drug card 1
TRANSCRIPT
Andy Samelson's Drug Cards CLASS: Anti arrhythmic
Andy Samelson's Drug Cards Digoxin
Generic: digoxinTrade: Digitek, Lanoxin
Action: CHF – increases contractility Arrhythmias – Slows AV node impulse
Uses: Congestive heart failure, decreases arrhythmias and tachycardia.
Dosage Range: Oral- 0.125 mg – 0.5 mg I.V. or I.M.- 0.1 mg – 0.4 mg
Route: Capsule, I.V. or I.M.
Pharmacodynamics: Onset- (PO.) 1-2 hr (I.M.) 5-30 min Peak- (PO) 2-8 hr. (I.V) 1-4 hr
Common Side Effects: Dizziness, orthostatic hypotension, blurred or yellow vision, headache, fatigue, N.V.D.
Nursing Implications: Check apical pulse before administration, monitor B/P, instruct patients to notify physician if experiencing side effects.
Drug Interactions: Benzos, Quinidine, various antibiotics can increase level of digoxin. Loop diuretics can cause dig toxicity.
Andy Samelson's Drug Cards CLASS: Loop Diuretic
Andy Samelson's Drug Cards Lasix
Generic: furosemideTrade: Lasix
Action: Inhibits reabsorption of sodium and chloride in ascending loop of Henle, increasing excretion of water, sodium, magnesium, and calcium.
Uses: Edema r/t CHF or renal disease, management of HTN.
Dosage Range: Oral- 20-80mg/day – increase slowly to desired range. 2X daily for edema. Route: Tablet, PO solution , I.V. or I.M.
Pharmacodynamics: Duration- 12-24 hr.
Common Side Effects: N.V.D., orthostatic hypotension, dizziness, fatigue, electrolyte imbalance.
Nursing Implications: Monitor B/P, orthostasis, electrolyte levels, and monitor for hearing problems (I.V. and parenteral).
Drug Interactions: Can cause hypokalemic digoxin toxicity, hypotension with antihypertensives, salicylates (high dose) toxicity.
Andy Samelson's Drug Cards CLASS: diuretic
Andy Samelson's Drug Cards hydrochlorothiazide (HCTZ)
Generic: hydrochlorothiazide (HCTZ)Trade: Aquazide H, Hydrocot, Oretic, Microzide
Action: Inhibits sodium reabsorption, increasing excretion of sodium, water, and potassium.
Uses: mild HTN, edema in renal failure and CHF.
Dosage Range: Oral- 25-100mg/day max:200mg/day
Route: Capsule, tablet
Pharmacodynamics: Onset- (PO.) 2 hr. Peak- (PO) 4 hr.
Common Side Effects: N.V.D., orthostatic hypotension, dizziness, fatigue, electrolyte imbalance.
Nursing Implications: Monitor B/P, orthostasis, electrolyte levels, interactions with digoxin..
Drug Interactions: Can cause hypokalemic digoxin toxicity, hypotension with antihypertensives, NSAIDs can reduce efficacy.
Andy Samelson's Drug Cards CLASS: Thyroid agent
Andy Samelson's Drug Cards levothyroxine
Generic: levothyroxineTrade: Synthroid, Levoxyl, Levothroid, Unithroid
Action: Elevates metabolic activity by acting as a replacement thyroid hormone.
Uses: Hypothyroidism, pituitary TSH suppression.
Dosage Range: Oral- 1.7 mcg/kg/day I.V./I.M. 50% of oral dose
Route: injection, powder for re-constitution, tablet.
Pharmacodynamics: Onset- (PO.) 3-5 days (I.V./I.M.) 6-8 hr. Peak- 4-6 weeks to see effective action for each dose.
Common Side Effects: elevated B/P, tachycardia, arrhythmia, anxiety, insomnia, increased appetite, decreased bone density, diaphoresis, heat intolerance.
Nursing Implications: I.V. Form must be prepared immediately before administration. Monitor TSH levels, B/P, heart rate, and other side effects.
Drug Interactions: Iron decreases absorption, may have interactions with antidiabetic agents, Ketamine may cause marked HTN, tricyclics change therapeutic index for both drugs.
Andy Samelson's Drug Cards CLASS: ACE inhibitor
Andy Samelson's Drug Cards Vasotec
Generic: enalaprilTrade: Vasotec
Action: Prevents angiotensin 1 conversion to angiotensin 2, reduces aldosterone secretion, ultimately lowering blood pressure.
Uses: Mild to severe HTN, diabetic nephropathy, CHF..
Dosage Range: Oral- 2.5 mg - 5 mg/day then increase as required. I.V.- 1.25 mg/q6hr. Route: injection, tablet
Pharmacodynamics: Onset- (PO.) 1 hr. Peak- (PO) 4-8 hr. Duration-(PO) 12-24 hr.
Common Side Effects: orthostatic hypotension, headache, dizziness, fatigue, N.V.D. Anorexia.
Nursing Implications: Monitor B/P, orthostasis, possible depression, angioedema, instruct patients not to stop abruptly..
Drug Interactions: insulin causes possible hypoglycemia, aspirin dulls effects, lithium toxicity increases, increased risk of hyperkalemia with potassium-sparing diuretics.
Andy Samelson's Drug Cards CLASS: antibiotic
Andy Samelson's Drug Cards sulfamethoxazole and trimethoprim
Generic: sulfamethoxazole and trimethoprimTrade: Bactrim, Septra
Action: Inhibits bacterial synthesis and growth (bacteriostatic).
Uses: oral treatment of UTIs, acute exacerbations of chronic bronchitis, enteritis from Shigella. I.V. treatment of typhoid, PCP (yeast-like fungus that causes pneumonia.) in immuno-compromised patients.
Dosage Range: Oral- one 800/600mg tab qd x12d I.V.- 8-10mg/kg/day x 12 days
Route: injection, oral suspension, tablet & double strength tablet.Pharmacodynamics: N/A
Common Side Effects: N.V. Anorexia, urticaria.
Nursing Implications: Not for I.M. Injection, must dilute well, take with water on empty stomach, maintain adequate fluid intake to ease strain on kidneys.
Drug Interactions: may increase hyperkalemia with ACE inhibitors and potassium-sparing diuretics, may potentiate Warfarin, increase toxicity of methotrexate.
Andy Samelson's Drug Cards CLASS: antibiotic, PCN
Andy Samelson's Drug Cards amoxicillin
Generic: amoxicillinTrade: Trimox
Action: Inhibits bacterial cell-wall synthesis, and eventually lyses them. (Bacteriocidal)
Uses: treatment of ear, sinus, skin, urinary, and respiratory infections, prophylaxis for surgery, part of multi-drug regimen for H. pylori.
Dosage Range: Oral- (typical) 500mg q12hr
Route: capsule, oral suspension, tablet, chewable
Pharmacodynamics: N/A
Common Side Effects: N.V.D. Dermatitis, possible Stevens-Johnson syndrome, possible behavioral changes.
Nursing Implications: Assess for infection during regimen, monitor for anyphylaxis, C&S before first dose, administer round the clock, instead of just daylight hours, S&S of infection should disappear within 1-2 days.
Drug Interactions: may decrease efficacy of oral contraceptives, may increase effects of warfarin.
Andy Samelson's Drug Cards CLASS: antibiotic
Andy Samelson's Drug Cards vancomycin
Generic: vancomycinTrade: Vancocin
Action: Inhibits cell wall synthesis of bacteria.
Uses: MRSA, meningitis, C. difficile
Dosage Range: Oral- 125mg qid x 10d I.V.- 10-15mg/kg or 1G q12hr
Route: injection, capsule, infusion
Pharmacodynamics: N/A
Common Side Effects: N.V. Stomatitis, chills, hypotension, rash.
Nursing Implications: P&T drawn, slow infusion rate if rash appears, dosage modification for renal impairment, do no give I.M., do not administer anti-diarrheal products for patients on oral vancomycin.
Drug Interactions: increased toxicity in: anesthetic agents and/or other ototoxic or nephrotoxic agents.
Andy Samelson's Drug Cards CLASS: antipsychotic
Andy Samelson's Drug Cards Zyprexa
Generic: olanzapineTrade: Zyprexa, Zydis
Action: antagonism of dopamine and serotonin receptor sites.
Uses: schizophrenia, acute manic episodes of bi-polar disorder, maintenance of bi-polar disorder.
Dosage Range: 5-10 mg qd, titrate to max 20mg
Route: injection, tablet
Pharmacodynamics: N/A
Potential Side Effects: hypotension, anticholinergic effects, arrhythmia, pseudoparkinsonism, dystonia, hyperglycemia, sedation, weight gain
Nursing Implications: P&T drawn, slow infusion rate if rash appears, dosage modification for renal impairment, do no give I.M., do not administer anti-diarrheal products for patients on oral vancomycin.
Drug Interactions: increased toxicity in: anesthetic agents and/or other ototoxic or nephrotoxic agents.
Andy Samelson's Drug Cards CLASS: anticoagulant
Andy Samelson's Drug Cards warfarin
Generic: warfarinTrade: Coumadin
Action: interferes with hepatic synthesis of Vit K dependent coagulation factors.
Uses: prophylaxis and treatment of venous thrombosis, pulmonary embolism, after M.I.
Dosage Range: 2-5 mg qd
Route: injection, tablet
Pharmacodynamics: Onset: 36-72 hr. Peak: 5-7 days
Common Side Effects: Prolonged bleeding, headache, hematuria, N.V.D., hemoptysis
Nursing Implications: Avoid all I.M. Injections, monitor for S&S of bleeding.
Drug Interactions: Numerous – primarily decreased or increased efficacy of warfarin.
Andy Samelson's Drug Cards CLASS: anticoagulant
Andy Samelson's Drug Cards heparin
Generic: heparinTrade: Hep-lock
Action: prevents conversion of fibrinogen to fibrin (prevents clots).
Uses: prophylaxis and treatment of thromboembolic disorders.
Dosage Range: line patency: 100 units DVT prophylaxis: 5000 u SQ q8-12hr M.I.: rates vary with scenario
Route: infusion, injection.
Pharmacodynamics: Onset: subQ- 20-30 min I.V. - immediate Duration: dose-dependant
Common Side Effects: bruising, prolonged bleeding, rebound hyperlipidemia on D/C, osteoporosis, persistent erection.
Nursing Implications: Do not administer I.M. - watch for S&S of bleeding.
Drug Interactions: NSAIDs, aspirin, may potentiate. Nitroglycerin may decrease efficacy, nicotine, digoxin, and antihistamines all may potentiate.
