Visit: https://nursing.com/140meds to request your free copy of "140 Must Know Meds"

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

Visit: https://nursing.com/140meds to request your free copy of "140 Must Know Meds"

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

Visit: https://nursing.com/140meds to request your free copy of "140 Must Know Meds"

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

Zofran

nausea/vomiting

blocks effects of serotonin on vagal nerve and CNS

antiemetic

5-HT3 antagonist

• administer slowly over 2-5 minutes – fatal QT prolongation and VTach, respiratory arrest
• may cause headache, constipation, diarrhea, dry mouth
• asses nausea and vomiting
• assess for extrapyramidal symptoms
• monitor liver function tests

omeprazole

Prilosec

GERD, ulcers, Zollinger-Ellison syndrome, reduce the risk of GI bleed in critically ill patients, heart burn

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

antiulcer agent

proton-pump inhibitor

• take 30-60 minutes prior to eating
• capsules should be swallowed whole
• instruct patient to report black tarry stool

olanzapine

Zyprexa

schizophrenia, mania, depression, anorexia nervosa, nausea/vomiting related to chemotherapy

antagonizes dopamine and serotonin

antipsychotic, mood stabilizers

thienobenzodiazepines

• do not use while breastfeeding
• can cause neurolyptic malignant syndrome, seizures, suicidal thoughts, insomnia, tardive
dyskinesia, agranulocytosis, constipation, tremors
• assess mental status
• monitor hemodynamics
• assess blood sugars
• assess intake and output
• monitor liver function tests

hydromorphone

Dilaudid

moderate to severe pain

alters the perception and reaction to pain by binding to opiate receptors in the CNS, also suppresses the cough reflex

Opioid Analgesic, allergy, cold and cough remedies, antitussive

opioid agonist

• Assess BP, respirations, and pulse before and during administration – medication causes general
CNS depression
• Narcan (nalaxone) is the antidote for overdose
• use caution with concurrent use of MAOI – avoid use within 14 days of each other
• may be used as an antitussive
• advised to dilute with NS prior to administration and to administer slowly to decrease CNS
depression

Mycostatin

candidiasis, denture stomatitis

causes leakage of fungal cell contents

Antifungal

none

• may cause diarrhea, nausea, vomiting
• can be used to soak dentures
• assess mucus membrane

norepinephrine

Levophed

treatment of severe hypotension and shock

increase blood pressure and cardiac output by stimulating alpha-adrenergic receptors in the blood vessels, demonstrates minor beta activity

vasopressor

• monitor BP continuously if possible or every couple of minutes
• double check all concentrations with additional nurse
• may result in rebound hypotension due to tissue ischemia when discontinued
• monitor EKG and CVP
• if patient is awake instruct them to report headaches, dizziness, or chest pain

nitroprusside

Nitropress

hypertensive crisis, cardiogenic shock

peripheral vasodilation of arteries and veins decreasing preload and afterload

antihypertensive

vasodilator

• monitor HR, BP, and EKG continuously during therapy
• may cause cyanide toxicity
• sympathomimetics may decrease effectiveness
• PAOP monitoring may help with MI and CHF patients

nifedipine

Procardia

hypertension, angina, migraines, CHF

blocks calcium transport resulting in inhibition of contraction causing systemic vasodilatation

antianginals, antihypertensives

Ca Channel Blocker

• use caution in heart block, decreased blood pressure
• don’t consume grapefruit juice while taking medication
• may cause arrhythmias
• may cause elevated liver function tests
• may cause gingival hyperplasia, Steven’s Johnson syndrome
• monitor blood pressure and pulse
• monitor calcium levels
• instruct patient on taking heart rate and blood pressure

naproxen

Aleve

pain, dysmenorrhea, fever, inflammation

inhibits prostaglandin synthesis

nonsteroidal anti-inflammatory agents, nonopioid analgesics, antipyretics

none

• use caution with GI bleeding
• may increase risk for stroke and MI
• can cause GI bleeding, anaphylaxis, Steven’s Johnson syndrome
• aspirin can decrease blood levels and effectiveness
• assess pain
• patients should remain up-right for 30 minutes after administration

nalbuphine

Nubain

pain, analgesia during labor, sedation before surgery, supplement to balance anesthesia

alters perception and response to pain, causes CNS depression

Opioid Analgesic

opioid agonists/analgesics

• use caution with head trauma
• can cause dizziness, headache, nausea, vomiting, respiratory depression
• do not use with MAOIs
• assess pain
• may cause respiratory depression in newborn
• asses hemodynamic parameters
• may elevate pancreatic enzymes
• Narcan (naloxone) is the antidote

morphine

MS Contin

pain, pulmonary edema, MI

Binds to opiate receptors in the CNS and alters perception of pain while producing a general depression of the CNS.

