Chamberlain College of Nursing: NR 293 Exam 2 Study Guide

Know the indications, contraindications, adverse effects, interactions and safety/patient teaching for each class of drugs we covered in class. Remember to review specific exemplars of each class such as: Morphine: I ...

Know the indications, contraindications, adverse effects, interactions and safety/patient teaching for each class of drugs we covered in class. Remember to review specific exemplars of each class such as: Morphine: Indications Contraindications adverse effects interactions safety/patient teaching Acetaminophen Indications Contraindications adverse effects interactions safety/patient teaching Diazepam Indications Contraindications adverse effects interactions safety/patient teaching Phenobarbital Indications Contraindications adverse effects interactions safety/patient teaching Orlistat Indications Contraindications adverse effects interactions safety/patient teaching Methylphenidate hydrochloride Indications Contraindications adverse effects interactions safety/patient teaching Opioid Class II Narcotic Moderate to severe pain Epilepsy, heart, liver and kidney disease Allergy S/Sx, SOB, Edema to LE, CONSTIPATION NO MAOi's w/in 14days of taking Morphine, Monitor if taking vitamins/herbals, Avoid Alcohol Talk to MD before taking if you are preg/breast feeding. **Habit forming/high risk for dependence. Non-Opioid OTC Fever, Mild to moderate pain DO NOT take if you have any conditions involving the LIVER! Allergy S/Sx, bloody/black tary stool, sweating, tired feeling. Monitor PT/INR if patient is taking with an anti-coagulant. Don't exceed 3000mg in adults and 2000mg in the elderly and children. **Will not treat inflammation! Benzodiazepines Class II Narcotic Used to treat anxiety, muscle spasms, and seizures if you are pregnant, or if you have narrowangle glaucoma or untreated open-angle glaucoma, myasthenia gravis, sleep apnea or severe breathing problems, or severe liver disease. Allergy S/Sx, Seizures, confussion, lethragy, Nausea, lightheaded or dizziness. MAOis, Theophylline, RX for depression, seizures, or any medication ending in -azine To much of this drug will cause death, don't use if you are preg/breast feeding, have liver or kidney disease. **This drug is habit forming. Barbiturates Class IV Narcotic Phenobarbital is used to control seizures, also used to prevent withdrawal symptoms in people who are dependent on another barbiturate medication Dizziness, drowsiness, excitation, headache, tiredness, loss of appetite, N/V A personal or familial history of acute intermittent porphyria patients with marked impairment of liver function, or respiratory disease, or if you are taking Sodium oxybate (GHB) Drugs for anxiety, depression, pain, asthma, colds, or allergies. Certain medications for seizures such as phenytoin (Dilantin) and valproate (Depakene), Sodium oxybate (GHB) Don't take if you are pregnant, planning on becoming pregnant otr breast feeding. Don't use if you suffer from depression, or have ever had suicidal ideations. Lipase inhibitors It can help patients reach and maintain a healthy weight. Do not use this medicine if you had an allergic reaction to orlistat or if you are pregnant. Allergy S/Sx, Dark urine, pale stool, yellowing of the skin or eyes, sharp back pain, severe stomach pain, N/V, severe diarrhea RX to treat DM II, such as insulin, seizures, or anticoagulants. Cyclosporine should be taken 3h after, Levothyroxine 4h before, MVI 2h before. This medication may cause liver damage, kidney stones, gallbladder bile flow problems. It is not safe to take this medicine during pregnancy. It could harm an unborn baby. It can treat ADHD and narcolepsy CNS Stimulant if you have glaucoma, an overactive thyroid, muscle tics, or a history of Tourette syndrome. Allergy S/Sx, vision changes, chest pain, n/v, unusual sweating, drymouth, stomach pain, loss of appetite. Guanethidine, phenylbutazone, stomach medicine, BP medicine, anticoagulants, -Ramines, phenobarbital, phenytoin, primidone, alcohol This medication is habit forming, don't take with a HX of high BP, phenylketonuria, thyroid problems, MI, CVA, Seizures. HX of drug/alcohol abuse.Ergot alkaloids Indications Contraindications adverse effects interactions safety/patient teaching Phenytoin