Pharmacology Bundle 20221 2 PDF

lOMoARcPSD|23169440
Pharmacology
Bundle
@NursingStoreRN
NURSINGSTORERN
Descargado por lol dafsdf (aefsJcfafnlkae@hotmail.com)
lOMoARcPSD|23169440
I- Medication Affecting the Nervous Neuromuscular blocking agents

System … 01 Muscle relaxants: direct acting
Sedative hypnotic anxiolytics - benzodiazepines Muscle relaxants: Centrally acting (CNS)
Atypical anxiolytic / Nonbarbiturate anxiolytic Bone disorder – calcium supplements
Selective Serotonin Reuptake inhibitor – SSRI Bone disorder – Hypocalcemic MEds
Antidepressants Selective estrogen receptor modulator
Serotonin-Norepinephrine Reuptake inhibitor Bisphosphonates
Atypical antidepressants Antigout medication
Tricyclic antidepressants - TCA
Monoamine Oxidase Inhibitors - MAOI IV- Medication affecting Respiratory
Bipolar disorder – mood stabilizer System … 11
Bipolar disorder – mood stabilizer antiepileptics Beta2 adrenergic agonists
Antipsychotics: 1st, 2nd, 3rd Generation Methylxanthines
CNS Stimulants – ADHD Inhaled Anticholinergics
Alcohol Abuse – Abstinence maintenance Glucocorticoids
Opioid’s abuse – abstinence from opioids Leukotriene modifiers
Smoking Abuse – abstinence from nicotine Antitussives: opioids / non-opioids
Alzheimer’s medication Expectorants
Myasthenia Gravis - Cholinesterase Inhibitor Mucolytics
Anti-Parkinson’s - Dopaminergic Decongestants
Anti-Parkinson’s – anticholinergic
Antiepileptics @NursingStoreRN
Antihistamines
Topical beta blockers – for open-angle glaucoma

V- Medication affecting Cardiovascular
Alpha2 adrenergic agonists
Prostaglandin analogs System … 13
Carbonic anhydrase inhibitor (systemic) Diuretics – High-Ceiling loop diuretics
Cholinergic (direct acting) Diuretics – thiazide diuretics
Hypnotic/Sedative - Insomnia Medications Diuretics – potassium-sparing diuretics
Hypnotic/Sedative – barbiturates Diuretics – Osmotic diuretics
General Anesthetic Meds Meds for BP – ACE Inhibitor
Meds for BP – Angiotensin II receptor blockers
Meds for BP – aldosterone antagonists
II- Medication for Pain and Inflammation
Meds for BP – direct renin inhibitor
… 08 Meds for BP – calcium channel blockers
Salicylate Meds for BP – Alpha adrenergic blockers
Nonsteroidal anti-inflammatory drugs – cox1 & Meds for BP – Centrally acting alpha2 agonists
Cox2 Inhibitor Medication for Hypertensive crisis
Nonsteroidal anti-inflammatory drugs – Cox2 Beta Blockers – Beta 1
Inhibitor Beta Blockers – Nonselective (1-2)
Acetaminophen Organic Nitrates – Antianginal Drugs
Opioids agonist Cardiac glycosides
Topical analgesic Antidysrhythmic medication
Adrenergic agonists - Catecholamines
III- Medication affecting Anticholinergic-antimuscarinic
Musculoskeletal System … 09 Antilipemic agents – Cholesterol medication

lOMoARcPSD|23169440
Antiflatulent
VI- Medication affecting BLOOD … 19 Pancreatic enzymes
Anticoagulants – IV / Sq
Anticoagulants – oral (Vit K Inhibitor) X- Medication affecting the Immune
Direct thrombin Inhibitor System … 31
Direct inhibitor of factor Xa Chemo Agents - Antimetabolites
Antiplatelets Immunosuppressant – polypeptide
Thrombolytic medication Antirheumatic – antimalarial
Fibrinolysis inhibitor Antitumor – anthracyclines
Erythropoietic growth factor Antimitotic – vinca alkaloids
Leukopoietic growth factor Antineoplastic – alkylating agents
Colloid Prostate cancer medication
Blood products Breast cancer medication
Biologic response modifier
VII- Vitamins and Minerals … 22
Magnesium XI- Medication affecting the Reproductive
Iron System … 33
Vit b12 - cyanocobalamin Estrogens
Folic acid Progesterone
Calcium Androgen
Potassium 5-alpha reductase inhibitor
Alpha1 adrenergic antagonists
VIII- Medication affecting Endocrine Erectile dysfunction – phosphodiesterase type 5
System … 23 @NursingStoreRN
Inhibitor
Insulin Medication affecting labor
Oral antidiabetics
Hyperglycemic meds XII- Medication for Infection … 35
Thyroid hormone Penicillins
Antithyroid – thionamides, Iodine Cephalosporins
Anterior pituitary hormone – growth hormone Carbapenems
Antidiuretic hormone Glycopeptide antibiotic
Adrenal hormone replacement Tetracyclines
Mineralocorticoid Macrolides
Hyperpituitarism Medication Lincosamides
Aminoglycosides
IX- Medication affecting GI … 27 Sulfonamides
Antibiotics Urinary tract antiseptics
Histamine2-receptor antagonist Fluoroquinolones
Proton pump inhibitor Antiprotozoals
Mucosal protectant Antifungals
Antacids Topical antibacterial
Prostaglandin e analog Topical fungal
Antiemetics Psoriasis - topical
Antidiarrheals Topical antiparasitic
Laxatives Antitubercular medication
Medication for Irritable Bowel Syndrome (IBS) Antiviral medication
Medication for Inflammatory Bowel Disease

lOMoARcPSD|23169440
Medication Affecting the Nervous System

Sedative hypnotic anxiolytics - benzodiazepines
Alprazolam (Xanax), diazepam (Valium), lorazepam (Ativan), midazolam (Versed),
chlordiazepoxide (Librium)
Use: Anxiety, seizures, muscle spasms, alcohol withdrawal, and induction and
maintenance of anesthesia, Insomnia.
Action: enhances GABA effects in the CNS. Relief from anxiety occurs rapidly.
S/E: Sedation, amnesia, dependency/withdrawal, respiratory depression.
Nurse: No grapefruit juice. Do not discontinue abruptly.
Antidote: flumazenil.
Atypical anxiolytic / Nonbarbiturate anxiolytic

buspirone (Buspar)
Use: Anxiety, panic disorder, OCD, PTSD.
Action: Binds to serotonin and dopamine receptors in the brain. Increases
norepinephrine metabolism. Dependency is much less likely, and doesn’t cause
sedation. Long-Term Use. Effects develop slowly (2-4 weeks)
S/E: Dizziness, nausea, headache, agitation.
Nurse: Take with food. No grapefruit juice. Avoid Erythromycin, ketoconazole,
St. John’s Wort
@NursingStoreRN
Selective Serotonin Reuptake inhibitor – SSRI
paroxetine (Paxil), sertraline (Zoloft), fluoxetine (Prozac), citalopram, fluvoxamine
Use: Anxiety, depression, OCD, PTSD, Panic disorders, Social Anxiety
Action: Inhibits serotonin reuptake (increases serotonin).
S/E: Sexual disfunction, weight gain, insomnia.
Nurse: Watch for Serotonin Syndrome (agitation, confusion, hallucinations, fever,
diaphoresis, tremors, myoclonus). Do not take with St. John’s wort, TCAs, or
MAOIs. Full effects not felt for up to 4 weeks. Taper Dose before Stopping.
Serotonin-Norepinephrine Reuptake inhibitor – SNRI

venlafaxine (Effexor), duloxetine (Cymbalta), levomilnacipran (Fetzima)
Use: Depression, Anxiety, Pain due to fibromyalgia, osteoarthritis, low-back pain,
diabetic neuropathy.
Action: Inhibits serotonin and norepinephrine reuptake (increases serotonin and
norepinephrine). Similar effect to the SSRIs
S/E: Nausea, weight loss, HT, Tachycardia, Dizziness, Sexual Disfunction,
Serotonin Syndrom
Nurse: Watch for Serotonin Syndrome (agitation, confusion, hallucinations, fever,
diaphoresis, tremors, myoclonus). Avoid Alcohol and other CNS depressants.
NursingStoreRN
1
lOMoARcPSD|23169440

atypical antidepressants
bupropion (Wellbutrin, Zyban), trazodone (Oleptro), Vilazodone, Mirtazapine
Use: Depression, Smoking cessation, alternative to SSRIs
Action: Inhibits dopamine and norepinephrine uptake (Norepinephrine-Dopamine
Reuptake Inhibitor).
S/E: Headache, dry mouth, GI distress, weight loss, agitation, seizures, HT
Nurse: MAOIs should be discontinued 2 weeks prior treatment.
Tricyclic antidepressants - TCA

amitriptyline (Elavil), imipramine (Tofranil), Amoxapine, Doxepin, Clomipramine
Use: Depression, neuropathic pain, fibromyalgia, anxiety, insomnia, ADHD, Bipolar
Action: Increases effect of serotonin and norepinephrine in the CNS by blocking
reuptake of norepinephrine/serotonin.
S/E: Sedation, orthostatic hypotension, anticholinergic effects (dry mouth, blurry
vision, Photophobia, urinary retention, constipation, Tachycardia), dysrhythmias,
sweating, seizures.
Nurse: To counteract anticholinergic side effects: chewing gums, wear sunglasses,
increase fluid (2-3L/day) and fiber intake. Take Med at Bedtime.
@NursingStoreRN
Monoamine Oxidase Inhibitors - MAOI
phenelzine (Nardil), tranylcypromine (Parnate), isocarboxazid (Marplan) (PANAMA)
Use: Depression, Bulimia, Panic Disorders, Anxiety, OCD, PTSD
Action: Blocks MAOI enzymes in the brain, which increases levels of dopamine,
norepinephrine, serotonin and tyramine in the body.
S/E: Agitation, anxiety, orthostatic hypotension, hypertensive crisis.
Nurse: DO NOT eat foods rich in tyramine (aged cheese, avocados, bananas, red wine,
salami/pepperoni, chocolate, soy sauce). Full effects not felt for up to 4 weeks.
Interaction with TCAs, SSRIs, ephedrine, amphetamines.
bipolar disorder – mood stabilizer

lithium carbonate
Use: Bipolar disorder. Controls episodes of Acute Mania
Action: Produces neurochemical changes in brain, including serotonin receptor blockade.
S/E: Fine hand tremors, polyuria, weight gain, kidney toxicity, electrolyte imbalances,
fatigue, hypothyroidism, leukocytosis.
Nurse: Administer with meals. Monitor for toxicity (plasma levels >1.5 mEq/L): coarse
tremors, confusion, hypotension, seizures, tinnitus. No diuretics, anticholinergics, or
NSAIDs. Contraindicated for patients with renal disease. Closely monitor sodium
levels. Need adequate fluid and sodium intake.
NursingStoreRN
2
lOMoARcPSD|23169440

bipolar disorder – mood stabilizer antiepileptics
carbamazepine (Tegretol), valproic acid (Depakene), lamotrigine (Lamictal)
Use: Treatment/Prevention of mania and depressive episodes.
Carbamazepine
Action: Decreases synaptic transmission in CNS.
S/E: Blood dyscrasias (anemia, leukopenia, thrombocytopenia), vision issues
(nystagmus, diplopia), hypo-osmolarity, rash, hepatotoxicity.
Nurse: Monitor CBC levels. Administer at Bedtime,
Valproic Acid:
Action: It Increases GABA (inhibitor transmitter) in CNS.
S/E: Hepatotoxicity, GI effects, pancreatitis, thrombocytopenia, hepatotoxicity
Nurse: Monitor for liver function. Avoid in Children <2yo.
Lamotrigine:
Action: It inhibits Na transport
S/E: Double or blurred Vision, Dizziness, GI upset, rash
Nurse: If rash occurs, withhold medication.
Antipsychotics: 1st Generation

chlorpromazine (Thorazine), haloperidol (Haldol), droperidol (Inapsine)
Use: Schizophrenia, psychotic disorders (delusions, hallucinations, bizarre behavior)
Action: Alters the action of dopamine in the CNS.
S/E:
- Extrapyramidal Symptoms: Dystonia, Parkinson’s symptoms (shuffling gait, rigidity),
@NursingStoreRN
tardive dyskinesia (lip smacking, tongue rolling), akathisia (restlessness, pacing).
- Neuroleptic Malignant Syndrome: Fever, BP fluctuations, dysrhythmias, muscle rigidity.
- Others: Agranulocytosis, anticholinergic effects, orthostatic hypotension, sedation, seizures
Nurse: Monitor V/S q1-2hrs. Anticholinergics (benztropine) can be used to control EPS. Muscle
relaxants (dantrolene) can be used to treat NMS
Antipsychotics: 2nd and 3rd Generation

risperidone (Risperdal), olanzapine (Zyprexa), clozapine (Clozaril)
[ Aripiprazole, brexpiprazole, cariprazine  3rd Generation ]
Use: Schizophrenia. Control positive and negative symptoms (anergia, anhedonia, social
withdrawal)
Action: Serotonin and Dopamine antagonist.
S/E: Diabetes, weight gain, increased cholesterol, sedation, orthostatic hypotension,
anticholinergic effects, menorrhagia, decreased libido. Clozapine carries risk for
agranulocytosis
Nurse: Monitor blood glucose during therapy. Monitor for infection.
CNS Stimulants – ADHD NursingStoreRN

methylphenidate (Ritalin) amphetamine mixtures (Adderall)
Use: ADHD, conduct disorders, intermittent explosive disorders, Narcolepsy.
Action: Elevates levels of Norepinephrine and Dopamine in the CNS
S/E: Insomnia, dysrhythmias, decreased appetite, weight loss, growth suppression.
Note: for It DO NOT administer at night, give medication during or after meals,
monitor weight during therapy.
3
lOMoARcPSD|23169440

