CLASSIFICATION Proton pump inhibitor


MODE OF ACTION Gastric acid-pump inhibitor: Suppresses gastric acid secretion by specific inhibition of the hydrogen-potassium ATPase enzyme system at the secretory surface of the gastric parietal cells; blocks the final step of acid production.

INDICATION short-term treatment of active duodenal ulcer

SIDE EFFECT CNS: Headache, dizziness, asthenia, vertigo, insomnia, apathy, anxiety, paresthesias, dream abnormalities Dermatologic: Rash, inflammation, urticaria, pruritus, alopecia, dry skin GI: Diarrhea, abdominal pain, nausea, vomiting, constipation, dry mouth, tongue atrophy Respiratory: URI symptoms, cough, epistaxis Other: Cancer in preclinical studies, back pain, fever

NURSING CONSIDERATIONS >Give before meals >Do not crush or chew tablets, swallow whole >Evaluate for therapeutic response like relief of Gastrointestinal symptoms

Furosemide Lasix

Diuretics, Loop

Inhibits the reabsorption of sodium and chloride in the proximal and distal tubules as well as the ascending loop of Henle, this results in the excretion of sodium,

Edema, nephrotic syndrome

F&E: Fluid and electrolyte depletion, Dehydration, Hypovolemia, Thromboembolsm OTIC: Tinnitus, hearing 

Note indications for therapy and other agents trialed 
Observe for ototoxicity  Assess closely for

IV for acute pulmonary

chloride and to a lesser degree, potassium and bicarbonate ions.


impairment GI: Nausea, oral and gastric irritation, vomiting, anorexia CNS: vertigo, headache, dizziness, blurred vision Hemat: Anemia, Neutropenia CV: Orthostatic Hypotension 

PO to treat HPN in conjunction with spironolactic

signs of vascular thrombosis  Monitor BP, weight, edema, breath sounds, I & O  For chronic use, assess for thiamine deficiency

Ketorolac Toradol

Nonsteroidal antiinflammatory agents, nonopioid analagesics

Inhibits prostaglandin synthesis, producing peripherally mediated analgesia - Also has antipyretic and anti-inflammatory properties.

Short term management of pain

CNS:drowsiness abnormal thinking dizziness CV: edema,pallor, vasodilation GI: GI Bleeding abnormal taste, diarrhea, dry mouth GU: oliguria, renal toxicity, urinary frequency - - HEMAT: prolonged bleeding time MISC: allergic reaction, anaphylaxis 

Consider supplemental opioid analgesics for breakthrough pain; don't increase the dose or frequency of ketorolac.  Hypersensitivity reactions may occur after an I.M. or I.V. dose; have epinephrine and emergency equipment available. 

Assess for unusual bleeding or bruising, edema, and renal impairment.  Test stools and emesis for occult blood. .  Ketorolac is also available in oral form. Oral therapy is indicated only as a continuation of I.V. therapy; don't give oral ketorolac to patients who weren't on I.V. ketorolac.

Tramadol Hydrochlooride Ultram

Analgesic, centrally acting

Binds to mu-opioid receptors and inhibits the reuptake of norepinephrine and serotonin; causes many effects similar to the opioids dizziness, somnolence, nausea, constipation but does not have the respiratory depressant effects

Relief of moderate to moderately severe pain.

CNS: Sedation, dizziness or vertigo, headache, confusion, dreaming, sweating, anxiety, seizures CV: Hypotension, tachycardia, bradycardia Dermatologic: Sweating, pruritus, rash, pallor, urticaria GI: Nausea, vomiting, dry mouth, constipation, flatulence 

Assess type, location, and intensity of pain before and 2-3 hr (peak) after administration.  Assess BP & RR before and periodically during administration. Respiratory depression has not occurred with

Other: Potential for abuse, anaphylactoid reactions

recommended doses.  Encourage patient to cough and breathe deeply every 2 hr to prevent atelactasis and pneumonia.