Indications Contraindications adverse effects interactions safety/patient teaching Levodopa-carbidopa Indications Contraindications adverse effects interactions safety/patient teaching Benztropine Indications Contraindications adverse effects interactions safety/patient teaching Amantadine Indications Contraindications adverse effects interactions safety/patient teaching Risperidone Indications Contraindications adverse effects interactions safety/patient teaching Haloperidol Indications Contraindications adverse effects interactions safety/patient teaching MAOIs Indications Contraindications adverse effects interactions safety/patient teaching Viral m2 channel inhibitor/ Dopamine agonist It can treat and prevent the flu (influenza type A). It can also treat Parkinson's disease and parkinsonlike symptoms caused by certain medications narrow-angle glaucoma, heart disease, kidney disease, liver disease, low blood pressure, swelling or water retention, epilepsy, or a history of seizures. Tell your doctor if you also have a history of eczema or neuroleptic malignant syndrome (NMS) Allergy S/Sx, ∆ in amount that you urinate, Flu like S/Sx, mood ∆, uncontrolled muscle movement, tachypnea, tachycardia, purple patches on the skin. RX ending in -azide, bactrim, quinine or quinidine, diet pills, diarrhea mental disorders, urinary problems, diet pills, 48h after of Flumist, or 2 weeks before Don't drink alcohol, don't take if you are pregnant or brestfeeding. Dopamine precursor It can treat Parkinson's disease. pregnant or breastfeeding, kidney, liver disease,endocrine problems, lung or breathing, a sleep disorder, heart or blood vessel problems, heart rhythm problems, or a history of heart attack. wide-angle glaucoma, phenylketonuria (PKU), or a history of stomach ulcer or mental illness. Allergy S/Sx, chest pain, difficulty breathing, conpulsive behaviors MAOi's within 14d, isoniazid, reglan, dilantin, risperdone, tetrabenazine, a phenthiazine (-azine), BP medications This medicine is not right for everyone. Do not use it if you had an allergic reaction to carbidopa or levodopa, or if you have narrow-angle glaucoma, .skin lesions, or a history of skin cancer. Do not stop using this medicine suddenly. Your doctor will need to slowly decrease your dose before you stop it completely. Antipsychotic It can treat certain types of mental disorders. It can also control symptoms of Tourette syndrome pregnant or breastfeeding, or if you have liver disease, kidney disease, heart or blood vessel disease, blood pressure problems, overactive thyroid, or history of seizures or breast cancer. Allergy S/Sx, unrination ∆, ∆'s in vision, flu like s/sx, HA, increased confussion, balance problems, increased fall risk Anticonvulsant It can treat and prevent seizures. May interact with some BP medication, lithium, phenindione, RX for TX of seizures, or parkinsons. Don't drink alcohol with this medication. You should not use this medicine if you have had an allergic reaction to haloperidol, or if you have Parkinson disease. This medicine should not be given to patients with severe brain disease. breastfeeding, or if you have kidney disease, liver disease, depression, diabetes, or porphyria. Increased r/o suicidal thoughts, serrious skin reactions, liver damage.Decreased blood lvls, bleeding problems, increased CBG's St John's wort, albendazole, amiodarone, aspirin, chlordiazepoxide, cyclosporine, diazepam, diazoxide, digoxin, disulfiram, folic acid, furosemide, isoniazid, methylphenidate, nisoldipine, praziquantel, quinidine, reserpine, ifampin, sucralfate, theophylline, tolbutamide, or vitamin D. Do not take an antacid or supplement that contains calcium, aluminum, or magnesium at the same time you take phenytoin. Take the antacid or supplement at a different time of day. Do not drink alcohol while you are using this medicine Antipsychotic It can treat schizophrenia, bipolar disorder, and irritability caused by autism. pregnant, breastfeeding, or if you have kidney disease, liver disease, diabetes, high cholesterol, Parkinson disease, trouble swallowing, or a history of breast cancer or seizures. Tell your doctor if you have heart failure, low blood pressure, or a history of a heart attack or stroke. Allergy S/Sx, tarditive diskensia, Flu s/sx, prolonged erection, swelling