Alcohol Abuse – Abstinence maintenance
disulfiram (Antabuse), naltrexone (Vivitrol), acamprosate
Use: for Alcohol abuse (promotes abstinence)
Disulfiram: If mixed with alcohol, will cause acetaldehyde effect (vomiting, sweating,
palpitations, hypotension)
Naltrexone: Suppresses craving for alcohol.
Acamprosate: Decreases abstinence symptoms (dysphoria, anxiety, restlessness)
Opioid’s abuse – abstinence from opioids

buprenorphine (Subutex) methadone (Methadose)
Use: Withdrawal and maintenance for opioid use disorder. Management of severe chronic pain.
Action: It Binds to opiate receptors in CNS, decreasing painxand causing CNS depression.
S/E: Sedations, confusion, constipation, hypotension, respiratory depression
Nurse: Monitor pain level, V/S, respiratory status. Increase fiber and fluid intake.
Antidote: Naloxone
smoking Abuse – abstinence from nicotine

varenicline (Chantix)
Use: Decrease Nicotine craving and manifestations of withdrawal.
Action: Nicotinic receptor agonist that promotes the release of dopamine to simulate
pleasurable effects of nicotine.
S/E: Anxiety, depression, irritability, insomnia,@NursingStoreRN
GI distress, muscle pain
Nurse: Monitor patient closely for depression/suicidal thoughts. Bupropion can also be used
for smoking cessation. Nicotine replacements (gums, patch, nasal spray) are also available
Cholinesterase Inhibitor = Anticholinesterase

Alzheimer’s medication – Cholinesterase Inhibitor
donepezil (Aricept)
Use: for Alzheimer’s disease
Action: Increases Ach (by inhibiting cholinesterase), which may
x improve memory, cognition,
and ability to perform ADLs.
S/E: Headache, diarrhea, nausea.
Nurse: It Take at bedtime. Donepezil does NOT cure Alzheimer’s disease.
Antidote: Atropine
Myasthenia Gravis - Cholinesterase Inhibitor NursingStoreRN

neostigmine, pyridostigmine, Edrophonium
Use: Myasthenia Gravis (improves strength/mobility), reversal of neuromuscular blocking
agents.
Action: Increases Ach at receptor sites (by inhibiting cholinesterase).
S/E: Excess ACh, which causes: increased salivation, diarrhea, nausea/vomiting, sweating,
bradycardia.
Nurse: Edrophonium is given to diagnose Myasthenia Gravis.
Antidote: Atropine
4
lOMoARcPSD|23169440

Anti-Parkinson’s - Dopaminergic
levodopa/carbidopa (Sinemet), bromocriptine
Use: for Parkinson’s disease. Relieve Tremors and muscle rigidity. Don’t halt the progression.
Action: Increases dopamine in CNS (levodopa converted to dopamine in CNS, and carbidopa
prevents breakdown of levodopa).
S/E: Nausea/vomiting, drowsiness, dyskinesias (tics, tremors), orthostatic hypotension, darkening
of urine and sweat, psychosis, diarrhea, bradycardia.
Nurse: Avoid foods high in protein, because absorption is delayed, and reduces therapeutic effect.
Bromocriptine: Ergot derivate. It is used less frequently. It’s poorly tolerated
Anti-Parkinson’s – anticholinergic
benztropine (Cogentin)
Use: for Parkinson’s Disease.
Action: Decreases ACh in CNS.
S/E: Anticholinergic effects (dry mouth, blurry vision, urinary retention, constipation)
Nurse: To counteract anticholinergic S/E, chew gum, wear sunglasses, increase fiber and fluid intake.
Antiepileptics
phenytoin (Dilantin), topiramate (Topamax), levetiracetam (Keppra), primidone (Mysoline)
phenytoin (Dilantin) @NursingStoreRN
S/E: Gingival hyperplasia, vision issues, dizziness, GI distress, skin rash
Nurse: Monitor phenytoin blood levels during therapy (Therapeutic range: 10-20 mcg/ml).
Decreases effectiveness of oral contraceptives.
Topiramate (Topamax)
S/E: Vision Issues, dizziness, sedation FI upset, metabolic acidosis.
Nurse: Monitor serum bicarbonate before and during therapy
Levetiracetam (Keppra)
S/E: Behavioral abnormalities, fatigue, agranulocytosis.
Nurse: Monitor CBC levels
Primidone (Mysoline)
S/E: Drowsiness, GI upset, blood dyscrasias
Nurse: Monitor primidone blood levels during therapy (Therapeutic range: 5-13mcg/ml).
Decreases effectiveness of oral contraceptives.
Benzodiazepines used for status epilepticus (acute prolonged seizure):
Diazepam, Lorazepam
NursingStoreRN
5
lOMoARcPSD|23169440

anti-glaucoma Medication
topical beta blockers – for open-angle glaucoma NursingStoreRN

timolol, carteolol, metipranolol, levobunolol
Use: for primarily open angle glaucoma.
Action: It’s a NON-Selective beta blocker, it decreases aqueous humor production,
which decreases Intraocular Pressure.
S/E: Temporary stinging discomfort in the eye
Note: DO NOT touch eye with applicator, hold lacrimal duct for 60 sec after
application to prevent systemic effects (hypotension, bronchoconstriction,
bradycardia).
Intraocular Pressure: 10-21mmHg
alpha2 adrenergic agonists

brimonidine
Use: for primarily open angle glaucoma
Action: Decreases aqueous humor production and outflow, which decreases IOP
S/E: Stinging, eye pain, pruritus, drowsiness, blurred vision.
Nurse: Do NOT touch eye with applicator, hold lacrimal duct for 1 min after
application to prevent systemic effects.
@NursingStoreRN
prostaglandin analogs
latanoprost (Xalatan), travoprost (Travatan)
Use: for primarily open angle glaucoma
Action: Lowers IOP by improving aqueous humor outflow.
S/E: Stinging, eyelash growth, eye color change (increase in iris pigmentation)
Nurse: DO NOT touch eye with applicator, hold lacrimal duct for 1 min after
application to prevent systemic effects
carbonic anhydrase inhibitor (systemic)

acetazolamide, methazolamide
Use: for Glaucoma. Also for acute altitude sickness, seizure and Heart Failure (diuretic)
Action: Reduces production of aqueous humor by causing diuresis through renal effects.
S/E: Flulike symptoms, GI upset, electrolytes imbalances (Na and K), hyperchloremic
acidosis.
Nurse: Administer with food to minimize GI upset. Monitor electrolytes.
cholinergic (direct acting)

pilocarpine, acetylcholine
Use: for Open Angle Glaucoma.
Action: lowers IOP by improving aqueous humor outflow.
S/E: Blurred Vision, stinging, eye pain.
Nurse: DO NOT touch eye with applicator, hold lacrimal duct for 1 min after application
to prevent systemic effects (hypotension, bronchoconstriction, bradycardia).

6
lOMoARcPSD|23169440

Hypnotic/Sedative - Insomnia Medications
zolpidem (Ambien), eszopiclone (Lunesta), zaleplon
Use: for Insomnia
Action: Increases GABA in the CNS, promoting sedation/sleep.
S/E: Daytime sleepiness, dizziness, abnormal thinking/behavior.
Nurse: Allow for at least 8 hours of sleep.
Melatonin is also used for insomnia. It is a supplement that regulates the
sleep/wake cycle.
Hypnotic/Sedative – barbiturates
pentobarbital, phenobarbital
Use: Preoperative sedation, seizures. Also used to induce coma with high ICP.
Action: Increases GABA, resulting in CNS depression.
S/E: Drowsiness, lethargy, hypotension, respiratory depression, constipation, GI upset
Nurse: Monitor V/S, have resuscitation equipment at bedside. Avoid alcohol
@NursingStoreRN
General Anesthetic Meds
propofol (Diprivan)
Use: Induction and maintenance of general anesthesia. Sedation of intubated patients.
Action: potentiates the effect of GABA. Does NOT provide analgesia.
S/E: Amnesia, bradycardia, hypotension, respiratory depression.
Nurse: Monitor V/S continuously. Use unused portion of propofol within 6 hours due to
risk of bacterial contamination.
NursingStoreRN
7
lOMoARcPSD|23169440
Medication for Pain and Inflammation

salicylate
aspirin (Bayer)
Use: for Pain, inflammation, fever, Kawasaki disease, prevention of TIAs, MIs.
Action: Inhibits prostaglandin synthesis, decreases platelet aggregation.
S/E: Tinnitus, GI bleeding, GI upset, rash.
Nurse: DO NOT use in patients with peptic ulcer disease or bleeding disorder. Monitor for
salicylism (tinnitus, vomiting/diarrhea, respiratory alkalosis). DO NOT give aspirin to
children with fever (due to Reye’s syndrome)
nonsteroidal anti-inflammatory drugs – cox1 & Cox2 Inhibitor

ibuprofen (Advil, Motrin, Excedrin), naproxen (Aleve), ketorolac (Toradol), indomethacin (Indocin)
Use: Analgesia of Mild to Moderate Pain, fever, inflammation, dysmenorrhea.
Action: Inhibition of cyclooxygenase.
S/E: GI upset, GI bleeding, renal toxicity, rash, headache
Nurse: Do NOT use in patients with peptic ulcer disease or bleeding disorder. Avoid alcohol.
nonsteroidal anti-inflammatory drugs – Cox2 Inhibitor

celecoxib (Celebrex)
Use: Suppress inflammation, relieves pain, decreases fever, and can protect against colorectal cancer.
Action: Inhibits Cox 2 enzyme, which decreases synthesis of prostaglandins. This results in decreases
pain and inflammation.
S/E: Thrombosis (MI, stroke), GI bleeding, rash
Nurse: DO NOT administer to patients with@NursingStoreRN
allergy to aspirin, NSAIDs or sulfonamides.
acetaminophen
acetaminophen (Tylenol)
Use: for Pain and Fever.
Action: Slows the production of prostaglandins in the CNS.
S/E: Hepatotoxicity in high doses
Nurse: DO NOT exceed 4g/day. Many OTC medications contain acetaminophen.
Acetylcysteine is antidote for overdose.
opioids agonist
fentanyl, morphine, dilaudid, oxycodone (Oxycontin)
Use: Moderate to severe pain, promotion of sedation.
Action: It Binds to opioid receptors in the CNS.
S/E: Respiratory depression, sedation, constipation, GI upset, hypotension, urinary retention
Nurse: Monitor pain level, V/S, respiratory status. Administer slowly. Administer around the
clock for Cancer pain. Increase fluid and fiber intake.
Antidote: Naloxone. Reverses analgesia and can result in hypertension, tachycardia, agitation.
topical analgesic
NursingStoreRN
lidocaine (Xylocaine)
Use: Decreases pain in conditions involving the skin and mucous membranes.
Action: Blocks conduction of pain impulses in a circumscribed area.
S/E: Rare, possibly stinging or erythema at site of application.
Nurse: For emla cream, apply 1 hour before procedure and cover with occlusive dressing
Descargado por lol dafsdf (aefsJcfafnlkae@hotmail.com) 8

