Generic Name & Dose, strength, Indication/ mechanisms Adverse/ Side Effects Nursing

Rationale Client teaching

Brand Name & formulation of drug action & Drug Interaction Responsibilities
DATE
ORDERED Ordered: Indications: Side effects: Before:  Take drug with
9/17/15 80 mg tab PO food or after
No stock: NGT Mild to moderate pain. GI: Nausea and  Check the  To ensure the meals if GI upset
9/22/2015 Fever. vomiting, dyspepsia, doctor’s order. patient’s 5 rights occurs.
Inflammatory condition- epigastric discomfort, in the drug
Generic: Timing: rheumatic fever, anorexia, During: administration.  Do not crush,
rheumatoid arthritis, hepatotoxicity. (Edmunds, 2010) chew, sustained-
aspirin OD AFTER osteoarthritis  Ensure the 5 release products.
LUNCH Reduction of risk of HEMATOLOGIC: right’s when  To protect the
recurrent TIA’s or CVA Occult blood loss, giving the drug. nurse legally and  Avoid straining
Brand: Duration: in males with history of hemostatic defects. will prove the and nose
TIA due to febrile platlet After: care to the picking.
Aspilet Maintenance emboli. HYPERSENSITIVITY: patient. (Erbs &
drug Reduction of death or Anaphylactoid  Document the Kozier, 2009)  Use soft bristled
nonfatal MI in patients reactions to drug given on toothbrush.
Classification: with history of infarction anaphylactic shock. the patient’s  To provide safety
Analgesic Other forms: or unstable angina chart. to the patient and  Ensure that no
(nonopioid) pectoris. as well protects contraindicated
Anti- MI prophylaxis. the nurse. ( drugs are taken
inflammatory Suppositories- Unlabeled used:  Monitor PT and Edmunds, 2010) with aspirin.
Antiplatelet 120, 200, 300, prophylaxis against bleeding time,
Antipyretic 600 mg cataract formation with as ordered. Be  To treat  Obtain
Antirheumatic long term use. prepared to hypothrombinemi temperature 1
NSAIDs administer a. hour after
Salicylate Mechanism of action: vitamin k, if (Nurse’s Drug
ordered. Handbook, 2011)
Analgesic and
antirheumatic effect are
attributable to aspirins
ability to inhibit the

26
synthesis of
prostaglandins,
important mediators of
inflammation. Antipyretic
effects are not fully
understood, but aspirin
probably acts in the
termoregulatory center
of the hypothalamus to
block effects of
endogenous pyrogene
by inhibiting synthesis of
the prostaglandin
intermediary. Inhibition
of platelet aggregation is
attributable to the
inhibition of platelet
synthesis of
thromboxane A2, a
potent vasoconstrictor
and inducer of platelet
aggregation.This effect
occurs at low doses and
lasts for the life of the
platelet ( 8 days). Higher
doses inhibits the
synthesis of
prostacyclin. A potent
vasodilator and inhibitior
of platelet
aggregation.

