ok lets just say you are on page 659 of saunders and you are reading about the endocrine meds......lets just say.
and at the bottom of the page there are 4 medicines and what they are used for and what the side effects are for each one.
How in the heck are you supposed to remember these??? (and all the others?)
I mean is there a trick to the names?
one ends in -ide
one ends in -ine
one is somatrem and the other somatropin
I am just asking about these 4 cause it is what I am on at the moment. but lets just say I am asking about the other million meds tooo!!! can you feel my fustration?
please help me see the light at the end of the tunnel...LOL:o
YOU ALL ARE SOOOO WELCOME. I am so happy to sow seeds that will benefit others. If you need an answer or help with anything else pertaining to Nursing/NCLEX-RN please let me know. Nurse Rozy
Specializes in Community Health, Med-Surg, Home Health.
Delmar's Comprehensive NCLEX-PN/RN has a nice summary of the medications, and they are infused throughout the book according to the disease process. They have the suffixes and narrow things down in a better way, and yes, Saunders does as well.
action: >metabolic rate, controls protein synthesis, > cardiac output, renal bld flow, o2 consumption, body temp, bld volume, growth, development at cellular level, exact mechanism unknown
dosage: severe hypothyroidism- adult:po 50mcg qd, increased by 50-100 mcg q 1-4 wk until desired response, maintenance dose 75-125 mcg qd; im/iv 50-100mcg/d as a single dose or 50% of usual oral dosage. child: >12yr po 2-3mcg/kg/day, 6-12yr po 4-5mcg/kg/day; 1-5yr po 5-6 mcg/kg/day, 6-12mos po 6-8 mcg/kg/day, up to 6mos po 8-10 mcg/kg/day – all children's as single dose am; myxedema coma- adult: iv 200-500 mcg, may increase by 100-300mcg after 24 hr; use oral med asap
interactions: >risk cardiac insufficiency when used w/ epinephrine products; effects of anticoagulants, sympathomimetics, tricyclics;
pharmacokinetics: po onset 3-5 days, pk 1-3wks, duration 1-3wk; iv onset 6-8hr, pk 24h duration unknown. t ½ 6-7 days; distributed throughout body tissues
2. atorvastatin (lipitor)
class: [color=#7f0000]antilipidemic
action: inhibits hmg-coa reductase enzyme, which reduces cholesterol synthesis
dosage: po 10mg qd, usual range 10-80, adjustments may be made in 2-4wk intervals, max 80/d
class: [color=#00ff00]sedative, hypnotic, antianxiety. benzodiazepine. controlled substance schedule iv.
action: potentiates the actions of gaba, esp in system and reticular formation
uses: anxiety, irritability in psychiatric or organic disorders, preop, insomnia, adjunct in endoscopic procedures
dosage: anxiety: adult po 2-6mg/day in divided doses, not to exceed 10mg/day. geriatric: po 0.5-1mg/day or 0.5-1mg hs. child po 0.05mg/kg/dose, q 4-8h. insomnia: po 2-4mg hs; only minimally effective after 2wk continuous therapy. preop: adult im 50mcg/kg 2h prior to surgery; iv 44mcg/kg 15-20min prior to surgery. child iv 0.05mg/kg. status epilepticus: neonate iv 0.05mg/kg. child iv 0.1mg/kg up to 4mg/dose; rectal (off label) 0.05-0.1mg x 2; wait 7 min before giving 2nd dose.
pharmacokinetics: po onset.5h, pk 1-6h, duration 24-48hr. im onset 15-30min, pk 1-1.5h, duration 24-48h. iv onset 5-15min, pk uk, duration 24-48h.
4. atenolol (tenormin)
class: antihypertensive,antianginal; beta blocker (b1, b2 high doses)
action: blocks stimulation of b adrenergic receptor within vascular smooth muscle; produces negative chronotropic activity (affecting the time or rate, as the rate of contraction of the heart), negative inotropic activity ( recovery time), slows conduction of av node,
uses: mild to moderate htn, prophylaxis of angina pectoris, suspected or known mi (iv)
dosage: adult: iv 5mg, repeat 10 min if initial dose well tolerated, then start po dose 10 min after last iv dose. adult: po 50mg qd, increasingq 1-2wk to 100mg qd; may increase to 200mg qd for angina. elderly: po 25mg/day initially. renal disease: adult- po ccr 15-35 ml/min, max 50mg/day; ccr
pharmacokinetics: iv onset rapid, pk 5 mins, duration uk; po pk2-4 hr, onset 1 hr duration 24 hr; t½ 6-9hr, excrete unchanged in urine, 5-15% protein bound.
5. amoxicillin (amoxil, trimox)
class: antiinfective, antiulcer; aminopenicillin
action: interferes with cell wall replication of susceptible organisms; the cell wall, rendered osmotically unstable, swells and bursts from osmotic pressure.
precautions: hypersensitivity to chephalosporins, neonates, renal disease
interactions: > amox level: probenecid, anticoagulant action: warfain (coumadin), delayed or reduced absorption: khat so separate by 2hr
pharmacokinetics: po pk 2h, duration 6-8h, t½ 1-1 1/3 h
6. estrogens; conjugated tablets (premarin)
class: estrogen, hormone
action: needed for adequate fx female reproductive sys; affects release of pituitary gonadotropins, inhibits ovulation, adequate ca+ use in bone.
uses: menopausal sx, inoperable breast cancer, prostatic cancer, abnormal uterine bleeding, hypogonadism, primary ovarian failure, prevention of osteoporosis
dosage: menopause: po 0.3-1.25mg qd 3wk on, 1wk off; prevention of osteoporosis: po 0.625mg qd or in cycle; atrophic vaginitis: vag cream 2-4g ml qd x 21 days, off for 7 days, repeat; prostatic cancer: po 1.25-2.5mg tid; breast cancer: po 10mg tid x 3mo or longer; abnormal uterine bleeding iv/im 25mg, repeat in 6-12hr; castration/primary ovarian failure: po 1.25mg qd 3 wk on, 1wk off; hypogonadism po 2.5mg bid-tid x 20 days/mo
precautions: htn, asthma, blood dyscrasias, gallbladder disease, chf, diabetes, bone disease, depression, migraines, convulsive disorders, hepatic, renal, family hx of cancer of breast or repro tract, smoking
interactions: may need to increase thyroxine dose; >toxicity: cyclosporine, dantrolene, action of corticosteroids; > estrogen level: grapefruit juice.
