Nclex meds part 2

bejevile's version from 2015-05-13 00:11


Question Answer
Antipsychotics Contraindications/precautions Contraindicated in clients with Parkinson’s disease; or those with liver, renal, or cardiac Insufficiency. Caution with elderly, debilitated, or diabetic clients, or clients with respiratory insufficiency, or intestinal obstruction
1st Generation Antipsychotics CNS Side Effects – NeurologicAcute movement disorders- Dystonia, akathesia, dyskinesia, akinesia, Delayed-onset movement disorders (Tardive dyskinesia, tardive dystonia), Abnormal Involuntary Movement Scale (AIMS) (Assesses presence of and degree of abnormal movements), Lowered seizure threshold, Neuroleptic malignant syndrome (NMS)-Potentially fatal, Poikilothermy (hypothermia or hyperthermia)
1st Generation Antipsychotics CNS Side Effects – CognitiveConfusion, Sedation, Delirium, Memory impairment, Apathy
1st Generation Antipsychotics Neuroendocrine effectsHyperprolactinemia, polyuria / polydipsia (SIADH)
1st Generation Antipsychotics Peripheral Side Effects – CardiovascularOrthostatic hypotension, Reflex tachycardia, Cardiac rhythm disturbances- Increased risk identified – BLACK BOX
1st Generation Antipsychotics Peripheral Side Effects – GI / Hepatic Dry mouth, Nausea / vomiting, Constipation, Paralytic ileus, Cholestatic jaundice
1st Generation Antipsychotics Peripheral Side Effects – MetabolicWeight gain, Hyperglycemia / diabetes, Hyperlipidemia
1st Generation Antipsychotics Peripheral Side Effects – RenalUrinary hesitancy, Urinary retention, Urinary tract infection
1st Generation Antipsychotics Peripheral Side Effects – SexualMenstrual irregularities, Gynecomastia, Galactorrhea, Amenorrhea, Impaired ovulation and spermatogenesis, Erectile dysfunction, Retrograde ejaculation, Anorgasmia
1st Generation Antipsychotics Peripheral Side Effects – HematologicLeukopenia, Agranulocytosis, Thrombocytopenic purpura, Hemolytic anemia, Pancytopenia
1st Generation Antipsychotics Peripheral Side Effects – OcularBlurred vision, Dry eyes, Narrow-angle glaucoma, Benign pigmentation, Lenticular opacities
1st Generation Antipsychotics Peripheral Side Effects – CutaneousAllergic rashes, Photosensitivity / skin burns- Educate patient to use sun screen lotion, Decreased sweating
Atypical Antipsychotic medication Major Side EffectsHigh Risk of agranulocytosis- CBC Monitoring Weekly is Mandatory Protocol, Report weekly to have blood levels drawn and to obtain a weekly supply of the drug, Weight gain, Severe constipation, Hypersalivation (most common with clozapine), Anticholinergic Effects


Question Answer
ImipramineTCA antidepressant
AmitriptylineTCA antidepressant
TCA nursingtake at night, orthostatic hypotension, avoid alcohol and sun
CitalopramSSRI antidepressant
EscitalopramSSRI antidepressant
FluoxetineSSRI antidepressant
FluvoxamineSSRI antidepressant
ParoxetineSSRI antidepressant
SertralineSSRI antidepressant
Bupropion (for depression)atypical antidepressant, Avoid use with seizure disorders – lowers seizure threshold, Use cautiously with renal/hepatic impairment, avoid alcohol
Trazodoneatypical antidepressant
Tricyclic Antidepressants (TCAs) Side EffectsAnticholinergic, Sedation, Orthostatic hypotension, Sexual dysfunction
Tricyclic Antidepressants (TCAs) Adverse ReactionsOverdose often fatal, All TCAs slow cardiac conduction, All TCAs lower seizure threshold
 TCA nursing considerationgiven at night, takes a few weeks, s/e decrease with time, don’t stop suddenly, no alcohol or sleeping pills, sunscreen
 Isocarboxazid (Marplan)Monoamine oxidase inhibitors (MAOIs)
 Phenelzine (Nardil)Monoamine oxidase inhibitors (MAOIs)
 Tranylcypromine (Parnate)Monoamine oxidase inhibitors (MAOIs)
 Monoamine oxidase inhibitors (MAOIs) Adverse ReactionsHigh tyramine intake can cause severe hypertensive crisis, Overdose can be very lethal, Many drug-drug interactions can cause fatal interactions
 Monoamine oxidase inhibitors (MAOIs) Side EffectsAnticholinergic, Orthostatic hypotension, Sexual dysfunction, May cause insomnia, no alcohol, d/c before general anesthesia, urinary retention, High tyramine intake can cause severe hypertensive crisis, Overdose can be very lethal, Many drug-drug interactions can cause fatal interactions
 Tyramine foodsaged cheese, bologna, pepperoni, salami, figs, banana, raisins, beer, chianti, pseudoephedrine meds
 Selective serotonin reuptake inhibitors (SSRIs) Side EffectsSexual dysfunction- Men – abnormal ejaculation or impotence, Women – delay or loss of orgasm, GI effects- Anorexia, diarrhea, indigestion, nausea, Insomnia – take dose early in the day, Headaches, Weight Loss, Serotonin syndrome
Lithiummood stabilizer, bipolar drug, relieve symptoms and prevent reoccurrences, can take with food, make sure taking in lots of fluid and adequate salt
Carbamazepinemood stabilizer, bipolar drug, relieve symptoms and prevent reoccurrences, take with food
Valproate (Depakote)Mood Stabilizers, May cause weight gain, Monitor liver functioning, used as anticonvulsant, no carbonated beverages, take with food
Lamotrigine (Lamictal)Mood Stabilizers, anticonvulsant, take with meals
Carbamazepine (Tegretol)Mood Stabilizers, Monitor for blood dyscrasias, anticonvulsant use, take with meals, photosensitivity, lots of drug interactions, watch for respiratory depression
Oxcarbazepine (Trileptal)Mood Stabilizers
Topirimate (Topamax)Mood Stabilizers, anticonvulsant


