DRUG SUFFIXES CHEAT SHEET

–SORTED ALPHABETICALLY–

A suffix is the ending of a word, placed after the word’s stem, which
often communicates meaning. Drug suffixes are commonly used to
group drugs based on the drug’s action.

Name Drug Classification Examples Action

Increase the fluid

excreted by the
kidneys, while retaining
potassium in the body.
Potassium-Sparing spironolactone reduces cardiovascular
-actone Diuretics aldactone congestion and edema
that results from CHF.
They also lower blood
pressure.
“Clot busters” that
break down clots that
streptokinase lead to heart attacks or
-ase Thrombolytics alteplase (tPA) strokes, to restore
blood flow to the
obstructed area.

Treat and prevent

azine Antiemetics promethazine nausea and vomiting.

Prevent the
transmission of nerve
lidocaine
-caine Local Anesthetics impulses or pain
xylocaine
without causing
unconsciousness.
Broad spectrum antibiotics
tetracycline
-cycline Tetracyclines that treat bacterial
doxycycline
infections.
Relax blood vessels,
therefore increasing blood
-dipine Calcium Channel amlodipine nifedipine supply and oxygen to the
Blockers heart and reducing the
heart’s workload while
lowering blood pressure.
 Name Drug Classification Examples Action

ciprofloxacin Broad spectrum

-floxacin Fluoroquinolones levofloxacin antibiotics that treat
bacterial infections.

repaglinide Lower blood glucose

Meglitinides levels by triggering the
-ide nateglinide
production of insulin;
glyburide
used to treat type 2
glipizide diabetes.
Sulfonylureas

diphenhydramine Treat allergy symptoms,

loratadine such as sneezing, runny
Antihistamines nose, itching, and hives,
brompheniramine
caused by histamine
activation.
-ine Block or delay the
fluoxetine reabsorption of
Selective Serotonin
sertraline serotonin; used to
Reuptake Inhibitors
treat major depressive
(SSRIs)
disorders and anxiety
disorders
Treat anxiety;
prolonged use may
-lam Benzodiazepines alprazolam
lead to physical
dependence.

Increase the fluid excreted

by the kidneys, while
atenolol retaining potassium in the
metoprolol body. reduces
-lol Beta Blockers
propranolol cardiovascular congestion
and edema that results
from CHF. They also lower
blood pressure.

Anti-inflammatory
drugs used to control
Corticosteroids methylprednisolone
-lone many different
inflammation-related
symptoms.
 Name Drug Classification Examples Action

Broad spectrum
-micin - gentamicin
Aminoglycosides antibiotics that treat
mycin tobramycin
bacterial infections.

Treat anxiety;
alprazolam prolonged use may
-pam Benzodiazepines diazepam lead to physical
lorazepam dependence.

Dilate the bronchi and

bronchioles,
theophylline decreasing resistance
-phylline Bronchodilators in the airway and
increasing airflow to
the lungs. Often used
for asthma and COPD.

Block or delay the

reabsorption of
Selective Serotonin citalopram serotonin; used to
-pram Reuptake Inhibitors treat major depressive
(SSRIs) disorders and anxiety
disorders

Anti-ulcer drugs that

Proton Pump lansoprazole
-prazole reduce gastric acid
Inhibitors omeprazole production.

Reduce blood pressure

captopril by dilating blood
-pril ACE Inhibitors lisinopril vessels, thus reducing
the heart’s workload.

Inhibit blood vessel

Angiotensin-II
losartan constriction, helping
-sartan Receptor
valsartan blood vessels relax,
Blockers
which lowers blood
pressure.

Anti-inflammatory
drugs used to control
-sone Corticosteroids
dexamethasone many different
prednisone inflammation-related
symptoms.
 Name Drug Classification Examples Action

Reduce LDL
atorvastatin cholesterol and lower
-statin Antilipidemics simvastatin risks from
cardiovascular disease.

Dilate the bronchi and

bronchioles,
decreasing resistance
albuterol levabutero
-terol Bronchodilators in the airway and
increasing airflow to
the lungs. Often used
for asthma and COPD.

Increase fluid and

potassium excreted by
the kidneys. Reduces
Thiazide Diuretics hydrochlorothiazide cardiovascular
-thiazide
congestion and edema
that results from CHF.
They also lower blood
pressure.

Block the action of

H2-receptor histamine in the
cimetidine
-tidine Antagonists (H2 stomach, decreasing
famotidine
Blockers) the production of
stomach acid.

Treat depression,
Tricyclic amitriptyline bipolar disorder,
-triptyline Antidepressants anxiety, OCD, and
nortriptyline
other mood disorders.
 Antibiotics
Antibiotics are powerful medications that treat certain infections and can
save lives when used properly. They either stop bacteria from reproducing
or destroy them.
They include a range of powerful drugs used to treat diseases caused by
bacteria.
Antibiotics cannot treat viral infections, such as cold, flu, and most coughs.
The main types of antibiotics include: Penicillins - for example,
phenoxymethylpenicillin, flucloxacillin and amoxicillin. Cephalosporins -
for example, cefaclor, cefadroxil and cefalexin. Tetracyclines - for example,
tetracycline, doxycycline and lymecycline

Fast facts on antibiotics Side effects of Antibiotics

Alexander Fleming Diarrhea
discovered penicillin, the Nausea
first natural antibiotic, in Vomiting
1928. Rash
Antibiotics cannot fight viral Upset stomach
infections. Sensitivity to sunlight, when
Fleming predicted the rise of taking tetracyclines
antibiotic resistance.

