NCLEX Medications Review (part 1)

NCLEX Medications Review (part 1)

I hope you are enjoying your week. We tutor nurses, many times helping those who have failed the NCLEX to pass it. One of the things we do as a wrap of for the students who take the NCLEX is to get a general idea of the types of questions they had on the test. WE don’t ask for specifics, just general topics. We hear over and over again that medications are on the test, and many of those drugs are ones that you see advertised on television, the newer drugs that are on the market. We have started to provide our tutor students with pdfs that they can use to help them study. I thought I would share these last two lists for you. One of them is today and the next we’ll post on Thursday and I hope it will help you in your studies.

A reminder we have a 10% discount for all of our packages – you can use the coupon code SAVE10%MAY  – we have a limited number of tutor spots open for June.

Movantik (naloxegol )–  Generic names of the drug are in the ( )

MOVANTIK is used to treat opioid induced constipation (OIC) caused by prescription pain medicines called narcotic or opiates, in adults with long-lasting (chronic) pain that is not caused by cancer. Naloxegol treats constipation without reducing the pain-relieving effects of the narcotic.

Movantik is used in people who have been taking narcotic pain medicine for at least 4 weeks, to treat chronic pain that is not caused by cancer.

How to take it:

Usually taken once per day. Follow all directions on your prescription label. Do not use this medicine in larger or smaller amounts or for longer than recommended.

Take Movantik on an empty stomach, at least 1 hour before or 2 hours after your first meal of the day. Tell your healthcare provider if you stop taking your opioid pain medicine. If you stop taking your opioid pain medicine, you should also stop taking Movantik.

Do not crush, chew, or break a Movantik tablet. Swallow it whole. Call your doctor if your symptoms do not improve after 3 days of treatment. Store at room temperature away from moisture and heat.

MOVANTIK may cause serious side effects, including:

• Opioid withdrawal. You may have symptoms of opioid withdrawal during treatment with MOVANTIK, including sweating, chills, diarrhea, stomach pain, anxiety, irritability, and yawning. Patients taking methadone to treat their pain may be more likely to experience stomach pain and diarrhea. Tell your doctor if you have any of these symptoms
• Severe Stomach Pain and/or Diarrhea. This can happen within a few days of starting MOVANTIK and can lead to hospitalization. If either of these side effects occurs, stop taking MOVANTIK and call your doctor immediately
• Tear in your stomach or intestinal wall (perforation). Stomach pain that is severe can be a sign of a serious medical condition. If you get stomach pain that gets worse or does not go away, stop taking MOVANTIK and get emergency medical help right away

• If you stop taking your opioid pain medicine, stop taking MOVANTIK and tell your doctor
• Avoid eating grapefruit or drinking grapefruit juice during treatment with MOVANTIK
• The most common side effects of MOVANTIK include: Stomach (abdomen) pain, diarrhea, nausea, gas, vomiting, headache, and excessive sweating

Get emergency medical help if you have any signs of an allergic reaction to Movantik: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

• severe stomach pain that will not go away;
• severe, persistent, or worsening abdominal pain, diarrhea, or nausea;
• nausea or vomiting that are new or worsening symptoms; or
• symptoms of narcotic medicine withdrawal – anxiety, sweating, chills, yawning, stomach pain, diarrhea.

Common Movantik side effects may include:

• nausea, vomiting, stomach pain;
• diarrhea, gas; or

Eliquis (apixaban)

Eliquis (apixaban) blocks the activity of certain clotting substances in the blood and is used to lower the risk of stroke caused by a blood clot in people with a heart rhythm disorder called atrial fibrillation.

Eliquis is also used after hip or knee replacement surgery to prevent a type of blood clot called deep vein thrombosis (DVT), which can lead to blood clots in the lungs (pulmonary embolism).

Eliquis is also used to treat DVT or pulmonary embolism (PE), and to lower your risk of having a repeat DVT or PE.

No Spinal taps for patients who are taking this drug.

2.5 mg orally 2 times a day

Duration of therapy:
-Hip replacement: 35 days
-Knee replacement: 12 days

Comments:
-The initial dose should be taken 12 to 24 hours after surgery (for hip or knee replacement surgery prophylaxis).