dosage: adult- po 20-80 mg/day in am; may give another dose in 6hr up to 600mg/day; im/iv 20-40mg, increased by 20mg q2hr until desired response. child- po/im/iv 2mg/kg; may increase by 1-2mg/kg/q6-8hr up to 6mg/kg. pulmonary edema- iv 40mg given over several min, repeated in 1 hr; increase to 80mg if needed. hypertensive crisis/acute renal failure: iv 100-200mg over 1-2min. antihypercalcemia: adult- im/iv 80-100mg q 1-4hr or po 120mg qd or divided bid; child- im/iv 25-50mg, repeat q4hr if needed
pharmacokinetics: po onset 1 hr pk 1-2hr, duration 6-8hr; absorbed 70%. iv onset 5min pk ½ hr, duration 2hr (metab by liver 30%). excreted in urine, some as unchanged drug, feces; t½ 1hr
action: inhibits ca+ influx during depolarization, relaxes
coronary muscle, dilates coronary arteries; relaxing the muscles lining the arteries of the rest of the body lowers the blood pressure, which reduces the burden on the heart. reducing burden lessens the heart muscle's demand for oxygen, and further helps to prevent angina
dosage: angina- po 5-10mg qd; htn po 2.5-5mg qd initially,
max 10mg/day
se: most common-headache and edema(swelling) of lower extremities. less common- dizziness, flushing, fatigue, nausea, palpitations
action: bronchodilation by action on b2 (pulmonary)receptors by increasing levels of camp, which relaxes smooth muscle; produces bronchodilation, cns, cardiac stimulation, as well as > diuresis and gastric acid secretion; longer acting than isoproterenol
uses: prevention of exercise-induced asthma, acute bronchospasm, bronchitis, emphysema, bronchiectasis, or other reversible airway obstruction
dosage: exercise-induced bronchospasm: adult: inh (metered dose inhaler) 2 puffs 15mins before exercising. other resp conditions: adult and child> 12 yr: inh 2 puffs q4hr; po 2-4mg tid-qid, not to exceed 8mg; volmax xr 8mg q12h; repetabs4-8mg q12h; neb/ippb 2.5mg tid-qid. geriatric: po 2mg tid-qid, may increase gradually to 8mg tid-qid. child 2-12yr: inh 0.1mg/kg tid (max2.5mg tid-qid); neb/ippb 0.1-0.15mg/kg/dose tid-qid or 1.25mg tid-qid for child 10-15kg or 2.5mg tid-qid15kg. adult and child>4yr: inh cap (rotohaler inhalation) 200mcg cap inhaledq4-6hr; may use 15min before exercise
se: tremors, anxiety, restlessness, bronchospasm
contra: hypersensitivity to sympathomimetics, tachydysrhythmias, severe cardiac disease, heart block
precautions: cardiac disorders, hyperthyroidism, diabetes, htn, prostatic hypertrophy, narrow-angle glaucoma, seizures, exercise-induced bronchospasm (aerosol) in children
interactions: > action of aerosol bronchodilators, >action of albuterol: tricyclic antidepressants, maoi's, other adrenergics; do not use together. may inhibit action of abluterol: other b-blockers. severe hypotn: oxytoxics. toxicity:theophylline. ecg changes/hypokalemia: k+-losing diruretics. >stimulation: ephedra, caffeine (cola nut, green/black tea, guarana, mate, coffee, chocolate).
pharmacokinetics: well absorbed po, extensively metabolized in liver and tissues, crosses bld brain barrier. po onset ½ h, pk 2 ½ hr, duration 4-6h, t ½ 2 ½ h. po-xr onset ½ h; pk 2-3h; duration 12h. inh: onset 5min, pk 1-1 ½ h, duration 4-6h, t ½ 4h
10. alprazolam (zanax)
class: [color=#00ff00]antianxiety; benzodiazepine; schedule iv
action: depresses subcortical levels of cns, including limbic system, reticular formation
uses: anxiety, panic disorders, anxiety with depressive sx
dosage: anxiety disorder: po 0.25-0.5mg tid, not to exceed 4mg/day in divided doses. elderly: po 0.125-0.25 mg bid; increase by 0.125 as needed. panic disorder: po 0.5 mg tid may increase, max 10mg/day. premenstrual dysphoric disorders: po 0.25mg bid-qid, starting on day 16-18 of menses, taper over 2-3 days when menses occurs. social phobia: po 2-8mg/day. hepatic dose: reduce by 50%
pharmacokinetics: po onset 2 h, pk 4h, duration 6-12h, t½ 6-15h, excreted unchanged by kidneys
12. sertraline (zoloft)
class: [color=#7f7f7f]antidepressant; ssri
action: inhibits serotonin reuptake in cns; >action of seotonin; does not affect dopamine, norepinephrine
dosage: adult-po 50mg qd; may > to max of 200mg/day; do not change dose at intervals of by 25mg q3days to desired dose. child 6-12 yr: po 25mg qd. child 13-17yr po 50mg qd.
uses: major depression, ocd, ptsd, panic disorder
se: insomnia, agitation, somnolence, dizziness, headache, tremor, fatigue, male sex dysfx, diarrhea, nausea, constipation, anorexia, dry mouth, vomiting, flatulence
contra: pimozide
precautions: elderly, hepatic, renal, epilepsy, recent mi
interactions: > effects of: antidepressants (tricyclics), diazepam, tobutamide, warfarin, benzodiapzepines, sumatriptan. fatal reactions: maoi's. > sertraline levels: cimetidine, warfarin, other highly protein bound drugs. altered lithium levels: lithium. sertraline in contraindicated with pimozide. potentiation of ssri, serotonin syndrome: st. john's wort, sam-e; do not use together.
