NURS 3210 Part 2 Drug Charts Instructions: As we discuss the different medications classes and types, complete the chart. The more pertinent information you provide regarding the drug’s nursing implications will assist in your learning. The information in the chart should be written in a way to provide complete and adequate patient education and teaching. Students must submit the chart in the indicated area in Blackboard (unless otherwise instructed by faculty) throughout the semester per the course calendar in the syllabus. Failure to comply with these instructions will resort in a loss of 5 points per infraction. Drug Class Prototype Indications of Use Goal of therapy Administration Therapeutic Effects Adverse Effects Contraindications Salicylates Aspirin (acetylsalicylic acid) Pain, fever, inflammation, and cardiac problems (i.e., blood clot and heart attacks). Lower pain, fever, and decrease inflammation. Decrease blood clot formation. Orally (with food to decrease stomach upset), Rectally Pain reduced, temperature decreased, decrease signs of inflammation (pain, redness, and swelling at the area), absence of myocardial infraction (heart attack) or stroke Nausea, heartburn, decreased blood clot formation from GI blood loss, and bruising. Sensitivity (allergy) to drug or risk of bleeding. Nonnarcotic analgesic antipyretic Acetaminophen (Tylenol) Minor pain and fever. Lower pain and decrease fever. Orally (with food to decrease stomach upset), Rectally Pain reduced and temperature decreased. Yellow tint to the skin or eyes (jaundice), liver damage, and kidney failure Sensitivity (allergy) to drug, or liver/kidney damage Nonsteroidal antiinflammatory Ibuprofen (Motrin) Minor-moderate pain, fever, inflammation. Lower pain, decrease temperature, improve signs and symptoms of inflammation (pain, redness, swelling, tissue destruction and scarring) Orally, IV Pain reduction, decreased temperature, and improved signs of symptoms of inflammation (less pain, swelling, and redness) GI: heartburn, nausea, constipation, GI ulcer with hidden blood loss (blood in stool) Allergy to NSAIDs (nonsteroidal antiinflammatory drugs) and aspirin GU: liver damage, elevated labs that test kidney function (BUN, creatinine), and edema Other Antidote: Mucomyst for toxicity Respiratory: difficulty breathing Allergic reactions Corticosteroid Prednisone Relief of inflammation in different areas of the body. Lessen swelling, redness, itching, and allergic reactions, relief for inflamed areas of the body. Dependent on area of inflammation: Oral tablet. Oral & nasal inhalation. Injection: IV, Intramuscular. Rectal. Topical (local). Eye and ear drops Reduce swelling, redness, itching, and allergic reactions. Relieve different sites of inflammation areas of the body. Increased risk of infection, low blood sugar, weight gain from fluid retention, reddened skin, stretch marks, slow wound healing, irregular menstrual cycles Fungal infections, people at risk of catching an infection Used to relieve symptoms; do not cure the underlying disease Drug Class Prototype Indications of Use Goal of therapy Administration Therapeutic Effects Adverse Effects Contraindications Other Penicillin Ampicillin (Principen) Bacterial infections Treat a wide variety of bacterial infections. PO: give on an empty stomach. Serum creatinine and blood urea nitrogen (BUN), in normal ragerepresent appropriate kidney function Allergic reaction: skin rash, hives, itching, severe diarrhea, shortness of breath, fever, sore throat, black tongue, or any unusual bleeding Sensitivity or allergic reactions to any penicillin forms and cephalosporin Take 1 hour before or 2 hours after a meal IV Patient’s infection has resolved as evidence by: negative cultures, normal temperature, and normal white blood cell (WBC) count GI: abdominal pain, diarrhea, stomach inflammation, and nausea/vomiting IM, IV, PO: take most with food or milk to prevent stomach upset Serum creatinine and blood urea nitrogen (BUN), in normal ragerepresent appropriate renal function GI: abdominal pain, diarrhea, stomach inflammation, nausea/vomiting Sensitivity or allergic reactions to cephalosporin and penicillin Some forms should not be taken with antacids Sensitivity to aminoglycosides; caution in patients with kidney damage Hearing loss may be