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: Opioid Phenobarbital Barbiturates
Class II Narcotic Class IV Narcotic
Phenobarbital is used to control seizures, also used to
Indications Moderate to severe pain Indications prevent withdrawal symptoms in people who are dependent
on another barbiturate medication
Contraindications Epilepsy, heart, liver and Contraindications Apatients
personal or familial history of acute intermittent porphyria
kidney disease with marked impairment of liver function, or respiratory
disease, or if you are taking Sodium oxybate (GHB)
adverse effects Allergy S/Sx, SOB, Edema to LE, adverse effects Dizziness, drowsiness, excitation, headache, tiredness,
CONSTIPATION loss of appetite, N/V
interactions NO MAOi's w/in 14days of taking Morphine, interactions Drugs for anxiety, depression, pain, asthma, colds,
or allergies. Certain medications for seizures such as
Monitor if taking vitamins/herbals, Avoid Alcohol phenytoin (Dilantin) and valproate (Depakene), Sodium oxybate (GHB)
safety/patient teaching safety/patient teaching
Talk to MD before taking if you are preg/breast feeding. Don't take if you are pregnant, planning on becoming pregnant otr breast feed
**Habit forming/high risk for dependence. Don't use if you suffer from depression, or have ever had suicidal ideations.
Acetaminophen Non-Opioid Orlistat Lipase inhibitors
OTC
Indications Fever, Mild to moderate pain Indications It can help patients reach and maintain a healthy weight.
Contraindications DO NOT take if you have
any conditions involving the LIVER!
Contraindications Do not use this medicine if you had an allergic
reaction to orlistat or if you are pregnant.
Allergy S/Sx, bloody/black tary stool, Allergy S/Sx, Dark urine, pale stool, yellowing of the skin
adverse effects adverse effects or eyes, sharp back pain, severe stomach pain, N/V, severe
sweating, tired feeling. diarrhea
interactions Monitor PT/INR if patient is taking with an interactions RX to treat DM II, such as insulin, seizures, or anti-
coagulants. Cyclosporine should be taken 3h after,
anti-coagulant. Levothyroxine 4h before, MVI 2h before.
safety/patient teaching safety/patient teaching
Don't exceed 3000mg in adults and 2000mg in the elderly and This medication may cause liver damage, kidney stones, gallbladder bile flow
children. problems. It is not safe to take this medicine during pregnancy. It could harm
**Will not treat inflammation! an unborn baby.
Diazepam Benzodiazepines Methylphenidate hydrochloride CNS Stimulant
Class II Narcotic
Indications Used to treat anxiety, muscle spasms, and seizures Indications It can treat ADHD and narcolepsy
if you are pregnant, or if you have narrow-
angle glaucoma or untreated open-angle if you have glaucoma, an overactive thyroid,
Contraindications glaucoma, myasthenia gravis, sleep apnea
or severe breathing problems, or severe
Contraindications muscle tics, or a history of Tourette syndrome.
liver disease.
Allergy S/Sx, Seizures, confussion, lethragy, Allergy S/Sx, vision changes, chest pain, n/v, unusual
adverse effects adverse effects sweating, drymouth, stomach pain, loss of appetite.
Nausea, lightheaded or dizziness.
Guanethidine, phenylbutazone, stomach medicine,
interactions MAOis, Theophylline, RX for depression, seizures, interactions BP medicine, anticoagulants, -Ramines, phenobarbital,
or any medication ending in -azine phenytoin, primidone, alcohol
safety/patient teaching safety/patient teaching
To much of this drug will cause death, don't use if you are preg/breast This medication is habit forming, don't take with a HX of high BP,
feeding, have liver or kidney disease. phenylketonuria, thyroid problems, MI, CVA, Seizures. HX of drug/alcohol
**This drug is habit forming. abuse.
, Viral m2 channel inhibitor/
Ergot alkaloids Amantadine Dopamine agonist
It can treat and prevent the flu (influenza type A).
It can also treat Parkinson's disease and parkinson-
Indications Indications like symptoms caused by certain medications
narrow-angle glaucoma, heart disease, kidney disease,
liver disease, low blood pressure, swelling or water
Contraindications Contraindications retention, epilepsy, or a history of seizures.