Andy Samelson's Drug Cards CLASS: insulin
Andy Samelson's Drug Cards regular insulin
Generic: insulin regularTrade: Humulin R, U-500, Novolin R.
Action: Breaks down blood sugar and stimulates creation of glycogen.
Uses: Diabetes type 1
Dosage Range: SubQ: 0.5-1.2 units/kg/day in divided doses.
Route: injection, I.V.
Pharmacodynamics: Onset: 0.5 hr Duration: 6-8 hr
Common Side Effects: hypoglycemia, other assorted adverse effects rarely associated (frequency undetermined.)
Nursing Implications: SubQ injection in thigh, buttocks, arm, or abdomen – rotate sites. Glucometer measurement important. Draw regular insulin first when mixing preparations. Roll vial to resuspend. Administer 15 min prior to meal.
Drug Interactions: oral contraceptives, nicotine, thiazide diuretics, thyroid hormone, corticosteroids all DECREASE effect. Alcohol, anabolic steroids, MAOI's, salicylates all INCREASE effect.
Andy Samelson's Drug Cards CLASS: insulin
Andy Samelson's Drug Cards Humalog
Generic: insulin lisproTrade: Humalog.
Action: Breaks down blood sugar and stimulates creation of glycogen.
Uses: Diabetes type 1
Dosage Range: SubQ: 0.5-1.2 units/kg/day in divided doses. (equipotent to regular insulin)
Route: injection
Pharmacodynamics: Onset: 0.2 – 0.5 hr Duration: 3-4 hr
Common Side Effects: hypoglycemia, other assorted adverse effects rarely associated (frequency undetermined.)
Nursing Implications: SubQ injection in thigh, buttocks, arm, or abdomen – rotate sites. Glucometer measurement important. Draw fast-acting insulins first in mixed doses. Administer 15 min prior to or after meal.
Drug Interactions: oral contraceptives, nicotine, thiazide diuretics, thyroid hormone, corticosteroids all DECREASE effect. Alcohol, anabolic steroids, MAOI's, salicylates all INCREASE effect.
Andy Samelson's Drug Cards CLASS: insulin
Andy Samelson's Drug Cards Ultra-Lente
Generic: insulin NPHTrade: Humulin N, Novolin N
Action: Breaks down blood sugar and stimulates creation of glycogen.
Uses: Diabetes type 1
Dosage Range: SubQ: 0.5-1.2 units/kg/day in divided doses. (equipotent to regular insulin)
Route: injection
Pharmacodynamics: Onset: 1-2 hr Duration: 18-24 hr
Common Side Effects: hypoglycemia, other assorted adverse effects rarely associated (frequency undetermined.)
Nursing Implications: SubQ injection in thigh, buttocks, arm, or abdomen – rotate sites. Glucometer measurement important. Draw shorter acting insulins first in mixed doses. Roll vial to resuspend.
Drug Interactions: oral contraceptives, nicotine, thiazide diuretics, thyroid hormone, corticosteroids all DECREASE effect. Alcohol, anabolic steroids, MAOI's, salicylates all INCREASE effect.
Andy Samelson's Drug Cards CLASS: insulin
Andy Samelson's Drug Cards insulin 70/30 (NPH and Regular)
Generic: insulin 70/30Trade: Humulin 70/30, Novolin 70/30.
Action: Breaks down blood sugar and stimulates creation of glycogen.
Uses: Diabetes type 1
Dosage Range: SubQ: 0.5-1.2 units/kg/day in divided doses.
Route: injection (SubQ only)
Pharmacodynamics: Onset: 0.5 hr Duration: 18-24 hr
Common Side Effects: hypoglycemia, other assorted adverse effects rarely associated (frequency undetermined.)
Nursing Implications: SubQ injection in thigh, buttocks, arm, or abdomen – rotate sites. Glucometer measurement important. Roll vial to resuspend. Administer prior to breakfast and supper.
Drug Interactions: oral contraceptives, nicotine, thiazide diuretics, thyroid hormone, corticosteroids all DECREASE effect. Alcohol, anabolic steroids, MAOI's, salicylates all INCREASE effect.
Andy Samelson's Drug Cards CLASS: antibiotic, PCN
Andy Samelson's Drug Cards penicillin
Generic: penicillinTrade: Pfizerpen, Veetids
Action: interferes with cell-wall synthesis and causes death. (Bactericidal)
Uses: Most gram + organisms, except Staph A.
Dosage Range: Varies by disease organism
Route: Infusion, injection, or tablet (Pen V)
Pharmacodynamics: N/A
Common Side Effects: Anyphylaxis, hypersensitivity, rash.
Nursing Implications: Administer round the clock, instead of daylight hours. Empty stomach is best.
Drug Interactions: decreases efficacy of oral contraceptives, may potentiate warfarin, tetracyclines decrease effectiveness.
Andy Samelson's Drug Cards CLASS: analgesis, narcotic
Andy Samelson's Drug Cards Percocet
Generic: Oxycodone and AcetaminophenTrade: Endocet, Percocet, Roxicet
Action: Oxycodone binds with opiate receptors, and acetaminophen inhibits production of prostaglandins while lowering fever by acting on temp control center.
Uses: moderate to severe pain.
Dosage Range: Oral- 2.5 – 5 mg q6hr Max: 4 G qd acetaminophen-based
Route: Capsule, tablet, solution
Pharmacodynamics: N/A
Common Side Effects: constipation, over-sedation, dysphoria, euphoria, nausea, respiratory depression, skin rash.
Nursing Implications: Monitor for pain relief, over-sedation, confusion, and constipation.
Drug Interactions: anesthetics can lead to additive CNS depression, anticholinergics can lead to paralytic ileus.
Andy Samelson's Drug Cards CLASS: gastrointestinal agent
Andy Samelson's Drug Cards Prilosec OTC
Generic: omeprazoleTrade: Prilosec OTC
Action: inhibits parietal stomach cells from producing acid.
Uses: erosive esophagitis, gastroesophageal reflux disease, ulcers.
Dosage Range: Oral- 20-40 mg/day
Route: Capsule, tablet (both delayed-release).
Pharmacodynamics: Onset:1 hr, Peak: 2hr Duration: 72 hr.
Common Side Effects: N.V.D., flatulence, headache, dizziness, taste perversion.
Nursing Implications: Maintain integrity of capsule during administration, take before eating.
Drug Interactions: May decrease excretion of methotrexate, may prolong elimination of warfarin
Andy Samelson's Drug Cards Andy Samelson's Drug Cards
CLASS: vasodilator, anti-anginal nitroglycerin
Generic: nitroglycerinTrade: Nitrek, Nitrostat, Nitro-bid
Action: Relaxes smooth muscle, dilating vessels – improves flow to ischemic regeions.
Uses: Treatment of angina pectoris, M.I., acute HTN.
Dosage Range: Oral- 2.5 - 9 mg max: 26mg qd I.V.- 5 mcg/min titrate to max 200mcg/min Ointment: 0.5 - 2” every 6 hr, + 12 hr break Patch: 0.2 – 0.4mg/hr + 12 hr break. Sublingual: 0.2 – 0.6 mg q 5 min max: 3 doses
Route: Capsule, infusion, injection, ointment, solution, tablet, trans-dermal patch.
Pharmacodynamics: Onset- (PO.) 1-3 min (Patch) 40-60 min Peak- (PO) 4-10 min.. (Patch) 1-3 hr Duration- (PO) 30-60 min (Patch) 18-24 hr
Common Side Effects: headache, hypotension, syncope (fainting from loss of O2 to brain), lightheadedness.
Nursing Implications: Do not chew or swallow sublingual form, alternate patch sites, keep patches on 12 on/12 off schedule. Call 911 if no relief after 3 sublingual doses. Must be stored in glass bottles.
Drug Interactions: alcohol can aggravate hypotension, sildenafil, tadafil, and vardenafil are strongly contraindicated for concurrent use with nitrates, as they cause severe hypotension. 24 hour period between nitrates and these drugs is recommended.
Andy Samelson's Drug Cards CLASS: antiarrhythmic agent/anticonvulsant
Andy Samelson's Drug Cards Dilantin
Generic: phenytoinTrade: Dilantin
Action: Prolongs refractory period, and decreases seizure activity.
Uses: management of grand mal seizures, prevention thereof, arrhythmias r/t dig toxicity, and trigeminal neuralgia.
Dosage Range: Oral/I.V. 100mg tid
Route: Capsule, injection, oral suspension, chewable tablet.
Pharmacodynamics: N/A
Common Side Effects: Hypotension, gingival hypertrophy, bradycardia, headache, insomina, blurred vission, N.V.D., folic acid depletion.
Nursing Implications: Stop enteral feedings 2 hr prior to giving. I.V. Injections should be followed with flush to avoid irritation of vein, must me diluted to <6mg/mL in saline for infusion.
Drug Interactions: Numerous, primarily involving faster metabolism of other drugs, decreasing their efficacy.
Andy Samelson's Drug Cards Andy Samelson's Drug Cards
CLASS: beta blocker metoprolol
Generic: metoprololTrade: Lopressor, Toprol-XL
Action: inhibits beta1 andrenergic receptors, slowing heart-rate, and lowering blood pressure.
Uses:HTN, angina, prevention of M.I. Atrial fibrillation, CHF, or used in concurrently with ACE inhibitors and/or digoxin.
Dosage Range: Oral- 25 – 300mg/day (typical)
Route: injection, E.R. tablet.
Pharmacodynamics: Onset: 1.5 - 4 hr Duration: 10 - 20 hr
Common Side Effects: drowsiness, insomnia, decreased sexual ability, bradycardia, edema, reduced peripheral circulation, NVD, bronchospasms
Nursing Implications: Monitor for orthostatic hypotension, mental status changes, and apical and peripheral pulses.
Drug Interactions: may decrease metabolism of antipsychotic agents, NSAIDs may decrease efficacy of drug.
Andy Samelson's Drug Cards CLASS: anticoagulant
Andy Samelson's Drug Cards Lovenox
Generic: enoxaparinTrade: Lovenox
Action: prevents conversion of fibrinogen to fibrin (prevents clots).
Uses: prophylaxis and treatment of thromboembolic disorders, DVTs, unstable angina, and M.I.
Dosage Range: DVT prophylaxis:30-40mg bid M.I.: 1mg/kg SubQ bid with aspirin
Route: injection
Pharmacodynamics: Peak: 3 hr Duration: 275 min.
Common Side Effects: bruising, prolonged bleeding, N.V.D. injection-site hematoma.
