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SSRI (Selective Serotonin Reuptake Inhibitor) End in -ine SNRI (Selective Serotonin/Norepinephrine Reuptake Inhibitor) Action Long Term Inhibits uptake of serotonin Affects serotonin & Norepinephrine Drug Name Fluoxetine (Prozac)- OCD Paroxetine (Paxil)” sedation” Sertraline (Zoloft) Escitalopram (Lexapro) Citalopram Fluvoxamine Effexor (Venlafaxine) XR Duloxetine (Cymbalta) Atomoxetine (1st^ # 1 non stimulant) Disulfiram- ETOH detox med-make u sick Use Depression -1st^ line drug Anxiety- 1st^ line drug. OCD Eating disorders Social phobias PTSD Panic disorders Depressive episodes Fibromyalgia Anxiety disorders Diabetic neuropathy Panic disorders Side Effects Weight gain/loss Sexual dysfunction Serotonin syndrome Headache Tremors Relentlessness GI symptoms Hypotension Diaphoresis Nocturnal teeth grinding Visual Changes Dizziness Skin rash/Itch Weight gain/loss Anxiety Irregular heartbeat GI symptoms Tremors Diaphoresis Visual Changes Hypotension Dizziness Skin rash/Itch Nursing Considerations Suicidal I dealation Avoid St. Johns Wart Takes 3-4 weeks to work. Take with food Suicidal I dealation Avoid St. Johns Wart Takes 3-4 weeks to work. Same time dosing with food Sexual dysfunction DO NOT MIX with TCA or MAOI’s
NDRI (Norepinephrine-dopamine reuptake inhibitor)
Action Not approved for children Drug name
Bupropion (Wellbutrin, Zyban)
Use Smoking cessation Depression ADHD SAD Side Effect Headaches Seizures hypo-hypertension. Weight gain may cause agitation
Nursing Considerations Takes 3-4 weeks to take therapeutic effect.-Give in the am TID dosing, unless given in ER tabs Avoid TB medication (decrease metabolism of med)AED, TCIs, Benzos, can cause seizures
Benzodiazepines
Benzodiazepines GAMA End in -lam or -pam Anxiolytic Benzodiazepines Action Acute/Short term Acute/Short term
Drug Name^ ^ Lorazepam (Ativan)- PRE-OP
Diazepam (Valium)- avoid grapefruit. Alprazolam (Xanax) Chlordiazepoxide (Librium) CAN CAUSE DEPENDENCY Buspirone (Buspar)-long term panic attacks DOESN’T PRODUCE DEPENDENCY Midazolam (Versed)- PRE-ANESTHESIA -sedation Use Acute anxiety ETOH withdrawal Muscle spasms Seizures Pre-operative Alprazolam (Xanax)- panic disorder* Lorazepam (Ativan)- Status Epilepticus, seizures* EtOH withdrawal Short/long term anxiety Panic attacks long term. Anxiety for adults, elderly & children 6 yrs. Of age & older Midazolam (Versed)-pre-anestesia anxiety colonoscopies produces memory loss Side Effect ^ Can cause over-sedation. Decreased BP-orthostatic. Serious effects on those with liver/renal disease *Alprazolam (Xanax)- Headache/Dry mouth Dizziness and confusion in the elderly Not to be given with MAOIs -severe hepatic or renal hypersensitivity Midazolam (Versed)- Slow HR & RR, lightheaded feeling & sedation Nursing Considerations Avoid ETOH Dependency/abuse issues *Lorazepam (Ativan)- slowly tapered off *Diazepam (Valium)- Avoid GRAPEFRUIT JUICE , antifungal meds, St. Johns wart. Watch for orthostatic Hypotension. Take V/S before giving medication Avoid GRAPEFRUIT JUICE With or w/out food Avoid ETOH, antifungal medications, Herbal meds, Valerian, St. John’s wort, and Kava (increases CNS effects) Multi-time dosing throughout the day- Cumulative effect may take 3-4 weeks before symptoms are relieved. Midazolam (Versed)- drowsy, fall risk, side rails up Antidote /reversal ^ Flumazenil (Romazicon) “I FLU fast in my Mercedes BENZ” V/S before push Slow push IV over 30 seconds.
