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A comprehensive review of various medications commonly used in nursing practice. It covers opioid drugs, benzodiazepines, muscle relaxants, antiepileptic drugs, anxiolytics, antipsychotics, ssris, and treatments for substance abuse, hypothyroidism, hyperthyroidism, and diabetes. Each medication category includes examples, indications, adverse effects, contraindications, and important considerations for administration and patient education. This study guide is designed to help nursing students prepare for exams by providing key information in a concise and organized manner, focusing on essential pharmacological concepts and clinical applications. It also includes information about drug interactions and overdose management.
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Opioid drugs Synthetic drugs that bind to opiate receptors to relieve pain. Codeine and hydrocodone Examples of mild agonist opioid drugs. Morphine, hydromorphone, oxycodone, meperidine, fentanyl, and methadone Examples of strong agonist opioid drugs. Moderate to severe pain (main), cough suppression, diarrhea, and to balance anesthesia What are opioid drugs used for?
Respiratory insufficiency, elevated ICP, morbid obesity, sleep apnea, paralytic ileus, and pregnancy When are opioid drugs cautiously given? CNS depression (respiratory depression), N/V, urinary retention, diaphoresis, flushing, pupil constriction (miosis), constipation, hypotension, and itching What are the adverse effects of opioid drugs? Opioid antagonists like naloxone and naltrexone What is opioid drug toxicity and overdose treated with, regardless of withdrawal symptoms if a person experiences severe respiratory depression. Naloxone hydrochloride Pure opioid antagonist drugs available without a prescription that completely or partially reverse opioid-induced respiratory depression and are used by 1st responders for illegal drug/opioid overdoses.
Acetylcysteine What is the antidote for acetaminophen overdose? Benzodiazepines Sedative-hypnotic or anxiolytic drugs that calm the CNS, control agitation and anxiety, reduce excessive sensory stimulation, induce sleep, and induce skeletal muscle relaxation. Alprazolam, diazepam, and lorazepam (HINT: -zepam) What are some common benzodiazepine medications? Sedation, sleep induction, skeletal muscle relaxation, anxiety relief, anxiety-related depression, acute seizure disorders, alcohol withdrawal, agitation relief, balance anesthesia, and moderate/conscious sedation What are the indications for benzodiazepines?
Decreased CNS activity, sedation, hypotension, drowsiness, loss of coordination, dizziness, HA, N/V, dry mouth, and constipation What are some adverse effects of benzodiazepine medications like alprazolam, diazepam, and lorazepam? Oral contraceptives, opioids, and azole antifungals (enhanced sedative effects and impaired hepatic elimination of the benzodiazepine) What are some interactions of benzodiazepine medications like alprazolam, diazepam, and lorazepam? Flumazenil What is the antidote for benzodiazepine toxicity? Zolpidem Short-acting nonbenzodiazepine hypnotic medication. daytime sleepiness Zolpidem has a lower incidence of ____ when compared to benzodiazepine hypnotics.
Muscle relaxants work best when used along with... Euphoria, lightheadedness, dizziness, drowsiness, fatigue, and muscle weakness What are some adverse effects of muscle relaxants? Valporic acid Antiepileptic drug used for generalized seizures, bipolar disorder, and controlling partial seizures. Drowsiness, GI disturbances, tremor, weight gain, hair loss, hepatotoxicity, and pancreatitis What are some adverse effects of valporic acid? Liver impairment and urea cycle disorders What are the contraindications for valporic acid?
Adhere closely to dose/frequency, take at same time everyday, notify HCP of missed doses (increased risk of seizure activity), do not crush/open capsules, and take with food and 6-8oz of water What considerations and education is associated with antiepileptic drugs? Buspirone Anxiolytic with an unknown mechanism of action administered on a scheduled bases that lacks the sedative properties and dependency potential of other benzodiazepines. Paradoxical anxiety, blurred vision, HA, and nausea What are the adverse effects of buspirone, an anxiolytic? Antipsychotics Drugs that block dopamine receptors in the brain and areas associated with emotion, cognitive, and motor function. Haloperidol, risperidone, olanzapine, and quetiapine
Bupropin, citalopram, duloxetine, and trazodone What are some selective serotonin reuptake inhibitor (SSRI) medications? Bleeding, insomnia, weight gain, sexual dysfunction, and serotonin syndrome What are the adverse effects of selective serotonin reuptake inhibitor (SSRI) medications like bupropin, citalopram, duloxetine, and trazodone? Serotonin syndrome Adverse effect of SSRIs characterized by delirium, agitation, tachycardia, sweating, myoclonus, hyperreflexia, shivering, and course tremors Warfarin and phenytoin (more pronounced drug effect with SSRIs) What may selective serotonin reuptake inhibitors interact with?