pharmacokinetics: po pk 4.5-8.4h; steady state 1 wk; 99%plasma protein bound, t ½ 1-4days, extensively metabolized, metabolite excreted in urine, bile
13.paroxetine (paxil)
class: [color=#7f7f7f]antidepressant; ssri
action: inhibits cns neuron uptake of serotonin but not of norepinephrine or dopamine
uses: major depressive disorder, ocd, panic disorder, generalized anxiety disorder
dosage: po 20mg qd inam; after 4 wk if no improvement may > by 10mg/day q wk to desired response, max 60mg/day or controlled releases 25mg/day weekly up to 62.5mg/day. geriatric start at 10mg/day, max 40mg/day. renal:10mg/day in am, may increase to max 50mg/day. ocd: po 40mg/day, start w/ 20mg/day, > 10mg/day increments max 60mg/day. panic disorder: po 40mg/day start w/ 10mg/day > 10mg/day increments, max 60mg/day or controlled release 12.5 mg/day, max 75mg/day
se: upset stomach, drowsiness, weakness or tiredness, excitement or anxiety, insomnia, nightmares, dry mouth, changes in appetite or weight
interactions: possible fatal: maoi's; > effects c other cns depressants- alcohol, opioids, sedative/hypnotics, antipsychotics, skeletal muscle relaxants; > cns depressionc chamomile, hops, kava, skullcap, valerian
pharmacokinetics: po onset ½- 1h, pk 2-2 ½h, duration 4-6h. t 1/2 6-12h
15. azithromycin (zithromax, z-pak)
class: antiinfective; macrolide
action: binds to 50s ribosomal subunits of susceptible bacteria and suppresses protein synthesis; much greater spectrum of activity than erythromycin.\
dosage: most infx: adult –po 500mg/day on day 1, then 250mg qd on days 2-5 for a total dose of 1.5g. child2-15yr- po 10mg/kg on day 1, then 5mg/kg x 4 days. cervicitis, chlamydia, chancroid 1g single dose, gonorrhea 2g single dose. pelvic inflammatory disease po/iv 500mg iv q24hr x 2 doses, then 500mg po q24hr x 7-10 days. mac po 600mg/day in combination w/ ethambutol. pneumonia po/iv 500mg/ iv q24h x 2 doses, then 500mg po q 24h x 7-10days. endocarditis prophylaxis adult: po 500mg 1 hr prior to procedure. child po 15mg/kg 1 h prior to procedure.
action: inhibits bacterial cell wall synthesis, rendering cell wall osmotically unstable, leading to cell death by binding to cell wall membrane.
dosage: moderate infx: adult: po 250-500mg q6h, child: po 25-50mg/kg/day in 4 equal doses. moderate skin infections: adult –po 500mg q12h. endocarditis prophylaxis 2g 1 h before procedure. severe infx: adult po 500mg –1g q6h; child po 50-100 mg/kg/day in 4 equal doses
action: inhibits hmg-coa reductase enzyme, which reduces cholesterol synthesis
dosage: po 5-10mg qd in pm initially; usual range 5-40mg/day qd in pm, not to exceed 80mg/day ; dosage adjustments may be made in 4wk intervals or more. elderly/renal po 5mg/day
se: liver dysfx, myositis, rhabdomyolysis
contra: active liver disease
precautions: past liver disease, alcoholism, severe acute infx, trauma, hypotn, uncontrolled seizure disorders, severe metabolic disorders, electrolyte imbalances
action: suppresses gastric secretion by inhibiting h/k+ atpase enzyme system in gastric parietal cell; characterized as gastric acid pump inhibitor, since it blocks final step of acid production
dosage: ng tube: use intact granules mixed in 40ml of apple juice and injected thru ng tube, then flush c apple juice. duodenal ulcer: po 15mg qd before eating for 4 wk then 15mg qd to maintain healing of ulcers; associated c helibacter pylori – 30mg + 500mg clarithromycin, 1g amoxicillan bid x14days or 30mg + 1g amoxicillan x 14d. erosive esophagitis: po 30mg qd before eating for up to 8wk, may use another 8 wk course if needed. hypersecretory conditions: po 60mg qd up to 90mg bid
dosage: analgesic:po 200-400mg q4-6h no to exceed 3.2g/day. child: po 4-10mg/kg/dose q6-8h. antipyretic: child 6mo-12yr: po 5mg/kg (temp 102.5), may repeat q4-6h, max 40mg/kg/day. anitinflammatory: po 300-800mg tid-qid, max 3.2g/d. child po 30-40 mg/kg/day in 3-4 divided doses, max 50mg/kg/day.
action: lowers bf by b-blocking effects; reduces elevated renin plasma levels; blocks b2 adrenergic receptors in brochial, vascular smooth muscle only at high doses
uses: mild to moderate htn, acute mi to reduce cardiovascular mortality, angina pectoris, nyha class ii, iii heart failure
dosage: htn: po 50mg bid, or 100mgqd; may give up to 200-450mg in divided doses. ext rel give qd. geriatric: po 25mg/day initially, > weekly as needed. mi early tx: iv bolus 5mg q2min x 3, then 50mg po 15 min after last dose and q6h x 48h; late tx po maintenance 100 mg bid for 3 mos. angina po 100mg qd, > qwk prn or 100mg ext rel qd.
action: inhibits cns neuron uptake of serotonin but not of norepinephrine
uses: major depressive disorder, obd, bulimia, sarafem: pmdd
dosage: depression: adult po 20mg qd in am; after 4wk if no clinical improvement is noted, dose may be > to 20mg bid in am, pm, not to exceed 80mg/day. geriatric 10mg/day, > as needed. child: 5-18yr po 5-10mg/day, max 20mg/day. pmdd po 10-20mg qd, may be taken qd week before menses.
interactions: no maoi's with or 14 days prior. st. john's wort: do not use together.
