E Kart Drugs 4i2p3i

1. Generic Name: Isosorbide dinitrate/mononitrate Brand Name: Isoket Classification: anti anginal Action: Increases supply of oxygen to the heart by dilating both the arteries and veins which supply the heart itself. Indications: Preventive and long-term treatment of angina pectoris/post MI angina. Treatment of severe of severe CHF in combination with cardiac glycosides, diuretics, ACE inhibitors, arterial vasodilators; pulmonary hypertension Nursing Considerations: 1. Assess for pain: duration, time started, activity being performed, character, intensity 2. Monitor B/P, pulse at baseline and during treatment Side Effects: headache, dizziness, weakness, orthostatic hypotension, tachycardia, palpitations, flushing, nausea, vomiting, rash 2. Generic Name: Flumazenil Brand Name: Anexate Classification: benzodiazepine antagonist Action: Antagonizes the actions of benzodiazepines on the CNS, competitively inhibits the activity at the benzodiazepine receptor complex Indications: Reversal of centrally sedative effects of benzodiazepines Nursing Considerations: 1. Assess cardiac status using continuous monitoring 2. Assess for seizures, protect patient from injury 3. Assess GI symptoms: nausea, vomiting, place in side-lying position to prevent aspiration 4. Assess for allergic Side Effects: Anxiety, palpitations, nausea, vomiting, seizures, diaphoresis 3. Generic Name: Naloxone Brand Name: Naloxone HCL Classification: Narcotic antagonist Action: May displace opioid analgesics from their receptors (competitive antagonism) to reverse its effect

Nursing Considerations: 1. Medrol may contain tartrazine. Watch for allergic reaction to tartrazine in patients with sensitivity to aspirin 2. Drug may use for alternate-day therapy 3. Determine if patient is sensitive to other corticosteroid 4.Give oral dose with food when possible 5. Don’t give Solu-Medrol intrathecally because severe adverse reactions may occur Side Effects: Anxiety, seizures, immune system suppression, fluid and electrolytes disturbance 5. Generic Name: Clarithromycin Brand Name: Cloranta Classification: Macrolides, Antibiotics Action: Inhibits or interferes with bacterial protein synthesis by binding to the 50s ribosomal subunits of bacterial chromosome Indications: treatment of respiratory tract infection, treatment of leprosy and for prophylaxis and treatment of opportunistic mycobacterial infections. Also used in combination with pyrimethamine in AIDS Nursing Considerations: 1. Assess possible occurrence or drug induced adverse reactions 2. monitor hepatic and hematologic status 3. Assess bowel pattern, discontinue drug if severe diarrhea occur 5. Assess for possible overgrowth of superinfection Side Effects: diarrhea, nausea, abnormal taste, abdominal pain, tooth discoloration, glositis 6. . Generic Name: Verapamil Brand Name: Isoptin Classification: Antianginal Action: Inhibits movement of calcium ions across cell membrane resulting contraction of myocardial and vascular smooth muscle and depression of both impulse formation (automaticity) and conduction velocity Indications: Diltiazem is used in the management of angina pectoris and hypertension. Also avail. In IV istration in the treatment of various arrhythmias.

Indications: Narcotic overdose. Post-op narcotic depression Nursing Considerations: 1. Assess signs of opioid withdrawal in drug dependent individual that that may occur up to 2 hrs. after istration: cramping, hypertension, anxiety, vomiting 2. Assess cardiac status and monitor vital signs during therapy 3. Assess pain, respirations

Nursing Considerations: 1. Assess fluid volume status 2. Monitor B/P, and pules, pulmonary capillary wedge pressure, CVP, index, often during infusion 3. Monitor ALT, AST, bilirubin daily 4. Monitor if platelets are <150,000/mm³, if so drug is usually dc 5. Monitor for extravasation: change site every 48 hours

Side Effects: tachycardia, increased B/P, hypotension tremulousness, seizures, cardiac arrest, pulmonary edema

Side Effects: headache, ankle edema, hypotension, dizziness, flushing, fatigue, nausea

4. Generic Name: Methylprednisolone Brand Name: Depo-Medrol Classification: Corticosteroid

7. Generic Name: Phytomenadione Brand Name: Konakion Classification:

Action: As a glucocorticoid, it has marked anti-inflammatory action due to its ability to inhibit prostaglandin synthesis. As an immunosuppressant, it inhibits phagocytosis and migration of macrophages and leukocytes to the site of inflammation as well as stabilizes lysosomes to prevent release of enzymes and reverses increased capillary permeability.