DO NOT TAKE IF HR, < 60
bpm
Diuretics
Drug Name
Furosemide (Lasix) Hydrochlorothiazide
(HCTZ) (Apo-Hydro
Spironolactone
(Aldactone)
Calcium Gluconate
Action Loop Diuretic Potassium wasting Diuretic. Takes fluid away K+ and Na+ sodium wasting. Produces diuresis and lowers BP. Potassium Diuretic Block aldosterone promotes Na+ and H2o excretion and sparing Potassium. Puts-keeps fluid in Intravenous medication Tx: conditions arising from calcium. deficiencies such as hypocalcemia tetany, hypocalcemia related to hypoparathyroidism, and hypocalcemia due to rapid growth or pregnancy Use Severe- pulmonary edema (cough causes pink frothy sputum) Left sided heart failure Fluid retention & swelling Liver disease Kidney disease Congestive heart failure Hypertension Edema Diabetes Insipidus Calcium containing Calculi. Hepatic/liver failure Postmenopausal osteoporosis Hypertension Diagnostic aid for Aldosteronism Hypokalemia Pitting edema hyperkalemia cardiotoxicity ECG monitoring Antidote for Hypermagnesem ia Side Effects Electrolyte depletion decrease K+ and Na+ GI symptoms Dizziness, headaches, blurred vision Ototoxicity Cold clammy skin, confusion, thirst d/t low serum Na+ Electrolyte depletion decrease K+ and Na+ Dizziness, headaches, blurred vision Cold clammy skin, confusion, thirst d/t low serum Na+ DO NOT give w/ Heparin, Ace inhibitors, Lithium, NSAIDs, or salt substitutes. Weight Loss Hyperkalemia GI symptoms Severe: hyperkalemia- arrhythmias,
Dry mouth
increased thirst
Increased
urination
tingling
sensations
constipation
Cardiac
arrhythmia
decreased BP.
bradycardia
Nursing Conside rations
Do not give in
patients with Sulfa Allergies.
Careful dosing
w/ given with Lithium (induces Lithium Toxicity) Expected effects: vigorous diuresis. Acute hypotension with
Do not give in
patients with Allergies to Sulfa +Thiazide Careful dosing w/ given with Lithium (induces Lithium Toxicity) Expected effects: vigorous diuresis. Acute hypotension with Cold clammy skin, confusion, thirst d/t low serum Na+ Take with food to avoid GI upset Low K+ diet Hypotension Rapid intraveno us injection may lead to symptoms of hypercalcemia. slowly, at a rate of 1. mL/minute ( mg/minute) or less to avoid adverse
volume depletion Increase food rich in K+ volume depletion Increase food rich in K+ reactions. Monitor V/S Monitor Serum Ca+
ANTIEMETIC
Drug Name Ondansetron (Zofran)
Pre-op
Metoclopramide
(Reglan)
Pre-op
Dolasetron Mesylate
(Anzemet)
Action The antiemetic drug blocks serotonin both peripherally on vagal nerve terminals and centrally in the chemoreceptor trigger zone. Prokinetic Blocks dopamine receptors in the chemoreceptor trigger zone cause enhanced motility and accelerated gastric emptying without stimulating secretions. It prevents nausea and vomiting by blocking serotonin peripherally, centrally, and in the small intestine. Use Pre-op to avoid N/V due to anesthesia. chemotherapy Anti-vomiting Slow IV push Check lungs for aspiration GERD, to decrease gastroparesis (motility of the stomach). Anti-vomiting Treat N/V Loss of appetite Heartburn Feeling of fullness Check lungs for aspiration prevention of chemotherapy- induced and post-op N/V Side Effect headache lightheadedness drowsiness dizziness malaise/fatigue. constipation diarrhea Hypotension Restlessness sleepy dizzy diarrhea, exhausted insomnia confusion depression tardive dyskinesia. Hypotension Headache, dizziness, fatigue, drowsiness, hypo/hypertension. tachycardia, bradycardia. Diarrhea, constipation, increased AST/ALT, abdominal pain, anorexia, urinary retention, oliguria. Nursing Considerati ons Bed rails up for safety. QT prolongation, monitor ECG in those with hypokalemia, Slow IV push to prevent a paradoxical reaction Increases QT prolongation- thiazide/loop
EPO ^ surgery