> se: highly protein bound drugs. > effect: haloperidol. t ½ of diazepam. > levels or toxicity of carbamazepine, lithium, digoxin, warfarin, pheytoin. > levels of tricyclics, phenothiazines. paradoxical worsening of ocd: buspirone. > cns depression: alcohol, antidepressants, opioids, sedatives. > action c kava.
pharmacokinetics: po pk 6-8h, terminal t ½ 2-3days, steady state 28-35 days, 94% protein bound
35. lorazepam (ativan)
class: [color=#00ff00]sedative, hypnotic, antianxiety. benzodiazepine. controlled substance schedule iv.
action: potentiates the actions of gaba, esp in system and reticular formation
uses: anxiety, irritability in psychiatric or organic disorders, preop, insomnia, adjunct in endoscopic procedures
dosage: anxiety: adult po 2-6mg/day in divided doses, not to exceed 10mg/day. geriatric: po 0.5-1mg/day or 0.5-1mg hs. child po 0.05mg/kg/dose, q 4-8h. insomnia: po 2-4mg hs; only minimally effective after 2wk continuous therapy. preop: adult im 50mcg/kg 2h prior to surgery; iv 44mcg/kg 15-20min prior to surgery. child iv 0.05mg/kg. status epilepticus: neonate iv 0.05mg/kg. child iv 0.1mg/kg up to 4mg/dose; rectal (off label) 0.05-0.1mg x 2; wait 7 min before giving 2nd dose.
pharmacokinetics: po onset.5h, pk 1-6h, duration 24-48hr. im onset 15-30min, pk 1-1.5h, duration 24-48h. iv onset 5-15min, pk uk, duration 24-48h.
37. metformin (glucophage)
class: [color=#ffff00]antidiabetic
action: inhibits hepatic glucose production and > sensitivity of peripheral tissue to insulin
dosage: po 500mg bid initially, then > to desired response 1-3g; dosage adjustments q2-3wk or 850mg qd c morning meal c dosage > every other wk, max 2500mg/day, ext rel max 2000mg/day.
action: inhibits reuptake of dopamine, serotonin, norephinephrine
dosage: po 100mg bid initially, then > after 3 days to 100mg tid if needed; may increase after 1 mo to 150 mg tid; sr 150bid, initially 150mg am, > to 300 mg/day if initial dose is tolerated.
se: headache, agitation, dizziness, akinesia, bradykinesia, confusion, seizures, insomnia, sedation, tremors, dysrhythmias, htn, tachycardia, complete av block, nausea, vomiting, dry mouth, constipation, menstrual irregularities, rash, sweating, blurred vision, auditory disturbance, weight loss or gain
pharmacokinetics: po onset12-24h, pk 1.5-3days, duration 3-5days, t ½ 1.5-2.5days, 99% bound to plasma proteins.
71. pantoprazole (protonix)
class: proton pump inhibitor; benzimidazole
action: suppresses gastric secretion by inhibiting h/k+ atpase enzyme system in gastric parietal cell; characterized as gastric acid pump inhibitor, since it blocks final step of acid production
uses: gerd, severe erosive esophagitis, pathologic hypersecretory conditions (zollinger-ellison syndrome)
dosage: gerd po 40mg qd x 8 wk, may repeat course. erosive esophagitis: iv 40mg qd x 7-10d, po 40mg qd x 8wk, may repeat. hypersecretory conditions: iv 80mg q12h; max 240 mg/day.
se: headache, diarrhea, abdominal pain, rash
interactions: may > serum levels of pantoprazole: diazepam, phenytoin, flurazepam, triazolam, clarithromycin. possible > bleeding: warfarin. may delay absorption: sucralfate.
pharmacokinetics: pk 2.4h, duration>24h, t 1/2 1.5h, 97%protein binding, in elederly elimination rate
dosage: po 10-30mg q4h (5mgq6h for oxyir, oxyfast- oxyfast conc. sol. is extremely concentrated; do not use interchangeably). child po 0.05-0.15mg/kg/dose up to 5mg/dose q4-6h; not recommended in children.
action: inhibits the na+-k+ atpase, which makes more ca+ available for contractile proteins, resulting in > cardiac output; > force of ctx (+ inotropic effect);
uses: chf, atrial fib, atrial flutter, atrial tachy, cardiogenic shock, paroxysmal atrial tachy, rapid digitalization in these disorders
dosage: adult iv digitalizing dose 0.6-1.0mg given as 50% of the dose initially, additional fractions given at 4-8h intervals; po digitalizing dose 0.75-1.25mg given as 50% of the dose initially, additional fractions at 4-8h intervals; maintenance 0.063-0.5mg/day(tabs), or 0.350-0.5mg/day(gelatin cap). see drug guide for child.
uses: stable niddm, alone or in combo c sufonylureas, metformin, or insulin
dosage: po 4mg qd or in 2 divided doses, may > to 8mg qd or in 2 divided doses after 12wk
se: no common se's listed.others:weight gain, accidental injury, uri, sinusitis, anemia, back pain, diarrhea, edema, fatigue, headache, hyper/hypoglycemia.
