BRAND GENERIC DOSAGE ACTION INDICATION CONTRA- PRECAUTIONS NURSING

NAME NAME INDICATION CONSIDERATION

Plavix Clopidogrel Tab OD Blocks ADP Reduction of - Hypersensitivity. - Patients who may be at - Assess for symptoms
receptors which atherosclerotic events in - Severe liver risk of increase of stroke, MI during
prevent fibrinogen patients with impairment. bleeding from trauma, treatment.
binding at the site atherosclerosis documented - Active pathological surgery, or other - Monitor signs of
and thereby reduce by recent stoke, myocardial bleeding e.g. peptic pathological conditions. bleeding;
the possibility of infarction, or established ulcer and - Elective surgery. hemoglobin and
platelet adhesion peripheral arterial disease. intracranial - Patients who have hematocrit
and aggregation. hemorrhage. lesions with a periodically.
- Pregnancy and propensity to bleeding. - Monitor liver
lactation. - Patients with moderate function studies:
hepatic disease who AST, ALT, bilirubin,
may have bleeding creatinine if patient
diatheses. is on long term
therapy; thrombo-
cytopenia may occur.

Drug Indication Action Adverse Contraindication Nursing Patient

Reaction Consideration Teaching
Generic Name: ● is a second- ●cefuroxime is ●hypersensiti ●cefuroxime is ●store cefuroxime ●patients should
generation bactericidal and vity reactions, contraindicated if tablets at room be counseled
 Cefuroxime antibacterial has a similar gastrointestina there is a history of temperature away that antibacterial
used in the spectrum of l disturbances, hypersensitivity to from moisture and drugs including
Brand Name: treatment of antimicrobial rarely pain at cephalexin or other heat. ampicillin and
Ceftin susceptible action and injection site, cephalosporins ●store cefuroxime sulbactam
infections, pattern of candidiosis, oral suspension in should only be
Classification: bone and joint resistance to eosinophilia, the refrigerator. used to treat
infections, those of neutropenia, Do not allow it to bacterial
Cephalosporin, bronchitis (and cefamandole. It leucopenia, freeze. infections.
other lower is more resistant thrombocytop ●shake the oral ●they do not
Second respiratory-tract to hydrolysis by enia, transient suspension well treat viral
Generation infections), beta-lactamases rise in liver just before infections (e.g.,
gonorrhoea, than enzymes, and measure a dose the common
meningitis, cefamandole, positive ●give this cold).
otitis media, and therefore Combo’s test medication for the ●the medication
peritonitis, may be more entire length of should be taken
pharyngitis, active against time prescribed by exactly as
sinusitis, skin beta-lactamase- your doctor directed.
infections and producing ●can pass into ●kipping doses
urinary-tract strains of, for breast milk and or not
infections. It is example, may harm a completing the
also used for Haemophilus nursing baby. Do full course of
surgical influenzae and not give this therapy may (1)
infection Neisseria medication decrease the
prophylaxis. gonorrhoeae.. without telling to effectiveness of
the doctor. the immediate
treatment.

