Furosemide is a loop diuretic that inhibits reabsorption of sodium and chloride Reduce dosage if given with other antihypertensives;
antihypertensives; readjust dosage
mainly in the medullary portion of the ascending Loop of Henle.
Therapeutic actions
Furosemide inhibits reabsorption of Na and chloride mainly in the medullary portion
of the ascending Loop of Henle. Excretion of potassium and ammonia is also
increased while uric acid excretion is reduced. It increases plasma-renin levels and
secondary hyperaldosteronism may result. Furosemide reduces BP in hypertensives
as well as in normotensives. It also reduces pulmonary oedema before diuresis has
set in.
Indications
Oral, IV: Edema associated with CHF, cirrhosis, renal disease
IV: Acute pulmonary edema
Oral: Hypertension
Adverse Effects
Fluid and electrolyte imbalance.
Rashes, photosensitivity, nausea, diarrhoea, blurred vision, dizziness,
headache, hypotension. Bone marrow depression (rare), hepatic
dysfunction.
Hyperglycaemia, glycosuria, ototoxicity.
Potentially Fatal: Rarely, sudden death and cardiac arrest.
Hypokalaemia and magnesium depletion can cause cardiac arrhythmias.
Contraindications
Severe sodium and water depletion, hypersensitivity to sulphonamides
and furosemide, hypokalaemia, hyponatraemia, precomatose states
associated with liver cirrhosis, anuria or renal failure.
Addisons disease.
Interventions
BLACK BOX WARNING: Profound diuresis with water and electrolyte depletion
can occur; careful medical supervision is required.
gradually as BP responds.
Administer with food or milk to prevent GI upset.
Give early in the day so that increased urination will not disturb sleep.
Avoid IV use if oral use is at all possible.
WARNING: Do not mix parenteral solution with highly acidic solutions
with pH below 3.5.
Do not expose to light, may discolor tablets or solution; do not use
discolored drug or solutions.
Discard diluted solution after 24 hr.
Refrigerate oral solution.
Measure and record weight to monitor fluid changes.
Arrange to monitor serum electrolytes, hydration, liver and renal
function.
Arrange for potassium-rich diet or supplemental potassium as needed.
Teaching points
Record intermittent therapy on a calendar or dated envelopes. When
possible, take the drug early so increased urination will not disturb
sleep. Take with food or meals to prevent GI upset.
Weigh yourself on a regular basis, at the same time and in the same
clothing, and record the weight on your calendar.
Blood glucose levels may become temporarily elevated in patients
with diabetes after starting this drug.
You may experience these side effects: Increased volume and frequency
of urination; dizziness, feeling faint on arising, drowsiness (avoid rapid
position changes; hazardous activities, like driving; and consumption of
alcohol); sensitivity to sunlight (use sunglasses, wear protective
clothing, or use a sunscreen); increased thirst (suck on sugarless
lozenges; use frequent mouth care); loss of body potassium (a
potassium-rich diet or potassium supplement will be needed).
Report loss or gain of more than 3 pounds in 1 day, swelling in your
ankles or fingers, unusual bleeding or bruising, dizziness, trembling,
numbness, fatigue, muscle weakness or cramps.
Metoprolol is a beta-blocker that affects the heart and circulation (blood flow
through arteries and veins).
1
Metoprolol is used to treat angina (chest pain) and hypertension (high blood
pressure). It is also used to treat or prevent heart attack.
Atorvastatin calcium
Drug classes
Antihyperlipidemic
HMG-CoA reductase inhibitor
Therapeutic actions
Inhibits HMG-CoA reductase, the enzyme that catalyzes the first step in
the cholesterol synthesis pathway, resulting in a decrease in serum
cholesterol, serum LDLs (associated with increased risk of CAD), and
increases serum HDLs (associated with decreased risk of CAD);
increases hepatic LDL recapture sites, enhances reuptake and
catabolism of LDL; lowers triglyceride levels.