Tell your doctor if you also have a history of eczema
or neuroleptic malignant syndrome (NMS)
adverse effects adverse effects 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
interactions interactions mental disorders, urinary problems, diet pills, 48h after of Flumist, or
2 weeks before
safety/patient teaching safety/patient teaching
Don't drink alcohol, don't take if you are pregnant or brestfeeding.
Phenytoin Anticonvulsant Risperidone Antipsychotic
It can treat schizophrenia, bipolar disorder, and
IndicationsIt can treat and prevent seizures. Indications irritability caused by autism.
breastfeeding, or if you have kidney disease, pregnant, breastfeeding, or if you have kidney disease, liver disease,
Contraindications liver disease, depression, diabetes, or Contraindications diabetes, high cholesterol, Parkinson disease, trouble swallowing, or a history
of breast cancer or seizures. Tell your doctor if you have heart failure,
porphyria. low blood pressure, or a history of a heart attack or stroke.
adverse effects Increased r/o suicidal thoughts, serrious skin
adverse effects Allergy S/Sx, tarditive diskensia, Flu s/sx, prolonged erec
reactions, liver damage.Decreased blood lvls,
bleeding problems, increased CBG's
swelling of breast
St John's wort, albendazole, amiodarone, aspirin, chlordiazepoxide, Some foods and medicines can affect how risperidone works.
interactions cyclosporine, diazepam, diazoxide, digoxin, disulfiram, folic acid, furosemide, interactions Tell your doctor if you are using carbamazepine, clozapine, fluoxetine,
isoniazid, methylphenidate, nisoldipine, praziquantel, quinidine, reserpine, furosemide, levodopa, paroxetine, phenobarbital, phenytoin, quinidine,
ifampin, sucralfate, theophylline, tolbutamide, or vitamin D. rifampin, or blood pressure medicine.
safety/patient teaching safety/patient teaching
This medicine may make you drowsy or dizzy. Do not drive or do anything else that could be dangerous until
Do not take an antacid or supplement that contains calcium, aluminum, or magnesium at the same time you know how this medicine affects you.
you take phenytoin. Take the antacid or supplement at a different time of day. This medicine may change how your body regulates temperature. Avoid activities that could cause you to become
Do not drink alcohol while you are using this medicine 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.
Levodopa-carbidopa Dopamine precursor Haloperidol Antipsychotic
Indications It can treat Parkinson's disease. Indications Itcontrol
can treat certain types of mental disorders. It can also
symptoms of Tourette syndrome
pregnant or breastfeeding, kidney, liver disease,endocrine problems,
lung or breathing, a sleep disorder, heart or blood vessel problems, pregnant or breastfeeding, or if you have liver disease, kidney disease,
Contraindications heart rhythm problems, or a history of heart attack. wide-angle Contraindications heart or blood vessel disease, blood pressure problems, overactive thyroid,
or history of seizures or breast cancer.
glaucoma, phenylketonuria (PKU), or a history of stomach ulcer
or mental illness.
Allergy S/Sx, unrination ∆, ∆'s in vision, flu like s/sx, HA,
adverse effects Allergy S/Sx, chest pain, difficulty breathing, adverse effects increased confussion, balance problems, increased fall risk
conpulsive behaviors
interactions MAOi's within 14d, isoniazid, reglan, dilantin, risperdone, interactions May interact with some BP medication, lithium, phenindione, RX
tetrabenazine, a phenthiazine (-azine), BP medications for TX of seizures, or parkinsons.
safety/patient teaching safety/patient teaching
This medicine is not right for everyone. Do not use it if you had an allergic Don't drink alcohol with this medication.
reaction to carbidopa or levodopa, or if you have narrow-angle glaucoma, You should not use this medicine if you have had an allergic reaction to
.skin lesions, or a history of skin cancer. haloperidol, or if you have Parkinson disease. This medicine should not be
Do not stop using this medicine suddenly. Your doctor will need to slowly
given to patients with severe brain disease.
decrease your dose before you stop it completely.