irreversible. Hypersensitivity/allergy to ciprofloxacin or any drug in quinolones class Avoid sun if possible; sunscreen not enough Allergy to tetracycline; kidney and liver damage Avoid sunlightwear sunscreen & protective clothing in the sun Cephalosporin Aminoglycoside Cefazolin (Ancef) Gentamicin (Garamycin) Bacterial infections & prevent infection from surgery Bacterial infections Treat bacterial infections & used to prevent infections at a surgical site Destroy the bacteria causing the bacterial infections IM IV, IM, PO Reversal or prevention of infection Allergic reaction: hives, itching, skin rash Signs and symptoms of infection are resolving (normal temperature, WBC count) Kidney failure (decrease urine output, abnormal labs that assess kidney function) Damage to the ear: dizziness, spinning dizziness, ringing in the ears, and hearing loss Fluoroquinolones Tetracycline Ciprofloxacin (Cipro) Tetracycline (Sumycin) Bacterial infections Bacterial infections Treat bacterial infections Treat a broad variety of bacterial infections PO: with or without foot, IV PO: most effective on an empty stomach; IV Reversal of infection; assess of factors that increase the risk of adverse effects (kidney damage, insufficient fluid intake, use of multivitamins/antacids, or frequent exposure to sunlight) Sensitivity Decreased signs and symptoms of the infection (normal temperature and normal white blood cell (WBC) count Sensitivity GI: nausea/vomiting, & abdominal discomfort Photosensitivity: sensitivity/allergy to sunlight GI: gas, diarrhea, nausea, vomiting Development of a second infection: sore throat, white patches on gums in mouth Avoid taking iron, multivitamins, & antacidstake Cipro 2 hours before or 6 hours after these agents Do not take with dairy products, antacids, or iron supplements Allergy to sunlight Kidney and liver damage Sulfonamides Trimethoprim– sulfamethoxazole (TMP-SMZ (Bactrim, Septra) Bacterial infections Treat bacterial infections PO: with or without food, with glass of water; IV, topical Ending the infection; reversal & improvement of symptoms (normal temperature, normal WBC count) Sensitivity & development of a second infection GI: abdominal pain, nausea, vomiting, diarrhea, anorexia, & inflamed pancreas Allergy to any sulfa drug, trimethoprim, TMP-SMZ, or any other sulfonamides, salicylates (Aspirin) Avoid: prolonged exposure to sunlightwear sunscreen & protective clothing Dermatological: itching, hives, sun allergy Kidney: increased labs that reflect kidney function (BUN, creatinine), & kidney failure Anti-infective Vancomycin (Vancocin) Treat resistant microorganisms (MRSA, methicillinresistant S. aureus) Treat resistant bacteria infections Oral & IV Signs and symptoms of infection resolving (normal temperature and WBC counts) Low blood pressure, flushing (redness of skin), and skin rash (red man syndrome) Allergy to vancomycin; kidney disease Drug Class Prototype Indications of Use Goal of therapy Administration Therapeutic Effects Adverse Effects Contraindications Other Statin Atorvastatin (Lipitor) High plasma cholesterol and lipoprotein (fat) levels Reduce LDL (bad) cholesterol levels and reduce total blood cholesterol levels Orally: usually taken at night Maintenance of cholesterol levels GI: nausea, constipation, diarrhea, abdominal cramps or pain Pregnancy & breast-feeding women Liver function assessed 12 weeks after initiation, every increase in dose, and then periodically Liver impairment Musculoskeletal: injury to muscle tissue (muscle ache, pain, or weakness) Fibrates Cholesterol Absorption Inhibitor Miscellaneous Dyslipidemia Agent AngiotensinConverting Enzyme (ACE) Inhibitors Fenofibrate (TriCor) Ezetimibe (Zetia) Niacin (nicotinic acid) Captopril (Capoten) High triglyceride (fat) levels in blood Reduce triglyceride levels in blood Orally: with food to increase absorption Triglyceride/cholesterol levels lowered to acceptable levels GI: discomfort and diarrhea High plasma cholesterol Prevent the absorption of cholesterollower total cholesterol and LDL (bad cholesterol) & increase HDL (good) cholesterol Orally: with or without food, at the same time each day Lowered cholesterol levels to an acceptable level GI: diarrhea, abdominal pain, & nausea Decreases LDL (bad) cholesterol & increases HDL (good) cholesterol Orally: immediate-release