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common_drugs_in_nclex-rn_2

common_drugs_in_nclex-rn_2

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Published by julialeo

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Published by: julialeo on Apr 19, 2009
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Name of the Drug
Brand Names
Classification and Action
Indications
Side Effects
Adverse Effects
Nursing Implication
Doxycycline
{Doxycin}, Monodox,
{Novodoxylin}, Periostat,
Vibramycin, Vibra-Tabs

CLASSIFICATION(S):
Therapeutic:anti-infectives
Pharmacologic:tetracyclines

\ue000

Inhibits bacterial protein
synthesis at the level of the 30S
bacterial ribosome.

\ue000

Low-dose products used in the
management of periodontitis
inhibit collagenase

\ue000
Therapeutic Effects:
o
Bacteriostatic action against
susceptible bacteria.
o
Decreased complications of
periodontitis

Treatment of various infections
caused by unusual organisms,
including:

Mycoplasma
Chlamydia
Rickettsia
Borellia burgdorferi

CNS: benign intracranial
hypertension (higher in
children).
GI: diarrhea, nausea,

vomiting, esophagitis,
hepatotoxicity,
pancreatitis.

Derm:photosensitivit y,
rashes.
Hemat: blood dyscrasias.
Local: phlebitis at IV site.

ADVERSE
hypersensitivity reactions,
superinfection

\ue000
General:
o

May cause yellow-brown discoloration and softening of teeth
and bones if administered prenatally or during early
childhood. Not recommended for children under 8 yr of age or
during pregnancy or lactation, unless used for the treatment of
anthrax.

\ue000
PO: Administer around the clock, at least 1 hr before or 2 hr after

meals. May be taken with food or milk if GI irritation occurs.
Administer with a full glass of liquid and at least 1 hr before going
to bed to avoid esophageal ulceration. Use calibrated measuring
device for liquid preparations. Shake liquid preparations well. Do
not administer within 1\u20133 hr of other medications.

o

Avoid administration of calcium, antacids, magnesium-
containing medications, sodium bicarbonate, or iron
supplements within 1\u20133 hr of oral doxycycline.

PATIENT/FAMILY TEACHING
\ue000
General:
o

Avoid taking antacids, calcium, magnesium-containing
medications, sodium bicarbonate, and iron supplements within 1\u20133
hr of oral doxycycline.

o
Use a nonhormonal method of contraception while taking
tetracyclines and until next menstrual period.
o
Use sunscreen and protective clothing to prevent photosensitivity
reactions.
o

Report the signs of superinfection (black, furry overgrowth on the tongue, vaginal itching or discharge, loose or foul-smelling stools). Skin rash, pruritus, and urticaria should also be reported.

INTERACTIONS
Drug\u2013Food:
\ue000
Calcium in foods or dairy products \u2193 absorption by forming
insoluble compounds (chelates); this effect is minimal with
1

Treatment of inhalational anthrax
(postexposure) and cutaneous
anthrax

\ue000

Treatment of gonorrhea and
syphilis in penicillin-allergic
patients

\u2022
Prevention of exacerbations
of chronic bronchitis
Treatment of acne.
doxycycline.
Epoietin
Epogen , EPO , Eprex , erythropoietin ,
Procrit

CLASSIFICATION(S):
Therapeutic:antianemics
Pharmacologic: , hormones

Pregnancy Category C
\ue000
Stimulates erythropoiesis
(production of red blood cells).
\ue000
Therapeutic Effects:
o
Maintains and may elevate
RBCs, decreasing the need
for transfusions.
CNS:, headache.
CV: hypertension ,
thrombotic events
(hemodialysis patients).
Derm: transient rashes.
Endo: restored fertility,
resumption of menses.
ADVERSE
SEIZURES,thrombus
formation
ASSESSMENT
\ue000

Monitor blood pressure before and throughout therapy. Inform
physician or other health care professional if severe hypertension
is present or if blood pressure begins to increase. Additional
antihypertensive therapy may be required during initiation of
therapy.

\ue000
Monitor response for symptoms of anemia (fatigue, dyspnea,
pallor).
\ue000

Monitor dialysis shunts (thrill and bruit) and status of artificial
kidney during hemodialysis. Heparin dose may need to be
increased to prevent clotting.

\ue000
Lab Test Considerations: May cause increase in WBCs and
platelets. May decrease bleeding times.
o

Serum ferritin, transferrin, and iron levels should also be
monitored to assess need for concurrent iron therapy.
Transferrin saturation should be at least 20% and ferritin
should be at least 100 ng/ml.

IMPLEMENTATION
\ue000
General: Transfusions are still required for severe symptomatic
anemia. Supplemental iron should be initiated with epoetin and
continued throughout therapy.
o

Institute seizure precautions in patients who experience
greater than a 4-point increase in hematocrit in a 2-wk period
or exhibit any change in neurologic status. Risk of seizures is
greatest during the first 90 days of therapy.

o
Do not shake vial; inactivation of medication may occur.
2

Discard vial immediately after withdrawing dose from single-
use 1-ml vial. Refrigerate multidose 2-ml vial; stable for 21
days after initial entry.

\ue000
Subcut: This route is often used for patients not requiring dialysis.
o

May be admixed in syringe immediately before administration
with 0.9% NaCl with benzyl alcohol 0.9% in a 1:1 ratio to
prevent injection site discomfort.

\ue000
Direct IV: Administer undiluted.
\ue000
Rate: May be administered as direct injection or bolus into IV
tubing or via venous line at end of dialysis session.
PATIENT/FAMILY TEACHING
\ue000
General: Explain rationale for concurrent iron therapy (increased
red blood cell production requires iron).
o

Discuss possible return of menses and fertility in women of
childbearing age. Patient should discuss contraceptive options
with health care professional.

o

Discuss ways of preventing self-injury in patients at risk for
seizures. Driving and activities requiring continuous alertness
should be avoided.

Drug\u2013Drug interaction:
\ue000
May increase the requirement forheparin anticoagulation during
hemodialysis.
Estradiol
Estrace; Climara; Estraderm;
Menostar

CLASSIFICATION(S):
Therapeutic:hormones
Pharmacologic:e s t ro g e n s

Pregnancy Category X
\ue000

Estrogens promote growth and
development of female sex
organs and the maintenance of

CNS: headache ,
dizziness, lethargy.
EENT: intolerance to
contact lenses , worsening
of myopia or astigmatism.
GI: nausea , weight

changes , anorexia,
increased appetite,
jaundice, vomiting.

GU:women\u2014

amenorrhea ,
dysmenorrhea ,
breakthrough bleeding,
cervical erosions, loss of

ASSESSMENT
\ue000
Assess blood pressure before and periodically during therapy.
\ue000
Monitor intake and output ratios and weekly weight. Report
significant discrepancies or steady weight gain.
\ue000
Menopause: Assess frequency and severity of vasomotor
symptoms.
IMPLEMENTATION
\ue000
General: Do not confuse Estraderm (estradiol) with Testaderm
(testosterone).
\ue000
PO: Administer with or immediately after food to reduce nausea.
\ue000
Transdermal: When switching from PO form, begin transdermal
3

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