lOMoARcPSD|23169440
Medication affecting Musculoskeletal System

neuromuscular blocking agents
succinylcholine, pancuronium
Use: As an adjunct to anesthesia in surgery or endotracheal intubation procedures.
Action: Blocks ACh at the neuromuscular junction, resulting in muscle relaxation and
hypotension.
S/E: Respiratory arrest, apnea, malignant hyperthermia (muscle rigidity, fever), muscle pain
following surgery, Hyperkalemia, Hypotension.
Nurse: Treatment of malignant hyperthermia includes administering O2 and dantrolene
(skeletal muscle relaxant) as well as cooling measures.
muscle relaxants: direct acting

dantrolene (Dantrium)
Use: Muscle spasticity r/t spinal cord injury, cerebral palsy and Multiple Sclerosis. Prevention
and treatment of malignant hyperthermia.
Action: Prevents release of calcium in skeletal muscles (inhibiting muscle contraction) to reduce
muscle spasticity.
S/E: Drowsiness, muscle weakness, GI upset, hepatic toxicity
Nurse: Monitor for signs of liver toxicity (anorexia, nausea/vomit, abdominal pain, jaundice.
muscle relaxants: Centrally acting (CNS)

baclofen (Gablofen, Lioresal)
Use: Relief Spasticity r/t spinal cord injury, cerebral palsy, Multiple Sclerosis.
@NursingStoreRN
Action: Enhances in CNS to reduce muscle spasticity.
S/E: Drowsiness, nausea, constipation, urinary retention.
Nurse: Increase fiber and fluid intake.
bone disorder – calcium supplements

calcium citrate, calcium carbonate, calcium acetate, calcium chloride (IV)
Use: Maintenance of musculoskeletal, neurologic, and cardiovascular function.
S/E: Hypercalcemia
Nurse: Monitor Calcium levels (9 - 10.5mg/dL).
bone disorder – Hypocalcemic MEds

calcitonin-salmon
Use: Postmenopausal osteoporosis, Piaget’s disease, and HYPERCALCEMIA.
Action: Prevents bone resorption by inhibiting osteoclast activity. Increases renal
excretion of calcium.
S/E: GI distress, nasal irritation/dryness (If given via intranasal route)
Nurse: Encourage weight-bearing exercise. Monitor bone density.
NursingStoreRN
9
lOMoARcPSD|23169440
Medication affecting Musculoskeletal System

Selective estrogen receptor modulator
raloxifene (Evista)
Use: Postmenopausal Osteoporosis, reduces risk of breast cancer.
Action: Binds to estrogen receptors, decreasing bone resorption.
S/E: Increased risk for embolic events (PE, DVT, stroke), hot flashes, leg cramps.
Nurse: Encourage increased intake of calcium and Vit D, weigh-bearing exercise. Monitor Bone Density.
bisphosphonates
alendronate (Fosamax)
Use: Prophylaxis and treatment of Postmenopausal osteoporosis, Paget’s disease.
Action: Inhibits bone resorption by decreasing number and action of osteoclasts.
S/E: Esophagitis, GI upset, muscle pain, visual disturbances
Nurse: Take on EMPTY stomach in the MORNING with at least 8oz of water. Sit
upright for 30 min after taking (to prevent esophageal ulceration). Encourage
intake of calcium and Vit D, weight-bearing exercise. Monitor bone density.
antigout medication
colchicine (Colcrys)
Use: for ACUTE Gout attack. Only effective for inflammation caused by gout.
Action: Interferes with WBC’s inflammatory response.
S/E: GI distress, thrombocytopenia, rhabdomyolysis (sudden muscle pain)
Nurse: NO grapefruit juice. Take meds with food.
@NursingStoreRN
probenecid (Probalan)
Use: Treats hyperuricemia with CHRONIC gout
Action: Inhibits renal reabsorption of uric acid.
S/E: GI upset, renal calculi
Nurse: Encourage fluid intake to prevent stone formation. Monitor uric acid levels
and renal function during therapy.
allopurinol (Zyloprim)
Use: Treats hyperuricemia with chronic gout.
Action: inhibits uric acid production.
S/E: GI distress, rash (Stevens-Johnson syndrome), hepatotoxicity,
nephrotoxicity
Nurse: Monitor renal and liver function during therapy. Takes 2-6 weeks for
improvement of symptoms.
Gout - gouty arthritis

A form of arthritis characterized by severe pain, redness, and tenderness
in joints; when too much uric acid crystallizes and deposits in the joints.
NursingStoreRN
lOMoARcPSD|23169440
Medication affecting Respiratory System

beta2 adrenergic agonists
Albuterol – Short-Acting. For Acute Asthma Attacks
Salmeterol / Formoterol (Inhaled) – Long-Acting. For Prevention of Asthma Attacks
Terbutaline (Oral) – Long-Acting. For Prevention of Asthma Attacks
Use: Causes Bronchodilation. For Asthma and COPD
Action: Activate beta2 receptors in the bronchial smooth muscle, resulting in bronchodilation
S/E: Chest Pain, palpitations, tremors, nervousness, tachycardia
Nurse: Use alone or in combination with glucocorticoids. If used with inhaled glucocorticoids,
use bronchodilator first, wait 5 min, then use glucocorticoids.
methylxanthines
Theophylline (Therapeutic level: 10-20 mcg/mL)
Use: Long-term control of Asthma, COPD.
Action: Increases cAMP, resulting in bronchodilation.
S/E: GI upset, headache, nervousness, dysrhythmias, seizures.
Nurse: Not used much due to serious side effects. Therapeutic level: 10-20 mcg/mL
Inhaled Anticholinergics
Ipratropium (Atrovent), Tiotropium
Use: COPD, rhinitis, asthma. Use alone or in combination with albuterol.
Action: Blocks muscarinic receptors of the bronchi, resulting in bronchodilation.
S/E: Dry mouth, bitter taste, throat/nasal irritation
Nurse: Increase fluids, suck on candy for dry@NursingStoreRN
mouth. Ipratropium/Albuterol combination
contraindicated for patients with peanut allergies.
glucocorticoids
Inhaled: Beclomethasone (QVAR), Mometasone (Asmanex), Budesonide (Pulmicort),
Fluticasone (Flovent)
Oral: Prednisone
IV: Hydrocortisone, Methylprednisolone
Use: Asthma, Rhinitis. Short Term IV for status asthmaticus. Inhaled for long
term prophylaxis. Promote Lung Maturity if preterm birth (Maternity Class).
Action: Prevent inflammation, suppress airway mucus production.
S/E: HYPERGLYCEMIA, Headache, pharyngitis, candidiasis, Infection
Nurse: Inhaler: Rinse mouth with water after administration. Use bronchodilator
first, wait 5 min, then use glucocorticoid.
leukotriene modifiers
NursingStoreRN
Montelukast (Singulair), Zafirlukast (Accolate), Zileuton (Zyflo)
Use: Long-Term therapy Asthma and prevention of exercise-induced bronchoconstriction.
Action: Decreases the effect of leukotrienes, which reduces airway inflammation and
bronchoconstriction.
S/E: Headache, increase liver enzymes (with zafirlukast and Zileuton)
Nurse: Take montelukast once daily in the evening or 2 hours before exercise (If taking
daily dose don’t take before exercise). Take zafirlukast without food.

lOMoARcPSD|23169440
Medication affecting Respiratory System

antitussives: opioids / non-opioids
Non-Opioids: Benzonatate (Tessalon), Dextromethorphan (Delsym), Diphenhydramine (Benadryl)
Opioids: Codeine, Hydrocodone
Benzonatate: Anesthetic effect on vagal nerve receptors in airways. S/E: Sedation, constipation,
GI upset
Dextromethorphan: Suppresses cough reflex in the medulla. S/E: Dizziness, sedation at high doses.
Codeine: Binds to opiate receptors in CNS. Decreases cough reflex. S/E: Sedation, respiration
depression, hypotension, constipation, GI upset
expectorants
Guaifenesin (Mucinex)
Use: non-productive cough associated with respiratory infections.
Action: Reduces the viscosity of secretions, making coughs more productive.
S/E: GI upset, dizziness
Nurse: Administer with a full glass of water.
mucolytics
Acetylcysteine (Acetadote, Mucomyst)
Use: Pulmonary disorders with thick mucous secretions (ex: cystic fibrosis).
Action: breaks molecules in the mucus, causing it to become less viscous.
S/E: Bronchospasm, nausea/vomit, rash
Nurse: Medication smells like rotten eggs. Use cautiously in patients with asthma.
@NursingStoreRN
Also used as antidote for acetaminophen overdose.
decongestants
Pseudoephedrine (Sudafed), phenylephrine, ephedrine, naphazoline
Use: for Rhinitis (nasal congestion).
Action: Causes vasoconstriction of respiratory tract mucosa.
S/E: Nervousness, palpitations, weakness, insomnia, rebound congestion.
Nurse: Use for short term therapy, no more than 3-5 days
Antihistamines
NursingStoreRN
1st Generation – diphenhydramine (Benadryl), promethazine, dimenhydrinate
2nd Generation – loratadine (Claritin), cetirizine (Zyrtec), Fexofenadine, Desloratadine
Intranasal: Azelastine, Olopatadine
Use: Used for allergic symptoms (rhinitis, itchy/watery eyes, sneezing), motion
sickness, urticaria., Insomnia.
Action: Inhibits H1 receptors, reducing the effect of histamine.
S/E: 1st gen: sedation, anticholinergic effects (dry mouth, constipation, urinary
retention, photosensitivity).
Nurse: Take at night. Take with meals for GI discomfort.

lOMoARcPSD|23169440
Medication affecting Cardiovascular System

Diuretics – High-Ceiling loop diuretics
furosemide (Lasix), Bumetanide, Ethacrynic Acid, Torsemide
Use: Pulmonary edema, edema (r/t heart failure, liver disease, kidney disease), hypertension.
Action: Blocks reabsorption of Na, Cl, and water in the ascending loop of Henle, causing rapid diuresis.
S/E: Dehydration, electrolyte imbalances (hypokalemia, hyponatremia), hypotension, ototoxicity,
hyperglycemia, rash.
Nurse: Administer bef 5pm if possible (to prevent disruption of sleep), infuse at 20mg/min, weigh
patient daily, monitor I&O, monitor electrolytes, encourage foods high in potassium (bananas, dark
leafy greens, potatoes, cantaloupe, avocado, tomatoes).
Diuretics – thiazide diuretics

hydrochlorothiazide (Microzide), Methyclothiazide, Chlorothiazide
Use: Hypertension (often in combination with antihypertensive medication), edema (r/t
heart failure, liver disease, kidney disease).
Action: Blocks reabsorption of Na, Cl, and water at the early distal convoluted tubule.
S/E: Dehydration, hypokalemia, hyponatremia
Nurse: Administer in morning (to prevent disruption of sleep), weigh patient daily,
monitor I&O, monitor electrolytes, encourage foods high in potassium (bananas, dark
leafy greens, potatoes, cantaloupe, avocado, tomatoes).
Diuretics – potassium-sparing diuretics

spironolactone (Aldactone)
@NursingStoreRN
Use: Heart Failure, hypertension. Contraindicated in patients with severe kidney
failure.
Action: Blocks aldosterone, promoting excretion of sodium and water, but retention
of potassium.
S/E: Hyperkalemia, amenorrhea, gynecomastia, impotence.
Nurse: Monitor K levels, teach patients to avoid salt substitutes containing
potassium.
Diuretics – Osmotic diuretics

mannitol (Osmitrol)
Use: Edema, increased intracranial pressure (ICP), increased intraocular pressure (IOP).
Action: It Reduces ICP and IOP by increasing serum osmolality, which draws fluid back
into the interstitial fluid and plasma.
S/E: Heart failure, pulmonary edema, renal failure, dehydration, electrolyte imbalances
(Na, K), phlebitis.
Nurse: Monitor weight, I&O, electrolytes. ICP: 10-15 mmHg. IOP: 10-21 mmHg
NursingStoreRN
13
lOMoARcPSD|23169440