of breast Some foods and medicines can affect how risperidone works. Tell your doctor if you are using carbamazepine, clozapine, fluoxetine, furosemide, levodopa, paroxetine, phenobarbital, phenytoin, quinidine, rifampin, or blood pressure medicine. This medicine may make you drowsy or dizzy. Do not drive or do anything else that could be dangerous until you know how this medicine affects you. This medicine may change how your body regulates temperature. Avoid activities that could cause you to become very cold, hot, or dehydrated. This medicine may make you bleed, bruise, or get infections more easily. Take precautions to prevent illness and injury. Wash your hands often. Central muscarinic antagonist It can treat Parkinson's disease and side effects of other drugs. pregnant or breastfeeding, or if you have glaucoma, bowel or stomach problems, an enlarged prostate, heart disease, or heart rhythm problems. Tell your doctor if you have a history of mental problems, or if you have a disease that affects your nervous system. Tell your doctor if you have jerky muscle movements caused by another medicine. Allergy S/Sx, hallucinations, constipation, abd pain, dry mouth, troubleswallowing, loss of appetite, weight loss, unable to sweat. This medicine may keep you from sweating enough, which may cause your body to get too hot. Be careful in hot weather, and while you exercise or use a sauna or whirlpool. This medicine may make you drowsy or cause you to have trouble thinking clearly. Do not drive or do anything that could be dangerous until you know how this medicine affects you. Tell your doctor if your neck muscles become stiff and suddenly weak. Your doctor may need to lower the dose you are taking. Haloperidol, A phenothiazine medicine, such as prochlorperazine, chlorpromazine, perphenazine, promethazine, thioridazine, A tricyclic antidepressant medicine, such as amitriptyline, doxepin, nortriptyline Monoamine oxidase inhibitor Monoamine oxidase inhibitors are chemicals that inhibit the activity of the monoamine oxidase enzyme family. They have a long history of use as medications prescribed for the treatment of depression. amphetamines,dopamine, ephedrine, levodopa, phenylpropanolamine and pseudoephedrine.MAOIs inhibit other drug-metabolising enzymes and may enhance the effects of barbiturates and possibly of other hypnotics, hypoglycaemic agents, antimuscarinic agents, beta blockers and thiazide diuretics. NO SSRI's with MAIO's cheese, pickled herring, meat/yeast extracts and fermented soya bean extract. a confirmed or suspected cerebrovascular defect or any patients with cardiovascular disease or confirmed or suspected cerebrovascular defect, hypertension, or history of headache. known hypersensitivity to isocarboxazid. pheochromocytoma, as such tumors secrete pressor substances whose metabolism may be inhibited by Marplan.a history of liver disease, or in those with abnormal liver function tests. severe impairment of renal function. See below ASE:: feeling dizzy when you stand up (postural hypotension). It is more likely to happen if you are older. Less commonly, some people have drowsiness, difficulty sleeping, headache, weakness and tiredness, a dry mouth, or constipation.Lithium Indications Contraindications adverse effects interactions safety/patient teaching SSRIs Indications Contraindications adverse effects interactions safety/patient teaching Naltrexone Indications Contraindications adverse effects interactions safety/patient teaching Disulfiram Indications Contraindications adverse effects interactions safety/patient teaching Cholinergics Indications Contraindications adverse effects interactions safety/patient teaching Anticholinergics Indications Contraindications adverse effects interactions safety/patient teaching Warfarin Indications Contraindications adverse effects interactions safety/patient teaching Thrombolytics Indications Contraindications adverse effects interactions safety/patient teaching nausea, diarrhea, dizziness, muscle weakness, fatigue, and a dazed feeling. Fine tremor, frequent urination, and thirst can occur and may It can treat and prevent manic episodes of bipolar disorder. Lithium should generally not be given to patients w/ significant renal or cardiovascular disease, severe debilitation or