Types of antibiotics

Class Examples
Pencillins Amoxicillin (Amoxil)

Macrolides Azithromycin (Zithromax)

Cephalosporins Cephalexin (Keflex)

Fluoroquinolones Ciprofloxacin (Cipro)

Lincosamides Clindamycin (Cleocin)

 Allergy
A raised rash, or hives
Swelling of the tongue and face
Coughing
Wheezing
Difficulty breathing

Antibiotics to prevent infection

Antibiotics are sometimes given as a precaution to prevent, rather than treat,

an infection. This is called antibiotic prophylaxis. Situations where antibiotics
are given as a preventive treatment include:
if you're having an operation
after a bite or wound that could get infected
if you have a health problem that means you're at higher risk of infection
such as if you've had your spleen removed or you're having
chemotherapy treatment

When antibiotics are needed?

Antibiotics may be used to treat bacterial infections that:

are unlikely to clear up without antibiotics
could infect others
could take too long to clear without treatment
carry a risk of more serious complications
People at a high risk of infection may also be given antibiotics as a precaution,
known as antibiotic prophylaxis.

Missing a dose of antibiotics

If you forget to take a dose of your antibiotics, take that dose as soon as you
remember and then continue to take your course of antibiotics as
normal.But if it's almost time for the next dose, skip the missed dose and
continue your regular dosing schedule.
 Pain Medications
Pain medicines, whether they’re over-the-counter or prescription strength,
can help you manage chronic pain and other kinds of pain. They’re powerful
drugs, so it's important to use them with care. It’s best to start with the
safest drugs at the lowest effective dose for the shortest amount of time and
work up from there as needed.

Over-the-Counter Pain Relievers

Over-the-counter (OTC) pain relievers include:
Acetaminophen (Tylenol)
Nonsteroidal anti-inflammatory drugs (NSAIDs), including ibuprofen,
naproxen, and diclofenac gel

Types of over-the-counter pain relievers

Common OTC pain medications include:

Acetaminophen:
This drug (Tylenol®) dulls pain receptors in the brain. As a result, you feel
less pain.
Nonsteroidal anti-inflammatory drugs (NSAIDs):
NSAIDs lower the production of prostaglandins. These hormone-like
chemicals irritate nerve endings, causing inflammation and pain. NSAIDs
include aspirin compounds (Excedrin®), ibuprofen (Advil® and Motrin®)
and naproxen sodium (Aleve®).
Combination:
Some pain relievers contain both acetaminophen and aspirin (an NSAID).
Certain OTC headache medicines also have caffeine.
Topical:
You apply this pain medication directly to your skin. It comes as a cream,
gel, spray or patch. Topical medicines block pain receptors in the brain.
They may contain aspirin, lidocaine, capsaicin pepper or other medication.
Some topical treatments make the skin feel warmer or cooler.
What do over-the-counter pain relievers treat?
OTC pain medications lower fevers and ease pain from a variety of problems,
including:

Arthritis, bursitis and tendonitis.

Back strains and sprains.
Broken bones.
Burns, including sunburns.
Colds, flu and ear infections.
Headaches and migraines.
Menstrual cramps (dysmenorrhea).
Muscle pain, including neck pain.
Surgeries and minor procedures.
Toothaches.

Prescription Pain Relievers

Prescription medicines to treat pain include:
Corticosteroids
Opioids
Antidepressants
Anticonvulsants (anti-seizure medications)
NSAIDs

What do prescription pain relievers treat?

Prescription pain relievers can alleviate pain brought on by:
Cancer.
Fibromyalgia.
Migraines.
Nerve (neuropathic) pain, including diabetes-related neuropathy.
Postoperative pain.
Severe arthritis pain.
Severe muscle pain, including back pain.
Traumatic injuries, including broken bones and burns.
 Types of prescription pain relievers

Prescription pain medications provide stronger pain relief than OTC drugs.
Types of prescription pain relievers include:
Antidepressants:
Antidepressants work on chemicals called neurotransmitters in the brain.
These drugs work best for chronic pain, including migraines. The largest
pain relief comes from tricyclics (Elavil®) and serotonin-norepinephrine
reuptake inhibitors (SNRIs), such as Effexor® and Cymbalta®. Studies
show that selective serotonin reuptake inhibitors (SSRIs) like Prozac®
don’t work as well for pain. SSRIs may make other pain medicines less
effective.
Anti-seizure medications:
Medications for epilepsy interrupt pain messages to the brain. Types
include gabapentin (Gabarone®) and pregabalin (Lyrica®). These
medicines can ease nerve pain and fibromyalgia.
Muscle relaxers:
These medications reduce pain by relaxing tight muscles. They also relieve
muscle spasms.
Opioids:
Opioids are lab-made narcotic pain medicines. They change how your brain
perceives pain messages. Because they can be addictive, healthcare
providers rarely prescribe opioids for chronic pain. You may take opioids
for a short time after a surgery or traumatic injury. Codeine, fentanyl,
hydrocodone and morphine are all opioids.
Steroids:
Corticosteroids are strong anti-inflammatory drugs. Like NSAIDs, they
stop your body from making chemicals that cause irritation and
inflammation. Steroids such as Prednisone® treat migraines and severe
arthritis and back pain.
Topical:
Your provider can choose among prescription-strength skin creams, gels,
sprays and patches. They can ease muscle pain, arthritis and fibromyalgia.
 Psychiatric Medication A to Z
A B C D E F
Abilify Benperidol Clozaril Denzapine Ebesque Faverin
Alaquet Biquelle Cipramil Depakote Edronax Fluanxol
Alzain Brancico Clopizol Depefex Efexor Fluoxetine
Anquil Brintellix Clopixol Depixol Epilim Flupentixol
Axalid Buspirone Cipralex Dolmatil Escitalopram Foraven
Alventa H Chloractil I L M
Amphero Haldol Circadin Imipramine Lamictal Majoven
Arpoya Halkid Cariprazine Invega Largactil Manerix
Ativan Haloperidol N Isocarboxazid Latuda Mintreleg
Allegron Heminevrin Nardil O Lecaent Modecate