with meals, timid-release without regard to meals Cholesterol levels lowered to acceptable levels Reduce blood pressure Orally: empty stomach, 1 hour before or 2 hours after meals, at the same time each day Blood pressure return to target limits without significant adverse effects High cholesterol levels Hypertension (high blood pressure) Liver: liver damage, increase cholesterol in the biliary tractcausing gallstones CNS: headache, dizziness, & fatigue Skin flushing (redness of skin), itching, stomach irritation Liver: increased ALT (enzyme in liver to assess damage) & hepatitis (liver inflammation) Lifestyle modifications to improve baseline blood pressure readings (weight Continuous cough Sudden deep swelling or welts under skin (usually around eyes and lips) Liver or severe kidney impairment; preexisting gallbladder disease, buildup of bile in liver, or constant liver function abnormalities of unknown source Pregnancy & breast-feeding women; accompanying use with a statin in people with active liver disease Take at night is used in combination with a statin Liver disease or unexplained liver dysfunction, or an active stomach ulcer Pregnancy Assess blood pressure and pulse on an ongoing basis with initial dosage adjustment and periodically during therapy loss, stop smoking, reduced salt intake) Critical hypotension on initiation (feel dizzy or faint) High potassium level in patients with Type 1 diabetes or kidney damage or taking potassium supplements, or potassiumsparing diuretics Angiotensin II Receptor Blockers (ARBs) Calcium Channel Blockers (CCBs) Organic Nitrates Losartan (Cozaar) Amlodipine (Norvasc) Nitroglycerin (NitroBid, Bitro-Dur) Hypertension (high blood pressure) Hypertension (high blood pressure) Onset chest pain Block vasoconstriction effects of the heart to lower blood pressure Lower blood pressure Orally: without regard to food Orally: without regard to food; IV Improvement (decrease) blood pressure Dizziness, muscle cramps or weakness Lifestyle modifications to improve baseline blood pressure readings (weight loss, stop smoking, reduced salt intake) Sudden deep swelling or welts under skin (usually around eyes and lips) Improvement (decrease) blood pressure CNS: drowsiness, fatigue, dizziness Lifestyle modifications to improve baseline blood pressure readings (weight loss, stop smoking, reduced salt intake) Cardiac: edema (swelling) of the hands, ankles, and feet; redness of the skin; pounding/racing heart Management and prevention of acute chest pain caused by a heart attack IV; Sublingual (take as soon as chest pain begins); Translingual spray (onto or under tongue); PO; Topical ointment Improvement (decrease) blood pressure Lifestyle modifications to improve baseline blood pressure readings (weight loss, stop smoking, reduced salt intake) Pregnancy High potassium levels Severe liver disease and severely low blood pressure; sensitivity to calcium channel blockers Avoid drinking grapefruit juice Severe headache, dizziness, slow heart rate, loss of consciousness, hypotension (low blood pressure), & low blood pressure when standing up from sitting or lying down Severe anemia, hypotension, and decreased volume of circulating blood in the body Apply topical forms to nonhairy area of skin (chest, abdomen, thighs; avoid areas away from the center of the torso) Beta-adrenergic Blockers Atenolol (Tenormin) Chest pain, heart attack, hypertension, heart failure, & irregular heartbeat Treat high blood pressure & chest pain PO, IV Improvement (decrease) blood pressure Heart failure, slowing of the heart rate 2nd & 3rd degree heart block, severe slow heart rate, heart failure, or hypotension Cardiac Glycosides Digoxin (Lanoxin) Heart failure & atrial fibrillation (AFibirregular heartbeat that can lead to blood clots, stroke, & heart failure) Treat mild to moderate heart failure. PO: taken with food or after meals, take at least 1 hr. before a prescribed antacid; IV Slowing of the heart rate “Skipped” heartbeats, nausea, vomiting, loss of appetite, abdominal discomfort, vision changes (yellow-green halos & problems with color perception), blurred vision, and mental changes Inflammation of the heart muscle, heart ventricles beat quickly, & lifethreating rapid, inadequate heartbeat. HR less than 60 beats/min in adults; do not administer