27
 Generic/Brand Indication/ Adverse/ Side
Dose, Strength & Nursing Client
Name & Mechanism of Drug Effects Rationale
Formulation Responsibilities Teaching
Classification Action Drug Interaction
DATE ORDERED:
Sept. 18, 19, 21, Ordered: Indication: Side Effects: Before:  Report
2015 promptly any
No stock: 9/22/15 atorvastatin Reduces LDL and CNS: headache  Check doctors  For client’s safety of the
(Lipitor) total triglyceride order, kardex & (Altman, 2005) following:
Generic: 40 mg 1 Tab NGT production as well GI: Abdominal pain, medication unexplained
OD AT HS as increases the constipation, ticket muscle pain,
atorvastatin plasma level of HDL diarrhea, dyspepsia,  Reduces tenderness,
calcium Timing: . flatulence,  Perform hand transmission of or weakness,
9PM increased liver washing microorganism especially
function test safety (Altman, with fever or
Brand: Mechanism of 2005) malaise,
Lipitor Action: RESP: sinusitis,  Prepare yellowing of
Duration: pharyngitis medication one  To prevent error skin or eyes,
>24 hours Atorvastatin is an at a time. (Altman, 2005) stomach pain
Classification: inhibitor of SKIN: rash with nausea,
Cardiovascular reductase 3-  Assess vital  For client’s safety vomiting, or
agent Other forms: hydroxy-3-methyl- Drug Interaction: signs (Altman, 2005) loss of
Antilipemic agent None glutary coenzyme A appetite, skin
(HMG-CoA), which Digoxin: may During rash or hives.
is essential to increase its levels to  For clients
hepatic production 20%  Identify the security & safety(  Do not take
of cholesterol. Lipitor Erythromycin: may client& explain Altman, 2005) drug during
increases the increase the procedure pregnancy
number of hepatic atrovastatin levels  Ensure because it
low-density-lipid up to 40%  Observed the therapeutic effects may cause
(LDL) receptors, Nelfinavir: may 10 rights of of the drug ( birth defects.
thus increasing LDL increase medication Altman,2005)

28
uptake and atrovastatin levels. administration  Immediately
catabolism of LDL.  Promote client’s inform
 Explain the cooperation(Altma physician of
procedure n, 2005) suspected or
known
After pregnancy.
 Promote client’s
 Assess & safety  Inform
monitor client (Atyman,2005) physician
for side regarding
effects/adverse concurrent
reaction use of any of
 Maintain clean the following
 Do after care environment(Altm drugs:
an, 2005) erythromycin,
niacin,
 For legal antifungals,
 Documentation Purpose(Altman, or birth
2005) control pills.

 Minimize
alcohol intake
while taking
this drug.

 Report to
physician for
any
unusualities.

29
Generic/ Brand Dose, Indication/ Adverse/Side Effects Nursing Rationale Client Teaching
Name and Strength and Mechanisms of and Drug Responsibilities
Classification Formulation Drug Action Interactions
Generic: Ordered: 1tab Indications: Adverse/Side  Assist patient’s in  To avoid  Tell patient that if he
losartan In AM Hypertension (used Effects: sitting position injury. feels dizzy or has
alone or with other CNS: dizziness,apin, and lying down if (Lippincott, low blood pressure
Brand: Cozaar antihypertensives) fatigue,head ache feeling dizzy. 2013) on standing, he
Timing: OD Cardiovascular risk CV: chest pain, should lie down, rise
Classification: reduction in pstientd hypertension  Check blood slowly from a lying
anti- at high risk and peripheral edema pressure standing position,
hypertensive Duration: unable to take ACE EENT: pharyngitis, regularly. and climb stairs
30 days inhibitors. sinusitis  To avoid slowly
GI: nausea,abdominal  Check and hypotension
Pharmacologic: Other forms: pain, diarrhea, palpate patient’s (Lippincott,  Tell the patient that
ACE II- receptor Tablets Mechanism of dyspepsia extremities. 2013) the drug may be
antagonist Action: GU: UTI taken without regard
Block MS: backpain,  Assess patient for to meals.
vasoconstricting and myalgia chest pain if blood  To note
aldosterone- RESP: cough, upper pressure peripheral  Instruct patient to lie
secreting effects of respiratory tract increase. edema. down if feeling dizzy
angiotensin II by infection (Lippincott, and rise slowly to
preventing angio Other: flulike 2013) sitting position
tensin II from binding symptoms
to the angiotensin I  To evaluate  Instruct patient or
receptor. Interaction: presence of significant others to
(Lippincott, 2013) Digoxin: may heart notify physician or
increase digoxin level. congestion. health care
Warfarin: may slightly (Lippincott, providers if urine
decrease warfarin 2013) output decreases
level. abruptly.