Meds for BP – Angiotensin-Converting Enzyme Inhibitor
captopril (Capoten), lisinopril (Prinivil, Zestril), Enalapril, Benazepril, Fosinopril
Use: Hypertension, heart failure, MI, diabetic nephropathy.
Action: It blocks conversion of angiotensin I to angiotensin II, causing
vasodilation.
S/E: Hypotension, Angioedema, Cough, Elevated Potassium, rash, altered taste
Nurse: Monitor BP, teach patient to change position slowly.
Meds for BP – Angiotensin II receptor blockers

losartan (Cozaar), valsartan (Diovan), Irbesartan, Olmesartan, Telmisartan
Use: Hypertension, diabetic nephropathy.
Note: It blocks action of angiotensin II, resulting in vasodilation.
S/E: Hypotension, dizziness, GI upset
Nurse: Monitor BP, teach patient to change position slowly
Meds for BP – aldosterone antagonists

eplerenone (Inspra); spironolactone
Use: Hypertension, heart failure (post-MI), Pre-Menstrual syndrome, acne in female.
Action: Reduce blood volume by blocking aldosterone receptors in the kidneys (excrete
Na and H2O, and retention of potassium.
S/E: Hyperkalemia, dizziness @NursingStoreRN
Nurse: Monitor BP and potassium levels during therapy.
Meds for BP – direct renin inhibitor

Aliskiren (Tekturna)
Use: Use for Hypertension.
Action: Inhibits renin, which prevents angiotensinogen from being activated.
S/E: Hypotension, angioedema, GI upset.
Nurse: Monitor BP during therapy.
Meds for BP – calcium channel blockers

nifedipine (Procardia), verapamil (Calan), diltiazem (Cardizem), Nicardipine, amlodipine
Use: Hypertension, angina, pre-term labor (nifedipine). Diltiazem-Cardiac dysrhythmias.
Action: Blocks calcium channel in blood vessels and heart, leading to vasodilation, decreased
HR and BP.
S/E: Peripheral edema, hypotension, bradycardia, headache, constipation.
Nurse: NO grapefruit juice, monitor BP and HR carefully. Admin diuretic for Edema.
Diltiazem can Increase Digoxin. Monitor levels and HR
Meds for BP – Alpha adrenergic blockers

Prazosin (Minipress), Doxazosin (Cardura), Terazosin (Hytrin)
Use: Hypertension. Doxazosin & Terazosin used for Benign Prostatic Hyperplasia
Action: Selective alpha1 blockage (venous/artery dilation, smooth muscle relaxation)
S/E: drowsiness, dry mouth, rebound Hypertension if stopped abruptly, Hypotension.
Nurse: Don’t stop abruptly (gradually over 2-4 days). Monitor BP

lOMoARcPSD|23169440

Meds for BP – Centrally acting alpha2 agonists
clonidine (Catapres), Guanfacine, Methyldopa
Use: Hypertension, Management ADHD, Severe Cancer Pain.
Action: It decreases sympathetic outflow to heart and blood
S/E: Dizziness, Drowsiness, Dry mouth
Nurse: Don’t stop abruptly (gradually over 2-4 days). Monitor BP
Medication for Hypertensive crisis

nitroprusside (Nitropress)
Use: Hypertensive crisis.
Action: Causes direct vasodilation of arteries and veins, rapidly decreasing BP
(preload and afterload).
S/E: Hypotension, dizziness, GI upset, cyanide toxicity, thiocyanate toxicity
Nurse: For severe hypotension, elevate the patient’s legs, decrease the dose, and
increase fluids per facility policy.
NursingStoreRN
Beta Blockers – Beta 1

metoprolol (Lopressor), atenolol (Tenormin), Esmolol
Use: Hypertension, angina, heart failure, MI.@NursingStoreRN
Action: It blocks beta 1 (heart) receptors. Decreases BP and HR.
S/E: Bradycardia, hypotension, fatigue, erectile dysfunction
Nurse: Monitor BP and pulse during therapy. It may mask signs of hypoglycemia
Beta Blockers – Nonselective (1-2 – Heart and Lungs)

propranolol (Inderal), labetalol, carvedilol (Coreg), Nadolol (Corgard)
Use: Hypertension, angina, arrhythmias, MI.
Action: It blocks beta 1(heart), and beta2(lungs) receptors. Decreases BP and HR.
S/E: Bronchospasm, fatigue, hypotension, bradycardia, erectile dysfunction.
Nurse: DO NOT USE in patients with asthma.
Organic Nitrates – Antianginal Drugs

nitroglycerin, isosorbide mononitrate (IMDUR) - sublingual
Use: Angina
Action: It causes Vasodilation, decreases preload and myocardial oxygen demand.
S/E: Orthostatic hypotension, headache, reflex tachycardia
Nurse: Store in cool/dark place. Take up to 3 tablets. Place 1st under tongue,
wait 5 min. If no relief, call 911. Take 2nd, wait 5 min. If no relief, take 3rd.
Topical: wear gloves, remove prior dose, rotate sites, place on hairless site.

lOMoARcPSD|23169440

cardiac glycosides NursingStoreRN
digoxin (Lanoxin)
Use: HEAR FAILURE, atrial fibrillation, atrial flutter.
Action: It causes Positive inotropic effect (increased force and efficiency of heart contractions)
and negative chronotropic effect (decreased HR).
S/E: Dysrhythmias, Bradycardia, digoxin toxicity (GI upset, fatigue/weakness, vision changes)
Nurse: CHECK pulse before administration (don’t administer if <60 bpm). Monitor digoxin levels
during therapy (therapeutic range: 0.5-2 ng/mL). Hypokalemia increases risk of digoxin toxicity.
Treat bradycardia with atropine, and toxicity with digoxin immune Fab (Digibind)
antidysrhythmic medication
Class I - procainamide, lidocaine (Xylocaine), Propafenone
Use: Ventricular dysrhythmias and supraventricular tachycardia.
Action: It’s a Sodium Channel Blocker, slow cardiac conduction velocity.
S/E: Hypotension, dysrhythmias, lupus, leukopenia, thrombocytopenia
Nurse: Monitor EKG, V/S, CBC levels. Therapeutic procainamide: 4-8 mcg/mL
Class II - propranolol (Inderal), metoprolol, atenolol, Esmolol, Acebutolol

Use: Atrial fibrillation, atrial flutter, ventricular dysrhythmias, hypertension, angina.
Action: Beta adrenergic blockers prevent sympathetic nervous system stimulation of heart.
S/E: Hypotension, bradycardia, fatigue, weakness, erectile dysfunction. Bronchospasm with
non-selective beta blockers (propranolol). @NursingStoreRN
Nurse: DO NOT USE non-selective beta blockers in patients with Asthma.
Class III – amiodarone, sotalol, ibutilide, dofetilide, dronedarone

Use: severe dysrhythmias.
Action: Potassium channel blocker.
S/E: hypotension, bradycardia, pulmonary toxicity, liver toxicity, thyroid dysfunction.
Nurse: NO grapefruit juice
Class IV - verapamil (Calan), diltiazem (Cardizem)

Use: Atrial Fibrillation, atrial flutter, supraventricular tachycardia, hypertension, angina.
Action: Calcium Channel Blocker.
S/E: Peripheral edema, hypotension, bradycardia, headache, constipation
Nurse: Monitor EKG and V/S. Teach patient to change positions slowly.
Class V - adenosine (Adenocard, Adenoscan)

Use: Supraventricular tachycardia.
Action: It decreases conduction time through AV node.
S/E: Arrythmias, shortness of breath, hypotension
Nurse: Monitor EKG rhythm. Teach patient to change position slowly.

16
lOMoARcPSD|23169440

adrenergic agonists - Catecholamines
epinephrine (Adrenalin, EpiPen)
Use: Anaphylactic Shock, Increase Heart Rate, Treatment of AV Block, Heart Failure, Shock,
and Cardiac Arrest.
Action: Vasoconstriction, Bronchodilation (stimulates alpha 1 sites (causing vasoconstriction),
beta 1 receptors (causing increased HR), beta 2 receptors (causing bronchodilation).
S/E: Hypertension, dysrhythmias, angina, nervousness, tremor
Nurse: Monitor V/S, EKG. When given for shock, correct hypovolemia FIRST before using
vasopressors.
norepinephrine (Levophed)
Use: for Shock, severe hypotension.
Action: It stimulates alpha 1 sites (causing vasoconstriction), beta 1 receptors (increases
cardiac output).
S/E: Hypertension, dysrhythmias
Nurse: Monitor V/S, EKG. When given for shock, correct hypovolemia FIRST before using
vasopressors.
dopamine (Intropin)
Use: Shock, Heart Failure, Acute Kidney Injury.
Action: It stimulates alpha 1 receptors (causing vasoconstriction), beta 1 receptors (causing
@NursingStoreRN
increased CO and HR), and dopaminergic receptors (causing increased renal perfusion).
S/E: Dysrhythmias, angina
Nurse: For hemodynamic shock, correct hypovolemia FIRST before using vasopressors.
dobutamine (Dobutrex)
Use: for Cardiogenic shock, heart failure.
Action: It stimulates beta 1 receptors (causing increased cardiac output).
S/E: Hypertension, dysrhythmias, angina
Nurse: Less effect on HR and BP. Monitor V/S, EKG, PAWP, CO, and CVP during therapy.
Epi 0.3mg Epi 0.15mg

for Adult & for Children
Children Weighing
Weighing 15-30 kg
>30 kg (33-66 lbs)
(>66 lbs)
NursingStoreRN
17
lOMoARcPSD|23169440

anticholinergic-antimuscarinic
atropine
Use: for Sinus bradycardia, heart block Used to decrease secretions during surgery.
Action: It inhibits ACh sites in the smooth muscles, secretory glands, and CNS. Decreases vagal
stimulation of the heart, which allows for an increase in heart rate.
S/E: Anticholinergic Side Effects (blurred vision, dry mouth, urinary retention, constipation,
tachycardia)
Nurse: Monitor urinary retention. Increase fluids and fiber intake to prevent constipation.
antilipemic agents – Cholesterol medication

HMG-CoA reductase Inhibitors (statins)
atorvastatin (Lipitor), simvastatin (Zocor), Lovastatin, Pravastatin, Fluvastatin
Use: for Hypercholesterolemia, prevention of coronary heart disease. Protects against MI.
Action: It decreases production of LDL, increases production of HDL.
S/E: Hepatotoxicity, GI upset, muscle pain, rhabdomyolysis
Nurse: Administer with EVENING meals (cholesterol is synthesized at night). Monitor liver
function and CK levels. Avoid alcohol. No grapefruit juice.
Cholesterol Absorption Inhibitor

ezetimibe (Zetia)
Use: Hypercholesterolemia
@NursingStoreRN
Action: It inhibits absorption of cholesterol in the small intestine.
S/E: Hepatotoxicity, Myopathy, muscle pain
Nurse: Monitor Liver function and CK levels.
Bile-Acid Sequestrants
colesevelam (Welchol), cholestyramine (Questran)
Use: for Hypercholesterolemia.
Action: It binds bile acids in intestine, causing increased excretions of cholesterol. Lowers LDL
cholesterol.
S/E: Constipation GI Upset
Nurse: Increase fiber intake and fluid intake. Take with food and a full glass of water.
Interferes with absorption of fat-soluble vit (ADEK)
Fibrates
gemfibrozil (Lopid), fenofibrate (Lipidil)
Action: It decreases triglyceride production and transport. Increases HDL levels.
S/E: GI upset, gallstones, hepatotoxicity, muscle pain
Nurse: Give 30 min bef breakfast and dinner. Monitor liver function
Vitamin B3
niacin (Vit B3)
Action: It decreases lipoprotein and triglyceride synthesis (in large doses).
S/E: Flushing of the face, GI upset, pruritis, hepatotoxicity, hyperglycemia.
Nurse: Monitor Liver function. Use cautiously in patient with diabetes
NursingStoreRN
lOMoARcPSD|23169440
Medication affecting BLOOD / Coagulation

anticoagulants – IV / Sq
IV/SQ: heparin
SQ (low molecular weight heparin): enoxaparin (Lovenox), Dalteparin
Use: for Stroke, DVT, PE, and other thromboembolic disorders requiring fast anticoagulants.
Action: It activates antithrombin, inhibit thrombus formation. Prevents new clots, does NOT
break up existing clots.
S/E: Bleeding, Heparin-Induced Thrombocytopenia, hypersensitivity
Nurse: Monitor aPTT. Therapeutic aPTT: 1.5-2 times baseline.
Antidote: Protamine. Monitor for bleeding (coffee ground emesis, tarry stools)
anticoagulants – oral (Vit K Inhibitor)

warfarin (Coumadin)
Use: Prevention and treatment of thromboembolic disorders (DVT, PE, AFIB with thrombus).
Preventions of complications following a MI.
Action: It antagonizes Vit K, which prevents formation of several clotting factors.
S/E: Bleeding, GI Upset, hepatitis
Nurse: Monitor PT/INR. Therapeutic INR: 2-3 (it takes 3-5 days to get to therapeutic level).
Antidote: Vit K
Direct thrombin Inhibitor