opioid analgesic

opioid agonist

• may cause alterations in mentation, hypotension, constipation, nausea, vomiting
• assess BP, pulse, and respiratory rate prior to administration and frequently during administration
• use caution if patient is receiving MAO Inhibitors
• Narcan (naloxone) is the antidote for opioid agonists

montelukast

Singulair

prevent or treat asthma, manage seasonal allergies, prevent exercise-induced bronchoconstriction

disrupts the effects of leukotrienes which effect airway edema, smooth muscle constriction, and cellular activity

allergy, cold, and cough remedies, bronchodilators

Leukotriene Antagonist

• assess respiratory status
• assess liver function tests
• medication does not treat acute asthma attacks

midazolam

Versed

sedation, conscious sedation, anesthesia, status epilepticus

acts to produce CNS depression, may be mediated by GABA

antianxiety agent, sedative/hypnotics

Benzodiazepine

• assess level of sedation during and for 2-6 hours following
• monitor blood pressure, pulse, respirations during IV administration
• may lead to apnea, cardiac arrest, respiratory depression
• antidote for overdose is Romazicon (flumazenil)

Flagyl

intra-abdominal infections, gynecoligical infections, skin infections, bone and joint infections, CNS
infections, septicemia, endocarditis, amebic liver abscess, peptic ulcer disease

Inhibits DNA and protein synthesis in bacteria, bactericidal

anti-infectives, antiprotozoals, antiulcer agents

none

• do not take with alcohol-disulfiram reaction
• assess for infection before and during treatment
• obtain cultures before therapy
• monitor neurologic status: parasthesia, weakness, ataxia, or seizures
• monitor intake and output, daily weights
• may alter liver enzyme tests

Hi NURSING.com family.  Are you getting ready for the NCLEX??   This show is the perfect NCLEX review, and as ALWAYS, we have pulled out the MOST important info that you need to become an Amazing nurse!

Listen in each week while we review 77 critical topics you need to pass the NCLEX-RN Exam.  Each episode will cover these MUST-know nursing topics with a perfect overview.  

Our new show is NCLEX Flash Notes.  You can search that in Apple podcasts or Spotify and pull up the SHOW.   NCLEX Flash Notes

NCLEX Flash Notes is your go-to last-minute refresher for the NCLEX exam. Cut through the fluff and get straight to the essential information with this free resource.  

metoclopramide

Reglan

prevention of nausea, vomiting, hiccups, migraines, gastric stasis

accelerates gastric emptying by stimulating motility

antiemetic

Dopamine D2 receptor antagonist, prokinetic

• do not use with GI obstruction
• may cause extrapyramidal reaction, neurolyptic malignant syndrome, tardive dyskinesia,
arrhythmias, blood pressure alterations, hematologic alterations, facial movements, sedation
• can decrease effects of levodopa
• assess nausea/vomiting
• monitor liver function tests

methylphenidate

Ritalin, Concerta

ADHD, narcolepsy

improves attention span in ADHD by producing CNS stimulation

central nervous system stimulant

none

• can cause sudden death, hypertension, palpitations, anorexia, hyperactivity, insomnia
• may decrease effects of Warfarin and Phenytoin
• do not use with MAOIs
• monitor cardiovascular system
• monitor for behavioral changes
• monitor for dependence
• do not consume caffeinated beverages
“Drug Holiday” used to assess dependence and status

Methergine

treatment of post-partum hemorrhage

stimulates uterine muscles causing uterine contraction

oxytocic

ergot alkaloids

• can cause hypertension, cramps, nausea, vomiting, dyspnea
• monitor BP, heart rate, uterine response
• assess calcium levels – effectiveness ↓ with hypocalcemia
• monitor uterine bleeding and notify physician of any changes

Mathadose

withdrawal symptoms, pain

Suppresses withdrawal symptoms. Binds to opiate receptors in the CNS and alters perception of pain while producing a general depression of the CNS. This depression also causes a decrease in the cough reflex and GI motility.