30
 Generic/ Brand Dose, Indication/ Adverse/ Side Nursing Rationale Client Teaching
Name & Strength & Mechanism of Action Effects Responsibilities
Classification Formulation Drug
Interaction
DATE ORDERED: Ordered: Indication: Adverse/ Side • Monitor patient's › To otain • Caution ambulatory patient
9/ 17/15 Effects: vital sign. baseline about getting out of bed or
1 gm/ tab •Parkinson's disease data(Lippincott walking.
Generic: NGT two •head injury CNS: • Do not give , 2013)
times daily •cerebral vascular Dizziness, medication in the • Warn outpatient to avoid
citicoline sodium disease headache, late afternoon or › it can cause driving and other hazardous
Timing: •alzheimer's disease nervousness, at night. difficulty activities that require mental
Brand: •cerebral surgery or restlessness sleeping. alertness until drug’s CNS
8am 6pm acute cerebral CV: • Be aware that (Lippincott, effects are known.
Zynapse disturbance tachycardia, this medication 2013)
Duration: •disturbance of hypertension, should be given • Teach patient to gain
- consciousness hypotension, within 24 hours of benefits and not to miss any
Classification: following brain surgery chest pain a stroke. dose.
Other . GI: diarrhea › to note drug
• Educate patient that he can
forms: EENT: blurred • Direct IV effectiveness(L
take the oral form of drug with
CNS Stimulant, vision administration ippincott,
or without food.
Peripheral tablet: 200- Mechanism of should be very 2013)
Vasodilators, 600 mg Action: Drug slowly •
Cerebral Activators, citicoline seems to Interaction:
Nootropics increase a brain • Watch for
chemical called meclofenoxate: possible adverse › to prevent
phosphatidylcholine. may decrease effects of drug. episodes of
This brain chemical is drug hypotension.
important for brain effectiveness. (Lippincott,
function. Citicoline 2013)
might also decrease Levodopa:
brain tissue damage potentiate or
when the brain is increases › To prevent
injured.It is usually citicoline effect. from further
31
known that complications.
phospholipid, (Lippincott,
especially lecithin, 2013)
decreases following
decline in brain activity
with cerebral trauma.
Citicoline, which is a
co-enzyme,
accelerates the
biosynthesis of lecithin
in the body.
This medication
enhances the action of
the brain stem ciliary
body especially the
ascending ciliary body
activating system,
which is closely related
to consciousness, but
does not exert effort on
the extrapyramidal
system. Citicoline
increases cerebral
blood flow and oxygen
consumption of the
brain and improves
cerebral circulation
and metabolism.

32
Generic/ Brand
Dose, Adverse/ Side
Name & Indication/ Mechanism Nursing
Strength & Effects Rationale Client Teaching
Classification of Action Responsibilities
Formulation Drug Interaction
Generic: Ordered: CNS: BEFORE
Metoprolol 50 mg 1 tab Indication: Fatigue, dizziness, 1. Tell patient that
tartrate oral - Hypertension fever, lethargy 1. Check doctor’s -To avoid medication abruptly stopping
- Early intervention for M.I order in patient’s error. therapy can worsen
Brand: Timing: - Angina Pectoris CV: AV block, chart. (Edmunds, 2010) condition.
Neobloc Once a day -Stable, symptomatic bradycardia, heart
heart failure failure, hypotension - To consider 2. Instruct patient to
Classification: Duration: 2. Assess patient’s effectiveness of take medication with
Maintenance G.I: initial vital signs medication. meals.
Antihypertensive dose Mechanism of Action: Diarrhea, nausea, before administering (Lippincott, 2009)
vomiting medication. 3. Advise patient to
Pharmacologic Other forms: Inhibits stimulation of - To monitor report adverse
: Injection: beta 1 – receptor sites in GU: effectiveness of drug reaction to the
Beta adrenergic 1 mg/ml in decreased cardiac Decreased libido 3. Assess patient’s medication. physician.
antagonist 5- ml excitability, cardiac condition regularly (Lippincott, 2009)
ampules and output, and myocardial Skin: rash and thereafter. 4. Advise patient to
carpuject oxygen demand. These notify health care
cartridge effects help relieve Respiratory: DURING staff if experiencing
angina and reduce blood Bronchospasm 1. Notify physician if - This indicates the listed side
pressure. pulse rate falls below adverse reaction to effects of the drug.
60 bpm or is the drug.
significantly lower (Lippincott, 2009)
than usual.
- Foods help increase
2. Give drug with drug absorption and
meals. alleviate G.I side
effects.

