Medication/IV Solution,
Route and FrequencyList
generic AND trade name
Methylnaltrexone (Relistor)
12 mg/
0.6 ml.
Opioid
receptor antagonist.
Sulfamethoxazole (Bactrim)
MECHANISM OF
ACTION
How does this medication
work? State in your own
words.
Blocks binding of opioids
to peripheral
opioid receptors within GI
tract. Therapeutic
Effect:Decreases
constipating
effect of opioids without
reducing analgesic
effect.
Blocks bacterial folic acid
synthesis and
growth. Therapeutic
Effect:Bactericidal
in susceptible
Why is What are the most What are nursing considerations for this
THISPATIENT important side/adverse medication?
receiving this effects What assessments/labs/other diagnostic
medication/IV THISPATIENTmay
tests do you have to check before
solution? exhibit?
Consider current administering this medication?
problem(s) and other
Include IV push/infusion rates.
medical
history/diagnoses/social
history
- Abdominal pain, - 30% of pts report defecation within
My patient was having flatulence, nausea. 30 min after drug administration.
constipation for the last
3 days because he was - Encourage fluid intake. Assess bowel
using opioids to manage sounds for peristalsis. Monitor daily pattern
his chronic back pain.
of bowel activity, stool consistency.
He receives this
medication to reduce - Laxative effect usually occurs within
and treat his
30 min but may take up to 24 hrs after
constipation.
medication administration.
Because my patient -Frequent:Anorexia, -Obtain history for hypersensitivity to
has a medical history nausea, vomiting, trimethoprim or any sulfonamide, sulfite
of recurrent Urinary sensitivity, bronchial asthma.
rash (generally 7–14
 microorganisms. tract infections, this days after therapy -Monitor renal, hepatic, hematology
drug is used as begins), urticaria. function.
prophylaxis.
-Rash, fever, sore -Continue medication for full length of
throat, pallor, purpura,
therapy.
cough, shortness of
-Report immediately any new symptoms,
breath may be early
esp. rash, other skin changes,
signs of serious adverse bleeding/bruising, fever, sore
effects.
throat, diarrhea.

allopurinol (Zyloprim) Decreases uric acid Management of -Occasional: PO: - Obtain baseline serum chemistries,
production by inhibiting
elevated uric acid in Drowsiness, unusual hepatic function tests. Instruct pt to drink
Xanthine xanthine oxidase, an
enzyme cancer treatment for hair loss. minimum of 2,500–3,000 ml of fluid daily
responsible for converting lymphoma. while taking medication.
oxidase inhibitor xanthine to - Pruritic maculopapular
uric acid.
Tab 300 mg rash, possibly - Discontinue medication
immediately if rash or other evidence of
accompanied by allergic reaction occurs.
malaise, fever, chills,
joint pain, nausea, - Assess serum chemistries, uric acid,
vomiting, should be hepatic function. Assess urine for cloudiness,
considered a toxic unusual color, odor.
reaction.

Morphine SR (Ms Contint) Binds with opioid My patient receives this - Frequent: Sedation, - Assess onset, type, location, duration of
receptors within CNS,
Tab inhibiting ascending pain medication to manage decreased B/P
his chronic back pain. (including pain. Obtain vital signs before giving
pathways.
15 Mg
 orthostatic medication. If respirations are 12/min or
hypotension),
diaphoresis, facial less (20/min or less in children), withhold
flushing, constipation, medication, contact physician.
dizziness,
- Be alert for decreased respirations,
drowsiness, nausea,
vomiting. B/P. Check for adequate voiding. Monitor
daily pattern of bowel activity, stool
- Overdose results in consistency; avoid constipation.
respiratory depression,
- Change positions slowly to avoid
skeletal muscle orthostatic hypotension.
flaccidity, cold/ clammy
skin, cyanosis, extreme
drowsiness

progressing to seizures,
stupor,

coma.

Pantoprazole Irreversibly binds to, Treatment, Rare (less than 2%): - Question history of GI disease, ulcers,
inhibits hydrogen
potassium adenosine maintenance of healing Diarrhea, headache, GERD.
(Protonix)
triphosphate, an
enzyme on surface of of erosive esophagitis dizziness, pruritus, rash. - Evaluate for therapeutic response (relief
Tab 40 Mg gastric parietal associated with
cells. Inhibits hydrogen of GI symptoms).
ion transport gastroesophageal reflux
into gastric lumen. - Report headache, onset of black, tarry
disease (GERD).

Reduction of relapse stools, diarrhea.

 rate of heartburn

symptoms in GERD.

Polyethylene glyco Induces My patient is receiving - Frequent (50%): Some - Assess bowel sounds for peristalsis.
diarrhea, cleanses bowel
without this medication because degree of abdominal Monitor
(Miralax) he has been
depleting electrolytes.
constipated for the past fullness, nausea, daily pattern of bowel activity, stool
Osmotic/
3 days. bloating.
consistency.
laxative.
- Monitor serum electrolytes, BUN, glucose,
17g urine osmolality.

- May take 2–4 days to produce a bowel

movement.

Sennosides-docusate Direct effect on intestinal My patient is receiving - Frequent:Red, brown - Encourage adequate fluid intake. Assess
smooth musculature
sodium (stimulates intramural this medication because discoloration of bowel sounds for peristalsis.
nerve plexi). he has been
(Senna plus) Therapeutic constipated for the past urine. - Monitor serum electrolytes in pts exposed
Effect:Increases
8.6-50mg peristalsis, 3 days. - Long-term use may to prolonged, frequent, excessive use of
promotes laxative effect. result in laxative medication.
dependence, chronic
constipation, loss of - Urine may turn red or brown (only
normal bowel function. temporary and not harmful).

- Laxative effect generally occurs in 6–12 hrs

but may take 24 hrs.
Medication/IV Solution, MECHANISM OF Why is THISPATIENT What are the most What are nursing considerations for this
Route and FrequencyList ACTION receiving this important side/adverse
How does this medication?
generic AND trade name medication work? State medication/IV solution? effects THISPATIENTmay
in your own words. What assessments/labs/other diagnostic
exhibit?
Consider current tests do you have to check before
problem(s) and other administering this medication?
medical
history/diagnoses/social Include IV push/infusion rates.
history

Warfarin (Coumadin) tablet Anticoagulant/coumarin The patient is The most important side The nursing consideration for this
Interferes with hepatic
55mg, oral, Daily prescribed coumadin as effect for this medication includes: monitoring PT, INR, and
synthesis of vitamin k
dependent clotting a prophylaxis to prevent medication is bleeding, CBC lab values, and assessing the patient for
factors (II, VII, IX, X) thrombus formation this is also evidenced by signs of bleeding and hemorrhage.
and embolization. The the patient’s most
patient has a history of recent medical problem
prosthetic valve when she suffered from
replacement and may an intracranial
be more susceptible to hemorrhage. Her home
forming blood clots. medication included the
 coumadin medication.

Oxacillin 2g in sodium Penicillin antibiotic The patient is on this The serious side effects If administering an antibiotic for the first
chloride 0.9% (NS) 100 mL Attaches to bacterial cell antibiotic medication to that can occur with this time, I would stay with the patient for 15
wall increasing
IVPB 2g intravenous, permeability of the cell treat her MSSA medication are infusion minutes prior to administration to monitor
200ml/hr Q4h which leads to eventual bacteremia and MSSA reactions(allergies), for any adverse/allergic reactions such as
cell lysis.
endocarditis. phlebitis at the IV site, rashes, pruritis, edema in her throat, or
ototoxicity, and renal difficulty breathing.
toxicity.
Monitor patient’s CBC’s, and BMP for kidney
function.

Polyethylene glycol Osmotic/laxative The patient may be Important side effects Prior to giving this medication, have water,
This powder in solution prescribed this for this medication stirrer, and cup prepared to reconstitute the
(Glycolax) 1 packet, QID
acts as an osmotic agent
that draws water into medication to prevent include abdominal packet with water.
the lumen of the GI constipation while she fullness, diarrhea,
Tract. It is best not to give this medication at least
is in the hospital and bloating, cramps,
less active. nausea, or vomiting. an hour apart from other PO medications
because other medications may not be
absorbed as well in the GI tract due to GI
cleansing effect of this drug. Commented [t1]: What assessment do you have to do before
giving the med?

