Professional Documents
Culture Documents
infection
Neurologic
1. Cholinergic Agents/Parasymphatomimetics
2. Anticholinergics/Parasymphatolytics
3. Adrenergic Agents/Symphatomimetics
4. Adrenergic Blocking Agents
5. Skeletal Muscle Relaxants
6. Anticonvulsants/Antiepileptics
7. Antiparkinsonian Agents
8. CNS Stimulants
Cholinergic Agents
Mechanism of action – stimulates
cholinergic receptors by mimicking
acetylcholine or inhibition of enzyme
cholinesterase
Indications – glaucoma, urine retention,
Myasthenia Gravis, antidote to
neuromuscular blocking agents : tricyclic
antidepressants and atropine
Cholinergic Agents
Prototype – synthetic acetylcholine,
pilocarpine, carbachol, bethanecol
(Urocholine), edrophonium (Tensilon),
neostigmine (Prostigmine),
pyridostigmine (Mestinon)
Adverse effects – blurring of vision,
miosis, increase in salivation, intestinal
cramps, bronchoconstriction, wheezing,
DOB, hypotension and bradycardia
Cholinergic Agents
Nursing considerations :
1. Warn & monitor clients of the side
effects.
2. Have atropine available for use as
antidote.
Anticholinergic Agents
Mechanism of action – block the binding
of acetylcholine in the receptors of
parasympathetic nerves
Indications – use preoperatively to dry up
secretions; treat spasticity of GI or urinary
tract, use for treatment of bradycardia,
asthma, parkinsonism; use for antidote in
organophosphate poisoning.
Anticholinergic Agents
Prototype – atropine, scopalamine
(Triptone), dicyclomine (Bentyl),
propantheline (Pro-Banthine)
Adverse effects - dry mouth , dilatation of
pupils, tachycardia, urinary retention,
ileus, heat stroke
Anticholinergic Agents
Nursing considerations :
1. Keep client in cool environment.
2. Watch out for signs of heatstroke and
dehydration.
3. Encourage clients to increase fluid
intake and use of sugarless gum/candy
for dry mouth.
4. For GI spasticity, administer 30 minutes
before meals and at bed time.
Adrenergic Agents
Mechanism of action – stimulate alpha
and beta adrenergic receptor directly or
trigger the release of catecholamines
indirectly causing sympathetic effects
Indications – cardiopulmonary arrest,
hypotension, COPD and asthma, nasal
congestions, allergic reaction,
anaphylactic shock
Adrenergic Agents
Prototype - epinephrine, norepinephrine,
ephedrine, dopamine, dobutamine,
phenylephrine, terbutaline, albuterol,
isoproterenol
Adverse Effects – restlessness, insomnia,
tremors, nausea, palpitations, angina,
tachycardia, HPN
Adrenergic Agents
Nursing considerations :
1. Contraindicated in clients w/
hyperthyroidism, pheochromocytoma &
cardiovascular disease.
2. Monitor vital signs and advice
precautions.
3. Should be taken with food.
Adrenergic Blocking Agents
2 Types:
Alpha blockers – phentolamine (Regintine),
phenoxybenzamine, prazosin (Minipress),
reserpine (Serpasil), terazosin (Hytrin),
clonidine (Catapress), methyldopa (Aldomet)
Beta blockers – atenolol (Tenormin),
esmolol (Brevibloc), metoprolol (Lopressor),
nadolol (Corgard), propanolol (Inderal),
timolol ( Blocadren)
Adrenergic Blocking Agents
Mechanism of actions:
Alpha blockers – inhibits action of a-
receptors in vascular smooth muscle to
cause vasodilatation
Beta blockers – compete with epinephrine
in b-receptors in heart, pulmonary
airways, peripheral circulation and CNS
Adrenergic Blocking Agents
Indications - Raynaud’s disease,
hypertension, pheochromocytoma, angina,
arrhythmias, mitral valve prolapse,
glaucoma
Adverse effects - orthostatic hypotension,
bradycardia, CHF, depression, insomnia
and vertigo, bronchospasm and dyspnea,
nasal stuffiness, cold extremities
Adrenergic Blocking Agents
Nursing considerations :
1. Administer oral alpha-blockers with milk to
minimize GI side effects.
2. Administer oral beta-blockers before meals and at
a.m. if insomnia occurs.
3. Check client’s apical pulse rate before drug
administration, refer if below 60 bpm.
