Glucophage

reduces the production of glucose in the liver through suppression of gluconeogenesis;

SE: anorexia, n/v, wt loss, b12 and folic acid deficiency, lactic acidosis (hyperventilation, myalgia, slugginesss, somnolence) d/c med if lactic acidosis occurs

 -          – 500mg /day.  start low & increase slowly.  It gives them gas.  Doesn’t tend to produce hypoglycemia.

 Get on a good exercise program.  Get the family involved cuz compliance will increase.  Carb counting is good cuz they can figure out how to eat more of the things they like. 

macrolides: 

prophalaxis against rheumatic fever or endocarditis also used in pertusis, and diptheria and infectious pneumonia or other resp infections

AE: pseudomembraneous colitis, angioedema, GI discomfort (n/v and epigatric pain), hepatotoxicity (abdominal pain, lethargy, jaundic), dysrhythmias, sudden cardiac death

disease dont use with antihistanmines, warfarin, asthma meds, anticonvulsants

report blood in stools

Expectorants:

increase productiove cough and mucus seretion thereby decreasing congestion

increase productive cough

 – is better.  Want them to cough to get mucus up & out.   Takes almost a full bottle to get that much in.  (USE SINGLE INGREDIENT PRODUCTS) Make sure they know how to read the label & know the dose limits.  Drink a lot of fluid.  Not caffeine – diuretic.

coll mist moist environment

sugarless candy mouth care

AE:n/v, headache, dizziness, nausea, diarrhea, rash

 take with food, safety precautions,

stop if get rash

second line tx for lice:

apply to dry hair and scalp until soaked and allow to dry naturally; leave on for 8 to 12 hours is FLAMMABLE

is used for older than 2yrs

Gastroprokinetics

controls nausea and vomiting; also increases upper GI motility management of GERD and n/v

AE: neuroleptic laginant syndrome EPS, sedation, diarrhea

watch out for spaticity, restlessness anxiety report!!!, admin benedryl if occur,

safety precautions, monitor for bowel fx and dehydration, contraindication:bowel obstruction, gi bleed, seizure, caution in kids due to EPS

dont use w/ other CNS or seizure meds opiod decrease effect

watch for tremors

cholinergic agonist/ intraoccular pressure reducer

lower intaoccular pressure through cillary contraction AE::retenal detachment systemic effects decreased visual accuity

drop into conjuctival sac not in eyeball hold lacrimal duct to prevent systemic absorption

dont do anything that requires seeing

prostaglandin

 contraindicated: women with active cardiovascular, renal, liver, or asthma problems

tx:control postpartal hemorrhage caused by uterine atony;;

 SE: n/v, flushing, diarrhea, bradacardia, bronchospasm, wheezing, cough, fever chills

 uterine cramping is expected; no smoking

(methlpredisolone, predisone) oral

solumedrol>give for angioedema

Corticosteroids

tx asthma or LTB;

antiinflammatory which decreases edema;

may cause cardio s/s like HTN; stridor resolves faster, child less frequently need emergency airway

shortterm use shouldnt be until peak flow reads 80% give w/ food give oral dose in morning

watch for unstable blood sugar or immunosuppression

AE: vertigo, headache, hypotension, shock, Na and fluid retension, amenorrhea, wt gain, mask infections

Corticosteroids that are given by mouth should be given with food; longterm is decreased growth, unstable blood sugar

monoclonal antibody; immunotherapy

a therapeutic antibody that targets IgE, blocking it from causing asthma symptoms or allergic reactions;

for kids 12 and up for moderate to severe persistant asthma injections required q 2 to 4 weeks based on serum IgE levels

AE: pulmonary edema, resp AE

preeclampsia

 –(IV & PO in obstetrics) 100 mg 2x day.

Beta 1 & 2 blockers.

Check apical pulse & hold if < 60.

2^ndline of drug IV.

Can cause HTN 

not for asthmatics, caution with bronchospasm

AE: dizziness, vertigo, fatigue, gastric pain, bronchospasm,

arent the first line for tx for HTN;

helps with edema, watch for angioedema; will have swelling of the face, itchy throats, look also for puffy eyes; these pt will need immediate ER visit;

also have a diuretic affect; captin and vasotec usually seen in children;

need a draw of a panel seven; as you hand the prescription to the pt you want to tell them they need it done w/ in 7 days after starting their  (VASOTEC); the panel seven tells the renal fx

ae such as cough hyperkalemia and worsening of renal fx

compare leg pressure to arm pressure

take two b/p reading each visit

tx: JRA

tastes good & may not have child proof cap. They don’t tell you, you find the bottle & don’t see any difference in the child immediately. Peak 2-3 hours with ears ringing (tinnitus). Stimulates respiratory center of the brain (hyperventilate)  respiratory alkalosis  ↑ metabolic rate, body can’t use carbs, using proteins  metabolic acidosis (purpura, ulcer, throwing up blood or charcoal looking blood (from deeper down & enzymes have had a chance to work on it). -

if hyperventilating they could aspirate by pulling it into their lungs. - If hyperventilating, use lavage. •

monoclonial antibody

reduction of s/s and inhibition of structural damge in JRA acts as a immune suppresor

 not for those who have fluid overload, caution w/ fever

AE: pulmonary edema, (dyspnea, chest pain, wheezing),

contr: presence of fluid overload

preeclampsia

longterm control of mild to moderate hypertension in preg–

 long term/long acting med.250mg 2x day.Slow onset of action & not for severe eclampsia 

AE: sedation, MYOCARDITIS, HEPATITIS

 monitor temp during therapy

monitor hepatic fx test and CBC

monitor for wt gain

may darken urine

oral hygiene

used in JRA, kawaski disease , rhematic fever

s/s of toxicity: nausea, disorientation, vomiting, dehydration, diaphoresis, hyperpnea, hyperpyrexia, bleeding, oliguria, tinnitus, convulsions, coma

 ;

want to administer NA bicarbonate and vitamin K contraindicated in viruses or post viruses like chicken pox, not for children with bleeding issues

dont take w/in two weeks of surgery; dont take w/ flu-like symp

 take w/ food or milk, avoid use with NSAIDS, dont take if smells like vinegar, not for less than 16 yrs

