Morphine: side-effects MORPHINE:MyosisOut of it (sedation)Respiratory depressionPneumonia (aspiration)HypotensionInfrequency (constipation, urinary retention)NauseaEmesis

Tricyclic antidepressants: members worth knowing"I have to hide, the CIA is after me":Clomipramine Imipramine Amitrptyline· If want the next 3 worth knowing, the DNDis also after me:Desipramine Norrtriptyline Doxepin

Patent ductus arteriosus: treatment"Come In and Close the door": INdomethacin is used to Close PDA

SIADH-inducing drugs ABCD:Analgesics: opioids, NSAIDsBarbituratesCyclophosphamide/ Chlorpromazine/ CarbamazepineDiuretic (thiazide)

Vir-named drugs: use"-vir at start, middle or end means for virus": · Drugs:Abacavir,Acyclovir,Amprenavir,Cidofovir,Denavir,Efavirenz,Indavir,Invirase,Famvir,Ganciclovir,Norvir,Oseltamivir,Penciclovir,Ritonavir,Saquinavir,Valacyclovir,Viracept,Viramune,Zanamivir,Zovirax.

Phenobarbitone: side effectsChildren are annoying (hyperkinesia, irritability, insomnia, aggression).Adults are dosy (sedation, dizziness, drowsiness).

Thrombolytic agents USA:Urokinase Streptokinase Alteplase (tPA)

Narcotic antagonistsThe Narcotic Antagonists are NAloxone and NAltrexone. · Important clinically to treat narcotic overdose.

Routes of entry: most rapid ways meds/toxins enter body"Stick it, Sniff it, Suck it, Soak it":Stick = InjectionSniff = inhalationSuck = ingestionSoak = absorption

Anticholinergic side effects"Know the ABCD'S of anticholinergic side effects":AnorexiaBlurry visionConstipation/ ConfusionDry MouthSedation/ Stasis of urine

Atropine use: tachycardia or bradycardia"A goes with B": Atropine used clinically to treat Bradycardia.

Aspirin: side effects ASPIRIN:AsthmaSalicyalismPeptic ulcer disease/ Phosphorylation-oxidation uncoupling/ PPH/ Platelet disaggregation/ Premature closure of PDAIntestinal blood lossReye's syndromeIdiosyncracyNoise (tinnitus)

Morphine: effects at mu receptor PEAR:Physical dependenceEuphoriaAnalgesiaRespiratory depression

Beta-1 vs Beta-2 receptor location "You have 1 heart and 2 lungs":Beta-1 are therefore primarily on heart. Beta-2 primarily on lungs.

SSRIs: side effects SSRI:Serotonin syndromeStimulate CNSReproductive disfunctions in maleInsomnia

Warfarin: action, monitoring WePT:

Warfarin works on the extrinsic pathway and is monitored by PT.

Propranolol and related '-olol' drugs: usage"olol" is just two backwards lower case b's. Backward b's stand for "beta blocker". · Beta blockers include acebutolol, betaxolol, bisoprolol, oxprenolol, propranolol.

Depression: 5 drugs causing it PROMS:PropranololReserpineOral contraceptivesMethyldopaSteroids

Lead poisoning: presentation ABCDEFG:AnemiaBasophilic strippingColicky painDiarrheaEncephalopathyFoot dropGum (lead line)

Cholinergics (eg organophosphates): effectsIf you know these, you will be "LESS DUMB":LacrimationExcitation of nicotinic synapsesSalivationSweatingDiarrheaUrinationMicturitionBronchoconstriction

Benzodiazepines: actions"Ben SCAMs Pam into seduction not by brain but by muscle":Sedationanti-Convulsantanti-AnxietyMuscle relaxantNot by brain: No antipsychotic activity.

Teratogenic drugs "W/ TERATOgenic":WarfarinThalidomideEpileptic drugs: phenytoin, valproate, carbamazepineRetinoidACE inhibitorThird element: lithiumOCP and other hormones (eg danazol)

Gynaecomastia-causing drugs DISCOS:

DigoxinIsoniazidSpironolactoneCimetidineOestrogensStilboestrol

Osmotic diuretics: members GUM:GlycerolUreaMannitol

Antibiotics contraindicated during pregnancy MCAT:MetronidazoleChloramphenicolAminoglycosideTetracycline

Lithium: side effects LITH:LeukocytosisInsipidus [diabetes insipidus, tied to polyuria]Tremor/ TeratogenesisHypothyroidism

caine -local anesthetics-cillin; antibiotic-dine ;anti-ulcer ( H2 blocker )-done; opioid analgesic-ide; oral hypoglycemics-lam; antianxiety-mide ;diuretic-mycin ;antibiotic-nium; neuromuscular blocking-olol; beta blocker-oxacin ;antibiotic-pam ;antianxiety-pril ;ACE inhibitor-sone ;steroids-statin ;cholesterol-vir; antiviral-zide; diuretic• -ase = thrombolytic-azepam = benzodiazepine-azine = antiemetic; phenothiazide-azole = proton pump inhibitor, antifungal-barbital = barbiturate-coxib (cox 2 enzyme blockers

-cep/-cef = anti-infectives-caine = anesthetics-cillin = penicillin-cycline = antibiotic-dipine = calcium channel blocker-floxacin = antibiotic-ipramine = Tricyclic antidepressant-ine = reverse transcriptase inhibitors, antihistamines-kinase = thrombolytics-lone, pred- = corticosteroid-mab = monoclonal antibiotics-micin = antibiotic, aminoglycoside-navir = protease inhibitornitr-, -nitr- = nitrate/vasodilator-olol = beta antagonist-oxin = cardiac glycoside-parin = anticoagulant-prazole = PPI’s-phylline = bronchodilator-pril = ACE inhibitor-statin = cholesterol lowering agent-sartan = angiotensin receptor blocker-sone = glucocorticoid-stigmine = cholinergics-terol = Beta 2 Agonist-thiazide = diuretic-tidine = antiulcer -trophin = Pituitary Hormone-vir = anti-viral, protease inhibitors-zosin = Alpha 1 Antagonist -zolam = benzo/sedative-zine = antihistamine• ANTICOAGULANTS - ends in parin, rinTHROMBOLYTICS - ends in ase, kinaseACE INHIBITORS - ends in prilANGIOTENSIN II RECEPTOR BLOCKER- ends in sartanALPHA ADRENERGIC - ends in zocinBETA-BLOCKERS - ends in ololCALCIUM CHANNEL BLOCKER - ends in dipineDIRECT ACTING VASODILATORS - starts with nitroCARDIAC GLYCOSIDES - starts with digBRONCHODILATORS - ends in terol, terenol, phrine, phyllineANTIHISTAMINES - ends in tadine, amine, ramineH2 BLOCKER - ends in tidineANTI-EMETICS - ends in setronPANCREATIC ENZYME REPLACEMENT - starts with pancrea

ADH MEDS - ends in pressinTHYROID MEDS - starts with thyro, thy, throCALCIUM REGULATORS - ends in dronate (hypocalcemia), tonin hypercalcemia)SULFONYLUREAS - ends in ide, amide, zide, rideNON-SULFONYLUREAS - ends in glinide, glitazoneANTIBIOTICS - ends in cillinCEPHALOSPORINS - starts with ceph, cefAMINOGLYCOSIDE - ends with mycin, micinQUINOLONES - ends in floxacin, oxacin