Sennosides-docusate Osmotic/laxative This medicine is a stool Cramping and diarrhea, Assess the patient’s abdomen prior to
Components in the
sodium (SENOKOT-S, PERI- softener. The patient is shortness of breath, administration and monitor for abdominal
medication alter the
COLACE) 8.6-50mg per water and electrolyte currently prescribed dizziness, edema. distension, hyperactive bowel signs, and
tablet, 2 tablet, oral, 2 transport in the large many medications and diarrhea.
intestine, helping soften
times daily the stool and increases more sedentary while in
movement down the the hospital. Assess patient’s respiration rate and monitor
intestinal tract. for any increases in edema.
Rifampin (rifadin) capsule
300mg PO 2x daily
Nystatin
(mycostatin)100,000
unit/gram powder topical
2x daily (groin area)
Chlorhexidine gluconate 2%
towelette 1 each, topical at
bedtime
Cetirizine (Zyrtec) tablet
10mg Daily
Antitubercular Anti- The patient is This medication can Prior to administration, assess the patient’s
infective/bacteriostatic; prescribed this oral produce red-orange or baseline CBC, renal function tests, and LFT,
bacteriocidal anti-
infective medication in red-brown discoloration continue to monitor labs to detect for
Inhibits mycobacterial combination with of urine, feces, saliva, or therapeutic effect and renal/hepatic
cell wall synthesis and
interferes with another antibiotic skin. impairment.
metabolism. medication to treat her
bacterial infection. Dangerous side effects Monitor patient for any signs of jaundice.
include hepatoxicity.
Polyene Antifungal The patient is Side effects for this Prior to applying topical medication, obtain
antibiotic prescribed this medication include skin baseline assessment of the patient’s skin
Binds to sterols in cell
membrane, increasing medication to treat her irritation at the site of irritation.
fungal cell membrane fungal skin rash in her application.
permeability, permitting Monitor the patient’s skin for therapeutic
loss of potassium and groin area.
other cellular effect or worsening of fungal infection/skin
components. rash.
(Fungistatic)
Antimicrobial/antifungal The patient is Side effects of this Nursing considerations include making sure
Binds to microbial cell prescribed this topical medication can include that the skin is completely dried after
wall proteins present on
the skin, increases medication to fight blistering, burning, applying medication before covering with
permeability and water against infections itching, rashes, peeling, any dressings.
leakage followed by cell
lysis. present on her toe swelling, or severe
wounds. The patient irritation at the site of Maintain baseline assessment of the toe
had developed Osler’s wounds and chart focused assessment.
application.
Nodes subsequent to Monitor site for signs and symptoms of
her endocarditis. irritation.
Antihistamine The patient was Side effects from this Prior to administration, assess the patient for
Competes with prescribed this medication can include
severity of itching and urticaria/skin rash.
histamine for H2
receptor sites on effector medication to treat a pharyngitis, dry mucous
cells in GI tract, blood skin rash with itching membranes, nausea, Continue to monitor patient’s affected skin
vessels, respiratory
 tract.
Carvedilol (Coreg) tablet Beta Adrenergic Blocker
6.25mg 2x daily with blocks stimulation of
beta1 adrenergic
breakfast and dinner. receptors
Diphenhydramine(Benadryl) Antihistamine
Antagonizes the effects
capsule 25mg PO Q6H PRN of histamine at
peripheral histamine1
(H1) receptors.
Inhibition of these
receptors can be used
for histamine-related
inflammation, like
urticaria and pruritus.
Sodium chloride (NS) flush IV fluid
Provides patency and
20 mL, IV, PRN
prevents clotting in IV
tubing.
(10mL PRN too)
Ondansetron (Zofran) 5HT3 antagonist
Blocks the effects of
injection 4mg, intravenous
serotonin at receptor
Q6H PRN sites located in vagal
nerve terminals and in
the chemoreceptor
trigger zone in the CNS.
that occurred on her vomiting, abdominal and for symptoms/relief from itching.
right leg during her pain, headache and
hospital stay. dizziness.
This medication was Side effects may include Prior to administration, assess the patient’s
prescribed to the the increase dizziness, BP and pulse.
patient to prevent MI. fatigue, back pain,
The patient has a bradycardia, orthostatic Reassess the patient’s BP and HR 20-30
history of congenital hypotension, pulmonary minutes after administration.
valvular disease. edema, and drowsiness.
The patient was Side effects from Prior to administration, assess the patient’s
prescribed this Benadryl include allergy symptoms and conduct a focused skin
medication as needed drowsiness, fatigue, and assessment.
for itching and rash. She dyspepsia.
Administer medication with food or milk to
acquired rashes along
her lower right leg decrease GI irritation.
during her
hospitalization.
The patient has a PICC Side effects can include Clean the IV port with alcohol swab prior to
line in her left arm. irritation, infection, attachment of syringe for flushing. Withdraw
Flushing is needed to infiltration, or phlebitis syringe and assess for blood to confirm IV
maintain clearance and at the PICC line site. catheter placement within the blood vessel.
function of the tubing.
The patient is Side effects include Prior to administration assess for baseline
Commented [t2]: Also: abd assessment
prescribed this headache, dizziness, level of nausea 0-10 scale.
medication as needed fatigue, weakness,
for symptoms of nausea constipation, diarrhea,
or vomiting. She may abdominal pain and dry
 have had nausea during mouth. Monitor 30 min after for therapeutic
her hospital stay after effectiveness and monitor for nausea, bowel
surgery. sounds, gastric distension.

Ipratropium-albuterol Anticholinergic The patient is Side effects include dry Prior to medication administration assess the
(DuoNeb) 0.5-2.5 mg/3mL This medication blocks prescribed this mouth and hoarseness. patient’s respirations, breathing patterns,
Ach receptors in the
Nebulizer solution 3mL, smooth muscle and medication as needed Increasing fluids or Oxygen saturation, and lung sounds for a
nebulization, Q4H PRN causes bronchodilation. to improve breathing sucking on sugar free baseline assessment.
and airway clearance. candy can decrease
symptoms of dry mouth.
Monitor patient’s respiratory status and oral
mucous membranes. Frequent oral hygiene
can help relieve dry mouth

Acetaminophen (Tylenol) Non opioid analgesic This patient is Acetaminophen can Prior to medication administration, assess
Inhibits prostaglandin prescribed Tylenol to cause constipation, the patients baseline level of pain. Assess the
tablet 650mg PO Q6H PRN
synthesis in CNS.
control her mild to dizziness, sleepiness, patient’s labs and vital signs. Ask the patient
moderate pain. nausea, and vomiting. In if they have any history of renal impairment
high doses, this or liver disease. Monitor the patient’s
medication can cause additional medications to see if they contain
hepatotoxicity. acetaminophen. It is important not to
exceed 4g/day. (Acetylcysteine is an antidote
for overdose.)

Monitor and assess the patient after 30-45

minutes for pain level.
Medication/IV Solution, MECHANISM OF Why is THISPATIENT What are the most What are nursing considerations for this
Route and FrequencyList ACTION receiving this important side/adverse medication?
How does this
generic AND trade name medication work? State medication/IV solution? effects THISPATIENTmay
in your own words. What assessments/labs/other diagnostic
exhibit?
Consider current tests do you have to check before
problem(s) and other administering this medication?
medical
history/diagnoses/social Include IV push/infusion rates.
history

Aspirin ( Ecotrin) Inhibits cyclo-oxygenase Treatment of mild to GI distress (including - Do not give to children or teenagers who
enzyme via
moderate pain, pt had abdominal
81mg TBEC acetylation. Inhibits have or recently had viral infections
formation of chest pain.
prostaglandin distention, cramping, (increases
derivative thromboxane heartburn.
A. risk of Reye’s syndrome).
- High doses of aspirin
may produce GI - Assess type,

bleeding and/or gastric location, duration of pain, inflammation.

mucosal lesions. Inspect appearance of affected joints for

immobility, deformities, skin condition.

- Do not, chew, crush, dissolve, or divide

enteric-coated tablets.

Sennosides-docusate Direct effect on My patient is receiving - Frequent:Red, brown - Encourage adequate fluid intake. Assess
intestinal smooth
sodium musculature this medication because discoloration of bowel sounds for peristalsis.
(stimulates intramural he has been
(Senna plus) nerve plexi). urine. - Monitor serum electrolytes in pts exposed
Therapeutic constipated for the past
Effect:Increases 3 days.
100mg peristalsis, - Long-term use may to prolonged, frequent, excessive use of
promotes laxative effect. result in laxative medication.
dependence, chronic
constipation, loss of - Urine may turn red or brown (only
normal bowel function. temporary and not harmful).

- Laxative effect generally occurs in 6–12 hrs

but may take 24 hrs.

Heparin porcine Interferes with blood Prophylaxis and -Pruritus, burning -Cross-check dose with co-worker.
coagulation by treatment of (particularly Determine
Inj 5000 units blocking conversion of
prothrombin to thromboembolic
thrombin and fibrinogen on soles of feet) caused aPTT before administration and
(Hep-Lock) to fibrin. disorders; anticoagulant by vasospastic
for extracorporeal 24 hrs following initiation of therapy,
reaction.
and dialysis procedures; then q24–48hrs for first wk of therapy or
-Bleeding complications
maintain until maintenance dose is established.
ranging from
patency of IV devices. -Monitor aPTT (therapeutic range at 1.5–
local ecchymoses to
major hemorrhage 2.5 times normal) diligently. Assess CBC,
occur more frequently platelet count, ALT, AST. Monitor urine and
in high-dose therapy,
intermittent IV infusion, stool for occult blood.
women
-Use electric razor, soft toothbrush to
60 yrs and older.
 prevent bleeding.

Insulin regular Acts via specific Treatment of -Localized redness, -Check blood glucose level. Discuss lifestyle
receptor to regulate
metabolism swelling,
(Humulin R, Novolin R) ; non–insulin- to determine extent of learning,
of carbohydrates,
protein, and dependent itching (due to improper
Inj fats. Acts on liver, emotional needs.
insulin injection
skeletal muscle, and type 2 diabetes mellitus
adipose tissue. technique), allergy to -Assess for hypoglycemia (refer to
(NIDDM) to
insulin cleansing pharmacokinetics
improve glycemic solution.
control. table for peak times and duration):
-Severe hypoglycemia cool, wet skin, tremors, dizziness,
(due to hyperinsulinism)
headache, anxiety, tachycardia, numbness
may occur with insulin
overdose, in mouth, hunger, diplopia.

decrease/delay of food -Instruct on proper technique for drug

intake, excessive
administration, testing of glucose, signs/
exercise, pts with brittle
symptoms of hypoglycemia and
diabetes.
hyperglycemia.

Metoprolol Selectively blocks beta1- Treatment of -Overdose may produce -Assess baseline renal function, LFT. Assess
adrenergic receptors.
Therapeutic Effect: hemodynamically profound bradycardia,
(Lopressor) B/P, apical pulse immediately before
Slows heart
rate, decreases cardiac stable acute myocardial hypotension,
output, reduces B/P. infarction, angina drug administration (if pulse is
Decreases myocardial
ischemia severity. pectoris, hypertension. bronchospasm. 60/min or less or systolic B/P is less than

-Abrupt withdrawal may 90 mm Hg, withhold medication, contact

result in diaphoresis,
physician).
palpitations, headache,
tremulousness, -Measure B/P near end of dosing interval

exacerbation of angina. (determines whether B/P is controlled

throughout day).

-Monitor B/P

for hypotension, respiration for shortness

of breath.
Medication/IV MECHANISM OF Why is THISPATIENT What are the most important What are nursing considerations for this
Solution, Route ACTION receiving this side/adverse effects medication?
and FrequencyList How does this medication/IV solution? THISPATIENTmay exhibit? What assessments/labs/other diagnostic tests do
generic AND trade medication work? Consider current
name State in your own you have to check before administering this
words. problem(s) and other medication?
medical
history/diagnoses/social Include IV push/infusion rates.
history

Enoxaparim - Potentiates action Long-term - Injection site hematoma,

of antithrombin III,
(Lovenox) inactivates DVT prevention following nausea, peripheral edema. -Obtain baseline CBC. Note platelet count.
coagulation factor
Injection Xa. Therapeutic hip replacement
Effect: Produces - May lead to bleeding Assess potential risk of bleeding.
40 mg anticoagulation. surgery, nonsurgical acute complications ranging
Does not illness. - Periodically monitor CBC, platelet count,
significantly from local ecchymoses to
influence PT, stool for occult blood (no need for daily
aPTT. major hemorrhage.
monitoring in pts with normal presurgical

coagulation parameters).