Don’t give over the counter meds that are combinations

Baclofen

(kemstro,lioresal)

skeletal muscle relaxant used 4 seizures

alleviation of s/s of spacitiy;

tx for cerebral palsy

AE:transient drowsiness, dizziness, weakness, fatigue, headache, insomnia, hypotension, nausea, urinary frequency d/c if liver dysfx develops taper drug over one to two weeks

no concurrent use w/ CNS depressant

report s/s of urinaryretension

oral hygiene for dry mouth

dont d/c abruptly

increase fluids and bulk

administered orally or intrathecal pump

fetal lung development

;  contraindications is inability to delay birth, adequate l/s ration, presence of condition that necessitate immediate birth (bleeding),

give before 34 weeks;

maternal side effects: hypertension, pulmonary edema especially used w/ toxolytics;

effects on fetus/neonate: monitor hor hypoglycemia, risk for sepsis,

 2 doses 24-48 hours b4 deleivery if they don’t have baby can do again in two weeks

stimulant laxative;

take b4 gi procedures; shortterm use when high opiod are used take one hour apart from milk or antacids

AE: abdominal cramps, nausea, rectal burning sensation, 

 adequate fluid intake

dont take w/in 1 hr of milk or antacids

can cause discoloration of urine

NSAID provide rapid sympotomatic relief in JRA inflammation suppresion and mild to moderate pain relief, fever reduction

SE:MI, CVA, GI bleed, exfoliative dermatitis, steven johnson syndrome, toxic epidurmal necrolysis

not for HTN pt

not for hx of GI bleed

reprt rash

dont take if allergy to sulfa, NSAID or aspirin

• Most prevalent STI • Transmitted during oral, vaginal & anal sex • 75% of women are asymptomatic • Dx testing – DNA test

 • Treat w/antibiotics (Zithromax) – Can give 1 does. - Treat partners • Untreated can lead to PID – can affect fallopian tubes (ectopic pregnancy) - Also increase risk to HIV/AIDS

• Male infection - Nongonoccal urethritis - Epididymitis & infertility

• pregnancy risks - preterm labor - neonatal pneumonia or conjunctivitis that can lead to blindness (opthalmia neonatorum)

• Effect FSH & LH & you do ovulate

 • Prevents ovulation

 • Take pill daily & at the same time • 21 day & 28 day packs

• Menses 1-4 days after last pill taken

• Good for nonsmoking women 40 to 45 (estrogen ↑ risk for thrombus)

 • Decreases breast milk production; given when breastfeeding is well established

• 0.2% failure rate

more effective; don’t want to take if have thrombophebilitis; know the contraindication: gallbladder, hyperlipedemia, liver disease, kidney disease or deficiency

 • 1st day of menses they are fine; 1st Sunday after menses they need back-up

• Some meds increase strength of pills & some decrease (antibiotics)

Extended active: seasonal has 84 active with 4 menses a year.

mast cell stabilizer

prophalaxis of asthma; prevent exercise induced asthma

antiinflammatory;

 ensure proper use of spacer and inhaler; clean daily rinsing and drying parts

SE: headache, nausea, dizziness, sorethroat

dont d/c abruptly because rebound

not for acute attack

  safe use in children 3 and up

may be used up to 4 times a day therpeutic response may take 2 weeks max effexts take 4 to 6 wks

prime canister 3 times b4 use

notify is sym dont improve in 7 days

not rescue drug 

Dermatologic Topical steroids

(bethametasone, hydrocortisone)

topical glucocorticoid

suppression of dermatologic inflammartion

AE: allergic contacy derm, atrophy, burning, dryness, edema (skin irritation)

wear gloves

no dressings on skin

give same time q day in AM

used to relieve perineal discomfort

 apply after a sitze bath

 wash hands b4 and after

tx utilze side lying position, stool softners, adequate fluid intake

anti-inflammatory, will have a cooling tingling sensation

sitz bath peri bottle after each defication and voiding pad change after each voiding and regulary ice pack right after birth analgesics tightening buttucks b4 sitting identify infection s/s and inspect area with mirror use

Erythromycin ophthalmic ointment

(ilotycin ophthalmic ointment)

(mainly gonorrhea);

instilled in narrow ribbon in lower conjuctival sac of each eye starting @ the inner canthus;

gentely close eye to ensure absorption;

neonatal se: sensitivity reactions leading to focus prob;ems and edema; usually disappear w/in 24 to 48hrs wash hands b4 administer dont irrigate eyes after adminitration;

may wip excess after 1 minute observe for hypersensitivity

• Secreted in large amounts by the ovaries • Control development of the female 2’ sex characteristic: breast development, widening of hips, fat tissue in buttocks & mons pubis • Causes endometerium to proliferate after menses • Greatest during proliferative phase • Increases uterine size & weight, expands blood supply • Myometrial contractility in uterus & fallopian tubes increase • Increases sexual desire • thins cervical mucus & makes it favorable to sperm. (sperm friendly)

is a big proble with clotting over wt and smokers @ big risk> hormone replacement therapys also have this

Estrogen SE

essential in erythropoesis

tx w/ malabsorbtion syndromes and anemia

 dont use w/ sulfa drugs or methotrexate

eat foods like green leafy veggies and liver

risk are heavy drinkers and childbearing

take with   B6 vitamin for red & white cell formation

       ·         Liver, lean beef, kidney & lima beans, dried beans, green leafy veggies, potatoes, whole wheat bread, p-nuts, orange juice. 

