Triglycerides elevation can falsely elevate glycosalated hemoglobin test.

Adrenergics Actions: Stimulate the sympathetic nervous system: increase in peripheral resistance, increase blood flow to heart, bronchodilation, increase blood flow to skeletal muscle, increase blood flow to uterus Stimulate beta-2 receptors in lungs Use for cardiac arrest and COPD Adrenergic Medications Levophed Dopamine Adrenalin Dobutrex Adrenergics Side effects: Dysrhythmias Tremors Anticholinergic effects Adrenergics Nursing Considerations: Monitor BP Monitor peripheral pulses Check output Anti-Anxiety Action: Affect neurotransmitters Used for: Anxiety disorders, manic episodes, panic attacks Anti-Anxiety Medications: Librium, Xanax, Ativan, Vistaril, Equanil Anti-Anxiety Side effects: Sedation Confusion Hepatic dysfunction Anti-Anxiety Nursing Considerations:

 Potention for addiction/overdose Avoid alcohol Monitor Liver Function AST/ALT Dont discontinue abruptly, wean off Smoking/caffeine decreases effectiveness

Antacids Actions: Neutralize gastric acids Used for: Peptic ulcer Indigestion, reflex esophagitis Antacids Medications Amphojel Milk of Magnesia Maalox Antacids Side effects: Constipation Diarrhea Acid rebound Antacids Nursing Considerations: Interferes with absorption of antibiotics, iron preps, INH, Oral contraceptives Monitor bowel function Give 1-2 hours after other medications 1-3 hours after meals and at HS Take with fluids Antiarrhythmics Action: Interfere with electrical excitability of heart Used for: Atrial fibrillation and flutter

 Tachycardia PVCs Antiarrhythmics Medications: Atropine sulfate Lidocaine Pronestyl Quinidine Isuprel Antiarrhythmics Side effects: Lightheadedness Hypotension Urinary retention Antiarrhythmics Nursing Considerations: Monitor vital signs Monitor cardiac rhythm Aminoglycosides (Antibiotics) Action: Inhibits protein synthesis in gram-negative bacteria Used for: Pseudomonas, E.Coli Aminoglycosides (Antibiotics) Medications: Gentamycin Neomycin Streptomycin Tobramycin Aminoglycosides (Antibiotics) Side effects: Ototoxicity and Nephrotoxicity Anorexia Nausea Vomiting Diarrhea Aminoglycosides (Antibiotics) Nursing Considerations:

 Harmful to liver and kidneys Check 8th cranial nerve (hearing) Check renal function Take for 7-10 days Encourage fluids Check peak/trough level Allergy: 1st symptom SOB

Cephalosporins (Antibiotics) Action: Inhibits synthesis of bacterial cell wall Used for: Tonsillitis, otitis media, peri-operative prophylaxis Meningitis Cephalosporins (Antibiotics) Medications: Ceclor Ancef Keflex Rocephin Cefoxitin Cephalosporins (Antibiotics) Side effects: Bone marrow depression: caution with anemic, thrombocytopenic patients Superinfections

 Rash Nursing Considerations: Take with food Cross allergy with PCN Avoid alcohol Obtain C&S before first dose: to make sure medication is effective against disease/bacteria Can cause false-positive for proteinuria/glycosuria Fluoroquinolones (Antibiotics) Action: Interferes with DNA replication in gram-negative bacteria Used for: E.Coli, Pseudomonas, S. Aureus Fluoroquinolones (Antibiotics) Medications: Cipro Fluroquinolones (Antibiotics) Side effects: Diarrhea Decreased WBC and Hematocrit Elevated liver enzymes (AST, ALT) Elevated alkaline phosphatase Nursing Considerations: C&S before starting therapy Encourage fluids Take 1 hour ac or 2 hour pc (food slows absorption) Dont give with antacids or iron preparation Maybe given with other medications (Probenicid: for gout) Macrolide (Antibiotics) Action: Binds to cell membrane and changes protein function Used for: Acute infections