contra: diabetic ketoacidosis
precautions: thyroid disease, hepatic, renal
interactions: may
pharmacokinetics: maximal reduction in fbs after 6-12wk, protein binding 99.8%, elimination t ½ 3-4h
action: >metabolic rate, controls protein synthesis, > cardiac output, renal bld flow, o2 consumption, body temp, bld volume, growth, development at cellular level, exact mechanism unknown
dosage: severe hypothyroidism- adult:po 50mcg qd, increased by 50-100 mcg q 1-4 wk until desired response, maintenance dose 75-125 mcg qd; im/iv 50-100mcg/d as a single dose or 50% of usual oral dosage. child: >12yr po 2-3mcg/kg/day, 6-12yr po 4-5mcg/kg/day; 1-5yr po 5-6 mcg/kg/day, 6-12mos po 6-8 mcg/kg/day, up to 6mos po 8-10 mcg/kg/day - all children's as single dose am; myxedema coma- adult: iv 200-500 mcg, may increase by 100-300mcg after 24 hr; use oral med asap
interactions: >risk cardiac insufficiency when used w/ epinephrine products; effects of anticoagulants, sympathomimetics, tricyclics;
pharmacokinetics: po onset 3-5 days, pk 1-3wks, duration 1-3wk; iv onset 6-8hr, pk 24h duration unknown. t ½ 6-7 days; distributed throughout body tissues
class: [color=#00ff00]sedative, hypnotic, antianxiety. benzodiazepine. controlled substance schedule iv.
action: potentiates the actions of gaba, esp in system and reticular formation
uses: anxiety, irritability in psychiatric or organic disorders, preop, insomnia, adjunct in endoscopic procedures
dosage: anxiety: adult po 2-6mg/day in divided doses, not to exceed 10mg/day. geriatric: po 0.5-1mg/day or 0.5-1mg hs. child po 0.05mg/kg/dose, q 4-8h. insomnia: po 2-4mg hs; only minimally effective after 2wk continuous therapy. preop: adult im 50mcg/kg 2h prior to surgery; iv 44mcg/kg 15-20min prior to surgery. child iv 0.05mg/kg. status epilepticus: neonate iv 0.05mg/kg. child iv 0.1mg/kg up to 4mg/dose; rectal (off label) 0.05-0.1mg x 2; wait 7 min before giving 2nd dose.
pharmacokinetics: po onset.5h, pk 1-6h, duration 24-48hr. im onset 15-30min, pk 1-1.5h, duration 24-48h. iv onset 5-15min, pk uk, duration 24-48h.
4. atenolol (tenormin)
class: antihypertensive,antianginal; beta blocker (b1, b2 high doses)
action: blocks stimulation of b adrenergic receptor within vascular smooth muscle; produces negative chronotropic activity (affecting the time or rate, as the rate of contraction of the heart), negative inotropic activity ( recovery time), slows conduction of av node,
uses: mild to moderate htn, prophylaxis of angina pectoris, suspected or known mi (iv)
dosage: adult: iv 5mg, repeat 10 min if initial dose well tolerated, then start po dose 10 min after last iv dose. adult: po 50mg qd, increasingq 1-2wk to 100mg qd; may increase to 200mg qd for angina. elderly: po 25mg/day initially. renal disease: adult- po ccr 15-35 ml/min, max 50mg/day; ccr
pharmacokinetics: iv onset rapid, pk 5 mins, duration uk; po pk2-4 hr, onset 1 hr duration 24 hr; t½ 6-9hr, excrete unchanged in urine, 5-15% protein bound.
5. amoxicillin (amoxil, trimox)
class: antiinfective, antiulcer; aminopenicillin
action: interferes with cell wall replication of susceptible organisms; the cell wall, rendered osmotically unstable, swells and bursts from osmotic pressure.
precautions: hypersensitivity to chephalosporins, neonates, renal disease
interactions: > amox level: probenecid, anticoagulant action: warfain (coumadin), delayed or reduced absorption: khat so separate by 2hr
pharmacokinetics: po pk 2h, duration 6-8h, t½ 1-1 1/3 h
6. estrogens; conjugated tablets (premarin)
class: estrogen, hormone
action: needed for adequate fx female reproductive sys; affects release of pituitary gonadotropins, inhibits ovulation, adequate ca+ use in bone.
uses: menopausal sx, inoperable breast cancer, prostatic cancer, abnormal uterine bleeding, hypogonadism, primary ovarian failure, prevention of osteoporosis
dosage: menopause: po 0.3-1.25mg qd 3wk on, 1wk off; prevention of osteoporosis: po 0.625mg qd or in cycle; atrophic vaginitis: vag cream 2-4g ml qd x 21 days, off for 7 days, repeat; prostatic cancer: po 1.25-2.5mg tid; breast cancer: po 10mg tid x 3mo or longer; abnormal uterine bleeding iv/im 25mg, repeat in 6-12hr; castration/primary ovarian failure: po 1.25mg qd 3 wk on, 1wk off; hypogonadism po 2.5mg bid-tid x 20 days/mo
precautions: htn, asthma, blood dyscrasias, gallbladder disease, chf, diabetes, bone disease, depression, migraines, convulsive disorders, hepatic, renal, family hx of cancer of breast or repro tract, smoking
interactions: may need to increase thyroxine dose; >toxicity: cyclosporine, dantrolene, action of corticosteroids; > estrogen level: grapefruit juice.