·         Store covered to protect from light

Cook only w/small amount of water & don’t overcook

 give to pregger

400 mg dosage in a pregnant woman

• 9-26 years old • Males & females • Warts in women/oral cancer in men

give 3 doses over 6 mo; begins around ages 9 to 26; prevents cervical cancer because HPV leads to cervical cancer

AE: local reaction, fainting

contraindicated in pregnancy or yeast allergy

increases blood glucose when low by stimulating gluconeolysis

tx hypoglycemia;

administer if unconscious by IM, SQ, paste or gel sl

in hosp setting  admin an IV iinfusion of dextrose to prevent prog of symptoms

since effects are temp additional snacks or meal is provided once the child is alert

monitor continuosly

antifungal ;

take orally for 8-12wks

 used for fungal infections of the skin (tinea infections (ringworm))

may have reaction when taken w/ drugs like antibiotics, sedatives or aspirin:  erhymatous macules, and papules, urticaria and mau be itchy (can take an antihistamine, cool compress, or corticosteroids to help this)

give with fatty foods such as peanutbutter or milk to enhance absorption

somatotropin

important for normal growth n develpoment

stimulation done for kids w/ low IGF1 and IGFBP3

admin sq or IM

use caution in kids receiving insulin

administered in deficiencies to promote growth and development (hypopituitarism, turners syndrome)

AE: hyperglcemia and hypothyroidism

monitor thyroid fx, look out for polyuria, polydipsia, polyphagia not for those w/ severe resp impairment catuin w/ diabetics

not use w/ glucocorticoids

admin 6 to 7 days a week

continued until bone maturation takes place

 report any joint pain

Put on wt control for this  looks thin but then chubby, not getting taller, bur puttin infants are weighed naked, look @ growth chart

anticoagulant

safeest to use cause it dont cross the placenta 

avoid foods high in vitamin K

contraindicated in those who have a intrauterine device, threatened abortion or indwelling catheters

AE: bleeding, loss of hair, xhills, fever, osteoporosis, supression of renal fx

avoid IM injections

dont rub sq inject sites

aPTT 1.5-2.5 (adults)

ptt 22-34 sec (kids)

antidote is protamine sulfate

Bed rest on left side.  Perform fetal surveillance

Can cause liver problems/failure, can get shellfish if you get the oyster’s off wrong side of river. • Viral • Can get over it & can get it again.

vaccine:

AE: local reaction

contraindicated in prego

• • 1st shot given in nursery (called zero); 2nd shot @ 1 month later; 3rd shot @ 6 months • Adults given in the same sequence. If at least basic minimum, don’t restart.
• se: include irritation @ injection
• nursing considerations: only for IM monitor temp and AE closely have epinep on hand for hypersensitivity
• Adults given in the same sequence. If at least basic minimum, don’t restart.contrainicated w/ allergy to bakers yeast

High phosphorus content foods:

Cheese, custard, chocolate, cola

Hot dogs

Ice cream

Peanut butter peas

Sausage

High sodium content foods:

Spagetti sauce, tomato sauce, steak sauce, salami, sauerkraut

O

Dill pickles or picked foods, dogs hot dogs

I

U

MSG

NSAID

tx inflammation, fever and pain

AE:  tinnitus, GI BLEED, HEPATITIS, exfoliative dermatitis, steven johnson syndrome, toxic epidermal necrolysis, anaphylaxis

report black-red stools

contraindicated with asthma or with anyone with a lung disorder; not for HTN people or bleeding disorders

 take w/ glass of water or milk and food remain upright for 15-30 min, make mask fever, don’t take prior to surgery

wear sunscreen

reporrt rash immediately 

 dont take w/ nephrotoxic drugs

hyperthyroidism

 AE: metalic taste, stomatis, sore teeth and gums, GI distress, small bowel lesions;

drink through a straw take with meals dont take with iodized salt of seafood dilute in a drink to help

with the taste take

same time each day

 increased fluid intake

stimulate active immunity against rubella virus burnign stining @ injection site

AE: site irritation; joint pain, anaphlaxis, thrombocytopenia

 2 to 4 wks late can have rash, sore throat, malaise, headache

not for neimycin sensativity or immunosuppresed, or if had blood products rubella titer need to asses in 3 months avoid pregnancy for 3 months need contraceptives!!!

will get this if not reubella immune right b4 discharged

give 12-15mo; 4-6 yo; 16-17; viral, transmission resp drop; s/s malaise

stop preterm; calcium channel blocker so affects contractility of uterus, also effects heart for b/p; can have unwanted effects on the heart; can lead to pulmonary edema; watch with overwt and or diabetic patients; every hour to two hours listen to lung sound; reflexes will be diminished; baby will come out floppy with resp depression

 toxicity: monitor I&O; give em fluids;

watch b/p and DTR carfully

• Teens/college (1st kiss commercial)

• Menactra • If you see purpura, you are almost dead. Hard to see with darker colored skin.

AE: local reacttion

contraindicated w/ hx of guillain barre syndrome 

(uterine stimulant)

 usd to prevent pp hemorhage; has vasocontrictive effects on all blood vessels especially large arteries which can result in hypertension particulaily in those who b/p is already elevate;

 contraindications: pregnancy, hepatic or renal disease, cardiac diasease, HTN, preeclampsia;

 caution during lactation

 SE: HTN, N/v, headache, bradycardia, dizziness, tinnitus, abdominal cramps, palpitations, dyspnea, chest pain

nursing: monitor for AE of water intoxiciation, such as light headedness, n/v, headache, malaise

AE of ergot toxicity (n/v, headache, muscle pain, cold extremities, chest pain, weakness no cigarettes!!

 will raise b/p which will give you a headache> increase pulse, never use during labor, used after the baby. Assess fundal ht, amount and character of lochia

for those who dont respond to NSAID slow joint degeneration and progression of JRA

 SE: bone marrow suppression, pulmonary fibrosis, stomatis, fetal death/congental abnomalies diet and growth maintained dont take with food hold vaccines

 report SOB, bleeding bruising

no alcohol

no vaccinations

 Used in a short period of time.  

antifungal tx candidias;

SE: liver toxicity, infusion reaction (fever chills rigor headache), thrombophlebitis, nephrotoxicity, hypokalemia, bonemarrow suppression

swish and swallow but for infants and children who cant do that they will need it swabed onto their oral mucosa

after feedings

opioid anagelsic ;

 ; maternal and fetal side effects:  sweaty clammy skin, nausea and vomiting; slows q thing down

 assess bladder

 safety precautions

narcan antidote

maternal contraindications:  rep depression, acute astma attack, bradycardia,

contraindicated in drug addicts (IV) can cause immediate withdrawl in a baby and infant who are addicts