Indications
Adjunct to diet in treatment of elevated total cholesterol, serum
triglycerides, and LDL cholesterol in patients with primary
hypercholesterolemia (types IIa and IIb) and mixed dyslipidemia,
primary dysbetalipoproteinemia, and homozygous familial
hypercholesterolemia whose response to dietary restriction of saturated
fat and cholesterol and other nonpharmacologic measures has not been
adequate
To increase HDL-C in patients with primary hypercholesterolemia and
mixed dyslipidemia
Adjunct to diet to treat elevated serum triglyceride levels
Adjunct to diet in treatment of boys and postmenarchal girls ages 1017
with heterozygous familial cholesterolemia if diet alone is not adequate
to control lipid levels and LDL-C levels are > 190 mg/dL or if LDL-C
level is > 160 mg/dL and there is a family history of premature CV
disease or the child has two or more risk factors for the development of
coronary disease
Prevention of CV disease in adults without clinically evident coronary
disease but with multiple risk factors for CAD such as age > 55 yr,
smoking, hypertension, low HDL-C, family history of early CAD; to
reduce the risk of MI and risk for revascularization procedures
and angina
Adverse effects
CNS: Headache, asthenia
GI: Flatulence, abdominal pain, cramps, constipation, nausea,
dyspepsia, heartburn, liver failure
Respiratory: Sinusitis, pharyngitis
Other: Rhabdomyolysis with acute renal failure, arthralgia, myalgia
Contraindications
Contraindicated with allergy to atorvastatin, fungal byproducts, active
liver disease or unexplained and persistent elevations of transaminase
levels, pregnancy, lactation.
Use cautiously with impaired endocrine function.
Nursing considerations
Teaching points
Take this drug once a day, at about the same time each day, preferably in
the evening; may be taken with food. Do not drink grapefruit juice
while taking this drug.
Institute appropriate dietary changes.
Arrange to have periodic blood tests while you are taking this drug.
Alert any health care provider that you are on this drug; it will need to
be discontinued if acute injury or illness occurs.
Do not become pregnant while you are on this drug; use barrier
contraceptives. If you wish to become pregnant or think you are
pregnant, consult your health care provider.
You may experience these side effects: Nausea (eat frequent small
meals); headache, muscle and joint aches and pains (may lessen over
time).
Report muscle pain, weakness, tenderness; malaise; fever; changes in
color of urine or stool; swelling.
Potassium Chloride
Kalium Durules,
Classifications: electrolytic and water balance agent; replacement solution
Pregnancy Category: A
2
Actions: Principal intracellular cation; essential for maintenance of intracellular
isotonicity, transmission of nerve impulses, contraction of cardiac, skeletal, and
smooth muscles, maintenance of normal kidney function, and for enzyme
activity. Plays a prominent role in both formation and correction of imbalances in
acidbase metabolism.
Therapeutic effects
Given special importance as therapeutic agents but are also dangerous if improperly
prescribed and administered. Utilized for treatment of hypokalemia.
Uses
To prevent and treat potassium deficit secondary to diuretic or corticosteroid therapy.
Also indicated when potassium is depleted by severe vomiting, diarrhea; intestinal
drainage, fistulas, or malabsorption; prolonged diuresis, diabetic acidosis. Effective
in the treatment of hypokalemic alkalosis (chloride, not the gluconate).
Contraindications
Severe renal impairment; severe hemolytic reactions; untreated Addisons disease;
crush syndrome; early postoperative oliguria (except during GI drainage); adynamic
ileus; acute dehydration; heat cramps, hyperkalemia, patients receiving potassium-
sparing diuretics, digitalis intoxication with AV conduction disturbance.
Administration
Oral
Give while patient is sitting up or standing (never in recumbent
position) to prevent druginduced esophagitis. Some patients find it
difficult to swallow the large sized KCl tablet.
Do not crush or allow to chew any potassium salt tablets. Observe to
make sure patient does not suck tablet (oral ulcerations have been
reported if tablet is allowed to dissolve in mouth).
Swallow whole tablet with a large glass of water or fruit juice (if
allowed) to wash drug down and to start esophageal peristalsis.
Follow directions for diluting various liquid forms of KCl exactly. In
general, dilute each 20 mEq potassium in at least 90 mL water or juice
and allowed to completely before administration.
Dilute liquid forms as directed before giving it through nasogastric tube.
Adverse effects
GI:Nausea, vomiting, diarrhea, abdominal distension.
BodyWhole:Pain, mental confusion, irritability, listlessness, paresthesias of
extremities, muscle weakness and heaviness of limbs, difficulty in swallowing,
flaccid paralysis.
Urogenital:Oliguria, anuria.
Hematologic:Hyperkalemia.
Respiratory:Respiratory distress.