P Q Nozinan Olena Li-liquid Mogadon

Psytoxil Quetiapine Nortriptyline Orap Librium Molipaxin
Prozep R Nitrazepam Oxactin Lomont S
Prozac Reaglia T Oxazepam V Seroquel
Prothiaden Risperdal Tegretol Olanzapine Valdoxan Seroxat
Priadel Reboxetine Tenprolide W Venaxx Sinepin
Politid Risperidone Tensium Welldorm Venlablue Slenyto
Phenergan X Trevicta Z Venlalic Solian
Parnate Xanax Tropium Zalasta Venlasoz Sominex
Pimozide Xeplion Temazepam Zaluron Vensir Stelazine
Paroxetine -- Trazodone Zaponex Venzip Stemetil
Phenelzine -- Trimipramine Zimovane ViePax Stesolid

-- -- -- Zispin Venlafaxine Stilnoct

-- -- -- Zolpidem Vortioxetine Sulpor

-- -- -- Zopiclone Valproate Sunveniz

-- -- -- ZypAdhera -- Surmontil
-- -- -- Zyprexa -- Sycrest
 Cardiac Medications
Sacubitril/valsartan
This is the first in a class of heart Nursing points:
failure medication called angiotensin Sacubitril/valsartan should not be
receptor neprilysin inhibitors. It given with an ACE inhibitor.
combines an angiotensin receptor
blocker (valsartan) with a neprilysin Adverse effects:
enzyme inhibitor (sacubitril). Adverse effects include dizziness,
Neprilysin breaks down natriuretic fatigue, cough, hypotension, and
peptides, which are responsible for hyperkalemia.
sodium and water loss when Indications:
ventricles are overloaded. Delaying Sacubitril/valsartan is indicated
their breakdown lengthens their to reduce the risk of
effects and removes more sodium hospitalization and death in
and water from the body, decreasing patients with chronic heart
intravascular volume and blood failure and reduced ejection
pressure, resulting in decreased fraction.
preload and afterload.

Angiotensin receptor blockers

Similar to ACE inhibitors, ARBs block the Nursing points:
action of angiotensin II. However, they work ARBs and ACE inhibitors
at a different level of interaction with angio shouldn’t be used
ten – sin II, reducing the risk of hyperkalemia interchangeably. ACE
or cough that’s seen with ACE inhibitors. inhibitors are preferred
ARBs block angiotensin II receptors in the over ARBs because they’re
blood vessels and the adrenal glands. In the associated with a decrease
blood vessels, ARBs cause venous and arterial in morbidity and mortality.
dilation to reduce both preload and afterload.
Blocking angiotensin II receptors in the
Adverse effects:
ARBs are well tolerated
adrenal glands decreases the release of
and have minimal side
aldosterone, which in turn increases the
effects.
excretion of sodium and water.
 Beta-blockers
Beta-blockers block the effects of Nursing points:
adrenaline, which comes on in Fluid retention may worsen heart
response to stressful situations. failure but can usually be managed
Beta-blockers are prescribed in the with diuretics. If bradycardia or
treatment of these four conditions: hypotension are problematic, the
Angina. provider may reduce the beta
Heart attack. blocker dose. Because of decreased
Congestive heart failure. heart rate and blood pressure
Abnormal heart rhythms. associated with beta blockers, they
Dosage of these medications must shouldn’t be administered at the
be adjusted for the desired response. same time as ACE inhibitors.
Your doctor will monitor you for Adverse effects:
dizziness (due to low heart rate) Adverse effects of beta blockers
kidney and liver problems. include fluid retention, fatigue,
bradycardia, and hypotension.

Examples: Bisoprolol, carvedilol, sustained-release metoprolol.

ACE inhibitors
Angiotensin-converting enzyme (ACE) inhibitors cause vasodilation in both
the venous and arterial systems, so they decrease both preload and afterload,
increasing blood flow to vital organ systems and improving ejection fraction.
These medications also block the enzyme needed to convert angiotensin I to
angiotensin II. Angiotensin II is a strong vasoconstrictor that raises blood
pressure, releases aldosterone, and leads to sodium and water retention. ACE
inhibitors prevent this cascade of effects.