 Acne URI Prophylaxis before dental procedures if allergic to PCN Macrolide (Antibiotics) Medications: Erythromycin Clindamycin Macrolide (Antibiotics) Side effects: Diarrhea Confusion Hepatotoxicity Superinfections Nursing Considerations: Take 1hr ac or 2-3 hr pc Monitor liver function Take with water (no fruit juice) May increase effectiveness of: Coumadin and Theophylline (bronchodilator) Penicillin Action: Inhibits synthesis of cell wall Used for: Moderate to severe infections Syphilis Gonococcal infections Lyme disease Penicillin Medications: Amoxicillin Ampicillin Augmentin Penicillin Side effects: Stomatitis Diarrhea Allergic reactions

 Renal and Hepatic changes Nursing Considerations: Check for hypersensitivity Give 1-2 hr ac or 2-3 hr pc Cross allergy with cephalosporins Sulfonamides (Antibiotics) Action: Antagonize essential component of folic acid synthesis Used for: Ulcerative colitis Crohns disease Otitis media UTIs Sulfonamides (Antibiotics) Medications: Gantrisin Bactrim Septra Azulfidine Sulfonamides (Antibiotics) Side effects: Peripheral Neuropathy Crystalluria Photosensitivity GI upset Stomatitis Nursing Considerations: Take with meals or foods Encourage fluids Good mouth care Antacids will interfere with absorption Tetracyclines (Antibiotics) Action: Inhibits protein sythesis

Used for: Infections Acne Prophylaxis for opthalmia neonatorum TEtracyclines (Antibiotics) Medications: Vibramycin Panmycin Tetracyclines (Antibiotics) Side effects: Discoloration of primary teeth if taken during pregnancy or if child takes at young age Glossitis Rash Phototoxic reactions Nursing considerations: Take 1 hr ac or 2-3 hr pc Do not take with antacids, milk, iron Note expiration date Monitor renal function Avoid sunlight UTIs Medication: o Furadantin Action: o Anti-infective Side effects: o Asthma attacks o Diarrhea Nursing Considerations: o Give with food or milk o Monitor pulmonary status UTIs Medication

o Mandelamine Action: o Anti-infective Side effects: o Elevated liver enzymes Nursing Considerations: o Give with cranberry juice to acidify urine o Limit alkaline foods: vegetables, milk, almonds, coconut

UTIs Medication o Pyridium Side effects: o Headache o Vertigo Action o Urinary tract analgesic Nursing Consideration o Tell patient urine will be orange Anticholinergics Action: Inhibits action of acethylcholine and blocks parasympathetic nerves (affects heart, eyes, respiratory tract, GI tract and the bladder) Dilates pupil, causes bronchodilation and decreased secretions Decrease GI motility secretions Used for: Opthalmic exam Motion sickness Pre-operative Anticholinergic Medications:

 Pro-Banthine Atropine Scopolamine Anticholinergic Side Effects: Blurred vision Dry mouth Urinary retention Chage in heart rate Nursing Consideration: Monitor output Contraindicated with glaucoma Give 30 min ac, hs, or 2hr pc Contraindicated: paralytic ileus, BPH Anticoagulants Action: Blocks conversion of prothrombin to thrombin Used for: Pulmonary embolism Venous thrombosis Prophylaxis after acute MI Anticoagulants Medications: Heparin Anticoagulants (Heparin) Side Effects: Hematuria Tissue irritation Nursing Considerations: Monitor clotting time or Partial Thromboplastin Time (PTT) Normal 20-45 sec Therapeutic level 1.5-2.5 times control AntagonistProtamine Sulfate Give SC or IV Anticoagulant Action:

 Interferes with synthesis of vitamin K-dependent clotting factors Used for: Pulmonary embolism Venous thrombosis Prophylaxis after acute MI Anticoagulant Medication: Coumadin Anticoagulant (Coumadin) Side Effects: Hemorrhage, Alopecia Nursing Considerations: Monitor Prothrombin Test (PT) Normal 9-12 sec Therapeutic level 1.5 times control AntagonistVitamin K (AquaMEPHYTON) Monitor for bleeding Give PO