thromboembolic disease the face, arms, or legs
Opioid Analgesic
DRUG NAME
Morphine Sulfate
Oxycodone/ MS
Contin or Oxycontin/
Percocet
Fentanyl (Duragesic)
mcg dosing
“Rage when removing
patch” ACTION Opioid Analgesic Opioid Analgesic Post-op Opioid Analgesic Post-op USE Moderate to severe pain 6 & up Moderate to severe pain postoperative pain relief- soft tissue surgery Moderate to severe pain adjunct to regional anesthesia SIDE EFFECT Drowsiness Dizziness Confusion Sedation Itchy skin change in B/P N/V constipation urinary retention Drowsiness Dizziness Confusion Headache dry mouth GI distress constipation delirium dizziness confusion euphoria sedation weakness Constipation N/V Urinary retention Muscle rigidity
Change the patch
every 72 hours NURSING CONSIDERATIONS Respiratory depression Apnea Seizures Shock cardiac arrest tachycardia thrombocytopenia. Monitor for respiratory depression. opioid withdrawal syndrome from prolonged use Seizures Bradycardia Arrest DVT, PE
respiratory
depression arrest
laryngospasm If used for post-operative pain control- ensure the patch is placed at least one hour before the end of the surgical procedure for full effectiveness ANTIDOTE/ REVERSAL Antidote: Naloxone (Narcan) also, for blood pressure support in septic shock. Increased HR & RR & BP & BP Tremors GI upset If this is used as a reversal for opioids, monitor patient’s pain level post-op
Biologic Response Modifier
Drug Name Use Side Effects Nursing Considerations
Filgrastim
(Neupogen)
Neutropenia Low N eutrophils = N eupogen Nausea Vomiting Arthralgia Alopecia Diarrhe Fever Fatigue skin rash anorexia cephalgia cough chest pain sore throat constipation, dizziness dyspnea. Respiratory distress syndrome if fever and dyspnea occur. Allergic reaction Rash Wheezing facial edema dyspnea.
Xanthine oxidase inhibitors.
Drug Name Use Side Effects Nursing Considerations
light-headedness. Nursing Considerations ^ This is a life-saving medication: Increased risks with known liver impairment- Medication is to be mixed ONLY with Sterile Water for IV PUSH INJECTION Lead to addiction severe drowsiness fast heartbeat mental/ mood changes seizures Trouble breathing.
Influenza
Drug name Oseltamivir (Tamiflu)^ Zanamivir (Relenza) Classification Antiviral-neuraminidase inhibitor -^ Neuraminidase inhibitors Use Infection with influenza Treats & prevents influenza. Shortens time you have symptoms Side Effects ^ Nausea/Vomiting,Diarrhea Dizziness, Headache Nosebleed eye redness discomfort, sleep problems (insomnia) Headache, Dizziness, Nausea, Vomiting, Diarrhea Cough, Wheezing, trouble breathing ear pain., cold symptoms such as stuffy nose, sneezing, and sore throat. Action. release of viruses from infected cells and facilitates viral movement within the respiratory tract. work by stopping the growth and spread of the flu virus in your body. Nursing Considerations ^ Take within 48 hours of the onset of symptoms. TAMIFLU does not take the place of receiving a flu vaccination. Patients aged 7 years and older who have been symptomatic for no more than 2 days.
Antibiotics
Drug Name Cephazolin (Ancef,
Kefzol)
Cefazolin
(Ancef, Kefzol)
Vancomycin
Action infection Timing of antibiotic administration is critical to efficacy. The first dose should always be given before the procedure, preferably within 30- 60 minutes before the incision. First generation cephalosporin killing bacteria or preventing their growth inhibits transpeptidation by binding to D- alanyl-D-alanine residues of the bacterial cell wall Use Prophylaxis reduces the incidence of surgical wound infection. Bacterial infections Preoperative prophylaxis infection of the intestines caused by Clostridium difficile. treat colitis (inflammation of the intestine caused by certain bacteria) that may occur after antibiotic treatment.
