Medication Aide Chapters 28-32

Glucocorticoids • Used in treatment of inflammatory, allergic, debilitating conditions (MS,

rheumatoid arthritis, shock, head trauma with edema, asthma, organ transplant)• Common side affects

• Abdominal distention• Headache• Increased appetite• Flushing• Mood changes• GI hemorrhage• Delayed wound healing

• Nursing precautions• Take with food or at mealtime• Do not stop drug abruptly• Avoid persons with URI• Eat foods rich in potassium, esp with Prednisone

• Examples • Prednisone• Decadron• Kenalog• Depo Medrol

Estrogens• Given to relieve hot flashes of menopause• Given to aide in contraception• Given for replacement therapy following surgical removal of ovaries• To slow progress of advanced prostate cancer

• Does increase risk of breast CA• Does increase risk of blood clots• S/E wt. gain & edema

• PROGESTERONES• Inhibits ovulation• Treat endometriosis• Hormonal balance to treat amenorrhea & abnormal uterine bleeding

• S/E wt. gain, edema• Break-thru uterine bleeding• Birth defects with a pregnancy

• ANDROGENS• Treat lack of male sex hormones• Breast CA in post menopausal women

• S/E changes in level of alertness• Women-increased male characteristics• Men-increased female characteristics

Reproductive conditions • Female

• Uterine dysfunction• PMS• Menopause• Endometriosis• Osteoporosis• Cancer• STDs• Treated with Estrogens-Premarin, Menest, Estrace, Ogen• Progestins-ProveraAygestin, Progesterone• Increases risk of breast cancer• Wt. gain, edema & blood clots

• Male • Delayed puberty• Sexual dysfunction• Tumors (prostate, testicular, breast)• STD’s • Hypogonadism-low testosterone• Eunuchism-no male hormones• Treated with androgens-Testoderm, Methitest, Halotestin

STD’S• Herpes-no known cure-Treated with anti-viral

drugs• Gonorrhea-Genital discharge-Treated with

Antibiotic’s• Chlamydia(Most common) Treated with

Antibiotic’s• Syphilis Treated with Antibiotic’s• Presence of chancres on the penis, vagina, lips, inside the

mouth• Causes death• Damages the CNS

Anti-infectives • Used to treat disorder caused by invasion of pathogenic microorganism • Common side effects

• Nausea• Headache• GI distress• Burning & stinging with topical use

• Nursing precautions• Provide support as client deals with fact infection is sexually transmitted, need to notify

sexual partners• Avoid sexual contact during treatment• Need for “follow-up” visits

• Examples• Doxycycline• Diflucan (antifungal)• Zovirax (antiviral)• Llotycin (erythromycin)• Flagyl• Vagistat• Valtrex

Oral contraceptives • Used to prevent pregnancy by preventing ovulation • Common side affects

• Fluid retention• Break through bleeding• Abdominal pain• Depression• Vascular headache• Nervousness

• Nursing precautions• Stop smoking• Possible decreased effectiveness during antibiotic therapy• Teach acronyms (ACHES)

• A-abdominal pain (severe)• C- chest pain or shortness of breath• H- Headache, severe with vertigo, weakness, numbness, speech difficulties• E- eye disorders (blurring, vision loss)• S- Severe leg pain, swelling in calf or thigh

• Examples • Triphasil (Estrogen/progestin)• Lo/Ovral• Norinyl• Natasia, Beyaz

Transdermal Contraceptive• Apply patch the same day every week• Apply on the buttock’s, abd., upper outer arm, or

upper torso-do not apply on the breast or where tight clothing may rub the patch

• Do not apply makeup, pwdr. lotion or cream to the area

• Contact the nse if becomes loose• Not effective the 1st 7 days of the 1st menstrual

cycle• Ortho Evra

BPH-benigned enlarged prostate• Causes urinary problems after the age of 50• Tx.-TURP• Adrenergic blocking agents(Uroxatral, Flomax)• Drowsiness, H/A, fainting, monitor BP-give with food• Anti-Adrogen agents(Avodart & Proscar)• Impotence, decreased sexual drive

Erectile Sexual Dysfunction

• Causes-Diabetes, spinal cord injuries, MS, Heart & circulatory disorders, prostrate problems, alcoholism, high BP, drug abuse, psychological factors

• Drug is taken 30 min. to 4 hrs prior to sexual activity• Color(blue or green) vision impairment• Hypotension or angina(do not take rx for angina-stop

sexual activity & lie down)• HA, flushing of the face & neck• If erection lasts more then 4 hrs. contact Dr.• Viagra(take on a empty stomach)• Levitra• Cialis

Common conditions of the urinary system• Infections• Cystitis• Pyelonephritis• Prostatitis • Urethritis