Nursing Implications: Do not administer I.M. - watch for S&S of bleeding. SubQ only.
Drug Interactions: NSAIDs, aspirin, may potentiate. Nitroglycerin may decrease efficacy, nicotine, digoxin, and antihistamines all may potentiate.
Andy Samelson's Drug Cards CLASS: ACE Inhibitor
Andy Samelson's Drug Cards Lisinopril
Generic: lisinoprilTrade: Prinvil, Zestril
Action: Reduces blood pressure by inhibiting the renin/angiotensin chain @ angiotensin 1.
Uses: HTN, systolic CHF
Dosage Range: Oral- 10-40 mg/day
Route: PO
Pharmacodynamics: Onset: 1 hr Peak: 6 hr Duration: 24 min.
Common Side Effects: hypotension, dizziness, fatigue, headache, hyperkalemia, NVD, dry cough
Nursing Implications: Watch for hypotensive effect within 1-3 hours of change/increase in dose.
Drug Interactions: Antacids (decrease concentration of ACEI), lithium – may increase blood levels because of salt retention, NSAIDs and salicylates may add to strain on kidneys.
Andy Samelson's Drug Cards CLASS: analgesis, narcotic
Andy Samelson's Drug Cards morphine sulphate
Generic: morphine sulphateTrade: Roxanol, MS Contin, MSIR, Avinza, Oramorph SR
Action: Binds to opiate receptors in CNS, increasing pain threshold, altering perception of pain, and depressing CNS.
Uses: severe acute and chronic pain, pre-anesthetic, dyspnea of acute L ventricular failure and pulmonary edema.
Dosage Range: Oral- 10-30 mg Q3-4 hr PRN I.V./I.M.- 2.5 – 10 mg Q 3hr PRN
Route: Cap, tab, injection, infusion, suppository
Pharmacodynamics: Onset: 20 min - 1 hr Duration: Epidural – 48 hr. ER tabs – 8-12hr Other- 4-5 hr
Common Side Effects: diaphoresis, constipation, CNS depression, hypotension, drowsiness, dizziness, nausea, xerostomia, NVD, numerous GI problems.
Nursing Implications: Observe patient for signs of tolerance, and/or over sedation and CNS depression.
Drug Interactions: CNS depressants, alcohol, MAOIs, all can potentiate and/or increase toxicity of morphine.
Andy Samelson's Drug Cards CLASS: vasodilator, anti-anginal
Andy Samelson's Drug Cards isosorbidide dinitrate
Generic: isosorbidide dinitrateTrade: Isordil
Action: Relaxes smooth muscle, dilating vessels – improves flow to ischemic regions.
Uses: Treatment of angina pectoris, M.I., acute HTN, dysphagia.
Dosage Range: Oral- 5 - 40 mg QID Sublingual: 2.5 - 5 mg q 5 min max: 3 doses
Route: Capsule, tablet (ER and SL)
Pharmacodynamics: Onset- (PO.) 1-3 min (SL) 2 - 10 min Duration- (PO) 4-6 hr (SL) 1 - 2 hr
Common Side Effects: headache, hypotension, syncope (fainting from loss of O2 to brain), lightheadedness.
Nursing Implications: Do not chew or swallow sublingual form, Call 911 if no relief after 3 sublingual doses.
Drug Interactions: alcohol can aggravate hypotension, sildenafil, tadafil, and vardenafil are strongly contraindicated for concurrent use with nitrates, as they cause severe hypotension. 24 hour period between nitrates and these drugs is recommended.
Andy Samelson's Drug Cards CLASS: corticosteroid
Andy Samelson's Drug Cards prednisone
Generic: prednisoneTrade: Deltasone, Prednisone Intensol, Sterapred
Action: Decreases inflammation, suppresses immune system, anti-emetic effects by inhibition of emetic center prostaglandin synthesis.
Uses: hypercalcemia, rheumatic disorters, respiratory problems, organ transplant, inflammation.
Dosage Range: Oral- 1 - 10 mg QD
Route: solution, tablet
Pharmacodynamics: Loading dose first
Common Side Effects: Insomnia, nervousness, increased appetite, dizziness, hirsutism, diaphoresis.
Nursing Implications: Administer w/ meals, do not D/C abruptly
Drug Interactions: barbituates, phenytoin decrease effect. NSAIDs increase risk of ulceration in GI tract. Decreases vaccine effectiveness.
Andy Samelson's Drug Cards CLASS: oral electrolyte supplement
Andy Samelson's Drug Cards potassium chloride
Generic: potassium chlorideTrade: K-DUR, Klor-Con, Micro-K
Action: Maintains nerve impulses in heart/brain/ muscle, responsible for muscle contraction, acid-base balance, and carbohydrate metabolism.
Uses: treatment of hypokalemia
Dosage Range: Oral- 40 - 80 meq QD Route: Capsule, tablet, injection, infusion, solution
Pharmacodynamics: N/A
Common Side Effects: NVD, flatulence, bradycardia, kyperkalemia, pain at site of injection, dyspnea
Nursing Implications: Dilute oral preps 2-6 parts dilutant, with water or fruit juice. Wax matrix tabs must be swallowed – not dissolved in mouth, may not be given IV push.
Drug Interactions: Increased effect with potassium-sparing diuretics, ACE inhibitors.
Andy Samelson's Drug Cards CLASS: antidiabetic agent
Andy Samelson's Drug Cards metformin
Generic: metforminTrade: Glucophage
Action: Improves insulin sensitivity, and decreases hepatic synthesis of glucose.
Uses: Diabetes type 2 (non-insulin dependant)
Dosage Range: Oral- 500 mg bid – 850 mg qd
Route: oral
Pharmacodynamics: N/A
Common Side Effects: NVD (very common), headache, hypoglycemia, indigestion, heart palpitations.
Nursing Implications: Do not crush, break, or chew ER form. NPO patients may need it to be held to prevent hypoglycemia.
Drug Interactions: oral contraceptives, nicotine, thiazide diuretics, thyroid hormone, corticosteroids all DECREASE effect. Cimetidine increases (60%) concentration in blood.
Andy Samelson's Drug Cards CLASS: antidiabetic agent
Andy Samelson's Drug Cards glipizide
Generic: glipizideTrade: Glucotrol
Action: Improves insulin sensitivity, and decreases hepatic synthesis of glucose. Also stimulates insulin release from pancreatic beta cells.
Uses: Diabetes type 2 (non-insulin dependant)
Dosage Range: Oral- 5 mg qd
Route: oral
Pharmacodynamics: Onset- 1.5 – 2 hr Duration- 12 – 24 hr.
Common Side Effects: NVD (very common), headache, hypoglycemia, indigestion, heart palpitations, blurred vision, edema, syncope, urticaria, hepatic jaundice.
Nursing Implications: Monitor for S&S of hypoglycemia, administer 30 min prior to meals.
Drug Interactions: steroids, ACE inhibitors, beta blockers, ethanol all effect blood sugar levels.
Andy Samelson's Drug Cards CLASS: antibiotic
Andy Samelson's Drug Cards ciprofloxacin
Generic: ciprofloxacinTrade: Cipro, Ciloxan
Action: Interferes with DNA synthesis in various microbial organisms
Uses: UTI, gonorrhea, opthalmic infections, sinusitis, assorted skin infections, anthrax.
Dosage Range: Oral- 400 – 600 mg bid (typical)
Route: oral, injection, IV infusion, opthalmic ointment
Pharmacodynamics: N/A
Common Side Effects: dizziness, headache, NVD, nervousness, insomnia, risk for super-infection.
Nursing Implications: Hold antacids 3-4 hour prior to giving, administer round the clock, encourage foods, instruct on use of opthalmic product, preferably administer on empty stomach.
Drug Interactions: low risk of increase of effects/concentrations of many other drugs.
Andy Samelson's Drug Cards CLASS: anti-convulsant
Andy Samelson's Drug Cards valproic acid
Generic: valproic acidTrade: Depakote ER
Action: Increased availability and/or mimicry of GABA. (An inhibitory neurotransmitter)
Uses: absence seizures, migraine prophylaxis, partial seizures, bi-polar disorder.
Dosage Range: Oral- 10-15mg/kg/day in 3 doses
Route: capsule, injection, tablet
Pharmacodynamics: N/A
Common Side Effects: children < 2yr extreme risk of hepatic failure, teratogenic effects on pregnancy, headache, somnolence, dizziness, insomnia, alopecia, NVD, weakness, tremors, arrhythmia, postural hypotension, edema, tachycardia, incontinence, constipation, weight gain, oral problems.
Nursing Implications: Monitor PT/PTT, liver enzymes, do not administer with carbonated drinks, take with food or milk, do not chew or crush.
Drug Interactions: salicylates increase toxicity, trycyclics are increased in concentration,
Andy Samelson's Drug Cards CLASS: antidepressant
Andy Samelson's Drug Cards sertraline
Generic: sertralineTrade: Zoloft
Action: SSRI
Uses: depression, OCD, PTSD, SAD
Dosage Range: Oral- 25 – 50 mg/day
Route: oral
Pharmacodynamics: N/A
Common Side Effects: insomnia, dizziness, fatigue, headache, xerostomia, diarrhea, ejaculatory disturbances, nervousness, decreased libido, constipation, anorexia, tremors
Nursing Implications: May increase risk of suicidal thoughts, monitor nutritional intake and weight, if somnolent – administer at bedtime.
Drug Interactions: increased risk of serotonin syndrome with serotonin agonists, alters metabolism of many other drugs.
Andy Samelson's Drug Cards CLASS: antidepressant
Andy Samelson's Drug Cards venlafaxine
Generic: venlafaxineTrade: Effexor
Action: Inhibits serotonin and norephinephrine re-uptake
Uses: depression, OCD, PTSD, SAD
Dosage Range: Oral- 37.5 – 75 mg/day
Route: capsule, tablet
Pharmacodynamics: N/A
Common Side Effects: insomnia, dizziness, fatigue, headache, xerostomia, diarrhea, ejaculatory disturbances, nervousness, decreased libido, constipation, anorexia, tremors
Nursing Implications: May increase risk of suicidal thoughts, monitor nutritional intake and weight, if somnolent – administer at bedtime.
Drug Interactions: increased risk of serotonin syndrome with serotonin agonists, alters metabolism of many other drugs.
Andy Samelson's Drug Cards CLASS: antispasmodic agent
Andy Samelson's Drug Cards oxybutynin
Generic: oxybutyninTrade: Ditropan, Oxytrol
Action: inhibits action of acetylcholine on smooth muscle, increases bladder capacity, decreases urgency and frequency of voiding.