Question Answer
Lithium at 1.5 to 2.0blurred vision, ataxia, tinnitus, persistent nausea/vomiting, diarrhea
Lithium at 2.0-3.5excessive output of dilute urine, increasing tremors, muscular irritability, psychomotor retardation, mental confusion, giddiness
Lithium at 3.5 and aboveimpaired consciousness, nystagmus, seizures, coma, oliguria/anuria, arrhythmias, MI, cardiovascular collapse.


Question Answer
Thiopentalbarbiturate, ultrashort acting, pre-op
Phenobarbital barbiturate, anticonvulsant, for IV keep resuscitation equipment available, nystagmus=early toxicity
Destroamphetamine sulfateADHD drug
AmphetamineADHD drug
DextroamphetamineADHD drug
MethamphetamineADHD drug
LisdexamfetamineADHD drug
MethylphenidateADHD drug
AtomoxetineADHD drug
Radioactive iodineantithyroid
Levothyroxinethyroid replacement
Liothyronine sodium (cytomel)thyroid replacement


Question Answer
Cortisone acetatesteroid, adrenal replacement therapy for adrenal insufficiency (Addison’s)
Hydrocortisonesteroid, adrenal replacement therapy for adrenal insufficiency (Addison’s)
Dexamethasonesteroid, adrenal replacement therapy for adrenal insufficiency (Addison’s)
Methylprednisolonesteroid, adrenal replacement therapy for adrenal insufficiency (Addison’s)
Prednisonesteroid, adrenal replacement therapy for adrenal insufficiency (Addison’s)
Beclomethasonesteroid, adrenal replacement therapy for adrenal insufficiency (Addison’s)
Betamethasonesteroid, adrenal replacement therapy for adrenal insufficiency (Addison’s)
Budesonidesteroid, adrenal replacement therapy for adrenal insufficiency (Addison’s)
Steroid nursingod leads to cushing syndrome, abrupt withdrawl can cause addisons crisis, single dose before 9am, doses should be evenly spaced, less infection symptoms (with higher infection risk) nightmares are first sign of psychosis, don’t use with TB hx, decreases effects of oral hypoglycemic, insulin, diuretics an k supplements, take with an antacid
TimololGlaucoma drug
LevobunololGlaucoma drug
AcetazolamideGlaucoma drug
Glaucoma med s/eblurred cision, lacrimation, pulmonary edema
Promethazine Antihistamine, antiemetic, phenergan
CetrizineAntihistamine, H1 Antagonist, 2nd generation, Zyrtec
FexofenadineAntihistamine, H1 Antagonist, 2nd generation, Allegra
LoratadineAntihistamine, H1 Antagonist, 2nd generation, Claritin
Atropineanticholinergic, used for bradycardia (s/e=tachy), no glaucoma, asthma or HTN, avoid heat, if PO 30min before food
Neostigmineanticholinesterase, used orally for Myasthenia gravis
Pyridostigmineanticholinesterase, used orally for Myasthenia gravis