Metoprolol tartrate Selectively blocks Slows heart -Diminished sexual function, Assess baseline renal function, LFT. Assess
beta1-adrenergic
(Lopressor) receptors. rate, decreases cardiac drowsiness, insomnia, unusual B/P, apical pulse immediately before
Tab 25, Oral, daily output, reduces B/P. fatigue/weakness.
drug administration (if pulse is
Decreases myocardial - Overdose may produce
 ischemia severity. profound bradycardia, 60/min or less or systolic B/P is less than

hypotension, bronchospasm. 90 mm Hg, withhold medication, contact

physician).

Ertapenem (Invanz) Penetrates -Produces bacterial - Diarrhea, nausea, - Question for history of allergies, particularly
bacterial cell wall of
Add vile 1g headache. to beta-lactams, penicillins, cephalosporins.
micro
cell death.
organisms, binds to - Antibiotic-associated colitis, Inquire about history of seizures.
other superinfections
penicillin-binding -For suspected E.Coli Monitor WBC count.
proteins, inhibiting infection (abdominal cramps, severe
- Monitor renal/hepatic function. Monitor
cell wall synthesis. watery diarrhea, fever) may
result daily pattern of bowel activity, stool

consistency. Monitor for nausea, vomiting.

from altered bacterial balance.

Psyllium (Konsyl) Dissolves and Esophageal/bowel obstruction - Encourage adequate fluid intake. Assess
swells in water Treatment of
providing may occur if administered with
increased bulk, occasional insufficient liquid bowel sounds for peristalsis. Monitor
moisture content in
stool. constipation, (less than 250 ml). daily pattern of bowel activity, stool consistency.
Therapeutic
Effect:Promotes Monitor serum electrolytes in
peristalsis, constipation associated
bowel motility. pts exposed to prolonged, frequent, excessive
with rectal disorders.
use of medication.
Dietary fiber
- Take each dose with full glass (250 ml)
supplement.
of water.
Medication/IV Solution, MECHANISM OF Why is What are the most What are nursing considerations for this
Route and FrequencyList ACTION THISPATIENT important side/adverse medication?
generic AND trade name How does this receiving this effects What assessments/labs/other diagnostic
medication work? medication/IV THISPATIENTmay
State in your own tests do you have to check before
solution? exhibit?
words. Consider current administering this medication?
problem(s) and other
Include IV push/infusion rates.
medical
history/diagnoses/social
history

Enoxaparim -(Lovenox) Potentiates action of Long-term - Injection site hematoma,

antithrombin III,
Injection inactivates DVT prevention nausea, peripheral -Obtain baseline CBC. Note platelet count.
coagulation factor
Xa. Therapeutic following hip edema.
40 mg Effect: Produces Assess potential risk of bleeding.
replacement
anticoagulation. - May lead to bleeding
Does not significantly surgery, nonsurgical complications ranging - Periodically monitor CBC, platelet count,
influence PT,
aPTT. acute illness. stool for occult blood (no need for daily
from local ecchymoses to
major hemorrhage. monitoring in pts with normal presurgical

coagulation parameters).

Metoprolol tartrate Selectively blocks Slows heart -Diminished sexual Assess baseline renal function, LFT. Assess
beta1-adrenergic
(Lopressor) receptors. function,
rate, decreases cardiac B/P, apical pulse immediately before
Tab 25, Oral, daily output, reduces B/P. drowsiness, insomnia,
unusual drug administration (if pulse is
Decreases myocardial
 ischemia severity. fatigue/weakness. 60/min or less or systolic B/P is less than

- Overdose may produce 90 mm Hg, withhold medication, contact

profound bradycardia,
physician).
hypotension,
bronchospasm.

Ertapenem (Invanz) Penetrates bacterial -Produces bacterial - Diarrhea, nausea, - Question for history of allergies,
cell wall of micro particularly
Add vile 1g headache.
organisms, binds to cell death. to beta-lactams, penicillins, cephalosporins.
penicillin-binding - Antibiotic-associated
colitis, other Inquire about history of seizures.
-For suspected
proteins, inhibiting superinfections
cell wall synthesis. E.Coli infection Monitor WBC count.
(abdominal cramps,
severe - Monitor renal/hepatic function. Monitor

watery diarrhea, fever) daily pattern of bowel activity, stool

may result consistency. Monitor for nausea, vomiting.
from altered bacterial
balance.

Psyllium (Konsyl) Dissolves and swells Esophageal/bowel - Encourage adequate fluid intake. Assess
in water providing Treatment of
increased bulk, obstruction may occur if
moisture content in occasional administered with bowel sounds for peristalsis. Monitor
stool. insufficient liquid
Therapeutic constipation, daily pattern of bowel activity, stool
Effect:Promotes
(less than 250 ml). consistency.
peristalsis,
bowel motility. constipation Monitor serum electrolytes in
 associated with pts exposed to prolonged, frequent,
excessive
rectal disorders.
use of medication.
Dietary fiber - Take each dose with full glass (250 ml)
supplement. of water.

Medication/IV Solution, Route
and FrequencyList generic AND
trade name
MECHANISM OF Why is THISPATIENT What are the most What are nursing considerations for this
ACTION receiving this important side/adverse
How does this medication?
medication work? medication/IV solution? effects THISPATIENTmay
State in your own exhibit? What assessments/labs/other diagnostic
words. Consider current tests do you have to check before
problem(s) and other administering this medication?
medical
history/diagnoses/social Include IV push/infusion rates.
history

Methylnaltrexone (Relistor) Blocks binding of - Abdominal pain, - 30% of pts report defecation within
opioids to peripheral
12 mg/ opioid receptors My patient was having flatulence, nausea. 30 min after drug administration.
within GI tract.
Therapeutic constipation for the last
0.6 ml. Effect:Decreases 3 days because he was - Encourage fluid intake. Assess bowel
constipating
Opioid effect of opioids using opioids to manage sounds for peristalsis. Monitor daily pattern
without reducing his chronic back pain.
receptor antagonist. analgesic of bowel activity, stool consistency.
effect. He receives this
medication to reduce - Laxative effect usually occurs within
and treat his
30 min but may take up to 24 hrs after
 constipation. medication administration.

Sulfamethoxazole (Bactrim) Blocks bacterial Because my patient has -Frequent:Anorexia, -Obtain history for hypersensitivity to
folic acid synthesis a medical history of trimethoprim or any sulfonamide, sulfite
and nausea, vomiting,
growth. Therapeutic recurrent Urinary tract sensitivity, bronchial asthma.
Effect:Bactericidal infections, this drug is rash (generally 7–14 days
in susceptible after therapy begins), -Monitor renal, hepatic, hematology
microorganisms. used as prophylaxis.
urticaria. function.

-Rash, fever, sore throat, -Continue medication for full length of

pallor, purpura,
therapy.
cough, shortness of
-Report immediately any new symptoms,
breath may be early
esp. rash, other skin changes,
signs of serious adverse bleeding/bruising, fever, sore
effects.
throat, diarrhea.

allopurinol (Zyloprim) Decreases uric acid Management of -Occasional: PO: - Obtain baseline serum chemistries, hepatic
production by
elevated uric acid in Drowsiness, unusual hair function tests. Instruct pt to drink minimum
Xanthine inhibiting
xanthine oxidase, an cancer treatment for loss. of 2,500–3,000 ml of fluid daily while taking
enzyme lymphoma. medication.
oxidase inhibitor responsible for - Pruritic maculopapular
converting xanthine
Tab 300 mg to rash, possibly - Discontinue medication immediately if rash
uric acid. or other evidence of allergic reaction occurs.
accompanied by malaise,
fever, chills, joint pain, - Assess serum chemistries, uric acid, hepatic
 nausea, vomiting, should function. Assess urine for cloudiness,
be considered a toxic unusual color, odor.
reaction.

Morphine SR (Ms Contint) Tab
15 Mg
Binds with opioid My patient receives this - Frequent: Sedation, - Assess onset, type, location, duration of
receptors within medication to manage decreased B/P (including
CNS, pain. Obtain vital signs before giving
inhibiting ascending his chronic back pain.
pain pathways. orthostatic hypotension),
diaphoresis, facial medication. If respirations are 12/min or
flushing, constipation, less (20/min or less in children), withhold
dizziness,
medication, contact physician.
drowsiness, nausea,
vomiting. - Be alert for decreased respirations,

- Overdose results in B/P. Check for adequate voiding. Monitor

respiratory depression,
skeletal muscle flaccidity,
cold/ clammy skin,
cyanosis, extreme
drowsiness
daily pattern of bowel activity, stool
consistency; avoid constipation.
- Change positions slowly to avoid
orthostatic hypotension.

progressing to seizures,
stupor,

coma.

Pantoprazole Irreversibly binds Treatment, Rare (less than 2%): - Question history of GI disease, ulcers,
to, inhibits hydrogen
(Protonix) potassium adenosine maintenance of healing Diarrhea, headache, GERD.
triphosphate, an
Tab 40 Mg enzyme on surface of erosive esophagitis dizziness, pruritus, rash. - Evaluate for therapeutic response (relief
of gastric parietal
cells. Inhibits associated with
of GI symptoms).
hydrogen ion
transport gastroesophageal reflux
into gastric lumen. disease (GERD). - Report headache, onset of black, tarry

Reduction of relapse stools, diarrhea.

rate of heartburn

symptoms in GERD.

Polyethylene glyco Induces My patient is receiving - Frequent (50%): Some - Assess bowel sounds for peristalsis.
diarrhea, cleanses this medication because degree of abdominal Monitor
(Miralax) bowel without
depleting he has been
electrolytes. constipated for the past fullness, nausea, bloating. daily pattern of bowel activity, stool
Osmotic/
3 days. consistency.
laxative.
- Monitor serum electrolytes, BUN, glucose,
17g urine osmolality.

- May take 2–4 days to produce a bowel

movement.