33
 3. Be aware that (Lippincott, 2009)
patient taking this
drug may at risk of - AV block results
AV block. from depressed AV
node conduction.
AFTER (Lippincott, 2009)

1. Assess patient’s
knowledge about - Includes health
the medication. teaching to patient
and family.
(Lippincott, 2009)
2. Assess vital signs
if it is in the - Provide efficacy of
accepted range. the medication.
(Lippincott, 2009)

34
Generic/ Brand Dose, Indication/ Mechanism Adverse/ Side Nursing Rationale Client Teaching
Name & Strength & of Action Effects Responsibilities
Classification Formulation Drug Interaction
DATE BEFORE:
ORDERED: Odered: Indication: - provides baseline  Obtain
9/17/15 - To prevent exercise CNS: Anxiety, Assess lung sounds, date (Lippincott, 2009) baseline
GIVEN: SEPT. 1 neb via induced asthma drowsiness, respiration assessment
18 inhalation - to prevent or treat headache, vertigo -provides baseline of patient’s
bronchospasm to patient CV: angina, Note amount, color date (Lippincott, 2009) respiratory
Timing: with reversible arryhtmias, chest and consistency of status
Generic: Every 8 obstructive airway pain sputum - Determine  Instruct
Salbutamol hours disease. effectiveness of patient to
EENT: altered taste, Monitor pulmonary medication. (Jones & take the drug
Brand: Duration: Mechanism of action: dry mouth and throat, function test before B, 2011) with a deep
Ventolin 3-6 hours Albuterol attaches to hoarseness initiating therapy breath to
beta2 receptors on ENDO: and all throughout increase
Pharmacologic bronhchial cell hyperglycemia course. effectiveness
Classification: membranes, which GI: anorexia, - If condition occurs ,  Encourage
stimulates the dysphagia, nausea DURING withhold medication coughing
Selective beta2 intracellular enzyme vomiting Observe for and contact prescriber after the
– adrenergic adenylate cyclase to MS: muscle cramps paradoxical immediately. (Jones & giving of
agonist, convert adenosine RESP: bronchospam B, 2011) drug.
sympathomimeti triphosphate (ATP) to bronchospasm, ( wheezing)  Encourage
c cyclic adenosine cought, dyspnea fluid intake
monophosphate. This -drug tolerance can
reaction decreases INTERACTIONS: Use minimal doses occur with prolonged
Therapeutic intracellular levels. It also for minimal periods use (JONES & B.
Classification: increases intracellular Beta blocker: 2011)
Bronchodilator calcium levels of Camp. Inhibited effects of
Together these effects salbutamol such as AFTER Drug tolerance may
relax bronchial smooth thephylline. occur for prolonged
muscle cells and inhibit Monitor for drug use (JONES & B.
histamine release. tolerance. 2011

