Drug Order Mechanism of Indications Contraindic Side Effects Adverse Effects Nursing Implication

Action ations
Generic Inhibits - Intra- - Comm CNS: Patient monitoring
Name: bacterial cell- abdominal Hypersensiti on SE: insomnia,
- wall synthesis infections vity to drug, dizziness,  Collect specimens for
Meropenem and penetrates - Bacterial its - drowsiness, culture and sensitivity
gram-negative meningitis components, headache; weakness,seizure testing as needed.
Brand Name: and gram- or other beta- - s However, be aware that
positive bacteria - lactams nausea CV: drug therapy may start
-Meronem, Complicate - hypotension, pending results.
-Merrem d skin and vomiting, phlebitis, -Monitor patient for
I.V. skinstructur - palpitations, hypersensitivity reaction
e infections diarrhea heart failure, or anaphylaxis. If either
- cardiac arrest, occurs, stop infusion
constipation myocardial immediately and initiate
-rash infarction emergency treatment.
- GI:  Monitor for CNS
anemia tongue irritability and seizures.
discoloration,  In prolonged therapy,
oral candidiasis, evaluate hematopoietic,
glossitis, renal, and hepatic
pseudomembran function and watch for
ous coliti overgrowth of
GU: nonsusceptible
vaginal organisms.
candidiasis  If diarrhea occurs, check
Hematologic: for pseudomembranous
anemia, colitis and obtain stool
eosinophilia, cultures.
leukopenia, bone  Obtain hearing tests in
marrow child being treated for
depression, bacterial meningitis
thrombocytopeni
 a, neutropenia Patient teaching
Musculoskeletal
: myoclonus  Advise patient to report
Respiratory: such adverse reactions as
chest discomfort, CNS irritability, diarrhea,
dyspnea, rash, shortness of breath,
hyperventilation or pain at infusion site.
Skin:
rash, urticaria,  As appropriate, review
pruritus, all other significant and
erythema at life-threatening adverse
injection site reactions and
Other: interactions, especially
altered taste, those related to the drugs
fever, pain, and tests mentioned
fungal infection, above.
anaphylaxis
Generic Interferes with - Severe -  Comm CNS: Patient monitoring
Name: protein systemic Hypersensiti on SE: tremor,
synthesis in infections vity to  numbness,  Monitor kidney function
Amikacin bacterial cells caused by aminoglycosi - depression, test results and urine
sulfate by binding to sensitive des diarrhea, confusion, cultures, output, protein,
30S ribosomal strains of  - lethargy, and specific gravity.
subunit, leading Pseudomon - hearing loss, headache,  Monitor results of peak
to bacterial cell as Breastfeedin - paresthesia, and trough drug blood
death aeruginosa, g spinning ataxia, levels.
Escherichia sensation neuromuscular  Evaluate for signs and
coli, or (vertigo), blockade, symptoms of ototoxicity
Proteus,  - seizures, (hearing loss, tinnitus,
Klebsiella, numbness, neurotoxicity ataxia, and vertigo).
Serratia, EENT:  Assess for secondary
 -skin
Enterobacte nystagmus and superinfections,
tingling,
r, other visual particularly upper
 -
Actinobacte muscle twitch disturbances, respiratory tract
r, ing and ototoxicity, infections.
Providencia, convulsions, hearing loss,
Citrobacter,  - tinnitus Patient teaching
or dizziness GI:  Inform patient that drug
Staphylococ  - nausea, may cause hearing loss,
cus species ringing or vomiting, seizures, and other
roaring in the splenomegaly, neurologic problems. Tell
- ears, stomatitis, him to report these
Uncomplica  - increased symptoms immediately
ted urinary allergic salivation,  Instruct patient to
tract reactions, anorexia immediately report fever,
infections  - GU: cough, breathing
caused by Clostridium azotemia, problems, sore throat,
susceptible difficile assoc increased urinary and other signs and
organisms iated diarrhea excretion of symptoms of infection.
(CDAD), casts, polyuria,  Caution patient to avoid
 -skin painful urination, driving and other
rash impotence, hazardous activities until
 -drug nephrotoxicity he knows how drug
fever Hematologic: affects concentration and
purpura, alertness.
 -
eosinophilia,  Instruct patient to notify
headache
leukemoid prescriber if he’s
 -
reaction, aplastic urinating much more or
numbness
anemia, much less than normal.
--tingling
neutropenia,  Advise patient to
 - agranulocytosis,
tremor minimize GI upset by
leukopenia, eating small, frequent
 - thrombocytopeni
nausea servings of food, and
a, pancytopenia, drinking plenty of fluids.
 - hemolytic
vomiting  Inform patient that he’ll
anemia undergo regular blood
 -
 increase in Hepatic: and urine testing during
white blood hepatomegaly, therapy.
cells hepatic necrosis,  As appropriate, review
(eosinophilia) hepatotoxicity all other significant and
 -joint Musculoskeletal life-threatening adverse
pain : joint pain, reactions and
 - muscle twitching interactions, especially
anemia Respiratory: those related to the drugs
 -low apnea and tests mentioned
blood above.
pressure
 -low
blood
magnesium.