@NursingStoreRN
dabigatran (Pradaxa), argatroban, Bivalirudin, desirudin
Use: Prevention and Treatment of Thrombosis (DVT), prevent strokes or embolisms.
Action: It blocks thrombin receptors, which prevents the activation of clotting factors
and decreases thrombus (clot) formation.
S/E: Argatroban: Bleeding, hypotension. Dabigatran: Bleeding, GI upset, angioedema
Nurse: Assess for bleeding
Direct inhibitor of factor Xa

rivaroxaban (Xarelto), apixaban (Eliquis)
Use: Prevention of Stroke, DVT, PE. Treatment of DVT or PE.
Action: Inhibits factor Xa to prevent formation of thrombin.
S/E: Bleeding, elevated liver enzymes (ALT, AST, GGt).
Nurse: Monitor liver function, hemoglobin, and hematocrit during therapy.
antiplatelets NursingStoreRN
clopidogrel (Plavix), abciximab (Reopro), Ticagrelor, Dipyridamole,
Aspirin  Pain/Inflammation Section
Use: Prevention MI, Ischemic Stroke or TIA, Intermittent Claudication.
Action: It inhibits platelet aggregation.
S/E: Clopidogrel: Bleeding, GI upset, rash. Abciximab: Bleeding, hypotension,
dysrhythmias.
Nurse: Assess for bleeding. Monitor EKG and V/S for abciximab.
19
lOMoARcPSD|23169440

thrombolytic medication
alteplase (Activase, tPA), streptokinase (Streptase), reteplase (Retavase)
Use: Treatment Acute MI, ischemic stroke, PE, and occluded central IVs.
Action: It converts plasminogen to plasmin, which breaks up fibrinogen.
S/E: Bleeding. Contraindicated in patients who have had a hemorrhagic
stroke, internal bleeding, recent trauma/surgery, severe hypertension.
Nurse: For an ischemic stroke, administer within 3 hours of symptoms.
Monitor labs and VS. Limit venipunctures and IM injections.
fibrinolysis inhibitor
aminocaproic acid
Use: for Hemorrhage.
Action: It inhibits the activation of plasminogen, which inhibits fibrinolysis
and enables clot formation.
S/E: GI upset, hypotension
Nurse: Assess for bleeding or thromboembolism (hypercoagulation is a risk).
erythropoietic growth factor

epoetin alfa: erythropoietin, darbepoetin alfa (long-acting)
Use: for Anemia r/t chronic kidney disease, HIV, chemotherapy.
Action: It stimulates bone marrow to increase production of red blood cells.
S/E: Hypertension (due to increase in Hct). Increased risk of DVT, stroke, MI
and seizures. @NursingStoreRN
Nurse: DO NOT agitate vial. Monitor BP and Hgb/Hct during therapy.
Ensure sufficient Iron levels. IV or SQ bolus injection.
leukopoietic growth factor

filgrastim (Neupogen), Pegfilgrastin
Use: Decreases risk of infection in Neutropenia (cancer, chemo, other
conditions)
Action: It causes bone marrow to increase production of neutrophils.
S/E: Bone pain, leukocytosis (high WBC levels), splenomegaly.
Nurse: DO NOT agitate vial. Monitor CBC twice a week.
colloid
albumin
Use: Hypovolemia, Shock, hemorrhage, burns, hemolytic disease in newborn.
Action: Expands circulating blood volume by exerting oncotic pressure.
S/E: circulatory overload, pulmonary edema, hypertension, sepsis,
hyperkalemia.
Nurse: Assess for signs of fluid overload. Contraindicated for HF patients.
NursingStoreRN
20
lOMoARcPSD|23169440

blood products
Whole Blood
Use: Replacement therapy for acute blood loss, volume expansion
Action: Increases circulating blood volume.
S/E: Acute Hemolytic Reaction, Anaphylactic, Hyperkalemia, Sepsis, Circulatory
Overload.
Nurse: Assess VS during first 15-30 min (stay with patient). Administer
Acetaminophen for Fever. If reactions, STOP transfusion. Have Epinephrine
ready for IM or IV Injection. Check K Levels (K: 3.5-5)
Packed Red Blood Cells (PRBCs)

Use: Severe Anemia, Hemoglobinopathies, Erythroblastosis fetalis.
Action: Increases the number of RBCs.
S/E: Acute Hemolytic Reaction, Anaphylactic, Hyperkalemia, Sepsis
Platelet Concentrate
Use: Thrombocytopenia (<20,000/mm3), Active Bleeding
Action: Increases platelet count
S/E: Febrile nonhemolytic reaction, Mild allergy, sepsis
@NursingStoreRN
Fresh Frozen Plasma (FFP)
Use: Active bleeding, extensive burns, shock, DIC, Antithrombin III deficiency,
Reversal anticoagulation effects of Warfarin.
Action: Replaces coagulation factors
S/E: Acute hemolytic reaction, Febrile nonhemolytic reaction, anaphylactic,
circulatory overload, sepsis.
Apheresed Granulocytes
Use: Severe neutropenia, Life/threatening bacterial/fungal infection, neonatal
sepsis Neutrophil dysfunction.
Action: Replaces neutrophils/granulocytes
S/S: Acute hemolytic reaction, Febrile nonhemolytic reaction, anaphylactic,
circulatory overload, sepsis.
NursingStoreRN
21
lOMoARcPSD|23169440
Vitamins and Minerals

magnesium
magnesium chloride, magnesium gluconate, magnesium oxide
Use: for Hypomagnesemia, stop preterm labor, anticonvulsant during labor.
Action: Plays a role in regulating skeletal muscle contractility and blood coagulation.
S/E: Diarrhea
Nurse: Monitor for signs of magnesium toxicity (decreased Deep Tendon Reflexes, urine
output <30ml/hr, respiratory depression, hypotension).
Antidote: calcium gluconate.
iron
PO: ferrous sulfate. IV/IM: iron dextran
Use: for Iron Deficiency Anemia.
Action: It is an essential component of hemoglobin, myoglobin, and many enzymes.
S/E: Oral: GI upset, constipation, teeth staining (drink with straw), dark green/black
stools (harmless). IM/IV: Staining at IV site, hypotension, flushing
Nurse: Vit C increases absorption. Take on empty stomach, 1hr before or 2hrs after meals.
Increase fiber and fluid intake to prevent constipation. If giving IM iron dextran, use Z-
track method. Encourage increased intake of foods high in Iron.
Vit b12 - cyanocobalamin

cyanocobalamin (Vit B12)
Use: for Pernicious Anemia.
Action: Synthetic form of B12, which is needed for RBC production.
S/E: Hypokalemia, GI upset, hypersensitivity@NursingStoreRN
Nurse: Use nasal spray for malabsorption due to lack of intrinsic factor. Higher dose of
folic acid can mask a B12 deficiency, leading to deterioration in cognitive functions.
Vegetarians are at risk for B9 and B12 deficiency.
folic acid
folic acid (Folate, Vit B9)
Use: for Megaloblastic and macrocytic anemia. In pregnancy to prevent neural tube defects.
Action: It stimulates the production of RBCs, WBCs, and platelets.
S/E: Rash, change in urine color (more intensely yellow)
calcium
calcium citrate, calcium carbonate, calcium acetate, calcium chloride (IV)
Use: Maintenance of musculoskeletal, neurologic, and cardiovascular function.
calcium carbonate and citrate: for Hypocalcemia, prevention of post-menopausal
osteoporosis.
calcium gluconate: Emergency treatment of hyperkalemia and hypermagnesemia
S/E: Hypercalcemia
Nurse: Monitor Calcium levels (9 - 10.5mg/dL).
potassium
potassium chloride
Use: for Hypokalemia.
Action: It’s a key electrolyte needed for maintenance of ICF, nerve function, and
regulation of muscle and heart contraction.
S/E: Arrhythmias, weakness. IV: Irritation at IV site. PO: GI upset
Nurse: K: 3.5-5 mEq/L
lOMoARcPSD|23169440
Medication affecting Endocrine System

insulin
Rapid – Short – Intermediate – Long Acting
Rapid-Acting: Lispro Insulin (Humalog), Aspart (Novolog), Glulisine, Inhaled Human Insulin
Onset: 15min, Peak: 1hr, Duration: 3-6hrs
Shor-Acting: Regular insulin (Humulin R, Novolin R).
Onset: 30min, Peak: 2-3hrs, Duration: 6-10hrs
Intermediate-Acting: NPH (Humulin N, Novolin N)
Onset: 2-4hrs, Peak: 4-12hrs, Duration: 16-24hrs
Long-Acting: Insulin glargine (Lantus), insulin detemir (Levemir)
Onset:2-3hrs, Peak: None, Duration: 24hrs
Nurse: Rotate injection sites to prevent lipohypertrophy. Monitor for Hypoglycemia
(tachycardia, diaphoresis, shakiness, headache, weakness)
NursingStoreRN
@NursingStoreRN
23
lOMoARcPSD|23169440

oral antidiabetics NursingStoreRN
Sulfonylureas
glipizide (Glucotrol), glyburide (Diabeta), Chlorpropamide
Use: for Type 2 Diabetes, used to control blood sugar levels.
Action: It Increases Insulin release from Pancreas.
S/E: Hypoglycemia, photosensitivity, GI upset
Nurse: Take 30 min before a meal. Do NOT use alcohol. Wear sunscreen
Meglitinides
repaglinide (Prandin), Nateglinide
Use: for Type 2 Diabetes.
Action: It increases Insulin release from Pancreas.
S/E: Hypoglycemia, angina
Nurse: Take 3 times a day, eat within 30 min of dose.
Biguanides
metformin (Glucophage)
Use: for Type 2 Diabetes.
Action: It Decreases glucose production in liver and increases glucose uptake.
S/E: GI upset, metallic taste, lactic acidosis, and B12 deficiency.
Nurse: Take with meal. Take B12 supplements if indicated. D/C metformin for procedures
requiring NPO or contrast dye. Monitor for signs of lactic acidosis (diarrhea, dizziness,
hypotension, bradycardia, weakness).
Thiazolidinediones @NursingStoreRN
pioglitazone (Actos), Rosiglitazone
Use: for Type 2 diabetes.
Action: It decreases insulin resistance and glucose production. Increases glucose uptake.
S/E: Fluid retention, elevated LDL, hepatotoxicity
Nurse: Contraindicated for patients with heart failure. Take once a day, with or without food.
Alpha-Glucosidase Inhibitor
acarbose (Precose), Miglitol
Use: for Type 2 diabetes.
Action: Slows carbohydrate absorption and digestion.
S/E: GI upset, hepatotoxicity, anemia
Nurse: It is Contraindicated for patients with GI disorders. Take 3 times a day with meals,
with the 1st bite of food.
hyperglycemic meds
glucagon (GlucaGen)
Use: for emergency hypoglycemia when patient is unable to take oral glucose. Decrease
GI motility for patients with radiological procedures.
Action: It Increases breakdown of glycogen into glucose, increasing blood glucose levels.
S/E: GI upset.
Nurse: Administer SQ, IM, or IV. Provide food as soon as patient is able to safely
swallow.