Benztropine Central muscarinic antagonist MAOIs Monoamine oxidase inhibitor
It can treat Parkinson's disease and side Monoamine oxidase inhibitors are chemicals that inhibit the activity of the monoamine
Indications effects of other drugs. Indications oxidase enzyme family. They have a long history of use as medications prescribed for
the treatment of depression.
pregnant or breastfeeding, or if you have glaucoma, bowel or a confirmed or suspected cerebrovascular defect or any patients with
stomach problems, an enlarged prostate, heart disease, or cardiovascular disease or confirmed or suspected cerebrovascular defect,
Contraindications 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.
Contraindications hypertension, or history of headache. known hypersensitivity to isocarboxazid.
pheochromocytoma, as such tumors secrete pressor substances whose
Tell your doctor if you have jerky muscle movements caused by another metabolism may be inhibited by Marplan.a history of liver disease, or in those
medicine. with abnormal liver function tests. severe impairment of renal function.
adverse effects Allergy S/Sx, hallucinations, constipation, abd pain, adverse effects See below
dry mouth, troubleswallowing, loss of appetite, weight amphetamines,dopamine, ephedrine, levodopa, phenylpropanolamine and
loss, unable to sweat. pseudoephedrine.MAOIs inhibit other drug-metabolising enzymes and may enhance
interactions Haloperidol, A phenothiazine medicine, such as prochlorperazine,
chlorpromazine, perphenazine, promethazine, thioridazine, A tricyclic
interactions the effects of barbiturates and possibly of other hypnotics, hypoglycaemic agents,
antimuscarinic agents, beta blockers and thiazide diuretics. NO SSRI's with MAIO's
antidepressant medicine, such as amitriptyline, doxepin, nortriptyline cheese, pickled herring, meat/yeast extracts and fermented soya bean extract.
safety/patient teaching safety/patient teaching
This medicine may keep you from sweating enough, which may cause your body to get too hot. ASE:: feeling dizzy when you stand up (postural hypotension). It is more likely to
Be careful in hot weather, and while you exercise or use a sauna or whirlpool. happen if you are older. Less commonly, some people have drowsiness, difficulty
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.
sleeping, headache, weakness and tiredness, a dry mouth, or constipation.
Tell your doctor if your neck muscles become stiff and suddenly weak. Your doctor may need to lower
the dose you are taking.
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: Opioid Phenobarbital Barbiturates
Class II Narcotic Class IV Narcotic
Phenobarbital is used to control seizures, also used to
Indications Moderate to severe pain Indications prevent withdrawal symptoms in people who are dependent
on another barbiturate medication
Contraindications Epilepsy, heart, liver and Contraindications Apatients
personal or familial history of acute intermittent porphyria
kidney disease with marked impairment of liver function, or respiratory
disease, or if you are taking Sodium oxybate (GHB)
adverse effects Allergy S/Sx, SOB, Edema to LE, adverse effects Dizziness, drowsiness, excitation, headache, tiredness,
CONSTIPATION loss of appetite, N/V
interactions NO MAOi's w/in 14days of taking Morphine, interactions Drugs for anxiety, depression, pain, asthma, colds,
or allergies. Certain medications for seizures such as
Monitor if taking vitamins/herbals, Avoid Alcohol phenytoin (Dilantin) and valproate (Depakene), Sodium oxybate (GHB)
safety/patient teaching safety/patient teaching
Talk to MD before taking if you are preg/breast feeding. Don't take if you are pregnant, planning on becoming pregnant otr breast feed
**Habit forming/high risk for dependence. Don't use if you suffer from depression, or have ever had suicidal ideations.
Acetaminophen Non-Opioid Orlistat Lipase inhibitors
OTC
Indications Fever, Mild to moderate pain Indications It can help patients reach and maintain a healthy weight.
Contraindications DO NOT take if you have
any conditions involving the LIVER!
Contraindications Do not use this medicine if you had an allergic
reaction to orlistat or if you are pregnant.