Sennosides-docusate sodium Direct effect on My patient is receiving - Frequent:Red, brown - Encourage adequate fluid intake. Assess
intestinal smooth this medication because discoloration of bowel sounds for peristalsis.
(Senna plus) musculature
(stimulates he has been
intramural nerve constipated for the past urine. - Monitor serum electrolytes in pts exposed
8.6-50mg plexi).
Therapeutic 3 days. - Long-term use may to prolonged, frequent, excessive use of
Effect:Increases result in laxative medication.
peristalsis,
promotes laxative dependence, chronic
effect. constipation, loss of - Urine may turn red or brown (only

Medication/IV Solution, Route
and Frequency List generic
AND trade name
Ranitidine
normal bowel function. temporary and not harmful).
- Laxative effect generally occurs in 6–12 hrs
but may take 24 hrs.
MECHANISM OF Why is THIS PATIENT What are the most What are nursing considerations for this
ACTION receiving this important side/adverse medication?
How does this
medication work? medication/IV solution? effects THIS PATIENT may
State in your own What assessments/labs/other diagnostic
exhibit?
words. Consider current tests do you have to check before
problem(s) and other administering this medication?
medical
history/diagnoses/social Include IV push/infusion rates.
history
Ranitidine works by Reduces gastric volume Diarrhea. - Check if the Pt has a history of abdominal
blocking the and helps with nausea pain
receptors of gastric
parietal cells, by
(Zantac) doing so, histamine symptoms. - Obtain a baseline regarding kidney and
cannot bind to the
receptor target and liver health status.
stomach acid is not
produced. - Monitor serum ALT, AST levels, BUN, GGT
and

creatinine. Assess mental status in elderly.

- For IV push, dilute each 50 mg with 20 ml

0.9% NaCl, D5W.

- For IV infusion, dilute with 0.9% NaCl, D5W

to a maximum concentration of 2.5 mg/ml.

- Administer IV push over minimum of 5 min

- Infuse IV piggyback over 15–20 min.

- Infuse IV infusion over 24 hrs

Furosemide Enhances excretion Pt has chronic heart Expected: Increased -Check and monitor vital signs, especially BP
of sodium, chloride, disease, this condition urinary frequency.
(Lasix) potassium by direct -Assess baseline serum electrolytes
action at ascending results in edema. Frequent: Nausea,
limb of loop of Furosemide is a loop dyspepsia, abdominal especially Potassium
Henle, as a result
water fallows as well diuretic used to reduce -Watch for signs of electrolytes imbalance
cramps, diarrhea or
and is being edema.
excreted. constipation. - Patient/Family teaching about expected
side effects ( frequent urination) and
recommend a diet rich in potassium

- Bolus of 20–40 mg, followed by infusion of

10–40 mg/hr; may double q2h.
Hydromorphone Binds to opioid Relives moderate so - Frequent: Drowsiness, - Obtain vital signs. If respirations are 12/
receptors in CNS as dizziness, hypotension,
(Dilaudid) a result it relives pt's severe pain. min or less (20/min or less in children),
moderate to severe decreased appetite
pain. It is a opioid
agonist drug. - Overdose results in withhold medication, contact physician.
respiratory depression - Monitor vital signs; assess for pain relief,

Cough

- Avoid alcohol, Avoid tasks that require

alertness/motor skills until response

to drug is established.

- IV: ADULTS, ELDERLY, CHILDREN WEIGHING

MORE THAN 50 KG (FOR OPIATE-NAIVE

PT): 0.2–0.6 mg q2–3h. USUAL DOSAGE:

1–2 mg q3–4h.

Insulin Glargine Insulin is a protein Pt has type II diabetes. - Localized redness - Check blood glucose level.
that binds to cell
receptors that are - Severe hypoglycemia - Instruct on proper technique for drug
responsible to
deliver the glucose
from outside the administration, testing of glucose, signs/
cells inside the cells.
- Insulin Glargine is
a long acting insulin
(24 hr). symptoms of hypoglycemia and
hyperglycemia.
 - Carry candy, sugar packets, other sugar

supplements for immediate response to

hypoglycemia.

-For subcutaneous use only.

Enoxaparin Inactivates -Prevention of postop - May lead to bleeding - Obtain baseline CBC. Note platelet count,
coagulation factors. complications ranging
deep vein thrombosis assess potential risk of bleeding.
(Lovenox) from local ecchymoses to
(DVT) major hemorrhage. - Assess for any sign of bleeding

- Usual length of therapy is 7–10 days.

Ondansetron Seratonin is - Prevention/treatment - Anxiety, dizziness, – Assess degree of nausea, vomiting.

essential in inducing drowsiness, headache,
Nausea/Vomiting. of nausea/vomiting
(Zofran) fatigue, constipation, -Avoid alcohol, barbiturates.
Ondasetron blocks
seratonin as a result diarrhea, hypoxia, urinary
it helps with - For IV infusion, dilute with 50 ml D5W or
nausea/vomiting retention. 0.9% NaCl before administration.
prevention.
-Adverse effects: - Give IV push over 2–5 min. • Give IV
Hypertension, acute renal infusion over 15–30 min.
failure, GI bleeding,
respiratory depression.

Metoprolol -Selectively blocks -Slows heart rate, -Diminished sexual -Assess baseline renal function, LFT. Assess
beta1-adrenergic
decreases cardiac function, B/P, apical pulse immediately before drug
(Betaloc) receptors.
output, reduces B/P. administration (if pulse is 60/min or less or
drowsiness, insomnia, systolic B/P is less than 90 mm Hg, withhold
unusual fatigue/weakness medication, contact physician).
 -Adverse effects: - May give undiluted. Administer IV injection
Overdose may produce
over 1 min. May give by IV piggyback (in 50
profound bradycardia,
ml D5W or 0.9% NaCl) over 30– 60 min.
hypotension,
bronchospasm.

Levothyroxine - binds to thyroid - Increases basal - Excessive dosage - Obtain baseline TSH, T3, T4, weight, vital
receptor metabolic rate, produces signs/symptoms
(Tirosint) proteins exerting signs.
metabolic effects enhances of hyperthyroidism
through DNA and gluconeogenesis, (weight loss, palpitations,
protein synthesis. - Do not discontinue drug therapy;
-increases stimulates protein increased appetite, replacement
metabolism synthesis. tremors).
for hypothyroidism is lifelong.

- Reconstitute 200- mcg or 500-mcg vial with

5 ml 0.9% NaCl to provide concentration of
40 or 100 mcg/ml, respectively; shake until
clear.

Lisinopril Suppresses renin- - Treatment of - Headache, dizziness, - Obtain B/P, apical pulse immediately
angiotensin- before each dose, in addition to regular
hypertension. postural hypotension.
(Zestril) aldosterone
system (prevents monitoring (be alert to fluctuations).
conversion of - Adjunctive therapy in -Adverse effects:
angiotensin management of heart Excessive hypotension - Assess for edema. Auscultate lungs for
I to angiotensin II
failure. (“first-dose syncope”) rales. Monitor I&O; weigh daily. Monitor
may occur in pts with HF, daily pattern of bowel activity, stool
severe salt/volume consistency.
depletion.

Vancomycin Inhibits RNA Bactericidal. - PO: Bitter/unpleasant - Avoid other ototoxic, nephrotoxic
synthesis and taste, nausea, vomiting,
interfere with
(Vancocin)
Medication/IV Solution, Route
and Frequency List generic
trade name, class
Lisinopril (Zestril)
bacterial cell mouth irritation medications if possible.
membrane
permeability. -Adverse effects: - Obtain culture, sensitivity test before giving
Nephrotoxicity (acute first dose
kidney injury, acute
tubular necrosis, renal - Monitor serum renal function tests, I&O.
failure), ototoxicity. - Check hearing acuity, balance.
- Continue therapy for full length of
treatment.
- IV: ADULTS, ELDERLY:10–20 mg/kg/
dose q8–12h.
MECHANISM OF Why is THIS PATIENT What are the most What are nursing considerations for this
ACTION receiving this important side/adverse
How does this medication?
medication work? medication/IV solution? effects THIS PATIENT may
State in your own exhibit? What assessments/labs/other diagnostic
words. Consider current tests do you have to check before
problem(s) and other administering this medication?
medical
history/diagnoses/social Include IV push/infusion rates.
history List Nursing Interventions.
Suppresses renin- Treatment of - Headache, dizziness, - Obtain B/P, apical pulse immediately
angiotensin- hypertension. Used
aldosterone postural hypotension. before each dose, in addition to regular
system (prevents alone or
conversion of
angiotensin in combination with - Excessive hypotension
 I to angiotensin II, a other (“first-dose syncope”) monitoring (be alert to fluctuations).
potent
vasoconstrictor. antihypertensives.
may occur in pts with HF, - Assess for edema. Auscultate lungs for
Adjunctive therapy in severe
Class: ACE inhibitor management rales. Monitor I&O; weigh daily.
salt/volume depletion.
- Monitor daily pattern of bowel activity,
of heart failure.
stool

consistency.

Captopril (Capoten) Suppresses renin- Treatment of - Rash. - Obtain B/P immediately before each dose,
angiotensin- hypertension, HF,
aldosterone - Hypotension (“first-dose in addition to regular monitoring (be
system (prevents diabetic
conversion of syncope”) may
angiotensin nephropathy, post-MI alert to fluctuations).
I to angiotensin II, a
for prevention of occur in pts with HF and
Class: ACE inhibitor potent in those who are - If hypotension occurs,
vasoconstrictor
ventricular failure. place pt in supine position with legs
severely sodium/volume
depleted. elevated.

- Assess skin for rash, pruritus. Assist with

ambulation if dizziness occurs.

Diltiazem(Cardizem) Inhibits calcium Relaxes coronary - Peripheral edema, - Record onset, type (sharp, dull, squeezing),
movement across
cardiac, vascular smooth dizziness, light- radiation, location, intensity, duration
vascular smooth-
muscle cell muscle, increases headedness, headache,
membranes
 (causes dilation of myocardial bradycardia, asthenia. of anginal pain, precipitating factors
coronary arteries,
Class: Calcium peripheral arteries, oxygen delivery in pts - Abrupt withdrawal may (exertion, emotional stress).
arterioles).
with vasospastic increase frequency,
channel blocker. - Assess
angina, decreases heart duration of angina, HF;
rate. second baseline renal/hepatic function tests. Assess

B/P, apical pulse immediately before

drug is administered.