Adverse effects: Nursing points:

Include hyperkalemia, renal failure, Although the cough can be
and a dry, persistent cough associated annoying, explain to the
with increased bradykinin. If the cough patient that it’s a side effect
is intolerable, the provider may of the medication and
discontinue the ACE inhibitors in favor encourage him or her to
of an angiotensin receptor blocker continue its use.
(ARB).
 Ivabradine
Ivabradine, the first sinoatrial (SA)- Adverse effects:
node modulator approved to treat include bradycardia and hypotension.
heart failure, decreases normal SA
node activity and lowers heart rate. It Nursing points:
Administer ivabradine as ordered if a
does not affect myocardial
contractility. ≥
patient’s heart rate is 70 bpm.

Diuretics
Diuretics help the body get rid of Adverse effects:
Electrolyte loss.
excess fluid and sodium. This
helps reduce the work the heart Nursing points:
must do. It also decreases fluid Instruct patients to decrease their dietary
buildup in the lungs and intake of sodium, weigh themselves daily,
elsewhere in the body. It is and take the diuretic early in the day to
prescribed to lower blood prevent nocturia. Hypokalemia is a side
pressure and to reduce swelling. effect of loop diuretics, so monitor patients’
Some of the common drug names serum potassium levels

are amiloride, chlorothiazide,

Examples:
Lasix, Lozol and Aldactone.
Furosemide, bumetanide, and torsemide.

Hydralazine/isosorbide dinitrate
The drugs Adverse effects:
isosorbide include headache, dizziness, and orthostatic hypotension.
dinitrate and
hydralazine have Nursing points:
Advise patients to change position slowly to
been combined
prevent falls due to postural changes in blood
into a single pill to
pressure.
reduce both
cardiac preload Indications:
and afterload This medication decreases deaths and hospitalization
through venous in African Americans, who are less responsive to
and arterial angiotensin-converting enzyme inhibitors because of
vasodilation. suspected differences in endothelial function.
 Endocrine Medications
Endocrine medications can be broken down into the following
categories:
Diabetic agents
Hormone agonists
Hormone antagonists

Diabetic Agents
Sulfonylureas (1st Generation)
Name Mechanism of Action Key Indication(s) Key Toxicity
Chlorpropamide Inhibits ATP-sensitive K+ Second-line Hypoglycemia
Tolazamide channels resulting in β- treatment for type II Renal failure
Tolbutamide cell depolarization and diabetes Disulfiram effects
insulin release

Sulfonylureas (2nd Generation)

Name Mechanism of Action Key Indication(s) Key Toxicity

Glipizide Inhibits ATP-sensitive K+ Second-line Hypoglycemia (long-

channels resulting in β- treatment for type II lasting)
Glyburide cell depolarization and diabetes Renal failure
insulin release Disulfiram effects

Biguinides
Name Mechanism of Action Key Indication(s) Key Toxicity

Exact mechanism First-line Lactic acidosis in

Metformin treatment for patients with poor
unknown
renal function
↓ gluconeogenesis type II diabetes
↑ insulin sensitivity and metabolic
↑ glycolysis syndrome
↓ serum glucose levels
↓ postprandial glucose
levels
 Alpha-Glucosidase Inhibitor
Name Mechanism of Action Key Indication(s) Key Toxicity

Acarbose Prevents breakdown of Refractory type II Osmotic diarrhea

Miglitol carbohydrates into single diabetes mellitus Flatulence
glucose molecules
decreasing rate of
absorption

Thioglitazones
Name Mechanism of Action Key Indication(s) Key Toxicity

Pioglitazone Stimulates PPAR-γ which Type II diabetes Heart failure

controls insulin-sensitive combination Hepatotoxicity
Troglitazone
genes resulting in increased therapy
Weight gain
insulin sensitivity in
Rosiglitazone
peripheral tissues

Hormone Agonists
Progestins
Name Mechanism of Action Key Indication(s) Key Toxicity
Synthetic progestin Appetite stimulant Weight gain
Megestrol
suppresses leuteinizing Anti-neoplastic Nausea
acetate
hormone by inhibition of
agent Vomiting
pituitary function
Anorexic mechanism

Estrogen
Name Mechanism of Action Key Indication(s) Key Toxicity
Polyestradiol Inhibits actions of Palliative prostate Feminization
dihydrotestosterone cancer therapy Nausea
Blocks LH secretion by Headache
pituitary
Water retention
Decreases testosterone
synthesis
Blocks testosterone uptake
into prostate cells

Diethylstilbestrol Inhibits HPG axis Believed to decrease Clear cell carcinoma

Blocks testosterone synthesis incidence of stillbirth Vaginal adenosis
Induces chemical castration T-shaped uterus
 Gonadotropin Releasing Hormones
Name Mechanism of Action Key Indication(s) Key Toxicity

Leuprorelin Acts as a gonadotropin Hormone Flushing

releasing hormone responsive cancer Sweating
agonist which inhibits (non-pulsatile) Fatigue
gonadotropin secretion Fertility (pulsatile) Edema

Hormone Antagonists

Anti-Estrogens
Name Mechanism of Action Key Indication(s) Key Toxicity

Tamoxifen Competitively binds to ER/PR positive Endometrial cancer

estrogen receptors breast cancer Growth plate fusion
inhibiting effects of Increased bone
estrogen density