SE; agranulytosis rash, urticaria, lymphadenopathy; contact PCM if rash fever or sore throat develops

 adjunct therapy like propanolol helps with tremors, tachycardia, and sweaty

want to monitor diet, growth and behavior

need increase caloric intake, five to 6 meals a day cool environment rest periods to fight easily fatigue

monitor for bone marrow suppresion

watch skin rash of cervical node swelling

opiod anagelsic

moderate to severe pain;

 AE: slows q thing down, blurred vision, sweating, hepatoxicity, uteral spasm

not for women with asthma, resp depression or convulsive disorder teach cough and deep breathing for possible depressed cough reflex look for resp depression monitor bowel and bladder

noconcurrent use with acetaminophen

oral hygiene

report consipation

monitor amylase and lipase

admin w/ food or milk for GI discomfort

anticonvulescent

monitor v/s frequently during administration may crush tab or milk with food or fluids

SE: largyospasm, angioedema, serum sickness,

toxicity: nystagmus, ataxia, resp depression, coma, hypotension, pinpoint pupils

supplement with vitamin D & folic acid

push IV closest to child

 used to induce labor 

 used immediately after birth hemorrhage;

contraindications: severe eclampsia or preeclampsia, predisposition to uterine rupture, nonreassue fetal stat,  previous csection, preterm infant, rigid unripe cervix;

nursing considerations: explain to client apply fetal monitor and obtain 15 to 20 minute tracing and NST to assess FHR b4 starting therapy goes in the secondary line ensure continous fetal monitoring and uterine contraction monitoring assess FHR, b/p, puulse. freq and duration of uterine contractions and uterine resting tone before each increase in  infusion

assess cervial dialation as needed ;

 d/c when nonreassurinf fetal status is noted, when uterine contractions are more frequnet in 2 minutes, if the duration of the contractions exceed 60 sec, insufficient relaxation of the uterus between contractions or a steady increase in resting tone is noted,

uterine stimulant

asess uterine tone and vaginal bleeding

AE: in mom coma, seizures;

can progress to cerebral edmea with seizures coma and death

also helps with subinvolution of the uterus

also expels retained placental fragments

cancause fetal intracranial hemorrhage or asphaxia

watch ouput closely cause once it stops you will have some serious diuresis

antimalarial agent used in JRA

to tx symptoms associated with skin lesion

AE: retinopathy and blindness

eye exams q 6 mo

stop med if blurred vision occurs

supresses the immune response of clients who are RH negative to rh poasitive RBCs from the fetus

 given @ 28 wks, after each abortion, ectopic pregnancy, hydaform mole, choroinic villus sampling, placenta previa, blunt trauma to ab, external cephalic eversion, abruption, or still birth also given 72 hrs after birth should not be given to previously sensitized women AE: soreness @ injection site

antituberculosis; broad spectrum antibiotic

SE: discoloration of body fluids, jaundice, anorexia, fatigue, gi discomfort (anorexia, nausea, ab discom) tears, sweat, spit and urine can be orange monitor liver fx alternative birthcontrol needed monitor bleeding times if taking warfarin

if smeone has meningitis whole family will be tx with this

can cause 8th cranial nerve damage (hearing loss)

long acting beta adrenergic

long-term control

dry powder inhaler relaxes the smooth muscles in the airway, used for nocturnal symptoms and used for prevention of exercised produced bronchospasm not for acute asthma flare for 30 to 60 min b4 physical activity; doses shouold be 12 hrs apart SE: tachycardia, tremor, irritability, insomonia (will last 8 to 12 hrs)

topical antifungal)

apply cream as thin layer bid for two weeks for tinea

AE: burning, rash, swelling,

d/c if these symp become severe

avoid occlusive dressives

keep infected area clean and dry

(pat dry)

 dont put near open wounds no scratching

• analgesic opioid
•  common SE: slows q thing down, fainting

• contraindicated in drug addicts (IV) can cause immediate withdrawl in a baby and infant who are addicts
• breastfeeding, women with chronic hypertension or preeclampsia

GIVE PHENERGAN WITH IT PHENERGAN POTENTIATES OR HELPS THE

AE:cardiovascular collapse anxiety, tachycardia, palpitations, altered appeptite, ab cramping, heat intolerance, fever, diaphoresis, wt loss an dmenstraul irregularities

caution with antiseizure and antidepressant meds and anticoagulants (increases bleeding times)

may have sleep disurbances or behavioral changes assess heart rate assess t4 and tsh levels, bone age, growth patterns need fruits and bulk in diet assess, visual memory and attention problems

take in morning

report chest pain, dizziness, or palpitations

report execcive wt loss

TSH is high when thyroid fx is lo 

 give in morning on an empty stomach

oral longterm control of chronic asthma

pg 461 relaxes the smooth muscle of uterus; big side effects is terbs: shaky jittery, feel like gonna jump out of skin; another big effect is pulmonary edema cause effects smooth muscle; will give lebetalol to help with this

d/c immediately if cleint exhibits s/s of pulmonary edema: chest pain, SOB, resp distress, wheezing and crackles, productive bloody cough

w/hold if HR is 120-140, chest pain or cardiac arrhythmias

 asthma treatment – smooth muscle relaxant.

 (breathine) prevention drug. •

no smoking

used to relieve perineal discomfort and edema and hemorrhoidal pain

 wash hands b4 and after tx utilze side lying position, stool softners, adequate fluid intake

 anti-inflammatory, will have a cooling tingling sensation

sitz bath peri bottle after each defication and voiding pad change after each voiding and regulary ice pack right after birth analgesics tightening buttucks b4 sitting identify infection s/s and inspect area with mirror use

; promotes liver formation og clotting factos. newborns dont have bacteria in the colon to synthesiza this

 protect drug from light, give b4 circumsicion,

 observe for bleeding including bleeding times pbserve for jaundice and kerictererus, 

 additional dose may be ordered if mom received anticoagulants 6 to 8 hrs after 1st injection

 is given with in the first hour of birth; given to everyone no matter the circumstances

 look for bleeing or brusing

not for IV

For shortterm pregnancy (you stop uses these methods you can generally get pregnant pretty quickly): IUD, condoms, diaphragm, pills, nuva ring

Vasectomy: have to come in for sperm counts until they are absent can get lady pregnant

antiemetic

also used in hyperemesis gravidum

AE:headache, dizziness, diarrhea;

 tx headache with nonopioid analgesics, monitor stool pattern concurrent use with antihypertensives can antensify hypotension

good to use in children

Assess for EPS (involuntary movement)

monitor liver fx

supresses normal intestinal flor b4 surgery SE:ototoxicity, , (strep tomycin> peripheral neuritis, optic nerve disfx, tingling/numbness of the hands and feet) watch for ear issues like hearing loss of balance issues, tinnitus, headache, nausea notify PCM and stop drug

 monitor I&O and BUN

dont take with loop diuretics

Gold Salts

slow worsening of JRA; most effective early 

AE: ,stop med if renal toxicity occurs or rash, stomatis, monitor CBCs amd bleeding in mouth

 monitor liver fx notify if GI prob occur

watch for allergic reactions

IM injection of gold salts. 

