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Calcium carbonate
Trade NameTums/Rolaids
IndicationTreatment of hypocalcemia, prevention of postmenopausal osteoporosis, treat- ment of hyperkalemia and hypermagnesemia, used as antacid
ActionCalcium is essential for nervous, muscular, and skeletal systems, helps maintain cell membranes, aids in transmission of nerve impulses and muscle contraction, aids in blood formation and coagulation
Therapeutic ClassMineral and electrolyte replacements/supplements
Pharmacologic ClassAntacids
Nursing Considerations• May cause cardiac arrest and arrhythmias • Monitor hemodynamics • May causes hypotension, bradycardia, and arrhythmias • Hypercalcemia can increase risk for digoxin toxicity • Instruct pt on foods that contain Vitamin D and encourage adequate intake • Monitor parathyroid hormone
Captopril
Trade NameCapoten
IndicationHypertension, management of CHF, decrease progression of DM neuropathy
ActionBlock conversion of angiotensin I to angiotensin II, increases renin levels and decreases aldosterone leading to vasodilation
Therapeutic ClassAntihypertensives
Pharmacologic ClassACE Inhibitor
Nursing Considerations• Can cause neutropenia – check WBCs regularly • Use cautiously with potassium supplements and potassium sparing diuretics • Use cautiously with diuretic therapy • Administer 1 hour before meals • Monitor blood pressure often • Monitor weight and fluid status • Monitor renal profile • Monitor CBC frequently • May lead to Rhabdomyolysis • Dry cough
Stadol
Indicationmoderate to severe pain, labor pain, sedation
Actionalters perception and response to pain by binding to opiate receptors in CNS
Therapeutic ClassOpioid Analgesic
Pharmacologic Classopioid agonists/antagonists
Nursing Considerations• use caution with concurrent use of MAOIs • may cause confusion, hallucinations, sedation • monitor for CNS depression • assess blood pressure pulse and respirations during administration • administer slowly through an IV line
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Buspirone
Trade NameBuspar
IndicationManagement of anxiety
ActionRelieves anxiety by binding to dopamine and serotonin receptors
Therapeutic ClassAntianxiety
Pharmacologic ClassAzapirone
Nursing Considerations• Do not administer concurrently with MAOI or grapefruit juice • May lead to dizziness, drowsiness, fatigue, and weakness • Patient may experience chest pain, palpitations, tachycardia • Instruct patient to take as directed • Instruct patient to avoid alcohol and other CNS depressantss
Bupropion
Trade NameWellbutrin
IndicationDepression, smoking cessation, treat ADHD in adults
ActionNot well understood, ↑ dopaminergic and noradrenergic transmission via reuptake
Therapeutic ClassAntidepressants, smoking deterrents
Pharmacologic ClassAminoketones
Nursing Considerations• May lead to seizures, suicidal thoughts • Do not administer if patient is taking MAOI • Use caution with renal and liver impairment • Assess mental status • Instruct patient to avoid alcohol (may lead to hallucinations, seizures, anxiety)
Bismuth subsalicylate
Trade NameKaopectate, Pepto-Bismol
IndicationDiarrhea, heartburn, indigestion, H. pylori associated ulcer
ActionStimulates the absorption of fluids and electrolytes in the intestinal wall, reduction in hypermotility of the stomach, and binds to toxins.
Therapeutic ClassAntidiarrheal, antiulcer, antacid
Pharmacologic ClassAbsorbent
Nursing Considerations• Contraindicated in aspirin hypersensitivity • Increase risk for impaction with geriatric and pediatric patients • Monitor liver profile • Bismuth may interfere with radiologic exams
Bisacodyl
Trade NameDulcolax
IndicationTreatment of constipation, bowel regimen
ActionStimulates enteric nerves to cause peristalsis which leads to fluid accumulation in the colon
Therapeutic ClassLaxatives
Pharmacologic ClassStimulant laxatives
Nursing Considerations• May lead to hypokalemia • May cause abdominal pain and cramps • Not for use within 1 hour of taking milk product • Assess for abdominal distention and bowel function • Instruct patient to drink 1500-2000 mL/day during therapy • Monitor fluid and electrolyte levels • Instruct patient to take as ordered
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