dosage: adult- po 20-80 mg/day in am; may give another dose in 6hr up to 600mg/day; im/iv 20-40mg, increased by 20mg q2hr until desired response. child- po/im/iv 2mg/kg; may increase by 1-2mg/kg/q6-8hr up to 6mg/kg. pulmonary edema- iv 40mg given over several min, repeated in 1 hr; increase to 80mg if needed. hypertensive crisis/acute renal failure: iv 100-200mg over 1-2min. antihypercalcemia: adult- im/iv 80-100mg q 1-4hr or po 120mg qd or divided bid; child- im/iv 25-50mg, repeat q4hr if needed
pharmacokinetics: po onset 1 hr pk 1-2hr, duration 6-8hr; absorbed 70%. iv onset 5min pk ½ hr, duration 2hr (metab by liver 30%). excreted in urine, some as unchanged drug, feces; t½ 1hr
action: inhibits ca+ influx during depolarization, relaxes
coronary muscle, dilates coronary arteries; relaxing the muscles lining the arteries of the rest of the body lowers the blood pressure, which reduces the burden on the heart. reducing burden lessens the heart muscle's demand for oxygen, and further helps to prevent angina
dosage: angina- po 5-10mg qd; htn po 2.5-5mg qd initially,
max 10mg/day
se: most common-headache and edema(swelling) of lower extremities. less common- dizziness, flushing, fatigue, nausea, palpitations
action: bronchodilation by action on b2 (pulmonary)receptors by increasing levels of camp, which relaxes smooth muscle; produces bronchodilation, cns, cardiac stimulation, as well as > diuresis and gastric acid secretion; longer acting than isoproterenol
uses: prevention of exercise-induced asthma, acute bronchospasm, bronchitis, emphysema, bronchiectasis, or other reversible airway obstruction
dosage: exercise-induced bronchospasm: adult: inh (metered dose inhaler) 2 puffs 15mins before exercising. other resp conditions: adult and child> 12 yr: inh 2 puffs q4hr; po 2-4mg tid-qid, not to exceed 8mg; volmax xr 8mg q12h; repetabs4-8mg q12h; neb/ippb 2.5mg tid-qid. geriatric: po 2mg tid-qid, may increase gradually to 8mg tid-qid. child 2-12yr: inh 0.1mg/kg tid (max2.5mg tid-qid); neb/ippb 0.1-0.15mg/kg/dose tid-qid or 1.25mg tid-qid for child 10-15kg or 2.5mg tid-qid15kg. adult and child>4yr: inh cap (rotohaler inhalation) 200mcg cap inhaledq4-6hr; may use 15min before exercise
se: tremors, anxiety, restlessness, bronchospasm
contra: hypersensitivity to sympathomimetics, tachydysrhythmias, severe cardiac disease, heart block
precautions: cardiac disorders, hyperthyroidism, diabetes, htn, prostatic hypertrophy, narrow-angle glaucoma, seizures, exercise-induced bronchospasm (aerosol) in children
interactions: > action of aerosol bronchodilators, >action of albuterol: tricyclic antidepressants, maoi's, other adrenergics; do not use together. may inhibit action of abluterol: other b-blockers. severe hypotn: oxytoxics. toxicity:theophylline. ecg changes/hypokalemia: k+-losing diruretics. >stimulation: ephedra, caffeine (cola nut, green/black tea, guarana, mate, coffee, chocolate).
pharmacokinetics: well absorbed po, extensively metabolized in liver and tissues, crosses bld brain barrier. po onset ½ h, pk 2 ½ hr, duration 4-6h, t ½ 2 ½ h. po-xr onset ½ h; pk 2-3h; duration 12h. inh: onset 5min, pk 1-1 ½ h, duration 4-6h, t ½ 4h
10. alprazolam (zanax)
class: [color=#00ff00]antianxiety; benzodiazepine; schedule iv
action: depresses subcortical levels of cns, including limbic system, reticular formation
uses: anxiety, panic disorders, anxiety with depressive sx
dosage: anxiety disorder: po 0.25-0.5mg tid, not to exceed 4mg/day in divided doses. elderly: po 0.125-0.25 mg bid; increase by 0.125 as needed. panic disorder: po 0.5 mg tid may increase, max 10mg/day. premenstrual dysphoric disorders: po 0.25mg bid-qid, starting on day 16-18 of menses, taper over 2-3 days when menses occurs. social phobia: po 2-8mg/day. hepatic dose: reduce by 50%
pharmacokinetics: po onset 2 h, pk 4h, duration 6-12h, t½ 6-15h, excreted unchanged by kidneys
12. sertraline (zoloft)
class: [color=#7f7f7f]antidepressant; ssri
action: inhibits serotonin reuptake in cns; >action of seotonin; does not affect dopamine, norepinephrine
dosage: adult-po 50mg qd; may > to max of 200mg/day; do not change dose at intervals of by 25mg q3days to desired dose. child 6-12 yr: po 25mg qd. child 13-17yr po 50mg qd.
uses: major depression, ocd, ptsd, panic disorder
se: insomnia, agitation, somnolence, dizziness, headache, tremor, fatigue, male sex dysfx, diarrhea, nausea, constipation, anorexia, dry mouth, vomiting, flatulence
contra: pimozide
precautions: elderly, hepatic, renal, epilepsy, recent mi
interactions: > effects of: antidepressants (tricyclics), diazepam, tobutamide, warfarin, benzodiapzepines, sumatriptan. fatal reactions: maoi's. > sertraline levels: cimetidine, warfarin, other highly protein bound drugs. altered lithium levels: lithium. sertraline in contraindicated with pimozide. potentiation of ssri, serotonin syndrome: st. john's wort, sam-e; do not use together.
pharmacokinetics: po pk 4.5-8.4h; steady state 1 wk; 99%plasma protein bound, t ½ 1-4days, extensively metabolized, metabolite excreted in urine, bile
13.paroxetine (paxil)
class: [color=#7f7f7f]antidepressant; ssri
action: inhibits cns neuron uptake of serotonin but not of norepinephrine or dopamine
uses: major depressive disorder, ocd, panic disorder, generalized anxiety disorder
dosage: po 20mg qd inam; after 4 wk if no improvement may > by 10mg/day q wk to desired response, max 60mg/day or controlled releases 25mg/day weekly up to 62.5mg/day. geriatric start at 10mg/day, max 40mg/day. renal:10mg/day in am, may increase to max 50mg/day. ocd: po 40mg/day, start w/ 20mg/day, > 10mg/day increments max 60mg/day. panic disorder: po 40mg/day start w/ 10mg/day > 10mg/day increments, max 60mg/day or controlled release 12.5 mg/day, max 75mg/day
se: upset stomach, drowsiness, weakness or tiredness, excitement or anxiety, insomnia, nightmares, dry mouth, changes in appetite or weight
interactions: possible fatal: maoi's; > effects c other cns depressants- alcohol, opioids, sedative/hypnotics, antipsychotics, skeletal muscle relaxants; > cns depressionc chamomile, hops, kava, skullcap, valerian
pharmacokinetics: po onset ½- 1h, pk 2-2 ½h, duration 4-6h. t 1/2 6-12h
15. azithromycin (zithromax, z-pak)
class: antiinfective; macrolide
action: binds to 50s ribosomal subunits of susceptible bacteria and suppresses protein synthesis; much greater spectrum of activity than erythromycin.\
dosage: most infx: adult -po 500mg/day on day 1, then 250mg qd on days 2-5 for a total dose of 1.5g. child2-15yr- po 10mg/kg on day 1, then 5mg/kg x 4 days. cervicitis, chlamydia, chancroid 1g single dose, gonorrhea 2g single dose. pelvic inflammatory disease po/iv 500mg iv q24hr x 2 doses, then 500mg po q24hr x 7-10 days. mac po 600mg/day in combination w/ ethambutol. pneumonia po/iv 500mg/ iv q24h x 2 doses, then 500mg po q 24h x 7-10days. endocarditis prophylaxis adult: po 500mg 1 hr prior to procedure. child po 15mg/kg 1 h prior to procedure.