Allergy S/Sx, bloody/black tary stool, Allergy S/Sx, Dark urine, pale stool, yellowing of the skin
adverse effects adverse effects or eyes, sharp back pain, severe stomach pain, N/V, severe
sweating, tired feeling. diarrhea
interactions Monitor PT/INR if patient is taking with an interactions RX to treat DM II, such as insulin, seizures, or anti-
coagulants. Cyclosporine should be taken 3h after,
anti-coagulant. Levothyroxine 4h before, MVI 2h before.
safety/patient teaching safety/patient teaching
Don't exceed 3000mg in adults and 2000mg in the elderly and This medication may cause liver damage, kidney stones, gallbladder bile flow
children. problems. It is not safe to take this medicine during pregnancy. It could harm
**Will not treat inflammation! an unborn baby.
Diazepam Benzodiazepines Methylphenidate hydrochloride CNS Stimulant
Class II Narcotic
Indications Used to treat anxiety, muscle spasms, and seizures Indications It can treat ADHD and narcolepsy
if you are pregnant, or if you have narrow-
angle glaucoma or untreated open-angle if you have glaucoma, an overactive thyroid,
Contraindications glaucoma, myasthenia gravis, sleep apnea
or severe breathing problems, or severe
Contraindications muscle tics, or a history of Tourette syndrome.
liver disease.
Allergy S/Sx, Seizures, confussion, lethragy, Allergy S/Sx, vision changes, chest pain, n/v, unusual
adverse effects adverse effects sweating, drymouth, stomach pain, loss of appetite.
Nausea, lightheaded or dizziness.
Guanethidine, phenylbutazone, stomach medicine,
interactions MAOis, Theophylline, RX for depression, seizures, interactions BP medicine, anticoagulants, -Ramines, phenobarbital,
or any medication ending in -azine phenytoin, primidone, alcohol
safety/patient teaching safety/patient teaching
To much of this drug will cause death, don't use if you are preg/breast This medication is habit forming, don't take with a HX of high BP,
feeding, have liver or kidney disease. phenylketonuria, thyroid problems, MI, CVA, Seizures. HX of drug/alcohol
**This drug is habit forming. abuse.
, Viral m2 channel inhibitor/
Ergot alkaloids Amantadine Dopamine agonist
It can treat and prevent the flu (influenza type A).
It can also treat Parkinson's disease and parkinson-
Indications Indications like symptoms caused by certain medications
narrow-angle glaucoma, heart disease, kidney disease,
liver disease, low blood pressure, swelling or water
Contraindications Contraindications retention, epilepsy, or a history of seizures.
Tell your doctor if you also have a history of eczema
or neuroleptic malignant syndrome (NMS)
adverse effects adverse effects 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
interactions interactions mental disorders, urinary problems, diet pills, 48h after of Flumist, or
2 weeks before
safety/patient teaching safety/patient teaching
Don't drink alcohol, don't take if you are pregnant or brestfeeding.
Phenytoin Anticonvulsant Risperidone Antipsychotic
It can treat schizophrenia, bipolar disorder, and
IndicationsIt can treat and prevent seizures. Indications irritability caused by autism.
breastfeeding, or if you have kidney disease, pregnant, breastfeeding, or if you have kidney disease, liver disease,
Contraindications liver disease, depression, diabetes, or Contraindications diabetes, high cholesterol, Parkinson disease, trouble swallowing, or a history
of breast cancer or seizures. Tell your doctor if you have heart failure,
porphyria. low blood pressure, or a history of a heart attack or stroke.
adverse effects Increased r/o suicidal thoughts, serrious skin
adverse effects Allergy S/Sx, tarditive diskensia, Flu s/sx, prolonged erec
reactions, liver damage.Decreased blood lvls,
bleeding problems, increased CBG's
swelling of breast
St John's wort, albendazole, amiodarone, aspirin, chlordiazepoxide, Some foods and medicines can affect how risperidone works.
interactions cyclosporine, diazepam, diazoxide, digoxin, disulfiram, folic acid, furosemide, interactions Tell your doctor if you are using carbamazepine, clozapine, fluoxetine,
isoniazid, methylphenidate, nisoldipine, praziquantel, quinidine, reserpine, furosemide, levodopa, paroxetine, phenobarbital, phenytoin, quinidine,
ifampin, sucralfate, theophylline, tolbutamide, or vitamin D. rifampin, or blood pressure medicine.
safety/patient teaching safety/patient teaching
This medicine may make you drowsy or dizzy. Do not drive or do anything else that could be dangerous until
Do not take an antacid or supplement that contains calcium, aluminum, or magnesium at the same time you know how this medicine affects you.
you take phenytoin. Take the antacid or supplement at a different time of day. This medicine may change how your body regulates temperature. Avoid activities that could cause you to become
Do not drink alcohol while you are using this medicine 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.