- Assist with ambulation if dizziness

occurs. Assess for peripheral edema.

-Do not abruptly discontinue medication.

Nifedipine (Procardia) Inhibits calcium Treatment of angina - Peripheral edema, - Record onset, type (sharp,
movement across
due to coronary artery
cardiac, headache, flushed skin, dull, squeezing), radiation, location,
vascular smooth-
muscle cell spasm (Prinzmetal’s dizziness. intensity,
membranes variant angina),
(causes dilation of - Nausea, shakiness, duration of anginal pain; precipitating
Class: Calcium coronary arteries, chronic stable angina
peripheral arteries, muscle cramps/pain, factors (exertion, emotional
channel blocker. arterioles). (effort-associated
drowsiness, palpitations,
stress).
angina).
nasal congestion, cough,
- Extended-release: dyspnea, - Assist with ambulation if light-headedness,
Treatment dizziness occurs.
wheezing.
of hypertension. - Go from lying to standing slowly
- May precipitate HF, MI
 in pts with cardiac

disease, peripheral
ischemia.

Amlodipine (Norvasc) Inhibits calcium Management of Frequent (greater than - Record onset, type (sharp,
movement across
hypertension, chronic 5%):Peripheral
cardiac dull, squeezing), radiation, location,
and vascular smooth
muscle cell stable angina, edema, headache, intensity,
membranes. vasospastic flushing. Occasional
(Prinzmetal’s duration of anginal pain; precipitating
Class: Calcium (5%–1%):Dizziness,
or variant) angina. palpitations, nausea, factors (exertion, emotional
channel blocker.
unusual fatigue or stress).
weakness (asthenia). - Assist with ambulation if light-headedness,
- Overdose may produce dizziness occurs.
excessive peripheral
- Go from lying to standing slowly
vasodilation, marked
hypotension

with reflex tachycardia,

syncopy.

Propranolol (Inderal LA,) Blocks beta1-, Antihypertensive, - Overdose may produce - Assess baseline renal function, LFT. Assess
beta2-adrenergic
receptors. profound bradycardia,
antianginal, B/P, apical pulse immediately before
Slows heart
rate; decreases B/P, antiarrhythmic, hypotension. Abrupt administering
Class: Beta- myocardial withdrawal
contractility,
adrenergic blocker.
demand.
Metoprolol (Lopressor)
Class: Beta -adrenergic blocker. cardiac output,
myocardial oxygen antimigraine. may result in diaphoresis, drug (if pulse is 60/min or
palpitations,
less or systolic B/P is less than 90 mm Hg,
headache, tremulousness.
withhold medication.
- Diminished sexual
- Assess pulse for quality, regularity,
function,
bradycardia.
drowsiness, difficulty
sleeping, unusual Monitor EKG for cardiac arrhythmias.
fatigue/weakness. - Do not abruptly discontinue medication.
- • Compliance with therapy regimen
is essential to control hypertension,
arrhythmia,
anginal pain.
Selectively blocks Treatment of - Metoprolol is generally - Assess baseline renal function, LFT. Assess
beta1-adrenergic
receptors. hemodynamically well tolerated,
B/P, apical pulse immediately before
Therapeutic Effect:
Slows heart stable acute myocardial with transient and mild
rate, decreases infarction, angina side effects. drug administration
pectoris, hypertension.
reduces B/P. - Overdose may produce - Measure B/P near end of dosing interval
Decreases
myocardial ischemia profound bradycardia, (determines whether B/P is controlled
severity.
hypotension, throughout day).
bronchospasm.
- Do not abruptly discontinue medication.
Compliance with therapy regimen
 is essential to control hypertension,

arrhythmias.

Atenolol (Tenormin) Selectively blocks Treatment of Metoprolol is generally - Assess baseline renal function, LFT. Assess
beta1-adrenergic
hypertension, alone or well tolerated,
receptors. B/P, apical pulse immediately before
Therapeutic Effect: in
Slows heart with transient and mild
Class: : Beta -adrenergic rate, decreases combination with other drug administration
side effects.
blocker. cardiac output,
agents; management
reduces B/P. - Overdose may produce - Measure B/P near end of dosing interval
Decreases
myocardial ischemia of angina; secondary profound bradycardia, (determines whether B/P is controlled
severity. prevention of
hypotension, throughout day).
post-MI. bronchospasm.
- Do not abruptly discontinue medication.

Compliance with therapy regimen

is essential to control hypertension,

arrhythmias.

Losartan Blocks Treatment of -Upper respiratory tract -Obtain B/P, apical pulse immediately before
vasoconstrictor,
hypertension. Used
aldosterone- infection. each dose, in addition to regular
secreting alone or
effects of
angiotensin II, in combination with -Overdosage may monitoring
inhibiting
other manifest as hypotension
Class: Angiotensin binding of -Maintain hydration (offer fluids frequently).
angiotensin II to antihypertensives. and tachycardia.
II receptor antagonist. AT1 receptors. Assess for evidence of upper
Bradycardia occurs less
 often. Institute supportive respiratory infection, cough.
measures.
-Female pts of childbearing age should

take measures to avoid pregnancy.

Valsartan Blocks Treatment of Upper respiratory tract Obtain B/P, apical pulse immediately before
vasoconstrictor, hypertension. Used
aldosterone- infection. each dose, in addition to regular
secreting alone or
effects of
Class: angiotensin II, in combination with -Overdosage may monitoring
inhibiting
other manifest as hypotension
Angiotensin binding of -Maintain hydration (offer fluids frequently).
angiotensin II to antihypertensives. and tachycardia.
II receptor antagonist. AT1 receptors. Assess for evidence of upper
Bradycardia occurs less

often. Institute supportive respiratory infection, cough.

measures. -Female pts of childbearing age should

take measures to avoid pregnancy.

Metoprolol and
Hydrochlorothiazide (Dutoprol) body from
Class:
thiazide diuretic and Beta-
adrenergic blockers
Hydrochlorothiazide The combination of - Metoprolol is generally -- Assess baseline renal function, LFT. Assess
is a thiazide diuretic
hydrochlorothiazide well tolerated,
(water pill) that B/P, apical pulse immediately before
helps prevent your and metoprolol is used
to treat high blood with transient and mild
absorbing too much side effects. drug administration
salt, which can cause pressure
fluid retention. (hypertension). - Overdose may produce - Measure B/P near end of dosing interval
profound bradycardia,
Metoprolol is a beta- (determines whether B/P is controlled
blocker. Beta-
blockers affect the hypotension,
throughout day).
heart and
circulation (blood
(metoprolol)
Hydrochlorothiazide
(Microzide)
Class: Thiazide
diuretic, antihypertensive.
Furosemide (Lasix)
flow through bronchospasm. - Check vital signs, esp. B/P for hypotension
arteries and veins).
- Increased urinary before administration. Assess baseline
frequency,
electrolytes, esp. for hypokalemia.
urine volume.
- Potassium depletion.
Inhibits sodium Treatment of mild to Increased urinary - Check vital signs, esp. B/P for hypotension
reabsorption in
distal moderate hypertension, frequency,
before administration. Assess baseline
renal tubules,
causing excretion of edema in HF, hepatic urine volume.
sodium, cirrhosis, renal electrolytes, esp. for hypokalemia.
potassium, hydrogen
ions, water. dysfunction (e.g., - Continue to monitor B/P, vital signs,
nephrotic syndrome). electrolytes,
I&O, daily weight. Note extent of
diuresis.
- Expect increased frequency, volume of
urination.To reduce hypotensive effect,
go from lying to standing
slowly
Enhances excretion Treatment of edema Increased urinary - Check vital signs, esp. B/P, pulse, for
of sodium, chloride,
 potassium by direct associated with HF frequency/ hypotension
action at ascending
Class: Loop limb of loop of and renal/hepatic volume. before administration. Assess
Henle.
disease; acute
diuretic. - Vigorous diuresis may baseline serum electrolytes, esp. for
pulmonary
lead to profound hypokalemia.
edema. Treatment of
water loss/electrolyte - Monitor B/P, vital signs, serum
hypertension,
depletion, resulting in electrolytes,
either alone or in
combination with other hypokalemia, I&O, weight. Note extent of diuresis.
hyponatremia,
antihypertensives. dehydration. - Expect increased frequency, volume of

urination. Report palpitations, signs of

electrolyte imbalances.

- Eat foods high in potassium

such as whole grains

Bumetanide (Bumex) Enhances excretion Management of edema Increased urinary - Check vital signs, esp. B/P, pulse, for
of sodium, chloride,
potassium by direct associated with frequency/ hypotension
action at ascending
limb of loop of HF, renal, or hepatic volume. before administration. Assess
Class: Loop diu Henle. disease
- Vigorous diuresis may baseline serum electrolytes, esp. for
retic. lead to profound hypokalemia.

water loss/electrolyte - Monitor B/P, vital signs, serum

depletion, resulting in electrolytes,

hypokalemia, I&O, weight. Note extent of diuresis.

hyponatremia,
 dehydration. - Expect increased frequency, volume of

urination. Report palpitations, signs of

electrolyte imbalances.

- Eat foods high in potassium

such as whole grains

Spironolactone (Aldactone) Interferes with Management of edema -Hyperkalemia (in pts with -Weigh pt; initiate strict I&O. Evaluate
sodium reabsorption
associated with renal hydration
by
competitively
inhibiting action of excessive aldosterone insufficiency, those taking status by assessing mucous membranes,
Class: Aldosterone aldosterone excretion or with potassium supplements),
in distal tubule, skin turgor. Obtain baseline serum
antagonist. promoting sodium HF; hypertension; dehydration,
and water excretion, electrolytes, renal/hepatic function,
increasing cirrhosis of liver with hyponatremia,
potassium urinalysis.
retention. edema or ascites, lethargy.
hypokalemia, nephrotic -Monitor serum electrolyte values, esp. for
-Severe hyperkalemia
syndrome, severe HF; may produce arrhythmias, increased potassium, BUN, creatinine.
primary Monitor B/P.
bradycardia, EKG changes
hyperaldosteronism. -Expect increase in volume, frequency
(tented T waves, widening
QRS complex, of urination.
ST segment depression). -Therapeutic effect takes

several days to begin and can last for

several days when drug is discontinued.