Generic name: CLopidogrel

Brand name: Norplat
Classification: Anti platelet
Action: Inhibits platelet aggregation by blocking ADP receptors on platelets, preventing clumping of platelets.
Indications: treatment of patients at risk for ischemic events and peripheral artery disease, acute coronary syndrome, as a loading dose with aspirin to prevent adverse cardiac events in coronary stent
implantation
Contraindications: hypersensitivity, active pathological bleeding, lactation, use cautiously with bleeding disorders, recent surgery, hepatic impairment, pregnancy
Side effects: Headache, dizziness, weakness, hypertension, edema, nausea, GI distress, constipation, diarrhea. Increased bleeding risk
Nursing considerations:
 Assess for hypersensitivity to clopidogrel
 Assess for bleeding disorders
 Provide small frequent meals if GI upset occurs
 Provide comfort measures and arrange for analgesics if headache occurs
 Give client awareness to the side effects of the drug
 Provide a safety environment
Generic name: Cilostazol
Brand name: Pletal
Classification: Antiplatelet
Dosage: 50mg/tab 1 tab BID PC
Action: Reversibly inhibits platelet aggregation induced by a variety of stimuli including ADP, thrombin, collagen, shear stress, epinephrine, arachidonic acid by inhibiting cAMP phosphodiesterase III;
produces vascular dilation in vascular beds with a specificity for femoral beds; seems to have no effect on renal arteries.
Indication: Reduction of symptoms of intermittent claudication allowing increased walking distance.
Contraindication: Contraindicated with allergy to cilostazol, heart failure of any severity (decreased survival rates have occurred), active bleeding, hemostatic disorders.
Side effects: dizziness, headache, heart failure, tachycardia, palpitations, diarrhea, cough, dyspepsia, peripheral edema, infection, back pain
Nursing considerations:
 Assess for heart failure
 Administer drug on an empty stomach, at least 30 min before or 2 hr after breakfast and dinner
 Encourage patient to avoid use of grape fruit juice
 Establish walking distance to monitor drug effectiveness
 Establish safety precautions to avoid injury and bleeding
 Encourage patient to continue therapy, results may not be seen for 2-4 wks
 Give patient awareness to the side effects of the drug

GENERIC NAME: INSULIN INJECTION (REGULAR)

TRADE NAME: (Human insulin) Humulin R, Novolin R, Novolin R PenFill, Novolin R Prefilled, Velosulin BR (Pork Insulin) Regular
Iletin II
CLASSIFICATION: Rapid-Acting Insulin Product
ACTION: Regular insulin is only preparation suitable for IV administration; ONLY comes in 100 units/mL; rarely used as sole agent due to
short duration of action; Injections should be clear: Any cloudy or colored solutions should not be used.
INDICATIONS: Suitable for treatment of diabetic coma, diabetic acidosis, other emergency situations; especially suitable for client
suffering from labile diabetes; during acute phase of diabetic acidosis or for client in diabetic crisis, client is monitored by serum glucose and
serum ketone levels
ROUTES OF ADMINISTRATION: Subcutaneous
USUAL DOSAGE: Diabetes: Adults 5-10 units given 15-30 min prior to meals and at bedtime (Peds 2-4 units)
 ADVERSE REACTIONS: Hypoglycemia, hypokalemia, injection site reaction, lipodystrophy, pruritus, rash

INTERACTIONS: ACE inhibitors/anabolic steroids/oral antidiabetics/calcium/chloroquine/clofibrate/clonidine - ↑ hypoglycemic effect of insulin;

Acetazolamide/AIDS antiviral drugs/albuterol/asparaginase/calcitonin/chlorthalidone/clozapine - ↓ hypoglycemic effect of insulin (ONLY PARTIAL LIST: TOO
MANY DRUG INTERACTIONS TO LIST)

CONTRAINDICATIONS: Hypersensitivity to insulin; during episodes of hypoglycemia in clients sensitive to any component of the product

NURSING CONSIDERATIONS: Assess for S/S of hypoglycemia (drowsiness, chills, confusion, anxiety, cold sweats, cool pale skin, excessive hunger, nausea,
headache, irritability, shakiness, rapid pulse, unusual tiredness or weakness); assess S/S for hyperglycemia (thirst, polydipsia, polyuria, drowsiness, blurred vision,
loss of appetite, fruity odor to breath, flushed dry skin); weigh client to determine amount to be given; monitor glucose levels carefully in elderly and with hepatic or
renal impairment; assess injection sites, monitor VS (many more considerations; too many to list)

GENERIC NAME: FLUCONAZOLE

TRADE NAME: Diflucan

CLASSIFICATION: Antifungal

ACTION: Is highly selective inhibitor of fungal cytochrome P450 and sterol C-14 alpha-demethylation; loss of normal sterols correlates with accumulation of 14
alpha-methyl sterols in fungi and may be responsible for the fungistatic activity; decrease in cell wall integrity and extrusion of intracellularmaterial, leading to
death