dehydration, or sodium depletion, and to patients receiving diuretics, since the risk of Lithium toxicity is very high in such patients. MAOIs, RX for depression, Robitussin, ACE inhibitors, Ca channel blockers, and many others. If you miss a dose of lithium, take it as soon as possible. However, i f it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses. They mimic the effects of acetylcholine and stimulate the parasympathetic nervous system. Indirect-Myasthenia Gravis & Alzheimer's DX Direct-Glaucoma & Atony/Neurogenic Bladder GI or GU tract obstruction, Bradycardia,Hyperthyroidism, Epilepsy, Hypotension, COPD, Parkinsons Disease Bradycardia, hypotension, conduction abnormalities, Headache, dizziness, convulsion, Abd cramps, increased secretions, N/V, Increased bronchial secretions, bronchospasms, Lacrimation, sweating, salivation, loss of binocular accommodation, miosis. -Anticholinergics, Antihistamines, Sympathomimetics Medications should not be stopped abruptly and taken as ordered. Toxicity S/Sx: SLUDGE S*Salivation, L*Lacrimation, U*Urinary Incont, D*Diarrhea, G* GI cramps, E* Emesis Depression -Panic disorder - Social anxiety disorder/social phobia - Bulimia nervosa Children and with Mania associated with Bipolar disorder. MAOIs, other SSRIs, st. Johns wart, anti-platelet RX Mild Sedation, GI Upset, urticaria, Hallucinations, Hyponatraemia, galactorrhoea, Urinar retention, Convulsions Patients should take the RX for 4-8 weeks before determining if it is effective *Drug Allergy, Narrow-angle glaucoma, Acute asthma, Myasthenia gravis, Respiratory distress, Acute cardiovascular instability, GI/GU obstructions Antihistamines, phenothiazines, MAOI's and TCA's *High risk of heat stroke in geriatric patients, so limit higher temperatures, physical exertion, and/or exercise, and stress fluid and salt intake Increased HR, dysrhythmias, Decreased bronchial secretions, Excitation, restlessness, irritability, disorientation, hallucinations, and delirium, Decreased salivation, GI motility, and gastric secretions, Urinary retention, Decreased sweating Anticholinergic drugs block or inhibit the actions of acetylcholine (ACh) in the PNS "Drugs that prevent the formation of a clot by inhibiting certain clotting factors."--essentially anticoagulants stops blood from clotting. Anti-Coagulant Warfarin is strongly contraindicated in pregnant woman Bleeding is the main complication There are many drugs that effect the action. Must have lab monitoring for PT/INR 2-3 is theraputic range for most patients. *Breaks down EXISTING clots* All thrombolytic drugs activate the conversion of plasminogen to plasmin Used for acute MI, arterial thrombosis, DVT, occlusion of shunts or catheters, pulmonary embolism, and acute ischemic stroke KDAs Any other drugs that alter clotting Internal, intracranial, and superficial bleeding, hypersensitivity, anaphylactoid reactions, nausea, vomiting, hypotension, and cardiac dyssrhythmia Increased bleeding when in concurrent use with anticoagulants, antiplatelets, or any other drug affecting platelet function It can treat problem drinking by creating an unpleasant reaction to alcohol. It's used in recovery programs that include medical supervision and counseling. Alcoholism medication severe myocardial disease or coronary occlusion, psychoses, and hypersensitivity to Disulfiram or to other thiuram derivatives used in pesticides and rubber vulcanization drowsiness, tiredness, headache, acne, metallic or garlic-like taste in the mouth, skin rash or acne, i mpotence, and swollen or sore tongue Anti-coagulants, isoniazid, caffiene Do not drink alcohol while taking disulfiram. Flushing, fast heartbeats, nausea, thirst, chest pain, vertigo, and low blood pressure may occur when alcohol .is ingested during disulfiram therapy. Do not take disulfiram for at least 12 hours after drinking alcohol. It can help prevent relapses into alcohol or drug abuse Acute hepatitis or liver failure, or patients on opioid medication or w/in 14days N/V, diarrhea, or constipation. Abd pain or cramping. Loss of appetite.HA. Dizziness.Nervousness, irritability, or anxiety.Tearfulness.Increased or decreased energy. Opioids May be at risk for Opioid addiction after taking medicationHeparin Indications Contraindications adverse effects interactions