Erythropoietin Alfa
(Epoetin Alfa)
Class: Stimulates production of
red blood cells.
It stimulates Stimulates production Headache, body aches, -Monitor Blood count
erythropoiesis and is cough, or injection site
used to treat of red blood cells.
irritation/pain may occur.
anemia, commonly
associated with
chronic renal failure
and cancer
chemotherapy

Folic acid Stimulates Treatment of Allergic hypersensitivity - Assess for therapeutic improvement:
production of megaloblastic and
platelets, occurs rarely
improved sense of well-being, relief
RBCs, WBCs in macrocytic
folate deficiency with parenteral form. Oral
Class: Coenzyme. anemia. anemias due to folate folic acid is from iron deficiency symptoms (fatigue,
deficiency shortness of breath, sore tongue, headache,
nontoxic.
(e.g., pregnancy, pallor).
inadequate dietary
intake). - Eat foods rich in folic acid, including

Supplement to prevent fruits, vegetables, organ meats.

fetal neural

tube defects.

Vitamin B12 Coenzyme in cells, Treatment of pernicious Skin rash, diarrhea, pain - Assess for signs, symptoms of vitamin B12
including bone
anemia, vitamin at
marrow, CNS, and deficiency (anorexia, ataxia, fatigue,
GI
tract, necessary for B12 deficiency due to injection site
Class: lipid metabolism, malabsorption diseases, hyporeflexia, insomnia, irritability, loss of
formation of myelin
increased B12 positional sense, pallor, palpitations on
 requirement due to exertion).

pregnancy, - Assess for HF, pulmonary edema,

thyrotoxicosis, hypokalemia
hemorrhage,
in cardiac pts receiving subcutaneous/
malignancy,
hepatic/renal disease. IM therapy.

- Foods rich in vitamin

B12 include clams, oysters, herring,

red snapper, muscle meats, fermented

cheese, dairy products, egg yolks.

Ferrous Sulfate (Fer-In-Sol) Essential component Prevention, treatment Mild, transient nausea. - Assess nutritional status, dietary history.
in formation of
Hgb, myoglobin, of iron deficiency
To prevent mucous membrane and teeth
enzymes. Promotes
effective anemia due to
Class: Enzymatic erythropoiesis and - Large doses may staining with liquid preparation, use
inadequate diet,
transport, utilization
malabsorption, aggravate existing GI tract
mineral. of oxygen. dropper or straw and allow solution to
pregnancy, blood loss. disease (peptic ulcer,
regional enteritis, drop on back of tongue.

- Monitor serum iron, total iron-binding

ulcerative colitis).
capacity, reticulocyte count, Hgb, ferritin.

Medication class Mechanism of Indications Side effects Nursing Patient teaching Drug examples
action (MOA) considerations
Alpha 1- Selectively blocks Enlarged prostate Dizziness, asthenia - Give first dose at - Full therapeutic  Doxazosin
adrenergic alpha l adrenergic (BPH) headache, edema. bedtime. If initial effect may not occur (Cardura)
blockers receptors, decreasing Hypertension dose for 3–4 wks.  Prazosin
 peripheral is given during - May cause syncope (Minipress)
vascular resistance. daytime, pt must (fainting); go from  Terazosin
remain lying to standing
recumbent for 3–4 slowly.
hrs.
- Monitor B/P, I/O.
Anticholinergics Competes with Preop to inhibit - Dry mouth, nose, - Determine if pt is - For preop use, -Atropine (Atropene)
acetylcholine for salivation/ throat (may sensitive to explain that warm - homatropine
common secretions; treatment be severe); atropine, flushing feeling may - fesoterodine
binding sites on of symptomatic decreased sweating; homatropine, occur (Toviaz)
muscarinic receptors sinus constipation; scopolamine.
located on exocrine bradycardia; AV irritation at - Monitor changes
glands, cardiac and block; ventricular subcutaneous or IM in B/P, pulse,
smooth muscle asystole. injection temperature.
ganglia, intramural site. Observe for
neurons. - Overdose may tachycardia if pt has
produce cardiac
tachycardia, abnormalities.
palpitations,
hot/dry/flushed
skin.
Loop diuretics Enhances excretion Treatment of edema - Increased urinary - Check vital signs, - Expect increased -Furosemide (Lasix)
of sodium, chloride, associated with HF frequency/ esp. B/P, pulse, for frequency, volume of - Hydrochlorothiazide
potassium by direct and renal/hepatic volume. Frequent: hypotension Urination (Microzide)
action at ascending disease; acute Nausea, dyspepsia, before - Report palpitations,
limb of loop of pulmonary abdominal administration. signs of
Henle. Therapeutic edema. Treatment of cramps, diarrhea or - Assess electrolyte
Effect: Produces hypertension, constipation. baseline serum imbalances (noted
diuresis, lowers B/P. either alone or in electrolytes, esp. previously),
combination with for hypokalemia. hearing abnormalities
other (sense of fullness in
antihypertensives. ears, tinnitus)
Potassium Interferes with Management of - Hyperkalemia (in - Weigh pt; initiate - Expect increase in - Spironolactone
sparing diuretics sodium reabsorption edema associated pts with renal strict I&O. Evaluate volume, frequency (Aldactone)
by with insufficiency, those hydration of urination. - Amiloride,
competitively excessive taking potassium status by assessing - Therapeutic effect -triamterene
 inhibiting action of aldosterone supplements), mucous takes
aldosterone excretion or with dehydration, membranes, several days to begin
in distal tubule, HF; hypertension; hyponatremia, skin turgor. and can last for
promoting sodium cirrhosis of liver lethargy. - Obtain baseline several days when
and water excretion, with - Severe serum drug is discontinued
increasing potassium edema or ascites, hyperkalemia may electrolytes, - Avoid foods high in
retention. hypokalemia, produce renal/hepatic potassium, such as
nephrotic arrhythmias, function, urinalysis. whole grains
syndrome, severe bradycardia, EKG - Monitor serum (cereals), legumes,
HF; primary changes electrolyte values, meat,
hyperaldosteronism. esp. for bananas, apricots,
increased orange juice, potatoes
potassium, BUN, (white, sweet),
creatinine raisins.
5Alpha reductase Inhibits 5-alpha Proscar: Reduces - Gynecomastia, - Digital rectal - Pt should be aware -Finasteride
inhibitors reductase, an risk of acute urinary sexual exam, serum of potential for (Propecia, Proscar)
intracellular retention, need for dysfunction prostatespecific impotence. May not -Dutasteride
enzyme that converts surgery in (impotence, antigen (PSA) notice improved (Avodart)
testosterone into symptomatic decreased libido, determination urinary flow even if
dihydrotestosterone benign prostatic decreased volume should be prostate gland
(DHT) in prostate hyperplasia (BPH) of ejaculate). performed in pts shrinks.
gland, resulting in alone or in with benign
decreased serum combination with prostatic
DHT. doxazosin hyperplasia (BPH)
(Cardura). before initiating
therapy and
periodically
thereafter.

Urinary tract Exerts topical Symptomatic relief Headache, GI -Assess pt for - Reddish orange Pyridium
analgesic analgesic effect on of pain, burning, disturbance, dysuria, urinary discoloration of urine (phenazopyridine)
urinary urgency, rash, pruritus. urgency or should be expected. •
tract mucosa. frequency resulting frequency. May stain fabric.╇
Therapeutic Effect: from lower - Monitor for • Take with meals
Relieves urinary tract mucosa therapeutic (reduces possibility
urinary pain, irritation (may be response: relief of
 burning, urgency,
frequency.
Medication/IV Solution,
Route and Frequency List
generic AND trade name
caused by infection, of dysuria (pain, GI upset).
trauma, surgery). burning), urgency,
frequency
of urination.
MECHANISM OF Why is THIS PATIENT What are the most What are nursing considerations for
ACTION receiving this important this medication?
How does this medication/IV side/adverse What assessments/labs/other diagnostic
medication work? solution? effects THIS tests do you have to check before
State in your own Consider current PATIENT may
words. exhibit? administering this medication?
problem(s) and other
medical Include IV push/infusion rates.
history/diagnoses/social
history

- Assess type, severity, frequency of

Helps loosen phlegm cough.
Guaifenesin Rare: Dizziness,
Stimulates and thin bronchial
respiratory tract headache, rash, Increase fluid intake, environmental
(Mucinex)
secretions diarrhea, humidity
by decreasing secretions, making
adhesiveness, cough more nausea, vomiting, to lower viscosity of lung secretions.
viscosity of
Class: Expectorants mucus. productive. abdominal pain.
- Initiate deep breathing, coughing
exercises.

- Assess type, severity, frequency of

Benzonatate Mild drowsiness, cough.
Relief of nonproductive
(Tessalon Perles, Zonatuss) Anesthetizes stretch cough, including
or cough receptors mild dizziness, Monitor amount, color, consistency of
in constipation, nausea,
alveoli of lungs, acute cough of minor sputum.
skin
bronchi, and pleura, throat/bronchial
Class: suppressing - Initiate deep breathing and coughing
eruptions, nasal
the cough reflex. irritation. exercises,
Antitussive congestion.

particularly in pts with impaired

 pulmonary

function.

- Avoid tasks that require alertness,

motor

skills until response to drug is

established.

Symptomatic treatment - Obtain baseline laboratory tests as

Oseltamivir of uncomplicated indicated.

(Tamiflu) acute illness caused by Confirm presence of influenza A or

influenza A or B Colitis, pneumonia,
Inhibits a enzyme B virus.
tympanic membrane
Class: essential in virus virus in adults and - • Begin as soon as possible from first
replication. children 1 yr and disorder, fever occur
Antiviral, Influenza, rarely. appearance of flu symptoms
Neuraminidase Inhibitors older who are (recommended within 2 days from
symptomatic no longer symptom
than 2 days. onset).

Treatment of fever, - Assess onset, type, location, duration

Ibuprofen Inhibits Occasional (9%– of
prostaglandin juvenile rheumatoid
synthesis. 3%): Nausea,
(Advil) pain, inflammation.
Therapeutic arthritis (JRA), vomiting,
Effect: Produces osteoarthritis, minor to
Class: analgesic, - Monitor for evidence of nausea,
dyspepsia, dizziness,
antiinflammatory moderate pain, primary dyspepsia.
NSAIDs effects; decreases rash.
fever. dysmenorrhea. Monitor CBC, renal function, LFT.
 Assess skin for rash.