INDICATIONS: Oropharyngeal and esophageal candidiasis; serious systemic candidal infection (including UTIs, peritonitis, candidemia, disseminated candidiasis,
and pneumonia); cryptococcal meningitis

ROUTES OF ADMINISTRATION: IV, oral suspension, tablets

USUAL DOSAGE: Candidal UTI and peritonitis – 50-200 mg/day: oropharyngeal or esophageal candidiasis – 150 mg as single oral dose

ADVERSE REACTIONS: Following single doses: headache, nausea, abdominal pain, diarrhea, angioedema; following multiple doses: Nausea, headache, skin
rash, vomiting, abdominal pain, serious hepatic reactions, seizures
 INTERACTIONS: Benzodiazepines – ↑ and prolonged serum levels → CNS depression and psychomotor impairment; Glyburide – ↑ plasma glyburide levels
related to ↓ liver breakdown; Glipizide – ↑ plasma glipizide levels related to ↓ liver breakdown; oral contraceptives – possible ↑ or ↓ plasma levels of ethinyl
estradiol and levonorgestrel; protease inhibitors – possible ↑ protease inhibitor levels with possible ↑ toxicity; MANY MORE

CONTRAINDICATIONS: Hypersensitivity to fluconazole, lactation

NURSING CONSIDERATIONS: Daily dose same for either IV or PO; store tablets under 30ºC (86ºF); loading dose of twice daily dose is recommended for first
day to obtain plasma levels close to steady state by second day; due to long half-life, once daily dosing (either IV or PO) is possible; do not use IV solution if
cloudy, precipitated, or seal broken; do not exceed continuous IV infusion rate of 200 mg/hr; check site frequently for extravasation/necrosis; describe clinical
presentation of fungal infection

GENERIC NAME: CARVEDILOL

TRADE NAME: Coreg
CLASSIFICATION: Alpha-beta adrenergic blocking agent

ACTION: Has both alpha- and beta-adrenergic blocking activities; decreases cardiac output, reduces exercise- or isoproterenol-induced tachycardia, reduces reflex
orthostatic hypotension, causes vasodilation, and reduces peripheral vascular resistance; BP is lowered more in the standing than in the supine position; significantly
lowers plasma resin activity when given for at least 4 weeks

INDICATIONS: Essential hypertension used either alone or in combination with other antihypertensive drugs, especially thiazide diuretics; mild to severe heart
failure of ischemic or cardiomyopathic origin, used with diuretics, ACE inhibitors, and digitalis to increase survival and reduce risk of hospitalization; reduce CV
mortality in clinically stable clients who have survived an acute MI and have a left ventricular ejection fraction of 40% or less

ROUTES OF ADMINISTRATION: Tablets

USUAL DOSAGE: 6.25-25 mg 2 times per day

ADVERSE REACTIONS: Dizziness, headache, nausea & vomiting, diarrhea, URTI, fatigue, pain, bradycardia, hypotension

INTERACTIONS: Antidiabetic agents - ↑ hypoglycemic effects R/T beta blockage; Clonidine – potentiation of BP and heart rate lowering effects; Cyclosporine -
↑ cyclosporine blood levels R/T ↓ liver breakdown; Digoxin - ↑ digoxin levels
CONTRAINDICATIONS: Clients with NYHA class IV decompensated cardiac failure, bronchial asthma, or related bronchospastic conditions, second- or third-
degree AV block, SSS (unless pacemaker is in place), cargiogenic shock, severe bradycardia, drug hypersensitivity; hepatic impairment; lactation

NURSING CONSIDERATIONS: Full antihypertensive effect seen within 7-14 days; addition of diuretic can produce additive effects and exaggerate orthostatic
effect; treat fluid retention with increased dose of diuretics, whether or not heart failure symptoms have worsened; reduce dosage if bradycardia (HR less than 55
bpm) occurs; take as prescrivbed with food, slows absorption/decreases orthostatic effects; avoid OTC agents; avoid activities that require mental acuity until drug
effects realized; do not stop abruptly; R/T beta-blocking activity (esp. with ischemic heart disease)