Corticosteriods

Inhibits the release of histamines, by decreasing the white bloods cells at the site thus suppressing the inflammatory

*Long Term RA, Lupus, Asthma, Organ transplant

Contra*Fungal infection, Peptic, live vaccines

SE-Thrombosembolism, GI bleeding, Increaed BP

Monitor F & Elec, BS, and K levels

Prednisone (Deltasone)

• Reduce Inflammatory response by suppressing the immune system
• Dose dictates dependency and damage to the body. Wach for peptic ulcers, delayed healing, osteoporosis & infections.

Prednisone

Cortisone

Desamethasone

Your #1 antiinflammatory Corticosteriods

end in ONE

Ck for fluid balance, potassium and gluscoes levels

Reduces swelling, warmth, redness, and pain

Uses: Addison's, hormone replacement, decrease inflammation, lupus, RA, IBS, Allergic conditions, asthma, Obstructive pulmonary disease, respiratory distress syndrome in infants, suppression of graft rejection.

Side Effects: Ulcers, GI bleeding, thromboembolism, hyperglycemis, healing, cushings syndrome

AMINOGLYCOSIDES

antibiotics/antivirals

amikacin, gentamicin, kanamycin, neomycin,netilmicin, paromomycin, streptomycin,tobramycin

Watch for ear & kidney damage. Peak & troughs done.

Side Effects: Nephrotoxicity and Ototoxicity

Bactericidal aginst gram negative and certain gram positive organisms. Serious infections.

Monitor renal function and sensory problems (hear)

Haloperidol (Haldol)

Class: antipsychotic

Psychotic disorders and TICs

Schizophrenia, acute psychosis, tourettes

Side Effects: Extrapyramidal reactions, neuroleptic, seizures, dry mouth, constipation

Nursing: Monitor target symptoms, assess involuntary movement (AIMS) Admin Haldol at bedtime to decrease day sedation

Morphine Sulfate

II Drug-Opioid agonist

Opium poppy is one of natures way to control pain

Also for pulmonary emboli to reverse rapid breathing & tachycardia.

RT: PO, IV, IM, SC, PR, or transdermal

Morphine Sulfate

Side effects: Rash, Respiratory depression, Bradycardia, Constipation, Orthostatic hypotension, Respiratory depression

Nursing: Assess pain and vs, before and after the dose. If given IV puch, watch for resp depression, hyoptension.

Benemid (Probenecid)-block renal uptake uric acid

Colchicine-Inhibit inflam & reduce pain & swelling

Zyloprin (Allopurinol)-decrease uric acid

We work together or alone to reverse symptoms

Side effects: blood dyscrasias, GI upset, Abd pain

Colchicine: Nausea

Probenecid: Vomiting, Headache

Allopurinal: Rash

Antigout agents can be given with food to decrease GI discomfort, avoid beer, may cause sudden gout attack. Increase fluid intake to increase secretion of uric acid.

Vistaril and Ativan

Antianxiety, sedative hypnotic

Hydroxyzine (Vistaril)-Preop and post op sedation. can be given IM or PO.

You will feel relaxed and then sleepy.

Watch for headache, hypotension, dry mouth, dizzey, hives.

Lorazepam (Ativan)-Pre op sedatin, seizures, anxiety. can be given PO, IM or IV push. You will feel calmer and then become more sedated

When using Ativan, watch for retrograde amnesia, unsteadiness, drowsiness, and abd discomfort.

Assess Motor response, vs, I & O's, electrolytes

Furosemide (Lasix)

PO, IV & IM

Hydrochlorothiazide (HydroDIURIL)

Treatment and control of eduma realted to CHF, cirrhosis, renal disease, hypertension.

Watch for hypotension, Ck I & O, Decreased K, Hyperglycemia

Loop diuretics inhibit sodium and chloride reabsorption in the loop of Henle. Thiazide acts in distal tubules.

Monitor for hearing loss

Heparin

Heparin helps control or prevent DVT, PE, & DIC.

Does not lyse or break up clots. It delays their formation.

Watch for bleeding rectal, oral, and nasal, CK PTT labs. Heparin interferes with the conversion of fibrinogen to fibrin and prothrombin with thrombin.

