MedMaster by NURSING.com – Details, episodes & analysis

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lactulose

Kristalose

Constipation, portal-systemic encephalopathy

draws water into the stool and softens stool, inhibits ammonia passing into the colon

laxative

osmotic

• use caution with DM
• may cause cramps, abdominal distention, hyperglycemia
• assess mental status, ammonia levels, abdominal distention
• patient should average 2-3 bowel movements per day

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ketorolac

Toradol

pain

pain relief due to prostaglandin inhibition by blocking of the enzyme cyclooxygenase (COX)

nonsteroidal anti-inflammatory agents, nonopioid analgesics

pyrroziline carboxylic acid

• may cause GI bleeding, Stevens-Johnson Syndrome, anaphylaxis, drowsiness
• should not exceed 5 days of therapy
• bleeding risk increased with garlic, ginger, and ginkgo
• may decrease effectiveness of hypertensive medications and diuretics

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ibuprofen

Advil / Motrin

Mild to moderate pain, inflammatory states

Decreases pain and inflammation by inhibiting prostaglandins

antipyretics, antirheumatics, nonopioid analgesics, nonsteroidal anti-inflammatory agents

nonopioid analgesics

• may cause GI bleeding, hepatitis, Stevens-Johnson Syndrome
• may cause anaphylaxis
• monitor for headache, nausea, vomiting, constipation
• therapy should be discontinued after first sign of rash
• monitor renal and liver labs
• patient should avoid using alcohol

Dilantin

tonic clonic seizures, arrhythmias, neuropathic pain

interferes with ion transport, shortens action potentials and decreases automaticity blocks sustained
high frequency repetitive firing of action potentials.

antiarrhythmics, anticonvulsants

hydantoins

• monitor serum phenytoin levels
• therapeutic levels 10-20 mcg/mL
• use cautiously in all patients
• can cause suicidal thoughts, ataxia, extrapyramidal symptoms, hypotension, tachycardia, arrhythmias, gingival hyperplasia, nausea, rash, drug induced hepatitis, agranulocytosis, Steven’s Johnson syndrome
• concurrent administration of enteral feedings may decrease absorption
• monitor for hypersensitivity
• assess seizures
• assess hemodynamics

Pyridium

urological pain

provides analgesia to the urinary tract mucosa

nonopioid analgesics

urinary tract analgesics

• will turn urine red or orange
• may cause headache, vertigo, hepatic toxicity
• monitor renal function

Paxil

major depressive disorder, OCD, anxiety, PTSD

block reuptake of serotonin in CNS

antianxiety agent, antidepressant

SSRI

• do not use with MAOIs
• can cause neurolyptic malignant syndrome, suicidal thoughts, serotonin syndrome, constipation,
diarrhea, insomnia
• decrease effectiveness of digoxin
• increase bleeding with warfarin
• assess for suicidal thoughts

GERD, heartburn, reduce the risk of GI bleed in critically ill patients

prevents the transport of H ions into the gastric lumen by binding to gastric parietal cells, ↓ gastric acid production

antiulcer agents

proton-pump inhibitors

• can cause hyperglycemia, abdominal pain
• decreases absorption of certain drugs
• may increase bleeding with warfarin
• assess for occult blood
• assess liver enzymes
• assess symptoms of heart burn
• administer slowly via IV push

Creon

pancreatic insufficiency, ductal obstruction

replacement of pancreatic enzymes: lipase, amylase, protease

digestive agent

pancreatic enzyme

• contraindicated with pig products allergy
• can cause shortness of breath, nausea, diarrhea, rash
• assess nutritional status
• monitor for steatorrhea
• may increase uric acid levels
• instruct patient to follow diet
• take with meals and snacks

Pitocin

labor induction, postpartum bleeding

stimulates uterine smooth muscle

hormones

oxytocics

• can cause ICH in fetus
• can cause asphyxia in fetus
• may cause coma and seizures in mother
• may cause painful contractions
• assess fetus
• assess contractions
• monitor blood pressure
• assess maternal electrolytes
• may cause uterine tetany

Oxycontin

pain

binds to opiate receptors in CNS altering the perception and sensation of pain

Opioid Analgesic

opioid agonists, opioid agonists/nonopioid, analgesic combinations

• may cause respiratory depression, constipation, confusion , sedation, hallucinations, urinary retention
• use caution with increased intracranial pressure
• don’t use with MAOIs
• assess hemodynamics
• assess pain
• may elevate pancreatic enzymes
• can cause physical dependence
• assess bowel function