·        

great for status epilectus

anticonvulesant and CNS depressant administer in IV site

SE: resp depression, anterograde amenisia

have rescusitation equipment on standby

admin vitals

monitor for memory loss

ativan: taper slowly, injection may cause gaspin syndrome in less age 12, avoid alcohol, after parental admin, keep pt supine for 8 hrs, admin liquid solution w/ water soda pudding or apple sauce

 Valium is not very effective but you will see it used but it’s not compatible with NS.  Ativan works better (IV push drugs)

no grapefruit juice

hypocalcemic hormone

AE: anaphalaxis

not for allwergy to seafood

flusing and warmth can occur w/in 1 hr

diet should be high in calcium and vitamin D

weight bearing exercises

assess tetany, monitor the ECG, and check chvostek's and trouseaus sigh

8-11

report nasal irritation

·         Increase intake by 50%

·         Recommendation is 1200 mg/day

·         Best source is dairy

·         Others: enriched cereals, legumes, nuts, dried fruits, broccoli, raisins, green leafy veggies, canned salmon, sardines with bones

·          supplements

-          Under age 25 bone density not complete)

-          Won’t drink milk or like it

-          Don’t take with iron

Bones don’t calcify until later in pregnancy

can cause vasodialation

 SE: cardiac arrest , fainting, hypotension, bradycardia, arrhythmias, constipation, increase gastric acid

nursing: 

 dont adminis by peripheral infusion , scalp vein, IM or SQ precipitates when given with bicarbonate

vitamin D must be taken in adequate amounts

watch for s/s of deficiency (parethesia, chovest sign, tremors)

avoid high oxalate foods

report kidney dyscomfort or passage of stones

9-10.5 normale

monitor b/p and pulse

tx partial, tonic clonic, sezures (ages for to 16)

AE: heart failure (edema), steven johnson syndrome, multiple organ reactions,

admin @ bed; start low nd go up

monitor platetlets and CBC

mild rash use antihistamines

dont take w/ grapefuit juice

ketogenic diet (high-fat, adequate-protein, low-carbohydrate)

monitor dyspnea, bruising, edema and infections

broad spectrum antiobiotic affective against pneumonia, peritonitis, UTI

AE: hypersensativity, suprainfection

 monitor for rash

monitor I&O and GI symp notify PCM if occur monitor for s/s of colitis (diarrhea, oral thrush, and vaginal infection or yeast infection) use w/ caution w/ renal impairment

will abate the bleeding SE: causes really bad nasty smelling diarrhea you wanna give immodium right along with it; contraindicated in: asthmatics, cardiovascular or renal disease

; maximum duration of use is 48 hours;

contraindicated in: cardiac, renal of pulmonary prob, PID

common se is nauseas and vomiting; fever, chills, headache, diarrhea

 should be given in a large muscle after injection monitor uterine status and bleeding carefuly report excess bleeding

watch vitals lookin out for elevated temp pulse and decreased b/p delay breastfeeding 24hrs after administration

have to stay in bed after administration

beta blocker

improves left ventricular fx, promotes vasodialation of systemic circulation, used for chronic HF and cardiomyopathy monitor for signs of CHF improvement monitor dizziness and hypotension may increase digoxin levels so monitor those levels monitor liver fx

SE: CHF s/s, braycardia, pulmonary edema

notify PCM if slow pulse or dyspnea occurs

antibiotics that tx UTI, PID, and menigitis

AE:anaphlaxis, thromboplebitis, pain with IM injection, pseudomembranous colitis

use caution w/ bleeding and renal issues

 if signs of hypersensitivity appear d/c

rotate inection sites

 diluted intermitent infusion slowly im injection deep in large muscle mass

 notify provider diarrhea and fever occurs especially if bloody and or pus fillef

oral course take with food

report rash or yeast infection

stool softner

good to used postpartum

helps with contipation prego, hemorrhoids, episiotomy, those @ risk for aneursym or MI,

AE: cramps, GI irritation, rectal burning sensation,

watch out for water retension in fluid , watch out for dehydration 

 dont take w/in 2 hrs of another laxative

no straining for cardiac pt

dont use if ab pain, nausea present

cyclooxygenase

or indomethacin

prostaglandin inhibitors

tocolytic drug to stop labor (supress uterine contrac)

highly effective @ delaying birth

fetal effects: constriction of the ductus arteriosus, necrotizing enterocolitis, intraventricular hemmorhage

no grapefruit juice

increases myocardiocontractility, tx CHF and atrial fibrillation assess apical 1 minute

assess for toxicity: arrhythmias, bradycardia, n/v, anorexia, diarhea, restlessness, drowsiness, fatigue and visual disturbances

-(hold <60 for adult) -<90; 1 year or older hold < 70. -Can be compounded into a liquid- - Don’t give after belly full of symilac cuz food will come back up reduces edema is also another effect of this can also affect potassium-

prostaglandin E2 that ripens cervix and stimulates  uterine contractions.