CV:Hypotension, bradycardia; cardiac depression, arrhythmias, or arrest; altered
sensitivity to digitalis glycosides. ECG changes in hyperkalemia: Tenting (peaking)
of T wave (especially in right precordial leads), lowering of R with deepening of S
waves and depression of RST; prolonged P-R interval, widened QRS complex,
decreased amplitude and disappearance of P waves, prolonged Q-T interval, signs of
right and left bundle block, deterioration of QRS contour and finally ventricular
fibrillation and death.
Nursing implications
Assessment & Drug Effects
Monitor I&O ratio and pattern in patients receiving the parenteral drug.
If oliguria occurs, stop infusion promptly and notify physician.
Lab test: Frequent serum electrolytes are warranted.
Monitor for and report signs of GI ulceration (esophageal or epigastric
pain or hematemesis).
Monitor patients receiving parenteral potassium closely with cardiac
monitor. Irregular heartbeat is usually the earliest clinical indication of
hyperkalemia.
Be alert for potassium intoxication (hyperkalemia, see S&S, Appendix
F); may result from any therapeutic dosage, and the patient may be
asymptomatic.
The risk of hyperkalemia with potassium supplement increases (1) in
older adults because of decremental changes in kidney function
associated with aging, (2) when dietary intake of potassium suddenly
increases, and (3) when kidney function is significantly compromised.
Patient & Family Education
Do not be alarmed when the tablet carcass appears in your stool. The
sustained release tablet (e.g., Slow-K) utilizes a wax matrix as carrier
for KCl crystals that passes through the digestive system.
Learn about sources of potassium with special reference to foods and
OTC drugs.
Avoid licorice; large amounts can cause both hypokalemia and sodium
retention.
Do not use any salt substitute unless it is specifically ordered by the
physician. These contain a substantial amount of potassium and
electrolytes other than sodium.
Do not self-prescribe laxatives. Chronic laxative use has been
associated with diarrheainduced potassium loss.
Notify physician of persistent vomiting because losses of potassium can
occur.
3
 Report continuing signs of potassium deficit to physician: Weakness, Treatment of patients at risk for ischemic eventshistory of MI,
fatigue, polyuria, polydipsia. ischemic stroke, peripheral artery disease
Advise dentist or new physician that a potassium drug has been Treatment of patients with acute coronary syndrome
prescribed as long-term maintenance therapy.
Do not open foil-wrapped powders and tablets before use. Contraindications and cautions
Do not breast feed while taking this drug without consulting physician.
Contraindicated with allergy to clopidogrel, active
pathological bleeding such as peptic ulcer or intracranial hemorrhage,
lactation.
Clopidogrel Use cautiously with bleeding disorders, recent surgery, hepatic
impairment, pregnancy.
Brand Name: Plavix
Adverse effects
Drug classes
CNS: Headache, dizziness, weakness, syncope, flushing
Adenosine diphosphate (ADP) receptor antagonist CV: Hypertension, edema
Dermatologic: Rash, pruritus
Antiplatelet
Pregnancy Category B GI: Nausea, GI distress, constipation, diarrhea, GI bleed
Other: Increased bleeding risk
Therapeutic actions
Nursing considerations
Inhibits platelet aggregation by blocking ADP receptors on platelets, preventing
clumping of platelets. Assessment
History: Allergy to clopidogrel, pregnancy,
Clopidogrel, a thienopyridine derivative, is a prodrug that undergoes metabolism by lactation, bleeding disorders, recent surgery, hepatic impairment, peptic
cytochrome P450 enzymes to form an active thiol metabolite. This metabolite acts as ulcer
a selective irreversible inhibitor of P2Y12 adenosine diphosphate (ADP) receptors on Physical: Skin color, temperature, lesions; orientation, reflexes, affect;
platelets, blocking ADP-mediated activation of the glycoprotein GPIIb/IIIa complex P, BP, orthostatic BP, baseline ECG, peripheral perfusion; R,
and as a result, inhibiting platelet aggregation.[1,2] adventitious sounds

Clopidogrel inhibits aggregation for the life of the platelet, typically 7 to 10 days. It Interventions
produces a dose-dependent effect, beginning 2 hours after a single dose and reaching Provide small, frequent meals if GI upset occurs (not as common as
steady-state after 3 to 7 days of treatment. After standard dosing in adults, the degree with aspirin).
of platelet inhibition is approximately 40 to 60%. Platelet function and bleeding time Provide comfort measures and arrange for analgesics if headache
typically return to baseline values within 5 days after occurs.

