Respiratory Drug Cards – BAM & SLM

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IV PUSH Drug Card

Drug Classifications

Table of Contents
1 ACE INHIBITORS………………………………………………………………………………………………………………………………. 3
2 ANGIOTENSIN RECEPTOR ANTAGONISTS (ARB)………………………………………………………………………………. 3
3 ANTICOAGULANTS…………………………………………………………………………………………………………………………… 4
4 ANTI-PLATELET ……………………………………………………………………………………………………………………………….. 4
5 ANTI-DEPRESSANTS………………………………………………………………………………………………………………………… 5
6 ANTI-NAUSEA ANTI-VERTIGO …………………………………………………………………………………………………………… 5
7 BETA-BLOCKERS……………………………………………………………………………………………………………………………… 6
8 CALCIUM CHANNEL BLOCKERS……………………………………………………………………………………………………….. 6
9 CEPHALOSPORINS…………………………………………………………………………………………………………………………… 7
10 CORTICOSTERIODS…………………………………………………………………………………………………………………………. 7
11 DIURETICS-THIAZIDES……………………………………………………………………………………………………………………… 8
12 NARCOTIC-ANALGESIC ……………………………………………………………………………………………………………………. 8
13 NEUROPATHIC PAIN MEDICATIONS………………………………………………………………………………………………….. 9
14 NON-STERIODAL ANTI- INFLAMMATORY AGENTS…………………………………………………………………………….. 9
15 QUINOLONES…………………………………………………………………………………………………………………………………. 10
16 SEDATIVES…………………………………………………………………………………………………………………………………….. 11
17 STATIN ANTIHYPERLIPIDEMIC AGENTS………………………………………………………………………………………….. 11
18 Food and Drug Interaction Reference………………………………………………………………………………………………….. 12

Most Common Used Drugs

Official drug guide with Top 40 Drugs.

Antibiotics Review Part 4: What are Macrolides?

When reviewing various drugs, the commonly taught principle is that when a drug ends in certain suffixes like “–lol,” that’s automatically a beta-blocker, whereas medications that end in “–pine” are calcium channel blockers.

However, since we do not live in a perfect world, there are always exceptions to the rule like atropine which ends in “–pine” but is not a calcium channel blocker and is actually an anticholinergic. Atropine spikes the heart rate which is the exact opposite of what a calcium channel blocker does.

That brings us to macrolides.

Macrolides Suffix

Macrolides are antibiotics primarily given to patients who have pneumococcal and streptococcal infections, especially on occasions wherein penicillin is prohibited. Zithromax or Azithromycin, and erythromycin, and clarithromycin are macrolides. Anything that ends in “–romycin” are considered as macrolides.

As established, there are exceptions to the rule of pharmacology suffixes, and one of these exceptions is identifying macrolides. See, the majority of antibiotic medications end in “-mycin.” Therefore, it would be confusing at some point to nurses to pinpoint which is a macrolide and which is another form of antibiotics.

Don’t get confused with neomycin, clindamycin, and even gentamycin because all these are different. Remember, macrolides usually end in “-romycin.”

Macrolides Patient Teaching

There are two important information that you need to impart to patients who are taking macrolides, namely:

  • Do not take medication with food
  • Do not expose patient under the sun

Food causes ineffective absorption of macrolides.

Another important detail to remember with macrolides is that it is contraindicated to patients who are allergic to it.

Macrolides and Coumadin

One of the nitpicky stuff about macrolides is that it will affect Coumadin’s effect on coagulation. Therefore, if a patient is taking Coumadin and is also prescribed with macrolides, checking the INR is essential to check if the patient is not coagulating at an increased rate.

Macrolides Side Effect

Some of the primary concerns when taking macrolides are:

  1. Gastrointestinal irritation or disturbances, especially with erythromycin.
  2. ECG results will show prolongation in the QT interval, also with erythromycin.
  3. Inhibits liver metabolism, which leads to interactions with various medications.

