DRUG LIST NCLEX ANTIBIOTICS *All antibiotics have GI effects Aminoglycosides -micin i.e. gentamicin -mycin i.e. vancomycin, neomycin Side effects: -Ototoxicity -Nephrotoxicity -GI irritation Vancomycin: Red man syndrome; administer over 60 minutes -Assess for allergies esp. anaphylactic allergies -Monitor appropriate lab values prior to administration i.e. aminoglycosides with BUN and Cr -Monitor for adverse effects and report to HCP if they occur -Monitor ins and outs -Encourage fluid intake -Emphasize importance of completing full prescribed course Cephalosporins (broad spectrum) Cef- i.e. cefaclor, cefradoxil, cefdinir, cefotaxime, cephalexin -GI disturbances -Nephrotoxicity -Superinfections i.e. C. difficile Similar to penicillins; contraindicated for clients with penicillin sensitivity Floroquinolones Floroquinol(one) bone marrow depression -floxacin i.e. ciprofloxacin, gatifloxacin Headache, dizziness, insomnia, depression -GI effects -bone marrow depression i.e. thrombocytopenia -photosensitivity, fever, rash *Contains main drugs questioned in UWorld and mentioned in MK; Antibiotics, CV drugs, Diuretics, Diabetic drugs, Mental health drugs, and Respiratory drugs (in that order) plus other main drugs. i.e. proton pump inhibitors, dilantin, NSAIDs 2 Macrolides -thromycin i.e. azithromycin, erythromycin -GI effects -pseudomembranous colitis (c. diff colitis) -superinfections -Hepatotoxic *Contains main drugs questioned in UWorld and mentioned in MK; Antibiotics, CV drugs, Diuretics, Diabetic drugs, Mental health drugs, and Respiratory drugs (in that order) plus other main drugs. i.e. proton pump inhibitors, dilantin, NSAIDs 3 -causes a prolonged QT interval, which may lead to sudden cardiac death due to torsades de pointes Penicillins -cillin i.e. amoxicillin, carbenicillin, ampicillin -hypersensitivity reactions, including anaphylaxis -related to cephalosporins -GI effects Sulfonamides Sulfa- i.e. sulfadiazine, sulfasalazine -hepatotoxic and nephrotoxic -bone marrow depression i.e. thrombocytopenia -photosensitivity -ANY RASH WITH SULFONAMIDES MUST BE REPORTED TO HCP! Tetracyclines -cyclines i.e. doxycycline, tetracycline -GI effects -hepatotoxicity -teeth staining and bone damage -photosensitivity, hypersensitivity **Can cause pill induced esophagitis. Clients taking this should sit upright for a period of time after ingestion to prevent tablet from lodging in esophagus Antifungal medications Amphotericin B -gastrointestinal effects -nazole i.e Fluconazole -neuritis, dizziness, headache, Ketoconazole malaise, drowsiness, hallucinations Antiviral medications -clovir i.e. acyclovir, -hearing loss (ototoxicity) ganciclovir, foscarnet -peripheral neuritis *Contains main drugs questioned in UWorld and mentioned in MK; Antibiotics, CV drugs, Diuretics, Diabetic drugs, Mental health drugs, and Respiratory drugs (in that order) plus other main drugs. i.e. proton pump inhibitors, dilantin, NSAIDs 4 CARDIOVASCULAR MEDICATIONS Anticoagulants Oral: Warfarin, Dabigatran, Rivaroxaban Parenteral: Dalteparin, Heparin, Enoxaparin, Desirudin, Fondaparinux, Tinzaparin, Argatroban Prevent clot formation by inhibiting factors in clotting cascade and decreasing blood coagulability i.e. in MI, mechanical heart valves, DVT, atrial fibrillation, unstable angina Side effects: Hemorrhage Hematuria Thrombocytopenia Hypotension -contraindicated in clients taking NSAIDs, gingko and ginseng, corticosteroids, vit K containing foods (have this in moderation; no sudden increase or decrease) -contraindicated with active bleeding -Heparin-Induced Thrombocytopenia can be ironic in that it can cause stroke and embolism Thrombolytic medications -teplase i.e. alteplase, reteplase, tenecteplase Activates plasminogen which digests plasmin and dissolves clots in cases of MI, DVT, occluded shunts and pulmonary emboli Bleeding Dysrhythmias Allergic reactions -Contraindicated in active bleeding, history of hemorrhagic brain attack (stroke), intracranial or intraspinal surgery within the last 2 months, uncontrolled HTN -Apply direct pressure over a puncture site for 20 to 30 minutes -Used only for acute, life-threatening conditions Antidote: Aminocaproic acid Antiplatelet medications Aspirin, clopidogrel, cilostazol, dypiridamole, ticlopidine Inhibit aggregation of platelets in clotting process, thereby prolonging bleeding time GI bleeding Bruising Hematuria Tarry stools -may be used with anticoagulants -used in prophylaxis of long-term complications following MI, CAD, stents, and strokes Positive inotropes/cardiotonic medications Dobutamine Dopamine Imanrinone Milrinone Stimulate myocardial contractility and produce a positive inotropic effect for heart failure -increases CO, decreasing preload, improving blood flow to periphery and kidneys and increasing fluid excretion Dysrhythmias Hypotension Thrombocytopenia Adverse effects: Hepatotoxicity Hypersensitivity- wheezing, SOB, pruritus, urticaria (hives, clammy skin and flushing -used for IV administration; administer with IV infusion pump -monitor electrolyte (may lower K) and liver enzyme levels (may increase due to hepatotoxicity), platelet count, and renal function studies