Ethacrynic Acid (Edecrin)are consideredloop diureticsand arepotassium wasting; encourage client to increase intake of potassium-rich foods. Orange juice/Bananas, etc.Aminophylline (Truphylline)is a xanthinebronchodilator; major side effects:palpitations,nervousness, rapid pulse, dysrhythmias, nausea, and vomiting. Toxic effects: confusion, headache, flushing, tachycardia, and seizure.Morphine Sulfatedecreases blood return to the right side of the heart, and decrease peripheral resistance. In other words, decreases preload and afterload pressures and cardiac workload; causes vasodilation and pooling of fluid in extremities; providesrelief from anxiety.Intropin (Dopamine)vasoactive medication are given IV to restore BP in hypotensive states; Increases blood return to the right side of the heart, and increase peripheral resistance; side effects: headache, severe hypertension, dysrhythmias; check BP q2 minutes until stabilized, then q5 minutesTPNhang no longer than 24 hours; IV tubing and filters every 24 hours; site of catheter changed every 4 weeks.Fluoxetine (Prozac)a selective serotonin reuptake inhibitor (SSRI) used to treat depression andobsessive compulsive disorder. Side effects: postural hypotension, dry mouth, rapid heartbeat, anorexia, weight loss, severe headache. If dose is missed, omit dose and instruct client to return to regular dosing schedule.Propanolol (inderal)a beta-adrenergic blocker used as antihypertensive; Side effects: bronchospasm, bradycardia, depression, increase airway resistance. Take pulse and count respirations before administration and gradually decrease when discontinuing. Do not give to asthmatic patients.Glipizide (Glucotrol)an oral hypoglycemic that decreases blood sugar by stimulating insulin release from the beta cells of the pancreas; may cause aplastic anemia and photosensitivity.Prednisone (Deltasone)a corticosteroid. Side effects: hyperglycemiaBethanechol (Urecholine)a cholinergic or parasympathomimetic used to treat functional urinary retention; mimics action of acetylcholine.Ventricular Tachycardiacauses chest pain, dizziness, and fainting.1 grain = 60mgLevothyroxine (Synthroid)thyroid preparation should be administered at breakfast to prevent insomnia.Carbamazepine (Tegretol)interferes with action of hormonal contraceptives. Side effects: photosensitivity.Aluminum Hydroxide (Amphojel)an antacid; neutralizes hydrochloric acid and reduces pepsin activity; take one hour before and hour of sleep. Antacids most effective after digestion has started, but prior to the emptying of the stomach.Isoniazid (INH)Side effects:peripheral neuropathy(administer pyridoxine), rash, urticaria, and swelling of the face, lips, and eyelids.Pyridoxine (Vitamin B6, Beesix, Doxine)required for amino acid, carbohydrate, and lipid metabolism. Used in the transport of amino acids, formation of neurotransmitters, and sythesis of heme. Prevention of neuropathy.Carbamazepine (Tegretol)prevention of seizuresand relief of pain in trigeminal neuralgia. Trigeminal neuralgia(Tic douloureux)is an agonizing pain that may result in severe depression and suicide.Clonidine (Catapres-TTS)is a centrally acting alpha-adrenergic used to treat hypertension; Side effects: drowsiness, sedation, orthostatic hypotension, heart failure. If patch used be cautious around microwaves results in burns, dispose of carefully, and heat will increase medication absorption leading to toxicity.Phlebitistenderness, redness; remove iv, apply warm soaks to decrease inflammation, swelling, and discomfort.Autologous bloodmay give blood 5 weeks before surgery; can give 2 to 4 units of blood; may have to take iron pillsCarbidopa/Levodopa (Sinemet)used to treat symptoms of Parkinsons disease. Take immediately before meals and high-protein meals may impair effectiveness of medication. Reduces rigidity and bradykinesis and facilitates clients mobility.Doxycycline (Vibramycin)a tetracycline that is taken at regular intervals but not within 1 hour of bedtime because it may cause esophageal irritation. Use another method of birth control, do not take antacids within 1-3 hours of taking medication, and may cause photosensitivity.Albuterol (Proventil)a bronchodilator. Side effects: tremors, headache, hyperactivity, tachycardia. Use first before steroid medication so opens up bronchioles for steroid to get in. Wait one minute between puffs of the inhalers for best effect.Beclomethasone (Vanceril)a steroid medication. Side effect: fungal infections, dry mouth, throat infections.InsulinNPHOnset: 1.5 hoursPeak: 4-12 hoursRegularOnset: 0.5 hours Peak: 2.5-5 hoursTopiramate (Topamax)is an anticonvulsant. Should drink 2000-3000ml of fluid daily to prevent kidney stones. Side effects: orthostatic hypotension, ocular symptoms, blindness, and decrease effects of hormonal contraceptives.Propranolol (Inderal)a beta-blocker that takes up beta-adrenergic receptor sites, which prevents adrenaline from causing symptoms and glycogenolysis. Inderal may mask symptoms of hypoglycemia, removing the bodys early warning system.Phenazopyridine (Pyridium)acts on urinary tract mucosa to produce analgesic or local anesthetic