Other adverse effects of macrolides are nausea, abdominal cramps, vomiting, and diarrhea, all of which are related to gastrointestinal irritation. However, these are uncommon with macrolides like azithromycin and clarithromycin.

Macrolides Summary

So, we’ve discussed three important things that you have to remember when dealing with macrolides, and they are:

  1. Macrolides end in “-romycin.”
  2. Macrolides should not be taken with food.
  3. Patients who are taking macrolides should not be exposed under the sun.

That’s it for our macrolides. We still have a lot of antibiotics that we have discussed in our channel. We are also providing our members access to various nursing resources that can significantly help in their study habits, gaining an advantage in major exams, and even in the NCLEX®.

For other nursing-related topics, you can drop by our Simple Nursing website or check out our YouTube channel to get free content. See you guys at our next discussion!

Antibiotics Review Part 3: What is Tetracycline?

For individuals who are prone to acne eruptions, tetracycline is quite a familiar ingredient in their daily skin care routine. Tetracycline is a type of antibiotic medication that is used to treat some bacterial infections, which includes acne.

Tetracycline primarily works to cease the growth and the worsening of bacteria; this type of antibiotic can only ward off bacterial infections and is not applicable for infections caused by viruses.

Remembering Tetracycline

Antibiotic medications have numerous classes; therefore, remembering each antibiotic can be taxing. But there are ingenious ways on recalling each antibiotic type, or any subject or topic for that matter, then, by all means, stick to those ways. There are no rules regarding studying.

With tetracycline, you only have to associate the medication to cycling or someone riding a bicycle. That said, here are the hints that will help you get through with your tetracycline review.

  1. Tetracycline causes photosensitivity.

Going back to cycling, when a biker is out in the sun, it is expected that the person will get sunburned; same with tetracycline. Patients who take tetracycline will experience a breakdown in bacteria which then directly affects the skin’s epithelium. That said, patients should limit their exposure to the sun while taking tetracycline.

  1. Tetracycline causes teeth stains.

Tooth discoloration with yellowish stains is another side effect that manifests with tetracycline administration. To relate this to the cyclist analogy, when a person goes on a motorcycle or a bicycle, bugs tend to hit the windshield, or their helmets, or even the teeth, causing stains.

  1. Tetracycline without food.

Cycling is a rigorous sport that should not be done in a full stomach. Therefore, eating before working out is not allowed to avoid throwing up. This is the same with tetracycline – it should not be taken with food and milk. The best time to take tetracycline is before meals, preferably an hour or two before eating.

Other Side Effects

Side effects are essential with patient teaching. While the above-mentioned side effects are common with tetracycline medications, other mild side effects can occur while taking the drug, namely:

  • Nausea, diarrhea, and vomiting,
  • Dizziness and headache
  • Sore throat
  • Discomfort around the rectal area

On the other hand, the serious side effects that require immediate medical attention are the following:

  • Muscle pain
  • Painful and difficulty swallowing
  • Discoloration of the nails
  • Decreased urine output (a common sign of kidney affectation)
  • Tingling or numbness of the extremities
  • Allergic reaction

Summary

So, tetracycline is an antibiotic drug primarily given to patients with bacterial infections, which includes acne eruptions not only on the face but on various places of the body. Patients who are taking the drug should not be exposed to sunlight, will have tooth stains, and should take the pill at least an hour before meals.

For our next antibiotic lesson, we’ll tackle fluoroquinolones which includes medications like Ciprofloxacin. We have another fun way of remembering Ciprofloxacin through Cipro de Mayo. To know more about fluoroquinolones and Cipro de Mayo, check out our Simple Nursing website and YouTube channel.

Pharm: Calcium Channel Blockers for Heart Failure & MI

Heart failure is a condition that is identified as the heart’s inefficiency to pump blood supply to various areas of the body adequately. If there is an insufficient flow of blood, all primary functions of the body are disrupted. While there are instances wherein pumping difficulties cause the heart failure, other patients suffer due to stiffening and hardening of the muscles of the heart, resulting to reduction of blood flow.