 can be administered endocervically;

supine for 2 hours after

continuous electronic monotoring after for 2 hrs;

not for those sensative to prostaglandism not for nonreassuring fetal status, or any reaon baby cant be born w/ vagin, not used in clients receiving pitocin, not for those who can t give birth vaginally, not for those w/ previous csection, uterine scarring or rupture;

 caution , hx of asthma

matrnal side effects: uterine hyperstimulation, GI disturbance can cause a nonreassuring fetal heart rate patterns

monitor v/s, effacement and dialation carefully monotor fetal status prepare to adminiter terbutiline if uterine hyperstimulation

stay in bed after administering

this is a gel but cervidil is like a tampon you can take it out

mucolytic

loosens up and liqufies resp secretions

 in children with moderate to severe cistic fibrosis; decreases pulmonary infection risk

AE: GI upset, stomatatis, rhonorhea, bronchospasm

dont combine other drugs in nebulizer

wipe risdue off face and mask to prevent breakdown

store in fridge away from light

antiasmatic, bronchodialator, adrenergic aggent

Epitasis tx 

observe the child 3 hr after administration

 notify PCM immediately if SOB isnt relieved by medication or accompanied by diaphoresis, dizziness, palpitations or chest paIN

assess for paradoxical bronchospasm

assess for hypersensitivity reaction

can cause hyperglycemia

second prac have to check IV dose

antifungal

Candiadis> ,> with thrush if mom is breast feeding want to treat mom and baby

SE: hepatoxicity, exfoliative dermatative skin disorders, anaphalaxis

notify PCM of rash, ab pain, fevver, diarrhea, unusual fatigue, anorexia, nausea, jaundice, bleeding, brusing, palpitations, dark urine, pale stools

tx eclampsia> ward off pulmonary edema,

and CHF>fluid excretion

r Remove accumulated fluid & sodium –- Watch out for potassium. S/SX of hypocalemia - Will enhance effects of dig & may be able to reduce dig given. Pay close attention to pulse - May need potassium supplements, may be food or supplements. - 

3.5-5.0 potassium levels adults

3.3-4.6 kids

watch ECG

bone marrow supress can occur

watch for photosensativity

sulfa contrain

need to get a c section fast, emergency; need to intubate this patient, cause cant breathe independently, throat will hurt a few days later from intubation, anytime a person is being put to sleep you need to intubate them; babys will experience CNS depression; want to get that baby out quick because of this; can continue to effect the baby long after birth, takes them longer to excrete drugs so will see effects twice as long as babys

premedicated mom w/ antacids/ reglan

place a wedge under one hip to displace uterus

preeclampsia

vasodialator

tx hypertensive emergency

- IV med for severe HTN. 1^st line IV can cause severe dizziness.5mg IV push.Relaxes smooth muscle.

 AE: dizziness, anxiety, headache, reflex tachycardia

cramping, diarrhea, m/s weakness, lethargy, cardiac arrythmias, tachycardia, ventricular dysrhythmia

kayealate is the antidote

assess fundus for evidence of contraction and amount of uterine bleeding at least x4 for 2 hrs

after administration then x2 q hr until stable

assess H&H

 monitor b/p and pulse x4 for an hr after admin then x2 per hour until stable a

pply pulse ox weigh peri pads and chux

when the drug is insufficient, the fundus remains atonic and bleeding continuesm massahe the fundus. if massage fails to sustain contraction noticfy PCM continuoius EKG may be needed

 for hypotension, bleeding, tachycardia and shock elevate the legs 20 to 30 decgrees to increase venous return uterine cramping is expected; no smoking

NSAID

suppress preterm labor by blocking the production of prostaglandins which suppress uterine contractions

tx shouldnt exceed 48 hrs

monitor for hemmorrhage r/t to reduced platelette aggregation

administer rectally to advoid GI distress

report N?V, dyspnea, blurred vision, headache

monitor the neonate @ birth

should be d/c immediately if client exhibit s/s of pulmonary edema: chest pain, SOB, , resp distress, wheezing and crackles, productive blood tinged cough

not used ne more too much cause risk to fetus

used for PDA closure

AE: dizziness, drowsiness, psychiac disorders, constipation, dyspepsia, n/v, ANAPHYLAXIS, HEPATITIS, GI BLEED

NOT FOR SPIRIN ALLERGY

MONITOR RESP STATUS, HEART RATE, B/P, ECHOCARDIOGRAM AND HEART SOUNDS

STRICT i AND o

watch photosensitivity

prostaglandin inhibitor. Relaxes smooth muscle. PO do not give it after 32 weeks

long acting

1-2 hr onset

NPH

onset 1-3 peak 5-8 hrs

duration 12-18hr

stress infection or illness may increase or decrease needs monitor blood glucose qid and once a week @ midnight and 3am count carbs anticipate exercising

ipratropium

(atrovent)

Anticholinergics/bronchodialator

used for bronchitis and asthma

meterdose inhalor or nebulizer;

 inhibits bronchoconstriction and decreases mucuous production

 not for acute issues rinse mouth afterwards

SE: wheezing that increases, cough, nervousness, dry mouth, tachycardia, dizziness, palpitations, headache dont let get in eyes

dont exceed 12 doses in a day

 rinse mouth after wards to get rid of bitter taste,

when mult inhalation meds given 1st beta adrenergics, then this, and last inhaled corticosteroids

have suction, normal saline and catheters available for those w/ trach care 

for severe nodular acne especially when resistant to other treatment

requires informed consent

females need two pregnancy test and a monly test before presc is filled

females must use contraception 1 month before tx during and 1 mo after take with food

monitor triglycerides, cholesterol, and liver function

can be given with cystic fibrosis to help with constipation

will be given when ammonia levels are high in blood

 assess for ab distension

check bowel sounds

can cause diarhea

admin w/ full glass of water or juice

anticonvulsant

reducing the incidence of convulsion and tx for preeclampsia; secondarily relaxes smooth muscles which will help decrease b/p; also may decrease the frequency of uterine contractions in the tx of preterm labor;

 contraindication is  myocardianl issues; care taken w/ renal issues cause can become toxic quick