Action: Synthetic analog of vitamin K which is essential for hepatic synthesis of blood clotting factors II, VII, IX and X. Indications: vitamin K compounds are used in the treatment and prevention of hemorrhage associated with vitamin K deficiency. Nursing Considerations: 1. Assess for bleeding

Indications: Severe inflammation or immunosuppression

2. Monitor pro time during treatment ( 2-sec deviation from control time, bleeding time and clotting time) to determine dosage effectiveness 3. Monitor for possible drug induced averse reactions Side Effects: hypotension, cyanosis, headache, dizziness, urticaria, pain, swelling and tenderness at injection site 8. . Generic Name: Etoricoxib Brand Name: Arcoxia Classification: Non-steroidal anti inflammatory drug

Side Effects: Drowsiness, extrapyramidal reactions, restlessness, constipation, diarrhea, arrhythmias 11. Generic Name: Paracetamol Brand Name: Aeknil Classification: Analgesics (Non-Opiod) and antipyretics Action: Reduces fever by acting directly on the hypothalamic heat-regulating center to cause vasodilation and sweating which helps dissipate heat, there by reducing fever Indications: It is used to reduce fever, headache

Action: NSAIDs work by blocking the action of a substance in the body called cyclooxygenase. Cyclo-oxygenase is involved in producing prostaglandins in response to injury or certain disease. These prostaglandins cause pain, swelling and inflammation. NSAIDs block the production of these prostaglandins.

Nursing Considerations: 1. Assess all reactions: rash, urticaria 2. Monitor blood studies especially CBC and pro time if pt. is on long term therapies Side Effects: chest pain, hepatic toxicity, hypoglycemia

Indications: to moderate, sever pain for arthritis Nursing Considerations: 1. Not to be used in children and adolesvcents under 16 years of age. This medicine should not be used in pregnancy as it may delay labor, ase with caution in elderly people, decreased kidney function, decreased liver func. , hx of heart failure, diabetes. Smokers. Hx of allergies to medicines Side Effects: Dizziness, abdominal pain nausea, feeling weak, headache 9. Generic Name: Ketorolac Brand Name: Toradol Classification: Nonm steroidal anti inflammatory agents Action: Inhibits prostaglandin synthesisby decreasing the activity of the enzyme, cyclooxygenase which results in decreased formation of prostaglandin precursors chemicals that cells of the immune system make that cause the redness, fever, pain of inflammation and that also are believed to be important in the production of non inflammatory pain Indications: treatment for inflammation and pain Nursing Considerations: 1. Concurrent use with aspirin may decrease effectiveness, increades adverse GI effects with aspirin 2. istration in higher than recommended doses does not provide increased effectiveness, but may cause increased side effect Side Effects: drowsiness, GI bleeding, Steven Johnson Syndrome, Toxic epidermal necrolysis 10. Generic Name: Metoclopramide Brand Name: Plasil Classification: Anti-emitics Action: It blocks sdopamine receptors and makes the GI cells more sensitive to acetylcholine, leading to increased GI activity and rapid movement of food through the upper GI tract Indications: Management of esophageal reflux, treatment and prevention of post operative nausea and vomiting when nasogastric suctioning is undesirable Nursing Considerations: 1. Contraindicated to hypersensitivity possible obstruction or hemorrhage, history of seizures disorders, Parkinson’s disease 2. Assess for abdominal pain distension, bowel sound