This is where calcium channel blockers come in.

Calming the Heart

Here, we are informing the sympathomimetic response of the sympathetic nervous system to calm down by instructing the heart not to contract. This is done by taking the pressure off and blocking out the stimulus.

So, there are three types of medications that you can give to achieve this, namely:

  • Alpha-blockers (Catapres or Clonidine) – has vasodilation effects
  • Beta-blockers
  • Calcium channel blockers

Calcium Channel Blockers

As mentioned, one of the main problems with heart failure is increased volume and resistance inside the blood vessels; therefore, it is necessary that this resistance is relieved through calcium channel blockers. We are basically asking the blood vessels to relax and not be tensed.

Though Nitroglycerin is given to patients with myocardial infarction, the main goal is still taking off the electrical excitability from the blood vessels so as not to strain the heart muscles.

Cellular Level

The blood vessels are like rivers that are interlinked with each other. Looking at it at a cellular level, and taking into consideration a cell, which looks like a small city. Inside this city are various structures like the city hall (nucleus), power plant (mitochondria), trash company (lysosomes), and other parts like the Golgi apparatus, and endoplasmic reticulum.

In every city or cell, there are gates that allow elements to enter or exit, like in the case of sodium-potassium exchange. Fluids and electrolytes cause cellular excitability; calcium is an example of an electrolyte that causes tensed and constricted vessels.

Calcium: Bone versus Heart

Calcium causes bones to become stronger and more durable. Calcium for the heart, on the other hand, has a similar effect because it can cause the vessels to become stiff which would add to the resistance if there’s pressure, leading to hypertension.

Mechanism of Calcium Channel Blockers

Calcium channel blockers are given to make the heart very soft and supple. Like diuretics and beta blockers, calcium channel blockers decrease the rate and the hardness.

Calcium channel blockers are medications prescribed to relax the vessels of the heart, thereby increasing the blood supply and oxygen while reducing the workload. Some well-known calcium channel blockers are:

  • Diltiazem
  • Felodipine
  • Amlodipine

Other heart conditions wherein calcium channel blockers are applicable:

  • Hypertension
  • Hypertrophic cardiomyopathy
  • Coronary artery disease (CAD)

Patient Teaching

When taking calcium channel blockers, you should advise your patient that this type of medication has to be taken with either milk or food. Taking of blood pressure is also necessary to monitor any signs of side effects like decreased heart rate, hypotension, drowsiness, and lightheadedness.

For patients with myocardial infarction, emergency drugs are often given aside from maintenance medications. This will be discussed in our next article. You can also visit Simple Nursing’s website and YouTube channel to check out other nursing-related topics.

 

Antihistamine Pharmacology

Antihistamines are types of drugs that nurses usually encounter on a daily basis; these drugs are also available over-the-counter in various pharmacies worldwide. Before going into what antihistamines are, we must first understand what these drugs are blocking and how they affect the body.

In this lecture you can expect the following topics to be discussed:

  • The nature of histamines
  • Benadryl
  • Pepcid

The Nature of Histamines

When the body experiences irritation or mild trauma like accidentally hitting your finger with a hammer, the immediate response of the affected part would be to become inflamed. This is because the body gets prompted to release inflammatory agents to allow white blood cells, mast cells, and plasma cells to ward off the invader; thus, the affected site will swell because histamine is also released.

Histamines are like prostaglandins that cause pain, substance P, and COX-2. To remember what histamines are, just keep in mind the sound that a snake or a cat makes – hiss – because when people get mad, they become irritated and inflamed. Activating histamines is as easy as inhaling pollen from flowers or sniffing a cat’s fur.

Blocking Histamines

When histamines are released, the appropriate response would be to block them immediately, asking them to calm down or take the chill pill; stop being so pissed off. To address the blocking or cessation of histamines, antihistamines, like Benadryl and Pepcid, are given.