action: inhibits bacterial cell wall synthesis, rendering cell wall osmotically unstable, leading to cell death by binding to cell wall membrane.
dosage: moderate infx: adult: po 250-500mg q6h, child: po 25-50mg/kg/day in 4 equal doses. moderate skin infections: adult -po 500mg q12h. endocarditis prophylaxis 2g 1 h before procedure. severe infx: adult po 500mg -1g q6h; child po 50-100 mg/kg/day in 4 equal doses
action: inhibits hmg-coa reductase enzyme, which reduces cholesterol synthesis
dosage: po 5-10mg qd in pm initially; usual range 5-40mg/day qd in pm, not to exceed 80mg/day ; dosage adjustments may be made in 4wk intervals or more. elderly/renal po 5mg/day
se: liver dysfx, myositis, rhabdomyolysis
contra: active liver disease
precautions: past liver disease, alcoholism, severe acute infx, trauma, hypotn, uncontrolled seizure disorders, severe metabolic disorders, electrolyte imbalances
action: suppresses gastric secretion by inhibiting h/k+ atpase enzyme system in gastric parietal cell; characterized as gastric acid pump inhibitor, since it blocks final step of acid production
dosage: ng tube: use intact granules mixed in 40ml of apple juice and injected thru ng tube, then flush c apple juice. duodenal ulcer: po 15mg qd before eating for 4 wk then 15mg qd to maintain healing of ulcers; associated c helibacter pylori - 30mg + 500mg clarithromycin, 1g amoxicillan bid x14days or 30mg + 1g amoxicillan x 14d. erosive esophagitis: po 30mg qd before eating for up to 8wk, may use another 8 wk course if needed. hypersecretory conditions: po 60mg qd up to 90mg bid
dosage: analgesic:po 200-400mg q4-6h no to exceed 3.2g/day. child: po 4-10mg/kg/dose q6-8h. antipyretic: child 6mo-12yr: po 5mg/kg (temp 102.5), may repeat q4-6h, max 40mg/kg/day. anitinflammatory: po 300-800mg tid-qid, max 3.2g/d. child po 30-40 mg/kg/day in 3-4 divided doses, max 50mg/kg/day.
action: lowers bf by b-blocking effects; reduces elevated renin plasma levels; blocks b2 adrenergic receptors in brochial, vascular smooth muscle only at high doses
uses: mild to moderate htn, acute mi to reduce cardiovascular mortality, angina pectoris, nyha class ii, iii heart failure
dosage: htn: po 50mg bid, or 100mgqd; may give up to 200-450mg in divided doses. ext rel give qd. geriatric: po 25mg/day initially, > weekly as needed. mi early tx: iv bolus 5mg q2min x 3, then 50mg po 15 min after last dose and q6h x 48h; late tx po maintenance 100 mg bid for 3 mos. angina po 100mg qd, > qwk prn or 100mg ext rel qd.
action: inhibits cns neuron uptake of serotonin but not of norepinephrine
uses: major depressive disorder, obd, bulimia, sarafem: pmdd
dosage: depression: adult po 20mg qd in am; after 4wk if no clinical improvement is noted, dose may be > to 20mg bid in am, pm, not to exceed 80mg/day. geriatric 10mg/day, > as needed. child: 5-18yr po 5-10mg/day, max 20mg/day. pmdd po 10-20mg qd, may be taken qd week before menses.
interactions: no maoi's with or 14 days prior. st. john's wort: do not use together.
> se: highly protein bound drugs. > effect: haloperidol. t ½ of diazepam. > levels or toxicity of carbamazepine, lithium, digoxin, warfarin, pheytoin. > levels of tricyclics, phenothiazines. paradoxical worsening of ocd: buspirone. > cns depression: alcohol, antidepressants, opioids, sedatives. > action c kava.
pharmacokinetics: po pk 6-8h, terminal t ½ 2-3days, steady state 28-35 days, 94% protein bound
35. lorazepam (ativan)
class: [color=#00ff00]sedative, hypnotic, antianxiety. benzodiazepine. controlled substance schedule iv.
action: potentiates the actions of gaba, esp in system and reticular formation
uses: anxiety, irritability in psychiatric or organic disorders, preop, insomnia, adjunct in endoscopic procedures
dosage: anxiety: adult po 2-6mg/day in divided doses, not to exceed 10mg/day. geriatric: po 0.5-1mg/day or 0.5-1mg hs. child po 0.05mg/kg/dose, q 4-8h. insomnia: po 2-4mg hs; only minimally effective after 2wk continuous therapy. preop: adult im 50mcg/kg 2h prior to surgery; iv 44mcg/kg 15-20min prior to surgery. child iv 0.05mg/kg. status epilepticus: neonate iv 0.05mg/kg. child iv 0.1mg/kg up to 4mg/dose; rectal (off label) 0.05-0.1mg x 2; wait 7 min before giving 2nd dose.
pharmacokinetics: po onset.5h, pk 1-6h, duration 24-48hr. im onset 15-30min, pk 1-1.5h, duration 24-48h. iv onset 5-15min, pk uk, duration 24-48h.