Anti-Androgens
Name Mechanism of Action Key Indication(s) Key Toxicity

Flutamide Blocks action of Prostate cancer Gynecomastia

testosterone by binding (used prior to GnRH GI disturbance
to adrogen receptors analogues)

Enzyme Inhibitors
Name Mechanism of Action Key Indication(s) Key Toxicity

Anastrozole Inhibits aromatase ER/PR positive Osteoporosis

breast cancer Bone fracture
Fertility
 Medications For Infection
Penicillin Cephalosporin
Penicillin is a medication used to Cephalosporins are beta-lactam
manage and treat a wide range of antimicrobials used to manage a
infections. It is in the beta-lactam wide range of infections from
antibiotic class of drugs. This gram-positive and gram-negative
activity describes penicillin's bacteria. The five generations of
indications, action, and cephalosporins are useful against
contraindications as a valuable skin infection, resistant bacteria,
agent in treating infection. meningitis, and other infections

Carbapenems Tetracycline
Carbapenems exhibit unique Tetracyclines (tetracycline,
pharmacological properties and doxycycline, minocycline,
are typically used to treat tigecycline) are a class of
complicated bacterial infections. A medication used to manage and
carbapenem is often combined treat various bacterial infections.
with an antibiotic that targets Tetracyclines classify as protein
Gram-positive bacteria when used synthesis inhibitor antibiotics and
for the empirical treatment of are considered to be broad-
patients with serious nosocomial spectrum.
infections of unidentified origin.
Macrolides

Lincosamides Macrolides are a class of drugs

used to manage and treat
Lincomycin is the prototype of this various bacterial infections.
class and clindamycin the only Azithromycin, clarithromycin,
member of this group in clinical and erythromycin are
use. Clindamycin is a bacteriostatic commonly used to treat
antibiotic. It is mainly used in the infections like pneumonia,
treatment of infections caused by sinusitis, pharyngitis, and
Gram-positive bacteria. tonsillitis.
 Aminoglycoside Sulfonamide
Aminoglycosides are used in the Sulfonamides (SN) or sulfanilamides
treatment of severe infections of belong to an important class of
the abdomen and urinary tract, as synthetic antimicrobial drugs that
well as bacteremia and are pharmacologically used as broad
endocarditis. They are also used for spectrum for the treatment of
prophylaxis, especially against human and animal bacterial
endocarditis. Resistance is rare but infections
increasing in frequency
Antiprotozoal
Antifungal Antiprotozoal agents are a class of
drugs used to treat infections
Antifungal medicines are used to caused by protozoa, which are
treat fungal infections, which most single-cell organisms, belonging to
commonly affect your skin, hair and a group of parasites. Protozoans
nails. typically are microscopic and
Topical Antibacterials similar to plants and animals as
they are eukaryotes, thus having a
Topical antibacterials are clearly defined cell nucleus
commonly used for superficial
pyodermas such as impetigo and Antivirals
treatment or prevention of Antivirals are medications that help
infections following minor cuts, your body fight off certain viruses
abrasions, burns, and surgical that can cause disease. Antiviral
wounds. Several antibiotics and drugs are also preventive. They can
antiseptics are available for use in protect you from getting viral
different indications. One of the infections or spreading a virus to
major uses of topical antibacterials others.
is acne in which benzoyl peroxide
is the drug of the first choice either Antitubercular
singly or in combination with A broad-spectrum antibiotic used in
antibiotics or retinoids. the treatment of tuberculosis and
certain urinary tract infections
(UTI). An aminoglycoside antibiotic
used as an adjunct drug in
tuberculosis.
 Drug
Drug Class Generic Name Brand Name

Dosage Indications Mechanisms of Action

Adverse Effects Contraindications Interactions

Nursing Considerations Patient Education

 Therapeutic drug levels
Therapeutic drug levels are lab tests to look for the amount of a
drug in the blood.

Needle is introduced into

Tourniquet is applied
vein, blood is drawn into
and area is disinfected
vial and analyzed

How the Test is Performed?

A blood sample is needed. Most of the time, blood is drawn from a vein
located on the inside of the elbow or the back of the hand.
How to Prepare for the Test?
You will need to prepare for some drug level tests.
Your health care provider will tell you if you need to change the times
you take any of your medicines.
DO NOT stop or change your medicines without talking to your
provider first.
Why the Test is Performed?
With most medicines, you need a certain level of the drug in your blood to
get the proper effect. Some medicines are harmful if the level rises too high
and do not work if the levels are too low.
Monitoring the amount of the drug found in your blood allows your
provider to make sure the drug levels are in the proper range.
Drug level testing is important in people taking drugs such as:

Flecainide, procainamide or digoxin, which are used to treat abnormal

beating of the heart
Lithium, used to treat bipolar disorder
Phenytoin or valproic acid, which are used to treat seizures or other
conditions
Gentamicin or amikacin, which are antibiotics used to treat infections
Tacrolimus, sirolimus or cyclosporine, which are used to suppress
immune system activity against transplanted organs
Normal Test Results
Acetaminophen: varies with use
Amikacin: 15 to 25 mcg/mL (25.62 to 42.70 micromol/L)

Carbamazepine: 5 to 12 mcg/mL (21.16 to 50.80 micromol/L)

Cyclosporine: 100 to 400 ng/mL (83.20 to 332.80 nmol/L) (12 hours after dose)