safety/patient teaching Enoxaparin Indications Contraindications adverse effects interactions safety/patient teaching Antitussives Indications Contraindications adverse effects interactions safety/patient teaching Albuterol Indications Contraindications adverse effects interactions safety/patient teaching Salmeterol Indications Contraindications adverse effects interactions safety/patient teaching Corticosteroids Indications Contraindications adverse effects interactions safety/patient teaching Ipratropium Indications Contraindications adverse effects interactions safety/patient teaching Allopurinol Indications Contraindications adverse effects interactions safety/patient teaching Binds to a substance called antithrombin III, which turns off three main activating factors (activated factor II, X, and IX) Heparin-induced thrombocytopenia (HIT), 2 types: Type I-more gradual reduction in platelets Type II- acute fall in the number of platelets Known drug allergy, patients on coumadin prevention and treatment Differ from Heparin- more specific for activating factor X as oppososed to factor II, Indicated for prevention and treatment patients with an indwelling catheter bleeding, hematoma, dizziness, confusion, rash, GI distress, UTI, anemia, urinary retention It can prevent asthma attacks and exercise-induced bronchospasm. It can also treat COPD, including chronic bronchitis and emphysema. Anti-Coagulant Bronchodilator LMWH, Anti-Coag pregnant or breastfeeding, or if you have liver disease, heart or blood vessel disease, heart rhythm problems, high blood pressure, diabetes, epilepsy or seizures, thyroid problems, or low potassium in the blood. hoarseness, throat irritation, headache, rapid heartbeat, nervousness, dizziness, lightheadedness, insomnia, sweating, cough, dry mouth/throat, upset stomach, n/v, or diarrhea Salmeterol will not stop an asthma attack or other sudden, severe breathing problems once they have already started. Anti-Fungals, HIV RX, Macrolides, diuretics, COMTinh, beta-agonist, Beta-blockers, MAOIs Other anti-coags, antihistamines, antithrombin III, ASA, or other NSAIDs that contian ASA Heparin can cause you to have bleeding episodes while you are using it and for several weeks after you stop. anticoagulants, platelet inhibitors including ASA, salicylates, NSAIDs (including ketorolac tromethamine), dipyridamole, or sulfinpyrazone It is important that you give the injections at the same time each day. Skin bruises, itching, and bleeding around the injection site, can occur. are used to provide relief for inflamed areas of the body. They lessen swelling, redness, itching, and allergic reactions. They are often used as part of the treatment for a number of different diseases, such as severe allergies or skin problems, asthma, or arthritis dysphonia, hoarseness,oropharyngeal fungal infections,headache sore throat,nasal congestion , cold symptoms, N/V, diarrhea unpleasant taste upset stomach active untreated infections (except meningitis), some products contain alcohol and should be avoided in patients with known intolerance, minimally with lactation drugs resulting in decreased cortisone in the blood (e.g. rifampicin, carbamazepine, phenobarbital, phenytoin, primidone) or decrease the gastrointestinal absorption of cortisone (e.g. gastric dressing) lithium (corticosteroids decrease blood levels of lithium) Monitoring must include regular monitoring for side effects of oral steroids and to ensure that the appropriate dose of oral steroid is being prescribed, as well as monitoring of the disease being treated. suppress coughing, possibly by reducing the activity of the cough center in the brain. Increased Pressure in the Eye, Closed Angle Glaucoma, Chronic Difficulty having a Bowel Movement, High Blood Pressure, Stenosing Peptic Ulcer, Blockage of Urinary Bladder, Enlarged Prostate, Cannot Empty Bladder, Overactive Thyroid Gland Drowsiness, dizziness, headache, blurred vision, upset stomach, nausea, constipation, or dry mouth/nose/throat may occur Guaifenesin If your doctor prescribed this medication, do not share this medication with others bronchodilator treating, symptoms of asthma, colds, allergies, and COPD due to emphysema or chronic bronchitis hypersensitivity to atropine and related substances. For oral