Glipizide (Glucotrol)
Stimulates insulin release
Adverse effect: hypoglycemia
Give 30min before meals
Atropine Sulfate (Anti cholinergic)
Antidote: Physostigmine
Give diazepam for convulsions
Assess for GI obstruction
Don’t stop abruptly
Antidote for cholinergic
Dilates pupils
Methylphenidate (Ritalin)
Adverse effect: irregular heartbeat, liver toxicity
May cause dependency
Not for glaucoma, anxiety, suicidal, tourettes, psychotic pt.
Phenytoin (Dilantin)
Monitor albumin levels
Precipitate with dextrose
Not for absent seizures
Long term adverse effect: gingival, hyperplasia and dilatin facies
Not for pregnant pts
Lactulose
Pulls alnonia out of the body
Safe for liver pts
Not for pts with nausea or vomiting
Metformin
Doesn’t cause hypoglycemia, doesn’t increase insulin secretion
Decreases glucose production and absorption
Stop 48 hours before and after IV contrast take with meal
Metoclopramide
For gastroperistalsis GERD, nausea
Not for pts with GI obstruction and hemorrhage
Take 30min before meal
Levothyroxine
It’s for hypothyroidism
Adverse effect: cardiac dysrhythmia
Nervous nancy effects
Monitor TSH
No soy or seafood
Take in the morning and do not stop abruptly
Glargine (Insulin)
Long acting
No peak
Vitamin C
Promotes iron absorption
Adverse effect: CNS toxicity, irritability
OD can cause coma
Total parenteral nutrition (TPN)
Monitor BGL
Central pic line only
Change bag and tubing every 24 hours
May cause DTR, hypokalemia hypotension
Pyridostigmine
Antidote for cholinergic crisis
IV admin slowly 5mins, have atropine ready
Orange urine
MG pts 30min before food
Acetylsalicylic acid (NSAID)
Reyes syndrome for kids
Monitor for tinnitus
GI bleeding
Sumatriptan
For migraines
No blood thinners, ginko, ginger, echinacea, st john syndrome
Max twice a day 60mins apart
Dantrolene
For malignant hyperthermia
Caution: hepatoxicity
No alcohol, OTC cough suppress, CNS depressants, antihistamines
Colchicine
Acute gout crisis PRN
Febuxostat
Side effect: steven Johnson syndrome
Ibuprofen (NSAID)
Give with food
Not for CKD pts
Mild to moderate pain
No anticoagulants
Valproic acid (analgesics)
Migraine Naloxone
For OD on opioids
Acetylcysteine
Mucolytic, upper respiratory inf
Antidote for acetaminophen
Ipratropium
Dry and tacky cough
Not for soy and peanut allergy pts
Rinse mouth after
Albuterol first 2 to 5 mins
No diabetic med pramlintides
Furosemide (loop diuretic)
Loses everything
Safe for renal pts
Adverse effects: tinnitus and hypokalemia
Check vitamin k levels before admin
Interacts with digoxin
Oral contraceptives
Combo: estrogen and progestin
Progesterone only
Highly effective
Adverse effect: hypertension, thromboembolism (smokers)
NuvaRing transvaginal contraceptive
Estrogen and progestin
21 days on 7 days off
Soy helps with symptoms
Beclomethasone inhaler
Treatment for chronic asthma, not acute asthma.
May take several weeks.
Rinse mouth after to avoid oral candid
Bronchodilators first (ex-albuterol) first then steroid
Montelukast
Treatment for asthma and exercise induced
Not for acute attacks
Monitor AST and ALT before and during
Monitor for depression
Insomnia so take it at night
Take 2 hrs before exercise
Albuterol (SABA, bronchodilator)
For acute attacks, or exercise take 15 to 30mins before
No beta blockers
No caffeine cardiac pts
Monitor Heart rate
ACE Inhibitors
Top line choice
They end in “PRIL” = ace inhibitors
Uses: hypertension, heart failure, diabetic nephropathy (renal protective effect) = best for
diabetic pts
Adverse effects: angioedema (swelling around eyes, difficulty swallowing) and dry hacky
cough.
Pt teaching: stop immediately if adverse effects occur and monitor bp regularly.