Generic Name (Trade Name) Major ConcernsAnalgesic

Acetaminophen (Tylenol) Watch for LIVER and KIDNEY problemsHydrocodone with Acetaminophen ADDICTIVE(Lortab)Ibuprofen (Motrin) can lead to HPN and KIDNEY diseaseNaproxen (Aleve) can lead to HPN and KIDNEY diseaseAntianxiety

Alprazolam (Xanax) This drug can be ADDICTIVEDiazepam (Valium) Watch for Allergies, *also anticonvulsant*Lorazepam (Antivan) SEDATIONPromethazine HCI (Phenergan) *also antiemetic*Antibiotic

Amoxicilline (Augmentin) Watch for allergic reactionsAzithromycin (Zithromax Z-Pak) Watch for allergiesCephalexin (Keflex) If you are allergic to Cephalosporins, you might also be allergic to PenicillinDoxycycline hyclate (Vibramycin) Avoid for pregnant clientsPenicillin V Potassium (Penicillin) Watch for allergiesSulfamethoxazole (Septra, Bactrim) Can cause GI diturbanceAnticoagulant

Warfarin Sodium (Coumadin) Teach the client to limit the intake of GREEN LEAFY VEGETABLESWatch for signs of BLEEDINGAnticonvulsant

Clonazepam (Klonopin) Should not be stopped abruptlyDiazepam (Valium) Watch for Allergies, also antianxietyLorazepam (Antivan) SEDATIONAntidepressant

Sertraline (Zoloft) SEDATION Amitriptyline HCI (Elavil) Trazodone HCI (Desyrel) Antidiabetic

Glipizide (Glucotrol) Watch for HYPOGLYCEMIAMetformin (Glucophage) This drug should be stopped prior to a dye study such as

cardiac catheterizationAntihistamine

Cetirizine (Zyrtec)Fexofenadine (Allegra) DRY MOUTH Antihypertensive

Amiodipine (Norvasc) HYPERTENSIONAtenolol (Tenormin) cause DROP in PULSE Rate, check PR dailyDoxazosin Mesylate (Cardura)Lisinopril (Zestril) cause Postural HPN, remain supine for at least 30mins Metoprolol Succinate (Toprol XL) Teach the client to check his PULSE RATEMetoprolol Tartrate (Lopressor,Toprol) Teach the client to check his PULSE RATEAntihypertensive/Antianginal

Verapamil HCI (Calan)Anti-inflammatory

Ibuprofen (Motrin) can lead to HYPERTENSION and KIDNEY diseasePrednisone (Deltasone) can cause Cushing’s Syndrome and GI problemsAntigout

Allopurinol (Zyloprim) Drink at least 8 glasses of WATER per day

Antilipidemic – usually ends in statin

Simbastatin (Zocor) Can cause LIVER problems & muscle sorenessDo not take this drug with GRAPE-FRUIT JUICEAntiulcer/Histamine Blocker

Ranitidine HCI Best to take this drug with mealsAntiulcer/Proton Pump Inhibitor

Lansoprazole (Prevacid) Take this drug prior to mealsOmeprazole (Prilosec) Bronchodilator

Albuterol (Proventil) Tachycardia, MD check blood levels for toxicityDiuretic

Furosemide (Lasix) HYPOKALEMIAHydrochlorothiazide (HCTZ) HYPOKALEMIAHormone Replacement

Estrogen (Premarin) can ↑ blood clotsLevothyroxine (Levoxyl) can ↑ blood clotsLevothyroxin (Synthyroid) Teach the clients to check his PULSE RATEMuscle Relaxant

Cyclobenzaprine HCI (Flexeril) SEDATION Oral Contraceptive

Necon (Ortho-Novum 7/7/7) can ↑ blood clotsTrinessa (Ortho TriClen) can ↑ blood clotsOsteoporosis

Alendronate (Fosamax) Remain UPRIGHT for at least 30mins after taking to prevent GERD.Take with WATER

Potassium Supplement

Potassium Chloride (K-lyte) Check for renal function before giving this drugSleep Aid

Zolpidem (Ambien) Allow at least 8hrs of sleep time to prevent daytime drowsiness

ANTI PARKINSON'S

C- cogentin

A- artane

P- parlodel

A- akineton

B- benadryl

L- larodopa

E- Eldepryl

S- symmetril

Increase protein and give B6AkathisiaDystoniaTardive DysinesiaNeuroleptic Malignant Syndrome

ANTI-ANXIETY

V-valium

L-librium

A-ativan

S-serax

T-tranxene

M-miltown

E- equanil

V-vistaril

A-taxene

I-Inderal

B-buspar

Tolerance develop until seven days

A- void abrupt discontinuation after prolonged useN- Not give if BP is up, hepatic/renal dysfunction or history of drug abuseX-xanax, ativan, serax is also an anti-anxiety medsI-increase in 3D's- drowsiness, dizziness, decreased BPEnhances action of GABAT-teach client to rise slowly from supine positionY-es alcohol should also be avoided.

MAOI Drugs

M-marplan

N-nardil

P-parnate

Hypertensive crisis within several hours of ingestion of tyramine containing foodsTyramine foods:aged cheese, beer, ale, red wine, pickled foods, smoked or pickled fish, beef or chopped liver, avocado of figs.

ANTI-DEPRSSION

A- asendin

N-norpramin

T- tofranil

S-sinequan

A-anafranil- aventylV-vivactil

E-Elavil

P-paxil

Z-zoloft

D-riving is contraindicatedE-ffect has a delayed onset of 7-21 daysP-regnancy consult with your physicianR-elieves symptoms but never cureE- valuate vital signS-toppind drug abruptly is Out!S-afety measuresI-nstruct to report undesirable side effectO-bserve for suicidal tendenciesN-o alcohol or CNS depressants

ANTI-MANIC DRUGS

Lithium- Eskalith

Increase risk of toxicity when given with: thiazide diuretics, methyldopa, and NSAIDsDecrease lithium levels with excess sodium and antacids.Increase CNS toxicity with Haloperidol

0.6-1.2 -meq/l Therapeutic Effect> 1.5 meq/l Toxic2.0 meq/l lethal

L- evel - therapeutic 0.6-1.2 meq/lI-ncreased UrinationT-hirst IncreasedH-eadaches and TremorsI-ncreased fluidsU-nsteadyM-orton's Salt -adequate intake

HMG-CoA reductase inhibitors (statins): side effects, contraindications, interactions HMG-CoA:· Side effects:HepatotoxicityMyositis [aka rhabdomyolysis]· Contraindications:Girl during pregnancy/ Growing children· Interactions:Coumarin/ Cyclosporine

Beta-blockers: main contraindications, cautions ABCDE:AsthmaBlock (heart block)COPDDiabetes mellitusElectrolyte (hyperkalemia)

Amiodarone: action, side effects 6 P's:Prolongs action potential durationPhotosensitivityPigmentation of skinPeripheral neuropathyPulmonary alveolitis and fibrosisPeripheral conversion of T4 to T3 is inhibited -> hypothyroidism

Ca++ channel blockers: uses CA++ MASH:Cerebral vasospasm/ CHFAnginaMigranesAtrial flutter, fibrillationSupraventricular tachycardiaHypertension· Alternatively: "CHASM":Cererbral vasospasm / CHF