Spironolactone Aldactone

Potassium-sparing Diuretic

Competitively blocks the effects of aldosterone in the renal tubule, causing loss of sodium and water and retention of potassium.

Adjunctive therapy in edema associated with CHF Essential hypertension, usually in combination with other drugs

CNS: Dizziness, headache, drowsiness, fatigue, ataxia, confusion Dermatologic: Rash, urticaria GI: Cramping, diarrhea, dry mouth, thirst, vomiting. GU: Impotence, irregular menses, amenorrhea, postmenopausal bleeding Hematologic: Hyperkalemia, hyponatremia, agranulocytosis Other: Carcinogenic in animals, deepening of the voice, hirsutism, gynecomastia CNS: Restlessness, apprehension, anxiety, 

Used with other diuretics  Give with meals  Avoid salt substitutes containing potassium  Monitor I and O

Albuterol Sulfate

Bronchodilator Beta2-selective

In low doses, acts relatively selectively at

Relief and prevention of bronchospasm in 

Drug may decrease sensitivity of


adrenergic agonist

beta2-adrenergic receptors to cause bronchodilation and vasodilation; at higher doses, beta2 selectivity is lost, and the drug acts at beta2 receptors to cause typical sympathomimetic cardiac effects.

patients with reversible obstructive airway disease

fear, CNS stimulation, hyperkinesia, insomnia, tremor, drowsiness, irritability, weakness, vertigo, headache CV: Cardiac arrhythmias, tachycardia, palpitations, PVCs (rare), anginal pain Dermatologic: Sweating, pallor, flushing GI: Nausea, vomiting, heartburn, unusual or bad taste in mouth GU: Increased incidence of leiomyomas of uterus when given in higher than human doses in preclinical studies Respiratory: Respiratory difficulties, pulmonary edema, coughing, bronchospasm, paradoxical airway resistance with repeated, excessive use of inhalation preparations

spirometry used for diagnosis of asthma  Monitor for evidence of allergix reaction


Cardiac glycoside

Increases intracellular

For the treatment and

CNS: Headache, 

Take apical pulse for 1 full minute


calcium and allows more calcium to enter the myocardial cell during depolarization via a sodium potassium pump mechanism; this increases force of contraction (positive inotropic effect), increases renal perfusion (seen as diuretic effect in patients with CHF), decreases heart rate (negative chronotropic effect), and decreases AV node conduction velocity.

management of congestive cardiac insufficiency, arrhythmias and heart failure.

weakness, drowsiness, visual disturbances, mental status change CV: Arrhythmias GI: GI upset, anorexia

noting the rate, rhythm, quality before administering. If changes are noted, withhold the digoxin  Withdold med if pulse falls below ordered parameters  Monitor I and O ratio during digitalization, particularly in patients with impaired renal function. M0nitor for edema daily and auscultate of altered chest for rales>>

Dobutamine Hydrochloride Dobutrex

Inotropic, Adrenergic

Enhancing the force of myocardial contraction Increasing the H R, CO, and SV with minor effects to HR. Decrease elevated ventricular filling pressure and helps AV node conduction

Short term treatment of cardiac decompensation in organic heart disease of cardiac surgical pressures

CV: angina, hypertension, hypotension, increased heart rate, nonspecific chest pain, phlebitis, PVCs. GI: nausea and vomiting. Respiratory: asthma 

Monitor ECG and BP continuously during drug administration  Record I&O>  Drug is administered IV to improve cardiac

attacks, shortness of breath. Others: anaphylaxis

function thus increasing BP and improving urine output.>  Report any chest pain, increase SOB, headaches or IV site pain>

Clopidrogel Plavix

Adenosine diphosphate (ADP) receptor antagonist Antiplatelet

Inhibits platelet aggregation by blocking ADP receptors on platelets, preventing clumping of platelets.

