, MEDICATION NOTES
KEY: Orange- new drug class. Bold-the meds/category under that class
Anticholinergic-
Side Effects: Constipation. Sedation (don’t drive/operate heavy machinery), dry mouth. A hint: can’t see
(blurred vision), cant pee(urinary retention), cant spit (dry mouth), cant shit (constipation).
Contraindications : closed angle glaucoma (increases intraocular pressure), bowel ileus, urinary
retention, BPH.
Examples of anticholinergics:
• Many antihistamines, and TCA are anticholinergic.
• Oxybutynin (Ditropan), Tolterodine (Detrol), Solifenacin (Vesicare) –They are also
antimuscularic used to treat overactive bladder
• Dicyclomine (Bentyl)-They are also antispasmodic, and used to treat IBS (irritable bowel
syndrome)
• Atropine-It increases the heart rate for patients with symptomatic bradycardia. It can also be
given to dry patient’s secretions with the death rattle. Before giving it do ECG.
• Scopolamine-It’s an antiemetic for motion sickness and controls secretion. If it is given
transdermally-put on hairless, clean, dry area behind ear. Apply before traveling. Replace every
72 hours. Remove old one and put on new. Dispose old. Wash hands. It can also be given to dry
patient secretions with the death rattle
• Benzotropine (Cogentin)-It is used to treat EPS (extrapyramidal symptoms) from antipsychotic
medications.
PPI (Proton Pump Inhibitors)
• Examples: Pantoprazole (Protonix), Lansoprazole (Prevacid), Omeprazole, Esomeprazole
• If taken long term, it decreases calcium absorption and promotes osteoporosis (think risk for
fracture)
• It can cause diarrhea, pneumonia, and c. diff infection (because it suppresses acid and ruins
normal flora)
• Take 30 minutes before meals.
• It can be given when upper GI bleed to reduce GI secretions
Metoclopramide (Reglan)- is used for delayed gastric emptying, GERD, and an antiemetic. It increases GI
motility and promotes stomach emptying.
• Side effects: with long term use: sedation/fatigue, restlessness, headache, sleeplessness, dry
mouth, constipation, diarrhea
, • Side effects that are dangerous and needs to be reported to doctor immediately: EPS-extra
pyramidal symptoms like tardive dyskinesia. (To reverse EPS symptoms-Benztropine (Cogentin)).
Antacid-for ulcers
• Sucralfate (Carafate, Sulcrate)- Give before meals with water. Give at least 2 hours before and
after other medications.
Fiber
• Psyllium, bran
Antidiarrhea
• Loperamide (Imodium)- don’t use for more 2 days or if fever
Tuberculosis-
• All are hepatoxic except Ethambutol. So, you will have signs/symptoms like dark colored urine,
jaundice, fatigue, and anorexia. So do baseline liver function test, Avoid alcohol and hepatotoxic
drugs (like Tylenol)
• Rifampin (Rifadin)- Symptoms (that are normal) red/orange body fluids (like tears, sweat..). So,
wear eyeglasses not contact. Use non hormonal birth control because it can decrease the
effectiveness of oral contraceptives. Take with meals.
• Isoniazid--used to treat latent TB (if active TB, use it with other drugs). Side effects: peripheral
neuropathy (numbness, tingling of extremities). Take vitamin B6 (pyridoxine) to prevent
peripheral neuropathy.
• Ethambutol, or Pyrazinamide- to treat active TB. Side effect: optic neuritis (so have frequent
eye exam, report signs of decreased visual acuity and loss of color (red/green)).
Antiemetic-
• Ondansteron
Anintivirals- used to treat herpes
• Acyclovir (Zovirax), Famciclovir, Valacyclovir
ANTIPSYCHOTICS-used to treat schizophrenia
• Typical: Haloperidol, Fluphenazine
• Atypical: Clozapine, Risperidone, Olanzipine
• Haloperidol- first generation- contraindication for dementia patients
• Clozapine (Clozaril)- Adverse effects are: agranulocytosis (decrease neutrophils), cardiac
disease, and seizures. These are very severe so only used in patients not responding to other
KEY: Orange- new drug class. Bold-the meds/category under that class
Anticholinergic-
Side Effects: Constipation. Sedation (don’t drive/operate heavy machinery), dry mouth. A hint: can’t see
(blurred vision), cant pee(urinary retention), cant spit (dry mouth), cant shit (constipation).