Side effects –

• easy bruising, unusual bleeding (nose, mouth, vagina, or rectum), bleeding from wounds or needle injections, any bleeding that will not stop;
• heavy menstrual periods;
• headache, dizziness, weakness, feeling like you might pass out;
• urine that looks red, pink, or brown; or
• black or bloody stools, coughing up blood or vomit that looks like coffee grounds.

Xeljanz (tofacitinib)

is used to treat moderate to severe rheumatoid arthritis in adults who have tried methotrexate without successful treatment of symptoms.

Xeljanz is sometimes given in combination with methotrexate or other arthritis medicines.

You should not use Xeljanz if you are allergic to tofacitinib, or if you have a serious infection.

How to take it –

Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Swallow the extended release Xeljanz XR tablet whole. Do not break or crush the tablet.

You may take this medicine with or without food.

Do not crush, chew, or break an extended-release Xeljanz XR tablet. Swallow the tablet whole.

Xeljanz can lower blood cells that help your body fight infections and help your blood to clot. Your blood will need to be tested often. Further doses may be delayed based on the results of these tests. Your doctor may also want to check your skin for signs of cancer.

If you have hepatitis B or C you may develop liver symptoms while taking this medicine. Your doctor may want to check your liver function before and during your treatment with this medicine.

Store in the original container at room temperature away from moisture and heat.

Dosage –

Xeljanz: 5 mg orally twice a day. Xeljanz XR: one 11mg tablet taken once daily.

Comments:
-Do not start tofacitinib in patients with a lymphocyte count less than 500 cells/mm3, an absolute neutrophil count (ANC) less than 1000 cells/mm3 or a hemoglobin level less than 9 g/dL.
-Use in combination with biologic DMARDs or with potent immunosuppressants such as azathioprine and cyclosporine is not recommended.

Side Effects –

Get emergency medical help if you have any signs of an allergic reaction to Xeljanz: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Serious and sometimes fatal infections may occur during treatment with Xeljanz. Stop using this medicine and call your doctor right away if you have signs of infection such as:

• fever, chills, tired feeling, night sweats;
• stomach pain, loss of appetite, diarrhea, weight loss, or a change in your bowel habits;
• pain or burning when you urinate;
• body aches, sore throat, cough, flu symptoms, sores in your mouth and throat;
• stabbing chest pain, wheezing, feeling short of breath, cough with mucus or blood; or
• skin redness and swelling.

Xeljanz may also cause severe liver symptoms. Call your doctor at once if you have any of these liver symptoms:

• low fever, itching, tiredness;
• upper stomach pain, loss of appetite;
• dark urine, clay-colored stools; or
• jaundice (yellowing of the skin or eyes).

Common Xeljanz side effects may include:

• headache;
• diarrhea; or
• cold symptoms such as stuffy nose, sneezing, sore throat.

Farxiga (dapagliflozin)

Is an oral diabetes medicine that helps control blood sugar levels. Dapagliflozin works by helping the kidneys get rid of glucose from your bloodstream. Farxiga is used together with diet and exercise to treat type 2 diabetes. Farxiga is not for treating type 1 diabetes. The most common side effects of FARXIGA include yeast infections of the vagina or penis, and changes in urination, including urgent need to urinate more often, in larger amounts, or at night.

FARXIGA may cause serious side effects including:

• Dehydration (the loss of body water and salt), which may cause you to feel dizzy, faint, lightheaded, or weak, especially when you stand up (orthostatic hypotension). You may be at a higher risk of dehydration if you have low blood pressure; take medicines to lower your blood pressure, including water pills (diuretics); are 65 years of age or older; are on a low salt diet, or have kidney problems
• Ketoacidosis occurred in people with type 1 and type 2 diabetes during treatment with FARXIGA. Ketoacidosis is a serious condition which may require hospitalization and may lead to death. Symptoms may include nausea, tiredness, vomiting, trouble breathing, and abdominal pain. If you get any of these symptoms, stop taking FARXIGA and call your healthcare provider right away. If possible, check for ketones in your urine or blood, even if your blood sugar is less than 250 mg/dL
• Kidney problems. Sudden kidney injury occurred in people taking FARXIGA. Talk to your doctor right away if you reduce the amount you eat or drink, or if you lose liquids; for example, from vomiting, diarrhea, or excessive heat exposure
• Serious urinary tract infections (UTI), some that lead to hospitalization, occurred in people taking FARXIGA. Tell your doctor if you have any signs or symptoms of UTI including a burning feeling when passing urine, a need to urinate often, the need to urinate right away, pain in the lower part of your stomach (pelvis), or blood in the urine with or without fever, back pain, nausea, or vomiting
• Low blood sugar (hypoglycemia) can occur if you take FARXIGA with another medicine that can cause low blood sugar, such as sulfonylureas or insulin. Symptoms of low blood sugar include shaking, sweating, fast heartbeat, dizziness, hunger, headache, and irritability. Follow your healthcare provider’s instructions for treating low blood sugar
• Vaginal yeast infections in women who take FARXIGA. Talk to your healthcare provider if you experience vaginal odor, white or yellowish vaginal discharge (discharge may be lumpy or look like cottage cheese), or vaginal itching
• Yeast infection of skin around the penis (balanitis) in men who take FARXIGA. Talk to your healthcare provider if you experience redness, itching, or swelling of the penis; rash of the penis; foul smelling discharge from the penis; or pain in the skin around penis. Certain uncircumcised men may have swelling of the penis that makes it difficult to pull back the skin around the tip of the penis
• Increase in bad cholesterol (LDL-C). Your healthcare provider should check your LDL-C during treatment with FARXIGA
• Bladder cancer. In studies of FARXIGA in people with diabetes, bladder cancer occurred in a few more people who were taking FARXIGA than in people who were taking other diabetes medications. There were too few cases of bladder cancer to know if bladder cancer was related to FARXIGA. Tell your healthcare provider right away if you have blood or a red color in your urine or pain while you urinate

Rexulti (brexpiprazole)

an antipsychotic medication. It works by changing the actions of chemicals in the brain.

Rexulti is used to treat the symptoms of schizophrenia. Rexulti is also used together with other medications to treat major depressive disorder in adults.

Usual Adult Dose of Rexulti for Schizophrenia:

Initial dose: 1 mg orally once a day on Days 1 through 4
Titration: Based on clinical response and tolerability, titrate to 2 mg once a day on Day 5 through Day 7, then to 4 mg once a day on Day 8
Target Dose: 2 to 4 mg orally once a day
Maximum dose: 4 mg per day

Use: Treatment of schizophrenia.

Usual Adult Dose of Rexulti for Depression:

Initial dose: 0.5 mg or 1 mg orally once a day
Titration: Based on clinical response and tolerability, dose increases should be done at weekly intervals; titrate to 1 mg once a day, then up 2 mg once a day.
Target dose: 2 mg orally once a day
Maximum dose: 3 mg per day

Rexulti may impair your thinking or reactions. Avoid driving or operating machinery until you know how this medicine will affect you.

Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Dizziness or severe drowsiness can cause falls, fractures, or other injuries.

Avoid becoming overheated or dehydrated in hot weather. Rexulti can make it harder for your body to control its own temperature. It is easier to become dangerously overheated and dehydrated while you are taking this medicine.

Rexulti side effects

Get emergency medical help if you have signs of an allergic reaction to Rexulti: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

High doses or long-term use of Rexulti can cause a serious movement disorder that may not be reversible. Symptoms of this disorder include uncontrollable muscle movements of your lips, tongue, eyes, face, arms, or legs. The longer you take Rexulti, the more likely you are to develop a serious movement disorder. The risk of this side effect is higher in women and older adults.

Call your doctor at once if you have:

• severe agitation, distress, or restless feeling;
• a light-headed feeling, like you might pass out;
• trouble swallowing;
• feelings of warmth, intolerance to heat;
• thoughts about suicide or hurting yourself;
• twitching or uncontrolled muscle movements;
• a seizure (convulsions);
• high blood sugar – increased thirst, increased urination, hunger, dry mouth, fruity breath odor, drowsiness, dry skin, weight loss;
• low blood cell counts – sudden weakness or ill feeling, fever, chills, sore throat, swollen gums, painful mouth sores, red or swollen gums, skin sores, cold or flu symptoms, cough, trouble breathing; or
• a severe nervous system reaction – very stiff (rigid) muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors, feeling like you might pass out.