Levodopa-carbidopa Dopamine precursor Haloperidol Antipsychotic
Indications It can treat Parkinson's disease. Indications Itcontrol
can treat certain types of mental disorders. It can also
symptoms of Tourette syndrome
pregnant or breastfeeding, kidney, liver disease,endocrine problems,
lung or breathing, a sleep disorder, heart or blood vessel problems, pregnant or breastfeeding, or if you have liver disease, kidney disease,
Contraindications heart rhythm problems, or a history of heart attack. wide-angle Contraindications heart or blood vessel disease, blood pressure problems, overactive thyroid,
or history of seizures or breast cancer.
glaucoma, phenylketonuria (PKU), or a history of stomach ulcer
or mental illness.
Allergy S/Sx, unrination ∆, ∆'s in vision, flu like s/sx, HA,
adverse effects Allergy S/Sx, chest pain, difficulty breathing, adverse effects increased confussion, balance problems, increased fall risk
conpulsive behaviors
interactions MAOi's within 14d, isoniazid, reglan, dilantin, risperdone, interactions May interact with some BP medication, lithium, phenindione, RX
tetrabenazine, a phenthiazine (-azine), BP medications for TX of seizures, or parkinsons.
safety/patient teaching safety/patient teaching
This medicine is not right for everyone. Do not use it if you had an allergic Don't drink alcohol with this medication.
reaction to carbidopa or levodopa, or if you have narrow-angle glaucoma, You should not use this medicine if you have had an allergic reaction to
.skin lesions, or a history of skin cancer. haloperidol, or if you have Parkinson disease. This medicine should not be
Do not stop using this medicine suddenly. Your doctor will need to slowly
given to patients with severe brain disease.
decrease your dose before you stop it completely.
Benztropine Central muscarinic antagonist MAOIs Monoamine oxidase inhibitor
It can treat Parkinson's disease and side Monoamine oxidase inhibitors are chemicals that inhibit the activity of the monoamine
Indications effects of other drugs. Indications oxidase enzyme family. They have a long history of use as medications prescribed for
the treatment of depression.
pregnant or breastfeeding, or if you have glaucoma, bowel or a confirmed or suspected cerebrovascular defect or any patients with
stomach problems, an enlarged prostate, heart disease, or cardiovascular disease or confirmed or suspected cerebrovascular defect,
Contraindications 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.
Contraindications hypertension, or history of headache. known hypersensitivity to isocarboxazid.
pheochromocytoma, as such tumors secrete pressor substances whose
Tell your doctor if you have jerky muscle movements caused by another metabolism may be inhibited by Marplan.a history of liver disease, or in those
medicine. with abnormal liver function tests. severe impairment of renal function.
adverse effects Allergy S/Sx, hallucinations, constipation, abd pain, adverse effects See below
dry mouth, troubleswallowing, loss of appetite, weight amphetamines,dopamine, ephedrine, levodopa, phenylpropanolamine and
loss, unable to sweat. pseudoephedrine.MAOIs inhibit other drug-metabolising enzymes and may enhance
interactions Haloperidol, A phenothiazine medicine, such as prochlorperazine,
chlorpromazine, perphenazine, promethazine, thioridazine, A tricyclic
interactions the effects of barbiturates and possibly of other hypnotics, hypoglycaemic agents,
antimuscarinic agents, beta blockers and thiazide diuretics. NO SSRI's with MAIO's
antidepressant medicine, such as amitriptyline, doxepin, nortriptyline cheese, pickled herring, meat/yeast extracts and fermented soya bean extract.
safety/patient teaching safety/patient teaching
This medicine may keep you from sweating enough, which may cause your body to get too hot. ASE:: feeling dizzy when you stand up (postural hypotension). It is more likely to
Be careful in hot weather, and while you exercise or use a sauna or whirlpool. happen if you are older. Less commonly, some people have drowsiness, difficulty
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.
sleeping, headache, weakness and tiredness, a dry mouth, or constipation.
Tell your doctor if your neck muscles become stiff and suddenly weak. Your doctor may need to lower
the dose you are taking.