 SE: depressed DTR, cinfusion, oliguria, confusion, resp depression paralysis or collapse  

rapid admin of large doses can lead to cardiac arrest; effects in fetus/newborn: crosses the placenta, decreases in FHR; may have neuro and resp issues. monitor b/p every 10 to 15 min during administration monitor maternal serum m levels; therapuetic range is 4 to 8

monitor resp status below 12 bpm indicates possible toxicity assess patellor tendon reflex for evidence of loss of dimished reflexes (also lethagy change in OC) indicates toxicity urine output less than 30 per hr indicated accumalation stop giving if output or resp fall below acceptable range antagnoist is calcium (calcium glucanate should be available @ the bedside and delived over period of 3 minutes continuously monitor fetal heart tones during administration if given for preeclampsia continue postpartum to prevent seizures if given during birth neonate should be monitored for the first 24 to 48 hours

magnesium sulfate, terbutaline, indomethacin

(toxolytic therapy)

  tx reyes and cerebral edea lowers intraoccular pressure

dont use w/ sulfa allergy

watch out for hypo or hyperglycemia

used to decrease ICP

SE: SUDDEN DROP IN FLUID LEVELS, n/v, lightheadedness, hypotension, confusion, headache, rash, dry mouth, thirst, fluid and electrolyte imbalances

-- so measure how much they are diuresing with the hourly container on front-uremoter

 drug of choice for adults and children-

; SE: insomnia, nervousness, agitation, palpitations, changes in b/p and pulse, blurred vision, anorexia, wt loss, hepatotoxicity, dermatitis

 contraindications: tics, not for under age 6,

need CBCs, cardiac evals, plateletes, ht, wt growth grid

; observe for signs of bleeding dont withdraw quickly, taper,

report signs of bleeding, bruising, fever, sore throat; observe behavior

no caffeine

check wt'report palpitations or insomonia

no vassopressor or MAOI w/in 14 days

 prostaglandin used to ripen cervix and induce labor;

available po, vaginally , rect, subling; rect

also  used for pp hemorrhage;

contraindicated in women who had csection or uterine scarring, uterine rupture, advance maternal age, five or more previous pregnancies, uterine contractions 3 times in ten minutes, maternal asthma significant, bleeding during the pregnancy, placenta previa, nonreassuring fetal status use only during the 3rd trimester for cervical ripening or labor induction dose 3 to 6 hours apart pitocin should not be administered less than 4 hrs after the last dose of this need continuous fetal and uterine monitoring

SE: hyperstimulation of uterus administer terbutaline if this happens; diarrhea, hypertension, and vomiting

report diarrhea longer than a week, black tarry stools, and severe ab pain

Leukotrienes receptor antagonist/ bronchodialator

reduces inflammation

prevention and tx of chronic asthma and seasonal allergies;

should be taken 2 hr b4 activity

 available in granules for infants and chewable tabs for infants administer once in the evening w/ or w/ out food can be mixed w/ applesausce or icecream (not mixing w/ liquids)

report fever, acute asthma episodes, flulike symp, severe headache, lethergy

opiod analgesic

d/c if resp are 12 or less

can be used in children

slows everything down and it makes you itchy (have benedryl on hand)

Slowly ween off  for 2 to 4 weeks

contraindicated in drug addicts (IV) can cause immediate withdrawl in a baby and infant who are addicts

corticosteroids (nasal)/ antiinflammatory

prophalatic therapy for asthma

seasonal or allergic rhinitis

AE: headache, dysphonia, bronchospasm, ANAPHLAXIS, ANGIOEDEMA

use lowest dose in children

monitor growth

stop if have rash, dyspnea, hives, angioedema

when using bronchodilator use bronch first wait 5 min then use corticosteroid

calcium channel blocker/ tocolytic

  stop preterm labor supress uterine contrations

PO or sq

causing vaso-systemic dialation. (not for low b/p) 

 10 to 30 mg. 3x day. 

SE:  tachycardia, arrhythmias, peripheral edema, bradycardia, chestpain, hypotension, palpitations, syncope, steven johnson, CHF

Should not be used with mag sulfate!!

monitor potasium levls

report unrelieved chest pain and SOB

nursing interventions for prostaglandin gels:

cytotec, cervidil, prepidil

document # of sponges and dialators inserted

client should be in side lying position

monitor for SE: hypertension, diarhea, vomitig

caution in glaucoma, asthma, heart disease and renal disease

assit in digest of nutrient decreasing fat and bulk in cystic fibrosis;

 given prior to food ingestion, taken with snack and meals

parents need to learn what foods to avoid that contribute to digestive prob

fat soluable foods arent completely absorbed with food so must be take in a water soluble form

multivitamins taken twice a day usually good enough for that

diet should be high in calorie; fats and salt is necessary

AE: nausea, diarrhea, abdominal cramps, hyperuricosuria

antieliptic

CNS effects (sedation, ataxia, double vision, , cognitive impairment), gingivalhyperplasa, skin rash, endocrine effects (inteference w/ vit D metabiolism) hirsitism

need good oral hygiene

stop if rash develops

slow iv and dilute;

contraindicated with dexotrose

  adequate vitamin D calcium and folic acid

avoid concurrent use of antihistamines

frequent dental care to prevent gengival hyperplasia

not compatible in D5W

2’ line for seizures with 10cc NS/hr for _____& if seizure). 

strong antiinflammatory, immunosuppresant

tx asthma, allergy, leukemia, and RDS

 . take b/p twice per day initially.

 give daily in morning with food or mixed in food;

 monitor for: hypocalcemia, adrenal gi distress, insufficiency, infection, ; monitor wt, electrolytes, b/p. low sodium diet with adequate fluids get regular eye exams medical ID bracelet with hold immunizations if on high doses

given in what’s called a burst over a 5 day period. Don’t need to taper. Usually bid but can be done qid. Pills or liquid form. VERY BITTER •

aE:peptic ulceration, thromboembolism

not w/ grapefruit juice

limit caffine for oral forms

previcid (lansoprazole)

omeprazole (prilosec)