HypertensionAnginaSuprventricular tachyarrhythmiaMigranes

Anticholinergic side effects

Know the ABCD'S of anticholinergic side effects":

AnorexiaBlurry visionConstipation/ ConfusionDry MouthSedation/ Stasis of urine

Aspirin: side effects ASPIRIN:

AsthmaSalicyalismPeptic ulcer disease/ Phosphorylation-oxidation uncoupling/ PPH/ Platelet disaggregation/ Premature closure of PDAIntestinal blood lossReye's syndromeIdiosyncracyNoise (tinnitus)

Benzodiazepines: actions "Ben SCAMs Pam into seduction not by brain but by muscle":Sedationanti-Convulsantanti-AnxietyMuscle relaxantNot by brain: No antipsychotic activity

Cholinergics (eg organophosphates): effects

If you know these, you will be "LESS DUMB": or SLUDGELacrimationExcitation of nicotinic synapsesSalivationSweatingDiarrheaUrinationMicturitionBronchoconstriction

Methyldopa: side effectsMETHYLDOPA:

Mental retardationElectrolyte imbalanceToleranceHeadache/ HepatotoxicitypsYcological upsetLactation in femaleDry mouthOedemaParkinsonismAnaemia (haemolytic)

Physostigmine vs. neostigmineLMNOP

Lipid solubleMioticNaturalOrally absorbed wellPhysostigmine_ Neostigmine, on the contrary, is:Water solubleUsed in myesthenia gravisSyntheticPoor oral absorption

Antibiotics contraindicated during pregnancyMCAT:MetronidazoleChloramphenicolAminoglycosideTetracycline

Morphine: side-effects MORPHINE:MyosisOut of it (sedation)Respiratory depressionPneumonia (aspiration)HypotensionInfrequency (constipation, urinary retention)NauseaEmesis

Beta-blockers: main contraindications, cautionsABCDE:AsthmaBlock (heart block)COPD

Diabetes mellitusElectrolyte (hyperkalemia)

ADRS OF CHLORAMPHENICOL

smart boys in girls hostel B.... bone marrow depressionH...hypersensitivityI....irritative effectsS.....superinfectionsG.....Gray baby syndrome

Steroids: side effectsBECLOMETHASONE

Buffalo humpEasy bruisingCataractsLarger appetiteObesityMoonfaceEuphoriaThin arms & legsHypertension/ HyperglycaemiaAvascular necrosis of femoral headSkin thinningOsteoporosisNegative nitrogen balanceEmotional liability

Methyldopa: side effectsMETHYLDOPA:Mental retardationElectrolyte imbalanceToleranceHeadache/ HepatotoxicitypsYcological upsetLactation in femaleDry mouthOedemaParkinsonismAnaemia (haemolytic)

Captopril (an ACE inhibitor): side effectsCAPTOPRIL:

CoughAngioedema/ AgranulocystosisProteinuria/ Potassium excess

Taste changesOrthostatic hypotensionPregnancy contraindication/ Pancreatitis/ Pressure drop (first dose hypertension)Renal failure (and renal artery stenosis contraindication)/ RashIndomethacin inhibitionLeukopenia/ Liver toxicity

.Ca++ channel blockers: usesCA++ MASH

Cerebral vasospasm/ CHFAnginaMigranesAtrial flutter, fibrillationSupraventricular tachycardiaHypertension

Pulmonary infiltrations inducing drugs "Go BAN Me!":GoldBleomycin/ Busulphan/ BCNUAmiodarone/ Acyclovir/ AzathioprineNitrofurantoinMelphalan/ Methotrexate/ Methysergide

MPTP: mechanism, effect MPTP:Mitochondrial Parkinson's-Type Poison.· A mitochondrial poison that elicits a Parkinson's-type effect.

Antimuscarinics: members, action"Inhibits Parasympathetic And Sweat":Ipratropium Pirenzepine Atropine Scopolamine· Muscarinic receptors at all parasympathetic endings sweat glands in sympathetic.

Teratogenic drugs: major non-antibiotics TAP CAP:Thalidomide Androgens Progestins Corticosteroids Aspirin & indomethacin Phenytoin

Steroid side effects CUSHINGOID:CataractsUlcersSkin: striae, thinning, bruisingHypertension/ Hirsutism/ HyperglycemiaInfectionsNecrosis, avascular necrosis of the femoral headGlycosuriaOsteoporosis, obesityImmunosuppressionDiabetes

Beta blockers with CYP2D6 polymorphic metabolism"I Met Tim Carver, the metabolic polymorph":· The following beta blockers require dose adjustment due to CYP2D6 polymorphic metabolism:Metoprolol Timolol Carvedilol (in patients with lower or higher than normal CYP2D6 activity)

Beta blockers with intrinsic sympathomimetic activityPicture diabetic and asthmatic kids riding away on a cart that rolls on pinwheels. Pindolol and Carteolol

have high and moderate ISA respectively, making them acceptable for use in some diabetics or asthmatics despite the fact that they are non-seletive beta blockers.

Muscarinic effects SLUG BAM:Salivation/ Secretions/ SweatingLacrimationUrinationGastrointestinal upsetBradycardia/ Bronchoconstriction/ Bowel movementAbdominal cramps/ AnorexiaMiosis

Sulfonamide: major side effects· Sulfonamide side effects:Steven-Johnson syndromeSkin rashSolubility low (causes crystalluria)Serum albumin displaced (causes newborn kernicterus and potentiation of other serum albumin-binders like warfarin)

Epilepsy types, drugs of choice:"Military General Attacked Weary Fighters Pronouncing 'Veni Vedi Veci' After Crushing Enemies":· Epilepsy types: Myoclonic Grand mal Atonic West syndrome Focal Petit mal (absence)· Respective drugs: Valproate Valproate Valproate ACTH Carbamazepine Ethosuximide

Quinolones [and Fluoroquinolones]: mechanism"Topple the Queen": Quinolone interferes with Topoisomerase II.

Beta blockers:B1 selective vs. B1-B2 non-selectiveA through N: B1 selective: Acebutalol, Atenolol, Esmolol, Metoprolol.O through Z: B1, B2 non-selective: Pindolol, Propanalol, Timolol.

Ribavirin: indications RIBAvirin:RSVInfluenza BArenaviruses (Lassa, Bolivian, etc.)Hypertension: treatment ABCD:ACE inhibitors/ AngII antagonists (sometimes Alpha agonists also) Beta blockersCalcium antagonistsDiuretics

Narcotics: side effects "SCRAM if you see a drug dealer": Synergistic CNS depression with other drugsConstipationRespiratory depressionAddictionMiosisSex hormone drugs: male "Feminine Males Need Testosterone":FluoxymesteroneMethyltestosteroneNandroloneTestosterone

Ca++ channel blockers: uses CA++ MASH:Cerebral vasospasm/ CHFAnginaMigranesAtrial flutter, fibrillation

Supraventricular tachycardiaHypertension· Alternatively: "CHASM":Cererbral vasospasm / CHFHypertensionAnginaSuprventricular tachyarrhythmiaMigranes

Disulfiram-like reaction inducing drugs "PM PMT" as in Pre Medical Test in the PM:ProcarbazineMetronidazoleCefo (Perazone, Mandole, Tetan).