opioid analgesic

opioid agonist

• use caution if patient is receiving MAO Inhibitors
• may cause QT prolongation, hypotension, respiratory depression, dependence, confusion, sedation
• assess pain, vital signs, bowel function
• may increase pancreatic enzyme levels
• assess withdrawal symptoms

metformin

Glucophage

management of Type II DM, PCOS

decreases glucose production in the liver, decreases absorption, increases cellular insulin sensitivity

Antidiabetic

Biguanide

• do not use with renal dysfunction, metabolic acidosis
• may cause diarrhea, nausea, vomiting, lactic acidosis
• monitor patient closely for ketoacidosis and lactic acidosis, discontinue medication immediately
if acidotic
• may cause metallic taste
• instruct patient that medication does not cure diabetes

meperidine

Demerol

moderate to severe pain, sedation

Binds to opiate receptors in the CNS and alters perception of pain while producing a general depression of the CNS.

Opioid Analgesic

opioid agonists

• may cause alterations in mentation, hypotension, constipation, nausea, vomiting
• assess BP, pulse, and respiratory rate prior to administration and frequently during
administration
• use caution if patient is receiving MAOIs
• Narcan (naloxone) is the antidote for opioid agonists
• can cause seizure
• may increase pancreatic enzyme levels
• assess bowel function

mannitol

Osmitrol

increased ICP, oliguric renal failure, edema, increased intraocular pressure

inhibits reabsorption of water and electrolytes by increasing osmotic pressure, excreted by kidneys

diuretic

osmotic diuretic

• may cause phlebitis at IV site
• may cause dehydration, fluid and electrolyte imbalances
• monitor neuro status
• administer via a filter

magnesium sulfate

MgSO4

treatment of hypomagnesaemia, hypertension, preterm labor, torsade de pointes, asthma, anticonvulsant with eclampsia

magnesium plays a role in muscle excitability

mineral and electrolyte replacements/supplements

minerals/electrolytes

• use caution with renal insufficiency
• may cause decreased respiratory rate, arrythmias, hypotension, muscle weakness
• monitor EKG and respiratory status
• monitor Mg levels
• ensure dosage with secondary practitioner
• Calcium gluconate is the antidote
  • Magnesium toxicity results in respiratory depression and loss of deep tendon reflexes

losartan

Cozaar

hypertension, DM neuropathy, CHF

inhibits vasoconstrictive properties of angiotensin II

antihypertensives

angiotensin II receptor antagonist

• may cause hypotension, tacycardia, angiodema, hyperkalemia
• may increase digoxin levels
• assess blood pressure and heart rate
• assess fluid levels
• monitor daily weights with CHF
• monitor renal and liver
• instruct patient on how to take blood pressure

lorazepam

Ativan

anxiety, sedation, seizures

general CNS depression by potentiating inhibitory neurotransmitters

anesthetic adjuncts, antianxiety agents, sedative hypnotics

Benzodiazepine

• use caution with COPD and sleep apnea
• avoid alcohol use
• antidote is Flumazenil (Romazicon)
• may cause apnea, cardiac arrest, bradycardia, hypotension
• use caution with other CNS depressants
• administer slowly and dilute to decrease complications

Visit: https://nursing.com/140meds to request your free copy of "140 Must Know Meds"

hydrocodone/acetaminophen

Vicodin, Lortab, Norco

management of moderate to severe pain

alters the perception and reaction to pain by binding to opiate receptors in the CNS, also suppresses the cough reflex

opioid Analgesic, allergy, cold and cough remedies, antitussive

opioid agonists, nonopioid analgesic combinations

• use caution with concurrent use of MAOI – avoid use within 14 days of each other
• hypotension – monitor hemodynamics and respirations after administering
• may increase ICP use caution with head trauma
• Narcan (nalaxone) is the antidote for overdose
• DO NOT exceed 4g of acetaminophen per day

loperamide

Imodium

acute diarrhea, decrease drainage post ileostomy

inhibits peristalsis, reduces the volume of feces while increasing the bulk and viscosity

antidiarrheal

• may lead to constipation – insure proper use
• assess bowel function
• assess fluid and electrolyte levels

lithium

Lithizine

mania

alters cation transport and neurotransmitter reuptake

Mood Stabilizer

none

• do not administer with NSAIDs
• monitor drug blood levels frequently
• may cause seizures, arrhythmias, fatigue, confusion, nausea, anorexia, hypothyroidism, tremors
• Ace Inhibitors may increase serum levels
• instruct patient to maintain adequate fluid intake
• therapeutic level: 0.5-1.5 mEq/L

lisinopril

Prinivil

hypertension, management of CHF

block conversion of angiotensin I to angiotensin II, increases renin levels and decreases aldosterone
leading to vasodilation

antihypertensives

ACE Inhibitor

• dry cough
• first dose hypotension
• use cautiously with potassium supplements and potassium sparing diuretics
• use cautiously with diuretic therapy
• administer 1 hour before meals
• monitor blood pressure often
• monitor weight and fluid status
• monitor renal profile
• monitor liver function tests