4. Hypotensive precautions.
5. Warn clients not to drive or operate dangerous
machinery until he/she has adjusted to medications.
Skeletal Muscle Relaxants
Mechanism of action – depress CNS,
inhibit calcium ion release in the muscle,
enhance the inhibitory action of GABA
(gamma-amino butyric acid)
Indications – for acute musculoskeletal
pain, for muscle spasticity associated with
multiple sclerosis, cerebral palsy, CVA,
and spinal cord injury.
Skeletal Muscle Relaxants
Prototype – methacarbamol (Robaxin),
baclofen (Lioresal), dantrolene
(Dantrium), metaxalone (Skelaxin),
orphanedrine (Norgesic), chlorzoxazone
Adverse effects – hypotonia, ataxia,
hypotension, drowsiness, blurred vision,
bradycardia, depression, urine retention
Skeletal Muscle Relaxants
Nursing considerations :
1. Caution clients that mental alertness may be
impaired.
2. Monitor neuromuscular status, bowel and
bladder functions.
3. Inform clients that maximum benefit of
baclofen is attained for 1-2 months.
4. Reduce baclofen dosage gradually because of
associated withdrawal symptoms : Confusion,
hallucinations, paranoia & rebound spasticity.
Anticonvulsants
3 Types:
Hydantoins – phenytoin (Dilantin)
Barbiturates – phenobarbital (Luminal)
Miscellaneous – carbamazepine
(Tegretol), diazepam, clorazepate
(Tranxene), valproic acid (Dapakene),
ethosuximide (Zarontin)
Anticonvulsants
Mechanism of action – treat seizures by
depressing abnormal neuronal activity in
motor cortex
Adverse effects – sedation & drowsiness,
gingival hyperplasia, diplopia, nystagmus,
vertigo, dizziness, thrombocytopenia,
aplastic anemia
Anticonvulsants
Nursing considerations :
1. Advise female clients to use contraceptives.
2. Inform clients taking phenytoin that harmless urine
discoloration is common.
3. Warn clients with diabetes that hydantoins may increase blood
sugar level and that valproic acid may produce a false positive
result in urine ketone test.
4. Teach clients receiving carbamazepine to identify symptoms of
bone marrow depressions.
5. Reassure that barbiturates are not addictive at a low dosage.
6. Avoid taking alcohol with barbiturates.
7. Administer IV phenytoin slowly to avoid cardiotoxicity.
8. Avoid mixing other drugs in same syringe with phenytoin.
Antiparkinsonian Agents
2 Types:
Anticholinergic agents – trihexyphenidyl
(Artane), benztropine (Congentin)
Dopaminergic agents – Levodopa,
carbidopa-levodopa (Sinemet),
amantidine (Symmetrel), pergolide
(Permax), selegiline (Eldepryl),
bromocriptine
Antiparkinsonian Agents
Mechanism of actions:
Anticholinergic agents – inhibit cerebral
motor centers
Dopaminergic agents – increasing
dopamine concentrations or enhancing
neurotransmitter functioning
Antiparkinsonian Agents
Adverse effects of dopaminergic agents:
levodopa – nausea, vomiting, anorexia,
orthostatic hypotension, dark-colored
urine and sweat
amantidine – ankle edema, constipation
bromocriptine – palpitations, tachycardia
Antiparkinsonian Agents
Nursing considerations :
1. Give dopaminergic agents after meals to
reduce GI symptoms.
2. Reassure client that levodopa may cause
harmless darkening of urine and sweat.
3. Avoid taking Vit B6 (pyridoxine) with
levodopa because it speed up metabolism.
4. Educate clients to minimize orthostatic
hypotension.
5. Elevate leg to reduce ankle edema.
CNS Stimulants
Mechanism of action – increase
excitatory CNS neurotransmitter activity
and blocks inhibitory impulses
Indications – for obesity (amphetamines),
attention deficit hyperactivity disorders,
narcolepsy, drug-induced respiratory
depressions
CNS Stimulants
Prototype – amphetamines,
methylphenidate (Ritalin)
Adverse effects - nervousness, insomnia,
restlessness, hypertension, tachycardia,
headache, anorexia, dry mouth
CNS Stimulants
Nursing considerations :
1. Should be given at morning.
2. Don’t stop amphetamine abruptly to
avoid withdrawal symptoms.
3. Monitor blood pressure and pulse.
4. Ice chips or sugarless gum for dry mouth.
5. Watch out for growth retardation in
children taking methylphenidate.