Calcium Channel Blocker
Module 5
Drug Name Atropine Sulfate Etomidate (Amidate) Rocuronium (Zemuron)
Classification Antimuscarinic agent PRE-OP Neuromuscular Blocker PRE-OP Paralytic-non-depolarizing neuromuscular blocker Emergent PRE-OP Action Pre-Op reduces salivation and bronchial secretions. IV anesthetic agent used for the induction of general anesthesia and sedation for short procedures to produce muscle relaxation Use Treat bradycardia- low HR Reduces secretions & salivation. Dislocated joints tracheal intubation cardioversion, electroconvulsive produce muscle relaxation to help facilitate surgery and ventilation of the lungs in elective and emergent situations. Side Effect Headache GI upset Upper GI distress bitter taste. reddish rash on face and upper body (intravenously: red neck or Vancomycin Flushing Syndrome, related to infusion rate) Low blood pressure accompanied by flushing. Severe: ototoxicity, nephrotoxicity Nursing Considerations It must be diluted with sterile water. Can be given IV push 3-5 minutes Check infusion site Monitor BUN and creatinine. Slow IV administer. Trough levels are collected just prior to a person's next vancomycin dose. [10-15 mcg/mL] Peak levels are collected 1 to 2 hours after the completion of the intravenous vancomycin dose. [25- 40 mcg/ml] Classification Cephalosporin antibiotics Cephalosporin antibiotics Glycopeptide/Bactericidal Drug name Class Use Side Effect Action Nursing Considerations
Nifedipine
(Procardia)
End in
-pine
Calcium Channel Blocker (CC)
HTN
Control angina (chest pain) Raynaud’ s Burgers Disease Headache nausea. Dizziness lightheadedness. flushing (reddening of the skin), heartburn Muscle cramps constipation. cough. Hypotension lowers blood pressure by relaxing the blood vessels so the heart does not have to pump as hard. Take med same time every day. the extended-release tablet should be taken once daily on an empty stomach, either 1 hour before or 2 hours after a meal. Rise slowly from lying or sitting to avert orthostatic hypotension
muscles. (^) Avoid bronchospasm caused by exercise Rescue inhaler-short acting pain.
Ipratropium
Bromide
(Atrovent)
that relaxes muscles in the airways and increases airflow to the lungs.
COPD
chronic bronchitis emphysema Long acting-nebulizer Bronchodilator Dyspnea Headache throat irritation. Cough dry mouth, gastrointestinal motility disorders (including constipation, diarrhea, and vomiting), nausea, and dizziness. Do not use two doses at one time. Do not use more than 12 inhalations in 24 hours. Do not get this medicine in your eyes, especially if you have glaucoma.
Fluticasone/
Salmeterol
(Advair)
is used in children 12 years of age and older
COPD
Asthma Decrease inflammation of the lungs Prevents acute asthma. Long acting Steroid-long- acting beta- agonists (LABAs) Diarrhea N/V Glaucoma increased pressure in your eye, cataracts, or other vision changes. RINSE MOUTH AFTER INHALING CAN CAUSE CANDIDIASES-(fungal infection) Breathe in your mouth as deeply as possible until you take a deep breath. Do not breathe through your nose. Hold your breath and remove the mouthpiece from your mouth. Hold your breath for 10 seconds. exhale. 2 puffs Powder form
Theophylline
(Elixophyllin,
Theo-24)
The therapeutic level is 5-15 mcg/mL
COPD
Asthma 2 nd^ line-meds-for immediate use when albuterol is not working Toxic levels are exceeding 20mcg/mL (hyperglycemia, decreased clotting time, increased WBC Caffeine can increase the risk of toxicity and severe adverse effects. Methylxanthine (^) GI symptoms Restless Headache insomnia GERD Dizziness N/V Diarrhea Hypokalemia Hypercalcemia Palpitation tachycardia. Rapid IV administration : Dizziness, flushing, narrow therapeutic window levels slightly above this therapeutic window can have many adverse effects in the setting of acute and chronic toxicity. 10-20 mEq/mL
Montelukast
(Singular)
Blocks the action of leukotrienes. The body uses fatty signaling molecules during inflammation and allergic reactions. asthma and allergic rhinitis (sneezing, stuffy nose, runny nose, itching of the nose) prevent exercise-induced asthma. Leukotriene receptor antagonists (LTRAs) Headache Stomach pain. Heartburn upset stomach. nausea diarrhea Tooth pain. tired Dizziness Fever stuffy nose sore throat cough hoarseness Mild rash. taken simultaneously daily, even if your asthma seems better. You may take this medicine with or without food. Take at bedtime
Prednisone
(Deltasone)
DOSING PO:
Loading dose then daily decreases DOSING: Inhalation is not given during acute attacks because it may take 1- 4 weeks for an inhaled steroid to reach its full effect Control inflammation of joints & organs Pneumonia Swelling & pain Treats redness, pain & swelling Anti- inflammatory agents, known as corticosteroi ds. Increase BP Immunosuppressi on by decreasing WBC count Stimulant Increases blood sugar. -Loss of bone density-long-term use = Osteoporosis Cushing’s Syndrome increase in fluid retention = to increase in blood pressure -Weight gain Monitor for signs of Cushing’s Syndrome May require additional diabetic medication coverage. It may require an increased dose of HTN meds. Patient prone to infection Weight monitoring SAFETY- FALLS Take with food. ***Do not discontinue abruptly slow titration to discontinue medication Causes hyperglycemia - high BS
ACE INHIBITOR & ARB
because it can cause a life-threatening condition called Reye's syndrome.
