MEDICATION CLASSIFICATION

SSRIS

• Fluoxetine (Prozac)
• Citalopram (Celexa)
• Escitalopram (Lexapro)
• Paroxetine (Paxil)
• Sertraline (Zoloft)

• Major depression
• Bulimia
• Panic
• PTSD
• OCD
• ADHD

• CNS Stimulation
• Weight loss in early weight gain possibly later
• Serotonis Syndrome
• Withdrawal Syndrome
• Rash
• Sleepiness
• GI Bleed
• Bruxism

in clients taking MAIOs an TCAs

can increase warfarin levels resultingin risk of bleeding

can increase lithium level

• Use of Alcohol
• Take Medication with if needed
• administer in morning
• Therapeutic effect may not be seen for 1-3 weeks
• sudden D/C can result in relapse

MEDICATION CLASSIFICATION

tcas

Amitryptiline (elavil)

Imipramine ( Anafranil)

Clomipramine ( Anafranil)

Nortriptyline (Aventyle)

• Depression
• depressive episodes of bipolar disorders
• Autistic disorder
• ADHD
  Panic
• PTSD
  OCD

• orthostatic hypotension
• anticholinergic effects
• weight gain
• sedation
• toxicity
• decreased seizure threshold
• excessive sweating

MAOIs may cause hypertensive

alcohol, opioids, antihistamines

not with TCAs

• therapeutic effects may take 1-3 weeks
• sudden D/C can result in relapse

MEDICATION CLASSIFICATION

atypical anxiolytic: nonbarbituate anxiolytic

• panic disorder
• OCD
• social anxiety
• PTSD

CNS effects

dizziness, nausea, HA, agitation

Erythromycin

Ketoconazole

Grapefruit Juice

• take with meals
• take on regular basis

MEDICATION CLASSIFICATION

CNS Stimulants

• Methylphenidate (Ritalin)
• Dexmethylphenidate (Focalin)
  Dextroamphetamine (DextroStat)
• Amphetamine Mixture (Adderrall)

• ADHD
• Conduct Disorder

• Cns Stimulation
• Weight Loss
• Cardiovascular Effects
• hallucinations
• withdrawal reaction
• hypersensitivity skin to transdermal route

• MAIOs
• caffeine
• inhibits Dilantin and Coumadin
• OTC Cold and decongestant meds

MEDICATION CLASSIFICATION

Norepinephrine selective reuptake inhibitor

• Weight Loss
• GI effects (N/V)
• Suicidal Ideation
• Hepatoxicity

• cardiovascular disorders - use cautiously
• MAOIs

• not any changes in behavior
• may take 1 week for effects to develop

MEDICATION CLASSIFICATION

Antipsychotics - Atypical

• Risperidone (Risperdal)
• Olanzapine (Zyprexa)
• Quetiapine (Seroquel)

• Pervasive development disorders
• conduct disorder
• PTSD
• relief of psychotic symptoms

• onset of diabetes
• weight gain
• hypercholesterolemia
• orthostatic hypotension
• anticholinergic effects
• agitation, dizziness, sleep issues
• mild extrapyramidal such as tremors 

• alcohol
• dilantin
• diflucan

QUESTION #1

a nurse is caring for an adolescent in an inpt facility who has been diagnosed with major depression. The client has just started taking Prozac. what changes in the client weight could the nurse expect to see?

QUESTION #2

a nursee is caring for an adolescent whi is taking Elavil for depression. for which of the following should the nurse monitor

• Diarrhea
• Bradycardia
• Increased Salivation
• Urinary Hesitation

QUESTION #3

A nurse is caring for a school aged chiled who recently began Strattera. for which should the nurse monitor

• pale-colored urine
• upper abdominal tenderness
• seizure activity
• blurred vision

QUESTION #4

a nurse is teaching a school aged child and his parents proper use of Daytrana transdermal patch. which statment demonstrates understanding

• I will change to a new patch every other day after breakfast
• I will take the old patch off q am and put a new one on
• I will take the patch off no more than 9 hrs
• I will change the patch once a week

QUESTION #5

a child experiencing psychotic symptoms is beginning risperdone. the nurse plans to monitor periodic results of which lab value?