Delerium-causing drugs ACUTE CHANGE IN MS:Antibiotics (biaxin, penicillin, ciprofloxacin)Cardiac drugs (digoxin, lidocaine)Urinary incontinence drugs (anticholinergics)TheophyllineEthanolCorticosteroidsH2 blockersAntiparkinsonian drugsNarcotics (esp. mepridine)Geriatric psychiatric drugsENT drugsInsomnia drugsNSAIDs (eg indomethacin, naproxin)Muscle relaxantsSeizure medicines

Morphine: side-effects MORPHINE:MyosisOut of it (sedation)Respiratory depressionPneumonia (aspiration)HypotensionInfrequency (constipation, urinary retention)NauseaEmesis

Therapeutic dosage: toxicity values for most commonly monitored medications"The magic 2s":Digitalis (.5-1.5) Toxicity = 2.Lithium (.6-1.2) Toxicity = 2.Theophylline (10-20) Toxicity = 20.Dilantin (10-20) Toxicity = 20.APAP (1-30) Toxicity = 200.

Diuretics:thiazides: indications "CHIC to use thiazides":CHFHypertensionInsipidousCalcium calculi

Migraine: prophylaxis drugs"Very Volatile Pharmacotherapeutic Agents For Migraine Prophylaxis":Verpamil

Valproic acidPizotifenAmitriptylineFlunarizineMethysergidePropranolol

Adrenoceptors: vasomotor function of alpha vs. betaABCD:Alpha = Constrict.Beta = Dilate.

Antiarrhythmics: classificationI to IV MBA College· In order of class I to IV:Membrane stabilizers (class I)Beta blockersAction potential widening agentsCalcium channel blockers

Opiods: mu receptor effects "MD CARES":MiosisDependencyConstipationAnalgesicsRespiratory depressionEuphoriaSedation

Cancer drugs: time of action between DNA->mRNA ABCDEF: Alkylating agentsBleomycinCisplastinDactinomycin/ DoxorubicinEtoposideFlutamide and other steroids or their antagonists (eg tamoxifen, leuprolide)

Busulfan: features ABCDEF:Alkylating agentBone marrow suppression s/eCML indicationDark skin (hyperpigmentation) s/eEndrocrine insufficiency (adrenal) s/eFibrosis (pulmonary) s/e

Tricyclic antidepressants: members worth knowing"I have to hide, the CIA is after me":Clomipramine Imipramine Amitrptyline· If want the next 3 worth knowing, the DNDis also after me:Desipramine Norrtriptyline Doxepin

Torsades de Pointes: drugs causing APACHE:Amiodarone Procainamide Arsenium Cisapride Haloperidol Eritromycin

Serotonin syndrome: components Causes HARM:Hyperthermia Autonomic instability (delirium) Rigidity Myoclonus

Tetracycline: teratogenicityTEtracycline is a TEratogen that causes staining of TEeth in the newborn.

Patent ductus arteriosus: treatment"Come In and Close the door": INdomethacin is used to Close PDA.

Physostigmine vs. neostigmine LMNOP:Lipid solubleMioticNaturalOrally absorbed wellPhysostigmine· Neostigmine, on the contrary, is:Water solubleUsed in myesthenia gravisSyntheticPoor oral absorption

Beta 1 selective blockers"BEAM ONE up, Scotty":Beta 1 blockers:EsmololAtenololMetropolol

Antirheumatic agents (disease modifying): membersCHAMP:CyclophosphamideHydroxycloroquine and choloroquinineAuranofin and other gold compoundsMethotrexatePenicillamine

Auranofin, aurothioglucose: category and indicationAurum is latin for "gold" (gold's chemical symbol is Au).Generic Aur- drugs (Auranofin, Aurothioglucose) are gold compounds.· If didn't learn yet that gold's indication is rheumatoid arthritis, AUR- Acts Upon Rheumatoid.

Antiarrhythmics: class III members BIAS:BretyliumIbutilideAmiodaroneSotalol

MAOIs: indications MAOI'S:Melancholic [classic name for atypical depression]AnxietyObesity disorders [anorexia, bulemia]Imagined illnesses [hypochondria]Social phobias· Listed in decreasing order of importance.· Note MAOI is inside MelAnchOlIc.

SIADH-inducing drugs ABCD:Analgesics: opioids, NSAIDsBarbituratesCyclophosphamide/ Chlorpromazine/ CarbamazepineDiuretic (thiazide)

K+ increasing agents K-BANK:K-sparing diuretic

Beta blockerACEINSAIDK supplement

Reserpine action:Reserpine depletes the Reserves of catecholamines [and serotonin].

Succinylcholine:action, use Succinylcholine gets Stuck to Ach receptor, then Sucks ions in through open pore. You Suck stuff in through a mouth-tube, and drug is used for intubation.Beta-blockers: side effects "BBC Loses Viewers In Rochedale": BradycardiaBronchoconstrictionClaudicationLipidsVivid dreams & nightmares-ve Inotropic actionReduced sensitivity to hypoglycaemiaCisplatin: major side effect, action "Ci-Splat-In":Major side effect: Splat (vomiting sound)--vomiting so severe that anti-nausea drug needed. Action: Goes Into the DNA strand.

Vir-named drugs: use"-vir at start, middle or end means for virus": · Drugs:Abacavir,Acyclovir,Amprenavir,Cidofovir,Denavir,Efavirenz,Indavir,Invirase,Famvir,Ganciclovir,Norvir,Oseltamivir,Penciclovir,Ritonavir,Saquinavir,Valacyclovir,Viracept,Viramune,Zanamivir,Zovirax.

Phenobarbitone: side effectsChildren are annoying (hyperkinesia, irritability, insomnia, aggression).Adults are dosy (sedation, dizziness, drowsiness).

Prazocin: usagePrazocin sounds like an acronym of "praszz zour urine".Therefore Prazocin used for urinary retention in BPH.

Opioids: effects BAD AMERICANS:Bradycardia & hypotensionAnorexiaDiminished pupilary sizeAnalgesicsMiosis

EuphoriaRespiratory depressionIncreased smooth muscle activity (biliary tract constriction) ConstipationAmeliorate cough reflexNausea and vomitingSedation

TB: antibiotics usedSTRIPE:STreptomycin Rifampicin Isoniazid Pyrizinamide Ethambutol

Phenytoin: adverse effects PHENYTOIN:P-450 interactionsHirsutismEnlarged gumsNystagmusYellow-browning of skinTeratogenicityOsteomalaciaInterference with B12 metabolism (hence anemia)Neuropathies: vertigo, ataxia, and headache

Narcotic antagonistsThe Narcotic Antagonists are NAloxone and NAltrexone. · Important clinically to treat narcotic overdose.

Thrombolytic agents USA:Urokinase Streptokinase Alteplase (tPA)

Routes of entry: most rapid ways meds/toxins enter body"Stick it, Sniff it, Suck it, Soak it":Stick = InjectionSniff = inhalationSuck = ingestionSoak = absorption

Asthma drugs: leukotriene inhibitor actionzAfirlukast: Antagonist of lipoxygenasezIlueton: Inhibitor of LT receptor

Direct sympathomimetic catecholamines DINED:DopamineIsoproterenolNorepinephrineEpinephrineDobutamine

Anticholinergic side effects"Know the ABCD'S of anticholinergic side effects":AnorexiaBlurry visionConstipation/ ConfusionDry MouthSedation/ Stasis of urine

Atropine use: tachycardia or bradycardia"A goes with B": Atropine used clinically to treat Bradycardia.

