TIME RELEASE DRUGS:
Enteric-coated tablets and caplets are those coated with a thick shell that prevents the medication from being absorbed in the upper GI tract, allowing the medication to be absorbed more slowly. Spansules are capsules containing time-released beads that are released slowly. The nurse should not alter the preparation of these types of medications. The physician should be notified to obtain an alternative preparation if the client is unable to swallow a time-released preparation.
Feverfew: Used to prevent and treat migraines, arthritis, and fever. Should not be taken with Coumadin, aspirin, NSAIDs, thrombolytics, or antiplatelet medications because it will prolong the bleeding time.
Ginseng: Used as an anti-inflammatory. It has estrogen effects, enhances the immune system, and improves mental and physical abilities. Decreases the effects of anticoagulants and NSAIDs. It also should not be taken by patients taking corticosteroids because the combination of these two can result in extremely high levels of corticosteroids. High doses cause liver problems. A patient with hypertension and bipolar disorder should be cautioned regarding the use of ginseng because this herbal can interfere with medications used to treat these disorders.
Ginkgo: Improves memory and can be used to treat depression. It also improves peripheral circulation. Should not be taken with MAO inhibitors, anticoagulants, or antiplatelets. It increases the bleeding time in patients taking NSAIDs, cephalosporins, and valproic acid. Patients with seizure disorders should not take ginkgo because it can exacerbate seizure activity.
Echinacea: Used to treat colds, fevers, and urinary tract infections. Can interfere with immunosuppressive agents, methotrexate, and ketoconazole.
Kava-kava: Used to treat insomnia and mild muscle aches and pains. Increases the effects of central nervous system (CNS) suppressants and decreases the effects of levodopa. It can also increase the effect of MAOIs and cause liver damage.
St. John’s Wort: Used to treat mild to moderate depression. Increases adverse CNS effects when used with alcohol or antidepressant medications.
Ma Huang: Used to treat asthma and hay fever, for weight loss, and to increase energy levels. It increases the effect of MAOIs, sympathomimetics, theophylline, and cardiac glycosides.
Saw Palmetto: help increase testosterone levels, improve prostate health, reduce inflammation, prevent hair loss, and enhance urinary tract function. May increase the chance of bleeding or bruising when use with NSAID, anticoagulants, and antiplatelets.
PREGNANCY CATEGORY DRUGS:
Category A: No risk to fetus.
Category B: Insufficient data to use in pregnancy.
Category C: Benefits of medication could outweigh the risks.
Category D: Risk to fetus exist, but the benefits of the medication could outweigh the probable risks.
Category X: Avoid use in pregnancy or in those who may become pregnant. Potential risks to the fetus outweigh the potential benefits.
-caine = Local anesthetic (Lidocaine)
-pam or -lam = Benzodiazepine (Diazepam, Lorazepam)
-tal = Barbiturate (Phenobarbital, Thiopental)
Nal- or -one = Opioid antagonist (Naloxone, Naltrexone)
-zine = Typical antipsychotics or antihistamine (Chlorpromazine, Thioridazine)
-apine or idone = Atypical antipsychotic (Clozapine, Risperidone)
-olol = Betablocker (Propranolol)
-dipine = CCB (Nifedipine)
-pril = Ace inhibitor (Captopril)
-sartan = ARBS (Losartan)
-statin = HMG CoA Reductase Inhibitor (Lovastatin)
-zolamide = Carbonic anhydrase inhibitor (Acetazolamide, Dorzolamide)
-floxacin = Fluoroquinolone (Ciprofloxacin, Levofloxacin)
-azole = Antifungal (Ketoconazole, Fluconazole)
-quine = Antimalarial (Chloroquine, Primaquine)
-ovir = Antiviral (Acyclovir, Ganciclovir)
-ivir = Antiviral (Oseltamivir, Zanamivir)
-avir = Antiviral (Ritonavir, Indinavir)
-tidine = H2 blocker (Cimetidine, Ranitidine)
-Prazole = PPI (Omeprazole)
-lukast = Leukotriene receptor antagonist (Montelukast, Zafirlukast)
-coxib = Selective COX inhibitors (Celecoxib)
-parin = LMWH (Enoxaparin)