12. Generic Name: Hyoscine Butyl bromide Brand Name: Buscopan Classification: Antispasmodic Action: Exerts a spasmolytic action on the smooth muscle of the gastrointestinal biliary and genitourinary tract. As a quaternary ammonium derivativedoes not enter the CNS. Therefore anti cholinergic side effects at the CNS do not occur. Peripheral anticholinergic action results from a ganglion-blocking action within the visceral wall as well as from antimuscaribic activity Indications: Relief smooth muscle spasm Nursing Considerations: 1. Monitor I and O ratio, retention commonly causes decreased urinary output, Assess for constipation Side Effects: Nausea, vomiting, constipation, headache, dizziness 13. Generic Name: Epinephrine Adrenergic Brand Name: Epipen, Adrenalin Classification: Alpha and Beta Adrenergic agent Action: Naturally occurring neurotransmitter, the effects of which are mediated by alpha or beta retors in target organs. Effects on alpha receptors include vasoconstriction, contraction of dilator muscles of iris. Effects on beta receptors include positive chonotropic and inotropic effects on the heart (beta 1 receptors) .Bronchodilators, vasodilation and uterine relaxation (beta 2 receptor) decreased production ageas humor Indications: Temporary relief of bronchospasm, acute asthmatic attack, hypersensitivity, syncope due to heart block and restore cardiac rhythm in cardiac arrest Nursing Considerations: 1. Assess por allergy or hypersensitivity to epinephrine or components of drug preparation, narrow angle, shock other thgan anaphylactic shock hypovolemia Side Effects: tremor, hallucinations, seizures, nausea, vomiting, pallor 14. Generic Name: Diazepam Brand Name: Valium Classification: Benzodiazepines, anti anxiety, anti convulsants, sedatives Action: Depresses all levels of the CNS, including the limbic and reticular formation, probably through the increase action of

Gamma amino butyric acid which is a major inhibitory neurotransmitter in the brain Indications: Adjunct in the management of anxiety, pre operative sedation, conscious sedation, provides light anesthesia and antegrade amnesia, tx of status uncontrolled seizures, skeletal muscle relaxant, mngt. Of thre symptoms of alcohol w ithdrawal Nursing Considerations: 1. Contraindicated to hypersensitivity, cross sensitivity with other benzodiazepines may occur, comatose patient , pre existing CNS depression, uncontrolled severe pain 2. Monitor vital signs 3. Assess IV sites may cause phlebitis and nervous thromboss Side Effects: Dizziness, drowsiness, lethargy, headache, nausea, vomiting, hypotension 15. Generic Name: Promethazine hydrochloride Brand Name: Phenergan Classification: antihistamine Action: work by decreasing the effects of histamine, a chemical the body releases in response to certain irritants. Histamine narrows air ages in the lungs and contributes to inflammation. Antihistamines reduce itching and swelling and dry up secretions from the nose, eyes, and throat. Indications: relieves nasal stuffiness and inflammation and red, inflamed eyes caused by hay fever and other allergies. It is also used to treat itching, swelling, and redness from hives and other rashes; allergic reactions to blood transfusions; and, with other medications, anaphylactic shock (severe allergic reaction). Phenergan is also used as a sedative and sleep aid for both children and adults, and is prescribed to prevent and control nausea and vomiting before and after surgery and to prevent and treat motion sickness. It is also used, with other medications, for pain after surgery. Nursing Considerations: 1. Take Phenergan exactly as prescribed.

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If you miss a dose... If you are taking Phenergan on a regular schedule, take the forgotten dose as soon as you . If it is almost time for your next dose, skip the one you missed and go back to your regular schedule. Never take 2 doses at once.

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Storage instructions... Tablets should be stored at room temperature, away from light. Suppositories should be stored in the refrigerator, in a tightly closed container.

Side Effects: Blurred vision, dizziness, drowsiness, dry mouth, increased or decreased blood pressure, nausea, rash, sedation, vomiting 14. Generic Name: Neurobion Vit B1, B6, B12 Classification: Multivitamin Action: Multivitamins are used to treat vitamin shortages in the body that may occur because of illness, pregnancy, poor nutrition, decreased absorption of foods through the stomach, and many other circumstances

Indications: for those who lack vitamin B complex Nursing Considerations: 1. Take multivitamins exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you. 2.Take each dose with a full glass of water. 3.Take multivitamins with food to lessen stomach upset. 4.Do not take more of a multivitamin than is prescribed for you or is directed on the package. Large doses of multivitamins can be dangerous. 5.Store multivitamins at room temperature away from moisture and heat. Side Effects: Nausea, constipation, black stools, and diarrhea are among the most common. Taking multivitamins with food may decrease these side effects.