1460C Medications Module 1 (2025) PDF

**1460C MEDICATIONS -- MODULE** **1** ===================================== +-----------------+-----------------+-----------------+-----------------+ | **MEDICATION | **CLASSIFICATIO | **ADVERSE/SIDE | **NRSG. | | NAME** | N** | EFFECTS** | IMPLICATIONS** | |...

**1460C MEDICATIONS -- MODULE** **1** ===================================== +-----------------+-----------------+-----------------+-----------------+ | **MEDICATION | **CLASSIFICATIO | **ADVERSE/SIDE | **NRSG. | | NAME** | N** | EFFECTS** | IMPLICATIONS** | | | | | | | | **INDICATIONS | | **PATIENT | | | for USE** | | TEACHING** | +=================+=================+=================+=================+ | ***Serotonin | ***Taking | ***Flu-like | ***Notify PCP | | Syndrome*** | higher than | symptoms, | if delirium, | | | normal levels | difficulty | agitation, | | ***-as a result | of SSRI or | concentrating, | tachycardia, | | of taking | adding other | faintness, GI | muscle spasms, | | SSRIs*** | drugs to the | disturbances.** | hyperlexia, | | | medication | * | shivering, | | ***Discontinuat | regime*** | | coarse | | ion | | ***May need to | tremors*** | | of the drug | | take benzos to | | | must be done | | alleviate | ***No EtOH*** | | slowly*** | | agitation or | | | | | seizure-like | ***S**hivering* | | | | posturing,*** | | | | | | ***H**yperrefle | | | | ***Muscle | xia* | | | | stiffness*** | | | | | | ***I**ncreased | | | | ***May need to | temperature* | | | | switch to | | | | | another class | ***V**ital sign | | | | of | changes* | | | | medication*** | | | | | | ***E**ncephalop | | | | | athy* | | | | | | | | | | ***R**estlessne | | | | | ss* | | | | | | | | | | ***S**weating* | +-----------------+-----------------+-----------------+-----------------+ | **Fluoxetine | Selective | Weight | Suicidal | | (Prozac)** | Serotonin | loss/gain | ideations | | | Reuptake | | **\[BLACK B0X | | | Inhibitor- SSRI | GI symptoms, | WARNING\]** | | | | | | | | ***Tx- | tremors, | Serotonin | | | Anxiety*** | diaphoresis, | syndrome | | | | sexual | | | | ***Panic | dysfunction, | Avoid St John's | | | disorders*** | nocturnal teeth | wort | | | | grinding | interacting | | | ***Depression** | | with SSRIs. The | | | * | Hypotension | cumulative | | | | | effect may take | | | ***OCD - | | 3-4 weeks | | | PTSD*** | | before symptoms | | | | | are relieved. | | | | | | | | | | Take with food | | | | | | | | | | Sexual | | | | | Dysfunction/ED | +-----------------+-----------------+-----------------+-----------------+ | **Paroxetine | Selective | Weight | Suicidal | | (Paxil)** | Serotonin | loss/gain, | ideations | | | Reuptake | | **\[BLACK B0X | | | Inhibitor- SSRI | GI symptoms, | WARNING\]** | | | | tremors, | | | | ***Tx- | diaphoresis, | Serotonin | | | Anxiety*** | sexual | syndrome | | | | dysfunction, | | | | ***Panic | nocturnal teeth | Avoid St John's | | | disorders*** | grinding | wort | | | | | interacting | | | ***Depression** | Hypotension | with SSRIs. The | | | * | | cumulative | | | | | effect may take | | | ***OCD - | | 3-4 weeks | | | PTSD*** | | before symptoms | | | | | are relieved. | | | | | | | | | | Take with food | | | | | | | | | | Sexual | | | | | Dysfunction/ED | +-----------------+-----------------+-----------------+-----------------+ | **Sertraline | Selective | Weight | Suicidal | | (Zoloft)** | Serotonin | gain/gain, | ideations | | | Reuptake | | **\[BLACK B0X | | | Inhibitor- SSRI | GI symptoms, | WARNING\]** | | | | tremors, | | | | ***Tx- | diaphoresis, | Serotonin | | | Anxiety*** | sexual | syndrome | | | | dysfunction, | | | | ***Panic | nocturnal teeth | Avoid St John's | | | disorders*** | grinding | wort interacts | | | | | with SSRI's | | | ***Depression** | Hypotension | Cumulative | | | * | | effect may take | | | | | 3-4 weeks | | | ***OCD - | | before symptoms | | | PTSD*** | | are relieved. | | | | | | | | | | Take with food | | | | | | | | | | Sexual | | | | | Dysfunction/ED | +-----------------+-----------------+-----------------+-----------------+ | **Escitalopram | Selective | Irregular | Suicidal | | (Lexapro)** | Serotonin | Heartbeat | ideations | | | Reuptake | | **\[BLACK B0X | | | Inhibitor- SSRI | Weight loss/ GI | WARNING\]** | | | | symptoms, | | | | ***Tx- | anxiety, | Serotonin | | | Anxiety*** | tremors, | syndrome | | | | diaphoresis, | | | | ***Panic | visual changes, | Avoid St John's | | | disorders*** | dizziness, skin | wort interacts | | | | rash, itching | with SSRIs | | | ***Social | | | | | phobias*** | Hypotension | Same time | | | | | dosing, with | | | ***Depression** | | meals | | | * | | | | | | | Usually for | | | | | long-term | | | | | treatment. The | | | | | cumulative | | | | | effect may take | | | | | 3-4 weeks | | | | | before symptoms | | | | | are relieved. | | | | | | | | | | Take with food | | | | | | | | | | Sexual | | | | | Dysfunction/ED | +-----------------+-----------------+-----------------+-----------------+ | **Duloxetine | Selective | Irregular | Suicidal | | (Cymbalta)** | Serotonin/Norep | Heartbeat | ideations | | | inephrine | | **\[BLACK B0X | | | Reuptake | Weight | WARNING\]** | | | Inhibitor- SNRI | loss/gain, | | | | | | Serotonin | | | ***Tx- | GI symptoms, | syndrome | | | Anxiety,*** | anxiety, | | | | | tremors, | Avoid St John's | | | ***Depression** | diaphoresis, | wort interacts | | | * | visual changes, | with SSRIs | | | | dizziness, skin | | | | ***Pain | rash, itching | Orthostatic | | | associated with | | hypotension | | | peripheral | Hypotension | first week of | | | neuropathy*** | | therapy. | | | | | | | | ***Fibromyalgia | | Increased risk | | | *** | | of bleeding if | | | | | taking | | | | | anticoagulants. | | | | | Cumulative | | | | | effect may take | | | | | 3-4 weeks | | | | | before symptoms | | | | | are relieved. | | | | | | | | | | Take with food | | | | | | | | | | Sexual | | | | | Dysfunction/ED | +-----------------+-----------------+-----------------+-----------------+ | **Venlafaxine | Selective | Irregular | Suicidal | | (Effexor)** | Serotonin/Norep | Heartbeat | ideations | | | inephrine | | **\[BLACK B0X | | | Reuptake | Weight loss/ GI | WARNING\]** | | | Inhibitor- SNRI | symptoms, | | | | | anxiety, | Serotonin | | | ***Tx- | tremors, | syndrome | | | Anxiety,*** | diaphoresis, | | | | | visual changes, | Avoid St John's | | | ***Panic | dizziness, skin | wort interacts | | | disorders*** | rash, itching | with SSRIs | | | | | | | | ***Social | Hypotension | Can interact | | | phobias*** | | with | | | | | anticoagulants, | | | ***Depression** | | antifungals, | | | * | | diabetic meds, | | | | | | | | | | If the dose is | | | | | missed, do not | | | | | double the | | | | | dose. The | | | | | cumulative | | | | | effect may take | | | | | 3-4 weeks | | | | | before symptoms | | | | | are relieved. | | | | | | | | | | Take with food | | | | | | | | | | Sexual | | | | | Dysfunction/ED | +-----------------+-----------------+-----------------+-----------------+ | **Lorazepam | Benzodiazepines | Can cause | Doses need