Proton pump inhibitor

avoid alcohol, ASA, NSAIDS, smoking, caffeine

administer in the morning on an empty stomach 1 hr before meals;

see PCM if severe diarhea occurs;

contact PCM if ab pain black tarry stools or diarrhea develop

 SE: ab pain, diarrhea, dizziness, fatigue, headache, hematouria, nausea, protein uria, rash

betablocker

 tx tachycardias and lower bp/ hypothyroidism

also used for CHF

increases contractility

assess HR for bradycardia 1 min prior to giving

monitor I&O and WT

 restrict Na

AE: CNS depression

antidote to heparin

SE: anaphlaxis, angioedema, and pulmonary edema

assess fo r fish or insulin allergy

vasectomized and infertile men high risk for sensitivity

bulk forming laxative

useful in to prevent straining; helps with watery diarrhea

AE: bronchospasm, cramps, intestinal or esphageal obstruction, n/v

 shouldnt be used in pt w/ heart disease

adequate fluid intake

admini w/ full glass of water or juice

dont use when ab pain, n/v and fever is present

dont let mixture gel prior to drink cause can cause choking

follow mix w/ another 8 oz of fluid

local analgesic goes in plexus to (helps with pushing)

provides local anasthesia to the perinuim, vulva and rectal area during delivery or episiotomy

admin during the second stage of labor 10 to 20 min b4 delivery

AE: broad lig hematoma, compromise of maternal bearing down reflex

only relieves lower perineal pain; may not feel urge to bear down as much> complication is hematoma and nerve plexus damage; use ice packs to help with this; hematoma is going to present as severe pain> ice helps with swelling and pain

block goes in plexus to (helps with pushing) and local anesthesia (used right after birth/ repair laceration)

onset is 5 to 10

 minutes peak ub 30 min to 2hr (look for hypoglycemia)

duration 3-4 hrs take with meals stress infection or illness may increase or decrease needs monitor blood glucose qid and once a week @ midnight and 3am count carbs anticipate exercising

Immune modulators: monoclonal antibodies

used w/ methatrexate to tx JRA antiinflammatory

helps w/ crohn disease too

AE: bone marrow suppression, acute pulmonary edema (dyspnea, chest pain, wheezing) and flu-like symptoms

notify pcm if upper resp infections occur

dont initiate therapy in pt w/ active infections

antiviral

 tx severe lower resp tract disease cause by rsv in infants and young children

AE:hemolytic anemia, CARDIAC ARREST, STEVEN JOHNSON SYNDROME

not for; , w/ out of cont cardiac disease, assess for signs of infection periodically assess for colitis (ab pain bloody diarrhea, fever) assess cardiac func periodically (n/v ab pain) d/c if these happen assess pulmonary fx may cause vision issues stop taking if have fever, rash, blister or sores in mouth, nosem or eyes

Most of the drugs you push for seizures are incredibaly irritating to vein

-- dilute with normal saline. Don't just stick in somebodys arm and push. You need the iv tubing going. Also go up higher on the tube to push it to give it a chance to dilute.

Give tylenol regularly in this pt;  fluid restriction; have head in a neutral position with the HOB elevated; give these pt colace liquids; always have suction setup;

short acting

 regular insulin

onset 30 min to 1

hr peak 2-5hr (hypoglycemia)

duration 6-8 hr stress

 infection or illness may increase or decrease needs monitor blood glucose qid and once a week @ midnight and 3am count carbs anticipate exercising

can be given iv

slow acting

, protomine, utralente

onset1.5-4hr

peak none

duration 20-24hr

cant be used acute tx for dka

potassium sparing diuretic;

removes excess fluid from lungs

used in CHF management

moniot for electrolyte imbalances in digoxin toxicity

AE:hyperkalemia ( lethargy, confusion, ataxia, muscle cramps arrhythmias) and maness/womeness (hirsuitism, gyngomastia)

notify if s/s of hyperkalemia

potass 3.5-5

maintence diuresis CHF, renal dysfx, hypertension, corticosteroid therapy tx

SE: dizziness, anorexia, photosensitivity, hypoklemia, blood dyscrasia

 consume high potassium foods

use snscreen

report bleedding, bruising and SOB

not for sulfa allergy

report ab pain or jaundice

potassium 3.5-5

clotrimazole, micronazole, ketoconazole,naftifine, terbinafine)

used twice for 4 weeks for tinea corporis (ring worms)

SE:(local) (irritation, burning, rash, and swelling

azithromycin, amoxicillin and erythromycin prescribed during pregnancy

broad spectrum antibiotics

bactericidal

anticonvulescant

tx simple and complex asence seizures

 dont dilute syrup with carbonated beverage;

 dont chew tablets or capsules;

 give with food

dont use with aspirin, allergy meds or sedatives

monitor platelette counts and bleeding times

AE:hepatoxicity, bone marrorow suppression (thrombocytopenia), n/v, indigestion, anorexia ab pain, jaundic, pancreaitis, thrombocytopenia

take with food

not for younger than 3yrs

monitor amalyse levels

monitor platelette ounts and bleeding times

dont w/draw abruptly

take med same time each day

liver fx test must be monitored 1st few months of therapy

in children usually give depakin which is a liquid cause cant swallow pills

anticoagulant

proph against 1pe, a fib, embolization, MI

AE: cramps, n/v. dermal necrosis, BLEEDING

 watch for bleeding use electric razors; the murmrur is more thrill like a cat purr (AORTIC STENOSIS)]

vitamin K is sthe antidote

pt:11-15 sec kids

pt:1.3/1.5 adults

limit foods high in vit K like green leafy veggies

 dont floss

dont drink alcohol or take antiplatelets like aspirin

monitor urine and occult stool

take 3-5 days to reach therepeutic levels

 children with chronic or acute ITP,  or children a with ITP secondary to HIV infection to increase platelet counts in non-splenectomized, Rho(D) positive patients with ITP.

 Platelet counts usually rise within one to two days and peak within seven to 14 days after initiation of therapy. immediately report symptoms of intravascular hemolysis including back pain, shaking chills, fever, discolored urine, decreased urine output, sudden weight gain, fluid retention/edema, and/or shortness of breath to their physicians.

SE: chills, fever, nausea, anemia

pt: 11-15 sec

platelette: 150,000-250,000

H2 receptor antagonist

may be administerd w/ or w/out food

 if taking antacids need to be taken 2 hrs apart

 SE: bradycardia, constipation, nausea, dizziness, aplastic anemia, arrythmias, agranulocytosis

this and reglan can be used in babies

 notify if ab pain persists or difficulty swallowing

no smoking

no aspirin or NSAID or caffeine

report bonemarrow suppresion s/s

report confuisn or hallucination