Anticonvulsants Action: Decreases flow of calcium and sodium across neuronal membranes Used for: Seizures Anticonvulsant Medications: Dilantin Luminal Depakote Tegretol Klonopin Anticonvulsant Side effects: Respiratory depression

 Aplastic anemia Gingival hypertrophy Ataxia Nursing Considerations: Dont discontinue abruptly Monitor I&O Caution with use of medications that lower seizure threshold: MAO inhibitors & anti-psychotics Good mouth care Take with food May turn urine pinkish-red/pinkish-brown Anti-Depressants Monoamine Oxidase Inhibitors (MAO) Action: Causes increases concentration of neurotransmitters Used for: Depression Chronic pain Anti-Depressants (Monoamine Oxidase Inhibitors) Medications: Marplan Nardil Parnate Anti-Depressants (Monoamine Oxidase Inhibitors) Side effects: Hypertensive Crisis (Sudden headache, diaphoretic, palpitations, stiff neck, intracranial hemorrhage) with food that contain Tyramine Nursing Considerations: Avoid foods containing Tyramine: Aged cheese, liver, yogurt, herring, beer and wine, sour cream, bologna, pepperoni, salami, bananas, raisins, and pickled products Monitor output Takes 4 weeks to work Dont combine with sympathomometics vasoconstrictors, and

cold medications Anti-Depressants Selective Serontonin Reuptake Inhibitors (SSRI) Action: Inhibits CNS uptake of serotonin Used for: Depression Obsessive-Compulsive Disorder Bulimia Anti-Depressants Selective Serontonin Reuptake Inhibitors (SSRI) Medications: Paxil Prozac Zoloft Anti-Depressants Selective Serontonin Reuptake Inhibitors (SSRI) Side effects: Anxiety GI upset Change in appetite and bowel function Urinary retention Nursing Considerations: Suicide precautions Takes 4 weeks for full effect Take in a.m. May urine to pinkish-red or Pinkish-brown Can be taken with meals Anti-Depressants (Tricyclics) Action: Inhibits reuptake of neurotransmitters Used for: Depression Sleep apnea Anti-Depressants (Tricyclics) Medications: Norpramin

 Elavil Tofranil Anti-Depressants (Tricyclics) Side Effects: Sedation/Confusion Anticholinergics affects Postural Hypotension Urinary retention Nursing Considerations: Suicide precautions/2-6 weeks to work Take at hs/Dont abruptly halt Avoid alcohol/OTC /Photosensitivity Insulin (Regular, Humulin R) Type: Fast acting Onset: -1 hr Peak: 2-4 hr Duration: 6-8 hr Insulin (NPH, Humulin N) Type: Intermediate acting Onset: 2hr Peak: 6-12hr Duration 18-26hr Insulin (Ultralente, Humulin U) Type: Slow acting Onset: 4hr Peak: 8-20hr Duration: 24-36hr Insulin (Humulin 70/30) Type: Combination Onset: hr Peak: 2-12hr Duration: 24hr Antidiabetic Agents

Action: Stimulates insulin release from beta cells in pancreas Used for: Type 2 diabetes (NIDDM) Antidiabetic Agents Medications: Diabinese Orinase Dymelor Micronase Antidiabetic Agents Side Effects: Hypoglycemia Allergic skin reactions GI upset Nursing Considerations: Take before breakfast Monitor glucose levels Avoid alcohol, sulfonamides, Oral Contraceptives, (MAO), aspirin because they help to make drug work better Hypoglycemic Agent Action: Stimulates liver to change glycogen to glucose Used for: Hypoglycemia Hypoglycemic Agent Medication: Glucagon Hypoglycemic Agent Side Effects: Hypotension Bronchospasm Nursing Considerations: May repeat in 15min Give carbohydrates orally to prevent secondary hypoglycemic reactions Antidiarrheals

Action: Slows peristalsis Increases tone of sphincters Used for: Diarrhea Antidiarrheals Medications: Kaopectate Lomotil Imodium Paregoric Antidiarrheals Side Effects: Constipation Anticholinergic effects (urinary retention, dry mouth) Nursing Considerations: Do not use with abdominal pain Monitor for urinary retention Give 2hr before or 3 hr after other meds