• Obstructions• Electrolyte or acid/base imbalance• Urinary retention

Acidifiers • Used to make urine more acidic (urinary tract

infection)• Common side effects• Nausea, vomiting• Anorexia• Thirst

• Nursing precautions • Report gastric disturbances promptly

• Examples • Aluminum chloride

Antibiotics • Used for bladder infections suppress growth of bacteria• Common side effects

• GI distress

• Nursing precautions• Many need to be taken with food or milk• May turn urine brown• Encourage additional fluid intake(2000cc./day)

• Examples• Furadantin• Macrodantin• Gantrisin• Septra• Bactrium• NegGram (nalidixix acid)• Monurol (fosfomycin)• Mandelamine (methenamine mandelate)

Urinary Relaxants/OAB

• Decreases urinary incontinence• Anti-cholinergic drugs-Enablex, Ditropan, Vesicare,

Detrol & Detrol LA, Sanctura• Dry mouth, urinary retention• Constipation• Blurred vision

Urinary bladder relaxant • Used to promote emptying of bladder• Common side effects• Nausea, vomiting• Low blood pressure

• Nursing precautions• Give on empty stomach

• Examples • Duvoid• Myotonachol• Urecholine (bethanechol chloride)

analgesic• Used to provide a local anesthetic effect on lining

of urinary tract• Common side effects• Headache• Nausea

• Nursing precautions• Give with food or liquids • Turns urine red or orange, may stain clothing

• Examples • Azodine• Pyridium

Common conditions of the sensory system • Eyes

• Cataracts• Glaucoma• Infections • Inflammation (bleparitis, keratitis)

• Ears• Infections• Wax build up• Loss of hearing• Dizziness• Osteoarthritis

• Nose • Rhinitis• Congestion

Administration rules for eye medication • Do not use more than one drop unless ordered otherwise• Wait at least 3- 5 minutes between drops if more then 1

kind of rx or 1-3 min if 2 or more gtts & the same kind of rx

• Apply drops before ointments• Explain to patient about burning or blurred vision• Know standard colors for ophthalmic labels and bottle

caps• Anti-infectives- brow or tan• Beta-adrenergic blocking agents- yellow, blue or both• Miotics- green• Mydriatics and cycloplegics- red• non-steriodal anti-inflammatory agents- gray

)

Drug therapy for Glaucoma

• Used to relieve abnormally high pressure within eye (may lead to blindness)

• Causes decreased IOP to prevent further blindness• Common side effects

• Temporary blurred vision• Temporary eye discomfort including stinging, redness

• Nursing precautions• Systemic absorption is possible (sweating, salivation, nausea, vomiting,

trembling, changes in blood pressure & heart rhythm)

• Examples • Eserine• Betoptic (betaxolol hydrochloride)• Timopotic (timolol maleate)• Propine (dipivefrin hydrochloride)• Ismotic (isosorbide)• Isopto-carbachol (cabachol)• Isopto-Carpine, Pilocar (pilocarpine)

Prostaglandin Agonists

• Reduces IOP by increasing the out-flow of aqueous humor

• Used when other agents haven’t responded well• S/E Eye Irritation• Changes in the eye color• Lumigan• Xalatan• Travantan

Anti-Cholinergic Agents• Relaxes the eye muscles, causing the eye to dilate• Used with examinations of the eye’s interior• To rest the eye if inflamed• To measure the lens strength• S/E Eye sensitivity, irritation, blurred vision• dry mouth, tachycardia, dysrhythmias, urinary retention, constipation

• Isopto-Atropine• Isopto-Hydroscine• Mydriacyl

• a

Anti-fungal• 1 drop q 1-2 hr. intervals the 1st 3-4 days-then

reduced to q 3-4 hrs.• Cont. 14 to 21 days• S/E sensitivity to bright light• Eye pain(contact Dr.)• Natacyn

Antibacterial • Used to kill or slow growth of bacteria in conditions such as

conjunctivitis• Common side effects

• Temporary blurred vision• Temporary eye discomfort including burning, redness

• Nursing precautions• Prolonged, frequent used should be avoided, possibility of

hypersensitivity reactions and secondary infections• Apply light finger pressure to inner canthus of eye for one minute after

drops instilled

• Examples• Bacitracin ophthalmic• Garamycin ophthalmic• Tobrex ophthalmic• Neosporin ophthalmic

antiviral• Used to treat viral infections of eye such as herpes

simplex • Common side effects

• Blurred vision• Tearing • Redness• Burning• Sensitivity to bright light

• Nursing precautions• Used sun glasses to help reduce discomfort caused by

hypersensitivity to light

• Example • Herplex• Viroptic (trifluridine)