For the reduction of atherosclerotic events (myocardial infarction, stroke, and vascular death) in patients with atherosclerosis documented by recent stroke, recent myocardial infarction, or established peripheral arterial disease

CNS: Headache, dizziness, weakness, syncope, flushing CV: Hypertension, edema Dermatologic: Rash, pruritus GI: Nausea, GI distress, constipation, diarrhea, GI bleed Other: Increased bleeding risk 

Advise patients that excessive intake of alcohol should be avoided with this medication>  Ensure that patients know they should report any signs of increased bleeding and bruising.>



Mechanisms of action not understood; actions may be due to suppression of subcortical areas of the CNS; has clinically demonstrated antihistaminic, analgesic,

Symptomatic relief of anxiety and tension associated with psychoneurosis; adjunct in organic disease states in which anxiety is manifested; alcoholism and asthma;

CNS: Drowsiness, involuntary motor activity, including tremor and seizures y GI: Dry mouth, reflux, constipation y GU: Urinary retention 

Assess patient for profound sedation and provide safety precautions as indicated (side rails up, bed in low position, call bell within reach,

antispasmodic, antiemetic, mild antisecretory, and bronchodilator activity

y Hypersensitivity: Wheezing, dyspnea, chest tightness    

supervision of ambulation and transfer).Geri: Older adults are more sensitive to CNS and anticholinergic effects (delirium, acute confusion, dizziness, dry mouth, blurred vision, urinary retention, constipation, tachycardia).> Monitor for drowsiness, agitation, over sedation, and other systemic side effects. Assess falls risk and implement prevention strategies> AnxietyAssess mental status (orientation, mood, and behavior)> Nausea and VomitingAssess degree of nausea and frequency and amount of emesis> PruritusAssess

degree of itching and character of involved skin

Ceftrazidime Ceptaz

Antibiotic Cephalosporin (third generation)

Bactericidal: Inhibits synthesis of bacterial cell wall, causing cell death.

Lower respiratory infections caused by P. aeruginosa, other Pseudomonas, S. pneumoniae, S. aureus, Klebsiella, H. influenzae, P. mirabilis, E. coli, Enterobacter, Serratia, Citrobacter

CNS: Headache, dizziness, lethargy, paresthesias GI: Nausea, vomiting, diarrhea, anorexia, abdominal pain, flatulence, pseudomembranous colitis, liver toxicity GU: Nephrotoxicity Hematologic: Bone marrow depression decreased WBC, decreased platelets, decreased Hct Hypersensitivity: Ranging from rash to fever to anaphylaxis, serum sickness reaction Local: Pain, abscess at injection site; phlebitis, inflammation at IV site Other: Superinfections, disulfiram-like reaction with alcohol 

Ask patient if he is has allergies to penicillin and cephalosporin  If large doses are given, therapy is prolonged or patient is at high risk, monitor for sing and symptoms of super infection.

Tranexamic acid Cyklokapron

Antifibrinolytic antihemorrhagic

Tranexamic acid competitively inhibits activation of plasminogen (via binding to the kringle domain), thereby reducing conversion of plasminogen to plasmin (fibrinolysin), an enzyme that degrades fibrin clots, fibrinogen, and other plasma proteins, including the procoagulant factors V and VIII. Tranexamic acid also directly inhibits plasmin activity, but higher doses are required than are needed to reduce plasmin formation.

Medical: epistaxis, hemoptysis, hematuria, peptic ulcer with hemorrhage and blood dyscrasias with hemorrhage

CV: Hypotension Respiratory: respiratory tract and sinus congestion, sinusitis, acute sinusitis, sinus headache, and allergic sinusitis and sinus pain. Musculoskeletal: included back pain, musculoskeletal pain, muscle cramps and spasms, myalgia, and arthralgia including joint stiffness and swelling. GI: nausea, vomiting, and diarrhea. Abdominal pain has also been reported.

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