Contraindications : closed angle glaucoma (increases intraocular pressure), bowel ileus, urinary
retention, BPH.
Examples of anticholinergics:
• Many antihistamines, and TCA are anticholinergic.
• Oxybutynin (Ditropan), Tolterodine (Detrol), Solifenacin (Vesicare) –They are also
antimuscularic used to treat overactive bladder
• Dicyclomine (Bentyl)-They are also antispasmodic, and used to treat IBS (irritable bowel
syndrome)
• Atropine-It increases the heart rate for patients with symptomatic bradycardia. It can also be
given to dry patient’s secretions with the death rattle. Before giving it do ECG.
• Scopolamine-It’s an antiemetic for motion sickness and controls secretion. If it is given
transdermally-put on hairless, clean, dry area behind ear. Apply before traveling. Replace every
72 hours. Remove old one and put on new. Dispose old. Wash hands. It can also be given to dry
patient secretions with the death rattle
• Benzotropine (Cogentin)-It is used to treat EPS (extrapyramidal symptoms) from antipsychotic
medications.
PPI (Proton Pump Inhibitors)
• Examples: Pantoprazole (Protonix), Lansoprazole (Prevacid), Omeprazole, Esomeprazole
• If taken long term, it decreases calcium absorption and promotes osteoporosis (think risk for
fracture)
• It can cause diarrhea, pneumonia, and c. diff infection (because it suppresses acid and ruins
normal flora)
• Take 30 minutes before meals.
• It can be given when upper GI bleed to reduce GI secretions
Metoclopramide (Reglan)- is used for delayed gastric emptying, GERD, and an antiemetic. It increases GI
motility and promotes stomach emptying.
• Side effects: with long term use: sedation/fatigue, restlessness, headache, sleeplessness, dry
mouth, constipation, diarrhea
, • Side effects that are dangerous and needs to be reported to doctor immediately: EPS-extra
pyramidal symptoms like tardive dyskinesia. (To reverse EPS symptoms-Benztropine (Cogentin)).
Antacid-for ulcers
• Sucralfate (Carafate, Sulcrate)- Give before meals with water. Give at least 2 hours before and
after other medications.
Fiber
• Psyllium, bran
Antidiarrhea
• Loperamide (Imodium)- don’t use for more 2 days or if fever
Tuberculosis-
• All are hepatoxic except Ethambutol. So, you will have signs/symptoms like dark colored urine,
jaundice, fatigue, and anorexia. So do baseline liver function test, Avoid alcohol and hepatotoxic
drugs (like Tylenol)
• Rifampin (Rifadin)- Symptoms (that are normal) red/orange body fluids (like tears, sweat..). So,
wear eyeglasses not contact. Use non hormonal birth control because it can decrease the
effectiveness of oral contraceptives. Take with meals.
• Isoniazid--used to treat latent TB (if active TB, use it with other drugs). Side effects: peripheral
neuropathy (numbness, tingling of extremities). Take vitamin B6 (pyridoxine) to prevent
peripheral neuropathy.
• Ethambutol, or Pyrazinamide- to treat active TB. Side effect: optic neuritis (so have frequent
eye exam, report signs of decreased visual acuity and loss of color (red/green)).
Antiemetic-
• Ondansteron
Anintivirals- used to treat herpes
• Acyclovir (Zovirax), Famciclovir, Valacyclovir
ANTIPSYCHOTICS-used to treat schizophrenia
• Typical: Haloperidol, Fluphenazine
• Atypical: Clozapine, Risperidone, Olanzipine
• Haloperidol- first generation- contraindication for dementia patients
• Clozapine (Clozaril)- Adverse effects are: agranulocytosis (decrease neutrophils), cardiac
disease, and seizures. These are very severe so only used in patients not responding to other