lOMoARcPSD|23169440

thyroid hormone
levothyroxine (Synthroid, T4), liothyronine (Cytomel), Liotrix, Thyroid USP
Use: for Hypothyroidism, myxedema coma.
Action: It Acts as a synthetic form of thyroid hormones.
S/E: When dose is too high, hyperthyroidism (anxiety, GI upset, sweating, weight loss, heat
intolerance)
Nurse: Monitor T4 and TSH levels. Take on empty stomach with a full glass of water before
breakfast. Requires lifelong treatment
antithyroid - thionamides
Methimazole (Tapazole), propylthiouracil (PTU)
Use: for Grave’s disease, and in preparation for a thyroidectomy, emergency treatment of
thyrotoxicosis.
Action: It Blocks synthesis of thyroid hormones.
S/E: Agranulocytosis, GI upset, rash, hepatotoxicity. When dose is too high, hypothyroidism
(lethargy, weight gain, cold intolerance, bradycardia, depression)
Nurse: Monitor CBC levels and liver function.
antithyroid - Iodine
strong iodine solution (Lugol’s solution), Sodium Iodide, Potassium Iodide
Use: for Hyperthyroidism, thyrotoxicosis, preparation for thyroidectomy.
Action: It is Absorbed by thyroid gland. Inhibits thyroid hormone production and release.
S/E: GI upset, hypothyroidism, iodism (metallic@NursingStoreRN
taste, stomatitis, severe GI upset),
hypersensitivity (rash, pruritis)
Nurse: Increase fluid Intake. Radioactive iodine can also be used, which can cause radiation
sickness; contact with others should be limited.
Anterior pituitary hormone – growth hormone

somatropin (Genotropin)
Use: for Growth Hormone Deficiencies (pediatric and adult).
Action: It is Similar to naturally occurring GH, it stimulates growth, protein synthesis.
S/E: Hyperglycemia (polyuria, polyphagia, polydipsia), pancreatitis,
Nurse: Administer via IM or SQ, rotate injection sites. STOP treatment prior to
epiphyseal closure. Monitor growth rate and bone age frequently. Instruct patient to
report persistent, severe abdominal pain.
antidiuretic hormone
vasopressin (Vasostrict), desmopressin (DDAVP)
Use: for Diabetes Insipidus.
Action: It Mimics ADH (produced by the posterior pituitary), which causes reabsorption of
water in the kidneys.
S/E: Overhydration (pounding headache)
Nurse: Monitor I&O, urine specific gravity. Normal urine output is 0.5 to 1.5 ml/kg/hr
NursingStoreRN
25
lOMoARcPSD|23169440

adrenal hormone replacement
hydrocortisone, prednisone, methylprednisolone, dexamethasone (Decadron)
Route: Oral, IV
Use: cancer, allergic reactions, asthma, autoimmune disorders, inflammatory disorders.
Action: Mimic the effect of natural steroids hormones.
S/E: Osteoporosis, weight gain/fluid retention, hyperglycemia, hypokalemia, infection, peptic
ulcer disease, adrenal suppression, skin fragility, GI distress.
Nurse: Monitor for Sings of Infection and peptic ulcer disease (coffee ground emesis, tarry
stool). Periods of stress may require additional doses. Do not stop suddenly (must taper slowly).
Take Vit D and Calcium supplements. Avoid NSAIDs.
mineralocorticoid
fludrocortisone (Florinef) @NursingStoreRN
Use: for Adrenocortical Insufficiency (Addison’s Disease).
Action: It Mimics aldosterone, which causes sodium and water reabsorption in the kidneys. This
allows for maintenance of BP and Sodium balance in patients with adrenocortical insufficiency.
It is often used in combination with a glucocorticoid for Addison’s Disease.
S/E: Hypertension, edema, bone loss, hyperglycemia, hypokalemia, infection, peptic ulcer disease,
adrenal gland suppression, skin fragility, GI upset.
Nurse: Abrupt discontinuation may cause an Addisonian Crisis.
Hyperpituitarism Medication
Octreotide, Lanreotide, Pegvisomant
Use: Gigantism in children, acromegaly in adults.
Action: Suppresses growth hormone release.
S/E: GI distress, Hypo/Hyperglycemia. for Pegvisomant: Liver injury, Chest pain, Flu-like
symptoms
Nurse: Give injection with food or at bedtime. Monitor glucose. Monitor liver function.
NursingStoreRN
26
lOMoARcPSD|23169440
Medication affecting Gastrointestinal System

Antibiotics
Amoxicillin, Bismuth, Clarithromycin, Metronidazole, Tetracycline, Tinidazole
Use: for H. pylori bacteria
Action: sometimes include combination or 2 or 3 antibiotics for 14 days
S/E: GI distress
Nurse: Administer with food. Continue full course of antibiotics
histamine2-receptor antagonist
ranitidine (Zantac), famotidine (Pepcid), Cimetidine, Nizatidine
Use: for Duodenal and gastric ulcers, GERD, Zollinger-Ellison syndrome.
Action: It blocks H2 receptors in stomach, reducing gastric acid secretion.
S/E: Headache, GI upset
Nurse: Administer with meals and at bedtime.
proton pump inhibitor

omeprazole (Prilosec), pantoprazole (Protonix), Lansoprazole, Rabeprazole, Esomeprazole
Use: for Duodenal and gastric ulcers, GERD, Zollinger-Ellison syndrome.
Action: It Inhibits an enzyme needed for gastric acid secretion.
S/E: GI upset, C. Diff, bone fractures (with long-term use)
Nurse: Monitor for diarrhea, cramping, bloody stools.
@NursingStoreRN
mucosal protectant
sucralfate (Carafate)
Use: for Duodenal Ulcers.
Action: It Reacts with stomach acid to form a thick paste that adheres to ulcers (up to 6 hrs)
S/E: Constipation
Nurse: Take 1 hour before meals and at bedtime (4 times a day). Increase intake of fluids and fiber
antacids
aluminum hydroxide (Amphojel), Magnesium hydroxide (Milk of Magnesia), Calcium carbonate (TUMS)
Use: for Peptic Ulcer Disease, GERD, lowers phosphate levels with chronic kidney disease.
Action: It neutralizes stomach acid. Binds to phosphate in the stomach.
S/E: Constipation
Note: Administer after meals and at bedtime. Take 1-2 hours before or after other medications.
prostaglandin e analog NursingStoreRN

misoprostol (Cytotec)
Use: for Preventions of gastric ulcers in patients taking NSAIDs. Also induces labor by ripening the cervix.
Action: It decreases stomach acid secretion, increases production of protective mucus and bicarbonate.
Causes uterine contractions.
S/E: Dysmenorrhea, miscarriage, GI upset
Nurse: Assess women of childbearing age for pregnancy before administration for ulcer prevention. It will
cause miscarriage. Contraindicated while lactating.

lOMoARcPSD|23169440

antiemetics
ondansetron (Zofran), promethazine (Phenergan), meclizine (Antivert), Scopolamine,
Metoclopramide, Dronabinol, Dimenhydrinate
Ondansetron:
Use: for Nausea and Vomit (from chemo, radiation, OR).
Action: It Blocks serotonin receptors in Chemoreceptors Trigger Zone.
S/E: Headache, constipation, diarrhea
Promethazine, Meclizine:
Use: for Nausea, Vomiting, motion sickness.
Action: It Blocks effects of histamine, anticholinergic activity.
S/E: Drowsiness, dry mouth
Metoclopramide:
Use: For emesis r/t chemo, toxins, and postop.
Action: Dopamine Antagonist
S/E: Extrapyramidal Symptoms, Hypotension, Sedation, Anticholinergic effect
Dronabinol:
Use: for chemo induced nausea/vomiting
S/E: Dysphoria, Hypotension, Tachycardia
Scopolamine, Dimenhydrinate
Use: Motion Sickness
Action: Blocks transmission of nerve impulses from the inner ear to the vomiting center.
S/E: Sedation, Anticholinergic effects (dry mouth, urinary retention, constipation)
NURSE: For chemotherapy, administer 1 hour @NursingStoreRN

BEFORE.
For Motion Sickness, apply patch behind ear 4 hours before travel, or take the tablet 1
hour before travel.
antidiarrheals
loperamide (Imodium), diphenoxylate + atropine (Lomotil)
loperamide:
Use: It Inhibits peristalsis and prolongs transit time, reduced fecal volume,
increases fecal bulk and viscosity. Decreases loss of electrolytes.
S/E: Constipation, drowsiness, dry mouth
diphenoxylate + atropine:
Use: It Reduces GI motility.
S/E: Constipation, dizziness, confusion, dry mouth
Nurse: For dry mouth, tell patient to suck on candy. Diphenoxylate/atropine
also carries a risk for dependence with prolonged use.
NursingStoreRN
28
lOMoARcPSD|23169440

laxatives NursingStoreRN
Bisacodyl (Dulcolax), Senna, Docusate Sodium, Psyllium (Metamucil), Magnesium Hydroxide,
Lactulose
Stimulant Laxatives: Bisacodyl, Senna

Use: for Constipation, bowel preparation before surgery/procedure.
Action: It stimulates bowel peristalsis, and increase vol of water and electrolytes in intestines
S/E: Cramping, nausea/vomiting
Nurse: Administer with a full glass of water. Increase fiber and fluid intake, increase mobility.
Bulk-Forming Laxatives: Psyllium

Use: for Constipation, prevention of straining, management of chronic watery diarrhea.
Action: It Combines with water in intestines to soften stool and increase bulk.
S/E: Mild cramping, nausea/vomiting
Nurse: Administer with a full glass of water, followed by another glass of water. Increase
fiver and fluid intake, and increase mobility.
Surfactant Laxatives: Docusate Sodium

Use: for Prevention of Constipation.
Action: It draws water into stool, resulting softer bowel movements.
S/E: Mild cramping, diarrhea
Nurse: Administer with a full glass of water. Increase fiber and fluid intake.
Increase mobility to promote regularity.
@NursingStoreRN
Osmotic Laxative: Magnesium Hydroxide, Lactulose
Use: for Constipation, bowel prep before surgery/procedure. Lactulose is also used for hepatic
encephalopathy (due to a build up of ammonia in the body).
Action: It draws water into intestine, promotes peristalsis. Lactulose lowers the pH in the
colon, which promotes ammonia excretion.
S/E: Cramping, bloating, diarrhea, hypermagnesemia (with magnesium hydroxide and
magnesium citrate).
Nurse: When using magnesium hydroxide or magnesium citrate, watch for signs of Mg toxicity.
medication for Irritable Bowel Syndrome (IBS)

alosetron (Lotronex), lubiprostone (Amitiza)
IBS with diarrhea - Alosetron

Use: It Blocks 5HT3 receptors, which increases firmness of stool and decreases urgency
S/E: Constipation
IBS with constipation - Lubiprostone

Use: Increases fluid secretion in intestine and intestinal motility.
S/E: Diarrhea, nausea, headache
Nurse: Take medication with food.
29
lOMoARcPSD|23169440

medication for Inflammatory Bowel Disease
sulfasalazine (Azulfidine)
Use: for IBS, Crohn’s disease, ulcerative colitis.
Action: It Inhibits prostaglandin synthesis, which decreases colon inflammation.
S/E: Blood dyscrasias (anemia, agranulocytosis), GI upset, rash, headache, crystalluria,
fever.
Nurse: Monitor CBC. May cause orange-yellow discoloration of urine/skin.
Antiflatulent
simethicone (Gas-X)
Use: for Relief of painful gas in the GI tract.
Action: It causes the coalescence (merging) of gas bubbles.
S/E: No significant side effects
Nurse: Administer after meals and at bedtime.
pancreatic enzymes
pancrelipase (Creon, Pancreaze)
Use: for Pancreatic Insufficiency r/t pancreatitis, cystic fibrosis, GI bypass surgery.
Action: It contains lipase, amylase, and protease which facilitate the digestion of fat,
carbohydrates, and proteins in the GI tract.
S/E: Diarrhea, nausea, cramps
@NursingStoreRN
Nurse: Administer immediately before or with meals and snacks. Swallow pills whole
(do not crush). If pill is difficult to swallow, may open pill and sprinkle on applesauce
(acidic food).
NursingStoreRN
30
lOMoARcPSD|23169440
Medication affecting the Immune System