administration, contraindications are similar to other anticholinergics; they include narrow angle glaucoma and obstructions in the gastrointestinal tract and urinary system. hypersensitivity, pharyngeal edema, mouth edema, urinary retention, mydriasis, bronchospasm Interactions with other anticholinergics like tricyclic antidepressants, antiparkinson drugs and quinidine, which theoretically increase side effects, are clinically irrelevant when ipratropium is administered as an inhalant Allow 1 to 2 min between inhalations. Bronchodilator It can treat or prevent bronchospasm. Paradoxical Bronchospasm, High Blood Pressure, Diminished Blood Flow through Arteries of the Heart, Disease of Inadequate Blood Flow to the Heart Muscle, Prolonged Q-T Interval on EKG, Abnormal Heart Rhythm, Abnormal EKG with QT changes from Birth, Seizures, Overactive Thyroid Gland, Diabetes, Ketoacidosis, Excess Body Acid, Low Amount of Potassium in the Blood bronchospasm (wheezing, chest tightness, trouble breathing), especially after starting a new canister of this medicine; nervousness; shaking (tremor); headache; chest pain and fast, pounding, or irregular/uneven heartbeats Beta blockers such as atenolol (Tenormin), labetalol (Normodyne), metoprolol (Lopressor, Toprol XL), nadolol (Corgard), and propranolol (Inderal) Digoxin (Lanoxin), Diuretics (water pills), Epinephrine It is important to keep this medication on hand at all times. Uric acid reducer It can treat gout and kidney stones. Chronic Heart Failure, Allergic Reaction causing Inflammation of Blood Vessels, Liver Problems, Extreme Loss of Body Water, Moderate to Severe Kidney Impairment Stomach upset, nausea, diarrhea, or drowsiness may occur Some products that may interact with this drug are: certain asthma drugs (aminophylline, theophylline), azathioprine, "blood thinners" (e.g., warfarin), chlorpropamide, cyclosporine, didanosine, mercaptopurine. This drug may make you drowsy. Do not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely.Iron supplements (tablets and liquids) Indications Contraindications adverse effects interactions safety/patient teaching Iron dextran Indications Contraindications adverse effects interactions safety/patient teaching Folic acid Indications Contraindications adverse effects interactions safety/patient teaching Make sure you know the lab values I pointed out to you in class, and think about how your nursing care is related to the lab values. Some (but not all) of the main points we covered are: Opioids and related safety issues, patient teachings The differences in how we treat overdoses of opioids, benzodiazepines and barbiturates. Iron deficiency anemia stomach upset and pain, constipation or diarrhea, nausea, and vomiting certain iron metabolism problems (eg, hemosiderosis, hemochromatosis) or high levels of iron in the blood Doxycycline, mycophenolate, penicillamine, or thyroid hormones (eg, levothyroxine) because their effectiveness may be decreased by iron Take iron with a full glass (8 oz [240 mL]) of water Do not lie down for 30 minutes after taking iron. Take on an empty stomach iron deficiency anemia heart disease; liver disease; kidney disease (or if you are on dialysis); rheumatoid arthritis; bleeding or blood clotting disorder such as hemophilia;stomach bleeding;asthma or allergies;if you are allergic to any medication; or if you use a beta-blocker medicine- olol fast or slow heartbeats. chest pain, wheezing, trouble breathing; a light-headed f eeling, like you might pass out; flushing (warmth, redness, or tingly feeling); bluecolored lips or fingernails; red or pink urine; weak or shallow breathing (breathing may stop); seizure (convulsions); swelling, warmth, redness, or itching where the medicine was injected; or delayed effect (1-2 days after injection) --fever, chills, dizziness, headache, general ill feeling, nausea and vomiting, joint or muscle pain, back pain. This medicine can cause unusual results with certain medical tests. Tell any doctor who treats you that you are using iron dextran. Folic acid helps your body produce and maintain new cells, and also helps prevent changes to DNA that may lead to cancer. kidney disease (or if you are on dialysis), an infection, if you are an alcoholic, or if you have any type of anemia Folic acid def. Anemia Safety Issues -The biggest issue is respiratory depression, Acetaminophen & hepatotoxicity, Risk for addiction, abuse, Some PO versions are very high dose and aren't for your average patient. Extended release usually for clients that have been taking it long term; not for opioid naive. Teaching: -Bowel regimen- Remember receptors in GI tract, make sure they are not constipated, -Avoid ETOH, benzodiazepines, etc.