Uses: urinary incontinence/frequency
Dosage Range: Oral- 5 mg TID Patch- 3.9mg/day 2x weekly Route: tablet, transdermal patch
Pharmacodynamics: Onset- 30-60min Peak- 3-6hr Duration- 6-10 hr
Common Side Effects: dizziness, somnolence, xerostomia (very common), constipation, impaired urination.
Nursing Implications: Caution with geriatric patients because of anti-cholinergic activity.
Drug Interactions: anti-cholinergic and anti-histamine drugs potentiate effects. Additional sedation with alcohol and CNS depressants.
Andy Samelson's Drug Cards CLASS: vitamin
Andy Samelson's Drug Cards Vit B-12
Generic: Vit B-12Trade: Crystamine, Crysti 1000, Cyanoject, Ener-B, Nascobal
Action: coenzyme for many metabolic processes including fat and carb metabolism, protein synthesis, and hematopoesis.
Uses: pernicious anemia, b-12 deficiency, inadequate secretion of intrinsic factor.
Dosage Range: Oral- 250 mcg/day I.M./SubQ- 100-200 mcg/month
Route: oral, injection
Pharmacodynamics: N/A
Common Side Effects: peripheral vascular disease, anxiety, restlessness, itching, pain, NVD
Nursing Implications: IM or deep SubQ are vastly superior methods of introduction to oral. Monitor potassium concentrations in early therapy.
Drug Interactions: anticonvulsants, and metformin may decrease oral absorption.
Andy Samelson's Drug Cards CLASS: calcium channel blocker
Andy Samelson's Drug Cards diltiazem
Generic: diltiazemTrade: Cardizem, Dilacor, Tiazac
Action: relaxes coronary smooth muscle, increases myocardial O2 delivery
Uses: Oral: HTN, chronic angina Injection: atrial fibrillation
Dosage Range: Oral- 120 – 180 mg/day
Route: oral, injection (IV)
Pharmacodynamics: Onset: 30-60 min Peak: 2-3 hr
Common Side Effects: edema, headahce, hypotension, NVD, gout, constipation, weakness, dyspnea
Nursing Implications: Do not use with beta-blockers, do not crush/chew XR tabs.
Drug Interactions: May increase concentration/potentiate many other drugs.
Andy Samelson's Drug Cards CLASS: adrenergic agonist
Andy Samelson's Drug Cards clonidine
Generic: clonidineTrade: Catapres
Action: decrease in peripheral resistance, lowering B/P and HR
Uses: moderate HTN, not recommended as first line antihypertensive
Dosage Range:Oral- 0.1 mg BID max: 2.4mg/day Patch- 0.1-0.3mg/day
Route: oral, transdermal patch, injection
Pharmacodynamics: Onset- 0.5 – 1 hr Peak- 2-4 hr Duration- 6-10 hr
Common Side Effects: drowsiness, dizziness, pruritus, dry mouth, orthostatic hypotension, headache, fatigue, skin rash at patch site.
Nursing Implications: rotate patches weekly to hairless portion of upper outer arm or chest. D/C gradually.
Drug Interactions: other CNS depressants, beta blockers, antipsychotics, and narcotics may potentiate hypotensive effects.
Andy Samelson's Drug Cards CLASS: antidepressant
Andy Samelson's Drug Cards citalopram
Generic: citalopramTrade: Celexa
Action: SSRI
Uses: depression, OCD, PTSD, SAD
Dosage Range: Oral- 20 – 40 mg/day
Route: oral solution, tablet
Pharmacodynamics: N/A
Common Side Effects: insomnia, dizziness, fatigue, headache, xerostomia, diarrhea, ejaculatory disturbances, nervousness, decreased libido, constipation, anorexia, tremors
Nursing Implications: May increase risk of suicidal thoughts, monitor nutritional intake and weight, if somnolent – administer at bedtime.
Drug Interactions: increased risk of serotonin syndrome with serotonin agonists, alters metabolism of many other drugs.
Andy Samelson's Drug Cards CLASS: cortiosteroid inhalant
Andy Samelson's Drug Cards fluticasone and salmeterol
Generic: fluticasone and salmeterolTrade: Advair Diskus
Action: anti-inflammatory, relaxes bronchial smooth muscle
Uses: maintenance of asthma (not acute bronchospasms), COPD
Dosage Range: one inhalation 12 hours apart.
Route: inhaled
Pharmacodynamics: N/A
Common Side Effects: URTI, pharyngitis, headache, NVD, sinusitis,
Nursing Implications: Do not use for acute relief of asthma attacks, wash mouth out after use to decrease infections, do not use with spacer device.
Drug Interactions: sympathomimetics may enhance toxic/adverse effects.
Andy Samelson's Drug Cards CLASS: corticosteroid
Andy Samelson's Drug Cards triamcinolone
Generic: triamcinoloneTrade: Azmacort
Action: decreases inflammation and depresses immune response.
Uses: control of asthma, management of seasonal allergies (rhinitis).
Dosage Range: 200mcg QID max: 1600mcg/day
Route: inhaled, cream, injection, oral, ointment
Pharmacodynamics: N/A
Common Side Effects: angioedema, CHF, HTN, vasculitis, convulsions, mood swings, cushingoid state, diabetes mellitus manifestation, hypokalemix alkalosis, abdominal distension, intraocular pressure
Nursing Implications: Evaluate mental status, inject IM in large muscle (avoid deltoid), avoid SubQ, apply topicals sparingly, dose in morning.
Drug Interactions: barbituates, phenytoin, decrease effect. Salmeterol increases effect. Salicylates increase risk of GI ulcers.
Andy Samelson's Drug Cards CLASS: beta blocker
Andy Samelson's Drug Cards atenolol
Generic: atenololTrade: Tenormin
Action: inhibits beta1 andrenergic receptors, slowing heart-rate, and lowering blood pressure.
Uses:HTN, angina, prevention of M.I. Atrial fibrillation, CHF, or used in concurrently with ACE inhibitors and/or digoxin.
Dosage Range: Oral- 25 – 100mg/day (typical)
Route: injection, E.R. tablet.
Pharmacodynamics: N/A
Common Side Effects: drowsiness, insomnia, decreased sexual ability, bradycardia, edema, reduced peripheral circulation, NVD, bronchospasms
Nursing Implications: Monitor for orthostatic hypotension, mental status changes, and apical and peripheral pulses.
Drug Interactions: may decrease metabolism of antipsychotic agents, NSAIDs may decrease efficacy of drug.
Andy Samelson's Drug Cards CLASS: antiemetic
Andy Samelson's Drug Cards ondansetron
Generic: ondansetronTrade: Zofran
Action: blocks serotonin selectively on vagal nerve terminals.
Uses: prevention of nausea associated with chemo, radiation, post-op NV
Dosage Range: Varies with treatment
Route: IM, IV, oral
Pharmacodynamics: N/A
Common Side Effects: fatigue, headache, drowsiness, anxiety, diarrhea, constipation, urinary retention, hypoxia.
Nursing Implications: Oral dosage should be given 30 min prior to therapy. The IV version has also been used successfully orally.
Drug Interactions: Apomorphine promotes profound hypotension concurrently.
Andy Samelson's Drug Cards CLASS: analgesis, narcotic
Andy Samelson's Drug Cards fentanyl
Generic: fentanylTrade: Duragesic
Action: increases pain threshold, inhibits ascending pain pathways, alters perception of pain.
Uses: moderate to severe pain, pre-op anesthetic, chronic pain, cancer pain
Dosage Range: IM/slow IV 25-100 mcg 60 min prior to surgery.
Route: injection, IV, patch
Pharmacodynamics: Onset: IV-immediate Duration: 30-60 min
Common Side Effects: constipation, over-sedation, dysphoria, euphoria, nausea, respiratory depression, skin rash.
Nursing Implications: Monitor for pain relief, over-sedation, confusion, and constipation. May cause rebound respiratory depression, monitor for 12 hours after removal of patch.
Drug Interactions: anesthetics can lead to additive CNS depression, anticholinergics can lead to paralytic ileus. SSRIs may cause serotonin syndrome. MAOIs are contraindicated.
Andy Samelson's Drug Cards CLASS: antibiotic, 1st gen cephalosporin
Andy Samelson's Drug Cards cephalexin
Generic: cephalexinTrade: Keflex, Keftab, Biocef
Action: Inhibits bacterial cell wall synthesis and causes them to lyse.
Uses: RTI, skin infections, bone infections, UTI, acute bacterial endocarditis prophylaxis.
Dosage Range: Oral- 250 - 1000 mg qd Max: 4 G/day
Route: Capsule, tablet, suspension
Common Side Effects: hallucinations, NVD, agitation, angioedema, vaginitis, super infection risk.
Nursing Implications: administer on empty stomach, to increase absorption. Administer round the clock to increase P&T effectiveness.
Drug Interactions: anesthetics can lead to additive CNS depression, anticholinergics can lead to paralytic ileus.
Pharmacodynamics: N/A
Andy Samelson's Drug Cards CLASS: antibiotics
Andy Samelson's Drug Cards Gentamicin
Generic: gentamicinTrade: Garamycin
Action: Interferes with cell membrane on cells
Uses: Treats gram negative organisms like pseudomonas, serratia, bone infections, and septicemia.
Dosage Range: Oral- 1-2.5 mg/kg Q12
Route: ointment, injection
Pharmacodynamics: N/A
Common Side Effects: neurotoxicity, vertigo, ataxia, ototoxicity, nephrotoxicity
Nursing Implications: Therapeutic vs. nephrotoxic levels vary greatly, so renal tests are required to determine acceptable levels.
Drug Interactions: penicillins, cephalosporins, loop diuretics can potentiate and increase kidney difficulties.
Andy Samelson's Drug Cards CLASS: Parkinson’s agent
Andy Samelson's Drug Cards amantadine
Generic: amantadineTrade: Symmetrel
Action: antiviral for influenza, promotes dopamine increase in brain for anti-Parkinsonian effect.
Uses: treatment of drug-induced extrapyramidal symptoms, influenza A, and Parkinsons.
Dosage Range: Oral- 100-200 mg qd
Route: Capsule, tablet, syrup
Pharmacodynamics: N/A
Common Side Effects: Orthostatic hypotension, edema, CNS effects, nausea, xerostomia
Nursing Implications: Due not stop abruptly. If insomnia occurs, take early in the afternoon.
Drug Interactions: anti-cholinergics may potentiate, thiazide diuretics may increase toxicity.