Psychiatric
Sedatives, hypnotics, &
anxiolytics
Antidepressants & mood
stabilizers
Antipsychotics/neurolepti
cs
Anxiolytics
3 Types:
Benzodiazepines – diazepam (Valium),
lorazipam (Ativan), alprazolam (Xanax),
flurazepam (Dalmane)
Barbiturates – amobarbital, phenobarbital,
secobarbital
Miscellaneous – chloral hydrate (Noctec),
buspirone (Buspar), paraldehyde
Anxiolytics
Mechanism of actions:
Benzodiazepines – increase the effect of
inhibitory neuro transmitter GABA
(gamma-amino butyric acid)
Barbiturates and Miscellaneous agents –
depress CNS
Anxiolytics
Indications - induce sleep, sedate and
calm clients
Adverse effects - hangover-effect,
dizziness, CNS depression, respiratory
depression, drug-dependence
Anxiolytics
Nursing considerations :
1. Warn clients of injuries and falls.
2. Brief period of confusion and excitement upon
waking up is common with benzodiazepines.
3. Warn clients not to discontinue medications
abruptly without consulting a physician.
4. Avoid alcohol while taking these drugs.
5. Rotate and don’t shake the ampules of barbiturates.
Don’t mix with other drugs.
6. Warn female clients that diazepam is associated
with cleft lip.
Antidepressants
4 Types:
Tricyclic antidepressants – amitriptyline
(Elavil), protriptyline (Vivactil), imipramine
(Tofranil), desipramine
MAO (monoamine oxidase inhibitors) –
isocarboxazid (Marplan), phenelzine (Nardil),
tranylcypromine (Parnate)
Second-generation antidepressants – fluoxetine
(Prozac), trazodone (Desyrel)
Lithium
Antidepressants
Mechanisms of actions:
Tricyclic antidepressants – increase receptor
sensitivity to serotonin and/or norepinephrine
MAO inhibitors – inhibit the enzyme MAO that
metabolize the neurotransmitters
norepinephrine and serotonin
Second – generation antidepressants – inhibits
the reuptake of serotonin
Lithium – increase serotonin & norepinephrine
uptake
Antidepressants
Adverse effects - dry mouth, blurred
vision, urine retention, constipation
(anticholinergic effects), orthostatic
hypotension, insomnia, hypertensive crisis
(MAO), dehydration (Lithium)
Antidepressants
Nursing considerations :
1. Caution client to rise slowly to reduce the effects of orthostatic
hypotension.
2. Take antidepressant with food to enhance absorption
3. Explain to client that full response may take several weeks (2 weeks).
4. Assess client for constipation resulting from tricyclic antidepressant use.
5. Client taking MAO inhibitors should avoid tyramine-rich foods to avoid
hypertensive crisis such as aged cheese, sour cream, yogurt, beer, wine,
chocolate, soy sauce and yeast. Pentholamine (Regintine) is the drug of
choice for hypertensive crisis.
6. Inform physician and withhold fluoxetine if client develop rashes.
7. Take lithium with food to reduce GI effects – > 1.5 mEq/L blood level
may cause toxicity manifested by: confusion, lethargy, seizures,
hyperreflexia, maintain salt and adequate fluid intake, tremors may
occur but it is temporary, monitor white blood cell count (increase).
Antipsychotics
2 Types:
Phenothiazines – chlorpromazine
(Thorazine), trifluoperazine (Stelazine),
thioridazine (Mellaril)
Other Agents – clozapine (Clozaril),
haloperidol (Haldol)
Antipsychotics
Mechanism of action – block dopamine receptor in the
limbic system, hypothalamus, and other regions of the brain
Adverse effects
propanolol, esmolol
Class III (block K channels)
amiodarone, bretylium
Class IV (block Ca channels)
verapramil, diltiazem
Anti-arrhythmics
Nursing considerations :
1. Watch out for signs of CHF.
2. Have client weigh themselves and report
weight gain.
3. Watch out for signs of lidocaine
toxicity : - confusion and restlessness
Antilipemics
Mechanism of action – interfere with
cholesterol synthesis as well as decreasing
lipoprotein & triglyceride synthesis
Prototype :
cholesterol-lowering agents –
cholestyramine, colestipol, lovastatin,
atorvastatin (Lipitor)
triglyceride-lowering agents –
gemfibrozil, clofibrate
Antilipemics
Nursing considerations :
- monitor liver functions while using
statins.
