entire dose (6-12 month therapy)
Download the cheat: https://bit.ly/50-meds View the lesson: Generic Name ranitidine Trade Name Zantac Indication duodenal ulcers, GERD, heartburn, esophagitis, GI bleed Action inhibits action of histamine in gastric parietal cells, decreases gastric acid secretion Therapeutic Class antiulcer agents Pharmacologic Class histamine H2 antagonists Nursing Considerations • may cause arrhythmias, agranulocytosis, aplastic anemia, confusion • assess abdominal pain • monitor for blood in stool • monitor CBC
Download the cheat: https://bit.ly/50-meds View the lesson: Generic Name quetiapine Trade Name Seroquel Indication schizophrenia, depressive disorder, mania Action dopamine and serotonin antagonist Therapeutic Class antipsychotic, mood stabilizers Pharmacologic Class none Nursing Considerations • may cause neurolyptic malignant syndrome, seizures, dizziness, palpitations, weight gain, anorexia • QT interval prolongation • don't use with CNS depressants • assess weight frequently • monitor liver function test and CBC • may increase cholesterol
Download the cheat: https://bit.ly/50-meds View the lesson: Generic Name propylthiouracil Trade Name PTU Indication hyperthyroidism Action inhibits thyroid hormones Therapeutic Class Antithyroid Agent Pharmacologic Class none Nursing Considerations • hepatotoxicity, nausea, vomiting, agranulocytosis • monitor symptoms of hyperthyroidism • monitor for hypothyroidism • monitor WBC and liver function tests • weight patient frequently • may cause leukopenia, thrombocytopenia, jaundice • take with meals
Download the cheat: https://bit.ly/50-meds View the lesson: Generic Name propranolol Trade Name Inderal Indication hypertension, angina, arrhythmias, cardiomyopathy, alcohol withdrawal, anxiety Action blocks Beta 1 and 2 adrenergic receptors Therapeutic Class antianginal, antiarrhythimic (class II beta blockers), antihypertensive, headache suppressant Pharmacologic Class beta blocker Nursing Considerations • contraindicated in CHF, pulmonary edema, cardiogenic shock, bradycardia, heart block • monitor hemodynamic parameters (HR, BP) • may cause bradycardia, CHF, pulmonary edema • masks symptoms of hypoglycemia associated with diabetes mellitus • advise to change positions slowly to prevent orthostatic hypotension • instruct patient on how to take blood pressure • stopping abruptly may result in life threatening arrhythmias • monitor daily intake and output • advise patient to notify physician for difficulty breathing
Download the cheat: https://bit.ly/50-meds View the lesson: Generic Name propofol Trade Name Diprivan Indication anesthesia, induction, sedation, Action hypnotic, produces amnesia with no analgesic properties Therapeutic Class general anesthetic Pharmacologic Class none Nursing Considerations • use cautiously with CVD, lipid disorder, increased ICP • can cause apnea, bradycardia, hypotension • burning and pain at insertion site • can turn urine green • assess respiratory status and hemodynamics • maintain patent airway • assess level of sedation
Download the cheat: https://bit.ly/50-meds View the lesson: Generic Name Promethazine Trade Name Phenergan Indication allergic reactions, nausea and vomiting, sedation Action Blocks the effects of histamine, histamine plays a role in the immune response. Plays an inhibitory role on the chemoreceptor trigger zone in the medulla leading to an antiemetic effect. Possess anticholinergic properties producing CNS depression. Therapeutic Class antiemetic, antihistamine, sedative/hypnotic Pharmacologic Class phenothiazine Nursing Considerations • IV administration may cause damage to tissue, hypertension, impaired liver function • monitor for neuroleptic malignant syndrome, confusion, sedation • may cause CNS depression • assess sedation level and anticholinergic effects
Download the cheat: https://bit.ly/50-meds View the lesson: Generic Name procainamide Indication wide variety ventricular and atrial arrhythmias, PAC, PVC, VTach, post cardioversion Action decreases excitability and slows conduction velocity through the heart Therapeutic Class antiarrhythmic (Class IA Na Channel Blocker) Nursing Considerations • may cause ventricular arrhythmias, seizure, asystole, heart block • monitor EKG continuously may cause widening of QRS complex • may cause hypotension keep patient supine • monitor for signs of agranulocytosis monitor CBC frequently • can cause drug induced lupus syndrome
Download the cheat: https://bit.ly/50-meds View the lesson: Generic Name phenytoin Trade Name Dilantin Indication tonic clonic seizures, arrhythmias, neuropathic pain Action interferes with ion transport, shortens action potentials and decreases automaticity blocks sustained high frequency repetitive firing of action potentials. Therapeutic Class antiarrhythmics, anticonvulsants Pharmacologic Class hydantoins Nursing Considerations • monitor serum phenytoin levels • therapeutic levels 10-20 mcg/mL • use cautiously in all patients • can cause suicidal thoughts, ataxia, extrapyramidal symptoms, hypotension, tachycardia, arrhythmias, gingival hyperplasia, nausea, rash, drug induced hepatitis, agranulocytosis, Steven's Johnson syndrome • concurrent administration of enteral feedings may decrease absorption • monitor for hypersensitivity • assess seizures • assess hemodynamics
Download the cheat: https://bit.ly/50-meds View the lesson: Generic Name phenazopyridine Trade Name Pyridium Indication urological pain Action provides analgesia to the urinary tract mucosa Therapeutic Class nonopioid analgesics Pharmacologic Class urinary tract analgesics Nursing Considerations • will turn urine red or orange • may cause headache, vertigo, hepatic toxicity • monitor renal function
Download the cheat: https://bit.ly/50-meds View the lesson: Generic Name paroxetine Trade Name Paxil Indication major depressive disorder, OCD, anxiety, PTSD Action block reuptake of serotonin in CNS Therapeutic Class antianxiety agent, antidepressant Pharmacologic Class SSRI Nursing Considerations • do not use with MAOIs • can cause neurolyptic malignant syndrome, suicidal thoughts, serotonin syndrome, constipation, diarrhea, insomnia • decrease effectiveness of digoxin • increase bleeding with warfarin • assess for suicidal thoughts