Tramadol 

Acetaminophen 

Acetaminophen Drug Information:

-What do you educate for 

-maximum daily dose

Many medications include acetaminophen, including allergy medications. Do not exceeds 4grams/ day. 

Watch for symptoms of Liver failure

 -jaundice

-swelling

Acetaminophen Drug Information:

-When to use/ not use

-What to watch for

-Lab Values

-When to use/ not to use: Safe for bleeding disorders, not with liver dysfunction

-What to watch for: Jaundice, confusion due to high ammoinia, hand tremors, output <30mL/hour

Lab values: AST 0-35 ALT 0-40

Acetaminophen Drug Information:

Antidote

Acetylcysteine

ALT Levels

What does it monitor

0-40

Lab monitors Liver function 

AST Levels

What does it monitor

0-40

Lab monitors Liver function 

Opioid Agonist Antagonists:

Antidote 

Naloxone

Opioid Agonist Antagonists:

Drugs

Buprenorphine

Butorphanol

Nalbuphine

Pentazocine

Opioid Agonist Antagonists:

Drugs for opiod dependace

Buprenorphine (main one)

Nalbuphine

Pentazocine

Opioid Agonist Antagonists:

drug for labor pains

Butorphanol

Opioid Agonist Antagonists:

When treating oipiod dependace

-administration steps

-watch for

When treating oipiod dependace

-administration steps: stop opioids begin agonist antagonist 

-watch for: Abstinence syndrome/ withdraw 

symtoms include cramping vomitting hypertension shaking 

Lab Values: 

BUN

What does it test 

10-20

Kidney Function

Lab Values: 

Creatnine

What does it test 

0.5 - 1.2

Kidney Function

Lab Values: 

WBC

What does it test 

White Blood Count

4.1 - 11.2 (thousands)

NSAIDS:

Drugs 

-Naproxen

-Ketorolac 

-Aspirin

-Ibuprofen

-Celecoxib

NSAIDS:

How do they work 

NSAIDS block Cox 1 and Cox 2 

Cox 2- Want to block, decreases fever, pain, inflammation

Cox 1- Bad block, Decreases Platelet Aggragation

Celecoxib 

NSAID

Only works on COX 2 

(Never used on Cardiovascular patients, causes cardiovascular failure)

Ibuprofen

NSAID

Ketorolac

NSAID

Very strong

Not available OTC

Aspirin

NSAID

Recommended dose 81 mg/day to prevent Myocardial Infarction and Aschemic Strokes 

Naproxen

NSAID

NSAIDS:

Contraindications

-Peptic Ulcer Disease

-Bleeding Disorders

-Kidney Failure/ Disfunction

-Alcoholism

-Multiple NSAIDS at once

Kids with viruses and fever

NSAIDS:

Warnings

What to monitor 

Lab Values

Warnings- 1 Nsaid at a time

Can lead to GI Bleeding: Bloody stools, Black tar stools, bloody throw up, coffee ground vomit

Never use for kids with virus and fever

Salicylism: Ringing ears, Increased HR and respirations 

Raye Syndrome- Recent virus

Opioids:

NARCS-U

Nausea

Acute Toxicity

Respiratory Depression

Constipation

Sedation

Urinary Retention

Opioids:

When to use

Use for Acute pain

Fast relief

Cough supression

Opioids:

When to avoid 

Avoid use in head injuries 

Opioids:

Adverse Side effects

-normal

-Kill you

Normal- Nausea, constipation, sedation, urinary retention

Kill you- Actue Toxicity, Respiratory Depression <12 breaths/ min

Opioids:

Antidote

Naloxone

will reverse symptoms immediately

has a short half life

must continue reassessing 

Opioids:

Long term effects

Drug to fix it

Opioid Dependancy 

Methadone or Opioid agonist antagonist for withdraw symptoms 

Opioids:

Drugs

Morphine

Meperidene

Methadone

Hydrocodone

Hydrocodone & Acetaminophen

Hydromorphone

Fentanyl

Codeine

Oxycodone

Morphine

Opioid

Vasodialates, used during active Myocardial Infarction

Meperidene

Opioid

Contraindicated in people with kidney failure, causes seizures 

Codeine

Cough Supressant

make sure patient still coughs a little to clear out lungs & assess lungs for crackle noises

Fentanyl 

Opioid

10x strength of morphine

Hydromorphone

Opioid

7x strength of morphine

Oxycodone

Opioid

methadone

Opioid

Used to start transition off opioids

in opioid dependance

hydrocodone

Opioid 

common post-OP drug

hydrocodone/acetaminophen

Opioid

ensure not mixing with other acetaminophen

do not exceed acetaminophen 4g/day

Butorphanol

Opioid Agonist Antagonist

Used for labor pains 

nalbuphine

Buprenorphine

Opioid Agonist Antagonist

MAIN drug used to treat opiod dependance

pentazocine

Opioid Agonist Antagonist

Used for opioid dependance

Pain Adjuvants:

How are they used

Used With primary pain medication to increase pain relief and reduce opioid dose

never used alone

Anti-Gout

COMMON DRUGS 

colchicine

allopurinol

prednisone

Anti- Gout

prednisone

Glucocorticoid, monitor blood glucose levels

avoid in diabetics 

Anti- Gout

allopurinol

inhibit uric acid production, used for chronic gout. Monitor for kidney function and hypersensitivity 