Chemo Agents - Antimetabolites
methotrexate (Rheumatrex)
Use: Cancers, Rheumatoid Arthritis, Psoriasis, Crohn’s Disease.
Action: It Inhibits folic acid metabolism, which prevents cell replication. This causes death of
rapidly replicating cells. Also has an immunosuppressive effect.
S/E: Infections, hepatotoxicity, bone marrow suppression, GI upset, stomatitis.
Nurse: Notify provider right away for any signs of infection. Monitor liver function, CBC levels.
immunosuppressant – polypeptide
cyclosporine (Sandimmune)
Use: for Prevention of organ rejection in transplant patients, ulcerative colitis, rheumatoid
arthritis.
Action: It Inhibits normal immune response by blocking interleukin-2
S/E: Infections, hepatotoxicity, nephrotoxicity, GI upset, hirsutism, hypertension, tremor.
Nurse: Notify provider right away for any signs of infection. Monitor liver function, renal function.
antirheumatic – antimalarial
hydroxychloroquine (Plaquenil)
Use: for Rheumatoid Arthritis, lupus, and malaria.
Action: It Inhibits protein synthesis in susceptible organism, including plasmodia that cause
malaria. Also reduced inflammation.
@NursingStoreRN
S/E: GI upset, vision changes, seizures, agranulocytosis
Nurse: Monitor CBC levels during therapy. Take with meals to decrease GI upset.
antitumor – anthracyclines
doxorubicin (Adriamycin)
Use: for Solid tumors.
Action: It Binds to DNA, inhibit DNA and RNA synthesis. Causes death of rapidly replicating cells.
S/E: red discoloration of urine/sweat/tears. GI upset, alopecia, bone marrow suppression (anemia,
neutropenia, thrombocytopenia), cardiac toxicity
Nurse: Monitor for infection, administer antiemetics for nausea/vomiting, monitor cardiac function,
monitor CBC levels.
antimitotic – vinca alkaloids

vincristine
Use: Tumor and Cancers
Action: It Stops cell division during mitosis (M phase specific). Does NOT cause bone
marrow suppression.
S/E: Nerve Injury, phlebitis (IV site), GI upset, alopecia
Nurse: Administer antiemetics for nausea/vomiting, monitor for signs of neuropathy, use
central line for infusion.
NursingStoreRN
31
lOMoARcPSD|23169440
Medication affecting the Immune System

antineoplastic – alkylating agents
cyclophosphamide (Cytoxan), Melphalan, Bendamustine
Use: Broad Spectrum of neoplastic diseases (lymphomas, solid tumors, myelomas)
Action: It Inhibits protein synthesis by interfering with DNA and RNA synthesis.
S/E: Bone Marrow Suppression (anemia, leukopenia, thrombocytopenia), GI upset,
hemorrhagic cystitis, alopecia
Nurse: Increase fluid intake to 2-3L/day during therapy, monitor for blood in urine.
Monitor CBC levels. Give antiemetics for nausea/vomiting. Wear gloves when handling, and
wash hands immediately after handling.
prostate cancer medication

leuprolide (Lupron), Triptorelin, Goserelin, Histrelin
Use: for Prostate Cancer, endometriosis.
Action: It Acts as a synthetic form of LHRH (luteinizing hormone releasing hormone).
Decreases level of testosterone in testes. Reduces pain and lesions in endometriosis.
S/E: Hot flashes, gynecomastia, bone pain, decreased libido, GI upset, dysrhythmias.
Nurse: Increase calcium and Vit D intake. Monitor PSA (PSA : <4ng/mL) and testosterone
levels during therapy.
breast cancer medication

tamoxifen (Nolvadex)
Use: for Prevention and treatment of breast @NursingStoreRN
cancer.
Action: It Competes with estrogen for binding sites in breast, stopping growth of
estrogen/dependent cancer.
S/E: Hot flashes, vaginal bleeding, increased risk of thromboembolism (PE, DVT, stroke),
hypercalcemia, bone pain, increased risk of uterine and endometrial cancer.
Nurse: Monitor CBC and calcium levels during therapy. Advise patient to report bone pain.
biologic response modifier

interferon alpha-2b (Intron A), Aldesleukin (Proleukin®)
Use: for Cancer and Viral Infections (ex: hepatitis).
Action: Increases immune response and decreases production of cancer cells.
S/E: Flu-like symptoms (fever, muscle aches, chills, lethargy), bone marrow suppression,
cardiotoxicity, hepatotoxicity, dyspnea, alopecia, GI upset, psychiatric disorders.
Nurse: Monitor CBC levels, cardiac function (EKG), liver function throughout therapy.
Monitor for infection, bleeding.
NursingStoreRN
32
lOMoARcPSD|23169440
Medication affecting the Reproductive System
estrogens
conjugated estrogen (Premarin), estradiol (Estrace), Estradiol Hemyhydrate
Use: Contraception (along with progestins), Acne in females, postmenopausal symptoms
(hot flashes, mood changes), postmenopausal osteoporosis, dysmenorrhea (combination
estrogen/progesterone), prostate cancer.
Action: It Binds to estrogen receptors, promoting growth and development of female sex
organs and secondary sex characteristics in women.
S/E: Embolic events (DVT, PE, MI, stroke), hypertension, weight gain, edema, increased
risk of some cancers.
Nurse: Contraindicated in patients who smoke, have hypertension, have a high risk for
embolic events, or have estrogen-dependent cancer.
progesterone
medroxyprogesterone (Depo-Provera), norethindrone, Megestrol Acetate
Use: for Contraception (alone or with estrogens), dysmenorrhea, endometriosis,
endometrium cancer, prevention Preterm Birth.
Action: It Inhibits gonadotropin production, preventing follicular maturation and
ovulation.
S/E: Embolic events (DVT, PE, MI, stroke), menstrual changes, edema, increase risk of
breast cancer. Bone loss with injectable medroxyprogesterone.
Nurse: Contraindicated in patients who are at high risk for embolic events. With injectable
medroxyprogesterone, advise patient to take Calcium and Vit D supplements to reduce
bone loss. @NursingStoreRN
androgen
testosterone, Methyltestosterone
Use: Hypogonadism, delayed puberty in males, anemia, muscle wasting in AIDS,
postmenopausal breast cancer.
Action: It Promotes development of male sex organs and maintenance of male secondary
sex characteristics.
S/E: Acne, edema, liver dysfunction, polycythemia (increased in Hct and Hgb), premature
epiphyseal closure. In women, causes deepening of voice, baldness, hirsutism (male-
patterned hair growth in women)
Nurse: Contraindicated in patients with prostate cancer. High abuse potential.
5-alpha reductase inhibitor

finasteride (Propecia, Proscar)
Use: for Benign prostatic hyperplasia (BPH), baldness.
Action: It Inhibits 5-alpha-reductase, which prevents conversion of
testosterone. This results in reduced prostate size and increased hair growth.
S/E: Erectile dysfunction, gynecomastia
Nurse: Pregnant women should not handle this medication
NursingStoreRN
33
lOMoARcPSD|23169440
Medication affecting the Reproductive System

alpha1 adrenergic antagonists
tamsulosin (Flomax), doxazosin (Cardura), Terazosin, Alfuzosin
Use: Benign prostatic hyperplasia, baldness. Doxazosin is also used for hypertension.
Action: It Antagonizes alpha1 receptor in the prostate, which relaxes the smooth
muscles of the prostate. This results in improved urine flow.
S/E: Hypotension, dizziness, headache, issues with ejaculation.
Nurse: Take at the same time every day. Monitor BP.
erectile dysfunction – phosphodiesterase type 5 inhibitor

sildenafil (Viagra), tadalafil (Cialis)
Use: Erectile Dysfunction. Also used for pulmonary hypertension.
Action: It Enhances the effect of nitric oxide released during sexual stimulation, resulting
in increased blood flow to the corpus cavernosum. Vasodilation of pulmonary vasculature.
S/E: Priapism (prolonged erection), MI
Nurse:DO NOT take with other nitrates (such as nitroglycerin). Use cautiously in men
with cardiovascular disease.
medication affecting labor

Uterine Stimulant: Oxytocic
oxytocin (Pitocin), methylergonovine (Methergine), Misoprostol, Dinoprostone
Oxytocin:
@NursingStoreRN
Use: for Induction or enhancement of labor, placenta delivery, postpartum hemorrhage.
Action: It is a Uterine stimulant.
S/E: Painful contractions, uterine rupture, water intoxication.
Nurse: Closely monitor contractions (normal: 60-90 seconds in duration, every 2-3 min) and
maternal/fetal BP and pulse. Magnesium sulfate can be used to relax the uterus.
Methylergonovine:
Use: for Postpartum hemorrhage.
Action: It is a uterine stimulant
S/E: Hypertension, abdominal pain, nausea and vomiting
Dinoprostone, Misoprostol:
Use: Promote cervical ripening and stimulate uterine contractions
S/E: GI reactions, cervical/uterine lacerations, uterine tachysystole
Nurse: Assess fetal status, Monitor V/S. Monitor Contractions NursingStoreRN
(Preterm Labor)
terbutaline (Bricanyl)
Use: for Preterm labor, delays but does not prevent labor. Also used for COPD, asthma.
Action: It Activates beta 2 receptors, causing relaxation of the uterus. Also results in
bronchodilation.
S/E: Tachycardia, angina, hypokalemia, dysrhythmias, restlessness, tremor.
Nurse: Used for pregnancies <37 weeks gestation. Short-Term use only. Do NOT used beyond
48-72 hours. Other tocolytics include magnesium sulfate and nifedipine.
Indomethacin (Tivorbex)
Use: Suppress labor by inhibiting synthesis of prostaglandins.
S/E: Mom- Nausea, vomiting, thrombocytopenia, GI bleeding. Fetal- Pulmonary hypertension,
oligohydramnios, closure ductus arteriosus.
Nurse: Use in less than 32 weeks, administer for no more than 48 hrs.
34
lOMoARcPSD|23169440
Medication for Infection

Antibiotics Affecting Bacterial Cell Wall
Penicillins NursingStoreRN
Narrow-Spectrum: Penicillin G benzathine
Broad-Spectrum: amoxicillin (Moxatag), Ampicillin
Antistaphylococcal: Nafcillin, Oxacillin
Antipseudomonal: Ticarcillin, piperacillin/tazobactam (Zosyn)
Use: for Bacterial Infections.
Action: It Weakens bacterial cell wall, causing cell death.
S/E: Allergic Reactions (dyspnea, rash), GI distress, renal toxicity.
Nurse: Don’t give to patients with allergies to penicillin or cephalosporin.
Complete course of antibiotics. Use additional Contraceptives.
Monitor for allergic response.
cephalosporins
1st Generation: Cephalexin (Keflex), Cefadroxil, Cefazolin
2nd Generation: Cefaclor (Ceclor), Cefoxitin, Cefprozil, Cefuroxime
3rd Generation: Ceftriaxone (Rocephin), Cefdinir, Cefotaxime, Cefpodoxime,
Ceftazidime, Ceftibuten, Ceftizoxime
4th Generation: Cefepime, Cefditoren, Ceftaroline
5th Generation: Ceftaroline (Teflaro), Ceftobiprole (Zevtera)
@NursingStoreRN
Use: Broad Spectrum Bactericidal.
Action: Destroys Bacterial Cell Wall, causing destruction of microorganism.
S/E: Allergic reaction, superinfections, GI upset.
Nurse: Do not give to patients with history of allergies to penicillin. Do not
consume alcohol during therapy. Take with food.
carbapenems
Meropenem, imipenem/cilastatin (Primaxin), Doripenem (Doribax), Ertapenem
Use: for Serious Infections (pneumonia, peritonitis, UTI)
S/E: GI upset, rash, superinfection, seizures
Nurse: Patient allergic to penicillin and/or cephalosporin may have an allergic
reaction to carbapenems.
glycopeptide antibiotic
Vancomycin
Use: (Hospital Use) C. Diff, MRSA, Streptococcal Infections.
S/E: Ototoxicity, nephrotoxicity, infusion reactions (red man syndrome),
phlebitis.
Nurse: Monitor vancomycin trough levels (and possibly peak levels). Does may
need to be adjusted depending on creatinine levels. Infuse over 1hr (or more)