Common Rexulti side effects may include:

• weight gain; or
• feeling restless or being unable to sit still.

XYZAL-( levocetirizine )

Xyzal (levocetirizine) is an antihistamine that reduces the effects of natural chemical histamine in the body. Histamine can produce symptoms of sneezing, itching, watery eyes, and runny nose.

Usual Adult Dose for Allergic Rhinitis:

Seasonal and perennial allergic rhinitis and chronic idiopathic urticaria;
5 mg orally once daily in the evening

Xyzal side effects

Get emergency medical help if you have signs of an allergic reaction to Xyzal: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop using Xyzal and call your doctor at once if you have:

• painful or difficult urination;
• little or no urinating;
• pain or fullness in your ear, hearing problems;
• a light-headed feeling, like you might pass out;
• fever; or
• worsening allergy or urticaria symptoms.

Common Xyzal side effects may include:

• drowsiness, weakness;
• feeling tired;
• fever;
• stuffy nose, sinus pain, sore throat, cough;
• vomiting, diarrhea, constipation;
• dry mouth; or
• weight gain.

Tresiba (insulin degludec)

A long-acting insulin that starts to work several hours after injection and keeps working evenly for 24 hours. Insulin is a hormone that works by lowering levels of glucose (sugar) in the blood.

Tresiba is used to improve blood sugar control in patients one year of age and older with diabetes mellitus. Tresiba may be used for type 1 or type 2 diabetes.

Tresiba must not be given with an insulin pump, or mixed with other insulins. Do not inject insulin into a vein or a muscle. Tresiba is usually given once daily, at any time of the day. Follow your doctor’s dosing instructions very carefully.

Low blood sugar (hypoglycemia) can happen to everyone who has diabetes. Symptoms include headache, hunger, sweating, irritability, dizziness, nausea, fast heart rate, and feeling anxious or shaky. To quickly treat low blood sugar, always keep a fast-acting source of sugar with you such as fruit juice, hard candy, crackers, raisins, or non-diet soda.

• Refrigerate and use until expiration date; or
• Store at room temperature and use within 8 weeks (56 days).

Tresiba side effects

Get emergency medical help if you have signs of an allergic reaction to Tresiba: hives, itching, skin rash; wheezing, tiredness, trouble breathing; feeling like you might pass out; nausea, diarrhea; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

• fluid retention – weight gain, swelling in your hands or feet, feeling short of breath; or
• low potassium – leg cramps, constipation, irregular heartbeats, fluttering in your chest, increased thirst or urination, numbness or tingling, muscle weakness or limp feeling.

Common Tresiba side effects may include:

• low blood sugar;
• itching, mild skin rash; or
• thickening or hollowing of the skin where you injected the medicine.

Linzess (linaclotide)

Linzess (linaclotide) works by increasing the secretion of chloride and water in the intestines, which can soften stools and stimulate bowel movements.

Linzess is a prescription medicine used to treat chronic constipation, or chronic irritable bowel syndrome (IBS) in adults who have had constipation as the main symptom. The safety and effectiveness of Linzess has not been established in patients under 18 years of age.

Linzess should not be given to a child younger than 6 years old. Linaclotide can cause severe dehydration in a child.

Take Linzess in the morning on an empty stomach, at least 30 minutes before your first meal. Do not crush, chew, break, or open a capsule. Swallow it whole

290 mcg orally once a day

Linzess side effects

Get emergency medical help if you have any signs of an allergic reaction to Linzess: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Stop using Linzess and call your doctor at once if you have:

• severe or ongoing diarrhea;
• diarrhea with dizziness or a light-headed feeling (like you might pass out);
• signs of an electrolyte imbalance – increased thirst or urination, leg cramps, mood changes, confusion, feeling unsteady, irregular heartbeats, fluttering in your chest, muscle weakness or limp feeling;
• severe stomach pain; or
• black, bloody, or tarry stools.

Common Linzess side effects may include:

• diarrhea;
• stomach pain;
• gas; or
• bloating or full feeling in your stomach.