37. metformin (glucophage)
class: [color=#ffff00]antidiabetic[color=#ffff00]
action: inhibits hepatic glucose production and > sensitivity of peripheral tissue to insulin
dosage: po 500mg bid initially, then > to desired response 1-3g; dosage adjustments q2-3wk or 850mg qd c morning meal c dosage > every other wk, max 2500mg/day, ext rel max 2000mg/day.
action: inhibits reuptake of dopamine, serotonin, norephinephrine
dosage: po 100mg bid initially, then > after 3 days to 100mg tid if needed; may increase after 1 mo to 150 mg tid; sr 150bid, initially 150mg am, > to 300 mg/day if initial dose is tolerated.
se: headache, agitation, dizziness, akinesia, bradykinesia, confusion, seizures, insomnia, sedation, tremors, dysrhythmias, htn, tachycardia, complete av block, nausea, vomiting, dry mouth, constipation, menstrual irregularities, rash, sweating, blurred vision, auditory disturbance, weight loss or gain
pharmacokinetics: po onset12-24h, pk 1.5-3days, duration 3-5days, t ½ 1.5-2.5days, 99% bound to plasma proteins.
71. pantoprazole (protonix)
class: proton pump inhibitor; benzimidazole
action: suppresses gastric secretion by inhibiting h/k+ atpase enzyme system in gastric parietal cell; characterized as gastric acid pump inhibitor, since it blocks final step of acid production
uses: gerd, severe erosive esophagitis, pathologic hypersecretory conditions (zollinger-ellison syndrome)
dosage: gerd po 40mg qd x 8 wk, may repeat course. erosive esophagitis: iv 40mg qd x 7-10d, po 40mg qd x 8wk, may repeat. hypersecretory conditions: iv 80mg q12h; max 240 mg/day.
se: headache, diarrhea, abdominal pain, rash
interactions: may > serum levels of pantoprazole: diazepam, phenytoin, flurazepam, triazolam, clarithromycin. possible > bleeding: warfarin. may delay absorption: sucralfate.
pharmacokinetics: pk 2.4h, duration>24h, t 1/2 1.5h, 97%protein binding, in elederly elimination rate
dosage: po 10-30mg q4h (5mgq6h for oxyir, oxyfast- oxyfast conc. sol. is extremely concentrated; do not use interchangeably). child po 0.05-0.15mg/kg/dose up to 5mg/dose q4-6h; not recommended in children.
action: inhibits the na+-k+ atpase, which makes more ca+ available for contractile proteins, resulting in > cardiac output; > force of ctx (+ inotropic effect);
uses: chf, atrial fib, atrial flutter, atrial tachy, cardiogenic shock, paroxysmal atrial tachy, rapid digitalization in these disorders
dosage: adult iv digitalizing dose 0.6-1.0mg given as 50% of the dose initially, additional fractions given at 4-8h intervals; po digitalizing dose 0.75-1.25mg given as 50% of the dose initially, additional fractions at 4-8h intervals; maintenance 0.063-0.5mg/day(tabs), or 0.350-0.5mg/day(gelatin cap). see drug guide for child.
uses: stable niddm, alone or in combo c sufonylureas, metformin, or insulin
dosage: po 4mg qd or in 2 divided doses, may > to 8mg qd or in 2 divided doses after 12wk
se: no common se's listed.others:weight gain, accidental injury, uri, sinusitis, anemia, back pain, diarrhea, edema, fatigue, headache, hyper/hypoglycemia.
contra: diabetic ketoacidosis
precautions: thyroid disease, hepatic, renal
interactions: may
pharmacokinetics: maximal reduction in fbs after 6-12wk, protein binding 99.8%, elimination t ½ 3-4h
Bori
Rozy
106 Posts
Hello someone emailed me this and I am going to pass it on! I hope this HELPS EVERYONE! NURSE ROZY
DRUGS MOST COMMONLY COVERED ON NCLEX
SKIN:REPRO/GUT:
Psoralen,Sulfa
Tretinon,Mycostatin
Silverdene,Pyridium
Sulfamylon,Narcotics
Colchicine
NEURO:NEURO/MUSCULO:
Mannitol,Flexeril
Decadron,Baclofen
Dilantin,Dopernergic/Levodopa
Tegretol,Fosamax
EEN:BLOOD:
Timoptic,Iron
Miotic,Heparin
AT SO4,Lovenox
Erythromycin Ointment,Thrombolytics/Aspirin
Epogen
HEART: ANTIBIOTIC:
Digoxin,Cipro
Fusid,Doxycycline
Antihypertensive
Nitro,Viagra,Sandimmune
LUNGS:
Antitubercular
AntiAsthma/MDIs
ABT
Steroids
Zafirlukast
GIT:
H2 Receptors
Anticholinergics
Antacid/Mylanta
Proton Pump Inhibitors
Lactulose
ENDOCRINE:
Insulin
Hormones for Life
Tapazole
Synthroid
HERBAL MEDS
St. John's wort - antidepressant, photosensitive (C/I
in SULFA drugs)
Garlic - antihypertensive (avoid aspirin)
Ginseng - Anti stress (C/I in coumadin)
Green tea - antioxidant (check if risk for
calculi-oxalates)
Echinacea - immune stimulant (6-8 weeks only)(C/I in
SANDIMMUNE-Immunosuppressant)
Licorice - cough and cold
Ginger root - antinausea (C/I in Coumadin)
Ginkgo - improves circulation (C/I in anticoagulant,
headache side effect - check PT)
Ma huang - bronchodilator, stimulant (Ephedra)