• may cause angioedema

Levaquin

urinary tract infections, gonorrhea, respiratory tract infections, bronchitis, pneumonia, skin and bone
infections

inhibits DNA synthesis in bacteria

Anti-infective

fluoroquinolone

• contraindicated in allergies
• may cause QT prolongation, avoid use with other drugs that can cause QT prolongation
• can cause seizures, arrhythmias, pseudomembranous colitis, anaphylaxis, Stevens Johnson
syndrome

• increases the risk for tendinitis or tendon rupture

• may decrease plasma concentration of phenytoin
• monitor renal panel
• assess for infection, obtain cultures prior to therapy
• monitor liver function tests

Carbidopa/levodopa

Sinemet

Parkinson’s disease

Levodopa is converted to dopamine and works as a neurotransmitter, carbidopa
prevents the destruction of levodopa allowing it to cross the blood brain barrier

Antiparkinson agent

Dopamine Agonist

• May cause orthostatic hypotension
• May cause dark urine
• Weeks to months to take effect
• Do not use with MAOIs
• Do not use with glaucoma, melanoma
• Assess for parkinsonian symptoms
• Instruct patient to take as directed

levetiracetam

Keppra

Seizures

decreases severity and incidence of seizures by inhibiting presynaptic calcium channels and reducing neurotransmitter realease

anticonvulsants

pyrrolidines

• May cause suicidal thoughts, dizziness, weakness
• May alter RBC, WBC, and liver function
• May cause somnolence
• Should be infused over 15 minutes

radioactive iodine

none

thyroidectomy pretreatment, thyrotoxic crisis, radiation exposure

inhibits the release of thyroid hormones

Antithyroid Agent, control of hyperthyroidism

none

• may cause GI bleeding, diarrhea, hypothyroidism, goiter
• monitor for hypersensitivity

heparin

Hep-Lock

Venous thromboembolism prophylaxis and treatment, low dose used to ensure patency of IV catheters

increases the inhibitory effect of antithrombin on factor Xa

anticoagulant

antithrombotic

• monitor for signs of bleeding
• monitor platelet count
• may cause hyperkalemia
• have patient report any signs of bleeding

lamotrigine

Lamictal

seizures r/t epilepsy, bipolar

Inhibits sodium transport in neurons

anticonvulsant

• may cause suicidal thoughts, dizziness, behavior changes, nausea, vomiting, photosensitivity,
rash, Stevens-Johnson Syndrome
• use caution with oral contraceptive use
• assess mental status
• assess for seizures
• do not discontinue use abruptly

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

Visit: https://nursing.com/140meds to request your free copy of "140 Must Know Meds"

hydralazine

Apresoline

hypertension

arterial vasodilation by unclarified mechanism

anti-hypertensive

vasodilator

• may cause tachycardia, sodium retention, arrhythmias, angina
• use caution with MAOIs
• monitor blood pressure
• instruct patient on how to take blood pressure

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

isoniazide

INH

tuberculosis

Inhibits synthesis of mycobacterial cell wall

Antitubercular

none

• can cause jaundice
• may cause peripheral neuropathy, seizures, hepatitis
• patient should avoid high amounts of tyramine (pickled meats, aged/smoked meats, alcohol, exotic/aged cheese)
• monitor liver function tests
• complete full course of therapy (6-12 months)
• often used in combination with Rifampin

indomethacin

Indocin

Inflammatory disorders when patients do not respond to other medications

Decreases pain and inflammation by inhibiting prostaglandin synthesis

antirheumatics, ductus arteriosus patency adjuncts (IV only), nonsteroidal anti-inflammatory agents

none

• monitor for hepatitis and GI bleeding
• monitor for dizziness, drowsiness, and headache
• assess for anaphylactic reaction
• aspirin may decrease effectiveness
• monitor renal labs
• shake suspension before administration
• patient should wear sunscreen and protective clothing to protect against photosensitivity