Nurses must possess a wide range of knowledge about the vast number of drugs currently available, including their classification, actions and indications, routes of administration, appropriate dosages, side effects and adverse reactions, and antidotes (if available). To facilitate comprehension and retention of this essential information, the drug classification is often aligned for teaching purposes with the procedure, body system, or disease process in which it is used. In this way, the learner is better able to connect the use of a particular drug with a patient’s clinical situation. By recognizing the disease process affecting a particular client, the nurse can confirm what drugs should be administered to that client. The discussion that follows includes relevant information about common drugs although it is not all-inclusive. Drug dosage has been deliberately omitted and should always be cross-checked against reliable sources. Also highlighted are notes that represent the content and concepts frequently tested in nursing. Analgesics are drugs used to provide relief from pain. Included in this category are non-narcotic, nonsteroidal anti-inflammatory drugs (NSAIDs) and narcotic drugs. Some analgesics also have anti-inflammatory effects. Corticosteroids are drugs used to treat a variety of conditions by acting to suppress inflammation and the immune system.
Anesthetics are drugs that cause a reversible loss of sensation. Most anesthetics can cause respiratory depression, hypotension, and arrhythmias. A less common, but important and potentially fatal adverse reaction is malignant hyperthermia. As the result of an inherited condition, susceptible individuals develop hyperthermia, rhabdomyolysis, and muscle rigidity following administration of certain anesthetics. Without prompt treatment with dantrolene, death often occurs. Keep in mind that, when an anesthetic is administered to induce paralysis, a sedative should always be administered first
Anticoagulants are drugs that prevent the clotting of blood. Always monitor the patient’s coagulant level and obtain a complete blood count (CBC) before administering these drugs. Monitor for any type of bleeding.
Antimicrobials are drugs that destroy or inhibit the growth of micro-organisms. This classification includes antibiotic, antifungal, antiparasitic, and antiviral drugs. There are various methods by which antimicrobials can destroy or inhibit micro-organisms:
Always check for allergies before administering antibiotics (especially penicillin [PCN]). Make sure culture and sensitivity has been done before administration of the first dose of an antibiotic.
Antipyretics are fever-reducing drugs.
Cardiac drugs encompass a wide range of drugs used alone or in combination to treat diseases of the heart (arrhythmias, defects) and vasculature (coronary artery disease).
Chemotherapeutic (antineoplastic) drugs are used for palliative or curative effects in the treatment of patients with cancer. These agents inhibit different phases of the cell cycle, inhibiting DNA replication, cell division, or growth. Chemotherapy causes bone marrow depression, resulting in leucopenia and anemia. Loss of hair and damage to the oral mucosa are common side effects. Fertility may also be affected. Patients should be instructed to use a soft toothbrush; because there is increased risk of infection, they should also avoid crowds and practice good hand washing.
All patients who take diabetic medications are at risk for hypoglycemia. Control of blood glucose requires a thorough knowledge of the onset, peak, and duration of action of each drug being taken by the patient. In addition, there are numerous drugs that may cause either hypoglycemia (e.g., beta blockers) or hyperglycemia (e.g., steroids).
Diuretics are used to treat fluid overload. Before administration of a diuretic, it is essential to obtain both a current blood pressure reading and serum electrolyte levels. Do not administer the drug if the systolic pressure is 100 mmHg or lower or the patient has hypocalcemia, hypercalcemia, or hypomagnesemia.
Drugs used to treat gastrointestinal conditions.
Immunosuppressant drugs suppress or reduce the strength of the body’s immune system.
IV fluids are used to maintain water balance or as replacement or restorative therapy.
These drugs are used to treat various neurological, cognitive, and psychological disorders.
Reproductive drugs act upon the reproductive system and are important for the regulation of ovulation and menstruation.
Respiratory drugs are used to treat diseases of the pulmonary system (respiratory tract and lungs), including inflammatory and obstructive diseases, such as reactive airway and chronic obstructive pulmonary diseases.
Tuberculosis (TB) combination drugs represent a variety of drugs used to treat tuberculosis. The most difficult problem is compliance with the drug regimen due to the side effects.
Vitamin and mineral supplements are used to treat various conditions caused by nutritional deficiencies.
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Which condition would the nurse monitor for in the client on aminoglycoside and skeletal muscle relaxants?
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