SIDE EFFECTS - Question for history of hepatitis,

Occasional:Systemic: allergies
Nausea, vomiting, to azithromycin, erythromycins. Assess

Azithromycin diarrhea, abdominal for infection (WBC count, appearance of

pain.
(Zmax) Binds to ribosomal Bacteriostatic or wound, evidence of fever).
receptor sites of bactericidal, -Antibiotic-associated
Class: susceptible
organisms, colitis, other -Check for GI discomfort, nausea,
inhibiting RNA- depending on drug superinfections vomiting.
Macrolides dependent protein dosage.
synthesis. may result from Monitor daily pattern of bowel activity
altered
and stool consistency.
bacterial balance in
GI tract. -Continue therapy for full length of

treatment.

Treatment of - Question for hypersensitivity to

susceptible infections Antibiotic-associated levofloxacin,
Levofloxacin
due to S. pneumoniae, colitis, other
Inhibits DNA other fluoroquinolones.
(Levaquin) S. aureus, E. faecalis,
enzyme gyrase in super-infections
susceptible - Monitor serum glucose, renal function,
microorganisms, H. influenzae, M. (abdominal cramps,
interfering with catarrhalis, Serratia LFT. Monitor daily pattern of bowel
Class: Fluoroquinolones bacterial cell severe watery
activity,
replication, repair. marcescens, K. diarrhea, fever) may
pneumoniae, E. occur. stool consistency. Report
hypersensitivity
coli, P. mirabilis, P.
 aeruginosa, C. reaction: skin rash, urticaria, pruritus,

pneumoniae, photosensitivity promptly

Legionella
pneumophila,

Mycoplasma
pneumoniae.

- Diarrhea, loose

stools, nausea, skin

rashes, urticaria. - Question for history of allergies, esp.
Amoxicillin/Clavulanate
Treatment of
susceptible - Antibiotic- penicillins, cephalosporins, renal
(Amoclan) infections due Amoxicillin inhibits associated colitis,
bacterial cell wall impairment.
to streptococci, E. other superinfections
coli, E. faecalis,
P. mirabilis, beta- synthesis. Clavulanate - Hold medication and promptly report
(abdominal cramps,
Class:antibiotic- lactamase inhibits bacterial
producing severe rash, diarrhea (fever, abdominal pain,
Penicillins,Aminopenicillins H. influenzae, beta-lactamase.
Klebsiella spp., M. watery diarrhea, mucus and blood in stool may indicate
Âcatarrhalis, and S. fever) may result
aureus. antibiotic-associated colitis).
from

altered bacterial
balance.
Doxycycline Treatment of - Question for history of allergies, esp. to
susceptible - Anorexia, nausea,
infections due
(Adoxa) to H. ducreyi, vomiting, tetracyclines, sulfites.
Pasteurella pestis, Inhibits bacterial protein
P. diarrhea, dysphagia, - Monitor daily pattern of bowel activity,
tularensis, synthesis by
photosensitivity
Class: Bacteroides spp., V. stool consistency.
cholerae, binding to ribosomes.
(may be severe).
tetracycline antibiotic Brucella spp., - Do not take with antacids, iron
Rickettsiae, Y.
pestis, Francisella
tularensis, M. products
pneumoniae.

- Headache;
restlessness, - Assess lung sounds, pulse, B/P, color,
nervousness, character of sputum noted.
Albuterol tremors; nausea;
Stimulates beta2-
Treatment or dizziness; - Offer emotional
(AccuNeb) prevention of adrenergic receptors in
bronchospasm throat dryness and Support
due to reversible lungs, resulting in
obstructive airway irritation, pharyngitis;
relaxation of bronchial – Monitor rate, depth, rhythm, type of
Class: disease, prevention
of exercise induced B/P changes, respiration;
bronchospasm. smooth muscle.
Beta-2 Agonist including
hypertension; quality and rate of pulse; EKG;

heartburn, transient serum potassium, glucose.

wheezing.

Ipratropium bromide Maintenance Blocks action of - Cough, - Offer emotional support (high incidence
treatment of
bronchospasm due acetylcholine at
(Atrovent) parasympathetic dry mouth, of anxiety due to difficulty in breathing,
to
COPD, bronchitis, headache, nausea.
Class: emphysema, sites in bronchial Nasal: Dry sympathomimetic response to drug).
asthma. smooth muscle.
Muscarinic Antagonist nose/mouth, - Monitor rate, depth, rhythm, type of
headache, nasal respiration;
irritation.
quality, rate of pulse. Assess lung
- Worsening of angle-
closure glaucoma, sounds for rhonchi, wheezing, rales.

acute eye pain, Monitor ABGs.

hypotension occur
rarely.

- Question for hypersensitivity to any of

- Insomnia, the
heartburn, anxiety,
corticosteroids, components. Obtain
abdominal distention,
baselines for height, weight, B/P, serum
diaphoresis,
Methylprednisone sodium Anti-inflammatory or Suppresses migration glucose, electrolytes. Check results of
succinate acne, mood swings,
immunosuppressant of polymorphonuclear
in treatment of increased appetite, initial tests (tuberculosis [TB] skin test,
(Solu-Medrol) hematologic,
allergic, leukocytes, reverses facial flushing, GI X-rays, EKG).
Class: inflammatory, increased distress, delayed
autoimmune, or - Monitor I&O, daily weight; assess for
Corticosteroids neoplastic capillary permeability. wound healing,
desorders.
increased edema. Monitor daily pattern of bowel
susceptibility
activity, stool consistency. Check vital
to infection, diarrhea,
signs at least twice daily. Be alert for
constipation.
infection (sore throat, fever, vague
 symptoms).

Brand Generic Dosage Route Frequency Mechanism of Why Important Nursing Explain why/how these drugs may
Names Names Action (own patient Side Consideration used for Pain, or Activity/rest/slee
words) receiving /Adverse s ( or both)
this Effects
medicati
on
Vicodin® APAP(Aceta 10 mg/650 mg. PO PO:ADULTS, Hydrocodone Relief of Frequent: Obtain vital Used for moderate to severe pain.
minophen) • Give without regard to meals. CHILDREN binds to opioids moderate Lethargy, signs. If In addition to that it can be used for
+Hydrocodon • Extended-release capsules/tablets must WEIGHING 50 KG receptors in the to hypotension, respirations are people with chronic pain to improve
e be swallowed whole. Do not cut, crush, or OR MORE: Initially, CNS, by doing moderate diaphoresis, 12/ their activity/rest/sleep.
dissolve. 5–10 mg q3–4h as that it reduces ly severe facial min or less
needed. ADULTS, the incoming pain, flushing, (20/min or less
CHILDREN pain stimuli and nonprodu dizziness, in children),
WEIGHING alters pain ctive drowsiness. withhold
LESS THAN 50 KG: perception. cough. ADVERSE medication,
Initially, 0.1–0.2 -Acetaminophen EFFECTS/ contact
mg/kg appears to Overdose physician.
q3–4h as needed. inhibit results in -Asess pain
ELDERLY:2.5–5 mg prostaglandin respiratory (PQRST)
q4–6h. synthesis depression, Palpate bladder
in the CNS and, skeletal for urinary
to a lesser muscle retention.
extent, block flaccidity, Monitor daily
pain impulses cold/ pattern of
through clammy skin. bowel activity,
peripheral stool
action. consistency.
Initiate deep
breathing
and coughing
exercises,
particularly in
pts with
pulmonary
 impairment.