effects. Side effects: bright orange urine, yellowish discoloration of skin or sclera indicates drug accumulation due to renal impairment.Trimethoprim-sulfamethoxazole (Bactrim)most common side effect mild to moderate rash (urticaria)Aminoglycosides are ototoxic.Butorphanol Tartrate (Stadol)analgesic used for moderate to severe pain; Side effects include change in BP, bradycardia, respiratory depression.Salt substitutescontain potassium.Herbs: Toxicities and Drug Interactions1. ChamomileUses: Chamomile is often used in the form of a tea as a sedative.Reactions: Allergic reactions can occur, particularly in persons allergic to ragweed. Reported reactions include abdominal cramps, tongue thickness, tightness in the throat, swelling of the lips, throat and eyes, itching all over the body, hives, and blockage of the breathing passages. Close monitoring is recommended for patients who are taking medications to prevent blood clotting (anticoagulants) such as warfarin.2. EchinaceaUses: Largely because white blood cells in the laboratory can be stimulated to eat particles, Echinacea has been touted to be able to boost the bodys ability to fight off infection.S/E : unpleasant tastel, liver toxicity.C/I: ketaconazole, leflunomide (Arava), methotrexate (Rheumatrex), isoniazide (Nizoral).3. St. Johns WortUses: depression, anxiety, and sleep disorders. It is technically known as Hypericum perforatum.S/E: sun sensitivity which causes burning of the skin. Leave nerve changes in sunburned areas.C/I: tetracycline/Achromycin, sulfa- containing medications, piroxicam (Feldend).S/E: headaches, dizziness, sweating, and agitation when used in combination with serotonin reuptake inhibitor medications such as fluoxetine (Prozac) and paroxetine (Paxil).4. GarlicUses: lower blood pressure and cholesterolS/E: Allergic reactions, skin inflammation, and stomach upset , Bad breath . decrease normal blood clotting and should be used with caution in patients taking medications to prevent blood clotting (anticoagulants) such as warfarin /Coumadin.5. FeverfewUses: Most commonly used for migraine headaches.Reactions: Feverfew can cause allergic reactions, especially in persons who are allergic to chamomile, ragweed, or yarrow. Nonsteroidal anti-inflammatory drugs (NSAIDs such as ibuprofen (Advil), naproxen (Aleve) or Motrin) can reduce the effect of feverfew. A condition called postfeverfew syndrome features symptoms including headaches, nervousness, stiffness, joint pain, tiredness, and nervousness. Feverfew can impair the action of the normal blood clotting element (platelets). It should be avoided in patients taking medications to prevent blood clotting (anticoagulants) such as warfarin (Coumadin).6. Ginko BilobaUses: This herb is very popular as a treatment for dementia (a progressive brain dysfunction) and to improve thinking.Reactions: Mild stomach upset and headache have been reported. Ginko seems to have blood thinning properties. Therefore, it is not recommended to be taken with aspirin, nonsteroidal anti-inflammatory drugs (Advil), naproxen (Aleve) or Motrin), or medications to prevent blood clotting (anticoagulants) such as warfarin (Coumadin). Ginko should be avoided in patients with epilepsy taking seizure medicines, such as phenytoin (Dilantin), carbamazepine (Tegretol), and phenobarbital.7. GinsengUses: Ginseng has been used to stimulate the adrenal gland, and thereby increase energy. It also may have some beneficial effect on reducing blood sugar .in patients with diabetes mellitus. (Dr. Miller emphasized that there is substantial variation in the chemical components of substances branded as Ginseng.)Reactions: Ginseng can cause elevation in blood pressure, headache, vomiting, insomnia, and nose bleeding. Ginseng can also cause falsely abnormal blood tests for digoxin level. It is unclear whether ginseng may affect female hormones. Its use in pregnancy is not recommended. Ginseng may affect the action of the normal blood clotting element (platelets). It should be avoided in patients taking aspirin, nonsteroidal antiinflammatory drugs (such as ibuprofen (Advil), naproxen (Aleve) or Motrin), or medications to prevent blood clotting (anticoagulants) such as warfarin (Coumadin). Ginseng may also cause headaches, tremors, nervousness, and sleeplessness. It should be avoided in persons with manic disorder and psychosis.8. GingerUses: Ginger has been used as a treatment for nausea and bowel spasms.Reactions: Ginger may lead to blood thinning. It is not recommended to be taken with medications that prevent blood clotting (anticoagulants) such as warfarin (Coumadin).9. Saw PalmettoUses: Saw palmetto has been most commonly used for enlargement of the prostate gland. Saw palmetto has also been touted as a diuretic and urinary antiseptic to prevent bladder infections.Reactions: This herb may affect the action of the sex hormone testosterone, thereby reducing sexual drive or performance. Dr. Miller states that While no drug-herb interactions have been documented to date, it would be prudent to avoid concomitant use with other hormonal therapies (e.g., estrogen replacement therapy and oral contraceptives)