Andy Samelson's Drug Cards CLASS: Sedative/Hypnotic
Andy Samelson's Drug Cards Zolpidem
Generic: ZolpidemTrade: Ambien
Action: Dissimilar to benzos, selective GABA agonist.
Uses: Short term insomnia
Dosage Range: Oral- 5-10 mg max @ HS
Route: Capsule, tablet
Pharmacodynamics: Onset- (PO.) 30 min. Duration: 6-8 hr.
Common Side Effects: Dizziness, headache, somnolence, increased B/P, palpitations, numerous CNS effects.
Nursing Implications: Administer on empty stomach. Assist older adults with ambulation.
Drug Interactions: Any CNS depressant can potentiate the effects of this drug.
Andy Samelson's Drug Cards CLASS: Stool Softener
Andy Samelson's Drug Cards docusate
Generic: docusateTrade: Colace
Action: Reduces fecal surface tension, allowing for greater incorporation of water and lipids in stool.
Uses: Stool softener
Dosage Range: 50-500 mg/day in 4 divided doses
Route: Capsule, tablet, enema, suppository, gel cap, syrup.
Pharmacodynamics: Onset- 12-72 hours.
Common Side Effects: diarrhea, cramps, throat irritation.
Nursing Implications: Use for short period of time, assess for dependence as well as electrolyte and fluid loss. Notify doc if bleeding occurs or constipation isn’t relieved.
Drug Interactions: None listed
Andy Samelson's Drug Cards CLASS: CNS Stimulant
Andy Samelson's Drug Cards modafinil
Generic: modafinilTrade: Provigil
Action: Unknown – possibly inhibits GABA transmission.
Uses: treatment of excessive daytime sleepiness, adjunctive therapy for OSA.
Dosage Range: Oral- 100-300 mg/day
Route: tablet
Pharmacodynamics: N/A
Common Side Effects: headache, nausea, HTN, palpitations, tachycardia, nervousness, insomnia, xerostomia, diarrhea
Nursing Implications: Diabetics should monitor BS levels closely. Avoid ETOH, report chest pain/palpitations, respiratory difficulties.
Drug Interactions: increases metabolic clearance of many drugs, perhaps prematurely – leading to a therapeutic concentration of those drugs in the blood.
Andy Samelson's Drug Cards CLASS: insulin
Andy Samelson's Drug Cards insulin 70/30
Generic: insulin 70/30Trade: Humulin 70/30, Novolin 70/30.
Action: Breaks down blood sugar and stimulates creation of glycogen.
Uses: Diabetes type 1
Dosage Range: SubQ: 0.5-1.2 units/kg/day in divided doses.
Route: injection (SubQ only)
Pharmacodynamics: Onset: 0.5 hr Duration: 18-24 hr
Common Side Effects: hypoglycemia, other assorted adverse effects rarely associated (frequency undetermined.)
Nursing Implications: SubQ injection in thigh, buttocks, arm, or abdomen – rotate sites. Glucometer measurement important. Roll vial to resuspend. Administer prior to breakfast and supper.
Drug Interactions: oral contraceptives, nicotine, thiazide diuretics, thyroid hormone, corticosteroids all DECREASE effect. Alcohol, anabolic steroids, MAOI's, salicylates all INCREASE effect.
Andy Samelson's Drug Cards CLASS: Vitamin
Andy Samelson's Drug Cards Thiamine
Generic: thiamineTrade: Vitamin B1
Action: Essential in carb metabolism
Uses: Treatment of prophylaxis of various brain disorders, alcoholics, impaired GI absorption.
Dosage Range: 100mg QD
Route: injection, tablet
Pharmacodynamics: N/A
Common Side Effects: None
Nursing Implications: IM injections may cause pain at injection site.
Drug Interactions: None.
Andy Samelson's Drug Cards CLASS: Vitamin
Andy Samelson's Drug Cards folic acid
Generic: folic acidTrade: Folvite
Action: Prevents anemia, necessary for metabolism.
Uses: Treatment of anemias...
Dosage Range: 0.4 mg QD
Route: injection, tablet, capsule
Pharmacodynamics: N/A
Common Side Effects: Bronchospasm (uncommon)
Nursing Implications: Dilute for injectins...
Drug Interactions: May diminish effective concentration of Phenytoin.
Andy Samelson's Drug Cards CLASS: Proton pump inhibitor
Andy Samelson's Drug Cards pantoprazole
Generic: panoprazoleTrade: Protronix
Action: Supresses gastric secretions
Uses: Treatment of GERD
Dosage Range: 40mg QD
Route: injection, tablet, liquid
Pharmacodynamics: N/A
Common Side Effects: No overly common SE, other than headaches and diarrhea.
Nursing Implications: Do not administer via NGT. Do not crush tablets.
Drug Interactions: Increased anticoagulant effects have been reported with Coumadin and Warfarin.
Andy Samelson's Drug Cards CLASS: Anticonvulsant
Andy Samelson's Drug Cards gabapentin
Generic: gabapentinTrade: Neurontin
Action: Behaves similarly to GABA
Uses: seizures
Dosage Range: 300-1800 mg QD
Route: capsule, solution, tablet
Pharmacodynamics: N/A
Common Side Effects: Somnolence, fatigue, dizziness, ataxia, edema, confusion, NVD
Nursing Implications: Dosage must be adjusted in renal patients...
Drug Interactions: May increase effect of any CNS depressant.
Andy Samelson's Drug Cards CLASS: insulin
Andy Samelson's Drug Cards insulin 70/30 (NPH and Regular)
Generic: insulin 70/30Trade: Humulin 70/30, Novolin 70/30.
Action: Breaks down blood sugar and stimulates creation of glycogen.
Uses: Diabetes type 1
Dosage Range: SubQ: 0.5-1.2 units/kg/day in divided doses.
Route: injection (SubQ only)
Pharmacodynamics: Onset: 0.5 hr Duration: 18-24 hr
Common Side Effects: hypoglycemia, other assorted adverse effects rarely associated (frequency undetermined.)
Nursing Implications: SubQ injection in thigh, buttocks, arm, or abdomen – rotate sites. Glucometer measurement important. Roll vial to resuspend. Administer prior to breakfast and supper.
Drug Interactions: oral contraceptives, nicotine, thiazide diuretics, thyroid hormone, corticosteroids all DECREASE effect. Alcohol, anabolic steroids, MAOI's, salicylates all INCREASE effect.
Andy Samelson's Drug Cards CLASS: Antibiotic/Oral Rinse
Andy Samelson's Drug Cards Chlorhexidine Gluconate
Generic: Chlorhexidine GluconateTrade: BactoShield, Avagard, Peridex
Action: Bacteriostatic in small doses – bacteriocidal in large.
Uses: Dental rinse
Dosage Range: 15 ML for 30 sec.
Route: oral
Pharmacodynamics: N/A
Common Side Effects: Taste changes, teeth staining, tongue irritation.
Nursing Implications: Reduced taste sensation
Drug Interactions: none
Andy Samelson's Drug Cards CLASS: GI Agent/ Histamine2 blocker
Andy Samelson's Drug Cards Famotidine
Generic: FamotidineTrade: Pepcid
Action: Inhibits gastric secretion
Uses: Duodenal ulcers, gastric ulcers, GERD
Dosage Range: 20-40 mg every day.
Route: oral
Pharmacodynamics: N/A
Common Side Effects: headache, constipation.
Nursing Implications: Take with meals, do not take more than 14 days without consulting physician.
Drug Interactions: May decrease cyclosporin absorption
Andy Samelson's Drug Cards CLASS: Antipsychotic
Andy Samelson's Drug Cards Quetiapine
Generic: QuetiapineTrade: Seroquel
Action: Dopamine and serotonin antagonismUses: Schizophrenia, acute manic episodes of BPD.
Dosage Range: 50-200 mg per day.
Route: oral tablet
Pharmacodynamics: N/A
Common Side Effects: Somnolence, agitations, dizziness, headache, weight gain, xerostomia, postural hypotension, cholesterol and triglycerides increased, fever, pain, abdominal pain, flu-like symptoms.
Nursing Implications: Vital signs, lipid profile, monitor for cataracts.
Drug Interactions: lorazepam – clearance reduced 20%. Other CNS depressants oversedate.
Andy Samelson's Drug Cards CLASS: insulin
Andy Samelson's Drug Cards Novolog
Generic: insulin aspart protamineTrade: Novolog Mix 70/30
Action: Breaks down blood sugar and stimulates creation of glycogen.
Uses: Diabetes type 1 + 2
Dosage Range: SubQ: 0.5-1.2 units/kg/day in divided doses. (equipotent to regular insulin)
Route: injection
Pharmacodynamics: Onset: 0.2 hr Duration: 18-24 hr
Common Side Effects: hypoglycemia, other assorted adverse effects rarely associated (frequency undetermined.)
Nursing Implications: SubQ injection in thigh, buttocks, arm, or abdomen – rotate sites. Glucometer measurement important. Draw fast-acting insulins first in mixed doses. Administer 15 min prior to or after meal.
Drug Interactions: oral contraceptives, nicotine, thiazide diuretics, thyroid hormone, corticosteroids all DECREASE effect. Alcohol, anabolic steroids, MAOI's, salicylates all INCREASE effect.
Andy Samelson's Drug Cards CLASS: Thyroid agent
Andy Samelson's Drug Cards levothyroxine
Generic: levothyroxineTrade: Synthroid, Levoxyl, Levothroid, Unithroid
Action: Elevates metabolic activity by acting as a replacement thyroid hormone.
Uses: Hypothyroidism, pituitary TSH suppression.
Dosage Range: Oral- 1.7 mcg/kg/day I.V./I.M. 50% of oral dose
Route: injection, powder for re-constitution, tablet.
Pharmacodynamics: Onset- (PO.) 3-5 days (I.V./I.M.) 6-8 hr. Peak- 4-6 weeks to see effective action for each dose.
Common Side Effects: elevated B/P, tachycardia, arrhythmia, anxiety, insomnia, increased appetite, decreased bone density, diaphoresis, heat intolerance.
Nursing Implications: I.V. Form must be prepared immediately before administration. Monitor TSH levels, B/P, heart rate, and other side effects.
Drug Interactions: Iron decreases absorption, may have interactions with antidiabetic agents, Ketamine may cause marked HTN, tricyclics change therapeutic index for both drugs.
Andy Samelson's Drug Cards Andy Samelson's Drug Cards
CLASS: Laxative Senna
Generic: SennaTrade: Evacugen, exlax, senokot, x-prep
Action: Laxative
Uses: Constipation
Dosage Range: OTC packaging...