Corticosteriods• Used for allergic reactions of the eye, acute inflammation

not caused by infection• Common side effects

• Blurred vision• Eye irritation, stinging• Increased pressure within eye

• Nursing precautions• Used for limited time• Check frequently for increased pressure (prolonged used cause

glaucoma, cataracts)• Apply light finger pressure to inner canthus of eye for one minute after

drops instilled

• Examples• prednisolone acetate• Decadron

Anti-Inflammatory

• Before & after cataract surgery(Ocufen, Profenal, Voltarin

• Seasonal allergies(Acular)• Allergic eye disorders(Alomide, Alamast, Alocril)• Allergic conjunctivitis(Optivar, Emadine, Zaditor,

Patinol)

Mydriatics • Used to dilate pupil• Common side effects

• Local irritation• Sensitivity to light• Dry mouth• Flushing

• Nursing precautions• Do not use with glaucoma• Sunglasses will help light sensitivity• Apply light finger pressure to inner canthus of eye for one

minute after drops instilled

• Examples • Atropine sulfate

Artificial Tears Solutions• Used to provide lubricant to eyes if abnormally

dry, artificial tears • Common side effects

• Allergic reaction (redness of eyes)

• Nursing precautions • None

• Examples • Artificial tears• Lacrisen• Tears naturale • Isopto Plain• Liquifilm tears

Anti-infective• Used to treat ear infections• Common side effects• Burning• Irritation

• Nursing precautions• Stop topical therapy after 10 days to prevent overgrowth

• Examples • Cortisporin• Neomycin

Ceruminolytic • Aids in removal of ear wax • Common side effects• Redness• Irritation

• Nursing precautions• Report increased pain, redness, swelling

• Examples• Debrox• Cerumenex

Antihistamine, decongestants • Used to reduce nasal congestion & middle ear effusion

(outward spread of bacterial growth)• Common side effects

• Dry mouth• Somolence• Blurred vision

• Nursing precautions• Alert consumer to drowsiness • Avoid intake of alcohol

• Examples• Dimetapp• Drixxoral• Naldecon• Triaminic• Seldane

Anti-inflammatory(nose)• Used to decrease inflammation • Common side effects

• Burning• Headache• Nosebleeds

• Nursing precautions• Notify prescriber if symptoms do not improve within 3 weeks• Adhere to prescribed schedule

• Examples• Beconase AQ• Nasalide• Flonase• Nasacort

Decongestant (nose)• Used to shrink nasal mucosa• Common side effects

• Rebound nasal congestion• Headache• Restlessness

• Nursing precautions• Do not exceed recommended dosage

• Examples• Privine• Afrin• Tyzine• Otrivin• NeoSynephrine, sinex• Sudafed

Tumors • Growth of abnormal cells is called a tumor• Malignant tumor (cancer)• Invade and destroy nearby tissue.

• Benign tumor• Do not spread to other body parts. They can grow to a

large size, but are rarely life-threatening.

• Metastasis • Spread of cancer to other body parts

Increased risk factors • Second leading cause of death in the USA• Growing old• Tobacco• Sunlight• Ionizing radiation• Certain chemicals and other substances • Some viruses and bacteria• Certain hormones• Family history of cancer • Alcohol• Poor diet, lack of physical activity, and being

overweight

Treatment of Cancer• Surgery• Radiation therapy• Chemotherapy• Hormone replacement therapy• Biological therapy

Alkylating agents (chemotherapy)• Used to halt cell replication processes • Common side effects

• Nausea, vomiting• Anorexia• Stomatitis• Alopecia

• Nursing precautions• Give good oral hygiene• Watch for signs/symptoms of infection (sore throat, fever, fatigue)• Give alkeran on empty stomach

• Examples • Alkeran• Leukeran• Myleran• Cytoxan

Antimetabolites (chemotherapy) • Used to “interfere” in the pathways of dividing cells • Common side effects

• Nausea, vomiting• Diarrhea• Stomatitis• Alopecia

• Nursing precautions• Give good oral hygiene• Watch for signs/symptoms of infection (sore throat, fever, fatigue)• Give Xeloda 30 minutes after meals

• Examples • Methotrexate• Purinethol (meecaptopurine)• Hydrea• Xeloda• Avastin

Hormones • Used to make environment unsupportive of cancer cell growth by

changing hormonal levels within consumer • Common side effects

• Acne• Weight gain• Insomnia • Libido changes• cramps

• Nursing precautions• Monitor weight• Low salt diet• When administering steroids take with milk/antacid• Encourage food intake high potassium

• Examples • Steroids- prednisone, prednisolone• Estrogens- diethylstillbestrol (DES), Estinyl• Androgens- Halotestin, Malogen• Progestins- Megace