Desipramine: 150 to 300 ng/mL (563.10 to 1126.20 nmol/L)

Digoxin: 0.8 to 2.0 ng/mL (1.02 to 2.56 nanomol/L)

Ethosuximide: 40 to 100 mcg/mL (283.36 to 708.40 micromol/L)

Flecainide: 0.2 to 1.0 mcg/mL (0.5 to 2.4 micromol/L)

Gentamicin: 5 to 10 mcg/mL (10.45 to 20.90 micromol/L)

Imipramine: 150 to 300 ng/mL (534.90 to 1069.80 nmol/L)

Kanamycin: 20 to 25 mcg/mL (41.60 to 52.00 micromol/L)

Lidocaine: 1.5 to 5.0 mcg/mL (6.40 to 21.34 micromol/L)

Lithium: 0.8 to 1.2 mEq/L (0.8 to 1.2 mmol/L)

Methotrexate: varies with use

Nortriptyline: 50 to 150 ng/mL (189.85 to 569.55 nmol/L)

Phenobarbital: 10 to 30 mcg/mL (43.10 to 129.30 micromol/L)

Phenytoin: 10 to 20 mcg/mL (39.68 to 79.36 micromol/L)

Quinidine: 2 to 5 mcg/mL (6.16 to 15.41 micromol/L)

Salicylate: varies with use

Sirolimus: 4 to 20 ng/mL (4 to 22 nmol/L)

Tacrolimus: 5 to 15 ng/mL (4 to 25 nmol/L) (12 hours after dose)

Theophylline: 10 to 20 mcg/mL (55.50 to 111.00 micromol/L)

Valproic acid: 50 to 100 mcg/mL (346.70 to 693.40 micromol/L)

 AbNormal Test Results
Acetaminophen: greater than 250 mcg/mL (1653.50 micromol/L)
Amikacin: greater than 25 mcg/mL (42.70 micromol/L)

Carbamazepine: greater than 12 mcg/mL (50.80 micromol/L)

Cyclosporine: greater than 400 ng/mL (332.80 micromol/L)

Desipramine: greater than 500 ng/mL (1877.00 nmol/L)

Digoxin: greater than 2.4 ng/mL (3.07 nmol/L)

Ethosuximide: greater than 100 mcg/mL (708.40 micromol/L)

Flecainide: greater than 1.0 mcg/mL (2.4 micromol/L)

Gentamicin: greater than 12 mcg/mL (25.08 micromol/L)

Imipramine: greater than 500 ng/mL (1783.00 nmol/L)

Kanamycin: greater than 35 mcg/mL (72.80 micromol/L)

Lidocaine: greater than 5 mcg/mL (21.34 micromol/L)

Lithium: greater than 2.0 mEq/L (2.00 millimol/L)

Methotrexate: greater than 10 mcmol/L (10,000 nmol/L)

Nortriptyline: greater than 500 ng/mL (1898.50 nmol/L)

Phenobarbital: greater than 40 mcg/mL (172.40 micromol/L)

Phenytoin: greater than 30 mcg/mL (119.04 micromol/L)

Quinidine: greater than 10 mcg/mL (30.82 micromol/L)

Salicylate: greater than 300 mcg/mL (2172.00 micromol/L)

Theophylline: greater than 20 mcg/mL (111.00 micromol/L)

Tobramycin: greater than 12 mcg/mL (25.67 micromol/L)

Valproic acid: greater than 100 mcg/mL (693.40 micromol/L)

 Respiratory Medications
Beta2-agonists Methylxanthines
Beta2-agonists (bronchodilators) Methylxanthines are relatively
are a group of drugs prescribed to weak bronchodilators that are
treat asthma. Short-acting beta- administered systemically. They
agonists (SABAs) provide quick have been used for treatment of
relief of asthma symptoms. They acute exacerbations as well as for
can also be prescribed to be taken long-term control of asthma
before exercising in order to symptoms. The most common
prevent exercise-induced methylxanthine used for asthma
bronchoconstriction. treatment is theophylline.

Decongestants Antihistamines
Decongestants are a type of An antihistamine is a prescription
medicine that can provide short- or over-the-counter medication
term relief for a blocked or stuffy that blocks some of what histamine
nose (nasal congestion). does. “Anti” means against, so
They can help ease the symptoms antihistamines are medicines that
of conditions such as colds and flu, work against or block histamine.
hay fever and other allergic
reactions, catarrh and sinusitis. Glucocorticoids
They work by reducing the swelling
Inhaled and intranasal
of the blood vessels in your nose,
glucocorticoids (GCs) are the most
which helps to open the airways.
common and effective drugs for
Examples include pseudoephedrine
controlling symptoms and airway
Types of decongestants
inflammation in respiratory
nasal sprays
diseases such as allergic rhinitis,
Drops
chronic rhinosinusitis
Tablets or capsules
with/without nasal polyps, and
Liquids or syrups
asthma, and the respiratory
Flavoured powders to dissolve
epithelium is a primary target of
in hot water
GC anti-inflammatory actions.
 Nursing Process Related to Respiratory
Medications

Implementation of Interventions

Respiratory medications are available in many different formulations,

such as nasal spray, inhalations, oral tablets or liquids, injections, or
intravenous route, so it is always important to verify the correct route and
anticipate the associated side effects. For example, inhalations deliver the
required medicine or medicines directly to the lungs, which means the
medicine(s) can act directly on the lung tissues, minimizing systemic side
effects. On the other hand, intravenous medications are administered to
act quickly, but can cause systemic side effects. Additionally, some
products contain more than one medicine with different dosages (for
example, inhalers that combine a long-acting bronchodilator with a
glucocorticoid).