- prevent constipation, flatulence,
cholelithiasis
- encourage increase fluid and fiber
intake.
ACE Inhibitors
Mechanism of action – prevent peripheral
vasoconstriction by blocking conversion
of angiotensin I to angiotensin II
decreasing peripheral resistance
Prototype – captopril (Capoten), enalapril
(Vasotec), quinapril, lisinopril
Adverse effects – it cause hyperkalemia,
induce chronic cough
ACE Inhibitors
Nursing considerations :
- not to discontinue medications because
it can cause rebound hypertension.
- avoid using K+ sparing diuretics.
Calcium-Channel Blockers
Mechanism of action – decrease cardiac
contractility and the workload of the
heart, thus decreasing the need for O2, it
also promotes vasodilatation of the
coronary and peripheral vessels
Indications – hypertension, angina,
arrhythmia
Calcium-Channel Blockers
Prototype – Nifedipine (calcibloc, adalat),
Amlodipine (norvasc), Felodipine
(Plendil), Verapramil (Isoptin)
Adverse Effects – bradycardia,
hypotension, headache, reflex
tachycardia, constipation
Calcium-Channel Blockers
Nursing considerations :
- Administer between meals to enhance
absorption.
- Take client’s pulse rate before each
dose, withhold if pulse is below 60 bpm.
- Refer for signs of congestive heart
failure.
Diuretics
CARBONIC ANHYDRASE - blocks Na and K
INHIBITORS reabsorption; reabsorb Ca
- Acetazolimide (Diamox) - hypercalcemia
- increase Na+, K+, & LOOP DIURETICS
HCO3 secretion, along - Furosemide (Lasix)
with it is H2O - blocks Na, K, and Ca
- metabolic acidosis
reabsorption
OSMOTIC DIURETIC - hypocalcemia
- Mannitol
POTASSIUM SPARING
- Increase osmotic pressure DIURETICS
of the glomerular filtrate. - Spironolactone
- hypotension (Aldactone)
THIAZIDE DIURETICS - excrete Na and water but
- hydrochlorothiazide it reabsorb K
- hyperkalemia
Respiratory
Bronchodilators
Glucocorticoids
Mast Cell Stabilizers
Antihistamines (H1)
Anti-TB
Decongestants, Antitussives,
& Expectorants
Bronchodilators
2 Types:
1. Symphatomimetic – albuterol,
salbutamol, isoproterenol, salmeterol,
terbutaline
2. Xanthines – aminophylline, theophylline
Bronchodilators
Mechanism of actions:
- sympathomimetic (b-receptor agonist)
bronchodilators – dilate airways
- xanthine bronchodilators – stimulate
CNS for respiration
Indications – bronchospasm, asthma,
bronchitis, COPD
Bronchodilators
Adverse effects – palpitations and
tachycardia, restlessness, nervousness,
tremors, anorexia, nausea and vomiting,
headache, dizziness
Nursing considerations :
- Contraindicated hyperthyroidism, cardiac
dysrhythmia, or uncontrolled seizure disorder
- Should be used with caution in patient with
HPN and narrow-angle glaucoma
Glucocorticoids
Mechanism of action – act as anti-
inflammatory agents and reduce edema of
the airways, as well as pulmonary edema
Prototype – dexamethasone, budesonide,
fluticasone, prednisone, beclomethasone
Adverse effects – Cushing’s syndrome,
neutropenia, osteoporosis
Glucocorticoids
Nursing considerations :
- Take drugs at meal time or with food.
- Eat foods high in potassium, low in sodium.
- Instruct client to avoid individuals with RTI.
- Instruct client not to stop medication abruptly, it
should be tapered to prevent adrenal insufficiency
- Avoid taking NSAID while taking steroids.
- Take inhaled bronchodilators first before taking
inhaled steroids, and rinse mouth after using.
Mast Cell Stabilizers
Mechanism of action – stabilize mast cells that
release histamine triggering asthmatic attacks
Prototype – cromolyn sodium (Intal)
Nursing Consideration:
- Should be given before asthmatic attacks.
- Administer oral capsule at least 30 mins before
meals for better absorption.