to | | (Ativan)** | | over-sedation | be slowly | | | ***Tx: Acute | | titrated and | | | anxiety*** | Decreased | not abruptly | | | | BP-orthostatic | stopped to | | | ***EtOH | | avoid rebound | | | withdrawal*** | Serious effects | disinhibition | | | | on those with | | | | ***Muscle | liver/renal | (Increased | | | spasms*** | disease | sedation | | | | | alternates with | | | ***Status | | increased | | | Epilepticus | | activity) | | | (continuous | | | | | seizure | | Avoid EtOH | | | activity)*** | | | | | | | Can produce | | | ***Seizures*** | | dependency/abus | | | | | e | | | ***Pre-operativ | | issues | | | e*** | | | +-----------------+-----------------+-----------------+-----------------+ | **Diazepam | Benzodiazepines | Can cause | Can be taken | | (Valium)** | | over-sedation | with or without | | | ***TX: Acute | | food. | | | anxiety*** | Decreased | | | | | BP-orthostatic | Avoid EtOH, | | | ***EtOH | | antifungal | | | withdrawal*** | Serious effects | medications, | | | | on those with | Herbal meds, | | | ***Muscle | liver/renal | Valerian, St. | | | spasms*** | disease | John's wort, | | | | | and Kava | | | ***Status | | (increases CNS | | | Epilepticus | | effects) | | | (continuous | | | | | seizure | | Avoid | | | activity)*** | | ***GRAPEFRUIT | | | | | JUICE*** | | | ***Seizures*** | | | | | | | (inhibits | | | ***Pre-operativ | | metabolism of | | | e*** | | the medication) | | | | | | | | | | Can produce | | | | | dependency/abus | | | | | e | | | | | issues | +-----------------+-----------------+-----------------+-----------------+ | **Alprazolam | Benzodiazepines | Headache and | Can be taken | | (Xanax)** | | dry mouth Can | with or without | | | ***Tx: Acute | cause | food. | | | anxiety*** | over-sedation. | | | | | Serious effects | Avoid EtOH | | | ***Panic | on those with | | | | disorders*** | liver/renal | Can produce | | | | disease. | dependency/abus | | | | | e | | | | | issues | +-----------------+-----------------+-----------------+-----------------+ | **Chlordiazepox | Anxiolytic | Dizziness and | Watch for | | ide | | confusion in | orthostatic | | (Librium)** | Benzodiazepines | the elderly | Hypotension | | | | | | | | ***Tx: | | Take V/S before | | | Short-term use | | giving | | | for anxiety or | | medication | | | long-term | | | | | use.*** | | Can be taken | | | | | with or without | | | *EtOH | | food. | | | withdrawal* | | | | | | | Avoid EtOH | | | | | | | | | | Can produce | | | | | dependency/abus | | | | | e | | | | | issues | +-----------------+-----------------+-----------------+-----------------+ | **Buspirone | *Anxiolytic* | Not to be given | The start of | | (Buspar)** | | with MAOIs = | therapy can | | | *Tx: anxiety | severe hepatic | cause | | | for adults, | or renal | dizziness; | | | elderly, and | hypersensitivit | watch for | | | children 6 yr. | y | orthostatic | | | of age or | | Hypotension | | | older* | | | | | | | Avoid EtOH, | | | *Panic attacks- | | antifungal | | | long-term | | medications, | | | management* | | Herbal meds, | | | | | Valerian, St. | | | | | John's wort, | | | | | and Kava | | | | | (increases CNS | | | | | effects) | | | | | | | | | | Avoid | | | | | ***GRAPEFRUIT | | | | | JUICE*** | | | | | | | | | | (inhibits | | | | | metabolism of | | | | | the medication) | | | | | | | | | | Multi-time | | | | | dosing | | | | | throughout the | | | | | day- Cumulative | | | | | effect may take | | | | | 3-4 weeks | | | | | before symptoms | | | | | are relieved. | | | | | | | | | | **DOESN'T