Indications Teaching points

Take daily as prescribed. May be taken with meals.

4
 You may experience these side effects: Dizziness, light-headedness (this
may pass as you adjust to the drug); headache (lie down in a cool
environment and rest; OTC preparations may help); nausea, gastric
distress (eat frequent small meals); prolonged bleeding (alert doctors,
dentists of this drug use).
Report skin rash, chest pain, fainting, severe headache,
abnormal bleeding.
Aldazide
Generic Name:
Spironolactone 25 mg, Butizide 2.5 mg
Indications:
Essential hypertension, edema and ascites of CHF, liver cirrhosis,
nephriticsyndrome, idiopathic edema
Drug Classification:
Diuretic
Mechanism of Action:
: competes with aldosterone for receptor sites in the distal
renaltubules, increasing sodium chloride and water excretion while conserving potas
sium and hydrogen ions, may block the effect of aldosterone on arteriolar smooth
muscle as well
Pharmacology: Pharmacodynamics: Mechanism of Action: Spironolactone-
hydroflumethiazide is a combination of 2 diuretic agents with different but
complementary mechanisms and sites of action, thereby providing additive diuretic
and antihypertensive effects. Additionally, the spironolactone component helps to
minimize the potassium loss characteristically induced by the thiazide component.
The diuretic effect of spironolactone is mediated through its action as a specific
pharmacologic antagonist of aldosterone, primarily by competitive binding to
receptors at the aldosterone-dependent sodium-potassium exchange site in the distal
convoluted renal tubule. HCTZ promotes the excretion of sodium and water
primarily by inhibiting their reabsorption in the cortical diluting segment of the distal
renal tubule.
Spironolactone-hydroflumethiazide is effective in significantly lowering the systolic
and diastolic blood pressure in many patients with essential hypertension, even when
aldosterone secretion is within normal limits.
Both spironolactone and hydroflumethiazide reduce exchangeable sodium, plasma
volume, body weight and blood pressure. The diuretic and antihypertensive effects of
the individual components are potentiated when spironolactone and
hydroflumethiazide are given concurrently.
Adverse reaction:
Gynecomastia, GI symptoms, lethargy, headache andthrombocytopenia, leukopenia,
agranulocytosis, cutaneous eruptions,
pruritus,mental confusion, paresthesia, acute pancreatitis, jaundice, orthostatichypert
ension, muscle spasm, weakness, fever, ataxia
Contraindications:
Acute renal insufficiency, significant impairment of renal
function,anuria, hyperkalemia
Nursing Responsibilities:
Educate patient to avoid hazardous activity such as driving until response todrug is
known.
Take with meals or milk; avoid excessive ingestion of food high in potassium or use
of salt substitutes
Diuretic effect may be delayed 2-3 days and maximum hypertensive may
bedelayed 2-3weeks; monitor I and O ratios and daily weight, BP, serumelectrolytes
(K, Na) and renal function
Captopril (Capoten) is an ACE inhibitor and a common
antihypertensive. Captopril works by competitively inhibiting the conversion of
angiotensin I to angiotensin II.
Therapeutic actions
Captopril competitively inhibits the conversion of angiotensin I (ATI) to
angiotensin II (ATII), thus resulting in reduced ATII levels and
aldosterone secretion. It also increases plasma renin activity and
bradykinin levels. Reduction of ATII leads to decreased sodium and
water retention. By these mechanisms, captopril produces a hypotensive
effect and a beneficial effect in congestive heart failure.
Indications
Treatment of hypertension alone or in combination with thiazide-
type diuretics
Treatment of CHF in patients unresponsive to conventional therapy;
used with diuretics and digitalis
Treatment of diabetic nephropathy
Treatment of left ventricular dysfunction after MI
Unlabeled uses: Management of hypertensive crises; treatment of
rheumatoid arthritis; diagnosis of anatomic renal artery
5
 stenosis, hypertension related to scleroderma renal crisis; diagnosis of
primary aldosteronism, idiopathic edema; Bartters syndrome;
Raynauds syndrome
Adverse effects
Hypotension, tachycardia, chest pain, palpitations,
pruritus, hyperkalemia. Proteinuria; angioedema, skin rashes; taste
disturbance, nonproductive cough, headache.
Potentially Fatal: Neutropenia, usually occurs within 3 mth of starting
therapy especially in patients with renal dysfunction or collagen
diseases. Hyperkalaemia. Anaphylactic reactions.