- Drink a few sips of water before & after
inhalation to prevent cough & unpleasant taste
- Assess for lactose-intolerance
H1 Blockers
Mechanism of action – decrease
nasopharyngeal secretions and decrease
nasal itching by blocking histamine in
H1-receptor
Indications – common colds, rhinitis,
nausea and vomiting, urticaria, allergies
and as sleep aid
H1 Blockers
Prototype - Astemizole (Hismanal), Loratidine
(Claritin), Brompheniramine (Dimetapp),
Diphenhydramine (Benadryl), Cetirizine
(Iterax), Celestamine (Tavist)
Nursing Considerations :
- Administer with food and drink.
- Given IM via Z-track method or orally.
- Precautions in handling machine and driving
while taking these drugs.
- Ice chips or candy for dry mouth
Anti-TB
FirstLine:
Rifampicin Second Line:
Isoniazid Cycloserine
Pyrazinamide Kanamycin
Ethambutol Ethonamide
Streptomycin Para-
aminosalicylic
Acid
Anti-TB
- active tuberculosis are treated with drug
combination for 6-9 mos.
- multidrug-resistant strain (MDR-TB) are
medicated for 1 year up to 2 years
- given before meals
Rifampicin
- given on an empty stomach with 8 0z. of
water, 1 hour before or 2 hours after meals
and avoid taking antacids with
medications.
- hepatotoxic thus avoid alcohol.
- instruct the client that urine, feces,
sweat, and tears will be redorange in
color.
Isoniazid
- should be given 1 hr before or 2 hrs after
meals because food may delay absorption.
- should be given at least 1 hr before antacids.
- instruct to notify physician for signs of
hepatoxicity (jaundice), and neurotoxicity,
numbness of extremities.
- administer with Vitamin B6 to counteract
the neurotoxic side effects.
- avoid alcohol.
Pyrazinamide
- given for 2 months.
- increase serum uric acid and cause
photosensitivity.
Ethambutol
- contraindicated in children under 13
years old.
- obtain a baseline visual acuity because it
can cause optic neuritis.
- Instruct the client to notify the physician
immediately if any visual problems
occurs.
Streptomycin
- aminoglycoside antibiotic given IM.
- nephrotoxic and ototoxic.
- obtain baseline audiometric test and
repeat every 1-2 months because the
medications impairs the CN VIII.
Cough & Cold Remedies
3 Types:
1. Decongestants
2. Antitussives
3. Expectorants
Decongestants
Mechanism of action – acts through
sympathomimetic action, usually by
constricting arterioles & reducing blood
flow to the area
Prototype – phenylephrine
Antitussives
Mechanism of action – suppresses the
cough center in the medulla
Prototype – dextromethorpan
Expectorant
Mechanism of action – facilitate the
secretion of fluid in the respiratory tract,
thus liquefying secretions and allowing
for easier expectoration during a cough
Prototype – guaifenesin (Robitussin)
Gastrointestinal
Antacids
H2 Blockers
Proton-Pump Inhibitors
Mucosal Barriers
Anti-diarrheals
Laxatives
Emetics
Antiemetics
Antacids
Mechanism of action – neutralize the
stomach acidity
Prototype – aluminum/magnesium
compounds (Maalox), sodium bicarbonate
(Alka-Seltzer), calcium carbonate (Tums),
magnesium hydroxide (Milk of Magnesia)
Antacids
Adverse effects - metabolic alkalosis,
stone formation, electrolyte imbalance,
diarrhea (magnesium), constipation
(aluminum)
Antacids
Nursing considerations :
- Give 1 hr after meals.
- Avoid giving medications within 1-2 hrs
of antacid administration (decreases
absorption).
- Take fluids to flush after intake of
antacid suspensions.
- Monitor for changes of bowel patterns.
H2 Blockers
Mechanism of action - blocks H2
receptors in the stomach, reducing acid
secretions
Prototype – cimetidine (Tagamet),
ranitidine (Zantac), famotidine (Pepcid),
nizatidine (Axid)
H2 Blockers
Nursing considerations :
- Given before or with meals
- Avoid giving other drugs with
cimetidine
- Gynecomastia may develop with
chronic use of cimetidine
Proton-Pump Inhibitors
Mechanism of action – inhibit the proton
H+ to combine with Cl- to form
hydrochloric acid
Prototype – omeprazole (Losec),
Lansoprazole (Lanz), pantoprazole
(Pantoloc)
Nursing considerations :
- Given before meals preferably at
morning.
Mucosal Barriers
Mechanism of action - coats the mucosa to
prevent ulcerations
Prototype - sucralfate (Carafate),
misoprostol (Cytotec)
Nursing consideration :
- Given before meals.