oxycodone/ PO (Immediate-Release):ADULTS, PO (Immediate- Binds with Relief of Frequent: BASELINE Used for moderate to severe pain.
acetaminophen: ELDERLY: Release): ADULTS, opioid receptors moderate Drowsiness, ASSESSMEN In addition to that it can be used for
2.5 mg/325 mg, Initially, 5–15 mg q4–6h as ELDERLY: within CNS, to dizziness, T people with chronic pain to improve
5 mg/325 mg, 5 needed. Range: 5–20 mg/dose. Initially, 5–15 mg q4– causing moderate hypotension Assess onset, their activity/rest/sleep.
mg/500 mg, 7.5 CHILDREN, 6h as inhibition of ly severe (including type, location,
mg/325 mg, 7.5 6–18 YRS:0.1–0.2 mg/kg/dose needed. Range: 5–20 ascending pain pain, orthostatic duration of
mg/500 mg, 10 q4–6h as needed. Maximum dose: 10 mg/dose. CHILDREN, pathway. nonprodu hypotension), pain. Effect of
mg/325 mg, 10 mg for moderate pain, 20 mg for severe 6–18 YRS:0.1–0.2 ctive anorexia. medication is
mg/650 mg. pain. mg/kg/dose cough. Adverse reduced if
q4–6h as needed. effects: full pain recurs
Maximum dose: 10 Overdose before next
mg for moderate pain, results in dose. Obtain
20 mg for severe respiratory vital signs
pain. depression, before giving
Oxycodone+ skeletal medication. If
Percocet® APAP(Aceta muscle respirations are
minophe) flaccidity, 12/min or less
cold/ (20/min
clammy skin, or less in
cyanosis, children),
extreme withhold
drowsiness medication,
progressing contact
to seizures, physician.
stupor, - Initiate deep
coma. breathing,
coughing
exercises, esp.
in pts with
pulmonary
impairment.
 Monitor pain
relief,
respiratory rate,
mental status,
B/P, LOC.
200 mg capsules PO: Give with food, milk, antacids if GI PO:ADULTS, Inhibits Treatmen Occasional -Assess onset, This drug may be used to relive pain
distress occurs. ELDERLY, prostaglaninds t of fever, (9%– type, location, which in turns promotes better sleep
CHILDREN 12 YRS and blocks the juvenile 3%):Nausea, duration of improves quality of life.
AND OLDER:200– peripheral nerve rheumato vomiting, pain,
400 mg q4–6h prn. impulse. id dyspepsia, inflammation.-
arthritis dizziness, Monitor for
(JRA), rash. evidence of
Advil® Ibuprofen osteoarth Adverse nausea,
ritis, effects: dyspepsia.
minor to Overdose - Avoid aspirin,
moderate may result in alcohol during
pain, metabolic therapy
primary acidosis. (increases risk
dysmeno of GI
rrhea. bleeding).
Tablets PO (Immediate-Release):ADULTS, PO (Immediate- Binds to mu- Manage Frequent - Assess onset, Management of moderate to modera
(Ultram): ELDERLY: Release):ADULTS, opioid receptors, ment of (25%– type, location, severe pain.
50 mg. 50–100 mg q4–6h. ELDERLY: inhibits moderate 15%):Dizzine duration of
50–100 mg q4–6h. reuptake of to ss, vertigo, pain.
norepinephrine, moderate nausea, - Monitor
serotonin, ly constipation, pulse, B/P,
inhibiting severe headache, renal/hepatic
ascending and pain. drowsiness. function.
Ultram® Tramadol
descending Assist with
pain pathways. ambulation if
dizziness,
vertigo occurs.
- May cause
dependence.
Avoid alcohol,
OTC
 medications
(analgesics,
sedatives).
May cause
drowsiness,
dizziness,
blurred vision.
Oral PO PO: ADULTS, Reduces Relief of Frequent - Assess onset, -This is a analgesic drug used to red
Suspension: 7.5 ELDERLY: Initially, inflammatory signs/sy (9%–7%): type, location, pain for patients who have
mg/5 ml. 7.5 mg/day. response by mptoms Dyspepsia, duration of osteoarthritis,
Tablets: Maximum: 15 mg/day inhibiting of headache, pain/inflammat rheumatoid arthritis.
7.5 mg, 15 mg. (7.5 mg for prostaglandins osteoarth diarrhea, ion. -Help patient to be more active and
pts on dialysis). synthesis, results ritis, nausea. - Monitor CBC, less pain.
in decreased rheumato ADVERSE BMP, LFT.
Mobic® Meloxicam
sensation of id EFFECTS: - Take with
pain. arthritis. In pts treated food, milk to
chronically, reduce GI
peptic ulcer, upset.
GI
bleeding,
gastritis.
PO:ADULTS 65 PO PO: ADULTS, Produces Treatmen Nausea, -Assess onset, -This is a analgesic drug used to red
YRS AND Give controlled-release form whole. Do ELDERLY: 500– analgesic, anti- t of acute constipation type, location, pain for patients who have
YOUNGER,CH not break, crush, dissolve, or divide. • 1,000 mg/ inflammatory or long- abdominal duration of osteoarthritis,
ILDREN Best day in 2 divided doses. effects by term mild cramps/pain, pain/inflammat rheumatoid arthritis.
12 YRS AND taken with food or milk (decreases GI inhibiting to heartburn, ion. -Help patient to be more active and
OLDER: 220 irritation). prostaglandin moderate dizziness, - Assist with less pain.
mg (200 mg • Shake suspension well. synthesis. pain, headache, ambulation if
Aleve® Naproxen naproxen primary drowsiness. dizziness
sodium) q8–12h. dysmeno - Rare occurs.
rrhea, reactions Monitor CBC,
and with long- renal function,
different term use LFT
arthritis include daily pattern of
diseases. peptic ulcer, bowel activity,
GI bleeding, stool
 gastritis, consistency.
severe
hepatic
reactions

IV: ADULTS, IV, PO, Rectal IV:ADULTS, Appears to Relief of Later Signs - If given for Pt may take acetaminophne for pain
ADOLESCENT ADOLESCENTS inhibit mild to of Toxicity: analgesia, relief or to reduce fever.
S WEIGHING WEIGHING 50 prostaglandin moderate Vomiting, assess onset,
50 KG OR MORE:1,000 synthesis pain, right upper type,
KG OR MORE: mg q6h or 650 mg in the CNS and, fever. quadrant location,
1,000 mg q6h or q4h. Maximum single to a lesser tenderness, duration of
650 mg dose: 1,000 mg; extent, block elevated pain.
q4h. Maximum PO: ADULTS, pain impulses hepatic - Assess for
single dose: ELDERLY, through function fever.
1,000 mg. CHILDREN 13 YRS peripheral tests within Assess alcohol
PO: ADULTS, AND OLDER:325– action. 48–72 hrs usage.
Acetaminoph
Tylenol ELDERLY, 650 mg q4–6h or 1 g after - Therapeutic
en
CHILDREN 13 3–4 times a day. ingestion. serum
YRS level: 10–30
ANDOLDER:32 mcg/ml; toxic
5–650 mg q4–6h serum
or 1 g level: greater
3–4 times a day. than 200
mcg/ml. Do not
exceed
maximum daily
recommended
dose: 4 g/day.
acetaminophen/ IV, PO acetaminophen/ Acetaminophen Relief of Ambulatory Assess onset,
codeine: 300 codeine: 300 mg/15 appears to mild to pts, pts not in type, location, Pt is receiving this medication becau
mg/15 mg, mg, inhibit moderate severe pain duration of has pain and fever.
Codeine +
300 mg/30 mg, 300 mg/30 mg, 300 prostaglandin pain, may pain.
Tylenol 3® Acetaminoph
300 mg/60 mg. mg/60 mg. synthesis fever. experience -Assess
en
in the CNS. dizziness, temperature
Codeine Binds nausea, -Monitor bowel
to opioid vomiting, activity
 receptors in hypotension
CNS. Inhibits more
ascending pain frequently
pathways. than those in
supine
position
or with
severe pain.
-Liver
damage with
over use.
200 mg q12h PO: Capsules: 50 mg, 100 mg, 200 200 mg q12h Inhibits Therapeu Diarrhea, - Assess onset, Reduces inflammation,
(Maximum: 600 mg, (Maximum: 600 mg cyclooxygenase- tic back pain, type, location, relieves pain.
mg 400 mg day 1, then 400 2, the enzyme Effect:Re dizziness, duration of
day 1, then 400 mg/day) responsible for duces heartburn, pain/inflammat
mg/day) prostaglandin inflamma headaches, ion.
synthesis. tion, nausea, - Assess for
Celebrex® Celecoxib relieves abdominal allergy to sulfa,
pain. pain aspirin, or
NSAIDs
- Assess for
therapeutic
response: pain
Relief.
PO (Controlled- PO: Tablets Controlled-Release PO (Controlled- Binds with Around- Effects are -Assess onset, Around-the-clock management
Release): 10 mg, 15 mg, 20 mg, 30 mg, Release):ADULTS, opioid receptors the-clock dependent on type, location, of moderate to severe pain when
ADULTS, 40 mg, 60 mg, 80 mg. ELDERLY: within CNS, managem dosage duration of continuous analgesic is needed.
ELDERLY: - Swallow whole; do not Initially, 10 mg q12h. causing ent amount. pain.
Initially, 10 mg break, crush, dissolve, or divide. inhibition of of Ambulatory - Palpate
q12h. ascending pain moderate pts, pts not in bladder for
Oxycontin® Oxycodone
pathway. to severe severe urinary
pain pain may retention.
when experience
continuo dizziness,
us nausea,
analgesic vomiting,
 is hypotension
needed. more
frequently
than
those in
supine
position or
having severe
pain.
- Overdose
results in
respiratory
depression,
skeletal
muscle
flaccidity.
PO: ADULTS, IV,IM, SubQ PO, Rectal PO: ADULTS, Binds to opioid Relief of Drowsiness, -Obtain vital Relief of moderate to severe pain.
ELDERLY: 2–4 ELDERLY: 2–4 mg receptors in moderate dizziness, signs. If
mg q3–4h. q3–4h. CNS, reducing to severe hypotension respirations are
- IV: ADULTS, -- IV: ADULTS, intensity of pain pain. (including 12/
ELDERLY, ELDERLY, stimuli from orthostatic min or less
CHILDREN CHILDREN sensory hypotension), (20/min or less
WEIGHING WEIGHING nerve endings. decreased in children),
MORE THAN MORE THAN 50 KG appetite. withhold
50 KG (FOR (FOR OPIATE- -Overdose medication,
Hydromorpho OPIATE- NAIVE results in contact
Dilaudid
ne NAIVE PT): 0.2–0.6 mg q2– respiratory physician.
PT): 0.2–0.6 mg 3h. depression, -Assess onset,
q2–3h. skeletal type, location,
muscle duration of
flaccidity, pain.
cold/ -Antitussive:
clammy skin, Assess type,
cyanosis, severity,
extreme frequency of
drowsiness cough.
 progressing
to seizures,
stupor,
coma.

Tablets PO Tablets (Ambien):5 Enhances action Shortter Occasional Assess B/P, Shortterm
(Ambien):5 mg, • For faster sleep onset, do not give with mg, 10 mg. of inhibitory m (7%):Headac pulse, treatment of insomnia (with difficul
10 mg. or immediately after a meal. • Do not Before sleep. neurotransmitter treatment he. respirations, of sleep onset
break, crush, dissolve, or divide Ambien gamma- of Overdose mental
CR tablets; give whole. aminobutyric insomnia may produce status, sleep
acid (with severe ataxia patterns.
(GABA). difficulty (clumsiness, - Monitor sleep
of sleep unsteadiness) pattern of pt.
onset). , bradycardia, Evaluate for
diplopia, therapeutic
severe response to
drowsiness, insomnia:
Ambien® Zolpidem
nausea, decrease
vomiting, in number of
difficulty nocturnal
breathing, awakenings,
unconsciousn increase in
ess. length of sleep.
- Do not
abruptly
discontinue
medication
after long-term
use.
Capsules: 7.5 ADMINISTRATION/HANDLING PO:ADULTS, Enhances action Short- Drowsiness, - Question for Short-term treatment of insomnia.
mg, 15 mg, 22.5 PO CHILDREN 18 YRS of inhibitory term sedation, possibility of
mg, • Give without regard to meals. • Capsules AND neurotransmitter treatment rebound pregnancy
30 mg. may be emptied and mixed with OLDER: 15–30 mg at gamma- of insomnia before
Restoril® Temazepam
food. bedtime. ELDERLY, aminobutyric insomnia. (may occur initiating
DEBILITATED:7.5– acid for 1–2 therapy
15 mg at bedtime. (GABA), nights after (Pregnancy
resulting in CNS drug is Category
depression. discontinued) X).
. - Assess B/P,
- Abrupt or pulse,
too-rapid respirations
withdrawal immediately
may result before
in administration.
pronounced - Assess elderly
restlessness, or debilitated
irritability, pts for
insomnia, paradoxical
hand tremor, reaction,
abdominal/ particularly
muscle during early
cramps, therapy.
vomiting,
diaphoresis,
seizures.