lOMoARcPSD|23169440

Antibiotics Affecting Protein Synthesis
tetracyclines
doxycycline, tetracycline
Use: Broad Spectrum Antibiotics (acne, Lyme disease, STDs, Rocky Mountain spotted fever)
Action: Inhibit bacteria growth by preventing protein synthesis (Bacteriostatic)
S/E: tooth discoloration in children (and fetuses), photosensitivity, hepatotoxicity,
superinfection, GI upset.
Nurse: DO NOT give to pregnant women or children under 8 yo. Wear sunscreen. Should be
taken on an empty stomach with full glass of water. Decreases effectiveness of oral
contraceptives. Dairy products, foods high in calcium and iron, and antacids decrease absorption.
macrolides
Azithromycin (Zithromax), Erythromycin, Clarithromycin
Use: for patients who are allergic to penicillin. Pertussis, diphtheria, chlamydia
pneumonia and streptococcal infections.
Action: Inhibit bacteria growth by preventing protein synthesis (Bacteriostatic)
S/E: Ototoxicity, GI upset, dysrhythmias, rash
Nurse: Take on an empty stomach with a full glass of water.
Lincosamides @NursingStoreRN
Clindamycin (Cleocin), Lincomycin
Use: for Serious Bacterial Infections.
Action: It Inhibits protein synthesis. Bactericidal or bacteriostatic, depending on
the concentration.
S/E: GI upset, diarrhea, superinfection (C. Diff)
Nurse: Monitor bowel movements.
aminoglycosides
NursingStoreRN
Gentamicin, Amikacin, Kanamycin, Neomycin, Streptomycin, Tobramycin,
Netilmicin, Paromomycin
Use: E. Coli, Klebsiella Pneumonia, Pseudomonas, TB in combination with other
meds (ethambutol, rifampin, isoniazid), Intestinal amebiasis and tapeworm.
Action: It Inhibits protein synthesis.
S/E: Ototoxicity, nephrotoxicity, vertigo, ataxia
Nurse: Monitor patient for tinnitus and hearing loss. Monitor kidney function
(creatinine, BUN, urinalysis). Administer IM or IV. Monitor peak/trough
blood levels.

lOMoARcPSD|23169440

Sulfonamides
trimethoprim/sulfamethoxazole (Bactrim)
Use: UTI, E. Coli, bronchitis, pneumonia, otitis media.
Action: It Inhibits folic acid synthesis.
S/E: Stevens-Johnson syndrome , Crystalluria, GI upset, hypersensitivity, blood
dyscrasias, photosensitivity, rash.
Nurse: Assess patient for sulfa allergies. Monitor CBC levels. Advise patient to
wear sunscreen and increase fluid intake (to prevent crystalluria).
urinary tract antiseptics

Nitrofurantoin (Macrobid), Methenamine
Use: UTIs
Action: Broad Spectrum, damages Bacteria DNA
S/E: GI upset, hypersensitivity, pulmonary toxicity, peripheral neuropathy, brown
discoloration of urine.
Nurse: Take with food.
fluoroquinolones
Ciprofloxacin (Cipro), Levofloxacin, Moxifloxacin, Gemifloxacin
Use: for Bacterial infections, including UYIs, bone/joint infections, respiratory
infections, anthrax.
Action: Bactericidal, inhibit DNA synthesis.
S/E: Tendon Rupture, Diarrhea, superinfection, @NursingStoreRN
photosensitivity.
Nurse: Monitor bowel movements. Advise patient to wear sunscreen. May cause
increase in liver lab values (AST, ALT, LDH, bilirubin).
antiprotozoals
Metronidazole (Flagyl)
Use: Protozoal Infections (intestinal amebiasis, giardiasis, trichomoniasis, C. Diff,
Vaginalis, H. Pylori, prophylaxis for surgical procedures.
Action: Broad Spectrum Bactericidal against anaerobic bacteria.
S/E: Metallic taste, GI upset, dark urine, dizziness, headache
Nurse: DO NOT drink alcohol.
antifungals
NursingStoreRN
Amphotericin B (Fungizone), Ketoconazole, Fluconazole (Diflucan), Nystatin,
Miconazole, Terbinafine, Clotrimazole, Flucytosine
Use: Candidiasis, Aspergillosis, Cryptococcosis, Histoplasmosis, Blastomycosis. Tinea
pedis, tinea cruris, onychomycosis, and other fungal infections.
Action: Cause fungal cell death. Can be fungistatic or fungicidal.
S/E: Amphotericin B: Highly toxic (only for life-threatening fungal infections).
Hepatotoxicity, GI upset, nephrotoxicity, bone marrow suppression, phlebitis.
Ketoconazole: Hepatotoxicity, GI distress, arrhythmias.
Fluconazole: Hepatotoxicity, GI distress, rash
Nurse: Administer test dose of Amphotericin B for patient reaction. Monitor for
liver dysfunction (pale stools, dark urine, n/v, fatigue, jaundice)

lOMoARcPSD|23169440

topical antibacterial
bacitracin, mupirocin (Bactroban)
Use: for Localized bacterial infections. Effective against staphylococci and
streptococci. Mupirocin also effective against impetigo and beta-hemolytic
streptococci.
Action: Bacitracin inhibits cell wall synthesis. Mupirocin inhibits bacterial protein
synthesis.
S/E: Stinging, pruritus
Nurse: Clean and dry area before applying a small amount.
Bacitracin is applied 1-3 times daily. Mupirocin is applied 3 times daily.
topical fungal
clotrimazole (Lotrimin), miconazole (Monistat, Vagistat), nystatin
Use: for Tinea Pedis (athlete’s food), tinea cruris (jock itch), tinea corporis
(ringworm), cutaneous candidiasis.
Action: It Affects the integrity of the fungal cell wall.
S/E: stinging, redness
Nurse: Apply BID for 1-4 weeks. For tinea pedis (fungal infection on the scalp),
use selenium sulfide shampoo.
psoriasis - topical
Coal tar, Salicylic acid, Corticosteroids @NursingStoreRN
Coal tar: slows growth of skin cells, decreases itching/inflammation.
S/E: Photosensitivity, staining of clothes, and cancer (with high doses)
Salicylic acid: Keratolytic (softens and removes scales)
S/E: Mild burning, stinging
Corticosteroids: Decreases immune response and inflammation.
S/E: Burning, itching, irritation.
Other treatment includes systemic immunosuppressants (methotrexate,
cyclosporine), biologic agents (most end in -mab), and phototherapy.
topical antiparasitic
permethrin (Elimite)
Use: for Pediculosis (lice), scabies. Neurotoxin, leading to paralysis of the nervous
system of insects.
S/E: Skin irritation.
Nurse:
Lice: Shampoo with 1% permethrin. Remove nits with a nit comb.
Scabies: Apply from head to toe, wash after 8-14 hours. Treat entire family.
To prevent reinfestation wash clothing/linens in hot water. Bag linens that
cannot be washed in tightly sealed bags for 2 weeks.
NursingStoreRN
38
lOMoARcPSD|23169440

antitubercular medication
NursingStoreRN
Isoniazid, Rifampin, Pyrazinamide, Ethambutol
S/E: Hepatotoxicity
IsOniazid: (Orange Urine), neuropathy.
Rifampin: (Red Urine), GI upset. Decreases effectiveness of oral contraceptives.
Pyrazinamide: (Paresthesia), arthralgia (joint pain).
Ethambutol: (Eye problems, vision change)
Nurse: NO ALCOHOL. Monitor for signs if liver damage. Family members will need
to be tested for TB. Sputum samples needed every 3-4 weeks (patient no longer
infectious after 3 negative sputum cultures). Patients with active TB need to
wear masks in public.
antiviral medication
Acyclovir (Zovirax), Ganciclovir (Cytovene), Oseltamivir (Tamiflu),
Zanamivir (Relenza), Telaprevir, Boceprevir, Ribavirin
Acyclovir: Herpes Simplex and Varicella-zoster viruses.

S/E: Phlebitis, GI distress, nephrotoxicity
Ganciclovir: Cytomegalovirus
S/E: Phlebitis, GI upset, nephrotoxicity,@NursingStoreRN
bone marrow suppression (anemia,
neutropenia, thrombocytopenia)
Oseltamivir/Zanamivir: Influenza A and B
S/E: GI distress, headache
Ribavirin: Respiratory Syncytial Virus, Hepatitis C, and Influenza
Boceprevir/Telaprevir: Hepatitis C
Antiretrovirals: NRTIs
Zidovudine (Retrovir), Didanosine (Videx), Stavudine, Lamivudine, Abacavir
Use: First Line to treat HIV for short-term care
Action: Inhibit DNA synthesis (viral replication), reducing HIV
manifestations.
S/E: Suppress Bone Marrow (anemia, agranulocytosis, thrombocytopenia),
Lactic Acidosis, Nausea/Vomiting, Hepatomegaly
Nurse: Monitor CBC, Liver enzymes. Take med with food.

39

Pharmacology Bundle 20221 2 PDF

Uploaded by

Copyright:

Available Formats

You might also like

Pharmacology Bundle 20221 2 PDF

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Pharmacology Bundle 20221 2 PDF

Uploaded by

Copyright:

Available Formats

lOMoARcPSD|23169440

I- Medication Affecting the Nervous Neuromuscular blocking agents

Topical beta blockers – for open-angle glaucoma

Descargado por lol dafsdf (aefsJcfafnlkae@hotmail.com)

Descargado por lol dafsdf (aefsJcfafnlkae@hotmail.com)

Medication Affecting the Nervous System

Atypical anxiolytic / Nonbarbiturate anxiolytic

Serotonin-Norepinephrine Reuptake inhibitor – SNRI

Medication Affecting the Nervous System

Tricyclic antidepressants - TCA

bipolar disorder – mood stabilizer

Medication Affecting the Nervous System

Antipsychotics: 1st Generation

Antipsychotics: 2nd and 3rd Generation

CNS Stimulants – ADHD NursingStoreRN

Medication Affecting the Nervous System

Opioid’s abuse – abstinence from opioids

smoking Abuse – abstinence from nicotine

Cholinesterase Inhibitor = Anticholinesterase

Myasthenia Gravis - Cholinesterase Inhibitor NursingStoreRN

Medication Affecting the Nervous System

Medication Affecting the Nervous System

topical beta blockers – for open-angle glaucoma NursingStoreRN

alpha2 adrenergic agonists

carbonic anhydrase inhibitor (systemic)

cholinergic (direct acting)

Descargado por lol dafsdf (aefsJcfafnlkae@hotmail.com)

Medication Affecting the Nervous System

Medication for Pain and Inflammation

nonsteroidal anti-inflammatory drugs – cox1 & Cox2 Inhibitor

nonsteroidal anti-inflammatory drugs – Cox2 Inhibitor

Descargado por lol dafsdf (aefsJcfafnlkae@hotmail.com) 8

Medication affecting Musculoskeletal System

muscle relaxants: direct acting

muscle relaxants: Centrally acting (CNS)

bone disorder – calcium supplements

bone disorder – Hypocalcemic MEds

Medication affecting Musculoskeletal System

Gout - gouty arthritis

Medication affecting Respiratory System

Descargado por lol dafsdf (aefsJcfafnlkae@hotmail.com) 11

Medication affecting Respiratory System

Descargado por lol dafsdf (aefsJcfafnlkae@hotmail.com) 12

Medication affecting Cardiovascular System

Diuretics – thiazide diuretics

Diuretics – potassium-sparing diuretics

Diuretics – Osmotic diuretics

Medication affecting Cardiovascular System

Meds for BP – Angiotensin II receptor blockers

Meds for BP – aldosterone antagonists

Meds for BP – direct renin inhibitor

Meds for BP – calcium channel blockers

Meds for BP – Alpha adrenergic blockers

Descargado por lol dafsdf (aefsJcfafnlkae@hotmail.com) 14

Medication affecting Cardiovascular System

Medication for Hypertensive crisis

Beta Blockers – Beta 1

Beta Blockers – Nonselective (1-2 – Heart and Lungs)