Contraindications
Known hypersensitivity to the drug.
Bilateral renal artery stenosis,
hereditary angioedema;
renal impairment;
pregnancy.
Nursing Considerations
Interventions
Administer 1 hr before meals.
Monitor patient closely for fall in BP secondary to reduction in fluid
volume (due to excessive perspiration, and dehydration, vomiting,
or diarrhea); excessive hypotension may occur.
Reduce dosage in patients with impaired renal function.
Teaching points
Take drug 1 hour before meals; do not take with food. Do not stop
without consulting your healthcare provider.
Be careful of drop in blood pressure (occurs most often with diarrhea,
sweating, vomiting, or dehydration); if lightheadedness or dizziness
occurs, consult your healthcare provider.
Severe fetal damage can occur if captopril is taken during pregnancy.
Use of contraceptives is advised; if pregnancy should occur, stop drug
and notify health care provider.
Avoid over-the-counter medications, especially cough, cold, allergy
medications that may contain ingredients that will interact with ACE
inhibitors. Consult your healthcare provider.
You may experience these side effects: Cough, GI upset, loss of
appetite, change in taste perception (limited effects, will pass); mouth
sores (frequent mouth care may help); rash; fast heart rate; dizziness,
light-headedness (usually passes after the first few days; change
position slowly, and limit your activities to those that do not require
alertness and precision).
Report mouth sores; sore throat, fever, chills; swelling of the hands or
feet; irregular heartbeat, chest pains; swelling of the face, eyes, lips or
tongue; difficulty breathing.
Diazepam (Valium) is an anxiolytic, benzodiazepine and an antiepileptic.
Drug classes
Benzodiazepine
Anxiolytic
Antiepileptic
Skeletal muscle relaxant (centrally acting)
Therapeutic actions
Exact mechanisms of action not understood; acts mainly at the limbic system and
reticular formation; may act in spinal cord and at supraspinal sites to produce skeletal
muscle relaxation; potentiates the effects of GABA, an inhibitory
neurotransmitter; anxiolytic effects occur at doses well below those necessary to
cause sedation, ataxia; has little effect on cortical function.
Indications
Management of anxiety disorders or for short-term relief of symptoms
of anxiety
Acute alcohol withdrawal; may be useful in symptomatic relief of acute
agitation, tremor, delirium tremens, hallucinosis
Muscle relaxant: Adjunct for relief of reflex skeletal muscle spasm due
to local pathology (inflammation of muscles or joints) or secondary to
trauma;spasticity caused by upper motor neuron disorders (cerebral
palsy and paraplegia); athetosis, stiff-man syndrome
6
 Parenteral: Treatment of tetanus
Antiepileptic: Adjunct in status epilepticus and severe recurrent
convulsive seizures (parenteral); adjunct in seizure disorders (oral)
Preoperative (parenteral): Relief of anxiety and tension and to lessen
recall in patients prior to surgical procedures, cardioversion,
and endoscopic procedures
Rectal: Management of selected, refractory patients with epilepsy who
require intermittent use to control bouts of increased seizure activity
Unlabeled use: Treatment of panic attacks
Contraindications and cautions
Contraindicated with hypersensitivity to benzodiazepines; psychoses,
acute narrow-angle glaucoma, shock, coma, acute alcoholic
intoxication; pregnancy (cleft lip or palate, inguinal hernia, cardiac
defects, microcephaly, pyloric stenosis when used in first trimester;
neonatal withdrawal syndrome reported in newborns); lactation.
Use cautiously with elderly or debilitated patients; impaired liver or
renal function; and in patients with a history of substance abuse.