Respiratory medications are available in many different formulations, such

as nasal spray, inhalations, oral tablets or liquids, injections, or
intravenous route, so it is always important to verify the correct route and
anticipate the associated side effects. For example, inhalations deliver the
required medicine or medicines directly to the lungs, which means the
medicine(s) can act directly on the lung tissues, minimizing systemic side
effects. On the other hand, intravenous medications are administered to
act quickly, but can cause systemic side effects. Additionally, some
products contain more than one medicine with different dosages (for
example, inhalers that combine a long-acting bronchodilator with a
glucocorticoid).

Additionally, the nurse should also ensure the proper use of the inhalers
by the patient. Observe the patient self-administering the medication,
and further instruct the patient in proper use
 Nursing Process Related to Respiratory
Medications
Nursing Process: Evaluation

Finally, it is important to always evaluate the patient’s response to a

medication. With respiratory medications, the nurse should assess
decrease in allergy symptoms (cough, runny nose, tearing eyes) and
any decrease in shortness of breath. The nurse should complete a
respiratory assessment (respirations, pulse oximetry, and lung
auscultation) before and after the medications have been administered
and compare the results. If the symptoms are not improving or the
clinical assessment is worsening, prompt intervention is required
(such as notification of the health care provider for further orders) to
prevent further clinical deterioration.
 Musculoskeletal Meds
Musculoskeletal Pain
Musculoskeletal pain is pain that affects:
Bones.
Joints.
Ligaments.
Muscles.
Tendons.
Musculoskeletal pain can be acute, meaning it is sudden and severe. Or the
pain can be chronic (long-lasting). You may have localized pain (in one
area of your body), or it may affect your entire body.

Types of musculoskeletal pain

The most common types of musculoskeletal pain include:
Bone pain: Injuries such as bone fractures or other musculoskeletal
injuries cause bone pain. Less commonly, a tumor may cause bone
pain.
Joint pain: Stiffness and inflammation often accompany joint pain. For
many people, joint pain gets better with rest and worsens with
activity.
Muscle pain: Muscle spasms, cramps and injuries can all cause muscle
pain. Some infections or tumors may also lead to muscle pain.
Tendon and ligament pain: Ligaments and tendons are strong bands of
tissue that connect your joints and bones. Sprains, strains and overuse
injuries can lead to tendon or ligament pain.

Types of musculoskeletal pain

Common causes of musculoskeletal pain include:
Bone fractures.
Joint dislocation
Direct blows to muscles, bones or joints.
Overuse injuries.
Poor posture.
Symptoms of musculoskeletal pain
Symptoms may vary depending on the cause of your musculoskeletal
pain. Common symptoms include:
Aching and stiffness.
Burning sensations in the muscles.
Fatigue.
Muscle twitches.
Pain that worsens with movement.
Sleep disturbances.

How is musculoskeletal pain diagnosed?

Your healthcare provider starts a diagnosis by taking a thorough

medical history. Your healthcare provider may ask you questions to
determine:
If you have other symptoms, such as a rash or fever.
Whether your pain is acute or chronic.
Which factors make pain worse or relieve it.
Then, your healthcare provider does a hands-on exam to look for the
pain’s source. Your provider may touch or move the affected area.

How is musculoskeletal pain treated?

Your treatment plan will depend on the underlying cause of your

musculoskeletal pain. Common treatments include:
Acupuncture.
Chiropractic adjustment.
Occupational therapy.
Pain relievers.
Physical therapy.
Splints.
Steroid injections.
Therapeutic massage.
Can musculoskeletal pain treated at home?

Your healthcare provider may guide you to manage

musculoskeletal pain at home. Recommendations may include:
Hot and cold therapy.
Over-the-counter pain relievers.
Strengthening and conditioning exercises.
Stretching exercises.
Stress reduction techniques.

Medications used for musculoskeletal pain

Acetaminophen (Tylenol®).
Nonsteroidal anti-inflammatory drugs (NSAIDs).
Prescription medications, such as opioids.

How to prevent musculoskeletal pain?

Maintaining strong bones and joints is crucial for preventing
musculoskeletal pain. You can work to avoid musculoskeletal pain
if you:
Limit repetitive movements.
Use good posture.
Practice correct lifting techniques.
Stretch regularly.

How to cope with musculoskeletal pain?

To cope with musculoskeletal pain:
Avoid smoking, which increases inflammation.
Eat a healthy, non-inflammatory diet.
Rest the injured muscle, joint or bone.
Stretch daily or as often as your healthcare provider advises.
Take pain medications as prescribed.
Use ice and heat to decrease swelling and inflammation.
 Vitamins
Vitamins are organic substances present in minute amounts in
natural foodstuffs. Having too little of any particular vitamin may
increase the risk of developing certain health issues.
A vitamin is an organic compound, which means that it contains
carbon. It is also an essential nutrient that the body may need to get
from food.