CAUSE | | | | | DEPENDENCY | | | | | ISSUES** | +-----------------+-----------------+-----------------+-----------------+ | **Bupropion | Norepinephrine- | headaches- | 3-4 wks. to | | (Wellbutrin, | dopamine | seizures-hypo-h | reach | | Zyban)** | reuptake | ypertension | therapeutic | | | inhibitor | | effect-TID | | ***Not approved | (NDRI) | Weight gain may | dosing, unless | | for children*** | | cause agitation | given in ER | | | ***Tx: | | tabs | | | Depression/smok | | | | | ing | | Avoid TB | | | cessation/ADHD/ | | medication | | | SAD*** | | (decrease | | | | | metabolism of | | | | | med) AED, TCIs, | | | | | Benzodiazepines | | | | | , | | | | | Haloperidol | | | | | (can cause | | | | | seizures) | +-----------------+-----------------+-----------------+-----------------+ | **Flumazenil | Benzodiazepine | IV use only | V/S before push | | (Romazicon)** | Antagonist | | | | | | Re-sedation may | Slow push IV | | | ***Tx: reversal | occur; repeat | over 30 | | | of sedative | dosing of 0.2mg | seconds. | | | effect*** | | | | | | Headache, | | | | | diaphoresis, | | | | | | | | | | May cause | | | | | seizures in | | | | | those with | | | | | sedative-additi | | | | | on | | | | | withdrawal or | | | | | antidepressant | | | | | overdose. | | +-----------------+-----------------+-----------------+-----------------+ | **Atenolol | Beta 1 Blocker | - Dizziness o | Take medication | | (Tenormin)** | | r | as directed, at | | |  *blocking the | lightheaded | the same time | | **Beta 1** | action of | ness. | each day, even | | | certain natural | | if feeling | | **OFF-LABEL | chemicals in | - Tiredness, | well; do not | | DRUG USE** | your body, such | depression. | skip or double | | | as epinephrine, | Nausea. | up on missed | | Using a | on the heart | | doses. Take | | drug [[off-labe | and blood | - Dry mouth, | missed doses as | | l]] | vessels.* | stomach | soon as | | (https://www.he | | pain. | possible up to | | althline.com/he | ***Tx-Off label | | 8 hr. before | | alth/general-us | use for | - Vomiting, | the next dose. | | e/off-label-dru | short-term | gas or | Abrupt | | g-use) means | acute | bloating. | withdrawal may | | that a drug has | anxiety*** | | precipitate | | been approved | | - Hypotension | life-threatenin | | by the FDA for | *Hypertension* | | g | | one purpose, | *helps prevent | | arrhythmias, | | and it's being | strokes, **hear | | hypertension, | | used for a | t** attacks, | | or myocardial | | different | and kidney | | ischemia. | | purpose that | problems. This | | | | hasn't been | medication is | | | | approved.  | also used to | | | | | treat **chest | | | | | pain** (**angin | | | | | a**) | | | | | and to improve | | | | | survival after | | | | | a **heart** att | | | | | ack.* | | | +-----------------+-----------------+-----------------+-----------------+ | **Propranolol | ***Beta 2 | Reversible | Check heart | | (Inderal) | Blocker*** | airway | rate and BP | | Beta2** | | diseases, | daily before | | | *It competes | particularly as | medication | | **OFF-LABEL | with | thma or | admin. | | DRUG USE** | sympathomimetic | chronic | | | | neurotransmitte | obstructive | Do not take: | | Using a | rs | pulmonary | | | drug [[off-labe | for binding to | disease (COPD) | Aluminum | | l]] | receptors, | | hydroxide, | | (https://www.he | which inhibits | Slow heart | cimetidine, | | althline.com/he | sympathetic | rate (bradycard | anticholinergic | | alth/general-us | stimulation of | ia) | s | | e/off-label-dru | the heart and | (\