Bleomycin: action"Bleo-Mycin Blows My DNA to bits": Bleomycin works by fragmenting DNA (blowing it to bits). My DNA signals that its used for cancer (targeting self cells).

Aspirin: side effects ASPIRIN:AsthmaSalicyalismPeptic ulcer disease/ Phosphorylation-oxidation uncoupling/ PPH/ Platelet disaggregation/ Premature closure of PDAIntestinal blood lossReye's syndromeIdiosyncracyNoise (tinnitus)

Lupus: drugs inducing it HIP:HydralazineINHProcanimide

Vigabatrin: mechanism Vi-GABA-Tr-In:Via GABA Transferase Inhibition

Morphine: effects at mu receptor PEAR:Physical dependenceEuphoriaAnalgesiaRespiratory depression

Enoxaprin (prototype low molecular weight heparin): action, monitoring EnoXaprin only acts on factor Xa. Monitor Xa concentration, rather than APTT.

Beta-1 vs Beta-2 receptor location "You have 1 heart and 2 lungs":Beta-1 are therefore primarily on heart. Beta-2 primarily on lungs.

SSRIs: side effects SSRI:Serotonin syndromeStimulate CNSReproductive disfunctions in maleInsomnia

Ipratropium: action Atropine is buried in the middle:iprAtropium, so it behaves like Atropine.

Warfarin: action, monitoring WePT:Warfarin works on the extrinsic pathway and is monitored by PT.

Propranolol and related '-olol' drugs: usage"olol" is just two backwards lower case b's. Backward b's stand for "beta blocker". · Beta blockers include acebutolol, betaxolol, bisoprolol, oxprenolol, propranolol.

Depression: 5 drugs causing it PROMS:PropranololReserpineOral contraceptivesMethyldopaSteroids

Lead poisoning: presentation ABCDEFG:Anemia

Basophilic strippingColicky painDiarrheaEncephalopathyFoot dropGum (lead line)

Myasthenia gravis: edrophonium vs. pyridostigmineeDrophonium is for Diagnosis.pyRIDostigmine is to get RID of symptoms.

Morphine: effects MORPHINES:MiosisOrthostatic hypotensionRespiratory depressionPain supressionHistamine release/ Hormonal alterationsIncreased ICTNauseaEuphoriaSedation

Inhalation anesthetics SHINE:SevofluraneHalothaneIsofluraneNitrous oxideEnflurane· If want the defunct Methoxyflurane too, make it MoonSHINE.

Cholinergics (eg organophosphates): effectsIf you know these, you will be "LESS DUMB":LacrimationExcitation of nicotinic synapsesSalivationSweatingDiarrheaUrinationMicturitionBronchoconstriction

Benzodiazapines: ones not metabolized by the liver (safe to use in liver failure) LOT: Lorazepam Oxazepam Temazepam

Benzodiazepines: actions"Ben SCAMs Pam into seduction not by brain but by muscle":Sedationanti-Convulsantanti-AnxietyMuscle relaxantNot by brain: No antipsychotic activity.

Botulism toxin: action, related bungarotoxinAction: "Botulism Bottles up the Ach so it can't be the released":Related bungarotoxin: "Botulism is related to Beta Bungarotoxin (beta-, not alpha-bungarotoxin--alpha has different mechanism).

Teratogenic drugs "W/ TERATOgenic":

WarfarinThalidomideEpileptic drugs: phenytoin, valproate, carbamazepineRetinoidACE inhibitorThird element: lithiumOCP and other hormones (eg danazol)

Gynaecomastia-causing drugs DISCOS:DigoxinIsoniazidSpironolactoneCimetidineOestrogensStilboestrol

Benzodiazepenes: drugs which decrease their metabolism"I'm Overly Calm":IsoniazidOral contraceptive pillsCimetidine· These drugs increase calming effect of BZDs by retarding metabolism.

Anesthesia: 4 stages "Anesthesiologists Enjoy S & M":AnalgesiaExcitementSurgical anesthesiaMedullary paralysis

4-Aminopyradine (4-AP) use"4-AP is For AP":For AP (action potential) propagation in Multiple Sclerosis.

Osmotic diuretics: members GUM:GlycerolUreaMannitol

Sodium valproate: side effects VALPROATE:VomitingAlopeciaLiver toxicityPancreatitis/ PancytopeniaRetention of fats (weight gain)Oedema (peripheral oedema)Appetite increaseTremorEnzyme inducer (liver)

Nitrofurantoin: major side effects NitroFurAntoin:Neuropathy (peripheral neuropathy)Fibrosis (pulmonary fibrosis)Anemia (hemolytic anemia)Zafirlukast, Montelukast, Cinalukast:mechanism, usage"Zafir-luk-ast, Monte-luk-ast, Cina-luk-ast": · Anti-Lukotrienes for Asthma.· Dazzle your oral examiner: Zafirlukast antagonizes leukotriene-4.Zero order kinetics drugs (most common ones) "PEAZ (sounds like pees) out a constant amount":PhenytoinEthanolAspirin

Zero order· Someone that pees out a constant amount describes zero order kinetics (always the same amount out)

Hepatic necrosis: drugs causing focal to massive necrosis"Very Angry Hepatocytes":Valproic acidAcetaminophenHalothane

Steroids: side effects BECLOMETHASONE:Buffalo humpEasy bruisingCataractsLarger appetiteObesityMoonfaceEuphoriaThin arms & legsHypertension/ HyperglycaemiaAvascular necrosis of femoral headSkin thinningOsteoporosisNegative nitrogen balanceEmotional liability

Amiodarone: action, side effects 6 P's:Prolongs action potential durationPhotosensitivityPigmentation of skinPeripheral neuropathyPulmonary alveolitis and fibrosisPeripheral conversion of T4 to T3 is inhibited -> hypothyroidism

Monoamine oxidase inhibitors:Members "PIT of despair":PhenelzineIsocarboxazidTranylcypromine ·A pit of despair, since MAOs treat depression

Warfarin: metabolism SLOW:· Has a slow onset of action.· A quicK Vitamin K antagonist, though.Small lipid-soluble moleculeLiver: site of actionOral route of administration.Warfarin

Propythiouracil (PTU):Mechanism It inhibits PTU:Peroxidase/ Peripheral deiodinationTyrosine iodination Union (coupling)

Antibiotics contraindicated during pregnancy MCAT:Metronidazole

ChloramphenicolAminoglycosideTetracycline

Beta-blockers:nonselective beta-blockers"Tim Pinches His Nasal Problem"(because he has a runny nose...):TimololPindololHismololNaldololPropranolol

Methyldopa:side effects METHYLDOPA:Mental retardationElectrolyte imbalanceToleranceHeadache/ Hepatotoxicity psYcological upsetLactation in femaleDry mouthOedemaParkinsonismAnaemia (haemolytic)

Lithium: side effects LITH:LeukocytosisInsipidus [diabetes insipidus, tied to polyuria]Tremor/ TeratogenesisHypothyroidism