Benadryl

Diphenhydramine (Benadryl) is given either per orem, intravenous, or intramuscular. Benadryl given by mouth is readily available over-the-counter in groceries and drug stores. This medicine is effective in decreasing inflammatory response commonly used for the following:

  • Allergic eruptions
  • A non-productive cough caused by ACE-inhibitors
  • Blood transfusions

Benadryl for Blood Transfusion

Patients who are about to undergo blood transfusion are usually given Benadryl IV, pushing about 10 to 50 milligrams for about a minutes to prevent and decrease any type of allergic reaction and inflammatory response. Although, this is a routine procedure in hospitals and does not necessarily mean that the patient will have any allergic eruptions. Benadryl is just given to prevent any unwanted adverse reactions if there’s any.

Pepcid

Famotidine (Pepcid) is another type of antihistamine that blocks the release of histamine inside the stomach that can cause irritation and stomach ache. Pepcid is commonly used for episodes of gastroesophageal reflux (GERD) or gastritis, aiming to prevent any occurrence of peptic ulcers and decreasing acid production within the gastrointestinal tract.

So remember, between the two types of antihistamines mentioned in this piece, Benadryl is systemic, commonly used for throat irritation that may lead to a cough, and for blood transfusion. On the other hand, Pepcid is primarily given to patients who are suffering from GI tract irritation.

For a more comprehensive list of commonly used drugs inside a hospital setting and are a major nursing exam and NCLEX® favorites, just be part of our VIP membership and get the IV push drug card for free. This is included in our Pharma Boot Camp especially made for our members.

For other nursing-related topics, you can check out our Simple Nursing website and YouTube channel.

Emergency Pharmacology: A Highlight on Vasopressors (Dopamine)

Vasopressors are life-saving drugs that are commonly seen in an emergency setting. But what are vasopressors, and what are their mechanisms of action?

Vasopressors Defined

Vasopressors are types of medications that exert pressure on the veins, on the vascular beds to promote vasoconstriction. When this happens, there is an increase in blood flow to the heart, lungs, and the brain. Aside from these organs, the kidneys are also directly affected by vasopressors.

Upon administration of vasopressors, the kidneys are alerted to hold all the fluid in the body or what is also known as fluid retention, causing dilation in the renal cavity or arteries; this will be explained further as we go along.

Examples of Vasopressors

There are many examples of vasopressors available in the market, but there are only two that are commonly utilized inside the hospital, especially in emergency scenarios. These drugs are:

  • Norepinephrine (Levophed)
  • Dopamine

Between the two, we’ll focus our attention on dopamine.

Dopamine

Dopamine is usually the first line of drug given to anyone who is suffering from hypotension.

Much like any other vasopressors, the introduction of dopamine is going to prompt vasoconstriction, putting pressure on the vessels. The primary goal for the administration of dopamine is to increase blood pressure. Aside from boosting blood pressure, dopamine can also inadvertently increase heart rate.

As mentioned, the kidneys are also going to be affected through perfusion, holding the fluid in to retain blood and distribute it to the rest of the body.

Hypotensive Crisis

Vasopressors are given especially during a hypotensive crisis. A hypotensive crisis is a situation wherein the body is losing a lot of blood drastically, which can either be caused by the following:

  • Trauma, example: gunshot wound
  • Excessive vomiting
  • Diarrhea

Any of these events can lead to hypovolemic shock, which is a deficiency of blood or fluids within the vascular spaces. If there is the extremely low amount of blood perfusion, it will compromise the distribution of oxygen. Remember, without oxygen, the body will eventually expire.

The Function of the Kidneys

So, during a hypotensive crisis, the kidneys will swoop in to save what is left of the little blood in the body by ceasing the mechanism of urination. The kidneys will not allow pee to go out of the body, keeping it inside the vascular spaces until blood pressure will rise naturally.

Route of Dopamine

Dopamine is usually given with an intravenous infusion as a piggyback or slow infusion; this will help increase blood pressure and dilate the renal arteries. This is true during emergencies.