Anti gout

colchicine

only effective for current inflammation of gout, will abort an acute gout attack,

Watch for sudden muscle pain onset

uric acid may build up in synovial joints

Anti gout 

Contraindications

grapefruit juice, aspirin, warfarin, alcohol

Lidocaine

-what is it

-how is it used 

-Where do you not use it

-Contraindications

-Serious Side Effects 

Local Anesthetic

blocks local pain production w/out sedation- 3hrs

Do not use on extremitites- gain green

Contraindicated with high HR, has epinepherine

Side Effects: Systemic Infusion- metallic taste, ringing in ears, lip numbness 

Migraine Medications

Current On-set meds

NSAIDS- OTC

Ergotamine- do not use in child bearing age women, fetal abortion

Sumatriptan- go to perscription med, chest pressure normal but monitor for increased pain

Migraine Medications

chronic prevention meds

topiramate- monitor kidney function

amitriptyline- anticolenergic effects cant see, cant pee, cant spit, cant shit

Antibiotics affecting the Bacterial Cell Wall

Drugs

Penicillins

Cephalosporins

Carbapenems

Vancomycin

Antibiotics affecting the Bacterial Cell Wall

Penicillins

cross sensitivity to Cephalosporins

bacteriacidal- always assess for allergies and kidneys, take with food

treatment of choice for streph, menningtis, syphilis

Monitor output/lab values

Antibiotics affecting the Bacterial Cell Wall

Cephalosporins

4 generations, each higher generation is more likely to reach cerebral spinal fluid and more effective against gram negative bacteria 

cross sensitive to penicillins

drug of choice post-OP 

Antibiotics affecting the Bacterial Cell Wall

 Carbapenems

beta lactim- kill bacteria cell walls.

Drug of choice for pneumonia

Antibiotics affecting the Bacterial Cell Wall

Vancomycin

strongest antibiotic saved for serious infections that are resistant to penillin ie.MRSA

Treats superinfection C. difficile.

Red mans syndrome- if administered too fast, slow down infusion: rash hypotension flushing 

Watch with Corn allergy 

MYCIN DRUGS

mycin drugs hit kidneys harder. Mycins are ototoxic meaning toxic to the ears/ hearing. Drugs that are ototoxic are also nephrotoxic meaning toxix to the kidneys

Tetracycline

Most important is liver function

Labs- AST and ALT

can cause teeth staining mostly in kids

Have interaction with calcium and magnesium and iron. Take med on empty stomach

Important things to know about antibiotics

reduce the effectiveness of birth control

Must take entire course of antibiotics

do not stop when sympotoms subside

Watch for thrush and yeast infection

erythromycin

watch for ototoxicity, watch kidneys. Caution  use, contraindicated with many other drugs. Drug of choice for whooping cough and chlamydia

gentamicin

sulfamethoxazole-trimethoprim

most common for UTI. Treat active UTI. Inhibit bacteria growth via folic acid.

monitor for infection improvement

Watch for use in blood diseases.

Maintain fluid intake. Monitor liver 

nitrofurantoin

used as profolactic in person with reoccuring UTI. Bacteriostatic. Slows bacteria not kills.

urine may be brown but it's normal.

Do not crush drug. No for pregnant women birth defects caused

moxifloxacin, levofloxacin

use for severe urine GI bone joint infections. Drug of choice for ANTHRAX-60 day dose.

photosensitivity-severe sun burns

 Tendon ruptures- stop dose.

No kids under 10 

phenazopyridine

AZO-OTC UTI med

makes urine red or orange but normal.

Admin with or after meals to prevent GI.

Will relieve burning but does not eliminate bacteria. 

Antituberculosis Drugs

isoniazid

rifampin

isoniazid &

rifampin

Antituberculosis Drugs

DOT- direct observation therapy. Orange body fluids. Treatments are very longterm and specific. For laten and active TB. Assess for numbness

Antiprotozoal drug

treats C.difficile and anerobic bacterias. Pefolactic for surgical anerobic infections. Dark urine is normal. Stop if CNS affects seizures etc.

no alcohol products 

Antifungals (-azoles)

amphotericin B

nystatin

(-azoles)

nystatin

Antifungal

powder for topical fungals in body fat folds

amphotericin B

causes cell death. Very hard on system. Do a test dose slowly. Use in large vein. Need weekly kidney function test. High risk drug, highly toxic

Antivirals

main points

very hard on the liver, can cause anemia

you want symptoms to resolve and watch for any signs of infection!

acyclovir/ganciclovir

prevent reproduction. Used for herpes, expect symptom relief but not cure 

enfuviritide

treat hiv infection not cure. Doesn’t decrese spread risk. Very aggressive. Skipping dose can cause resistance and treatment failure 

Antiretrovirals

want to maintain symptom free and avoid opportunistic infections. Keep System free of infection. Stop replication, prevent infection.

TB drugs affect what

The liver 

drug to take when TB is latent

isoniazid

Drugs to take when TB is active 

isoniazid and Rifampin 

Metroniadazole

what drug causes the disulfur reaction 

Metroniadazole

if ANY alcohol product has been consumed w/in 12 hours

potassium issues means look at theeeee

heart

phlebitis

inflammation of vein

first line treatment of HIV

what are the major side effects

Retrovir 

enlarged liver