Cardiac Glycoside
Drug name Class Use Side Effect Action Nursing Considerations
Nitroglycerin
Can be given SL, PO, IV, or Transdermal (patch or cream). can use 3x to treat angina.
Nitrate
stable angina unstable angina increases blood flow. wear gloves. if chest pain isn’t treated call 9-1- cause heart attack. Headache Causes basil dilatation. orthostatic hypotension Dizziness Weakness Fainting Flushing dry mouth reflex tachycardia Versatile many routes: sublingual Translingual- spray transdermal patches ointment- Intravenous Sublingual administration assess for pain. repeat med after 5 minutes. if BP stable, a total of 3 times. Keep the medication in the same container. photosensitivity, check expiration date- ineffective after expiration date.
Digoxin
Immune fab for
reversal of
toxicity.
Cardiac
Glycosi
de
A-Fib A-Flutter Dysrhythmia Assess apical pulse for a minute Causes bradycardia Creatinine clearance serum digoxin levels electrolytes K+, Na+, Mg., Ca++ levels- can interfere and result in change in Na+/K+- ATPase pump. Parenteral or PO dosing IV: 2.4 to 3. mcg/kg once daily PO: 3.4 to 5. mcg/kg once daily Digoxin levels should be between 0.8 and 2.0 ng/ml. Assess apical pulse for 1 minute; if < 60, take again in 1 hour; if < 60 call prescriber with rate rhythm-hold medication ECG monitoring The toxic range for digoxin is greater than 2.5 ng/mL 10% of patients may show toxicities at levels less than 2 ng/mL (particularly in hypokalemia, hypomagnesemia, hypoxia, heart disease, & hypercalcemia.
Digoxin Toxicity Cardiac
Glycoside Heart Treats A-Fib Do not give with HR lower than 60 bpm. Do not give with beta blockers it will affect HR & drop K+ Early signs: Visual changes- halos around lights Lack of appetite N&V, Headache Confusion Anxiety Restlessness Weakness Changes in heart rhythm Parenteral or PO dosing Safety when taking Digoxin to prevent toxicity: Take only as directed. Do not stop taking digoxin abruptly. Do not take herbal medications. Follow-up with PCP regularly WEAR A MEDICAL ALERT JEWELRY
Anticoagulant
DRUG NAME Heparin Warfarin
(Coumadin)
MINIMIZE GREEN
LEAFY VEGETABLES
Enoxaparin Apixaban
(Eliquis)
Dabigatran
(Pradaxa)
Rivaroxaban
(Xarelto)
CLASS anticoagulant ANTIDOTE:
STOP
INFUSION
PROTAMINE
SULFATE
Oral anticoagulant ANTIDOTE:
Vit. K. FOR
INR
HIGHER THAN 3.5 - 4
Low molecular weight Anticoagulant [made from Heparin]
Not an IV
Direct Oral Anticoagulants (DOACs) USE prevents blood clots. used before surgery blood clots in veins or arteries. reduce the risk or prevent stroke, heart attack, or other serious conditions blood clot- deep vein thrombosis (DVT) blood clots in the lungs (pulmonary embolism) A-Fib dysrhythmia SIDE EFFECT ^ Easy bleeding &bruising. Pain redness, warmth irritation, or skin changes where the medicine was injected. itching of your feet; or. bluish-colored skin. Skin Assessment for: Heparin-induced Thrombocytope nia Petechia Easy bleeding Heavy menstrual Red or brown urine. Black or bloody stool. Severe headache stomach pain. Joint pain, Discomfort Swelling an injury. Vomiting of blood or looks like coffee grounds. Coughing up blood. bleeding. anemia Low RBCs Site pain Site bruising Fever Leg swelling. bleeding and compliance parameters should be considered for all patients. No routine anticoagulation studies are required. ACTION that prevents the formation of blood clots. anticoagulant a drug that inhibits the clotting of blood. It prevents blood clot formation by reducing the liver's production of factors that promote clotting. Due to its low molecular weight, it has less activity against factor IIa (thrombin) than unfractionated heparin That helps prevent the formation of blood clots. PO Dosing x 2 daily because of short half-life NURSING CONSIDERATION Heparin aPTT monitoring PT=Prothrombin Time
Interacts with:
Aspirin
Acetaminophen
Usually given for prophylaxis No routine test Routine monitoring of renal and hepatic function, signs/symptoms of
ex vitami n infarction hyperlipidemia mixed dyslipidemia increase HDL Sudden warmth, redness Tingly feeling Upset stomach. Vomiting Diarrhea Itchy dry skin Skin discoloration or headache TC, LDL-C, Apo B, and TG levels and to increase HDL-C
BEFORE STARTING
THERAPY
Low-fat diet No EtOH Avoid EtOH
STATINS
Drug name Class Use Side Effect Nursing Considerations Atorvastatin (Lipitor) -STATIN Inhibits 3-hydroxy- 3- statin (^) Decrease cholesterol and fats (such as LDL, HDLtriglycerides ) and raise Gastrointestinal symptoms:
diarrhea.