Route: Oral
Pharmacodynamics: Onset- (PO.) 6-10 hrs
Common Side Effects: NVD, cramps
Nursing Implications: Monitor for electrolyte imbalances, administer with water to decrease irritation.
Drug Interactions: N/A
Andy Samelson's Drug Cards CLASS: Lithium
Andy Samelson's Drug Cards Lithium
Generic: LithiumTrade: Lithobid, Eskalith
Action: Influences reuptake of serotonin
Uses: BPD treatment
Dosage Range: 900-2400mg/day in 3-4 divided doses. 50-75% of normal dose in renal impairment
Route: Capsule, tablet, syrup
Pharmacodynamics: N/A
Common Side Effects: hypotension, edema, syncope, sedation, confusion, stupor, coma, hypothyroidism, ataxia, coldness of fingers or toes.
Nursing Implications: administer with meals to decrease GI upset, encourage fluids, monitor for signs of toxicity.
Drug Interactions: Numerous – most act on decreasing or increasing serum concentrations of lithium... monitor closely.
Andy Samelson's Drug Cards CLASS: Electrolyte Replacement
Andy Samelson's Drug Cards Calcium Acetate
Generic: Calcium AcetateTrade: PhosLo
Action: Binds with phosphate and causes excretion in feces
Uses: Control of hyperphosphatemia in renal failure.
Dosage Range: Oral- 1000mg every day Route: Oral
Pharmacodynamics: N/A
Common Side Effects: Mild hypercalcemia, NV, constipation.
Nursing Implications: Monitor for hypercalcemia (unlikely)
Drug Interactions: Digitalis may become toxic, tetracycline, ABX, and beta-blockers are significantly reduced in ability to absorb.
Andy Samelson's Drug Cards CLASS: Laxative
Andy Samelson's Drug Cards Metamucil
Generic: PsylliumTrade: Metamucil
Action: Adsorbs water in intestines to form a viscous liquid which promotes peristalsis and decreases transit time.
Uses: constipation
Dosage Range: Varied gram strengths
Route: oral
Pharmacodynamics: N/A
Common Side Effects: esophageal or bowel obstruction, diarrhea, cramps.
Nursing Implications: monitor for impaction
Drug Interactions: N/A
Andy Samelson's Drug Cards CLASS: SSRI inhibitor
Andy Samelson's Drug Cards sertraline HCL
Generic: sertraline HCLTrade: Zoloft
Action: SSRI inhibitor
Uses: depression, PTSD, OCD
Dosage Range: 25-200 mg every day
Route: oral
Pharmacodynamics: maximum effects usually seen after 4 weeks
Common Side Effects: insomnia, fatigue, dizziness, h/a, nausea, xerostomia, heart palpitations, parasthesia, micturition disorders.
Nursing Implications: monitor nutrition, i/o, if somnolent, offer at bedtime.
Drug Interactions: benzos, amphetamines, carbamazepine, dextromethorphan, erythromycin, meperidine, all may carry risk of serotonin syndrome with this drug.
Andy Samelson's Drug Cards CLASS: gastric or duodenal ulcer treatment
Andy Samelson's Drug Cards sucralfate
Generic: sucralfateTrade: Carafate
Action: forms a viscous, adhesive substance protecting lining from peptic acid, pepsin, and bile salts
Uses: gastric or duodenal ulcers
Dosage Range: 1Gm every 4 hours
Route: oral
Pharmacodynamics: onset: 1-2 hours duration: 6 hours
Common Side Effects: constipation
Nursing Implications: monitor for constipation, administer 2 hr before or after other oral drugs. Tabs may be disintegrated in water first.
Drug Interactions: digoxin, warfarin, ciprofoxacin all may be decreased in effectiveness unless taken separately by 2 hours.
Andy Samelson's Drug Cards CLASS: electrolyte supplement
Andy Samelson's Drug Cards potassium chloride
Generic: potassium chlorideTrade: Kdur, Klor-con
Action: Major intracellular ion – essential for nerve impulses of heart, brain, and skeletal muscle.
Uses: hypokalemia
Dosage Range: 20-40 meq every day
Route: oral
Pharmacodynamics: N/A
Common Side Effects: NVD, bradykardia, hyperkalemia
Nursing Implications: liquid form should be diluted 2-6 times with water or juice.
Drug Interactions: increased effectiveness of ace inhibitors. Overdose may decrease effectiveness of digoxin therapy.
Andy Samelson's Drug Cards CLASS: Antacid
Andy Samelson's Drug Cards Mylanta
Generic: aluminum hydroxide and magnesium hydroxideTrade: Maalox, Mylanta
Action: antacid
Uses: acute treatment of symptoms of GERD, hyperacidity, prevention of stress ulcers.
Dosage Range: 30 ml PRN typical
Route: oral suspension
Pharmacodynamics: N/A
Common Side Effects: cramps, constipation, decreased GI motility, fecal impaction.
Nursing Implications: monitor BM's
Drug Interactions: decreased effect of dig, tetracyclines, benzos, and iron salts.
Andy Samelson's Drug Cards CLASS: antiemetic, antipsychotic agent
Andy Samelson's Drug Cards promethazine
Generic: promethazineTrade: phenergan
Action: competes with histamine, and depresses stimuli to brainstem
Uses: motion sickness, sedation
Dosage Range: 25 mg at HS, or 12.5 mg before meals.
Route: supp, tab, syrup
Pharmacodynamics: onset: 20 min duration: 4-6 hours
Common Side Effects: bradycardia, HTN, dizziness, drowsiness, NVD, xerostomia
Nursing Implications: rapid IV push may result in drop in B/P, do not exceed 25mg/min. Monitor mental status, and avoid extravasation.
Drug Interactions: miconazole and sertraline may increase effects.
Andy Samelson's Drug Cards CLASS: antiemetic, antipsychotic agent
Andy Samelson's Drug Cards promethazine
Generic: promethazineTrade: phenergan
Action: competes with histamine, and depresses stimuli to brainstem
Uses: motion sickness, sedation
Dosage Range: 25 mg at HS, or 12.5 mg before meals.
Route: supp, tab, syrup
Pharmacodynamics: onset: 20 min duration: 4-6 hours
Common Side Effects: bradycardia, HTN, dizziness, drowsiness, NVD, xerostomia
Nursing Implications: rapid IV push may result in drop in B/P, do not exceed 25mg/min. Monitor mental status, and avoid extravasation.
Drug Interactions: miconazole (nitrate) and sertraline may increase effects.
Andy Samelson's Drug Cards CLASS: Proton pump inhibitor
Andy Samelson's Drug Cards Nexium
Generic: esomeprazoleTrade: Nexium
Action: Suppresses gastric acid secretions
Uses: Short term treatment of GERD, or erosive esophagus trouble.
Dosage Range: Oral- 20 40 mg Route: Capsule, delayed release
Pharmacodynamics: N/A
Common Side Effects: H/A, NVD, flatulence, abdominal pain.
Nursing Implications: Do not break or crush capsules...
Drug Interactions: Benzos can be potentiated by excess oxidation. May decrease absorption of iron salts. May increase levels of sertraline.
Andy Samelson's Drug Cards CLASS: Laxative
Andy Samelson's Drug Cards bisacodyl
Generic: bisacodylTrade: Dulcolax
Action: Stimulates bowel muscles to enable bowel movement..
Uses: treatment of constipation
Dosage Range: Oral- 25 – 300mg/day (typical)
Route: tablet, syrup
Pharmacodynamics: N/A
Common Side Effects: NVD, diarrhea, H/A, dehydration
Nursing Implications: Monitor for rectal bleeding, use with caution in the elderly. Do not take with antacids or milk.
Drug Interactions: May decrease effective levels of many drugs.
Andy Samelson's Drug Cards CLASS: Sedative/hypnotic
Andy Samelson's Drug Cards chloral hydrate
Generic: chloral hydrateTrade: Aquachloral
Action: depresses central nervous system producing drowsiness and sedation.
Uses: short term treatment of insomnia.
Dosage Range: Oral- 300-500 mg QD (typical)
Route: tablet, syrup, suppository
Pharmacodynamics: N/A
Common Side Effects: drowsiness, over sedation, hypotension, xerostomia
Nursing Implications: Monitor for orthostatic hypotension, mental status changes, and over sedation. Do not stop taking suddenly – may be habit forming. Do not combine with other CNS depressants.
Drug Interactions: Other CNS depressants can potentiate. Other increases/decreases in effectiveness.
Andy Samelson's Drug Cards CLASS: Amino acid
Andy Samelson's Drug Cards Glutamine
Generic: glutamineTrade: numerous
Action: an essential amino acid used in immune system and brain function. Also inhibits muscle wasting in cancer patients.
Uses: wound healing, brain injuries, HIV
Dosage Range: Oral – 500 – 15,000 mg
Route: tablet, syrup, powder
Pharmacodynamics: N/A
Common Side Effects: Unknown.
Nursing Implications: Do not add to hot water – heat destroys it. Observe carefully with patients with renal or hepatic disease.
Drug Interactions: May decrease effectiveness of cancer drugs.
Andy Samelson's Drug Cards CLASS: Vitamin
Andy Samelson's Drug Cards cholecalciferol
Generic: cholecalciferol Trade: Vitamin D
Action: A fat soluble vitamin used for absorption of calcium.
Uses: Vit D deficiency.
Dosage Range: Oral – 1000 – 3000 IU per day.
Route: tablet, syrup, powder, injection.
Pharmacodynamics: N/A
Common Side Effects: N/V/D, headache, kidney stones, hypercalcemia
Nursing Implications: Monitor electrolyte levels carefully – use cautiously with renal patients.
Drug Interactions: May potentiate gabapentin, heparin, and phenobarbital.
Andy Samelson's Drug Cards CLASS: Muscle Relaxant
Andy Samelson's Drug Cards baclofen
Generic: baclofenTrade: Lioresal
Action: Prevents muscle spasms at the spinal cord level
Uses: Treatment of spasticity associated with MS or spinal cord lesions
Dosage Range: Oral – 15 mg Qd
Route: injection, solution, tablet
Pharmacodynamics: onset: 3-4 days
Common Side Effects: drowsiness, dizziness, vertigo, hypotension, weakness, rash, confusion, HA, ataxia
Nursing Implications: Avoid abrupt withdrawal, monitor epileptic patients carefully.
Drug Interactions: Increases effects of opiates, benzos, and HTN agents.
Andy Samelson's Drug Cards CLASS: Anti-depressant
Andy Samelson's Drug Cards paroxetine
Generic: paroxetineTrade: Paxil
Action: SSRI
Uses: Treatment of PTSD, GAD, OCD, and depression
Dosage Range: Oral – 20-50 mg QD
Route: Suspension, tablet
Pharmacodynamics: Maximum effect seen after 4 weeks.