Fat-soluble vitamins

Vitamins A, D, E, and K are fat-soluble. The body storesTrusted Source

fat-soluble vitamins in fatty tissue and the liver, and reserves of these
vitamins can stay in the body for days and sometimes months.

Dietary fats help the body absorb fat-soluble vitamins through the
intestinal tract.

Water-soluble vitamins

Water-soluble vitamins do not stay Trusted Source in the body for long
and cannot be stored. They leave the body via the urine. Because of this,
people need a more regular supply of water-soluble vitamins than fat-
soluble ones.
Vitamin C and all the B vitamins are water-soluble.

Vitamin A

It is fat-soluble.
Function: It is essential for eye health.
Deficiency: This may cause night blindness and keratomalacia, which
causes the clear front layer of the eye to grow dry and cloudy.
Good sources: These include liver, cod liver oil, carrots, broccoli, sweet
potatoes, butter, kale, , some cheeses, eggs, apricots, cantaloupe and milk.
Vitamin B1 Vitamin B2

It is water-soluble. It is water-soluble.
Function: It is essential for Function: It is essential for the
producing various enzymes that growth and development of
help break down blood sugar. body cells and helps metabolize
Deficiency: This may cause food.
beriberi and Wernicke-Korsakoff Deficiency: Symptoms include
syndrome. inflammation of the lips and
Good sources: These include fissures in the mouth.
yeast, pork, cereal grains, Good sources: These include
sunflower seeds, brown rice, asparagus, bananas,
whole grain rye, asparagus, kale, persimmons, okra, chard,
cauliflower, potatoes, oranges, cottage cheese, milk, yogurt,
liver, and eggs. meat, eggs, fish, and green beans.

Vitamin B3 Vitamin B6

It is water-soluble. It is water-soluble.
Function: The body needs niacin for the Function: It is vital for
cells to grow and work correctly. the formation of red
Deficiency: Low levels result in a health blood cells.
issue called pellagra, which causes Deficiency: Low levels
diarrhea, skin changes, and intestinal may lead to anemia
upset. and peripheral
Good sources: Examples include chicken, neuropathy.
beef, tuna, salmon, milk, eggs, tomatoes, Good sources: These
leafy vegetables, broccoli, carrots, nuts include chickpeas,
and seeds, tofu, and lentils. beef liver, bananas,
squash, and nuts.

Vitamin B5
It is water-soluble.
Function: It is necessary for producing energy and hormones.
Deficiency: Symptoms include paresthesia, or “pins and needles.”
Vitamin C Vitamin D

It is water-soluble. It is fat-soluble.
Function: It contributes to Function: It is necessary for the
collagen production, wound healthy mineralization of bone.
healing, and bone formation. It Deficiency: This may cause
also strengthens blood vessels, rickets and osteomalacia, or
supports the immune system, softening of the bones.
helps the body absorb iron, and Good sources: Exposure to UVB
acts as an antioxidant. rays from the sun or other
Deficiency: This may result in sources causes the body to
scurvy, which causes bleeding produce vitamin D. Fatty fish,
gums, a loss of teeth, and poor eggs, beef liver, and mushrooms
tissue growth and wound also contain the vitamin.
healing.

Vitamin E Vitamin K

It is fat-soluble. It is fat-soluble.
Function: Its antioxidant activity Function: It is necessary for
helps prevent oxidative stress, an blood clotting.
issue that increases the risk of Deficiency: Low levels may
widespread inflammation and cause an unusual
various diseases. susceptibility to bleeding, or
Deficiency: This is rare, but it may bleeding diathesis.
cause hemolytic anemia in Good sources: These include
newborns. This condition destroys natto, leafy greens,
blood cells. pumpkins, figs, and parsley.
Good sources: These include wheat
germ, kiwis, almonds, eggs, nuts,
leafy greens, and vegetable oils.
 Principles of Ethics for Nurses
Autonomy Justice
Autonomy is recognizing each
Justice is that there should be an
individual patient’s right to self-
element of fairness in all medical
determination and decision-making.
and nursing decisions and care.
As patient advocates, it is imperative
Nurses must care for all patients
that nurses ensure that patients
with the same level of fairness
receive all medical information,
despite the individual's financial
education, and options in order to
abilities, race, religion, gender,
choose the option that is best for
and/or sexual orientation.
them. This includes all potential
An example of this is when working
risks, benefits, and complications to
at a free flu clinic or diabetes
make well-informed decisions.
screening clinic. These are open to
Once the patient has all relevant
all individuals in the community
information, the medical and
regardless of the previously
nursing team can make a plan of care
mentioned factors.
in compliance with the medical
wishes of the patient.
It is important that nurses support Nonmaleficence
the patient in their medical wishes
and ensure that the medical team is Nonmaleficence is to do no harm. This
remembering those wishes. is the most well known of the main
Sometimes, nurses will need to principles of nursing ethics. More
continue to advocate for a patient specifically, it is selecting
despite the wishes being verbalized. interventions and care that will cause
the least amount of harm to achieve a
beneficial outcome
Beneficence The principle of nonmaleficence
ensures the safety of the patient and
Beneficence is acting for the good community in all care delivery. Nurses
and welfare of others and including are also responsible to report
such attributes as kindness and treatment options that are causing
charity. The American Nurses significant harm to a patient which
Association defines this as “actions may include suicidal or homicidal
guided by compassion.” ideations.