Cold symptoms
Runny/stuffy nose.
joint pain.
Insomnia.
Urinary tract infection.
Nausea.
Loss of appetite.
Indigestion symptoms
stomach discomfort or pain
Liver Functions – AST/ALT BEFORE STARTING THERAPY Report leg cramping- dose may need to be reduced. Take it at night (to mimic the liver function of producing cholesterol) Grapefruit and grapefruit juice may interact effects. Avoid the use of grapefruit products while taking atorvastatin. Avoid eating foods that are high in fat or cholesterol and EtOH.
Action: statin medications decrease cholesterol production in the liver and increase the number of LDL receptors on
the surface of hepatic cells
"good" cholesterol (HDL) in the blood. It belongs to a group of drugs known as "statins." It works by reducing the
amount of cholesterol made by the liver.
Cholesterol-reducing
Drug name Class Use Side Effect Nursing Considerations Ezetimibe (Zetia) Cholesterol- reducing Reduces reabsorption of cholesterol
Reduces blood cholesterol.
hypercholesterolemic
patients inhibited intestinal cholesterol absorption.
Diarrhea,
back pain
Stomach
abdominal pain
Numbness or tingly feeling
Tired feeling
Headache
Dizziness
Depressed mood
Serious effects:
liver disease.
myopathy/rhabdomyolysis.
renal impairment
Liver Functions – AST/ALT BEFORE STARTING THERAPY Be aware of the risk of myopathy and be told to report promptly any unexplained muscle pain, tenderness, or weakness. Pregnancy. Breastfeeding. Pregnancy Category C. Grapefruit and grapefrui t juice may interact with this medicine and lead to unwanted side effects. Therefore, avoid the use of grapefruit. Avoid eating foods that are high in fat or cholesterol and EtOH.
Antidiabetic Oral
Antidiabetic Injectables
Drug name Class Use Side Effect Action Nursing Considerations
Dulaglutide
(Trulicity)
Exenatide
(Byetta)
Liraglutide
(Victoza
End in -TIDE
Antidiabetic Injectables
Type II
Diabetes
Not a
replacemen t for insulin
Take if DM
is not controlled by oral therapy
Hypoglycemia
Pain at the injection site
Anorexia
Report signs of GI upset
may be early S&S of
pancreatitis Can cause weight loss
Glucose
Monitoring
S & S of
Hypoglyce mia,
headache,
irritability,
shakiness.
Encourage a
healthy diet and exercise. Drug Name Metformin (Glucophage)^ Micronase (Glyburide) Use Tx: Type II Diabetes-oral^ Tx: Type II Diabetes-oral Bad for the heart Action ^ Lowers glucose levels. Blocks glucose production from the liver and prevents glucose reabsorption in the intestines. Stimulates the pancreas to produce more insulin.
Side effects ^ GI upset
Hold 48 hours before a procedure using
contrast dye and wait 48 hours after the procedure to resume medication. IT DOES NOT CAUSE HYPOGLYCEMIA
Hypoglycemia
Weight Gain
Severe effects for those with liver/renal
disease
Interacts with many medications-
potentiates the antidiabetic effect- Check with PCP. Classification Biguanides Oral -Antidiabetic^ Sulfonylurea
Nursing Diagnosis ^ Glucose Monitoring
Multi-day dosing
Base-line BUN & creatinine before Rx.
Encourage a healthy diet and exercise.
Avoid EtOH,
may induce Lactic Acidosis
Glucose Monitoring
S & S of Hypoglycemia
Headache
irritability
shakiness
Encourage a healthy diet and exercise