Common Side Effects: Somnolence, insomnia, H/A, dizziness, decreased libido, nausea, xerostomia, constipation, weakness, diaphoresis.
Nursing Implications: Do no discontinue abruptly, monitor mood swings. Monitor for constipation.
Drug Interactions: Extensive.
Andy Samelson's Drug Cards CLASS: Narcotic
Andy Samelson's Drug Cards methadone
Generic: methadoneTrade: Dolophine
Action: Binds to opiate receptors in CNS, inhibiting response and perception of pain.
Uses: Management of severe pain, treatment in narcotic withdrawal programs.
Dosage Range: Oral – 2.5 – 10 mg Q 4hr PRN
Route: injection solution, tablet
Pharmacodynamics: oral: 30-60 min parenteral: 10-20 min
Common Side Effects: N/V/D, headache, kidney stones, hypercalcemia
Nursing Implications: Observe for excessive sedation, assist with ambulation.
Drug Interactions: Potentiates other CNS depressants.
Andy Samelson's Drug Cards CLASS: GI agent, prokinetic
Andy Samelson's Drug Cards metoclopramide
Generic: metoclopramideTrade: Reglan
Action: Blocks dopamine and serotonin receptors in high doses, enhances response to acetylcholine in upper GI tract, and increases motility.
Uses: treatment of GERD, gastric stasis, stimulates gastric empyting.
Dosage Range: 10-30 mg Q6HR
Route: injection, syrup, tablet
Pharmacodynamics: oral: 30-60min, IV – 1-3 min.
Common Side Effects: brady/tachycardia, drowsiness, dystonia, confusion, headache, depression, urticara
Nursing Implications: Slow IVP for patient's comfort – rapid push is associated with anxiety.
Drug Interactions: anticholinergic agents may antagonize effectiveness. CNS depressants may potentiate sedation.
Andy Samelson's Drug Cards CLASS: Anti-psychotic
Andy Samelson's Drug Cards risperidone
Generic: risperidoneTrade: Rispedal
Action: dopamine/serotonin antagonist.
Uses: treatment of bi-polar disorder or schizophrenia.
Dosage Range: 1-8 mg QD
Route: tablet, solution, injection
Pharmacodynamics: N/A
Common Side Effects: dizziness, sedation, headache, nausea, xerostomia, HTN, hypotension, weight loss/gain, extrapyramidal symptoms
Nursing Implications: Monitor for extrapyramidal effects.
Drug Interactions: Avoid use with MAOI's, CNS depressants, carbamazepine.
Andy Samelson's Drug Cards CLASS: Antineoplastic agent, appetite stimulant
Andy Samelson's Drug Cards megestrol
Generic: megestrolTrade: Megace
Action: synthetic progestin
Uses: treatment of anorexia, carcinoma, and breast cancer.
Dosage Range: 4-800 mg QD
Route: suspension, tablet
Pharmacodynamics: N/A
Common Side Effects: headache, HTN, rash, insomnia
Nursing Implications: Monitor for thromboembolism.
Drug Interactions: None reported.
Andy Samelson's Drug Cards CLASS: analgesis, narcotic
Andy Samelson's Drug Cards oxycodone
Generic: OxycodoneTrade: Oxycontin
Action: Oxycodone binds with opiate receptors
Uses: moderate to severe pain.
Dosage Range: Oral- 2.5 – 5 mg q6hr Route: Capsule, tablet, patch
Pharmacodynamics: onset – 30-60 min
Common Side Effects: constipation, over-sedation, dysphoria, euphoria, nausea, respiratory depression, skin rash.
Nursing Implications: Monitor for pain relief, over-sedation, confusion, and constipation.
Drug Interactions: anesthetics can lead to additive CNS depression, anticholinergics can lead to paralytic ileus.
Andy Samelson's Drug Cards CLASS: analgesis, narcotic
Andy Samelson's Drug Cards hydromorphone
Generic: hydromorphoneTrade: Dilaudid
Action: Oxycodone binds with opiate receptors,
Uses: moderate to severe pain.
Dosage Range: 2-8 mg
Route: capsule, suppository, injection, liquid
Pharmacodynamics: onset 15-30 minutes
Common Side Effects: constipation, over-sedation, dysphoria, euphoria, nausea, respiratory depression, skin rash.
Nursing Implications: Monitor for pain relief, over-sedation, confusion, and constipation.
Drug Interactions: anesthetics can lead to additive CNS depression, SSRI's may be additive, leading to serotonin syndrome.
Andy Samelson's Drug Cards CLASS: antidepressant
Andy Samelson's Drug Cards sertraline
Generic: sertralineTrade: Zoloft
Action: SSRI
Uses: depression, OCD, PTSD, SAD
Dosage Range: Oral- 25 – 50 mg/day
Route: oral
Pharmacodynamics: N/A
Common Side Effects: insomnia, dizziness, fatigue, headache, xerostomia, diarrhea, ejaculatory disturbances, nervousness, decreased libido, constipation, anorexia, tremors
Nursing Implications: May increase risk of suicidal thoughts, monitor nutritional intake and weight, if somnolent – administer at bedtime.
Drug Interactions: increased risk of serotonin syndrome with serotonin agonists, alters metabolism of many other drugs.
Andy Samelson's Drug Cards CLASS: Antipsychotic
Andy Samelson's Drug Cards Quetiapine
Generic: QuetiapineTrade: Seroquel
Action: Dopamine and serotonin antagonismUses: Schizophrenia, acute manic episodes of BPD.
Dosage Range: 50-200 mg per day.
Route: oral tablet
Pharmacodynamics: N/A
Common Side Effects: Somnolence, agitations, dizziness, headache, weight gain, xerostomia, postural hypotension, cholesterol and triglycerides increased, fever, pain, abdominal pain, flu-like symptoms.
Nursing Implications: Vital signs, lipid profile, monitor for cataracts.
Drug Interactions: lorazepam – clearance reduced 20%. Other CNS depressants oversedate.
Andy Samelson's Drug Cards CLASS: Laxative
Andy Samelson's Drug Cards bisacodyl
Generic: bisacodylTrade: Dulcolax
Action: Stimulates bowel muscles to enable bowel movement..
Uses: treatment of constipation
Dosage Range: Oral- 25 – 300mg/day (typical)
Route: tablet, syrup
Pharmacodynamics: N/A
Common Side Effects: NVD, diarrhea, H/A, dehydration
Nursing Implications: Monitor for rectal bleeding, use with caution in the elderly. Do not take with antacids or milk.
Drug Interactions: May decrease effective levels of many drugs.
Andy Samelson's Drug Cards CLASS: anticoagulant
Andy Samelson's Drug Cards warfarin
Generic: warfarinTrade: Coumadin
Action: interferes with hepatic synthesis of Vit K dependent coagulation factors.
Uses: prophylaxis and treatment of venous thrombosis, pulmonary embolism, after M.I.
Dosage Range: 2-5 mg qd
Route: injection, tablet
Pharmacodynamics: Onset: 36-72 hr. Peak: 5-7 days
Common Side Effects: Prolonged bleeding, headache, hematuria, N.V.D., hemoptysis
Nursing Implications: Avoid all I.M. Injections, monitor for S&S of bleeding.
Drug Interactions: Numerous – primarily decreased or increased efficacy of warfarin.
Andy Samelson's Drug Cards CLASS: AntiParkinson's/Anti-cholinergic
Andy Samelson's Drug Cards benztropine
Generic: benztropineTrade: Cogentin
Action: Anticholinergic, antihistamine, may inhibit reuptake of dopamine.
Uses: Parkinsonian symptoms, tardive dyskinesia
Dosage Range: 0.5 – 4 mg QD
Route: injection, tablet
Pharmacodynamics: Onset: 15-60 min. Action: 6- 48 hr
Common Side Effects: tachycardia, CNS disturbances, urinary retention, blurred vision
Nursing Implications: Do not discontinue abruptly. IV and IM methods = same onset time.
Drug Interactions: cumulative effect with anticholinergics, may increase digoxin levels..
Andy Samelson's Drug Cards CLASS: sedative, hypnotic
Andy Samelson's Drug Cards clonazepam
Generic: clonazepamTrade: Klonopin
Action: Unknown, believed to enhance GABA pathways.
Uses: anti-seizure prophylaxis
Dosage Range: 1.5 – 20mg QD
Route: tablet
Pharmacodynamics: Onset: 20-60 min Duration : 12 hr.
Common Side Effects: edema, ataxia, CNS depression, hallucinations, libido disturbances, constipation, blood dyscrasias, respiratory congestion
Nursing Implications: observe for excess sedation, resp depression, and orthostasis.
Drug Interactions: Valproic acid can cause absence seizures when used concurrently. CNS depressants may potentiate.
Andy Samelson's Drug Cards CLASS: Antihyperlipidemic agent
Andy Samelson's Drug Cards rosuvastatin
Generic: rosuvastatinTrade: Crestor
Action: stimulates LDL catabolism
Uses: management of cholesterol
Dosage Range: 5-40 mg QD
Route: tablet
Pharmacodynamics: Onset: 1 week hr. Peak: 4 weeks
Common Side Effects: edema, HTN, pharyngitis, NVD, GI disturbances, anemia
Nursing Implications: Monitor serum cholesterol levels.
Drug Interactions: Cyclosporines may increase serum levels of drug – limit intake to 5 mg QD when taken concurrently.
Andy Samelson's Drug Cards CLASS: alpha adrenergic blocking agent
Andy Samelson's Drug Cards tamsulosin
Generic: tamsulosinTrade: Flomax
Action: smooth muscle relaxant
Uses: treatment of BPH
Dosage Range: 0.4mg – 0.8mg QD
Route: capsule
Pharmacodynamics: N/A
Common Side Effects: Orthostatic hypotension, h/a, dizziness, abnormal ejaculation, libido decrease, somnolence.
Nursing Implications: Monitor for orthostasis, do not crush capsule.
Drug Interactions: other cardiac meds (beta blockers, calcium channel blockers) may increase risk of orthostasis.
Andy Samelson's Drug Cards CLASS: traditional anti-psychotic
Andy Samelson's Drug Cards perphenazine
Generic: perphenazineTrade: Trilafon
Action: inhibits post-synaptic dopaminergic receptors in limbic system.