35
 Generic/ Brand Dose, Strength Indication/ Mechanism Adverse/ Side Nursing Rationale Client Teaching
Name & & Formulation of Action Effects Responsibilities
Classification Drug Interaction
DATE Odered: Indication: CNS: confusion, BEFORE  Advise patient
ORDERED: - prevent deep vein fever, paralysis, to notify
9/17/15 .6 cc SQ thrombosis stroke Check patient’’s - patient may at prescribe
GIVEN: - to prevent ischemic CV: atrial history or any risk for prosthetic about adverse
SEPT.18. 19, 20 Timing: complications of unstable fibrillation, attachments like valve thrombosis reactions,
NO STOCK: Every 12 hours angina and non- Q wave congestive heart prosthetic heart (Jones & B, especially
9/22/15 MI failure, valves 2011) bleeding.
Duration: hyperlipidemia,  Instruct
Generic: - peripheral edema Check doctor’s patient to
enoxaparin Mechanism of action: EENT: epistaxis order. - To avoid seek
sodium Other forms: Potentiates the action of GI: Blood stools, medication error. immediate
Injection: antithrombin III, a elevated liver (Edmunds, 2010) help for
Brand: Lovenox coagulation inhibitor. By function test Assessed clotting evidence of
binding with RESP: dyspnea, time of the patient - ensure patient’s thromboembol
Classification: antithrombin,enoxaparine pneumonia safety from risk ism
Low- molecular rapidly binds with and of bleeding.  Stress
weight heparin inactivates clotting INTERACTIONS: (Jones,& B, importance of
factors.Without thrombin, Drugs: DURING 2011) complying
Therapeutic: fibrinogen cant convert to Cefamandole: with follow-up
Antithrombotic fibrin and clots cant form. possibly increased Watch patient visits.
risk of closely for  Teach family
hemorrhage bleeding - platelet below members how
NSAIDS; oral 100,0000/mm3 to give
anitgcoagulants; indicated medication at
plate;et bleeding home if
aggregation tendencies. needed.
inhibitor; possibly Keep protamine (Jones, & B,  Caution not to
increased risk of sulfate nearby in 2011) rub at site

36
bleeding and of case of accidental after giving
spinal or epidural overdose. - Protamine medication.
hematoma sulfate is an
AFTER antidote
( Jones & B,
Check for occult 2011)
stool as ordered.

Check serum
postassium for - indicates upper
elevation as GI bleeding.
ordered. (Jones, & B,
2011)

- increases in
patient with renal
impairment or
concurrent use of
potassium—
sparing diuretics.
(Jones & B,
2011)

37
 Generic/ Dose, Adverse/ Side
Indication/ Mechanism Nursing
Brand Name & Strength & Effects Rationale Client Teaching
of Action Responsibilities
Classification Formulation Drug Interaction
DATE Odered: Indication: RESP: BEFORE
ORDERED: Treatment of respiratory Bronchospasm,
9/17/15 1 tab affections characterized rhinorrhea, Assess patient’s - drug may  Report difficulty
GIVEN: SEPT. by thick and viscous epistaxis history for asthma or adversely affect with clearing the
18 – 22, 2015 Timing: hypersecretion SKIN: Rashes. bronchospasms respiratory function airway or any other
Once a day Pruritus (Jones & B, 2011) respiratory distress.
acute bronchitis, chronic GI: Nausea and  Report nausea, as
Generic: Duration: bronchitis Vomiting, Observe the Rights - ensure patient’s an antiemetic may
Acetylcysteine - and its exacerbations; Stomatitis, of patient in safety (Jones & B, be indicated.
pulmonary emphysema, hepatotoxicity medications 2011)  Note: Unpleasant
Brand: mucoviscidosis and CNS: Fever, odor of inhaled
Fluimucil bronchiectasis Dizziness , Fatigue drug becomes less
ENT: Blurred DURING noticeable with
Pharmacologic to treat acetaminophen vision, Nebulization continued use.
Classification: overdose Disturbances of Have patient wash causes sticky
N- actyl liver function his face and mouth residue in his face
derivative of Mechanism of action: at the end of and mouth.
cysteine Exerts mucolytic action Interactions treatment
through its free DRUG Ensure effectivity of
Classification: sulfhydrylgroup which Activated charcoal: Monitor for drug therapy
Mucolytic agent opens up the disulfide possibly characteristics of
bonds in the mucoproteins decreased patient’s cough
thus lowering mucous effectiveness of
viscosity. The exact oral acetylcysteine
mechanism of action in Nitroglycerin:
acetaminophen toxicity is increased effects AFTER
unknown. It is thought to of nitroglycerine Maintain drug
act by providing and possibly Refrigerate open vial effectiveness and
substratefor conjugation significant or disard after 96 potency.
with the toxic metabolite. hypotension and hours
headache

38
39