Can You Explain the Working of Following Drugs Flashcards

Action: increases the binding of insulin to its receptors and potentiates insulin actionUse: Treatment of type 2 diabetes as adjunct to diet and exercise & {it is also used in women with a certain disease of the ovaries (polycystic ovarian syndrome). Metformin may make menstrual cycles more regular and increase fertility.}Usual Adult Dose: 500mg daily bidRoutes: p.o. with to minimize GI effectsNursing Considerations/Alerts: monitor v/s, blood glucose, give with or shortly after main meals; withhold 48 hours before and 48 hours after receiving DV contrast dye. Headache, dizziness, agitated. Monitor serum folic acid and vitamin B12 every Teaching: take same time daily (NO DOUBLE DOSING); hypoglycemia s/s; report to M.D. immediately s/s of infection; report severe vomiting, diarrhea, fever or any illnesses that cause limited fluid intake. Avoid drinking alcohol while taking this drug. Explain the risk of lactic acidosis and the potential need for discontinuation of metformin therapy.*s/s of lactic acidosis: chills, diarrhea, dizziness, low bp, muscle pain, sleepiness, slow heartbeat or pulse, dyspnea or weakness

Action: cardiac glycosides. It works by affecting certain minerals (sodium and potassium) inside heart cells. This reduces strain on the heart and helps it maintain a normal, steady, and strong heartbeat. Use: Heart failure & a certain type of irregular heartbeat (chronic atrial fibrillation). Treating heart failure may help maintain your ability to walk and exercise and may improve the strength of your heart. Treating an irregular heartbeat can decrease the risk for blood clots, an effect that may reduce your risk for a heart attack or stroke. Usual Adult Dosage: IV--0.5-1mg given as 50% of the dose initially and one quarter of the initial dose in each of 2 subsequent does at 6-12hr intervals; PO--0.75mg-15mg given as 50% of the does initially… “ “; IM--rarely used (produces severe local irritation, erratic absorption) give no more than 2ml at any one site Routes: p.o., IM, IV Nursing Considerations/Alerts: monitor apical pulse for full 1 min before administering, withhold dose if pulse rate is <60bpm; monitor ECG throughout IV administration and 6 hr after each dose. Notify M.D. if bradycardia or new arrhythmias occur; geriatric pts digoxin has been associated with an incr fall risk *digitalis preparations--a drug prepared from the dried leaves or seeds of the foxglove Teaching: NO DOUBLE DOSING, call doc if pulse rate <60 or >100, review s/s of toxicity, take at the same time daily *toxicity s/s--abdominal pain, anorexia, nausea, vomiting, visual disturbances, bradycardia, and other arrhythmias

Action: Incr renal excretions of H2O, Na, Cl, Mg, K, Ca Use: treat hypertension. Lowering hypertension helps prevent strokes, heart attacks, and renal problems. Furosemide is a "water pill" (diuretic) causes you to make more urine. This helps your body get rid of extra water and salt. Reduces extra fluid in the body (edema) caused by conditions such as heart failure, liver disease, and kidney disease. This can lessen symptoms, shortness of breath and swelling in your arms, legs, and abdomen. Usual Adult Dose: EDEMA—P.O. =20-80mg/day as a signal does initially, may repeat in 6-8hr; HYPERTENSION—P.O.=40 bid (when added to regimen decr dose of other antihypertensives by 50%)adjust further dosing based on response Routes: P.O., IM, IV Nursing Considerations/Alerts: monitor BP and VS, serum electrolytes, I&O, weight. Watch for changes in initial assessment *hypokalemia s/s—changes in muscle strength, tremor, muscle cramps, altered mental status, cardiac arrhythmias *hyponatremia s/s—confusion, thirst, cold/clammy skin Teaching: expected incr frequency, volume of urination; report palpitations signs of electrolyte imbalances hearing abnormalities; eat foods high in K (whole grains, legumes, meat, bananas, apricots, orange juice, potatoes, raisins); avoid sunlight and sunlamps

Action: Binds to opiate receptors in the CNS. Alters perception of and response to painful stimuli, while producing generalized CNS depression; (therapeutic effect)-decr in severity of pain Use: Relief of moderate to severe pain; reduces post-op shivering; reduces rigors from amphotericin Usual Adult Dose: PO, IM, SQ—50mg q 3-4 hours may be incr prn (NOT TO EXCEED 600MG/24hr); IV—15-35mg/hr as a continuous infusion; PCA-10mg initially; with a range of 1-5mg/ incremental dose Routes: PO, IM, SQ, IV Nursing Considerations/Alerts: pt should be in recumbent (lying down) position b4 drug admin. by parenteral route. Monitor VS-resp: ≤12 withhold med, contact physician; monitor pain levels 15-30min after given (SQ, IM, PO) 5-10min after give (IV); monitor bm and bs; Side Effects-sedation, hypotension, diaphoresis (profuse perspiration), facial flushing, dizziness, nausea, vomiting, constipation Teaching: Avoid alcohol or other CNS depressants; change positions slowly to avoid orthostatic hypotension; tolerance or dependence may occur with prolonged use of high doses; medication should be taken b4 pain fully returns, within ordered intervals *IV INCOMPATIBLE WITH LASIX