Question Answer
Epinephrineadrenergic agonist, catecholamine
Norepinephrine: adrenergic agonist, catecholamine
Isoproterenoladrenergic agonist, catecholamine
Dopamineadrenergic agonist, catecholamine
Dobutamineadrenergic agonist, catecholamine
Terburalinadrenergic agonist, non-catecholamine


See pg 83
Question Answer
Ephedrineadrenergic agonist, non-catecholamine
Prazosinadrenergic antagonist, selective alpha1
Doxazosin adrenergic antagonist, selective alpha1
Terazosin adrenergic antagonist, selective alpha1
Phentolamine adrenergic antagonist, non-selective
Phenoxybenzamine adrenergic antagonist, non-selective
Guanabenzindirect antiadrenergic, alpha 2- agonists
Guanfacineindirect antiadrenergic, alpha 2- agonists
Tacarineanticholinesterase, AD drug
Donepezilanticholinesterase, AD drug
Rivastigmineanticholinesterase, AD drug
Galantamineanticholinesterase, AD drug
MemantineNMDA antagonist, AD drug


Question Answer
Aluminum hydroxide antacid
Milk of Magnesia antacid
Malox antacid
Propantheline bromideanticholinergic for urinary in continence and peptic ulcers, empty stomach
No anticholinergics withglaucoma
Fosphenytoin (cerebyx)anticonvulsant
Dilantin (phenytoin sodium)anticonvulsant, give with water or food to decrease irritation, can discolor sweat or urine, IV administration can cause cardiac arrest, no mixing with any drug or dextrose, vit D supplement
Primidoneanticonvulsant, can take with food
Magnesium sulfateanticonvulsant, watch for knee jerks, used in eclampsia
Zarontinanticonvulsant, monitor weight and behavior changes
Neurontin (gabapentin)anticonvulsant, monitor weight and behavior changes
Anticonvulsant side effectsrespiratory depression, anemia
Anticonvulsant nursingtolerance, don’t d/c abruptly, caution with MAOI
Amphotericin Bantifungal
Diflucan (fluconazole) antifungal
Flagyl (metronidazole)antifungal
Antifungal s/ehepatotoxicity, thrombocytopenia, leukopenia
Antifungal nursingtake with food
Antihistamines can causebronchospasm, take with food


Question Answer
Busulfanantineoplastic, give lots of fluids
Chlorambucilantineoplastic, avoid IM with low platelets
Cyclophosphamide: antineoplastic, alopecia, hypoglycemia, push fluids
Fluorouracil (5-FU): antineoplastic
Mercaptopurineantineoplastic, liver damage s/e
Doxorubicin (Adriamycin)antineoplastic, red urine, cardiotoxicity
Vincristineantineoplastic, diminished reflexes
Tamoxifenantineoplastic, hypercalcemia, bone pain


Question Answer
Antineoplastic agents require frequentCBCs
Antineoplastic generally causen/v, bone marrow suppression, decreased immune response, stomatitis and fatigue
Antineoplastic complications- bone marrow suppressionmonitor bleeding, avoid IM injections and rectal temps, strong pressure to venipuncture sites
TB med side effectsliver damage and orange pee
Dextromethorphancough suppressant, avoid alcohol, some resp depression
Acyclovirused for herpes simplex and zoster
Ribavirinantiviral, can decrease pulmonary status cause cardiac arrest and bacterial pneumonia, given in aerosol device, can’t be used in pregnancy
Zidovudineantiviral, causes anermia dizziness and insomnia, used for HIV
AlendronateFosamax, bone-reabsorption inhibitor
Risedronatebone-reabsorption inhibitor
IbandronateBoniva, bone-reabsorption inhibitor
bone-reabsorption inhibitor nursingtake in the morning with full glass of water before eating and sit upright for 30 min after
many asthma meds causehyperglycemia
Sucralfate (Carafate)drug for a duodenal ulcer, take 1 hour before bed , no antacids or H2 blockers


Question Answer
Electrolyte replacements Cacan cause dysrhythmias and constipation, watch EKG
Electrolyte replacements magcauses weak DTR, hypotension, resp should be >16 to give, test reflexes before doses
Electrolyte replacements Kcan cause dysrhythmias and resp issues, watch EKG and electrolytes, take with or after meals with full glass of water
Flomax (tamsulosin)give 30 min after the same meal everyday
Proscar (finasteride)BPH med, take for 6-12 months, pregnant women cnnot be exposed to semen from partner (harms fetus)
AvodartBPH med, take for 6-12 months, pregnant women cnnot be exposed to semen from partner (harms fetus)
Drugs that interact with grapefruit juiceCCB- amlodipine, diltiazem, felodipine, nicardipine, nifedipine, nimodipine, verapamil