Uses: schizophrenia, nausea
Dosage Range: 4-64 mg QD
Route: tablet
Pharmacodynamics: N/A
Common Side Effects: OH, blood sugar disturbances, photosensitivity, urinary disturbances, tardive dyskinesias, restlessness, ataxia, dizziness
Nursing Implications: monitor for OH, dilute concentrated forms with at least 2 oz of juice.
Drug Interactions: may inhibit anticholinergics, increased risk of Parkinsonian symptoms with Reglan, may cause OH in combination.
Andy Samelson's Drug Cards CLASS: vitamin
Andy Samelson's Drug Cards vitamin E
Generic: vitamin ETrade: Aquagem, Aquasol, E-Gems
Action: prevents breakdown of vit A+C, protects from effects of free radicals and hemolysis of RBCs.
Uses: dietary supplement, prevention of hemolytic anemia
Dosage Range: 15-1000 mg QD
Route: capsule, cream, powder, suppository
Pharmacodynamics: N/A
Common Side Effects: blurred vision (uncommon)
Nursing Implications: toxicity appears as flu-like symptoms.
Drug Interactions: may interfere with warfarin
Andy Samelson's Drug Cards CLASS: expectorant
Andy Samelson's Drug Cards guaifenesin
Generic: guaifenesinTrade: Mucinex, Humibid
Action: stimulates resp secretions and decreases mucous viscosity
Uses: presence of mucous in resp tract, relief of dry cough.
Dosage Range: 200-2400 mg qd
Route: syrup, liquid, tablet
Pharmacodynamics: N/A
Common Side Effects: dizziness, h/a, stomach pain, NVD, kidney stone formation (with large quantities)
Nursing Implications: Push fluids to ensure therapeutic action
Drug Interactions: N/A
Andy Samelson's Drug Cards CLASS: anti-diarrheal
Andy Samelson's Drug Cards bismuth subsalicylate
Generic: bismuth subsalicylateTrade: Kaopectate
Action: soothes gastric motility
Uses: diarrhea
Dosage Range: 10-500 mg qd
Route: syrup, tablet
Pharmacodynamics: N/A
Common Side Effects: constipation, h/a
Nursing Implications: monitor for constipation, push fluids
Drug Interactions: N/A
Andy Samelson's Drug Cards CLASS: anti-diarrheal
Andy Samelson's Drug Cards bismuth subsalicylate
Generic: bismuth subsalicylateTrade: Kaopectate
Action: soothes gastric motility
Uses: diarrhea
Dosage Range: 10-500 mg qd
Route: syrup, tablet
Pharmacodynamics: N/A
Common Side Effects: constipation, h/a
Nursing Implications: monitor for constipation, push fluids
Drug Interactions: N/A
Andy Samelson's Drug Cards CLASS: sympathomimetic vasoconstrictor
Andy Samelson's Drug Cards pseudoephedrine
Generic: pseudoephedrineTrade: Sudafed
Action: mimics sympathetic nervous system stimulation, vasoconstricts, dries secretions
Uses: excess mucous production, cold relief (decongestant)
Dosage Range: 60-240 mg QD
Route: tablet, syrup
Pharmacodynamics: N/A
Common Side Effects: CNS stimulation, dry mouth, HTN, h/a, NVD
Nursing Implications: monitor for constipation, push fluids
Drug Interactions: beta-blockers, HTN agents, anti-depressants can interefere.
Andy Samelson's Drug Cards CLASS: antiemetic
Andy Samelson's Drug Cards ondansetron
Generic: ondansetronTrade: Zofran
Action: blocks serotonin selectively on vagal nerve terminals.
Uses: prevention of nausea associated with chemo, radiation, post-op NV
Dosage Range: Varies with treatment
Route: IM, IV, oral
Pharmacodynamics: N/A
Common Side Effects: fatigue, headache, drowsiness, anxiety, diarrhea, constipation, urinary retention, hypoxia.
Nursing Implications: Oral dosage should be given 30 min prior to therapy. The IV version has also been used successfully orally.
Drug Interactions: Apomorphine promotes profound hypotension concurrently.
Andy Samelson's Drug Cards CLASS: analgesis, narcotic
Andy Samelson's Drug Cards fentanyl
Generic: fentanylTrade: Duragesic
Action: increases pain threshold, inhibits ascending pain pathways, alters perception of pain.
Uses: moderate to severe pain, pre-op anesthetic, chronic pain, cancer pain
Dosage Range: IM/slow IV 25-100 mcg 60 min prior to surgery.
Route: injection, IV, patch
Pharmacodynamics: Onset: IV-immediate Duration: 30-60 min
Common Side Effects: constipation, over-sedation, dysphoria, euphoria, nausea, respiratory depression, skin rash.
Nursing Implications: Monitor for pain relief, over-sedation, confusion, and constipation. May cause rebound respiratory depression, monitor for 12 hours after removal of patch.
Drug Interactions: anesthetics can lead to additive CNS depression, anticholinergics can lead to paralytic ileus. SSRIs may cause serotonin syndrome. MAOIs are contraindicated.
Andy Samelson's Drug Cards CLASS: Adrenal Corticosteroid
Andy Samelson's Drug Cards betamethasone
Generic: betamethasoneTrade: Diprosone
Action: prevents/controls inflammation, stimulates lung/surfactant development in fetus.
Uses: pre-term birth lung development, inflammation treatment.
Dosage Range: 0.6 – 7.2mg QD
Route: IM, oral, topical
Pharmacodynamics: N/A
Common Side Effects: flushing, sweating, irritability, HTN, fungal infections, acne, bruising, increased appetite.
Nursing Implications: Assess for infection, daily weights, b/p
Drug Interactions: hypokalemia with diuretics, decreases effects of insulin/blood thinners. NSAIDS concurrently risk of GI bleeds.
Andy Samelson's Drug Cards CLASS: hormone
Andy Samelson's Drug Cards oxytocin
Generic: oxytocinTrade: Pitocin
Action: produces uterine contraction, anti-diuretic effect, stimulates breast milk production.
Uses: induction of labor, post-postpartum bleeding.
Dosage Range: 1-2 mU/min (induction) 10-40 U in1000 mL diluted (hemorrhage) Route: IM, IV
Pharmacodynamics: Onset: 1-7 min Duration: 1hr.
Common Side Effects: seizures, tetanic contractions, HTN/OH, cardiac arrhythmias, abruptio placentae.
Nursing Implications: B/P, hemorrhage monitoring. Length, intensity, duration of contractions, FHT monitoring.
Drug Interactions: Concurrent use of vasopressors = HTN.
Andy Samelson's Drug Cards CLASS: HTN agent, tocolytic
Andy Samelson's Drug Cards magnesium sulfate
Generic: magnesium sulfateTrade: N/A
Action: draws fluid into colon, depresses CNS, relaxes smooth muscle
Uses: HTN treatment, dig toxicity, premature labor, seizure prophylaxis.
Dosage Range: 4 – 40 GM QD
Route: IM, oral, IV.
Pharmacodynamics: Duration IV: 30 min.
Common Side Effects: Sedation, depressed deep tendon reflexes, confusion, hypotension, resp depression.
Nursing Implications: Monitor reflexes, level of conciousness, constipation.
Drug Interactions: decreased effect of digoxin, increases effects of neuromuscular blockers, increases effects of anti-hypertensives.
Andy Samelson's Drug Cards CLASS: bronchodilator, tocolytic
Andy Samelson's Drug Cards terbutaline
Generic: terbutalineTrade: Brethine
Action: relaxes smooth muscle, CNS, diureses.
Uses: bronchospasms, hyperkalemia, premature labor.
Dosage Range: 2.5 mg Q 4-6 hr
Route: PO, SubQ
Pharmacodynamics: PO onset: 30 min peak: 1-2 hr duration: 4-8 hr
Common Side Effects: insomnia, anxiety, stimulation, dizziness, tachycardia, NVD.
Nursing Implications: monitor for tolerance, FHT, b/p, contractions.
Drug Interactions: MAOI's may cause hypertensive crisis.
Andy Samelson's Drug Cards CLASS: immune globulin
Andy Samelson's Drug Cards rhogam
Generic: rhogamTrade: RhoGam, BayRho
Action: suppresses immune response of rh negative mother.
Uses: prevention of immune-mediated abortion/sensitization in RH negative women.
Dosage Range: 120-300 mcg 2x in 72 hr.
Route: IM, IV.
Pharmacodynamics: n/a
Common Side Effects: lethargy, injection site pain.
Nursing Implications: assess allergies, confirm blood product accuracy, inject into deltoid – not gluteus.
Drug Interactions: decreased antibody response to live vaccines.
Andy Samelson's Drug Cards CLASS: opioid antagonist
Andy Samelson's Drug Cards naloxone
Generic: naloxoneTrade: Narcan
Action: competes with opioids at receptor sites
Uses: opiate overdose
Dosage Range: 0.4-2mg Q 3 min, max 10mg
Route: IM, IV, SubQ
Pharmacodynamics: IV onset: 1 min. IM/SQ onset: 2-5 min.
Common Side Effects: drowsiness, irritability, rapid pulse, NV, hepatoxicity, pulmonary edema.
Nursing Implications: assess for withdrawal symptoms, cardiac status, resp status, for pain.
Drug Interactions: decreases/eliminates effects of opiates.
Andy Samelson's Drug Cards CLASS: Prostaglandin
Andy Samelson's Drug Cards dinoprostone
Generic: dinoprostoneTrade: Cervidil
Action: stimulates uterine contractions, aborts during 2nd trimester, effaces and dilates cervix at term.
Uses: abortion, cervical dilation, induction.
Dosage Range: 10-20 mg max 240mg
Route: gel, suppository.
Pharmacodynamics: onset: 10min.
Common Side Effects: h/a, dizziness, decelerations, vaginal pain, nvd, leg cramps, rash.
Nursing Implications: check for contractions, monitor FHT, b/p, check for vaginal discharge.
Drug Interactions: increases effects of other oxytocics.
Andy Samelson's Drug Cards CLASS: Prostaglandin
Andy Samelson's Drug Cards misoprostol
Generic: misoprostolTrade: Cytotec
Action: cervical ripening, inhibits gastric secretions, protects gastric mucosa
Uses: abortion, cervical dilation, gastric ulcers, kidney transplant rejection prophylaxis.
Dosage Range: 25 mcg Q 3-6 hr intravaginally for cervical ripening.
Route: PO, gel
Pharmacodynamics: onset: 12 min.
Common Side Effects: nvd, hypermenorrhea.
Nursing Implications: check for contractions, monitor FHT, b/p, check for vaginal discharge.
Drug Interactions: take with food for maximum concentration in ulcer therapy.