Respiratory depression inducing drugs "STOP breathing":Sedatives and hypnoticsTrimethoprimOpiatesPolymyxins

Benzodiazepenes: antidote "Ben is off with the flu":Benzodiazepine effects off with Flumazenil. e-facts to avoid during pregnancy

e - erythromicin

f - fluoroquinolones

a - aminoglycosides

c - clarithromycin

t - tetracyclin

s - sulfonamideOtotoxic* Aminoglycosides (gentamicin)* Vancomycin

Nephrotoxic:* Penicillin* Gentamicin (aminoglycosides)* Amphotericin B* Acyclovir

Hepatotoxic:* Tetracycline* TMP-SMZ (esp. pregnant, breastfeeding or less that 2 months old)* INH* Rifampin

* Pyrazinamide * Ketoconazole

Decrease effectiveness of Oral Contraceptives:* Penicillin* Tetracycline* Rifampin

Caution or **Contraindicated w/ Impaired Renal Function1) TMP-SMZ:** Contra. if creatinine clearance < 15 ml/min (otherwise decrease dose 50%)2) Gentamicin3) Vancomycin4) Penicillin5) Cephalosporins6) Imipenem 7) ** Tetracycline (except doxycycline & minocycline)8) Nitrofurantoin ** Creatinine clearance <40 ml/min 9) Acyclovir (esp. if also dehydrated)10) Metronidazole11) **Amphotericin B

Caution or **Contraindicated w/ Impaired Hepatic Function1) **Erythromycin, clindamycin, clarithromycin, azithromycin2) **INH3) Rifampin (avoid giving to alcoholics

Parkinsonism: drugsSALAD

SelegilineAnticholinenergics...trihexyphe nidyl, benzhexol, ophenadrine

L-Dopa + peripheral decarboxylase inhibitor ...carbidopa, benserazideAmantadine

Dopamine postsynaptic receptor agonists ...bromocriptine, lisuride, pergolide

Benzodiazepines: ones not metabolized by the liver (safe to use in liver failure)LOT:LorazepamOxazepamTemazepam

Food & Drug Interactions Take with food

Ceftin - Cardene - Biaxin - Keflex - Demadex - Augmentin - Ceclor - Ticlid

Take 15 minutes before food

Prilosec - Propulsid

Take on an empty stomach(1 hour before or 2 hours after food) Prevacid - Zithromax - Carafate - Ampicillin

May take with or without food

Effexor - Prozac(avoid alcohol) - Pamelor(limit caffeine)

Take with food - Avoid alcohol

Xanax - Zoloft - Paxil - Restoril - Desyrel - Buspar - Klonopin - Flagyl

Take with food - Avoid alcohol - Limit caffeine

Ativan - Valium - Elavil

Take on empty stomach - Avoid alcohol

Isordil - Monoket - Procanbid - Sorbitrate - Nitroglycerin - Pronestyl - Imdur - Quinidine Sulfate - Ismo

Gastrointestinal Medications

Axid - take with food. Avoid alcohol, limit caffeine, may need a bland diet.

Tagamet - take with food. Avoid alcohol, limit caffeine, may need a bland diet. Take iron supplement separately by 2 hours.

Zantac/Pepcid - may take with or without food. Avoid alcohol. limit caffeine, may need a bland diet.

AntibioticsTake the following on an empty stomach 1 hour before or 2 hours after food.

Floxin/Noroxin- take with 8 ounces of water. Drink plenty of fluids.

Tetracycline - do not take milk, dairy products, iron or calcium supplements, antacids or mineral supplements within 1 hour before or 2 hours after taking this medication. Take with 8 ounces of water.

Penicillin- avoid taking with citrus juices or carbonated beverages. For best results take with 8 ounces of water.

Take the following with food especially if stomach is easily upset.

Erythromycin - limit caffeine.

Cipro- limit caffeine and drink plenty of fluids. Take antacids, magnesium, iron, calcium or zinc supplements separate by 2 hours.

Septra/Bactrim- drink plenty of fluids. Avoid high doses of vitamin C.

Antihypertensives(high blood pressure medication)Take the following on an empty stomach.

Capoten - decrease sodium, decrease calorie diet may be recomended. Avoid salt substitutes that contain potassium, caution with potassium supplements. Take calcium or magnesium supplements separate by 2 hours. Maintain adequate fluid intake.

Procardia - take with decreased fat meal to prevent flushing. Do not take with orange, grapefruit or other citrus fruit juices. A low salt diet may be recommended. Do not take calcium supplement within 3 hours of taking this medication. Avoid alcohol.

Cardizem - a low sodium, low calorie diet may be recommended.

Hydrocholorothiazide - diuretic potassium depleting. May need to decrease sodium, decrease calorie, increase potassium, increase magnesium. Avoid natural licorice. Limit alcohol. Caution with calcium supplements.

Triamterene - diuretic, potassium sparing. Avoid high potassium foods, potassium supplements, salts substitutes that contain potassium. A decreased sodium, decreased calorie diet may be recommended. Avoid natural licorice.

Calan (Verapamil/Isoptin)- decrease sodium, decrease calorie diet may be recommended. Limit caffeine. Caution with calcium and/or vitamin D supplements - hypercalcemia decreases effectiveness.

Take the following with food or on empty stomach:

Vasotec/Zestril/Accupril - avoid salt and salty foods. Avoid salt substitutes that contain potassium. Caution with potassium supplements. Avoid alcohol.

Atenolol/Metoprolol (Tenormin, Lopressor, Toprol XL) - a decreased sodium, decreased calorie diet may be recommended. Avoid natural licorice.

Hytrin/Cardura - a decreased sodium, decreased calorie diet may be recommended. Avoid natural licorice. Caution with alcohol.

AntihyperlipidemicsThese medications are prescribed to lower blood lipid (cholesterol) levels. A low cholesterol, low fat diet may be recommended. Avoid alcohol.

Pravachol - take on an empty stomach 1 hour before or 2 hours after foods.

Mevacor/Lopid - take with food.

Zocor/Lescol - may take with or without food.

Cardiovascular

Lanoxin - take this medication 1 hour before breakfast. Avoid high fiber foods such as bran, bran cereals or bran muffins for breakfast, but it is acceptable to eat high-fiber foods later in the day. Avoid natural licorice.

Miscellaneous Cardiac Medications

Quinidine (Quinaglute, Duraguin, Quinidex) - take this medication 1 hour before or 2 hours after food. Take with 8 ounces of water. Do not drink more than 1 or 2 glasses of citrus juice while on this medication. Caution with potassium supplements.

Take the following with food:

Lozol - a low sodium, low calorie, high potassium, high magnesium diet may be

recommended. Avoid natural licorice. Limit alcohol.

Edecrin - a high potassium, high magnesium diet may be recommended. Liberal sodium diet for most patients. Limit alcohol.

Trental- a low cholesteral, low calorie diet may be recommended. Limit caffeine.

Bumex/Lasix/Hydrodiuril- a low salt, high potassium diet may be recommended. Avoid natural licorice and alcohol.

Miscellaneous Medications

Theophylline - this medication will not work well if you eat more protein than usual. Try to eat the same protein foods each day. Avoid charcoal-broiled foods. Avoid caffeine. For Theo-24 only take with a high fat meal or snack.