Dopamine and ARF

Dopamine is also given to patients who are suffering from acute renal failure (ARF). When the kidneys are failing, dopamine will ignite the opening up of the renal arteries, causing more perfusion by shunting blood down to the kidneys so the patient won’t go into chronic renal failure, and potentially losing the kidneys.

How does one determine that there is low perfusion in the kidneys?

The mean arterial pressure (MAP) determines how much blood flow is getting around the body. Normally the MAP is from 85 – 100. However, if there are problems with the kidneys, the MAP will go below 65. If this happens, the perfusion becomes compromised. To prevent this, dopamine is given.

For our next lecture, we’ll be focusing on the second vasopressor we’ve mentioned – norepinephrine (Levophed). Check it out in Simple Nursing’s website and YouTube channel.

Antibiotics 101: What are Fluoroquinolones?

Fluoroquinolones is a type of antibiotics that are given to treat some illnesses related to the respiratory and the urinary tract system. In this lecture, we’ll be delving deeper into what fluoroquinolones are, how nurses can easily remember these drugs, and what to watch-out-for when giving the medications.

Let’s get right into it.

Cipro de Mayo

With tons of medications that are out there, how in the world are you going to identify which belong to fluoroquinolones? Easy; just remember Cipro de Mayo. Cipro de Mayo is like the famous Cinco de Mayo, a Mexican celebration that commemorates the victory of the Mexican Army against the French. Enough of that bit of background.

The point is, you can instantly recall what fluoroquinolones are by keeping in mind Cipro de Mayo. Now, how is Cipro de Mayo related to this type of antibiotics? Well, Ciprofloxacin (Cipro) is one of the most popular fluoroquinolones drugs given to patients inside a hospital setting.

Another tip to associate Cipro with fluoroquinolones is Folklorico which is a traditional dance done during Cinco de Mayo. Fluoroquinolones sound like Folklorico. I hope that helped you out in remembering fluoroquinolones, which is especially helpful during the NCLEX®.

The Suffix: Floxacin

Like most drugs, fluoroquinolones also has a distinct suffix that can also pinpoint medications belonging in this group. Most of the fluoroquinolones end in “-floxacin.” Some examples are:

  • Ciprofloxacin (Cipro)
  • Levofloxacin (Levaquin)
  • Ofloxacin (Floxin)

As indicated, fluoroquinolones are usually given to treat the following:

  • Respiratory tract infections
  • Urinary tract infections

Cipro and Levaquin are primarily given for urinary tract infections. Though these medications are not as strong as aminoglycosides or vancomycin, which are considered as the “big guns” in severe cases of infection, fluoroquinolones are still quite effective in resolving UTIs.

Specifications for Administration

There are a couple of things that you have to keep in mind when giving fluoroquinolones to patients.

  1. Fluoroquinolones should not be taken with food.
  2. Direct sunlight is prohibited.
  3. Watch out for the patient’s blood pressure.

Tetracycline, macrolides, and fluoroquinolones are drugs that shouldn’t be taken with food. You can remember this as:

  • TMF = Too Much Food – Tetracycline, Macrolides, Fluoroquinolones

Blood pressure, on the other hand, is another priority when it comes to fluoroquinolones. Make sure that you are assessing the patient for signs of increased blood pressure. Within 30 minutes, fluoroquinolones can precipitate an immediate drop in blood pressure for as much as 15 points once it is administered, especially when these drugs are given through an intravenous line.

So far, there has never been a nursing question related to blood pressure that was given in the NCLEX® so far regarding blood pressure. But as nurses, it is essential that you are aware of the side effects of giving fluoroquinolones especially if you’re working inside the emergency room.

For our next group of antibiotics, we’ll go into what sulfonamides (Bactrim) are, the indications, how the drug is given, and what to keep tabs on regarding side effects. Drop by Simple Nursing’s website and Youtube channel to check out more nursing-related topics.