• WBC count
• hgb and hct
• Fasting blood glucose
• serum sodium

Chapter 12 - Substance Abuse

• Effects usually 4-12 hrs and peaks 24-48 hr
• N/V, tremors, inability to sleep, tachycardia, diphoresis, seizures
• Librium, Valium, Ativan during detox
• disulfiram (Antabuse), Naltrexone (ReVia), Acamprostate ( Campral) -  help following detox

withdrawal within 1 hour to several days

agitation, insomnia, rhinorhhea, suicidal ideation

Methadone (Dolophine)

Clonidine (Catapres)

Buprenorphine (Subutex) with Naloxene (Suboxone)

irritability, nervousness, insomnia

Bupropion (wellbutrin)

nictoine replacement therapy

QUESTION #1

a nurse is monitoring a client who is receiving Ativan from withdrawal of alcohol. BP is stabilized, what other manifestations should the nurse watch for?

QUESTION #2

a nurse is teaching a client who is taking Colidine, which requires further instruction

• I can chew gum to help relieve a side effect
• This medication will take my cravings away from drugs
• I will probably be drowsy at first while taking this med
• This med should relieve the nausea

MEDICATION CLASSIFICATION

cholinesterase inhibitors

• Neostigmine (Prostigmine)
• Ambenonium (Mytelase)
• Pyridostigmine (Mestinone)
• Edrophonium (Tensilon)

• increased GI Motility
• bradycardia
• urinary urgency
• Cholinergic Crisis

Preg risk C

obstruction of GI

MEDICATION CLASSIFICATION

anti-parkinsons medications

• Dopaminergics - Levodopa
• Pramipexole (Mirapex)
• Benztropine (Cogentin)
• Amantadine (Symmetrel)
• Ropinirole (Requipe)
• Bromocriptine (Parlodel)
• Trihexyphenidyl (Artane)

Levodopa

N/V, dyskinesias, orthostatic hypotension, cardivascular effects, psychosis, discoloration of urine and sweat, activation of malignant melanoa

Pramipexole

inability to stay awake, orthostatic hypotension, psychosis, dyskinesias, nausea

Benztropine

N/V, anticholenergic effects, antihistamine effects

Amantadine

CNS Effects, confusion, anticholenergic effects, discoloration of skin

Levodopa plus Carbidopa

abnormal movements psychiatric disorders

Levodopa

preg risk C

MAIOs

Pramipexole

preg risk c

• may not be noticeable for several weeks or months
• eat high protein meals and snacks

MEDICATION CLASSIFICATION

Antiepileptics (AEDS)

• Phenobarbital (Luminal)
• Primidone (Mysoline)
• Phenytoin (Dilantin)
• Carbamazepine (Tegretol)
• Ethosuximide (Zarontin)
• Valprioc Acid (Depakote)
• Gabapentin (Neurontin)
• Diazepam (Valium)
• Lorazepam (Ativan)
• Lamotrigine (Lamictal)
• Oxcarbaxepine (Trileptal)

Phenocarbital

CNS Effects - drowsiness, confusion, anxiety

Toxicity

Phenytoin

CNS Effects - nystagmus, sedations

Ginivia hyperplasia

skin rash

teratogenic

cardiovascular effects

endocrine and other effects

carbamazepine

CNS Effects - nystagmus, dbl vision

blood dyscrasias

hypo-osmolarity

skin disorders

Ethosuximide

Gi effects

CNS effects - sleepiness, fatigue

Gi Effects - N/V

Hepatoxicty

Pancreatitis

Thrombocytopenia

Gabapentin

drowsiness

nystagmus

Diazepam

Respiratory depression

anterograde amnesia

QUESTION #1

clients who take phenytoin must perform good oral hygiene, why?

QUESTION #2

a client has been diagnosed with abscence seizures, what types of medications are used to treat this type?

Ethosuximide (Zarontin)

Valprioc Acid (Depakote)

QUESTION #3

a nurse is caring for a client taking valproic acid (Depakote) to prevent seizures. What lab values should the nurse monitor?

QUESTION #4

a client with parkinsons is taking levadopa/carbidopa (Sinemet) and pramipexole (mirapex) which should the nurse monitor?