Adverse effects
CNS: Transient, mild drowsiness initially; sedation, depression,
lethargy, apathy, fatigue, light-headedness, disorientation, restlessness,
confusion,crying, delirium, headache, slurred speech, dysarthria, stupor,
rigidity, tremor, dystonia, vertigo, euphoria, nervousness, difficulty in
concentration, vivid dreams, psychomotor
retardation, extrapyramidal symptoms; mild paradoxical excitatory
reactions, during first 2 wk of treatment, visual and auditory
disturbances, diplopia, nystagmus, depressed hearing, nasal congestion
CV: Bradycardia, tachycardia, CV collapse, hypertension and
hypotension, palpitations, edema
Dependence: Drug dependence with withdrawal syndrome when drug is
discontinued (common with abrupt discontinuation of higher dosage
used for longer than 4 mo); IV diazepam: 1.7% incidence of fatalities;
oral benzodiazepines ingested alone; no well-documented fatal
overdoses
Dermatologic: Urticaria, pruritus, skin rash, dermatitis
GI: Constipation; diarrhea, dry mouth; salivation; nausea; anorexia;
vomiting; difficulty in swallowing; gastric disorders; elevations of
blood enzymesLDH, alkaline phosphatase, AST, ALT; hepatic
impairment; jaundice
GU: Incontinence, urinary retention, changes in libido, menstrual
irregularities
Hematologic: Decreased hematocrit, blood dyscrasias
Other: Phlebitis and thrombosis at IV injection sites, hiccups, fever,
diaphoresis, paresthesias, muscular disturbances, gynecomastia; pain,
burning, and redness after IM injection
Nursing considerations
Interventions
WARNING: Do not administer intra-arterially; may
produce arteriospasm, gangrene.[/sws_red_box]
Change from IV therapy to oral therapy as soon as possible.
Do not use small veins (dorsum of hand or wrist) for IV injection.
Reduce dose of opioid analgesics with IV diazepam; dose should be
reduced by at least one-third or eliminated.
Carefully monitor P, BP, respiration during IV administration.
WARNING: Maintain patients receiving parenteral benzodiazepines in
bed for 3 hr; do not permit ambulatory patients to operate a vehicle
following an injection.
Monitor EEG in patients treated for status epilepticus; seizures may
recur after initial control, presumably because of short duration of drug
effect.
Monitor liver and renal function, CBC during long-term therapy.
Taper dosage gradually after long-term therapy, especially in epileptic
patients.
Arrange for epileptic patients to wear medical alert ID indicating that
they are epileptics taking this medication.
Discuss risk of fetal abnormalities with patients desiring to become
pregnant.
Teaching points
Take this drug exactly as prescribed. Do not stop taking this drug (long-
term therapy, antiepileptic therapy) without consulting your health care
provider.
Caregiver should learn to assess seizures, administer rectal form, and
monitor patient.
Use of barrier contraceptives is advised while using this drug; if you
become or wish to become pregnant, consult with your health care
provider.
7
 It is advisable to wear a medical alert ID indicating your diagnosis and a Bowel Movement, High Blood Pressure, Stenosing Peptic Ulcer,
treatment (as antiepileptic). Blockage of Urinary Bladder, Enlarged Prostate, Cannot Empty
You may experience these side effects: Drowsiness, dizziness (may Bladder, Overactive Thyroid Gland
lessen; avoid driving or engaging in other dangerous activities); GI Side-Effects:
upset (take drug with food); dreams, difficulty concentrating, fatigue, 1. Drowsiness
nervousness, crying (reversible). 2. Constipation
3. Diarrhea
4. Dizziness
Generic Name: Diphenhydramine hydrochloride 5. Dry mouth/nose/throat
Brand Name: Benadryl 6. Headache
Classification: Antihistamine, second generation, ethanolamine 7. Anorexia
Uses: 8. N&V
1. Treatment of hypersensitivity reactions 9. Anxiety
2. Treatment of motion sickness 10. GI upset
3. Treatment of Parkinsonism 11. Asthenia
4. Nighttime sleep aid Nursing Considerations:
5. Antitussive 1. Give full prophylactic dose 30min. prior to travel if used as a
Actions: prophylaxis for motion sickness
1. Has high sedative, anticholinergic and antiemetic effects 2. Take similar doses with meals and at bedtime
2. Blocks the action of acetylcholine 3. Do not use more than 2 weeks to treat insomnia
3. Blocks H-1 receptors on effector cells of the GI tract, blood vessels, and 4. For IV, may give undiluted
respiratory tract 5. Do not exceed IV rate of 25mg/minute
Contraindications: 6. Drug causes drowsiness. Avoid activities requiring mental alertness
1. Use with other products containing diphenhydramine 7. Use sun protection as it may cause photosensitivity
2. Hypersensitivity to antihistamines 8. Use sugarless candy/gum to diminish dry mouth effects
Special Concerns: 9. Avoid alcohol and other CNS depressants
1. Increases the risk of cognitive decline in the elderly 10. Stop therapy 72-96 hr. prior to skin testing. Report adverse effect and
2. Use with caution in clients suffering from the following: Increased lack of response
Pressure in the Eye, Closed Angle Glaucoma, Chronic Difficulty having