Action: Binds with opioid receptors within CNS (therapeutic effect)-alters pain perception, emotional response to pain Use: relief of moderate pain to severe, acute or chronic pain, pain due to MI and dyspnea from pulmonary edema not resulting from chemical respiratory irritant Usual Adult Dose (≥110lbs): PO, Rect—30-mg q 3-4hr initially (Avinza DO NOT EXCEED 1600mg/day); IM, IV, SQ—4-10mg q 3-4hr (MI: 8-15mg additional smaller doses may be given 3-4hr) Usual Adult Dose (<110lbs): PO, Rect—0.3mg/kg q 3-4hr initially; IM, IV, SQ—0.05-0.2mg/kg q 3-4hr, MAXIMUM: 15mg/dose Routes: IM, IV, SQ, PO, IT (intrathecal-space under arachnoid membrane of brain or spinal cord), RECT, EPIDURAL Nursing Considerations/Alerts: pt should be in recumbent (lying down) position b4 drug admin. by parenteral route; Monitor VS-resp: ≤12 withhold med, contact physician; monitor pain levels 15-30min after given (SQ, IM, PO) 5-10min after give (IV); monitor bm and bs; ALERTS: avinza dosage admin ONLY once a day & kadian dosage admin ONLY q12hr or once a day; extended-release & controlled-release tablets should be swallowed whole; do not break, crush dissolve, or chew results in rapid release and absorption of potentially toxic dose; Side Effects-sedation, hypotension, diaphoresis (profuse perspiration), facial flushing, dizziness, nausea, vomiting, constipation; Teaching: Avoid alcohol or other CNS depressants; change positions slowly to avoid orthostatic hypotension; tolerance or dependence may occur with prolonged use of high doses; medication should be taken b4 pain fully returns, within ordered intervals

Actions: coenzyme for metabolic functions (therapeutic effect)- GI lesions, reverses symptoms of cyanide toxicity Use: tx of pernicious anemia, vit b12 deficiency due to malabsorption diseases, incr b12 requirement due to pregnancy, thyrotoxicosis (excessive intake of TH), hemorrhage, malignancy (cancerous), hepatic/renal disease, Usual Adult Dose (vit b12 deficiency): PO—amount depends on deficiency, MAXIMUM: 1000mcg/day; IM, SQ—30mcg/day for 5-10days, then 100-200mcg/month; intranasal—30mcg/day for 5-10 days, then 100-200mcg/month Usual Adult Dose (pernicious anemia): PO (hematologic remission only)—1000-2000mcg/day; IM, SQ—100mcg/day for 6-7 days; intranasal—100mcg/day for 6-7 days; Route: IM, PO, SQ, intranasal Nursing Considerations/Alerts: assess patient for signs of vit b12 deficiency (pallor; neuropathy; psychosis; red, inflamed tongue; anorexia, insomnia) before and periodically during therapy Teaching: report symptoms of infection; use nasal preparation at least 1hr before or 1hr after consuming hot foods, liquids

Action: promotes incorporation of water into stool, resulting in softer fecal mass; may promote electrolyte and water secretion into the colon (therapeutic effect)-softening and passage of stool Use: pts who need to avoid straining during defecation; constipation associated with hard, dry stools Usual Adult Dose: PO—50-400mg in 1-4 divided doses; Rectum—50-100mg or 1 unit containing 283mg docusate sodium, soft soap, and glycerin Route: PO, RECTUM Nursing Considerations/Alerts: DO NOT USE LONGER THAN A WEEK; Assess bowel distention, bs, bm, color, consistency, and amt produced; administer with full glass of water or juice; optional on empty stomach for more rapid results; oral solution can be diluted in milk or fruit juice to decr bitter taste; DO NOT ADMINISTER WITHIN 2HR OF OTHER LAXATIVES Teaching: advise patients laxatives are short-term therapy; long-term can cause dependency and electrolyte deficiency; fiber, fluid, exercise, advise pt not to use when abdominal pain, nausea, vomiting, or fever is present; cardiac diseased pt no straining during bowel movements (valsalva maneuver)

Action: inhibits Ca movement across cardiac, vascular smooth-muscle cell membranes (cause dilation of coronary arteries, peripheral arteries, arterioles) (therapeutic effect)-decr heart rate; myocardial contractility; systemic vasodilation resulting in decr bp; severity attacks of angina Use: tx of angina due to coronary artery spasm & temp control of rapid pulse rate Usual Adult Dosage: PO—30-120mg 3-4 times daily; IV—0.25mg/kg, may repeat in 15 min with a dose of 0.35mg/kg Route: PO, IV Nursing Considerations/Alerts: assess bp and apical pulse before administering; look for peripheral edema, any signs of dizziness, or asthenia (loss of strength, energy) Teaching: do not abruptly discontinue meds; be careful when it comes to orthostatic hypotension; contact MD immediately if palpitations, sob, nausea, constipation

Action: bind to bacterial cell membranes, inhibits cell wall synthesis (therapeutic effect)-bactericidal action against susceptible bacteria Use: tx of susceptible infections due to skin and skin structure infections (including burn wounds), pneumonia, UTI, bone and joint infections, septicemia (blood poisoning), Usual Adult Dosage: IM, IV—500mg-2g q6-8hr (MAXIMUM: 12g/day) Route: IM, IV Nursing Considerations/Alerts: assess vital signs, appearance of wound, sputum, urine and stool, WBC (5,000-10,000); monitor bs, diarrhea, oral and vaginal candidiasis (fungal infection), abdominal cramping, fever, and blood stool; IM dosage massage well; question history of reaction to penicillins; Teaching: take meds same time; NO DOUBLE DOSING; instruct pt to notify MD if diarrhea occurs, bloody stools, mucus, or pus.