QUESTION # 5

a client with parkinsons has a new prescription for Levodopa (Dopar) which of the followings would the nurse watch for

• Hallucinations
• Memory Loss
• Mania
• Paranoid Ideas
• Nightmares

EYE DISORDERS

Types of Glaucoma

Primary Open-Angle Glaucoma - (POAG)

periphereal vision is lost gradually

IOP greater than 21 mm hg is at highest risk for POAG

Angle Closure glaucoma

acute disorder with sudden onset

irreversible blindness within 1-2 days without emergency

ocular pain, halos around lights, blurred vision, and photopia

Ear Disorders

Acute Otitis Media

mostly in young children

build up of fluid in middle ear

acute onset of pain

Otitis Externa

swimmers ear

MEDICATION CLASSIFICATION

beta-adrenergic blockers

Tomilol (Timoptic)

Carteolol (Ocupress)

Metipranolol (Optiipranolol)

Levobunolol (Betagan Liquifilm)

topical to treat POAG

may use to treat angle closure on emergency level

• stinging
• conjuctivitis
• systemic of beta blocker on heart and lungs can occur

• Oral beta adrenergic blockers
• beta adrenergic blockers

MEDICATION CLASSIFICATION

alpha2 adrenergic agonists

• Brimonidine (alphagan)
• Araclonidine (Iopidine)

Brimonidine long term topical treatment

iopidine for short term treatment

both for POAG

• localized stinging
• blurred vision
• reddened slera
• hypotension

MEDICATION CLASSIFIATION

Prostaglandin analogs

• Latanoprost (Xalatan)
• Travoprost (Travatan)
• Bimatoprost (Lumigan)

• permanent increased brown pigment
• stinging burning reddened conjuctiva
• blurred vision
• Migraine

MEDICATION CLASSIFICATION

osmotic agents

• Mannitol (Osmitrol)IV
• Urea (Ureaphil) IV
  Glycerin (Osmogly) PO
• Isosorbide (Ismotic) PO

MEDICATION CLASSIFICATION

carbonic anhydrase inhibitor (systemic)

• acetazolamide (Diamox)
• Methazolamide (Glauctabs, Neptazane)

Lowers IOP in which other meds have been inaffective

emergency med prior to surgey for acute angle

second line med for POAG

Glaucoma

Acute Mountain Sickness, and heart failure

• severe allergic reactions
• rare serious blood disorders
• GI Effects
• Electrolyte Depletion
• Flu-like symptoms
• CNS Disturbance
• Glucose disturbances in clients with DM

• Acetazolamide preg risk C
• use during lactation only after evaluation by MD
• high dose aspirin may result in acidosis

MEDICATION CLASSIFICATION

antimicrobials

• Amoxicillin (Amoxil)
• Amoxicillin/Clavulanate (Augmentin)
• Ceftriazone (Rocephin)
• Cefdinir (Omnicef)
• Cefuroxime (Ceftin)
• Cefpodoximin (vantin)
• Azithromycin (Zithromax)
• Clindamycin (Cleocin)

• possible allergic reaction
• GI Upset
• Suprainfection

MEDICATION CLASSIFICATION

Fluoroquinilone Antibiotic plus steriod medication

• Ciproflaxin plus dexamethasone (Cipro HC)
• Acetic Acid 2% solution drops (Vasolate)
• Ofloxacin Otic drops (Floxin)

CNS Effects - dizzness, tremors, convulsions

Rash

QUESTION #1

after instilling an eye drop that has a systemic effect the nurse should press which of the following to prevent absorption into the circulation?

• The bony orbit
• The nasolacrimal Duct
• The conjuctival sac
• The outer canthus of eye

QUESTION #2

a client has been prescribed brimonidine (alphagan), 1 drop daily in his right eye. he tells the nurse he wears contacts and wants to know if he can put them in while wearing contacts.

QUESTION #3

a nurse is caring for a client who has just been diagnosed with primary open angle glaucoma. which of the following does the nurse expect to find?

• sudden loss of central vision
• intraocular pressure 19 mm hg
• no reports of pain
• intact peripheral vision

QUESTION # 4

a nurse is preparing to administer Timolol (Timoptic) drops into the eye of a client who has glaucome. for which adverse effect should the nurse monitor

• Hypertension
• Bradycardia
• Seizures
• Jaundice

QUESTION #5

a nurse is caring for a preschooler who has otitis externa bilaterally. prescriptio of ciproflaxin plus dexamethasone. the childs mother asks the nurse what type of medication is in the drops, what is the correct reply?