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Dilantin
Indicationtonic clonic seizures, arrhythmias, neuropathic pain
Actioninterferes with ion transport, shortens action potentials and decreases automaticity blocks sustained high frequency repetitive firing of action potentials.
Therapeutic Classantiarrhythmics, anticonvulsants
Pharmacologic Classhydantoins
Nursing Considerations• monitor serum phenytoin levels • therapeutic levels 10-20 mcg/mL • use cautiously in all patients • can cause suicidal thoughts, ataxia, extrapyramidal symptoms, hypotension, tachycardia, arrhythmias, gingival hyperplasia, nausea, rash, drug induced hepatitis, agranulocytosis, Steven's Johnson syndrome • concurrent administration of enteral feedings may decrease absorption • monitor for hypersensitivity • assess seizures • assess hemodynamics
Pyridium
Indicationurological pain
Actionprovides analgesia to the urinary tract mucosa
Therapeutic Classnonopioid analgesics
Pharmacologic Classurinary tract analgesics
Nursing Considerations• will turn urine red or orange • may cause headache, vertigo, hepatic toxicity • monitor renal function
Paxil
Indicationmajor depressive disorder, OCD, anxiety, PTSD
Actionblock reuptake of serotonin in CNS
Therapeutic Classantianxiety agent, antidepressant
Pharmacologic ClassSSRI
Nursing Considerations• do not use with MAOIs • can cause neurolyptic malignant syndrome, suicidal thoughts, serotonin syndrome, constipation, diarrhea, insomnia • decrease effectiveness of digoxin • increase bleeding with warfarin • assess for suicidal thoughts
GERD, heartburn, reduce the risk of GI bleed in critically ill patients
Actionprevents the transport of H ions into the gastric lumen by binding to gastric parietal cells, ↓ gastric acid production
Therapeutic Classantiulcer agents
Pharmacologic Classproton-pump inhibitors
Nursing Considerations• can cause hyperglycemia, abdominal pain • decreases absorption of certain drugs • may increase bleeding with warfarin • assess for occult blood • assess liver enzymes • assess symptoms of heart burn • administer slowly via IV push
Creon
Indicationpancreatic insufficiency, ductal obstruction
Actionreplacement of pancreatic enzymes: lipase, amylase, protease
Therapeutic Classdigestive agent
Pharmacologic Classpancreatic enzyme
Nursing Considerations• contraindicated with pig products allergy • can cause shortness of breath, nausea, diarrhea, rash • assess nutritional status • monitor for steatorrhea • may increase uric acid levels • instruct patient to follow diet • take with meals and snacks
Pitocin
Indicationlabor induction, postpartum bleeding
Actionstimulates uterine smooth muscle
Therapeutic Classhormones
Pharmacologic Classoxytocics
Nursing Considerations• can cause ICH in fetus • can cause asphyxia in fetus • may cause coma and seizures in mother • may cause painful contractions • assess fetus • assess contractions • monitor blood pressure • assess maternal electrolytes • may cause uterine tetany
Oxycontin
Indicationpain
Actionbinds to opiate receptors in CNS altering the perception and sensation of pain
Therapeutic ClassOpioid Analgesic
Pharmacologic Classopioid agonists, opioid agonists/nonopioid, analgesic combinations
Nursing Considerations• may cause respiratory depression, constipation, confusion , sedation, hallucinations, urinary retention • use caution with increased intracranial pressure • don't use with MAOIs • assess hemodynamics • assess pain • may elevate pancreatic enzymes • can cause physical dependence • assess bowel function
Zofran
Indicationnausea/vomiting
Actionblocks effects of serotonin on vagal nerve and CNS
Therapeutic Classantiemetic
Pharmacologic Class5-HT3 antagonist
Nursing Considerations• administer slowly over 2-5 minutes – fatal QT prolongation and VTach, respiratory arrest • may cause headache, constipation, diarrhea, dry mouth • asses nausea and vomiting • assess for extrapyramidal symptoms • monitor liver function tests
omeprazole
Trade NamePrilosec
IndicationGERD, ulcers, Zollinger-Ellison syndrome, reduce the risk of GI bleed in critically ill patients, heart burn
Actionprevents the transport of H ions into the gastric lumen by binding to gastric parietal cells, ↓ gastric acid production
Therapeutic Classantiulcer agent
Pharmacologic Classproton-pump inhibitor
Nursing Considerations• take 30-60 minutes prior to eating • capsules should be swallowed whole • instruct patient to report black tarry stool
olanzapine
Trade NameZyprexa
Indicationschizophrenia, mania, depression, anorexia nervosa, nausea/vomiting related to chemotherapy
Actionantagonizes dopamine and serotonin
Therapeutic Classantipsychotic, mood stabilizers
Pharmacologic Classthienobenzodiazepines
Nursing Considerations• do not use while breastfeeding • can cause neurolyptic malignant syndrome, seizures, suicidal thoughts, insomnia, tardive dyskinesia, agranulocytosis, constipation, tremors • assess mental status • monitor hemodynamics • assess blood sugars • assess intake and output • monitor liver function tests
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