Monoamine Oxidase Inhibitors (Parnate, Nardil, Marplan) - avoid foods high in tyramine. If you eat foods high in tyramine while on this medication it can cause nausea, vomiting, high blood pressure and headaches. Avoid alcohol and limit caffeine.

Oral Hypoglycemics (Diabinese, Glucotrol, Diabeta, Micronase) - take with food and avoid alcohol. Compliance with a diabetic diet is important.

Coumadin (anticoagulant) - avoid excessive amounts of foods that are high in vitamin K. Do not drink herbal teas or green teas while taking this medication. Because of the varied effects that food can have on this medication, maintain a well balanced diet with a consistent intake of vitamin K. Avoid alcohol.

Foods High In TyramineAged cheese - Caffeine - Pickled Herring - Aged Meat - Chicken Liver - Raisins - Anchovies - Chocolate - Red Wine - Bananas - Cola Drinks - Salami - Beef Liver - Eggplant - Sausage - Beer - Figs - Sour Cream - Bologna - Mushrooms - Yeast Extract - Broad Beans - Pepperoni - Soy Sauce - Yogurt

Foods High In PotassiumApricots - Cantelope - Honeydew - Prune Juice - Asparagus - Carrots - Milk - Pumpkin - Artichokes - Celery - Mushrooms - Raisins - Avocado - Chocolate - Oranges - Spinach - Bananas - Dates - Orange Juice - Squash - Bran Flakes - Dried Beans - Parsnips - Tomatoes - Broccoli - Dried Fruit - Potatoes - Tomato Juice - Brussel Sprouts - Figs - Prunes - V-8 Juice - Yams

Foods High In Vitamin KBeef Liver - Green Tea - Brussel Sprouts - Cauliflower - Tomatoes - Soybeans/Soybean Oil - Green Leafy Vegetablesespecially Broccoli, Cabbage, Kale, Lettuce & Turnips

Foods that Contain CaffeineCoffe - Tea - Chocolate - Dark Sodas - Mountain Dew

Tyramine exceptions: most vegetables and fruits, fresh meat and fish, milk, yogurt, cottage cheese, cream cheese, major domestic brands of beer, most wines

MAOI's + tyramine-rich food= hypertensive crisis (s/s headache, tachycardia, palpitations, n/v). If hypertensive crisis occurs, BP can be lowered by IV phentolamine and sublingual nifedipine.

Here's some more tips too..PHARMACOLOGY

Insulin, Coumadin, Heparin, antihypertensives, viagra, digitalis, ritalin, actonel, accutane, anti-ulcer medications, nitroglycern, to name a few. Try to look at the suffixes:

ace inhibitors end with 'pril (eg: captopril) *note that this drug increases potassium in the blood,

angiotensinogen 2 inhibitors end in 'sartan (eg: losartan),

beta blockers end with 'olol (eg: metoprolol) *caution with patients who are diabetic or who are asthmatic,

cholesterol reducing drugs usually end with 'statin (eg: atorvastatin) * note that if the patient experiences muscular pain, they should stop immediately and report it to the doctor, also not to consume grapefruit juice,

impotence drugs end with "defil (eg: sildenefil-hope I spelled it correctly...if not please excuse the typo) *note that you cannot take this drug if you are taking nitrates such as nitroglycerin or isosorbide and go to the doctor if an erection last longer than 4 hours,

accutane is an acne drug, where a pregnancy test must be done on females before prescribing them

actonel (again, this may be a typo) cannot be taken unless a person is able to sit up for at least 1/2 hour to an hour after adminstration.

Know the acting times of insulin, which is fast acting, long acting or the lente. They may ask when will a person become hypoglycemic, and that would be during peak hours.

penicillin: if a person has an allergy to penicillin, they may be at risk for an allergy to a cephalosporin, in that case suggest a macrolide such as clarithromycin. Macrolides are known to cause severe stomach pain for some people. Also, if a nurse administers penicillin or cephalosporin, that the patient should remain with the nurse for 1/2 hour afterwards to intervene with allergic reactions.

Most drugs that end with 'mycin may cause nephrotoxicity or ototoxicity

Parameters for digitalis administration, and also that if potassium is low and calcium and magnesium is high, there is a higher chance for digitalis toxicity.

corticosteriods usually end with 'sone (eg: predinsone), may cause medication related diabetes, increase chances of infection, cause Cushoid symptoms (buffalo hump in back, thin skin, easy to bruise, etc...)

Aspirin should not be consumed with alcohol, increases bleeding, causes ulcers, should be taken with food to diminish gastric distress

Antidote for tylenol is Mucomyst.

dont forget your diuretics ... esp. those are imp. also I have some for now ...

meds that end in -sartan=decrease blood pressure, increase cardiac load (Used for those who side effect is cough with ACE)ANGIOTENSIN II RECEPTOR BLOCKERSside effects 2nd degree AV block, angina, muscle cramps monitor BUN,BP and pulse

-vastatin(Lovastatin)=decrease cholesterol, lower tricycerides (NOTE*Lipitor at night only do not take with grapefruit juice)ANTIHYPERLIPIDEMICSside effects muscle weakness, alopecia monitor liver/renal profile

cox=osteoarthritis, rheumatoid arthritis(relieve pain by reducing inflammation)NSAID/CO2 ENZYME BLOCKERside effects tinnitus, dizziness monitor bowel habits (could cause GI bleed, platlet count) Increase risk of strokes, heart attacks***

tidine=GERDHISTAMINE 2 ANTAGONIST(inhibit gastric acids)side effects agranulocytosis, brady/tachycardia monitor gastric PH/BUN ***If taking antacids take one hour after or before taking these drugs***

-prazole=ulcers, indigestion, GERD (Take before meals better absorption)PROTON PUMP INHIBITORSside effects gas, diarrhea, hyperglycemia monitor LFTs

-parin=thin blood, DVT, M.I.,post surgeries (Antidote Protamine sulfate--check PTT should be 1.5-2.0x) anticoag. decread vit. K levelsside effects hematuria, bleeding, fever monitor PTT, hematocrit and occult testing q 3mths

-pam-pate-aze/azo =Benzos/Antianxiety/anticonvulsantsside effects incontinence, respiratory depression/ monitor for LFT, respirations

-caine (anesthetic)-mab (monoclonal antibodies)-ceph or cef (cephalosporins)-cycline (tetracyclines)-cal (calciums)-done (opioids)

ganciclovir sodium causes neutropenia and thrombocytopenia and nurse should monitor for s/s of bleeding just as equiv. to a pt. on anticoag. therapy.