- depressants in general, be aware of them, -Caution with driving- be careful with things that require a lot of concentration until we know how the drug is going to effect them -Itching & nausea & vomiting (N/V) common-laying down will help, but walking will make it worse, . Sometimes patient says they itch/N&V- not allergic to drug but those are side effects of the drug, -Urinary retention- try to get patients to void every 4 hours, sometimes sensations to void aren't working correctly so we need to get them to make sure they are voidi Opioids**Naloxone Benzo**Flumazenil Barbs**NO AntidoteWho should and should not use Tylenol? When should it be avoided and when might it be the preferred medication? Be aware of which drugs act on the CNS and which drugs and substances, if given together, can result in additive CNS effects that may harm the patient. What patient teaching do we need to give to keep patients safe? Review the information about promoting sleep, but pharmacologic and non-pharmacologic methods. We talked about CNS stimulants of weighty loss, ADHD/ADD, and migraines. Review the information so you will know the safety issues, patient teachings, and nursing actions (assessment etc) for these drugs. What patient teachings will you need to provide your patients on anti-seizure medications? What do they need to know to take the medications safely and remain seizure free (as much as possible)? Think about what actions you might need to take or patient support you might need to provide if your patient cannot take their medications as prescribed. Remember to evaluate patients for both adverse and therapeutic responses to medications. Review the drug classes and/or individual drugs listed as needed. Make sure you review the vocabulary for each chapter. If you are unsure of what phrases such as tardive dyskinesia and extrapyramidal symptoms mean, look them up. People with liver disease should not use tylenol. Avoid if trying to treat inflammation Best choice for fever reducer.Review the primary safety considerations and patient teachings for antidepressants in general. Review opioid, alcohol, heroine, and nicotine addiction, overdoes and withdrawal. How do we treat each? What drugs are used? What are the primary patient safety considerations? What medications do we use to prevent relapse, and how are these drugs used/administered? Review how cholinergic drugs are used to help with myasthenia gravis. Do anticholinergic drugs have specific patient safety issues? What patient teachings might you need to give to patients to keep them safe? Note! I may have misspoken in class so let me be clear: we give heparin to patients to provide anticoagulant effects to patients just starting on Coumadin because it takes some time for the Coumadin to reach therapeutic levels. I may have said this backwards so please make note of this correction.  Know which lab test goes with which anticoagulant, and know the therapeutic levels given in your slides. Know any specific contraindications for using the various anticoagulants (combinations or circumstances). Know which respiratory drugs are short-acting and intermediate or long-acting, and in what order the various inhalers should be used. What patient teachings go with each type of inhaler?Know the various uses for CNS stimulants. Know patient teachings for antiepileptic drugs. What is serotonin syndrome and what signs/symptoms would alert you that your patient is developing the syndrome? Know proper administration techniques for the various iron preparations, and patient teachings you will provide your patients. Medication Calculation: You will see five questions. Review medication calculation including weight based calculations. I have not included anything new, so if you are able to do the types of calculations presented to you in the program thus far you should not have any problems. Good luck! Dr. Peters