Calcium Channel Blockers
Examples: nifedipine (Procardia XL)
Adverse effects: constipation, bradycardia, gingival hyperplasia
Pt teaching: increase fiber and fluids for constipation and avoid grapefruit juice can cause
risk of rapid toxicity.
Enoxaparin (Lovenox) (anticoagulant)
Classification: low molecular weight heparin
Uses: DVT prevention and treatment
Monitor for bleeding and bruising
Adverse effects: Bleeding and bruising
Warfarin (Coumadin)
Long term anticoagulation
Monitor PT/INR (therapeutic range 2-3, 2.5-3.5 for prosthetic valves)
Antidote for vitamin K
Dietary teaching: limit green leafy vegetables (high in vitamin K)
Heparin
Its given to pts with pulmonary embolism
Uses: DVT, PE and post MI management
Monitoring: APTT
Antidote: protamine sulfate
To decrease the size of the blood clot
Beta Blockers
Beta blockers end in “LOL”
Helps to decrease angina
Uses: hypertension, angina, arrythmias
Adverse effects: Bradycardia, Bronchoconstriction (caution in asthmatic pts)
Pt teaching: monitor heart rate and do not stop abruptly can cause risk of rebound
hypertension
We try not to give to pts that are asthmatic and diabetic.
Digoxin
Classification: cardiac glycoside
Uses: heart failure, post MI
Adverse effects: nausea, vomiting, vision changes (yellow halos) = hold the med and
check pts level of digoxin toxicity
Before we give med: check apical pulse for one full minute. Hold dose if pulse is less
than 60
Pt teaching: Monitor potassium levels. (risk of toxicity if k+ is low)
Beta1 Agonists
Examples: dobutamine, norepinephrine
Uses: cardiogenic shock and a cute heart failure.
Mechanism: increase heart rate and blood pressure and cardiac output and make the pulse
stronger
Pts monitoring: tachycardia and hypertension
Nitroglycerin (Nirates)
Uses: angina and chest pain
Action: vasodilation, reduces myocardial oxygen demand = bp is going to drop/decrease
Sublingual tabs (up to 3 doses, 5 minutes apart) under the tongue
Call 911 if no relief after the first dose
Contraindications: systolic bp is less than 90. We dont give med
Pt teaching: avoid standing abruptly after taking to prevent falls
Statin drugs
Examples: Simvastatin (Zocor)
Uses: lower cholesterol and reduces cardiovascular risk
Adverse effects: myopathy (muscle pain) = long term use of statin drug
Pt teaching: take in the evening, results seen after 2 to 3 weeks to see cholesterol level
changes
Fibric acid derivatives
Gemfibrozil is taking with a meal
Fenofibrate
Breaks down cholesterol
Adverse effect: gallstones, diarrhea, nausea and abdominal pain
Rifampin
Uses: tuberculosis treatment
Pt teaching: body fluids may turn orange/red (normal, not harmful)
Gentamicin (garamycin)
Adverse effects:
o Ototoxicity: hearing loss, dizziness
o Nephrotoxicity: monitor BUN and creatinine
o CBC = complete blood count
Peak/Trough monitoring:
o Trough: before administration. 30 min before giving the drug
o Peak: after administration. 30 to 1 hour after we give the drug
Vancomycin
Uses: MRSA treatment
Adverse effects:
o Ototoxicity: hearing loss, dizziness
o Nephrotoxicity: monitor BUN and creatinine
o CBC = complete blood count
Peak/Trough monitoring:
o Trough: before administration. 30 min before giving the drug
o Peak: after administration. 30 to 1 hour after we give the drug
Acyclovir (Zovirax)
HSV1 & HSV2
Decrease outbreaks, no cure
Physostigmine (indirect cholinergic)
Antidote: atropine
Push slow over 5 mins to avoid seizure and respiratory distress
Adverse effect: urinary frequency and muscle weakness
For delirium caused by anti-cholinergic
Atropine Sulfate (anti cholinergic)
Antidote for physostigmine (delirium/coma)
Give diazepam for convulsions
Assess for GI obstruction
Don’t stop abruptly
Antidote for cholinergic
Dilates pupils