SSRIs and MAOIs used together potentially fatal

caine= local anestheticscillin= antibioticsdine= anti-ulcer agentsdone= opiod analgesicside= oral hypoglycemicsiam= antianxiety agentsmicin= antibioticsnium= neuromuscular blocking agentsolol= beta blockersole= anti-fungaloxacin= antibioticspam= antianxiety agentspril= ace inhibitorssone= steroidsstatin= antihyperlipidemicsvir= antiviralszide= diuretics

Generic Name (Trade Name) Major ConcernsAnalgesicAcetaminophen (Tylenol) Watch for LIVER and KIDNEY problemsHydrocodone with Acetaminophen ADDICTIVE(Lortab)Ibuprofen (Motrin) can lead to HPN and KIDNEY diseaseNaproxen (Aleve) can lead to HPN and KIDNEY disease

AntianxietyAlprazolam (Xanax) This drug can be ADDICTIVEDiazepam (Valium) Watch for Allergies, *also anticonvulsant*Lorazepam (Antivan) SEDATIONPromethazine HCI (Phenergan) *also antiemetic*

AntibioticAmoxicilline (Augmentin) Watch for allergic reactionsAzithromycin (Zithromax Z-Pak) Watch for allergiesCephalexin (Keflex) If you are allergic to Cephalosporins, you might also be allergic to PenicillinDoxycycline hyclate (Vibramycin) Avoid for pregnant clientsPenicillin V Potassium (Penicillin) Watch for allergiesSulfamethoxazole (Septra, Bactrim) Can cause GI diturbance

AnticoagulantWarfarin Sodium (Coumadin) Teach the client to limit the intake of GREEN LEAFY VEGETABLESWatch for signs of BLEEDINGAnticonvulsantClonazepam (Klonopin) Should not be stopped abruptlyDiazepam (Valium) Watch for Allergies, also antianxietyLorazepam (Antivan) SEDATION

AntidepressantSertraline (Zoloft) SEDATION Amitriptyline HCI (Elavil) Trazodone HCI (Desyrel)

AntidiabeticGlipizide (Glucotrol) Watch for HYPOGLYCEMIAMetformin (Glucophage) This drug should be stopped prior to a dye study such as cardiac catheterization

AntihistamineCetirizine (Zyrtec)Fexofenadine (Allegra) DRY MOUTH

AntihypertensiveAmiodipine (Norvasc) HYPERTENSIONAtenolol (Tenormin) cause DROP in PULSE Rate, check PR dailyDoxazosin Mesylate (Cardura)Lisinopril (Zestril) cause Postural HPN, remain supine for at least 30mins Metoprolol Succinate (Toprol XL) Teach the client to check his PULSE RATEMetoprolol Tartrate (Lopressor,Toprol) Teach the client to check his PULSE RATE

Antihypertensive/AntianginalVerapamil HCI (Calan)

Anti-inflammatoryIbuprofen (Motrin) can lead to HYPERTENSION and KIDNEY diseasePrednisone (Deltasone) can cause Cushing’s Syndrome and GI problems

AntigoutAllopurinol (Zyloprim) Drink at least 8 glasses of WATER per day

Antilipidemic – usually ends in statinSimbastatin (Zocor) Can cause LIVER problems & muscle sorenessDo not take this drug with GRAPE-FRUIT JUICEAntiulcer/Histamine BlockerRanitidine HCI Best to take this drug with meals

Antiulcer/Proton Pump InhibitorLansoprazole (Prevacid) Take this drug prior to mealsOmeprazole (Prilosec)

Bronchodilator

Albuterol (Proventil) Tachycardia, MD check blood levels for toxicity

Diuretic Furosemide (Lasix) HYPOKALEMIAHydrochlorothiazide (HCTZ) HYPOKALEMIA

Hormone ReplacementEstrogen (Premarin) can ↑ blood clotsLevothyroxine (Levoxyl) can ↑ blood clotsLevothyroxin (Synthyroid) Teach the clients to check his PULSE RATE

Muscle Relaxant Cyclobenzaprine HCI (Flexeril) SEDATION

Oral ContraceptiveNecon (Ortho-Novum 7/7/7) can ↑ blood clotsTrinessa (Ortho TriClen) can ↑ blood clots

OsteoporosisAlendronate (Fosamax) Remain UPRIGHT for at least 30mins after taking to prevent GERD.Take with WATER

Potassium SupplementPotassium Chloride (K-lyte) Check for renal function before giving this drug

Sleep AidZolpidem (Ambien) Allow at least 8hrs of sleep time to prevent daytime drowsiness

Neutropenic Precautions■ For individuals with compromised immune system■ Use standard precautions, especially hand hygiene■ Caregivers and visitors should be free of communicable illnesses■ Private room if possible; keep room meticulously clean■ Teach to avoid sources of potential infection (crowds, confined spacessuch as airplanes, raw fruits/vegetables, flowers/plants)

DELEGATIONAs far as delegation, Kaplan stresses that the RN is ultimately responsible for all tasks delegated. Now I know from experience, LPNs can be given a lot of tasks that require assessment/gathering, planning, & evaluating loads of information...BUT in terms of the NCLEX-RN...they can't do ANY assessing, planning, evaluation, OR initial teaching. That is entirely the role of the RN on that exam! Also, LPNs can only be given patients that are hemodynamically *STABLE*. They can't be given any patients that require constant monitoring for evaluation purposes. LPNs are only allowed to implement written orders from MDs/APNs & follow instructions given to them by the RNs in charge to cover their patients. As far as the UAPs (unlicensed assistive personnel)...they can only be given the most basic of psychomotor nsg tasks like taking vital signs on stable patients...assisting with ADLs & ambulating patients for therapy & again...no assessing, planning, & evaluation...etc.

Another thing....MDs/APNs/Nsg Mgt/other interdisciplinary dept/personnel such as MSW/Chaplins/Resp/Occup/Physical Therapists are *ALWAYS* available to the NCLEX-RN staff nsg! These people are multiple & fruitful...but remember this.... *DO NOT PASS THE BUCK TO THEM* !!! You have to assume that there are standing….if not written orders for your patients...remember...this is a *perfect world*.If you see in your answer choice where "call the physician", "contact a supervisor from another dept", "refer grieving families to the Chaplin", for example, before you've exhausted everything that YOU as the RN can do for the patient...don't pick those answers.If though, you read that everything was done for the patient, i.e. O2 was started, the patient was repositioned, high vent alarms & you've disconnect the patient & started bagging...then & only then do you contact the physician, supervisor, Resp Therapist...etc. You may be asked questions on what to do for a patient based on their ABGs or common labs...you'll have to know the normals & what's expected when they're abnormal & know where to go from there. The only other time that you will "pass the buck" is when an UAP or a LPN observed something wrong with another RN's patient. You are not suppose to assess that patient since you don't know that patient's base vitals & situation. Only then would you inform either that RN or contact your supervisor (staying within your chain of command)...or both.I've seen questions that suggest an UAP of 12 years or a LPN of 20 years observes a new grad RN do something that they know (or feel) isn't right. What do you do? Confront said nurse, observed said nurse in their duties, or ask the reporting personnel to elaborate on how they come to feel this way. Unless what the UAP/LPN seen is unsafe...then you as the RN would ask that reporting personnel to explain their concerns further.

Primary Roles for the Licensed Nurse**General Education and Support to promote wellness, health maintenance and disease prevention as requested by client *Client initiates

Care Consultation related to health impairment, includes education and support to maintain client independence Client or nurse initiates

Care Coordination Nursing activities include: · consultation · needs assessment · teaching care provider to perform care activities · providing education, support and other direct care · monitoring client status · ongoing review of care provision Client or nurse initiates/directs

Care Coordination Nursing activities include all previous activities plus: · directing nursing care, including assignment and delegation of activities Nurse directs

Total Care Management Includes direct care, assignment and delegation responsibilities within health care system; care provided by both licensednurses and AP (delegated activities) Nurse directs