- Misoprostol is contraindicated for
pregnants.
- Sucralfate cause constipation.
Anti-diarrheals
Mechanism of action – decreases stomach
motility and peristalsis
Prototype – diphenoxylate (Lomotil),
loperamide (Imodium), kaolin/pectin
mixture (Kaopectate)
Anti-diarrheals
Nursing considerations :
- Monitor for rebound constipation.
- Be cautious taking if with infectious
diarrhea.
- Monitor atropine toxicity with
diphenoxylate.
- Clay, white or pale stool is common
with kaopectate.
Laxatives
a. lactulose (Cephulac), Na biphosphate (Fleet
enema) & magnesium salt (Milk of Magnesia)
- retain fluid and distend intestine
b. ducosate (Dialose)
- emulsify fecal fat and water
c. bisacodyl (Dulcolax) & senna (X-prep)
- irritates intestinal mucosa and stimulate intestinal smooth
muscles
d. bulk-forming laxative (Metamucil)
- increase fecal bulk and water content
e. mineral oil
- lubricates & prevent colon absorption
Emetics
Mechanism of action – induce vomiting
through stimulation of vomiting center of
medulla
Indications – ingestion of poisonous or
toxic substances
Prototype - ipecac syrup, apomorphine
Emetics
Nursing considerations :
- Consult poison control center before
induction of vomiting.
- Administer ipecac syrup with large
amount of fluid.
Antiemetics
Mechanism of action – inhibit the
vomiting reflex
Prototype – metoclopramide (Plasil)
Endocrine
Thyroid Agents
Parathyroid Agents
Oral Hypoglycemic
Agents
Insulin
Estrogen/Progesterone
Thyroid Agents
Mechanism of action – function as natural
or synthetic hormones
Prototype – Proloid (thryroglobulin ),
Synthroid (levothyroxine), Cytomel
( liothyronine)
Thyroid Agents
Nursing considerations :
- Taken in the morning.
- Caution with coronary artery disease.
- Monitor for signs of hyperthyroidism
and refer for decreasing the dose.
Parathyroid Agents
Mechanism of action – reduce bone
resorption, promotes calcium absorption
Prototype – calcitonin (Calcimar), etidronate
(Didronel), calcitrol (Rocaltrol), calcifediol
(Calcedrol)
Nursing considerations :
- Monitor signs of calcium imbalance
- Report for bone pains.
- Remain sitting upright after taking etidronate
Oral Hypoglycemics
Sulfonylureas
Biguanides
Alpha-glucosidase Inhibitors
Thiazolinidine
Meglitinidines
Sulfonylureas
- stimulate insulin secretions and increase
tissue sensitivity to insulin.
First Generation :
Chlorpropamide (Diabenese) – disulfiram
precautions
Tolbutamide (Orinase) – congenital defect
Second Generation :
Glypizide, Glymepiride
Biguanides
- facilitates insulin action on the
peripheral receptor site.
Metformin and Glucophage (Glucovance) –
side effect is lactic acidosis
Alpha-glucosidase Inhibitors
- delay carbohydrate absorption in the
intestinal system.
Acarbose (Precose) – side effect is diarrhea
Thiazolinidine
- increase tissue sensitivity of insulin.
Rosiglitazone (Avandia)
Meglitinidines
- stimulate insulin release in pancreatic B-
cells.
Repaglinide (Prandin)
Insulin
Insulin Onset Peak Duration
Immediate-acting ¼-½ ½-1 3
(lispro)
Short-acting ½-1 2–4 6–8
(regular,
semilente)
Intermediate- 1–2 6 – 12 18 – 24
acting (NPH,
Lente)
Long-acting 2–4 10 – 30 24 – 36
(ultralente)
Mixed (reg. 30%, ½ 4–8 25
NPH 70%)
Insulin
Nursing considerations :
- Usually given before meals.
- Roll the bottle in palm of hands, don’t shake.
- Inject amount of air that is equal to each dose into the bottle – short acting last (clear).
- Aspirate short acting first, then long or intermediate (cloudy).
- Alcohol is recommended for cleansing bottle but not with skin.
- Pinch skin, avoid I.M, don’t aspirate.
- Rotate the injection site an inch a part.
- Prefilled syringes are stored vertically, needle-up.
- May increase dose during illnesses.
- Used bottles stored in room temperature, unused bottle stored in refrigerator.
- Monitor for acute hypoglycemia :