Anticoagulant

Monitor PTT and activated aPTT 1.5 to 2 times normal.

Protamine sulfate is the antidote.

Warfarin Sodium (Coumadin)

Coumadin is used to prevent clot formation with DVT, PE, A FIB with embolism, TIA and coronary occlusive problems.

An overdose of Coumadin can cause hermorrage, headache, bruising, back pain, increase pluse, and decrease blood pressure.

Anticoagulant:

Side effects bronchospasm with anaphylaxis

Monitor PT and INR 2 to 3 usually INR.

Vit K is an antidote, pt decrease intake of green, leafy vegetables.

Albumin

Albumin is used to replace plasma volume and maintainn cardiac output in hypovolemic shock and liver problems.

Human Volume Expander

Albumin watch for allergic reactions, pulmonary edema, tachycardia, and hypertension.

Side Effects: Fluid overload

Nursing: Closely I & O, watch for anaphylactic reaction.

Bronchodilators

Albuterol (Proventil)

Salmeterol (Serevent)

Terbutaline sulfate (Brethine)

Beta 2 selective adrergic agonists 

Watch for toxicity

Side effects: Tachycardia, headache, irritabilty, pain, tremors.

Relax smooth muscles in bronchioles, dilation

asthma, bronchitis, emphysema

Long term Chronic Airway Problems

Side Effects: Tremors, anxiety, tachycardia.

BETA BLOCKER ACTIONS

B1 Blockers affect 1-Heart

B2 Blockers affect 2-Lungs

Beta 1 blcokers have a effect on the heart by decreasing rate and contractility, block receptors in the kidney, and suppress renin.

Beta 2 blockers have the same actions as beta 1 but also afftect the lungs, causing bronchoconstriction, and block vessel receptors, causing vasoconstriction.

THIAZIDE DIURETICS

hydrochloro thiazide

do not take if SULFA ALLERGY

max therapy 2-4 weeks

take am, PO, give with food

Decrease BP, trat emema CHF

Reabsorbed in distal tubule

Sunscreen, blood wk monitor electrolytes, Caution with renal impairment. Risk HYPOKALEMIA

LOOP DIURETICS

furosemide (Lasix)

Potent diuretic

1st choice trat increase BP with renal disease

furosemide (Lasix)

PO or IV give slow 1-2 min, if fast OTOTOXCITY AND TINNITUS

Loop Henle promote large amts of fluid out.

 Deafness, lupus worse

Eat K potassium rich food, ck weight, sunscreen

POTASSIUM SPARING DIURECTICS

spironolactone

Used to treat HYPOKALEMIA, pts taking Dig

Potassium NOT EXCRETED

spironolactone

Decreased BP, Manage Edema

Potassium NOT EXCRETED

Help to cope

 Interaction with aspirin decrease effect

POTASSIUM SPARING DIURETICS

Triamterence

Potassium NOT excreted

triamterence

Decreased BP, Manage Edema

Potassium NOT excreted

Avoid eating Potassium

s/s hyperkalemia

heart beat, fatigue, weak, tingling

Lithium

mood stabilizers

Manic episodes of manic depressive illness

Alters cation transport in nerve and muscle

Excreted almost entirely unchanged by the kidneys

SEIZURES, ARRHYTHMIAS, ECG, hypotension

Pt: drink fluids, periodic lab tests for lithium toxicity. Low sodium levels may increase risk for toxcity.

1st dose of lithium is NOT metabolized and is excreted by the kidneys.

Prozac, Luvox, Paxil

are

lorazepam(Ativan)

Schedule IV Drug

(limited abuse potential)

analgesic adjuncts/antianxiety agents

sedative/hypnotics

Pharm Class: benzodiazepines

• Anxiety disorder (oral)
• Preop sedation (injection)
• Decreases preop anxiety

Sedation/Decreased anxiety/Decreased seizures

RAPID IV: APNEA, CARDIAC ARREST, bradycardia, hypotension

Clonidine (Catapress)

Alpha 2 Selective agonists

Used as an antianxiety and analgesic drug. Also used to treat mild to moderate hypertension.

Clonidine (Catapress)

Alpha 2 Selective agonists