Withdrawal syndrome SSRIs must be tapered due to... methadone The goal of ____ therapy is to reduce the patient's dosage of the opioid so that they can live drug free; however, relapse rates are high and it can be abused. Respiratory depression What is the most common cause of death from opioid overdose? Elevated BP, HR, and temp, insomnia, tremors, and agitation What are the manifestations of ethanol withdrawal? Benzodiazepines What is the treatment for ethanol withdrawal with the dosage/frequency depending on severity?
Hypothyroidism Deficiency in thyroid hormones. Primary hypothyroidism Which classification of hypothyroidism is caused by an abnormality in the thyroid gland itself? Secondary hypothyroidism Which classification of hypothyroidism results when the pituitary gland is dysfunctional and does not secrete TSH? Tertiary hypothyroidism Which classification of hypothyroidism results when the hypothalamus gland does not secrete thyrotropin-releasing hormone, which stimulates TSH release? Thickened skin, hair loss, constipation, lethargy, and anorexia What are the manifestations of hypothyroidism?
Levothyroxine and liothyronine What is hypothyroidism treated with? Recent MI What are the contraindications for all thyroid replacement drugs, such as liotrix? Cardiac dysrhythmias, tachycardia, palpitations, angina, HTN, insomnia, tremors, HA, anxiety, N/D, menstrual irregularities, weight loss, sweating, heat intolerances, fever, etc. What are the adverse effects of liotrix, a thyroid replacement drug? Take in morning on an empty stomach (avoids sleep disturbances) and dosed in mcg What are some administration considerations for liotrix, a thyroid replacement drug? Hyperthyroidism
Lifestyle changes, oral drug therapy, and insulin (if first 2 are ineffective) What is type-2 diabetes treated with? Careful monitoring of blood glucose levels, therapy with 1+ drugs, and treatment of associated comorbidities What does effective treatment of type-2 diabetes with oral antidiabetic drugs involve? Metformin What is the first line and most common PO type-2 diabetes (DM) drug? Bloating, N/D, cramping, feeling of fullness, metallic taste, low B12, and lactic acidosis What are the adverse effects of metformin, a PO antidiabetic drug that treats type-2 diabetes? Hypoglycemia Abnormally low blood glucose levels, below 50 mg/dL.
Higher intake of protein and lower intake of carbs Mild cases of hypoglycemia are treated with diet, including... Confusion, irritability, tremors, and sweating What are the early manifestations of hypoglycemia? Hypothermia and seizures then coma and death if untreated What are the late manifestations of hypoglycemia? Glucose elevating drugs (oral glucose), 50% dextrose in water, and glucagon What is hypoglycemia treated with? Ability to consume food and for N/V since there may be problems if the patient takes PO drugs and cannot eat
Antibiotics that inhibit bacterial growth and protein synthesis and stops many essential bacterial functions. Doxycycline, tetracycline, minocycline, and tigecycline What are some common tetracycline medications? Vaginal candidiasis, gastric upset, enterocolitis, and maculopapular rash What are some adverse effects of tetracycline medications like doxycycline, tetracycline, minocycline, and tigecycline? Children <8 and pregnant women (discolors teeth by binding to Ca) What are some contraindications of tetracycline medications like doxycycline, tetracycline, minocycline, and tigecycline? Avoid milk products, iron preparations, antacids, and other dairy products because of the chelation and drug-binding that occur, take all medications with 6-8oz of fluid, use an alternative form of birth control if on oral contraceptives, and avoid sunlight and tanning beds because of photosensitivity
What are some nursing considerations for tetracycline medications like doxycycline, tetracycline, minocycline, and tigecycline? Sulfonamides One of the first groups of antibiotics that is often combined with another antibiotic like sulfamethoxazole-trimethoprim. Gram-positive and negative bacteria, UTIs, pneumocystitis jiroveci pneumia, URI, and staphylococcus infection What are sulfonamides used to treat? Hemolytic/aplastic anemia, photosensitivity, and Stevens-Johnson syndrome What are the adverse effects of sulfonamides? G6PD deficiency (hemolysis or RBC production) When should sulfonamides be cautiously be given?