Generic Long-acting -Type 1 -  Comm Metabolic: Assessment & Drug Effects

Name: insulin form. (insulin- Hypersensiti on SE: rebound
Promotes dependent) vity to drug  hyperglycemia  Monitor for S&S of
-insulin glucose diabetes or its  -cold (Somogyi hypoglycemia, especially
glargine transport, which mellitus and components symptoms effect), after changes in insulin
(long acting) stimulates type 2 (non-  -upper hypoglycemia dose or type.
carbohydrate insulindepe - respiratory Skin:  Lab tests: Monitor fasting
Brand Name: metabolism in ndent) Hypoglycemi tract infection urticaria, rash, blood glucose and
skeletal and diabetes a  -low pruritus, redness, HbA1C periodically.
- Toujeo cardiac muscle mellitus in blood sugar stinging, or  Withhold drug and notify
and adipose patients who (hypoglycemi warmth at physician if patient is
tissue. Also need long- a) injection site hypokalemic.
promotes acting  - Other:
phosphorylation insulin allergic edema, Patient & Family Education
of glucose in reactions lipodystrophy,
liver, where it’s - lipohypertrophy,  Do not inject into areas
 -
converted to Conversion allergic reactions with redness, swelling,
injection site
glycogen. from reactions including
Directly affects another  -body anaphylaxis itching, or dimpling.
fat and protein insulin type fat  Absorption patterns for
metabolism, in patients redistribution this drug are not
stimulates with type 1 (lipodystroph dependent on the
protein diabetes y) injection site.
synthesis, mellitus  -  Ingest some form of
inhibits release who need itching sugar (e.g., orange juice,
of free fatty long-acting  -rash dissolved table sugar,
acids, and insulin  - honey) if symptoms of
indirectly swelling of hypoglycemia develop;
decreases - Type 2 extremities and seek medical
phosphate and diabetes  - assistance.
potassium mellitus in weight gain  Check blood sugar as
patients prescribed; notify
receiving physician of fasting
oral blood glucose <80 and
hypoglycem >120 mg/dL.
ics  Notify the physician of
any of the following:
fever, infection, trauma,
diarrhea, nausea, or
vomiting. Dosage
adjustment may be
needed.
 Do not take any other
medication unless
approved by physician.
 Do not breast feed while
taking this drug without
consulting physician.
Generic Blocks - -  Comm CNS: Assessment & Drug Effects
Name: aldosterone- Hypertensio Hypersensiti on SE: dizziness,
secreting and n vity to fatigue,  Monitor for therapeutic
Irbesartan potent irbesartan,  - headache, effectiveness: Maximum
vasoconstrictive - losartan, or dizziness syncope pressure lowering effect
Brand Name: effects of Nephropath valsartan;  - CV: may not be evident for 6–
-Aprovel angiotensin II at y in patients pregnancy lightheadedne orthostatic 12 wk; indicated by
-Avapro tissue receptor with type 2 [(category C ss hypotension, decreases in systolic and
sites, which diabetes and first  -upset chest pain, diastolic BP.
reduces hypertensio trimester), stomach as peripheral edema  Monitor BP periodically;
vasoconstriction n category D your body EENT: trough readings, just
and lowers (second and adjusts to the conjunctivitis, prior to the next
blood pressure third medication vision scheduled dose, should
trimesters)], - disturbance, ear be made when possible.
lactation. diarrhea, pain, sinus  Lab tests: Monitor
 - disorders periodically BUN and
heartburn GI: nausea, creatinine, serum
diarrhea, potassium, and CBC with
 -
constipation, differential.
tiredness.
abdominal pain,
dry mouth Patient & Family Education
GU:
albuminuria,rena  Inform physician
l failure immediately if you
Metabolic: become pregnant.
gout,  Notify physician of
hyperkalemia episodes of dizziness,
Musculoskeletal especially when making
: joint pain, back position changes.
pain, muscle  Do not breast feed while
weakness taking this drug.
Respiratory:
upper respiratory
 tract infection,
cough, bronchitis
Other:
dental pain
Generic Inhibits HMG- - Adjunct to Hypersensiti Comm Body as a Assessment & Drug Effects
Name: CoA reductase, diet for the vity to on SE: Whole: 
Atorvastatin which catalyzes reduction of atorvastatin, Back pain,  Monitor for therapeutic
calcium first step in LDL myopathy,  - asthenia, effectiveness which is
cholesterol cholesterol active liver feeling sick hypersensitivity indicated by reduction in
Brand Name: synthesis; this and disease, (nausea) reaction, the level of LDL-C.
-Lipitor action reduces triglycerides unexplained - myalgia,  Lab tests: Monitor lipid
concentrations in patients persistent indigestion rhabdomyolysis.  levels within 2–4 wk
of serum with transaminase - CNS:  after initiation of therapy
cholesterol and primary elevations, headaches Headache.  or upon change in
low-density hypercholes pregnancy  -aches GI: Abdominal dosage; monitor liver
lipoproteins terolemia (category X), and pain in pain, functions at 6 and 12 wk
(LDLs), linked and mixed lactation. back and constipation, after initiation or
to increased risk dyslipidemi joints diarrhea, elevation of dose, and
of coronary a. dyspepsia, periodically thereafter.
 -
artery disease flatulence,  Assess for muscle pain,
nosebleeds
(CAD). Also increased liver tenderness, or weakness;
 -sore
moderately function tests.  and, if present, monitor
throat
increases Respiratory:  CPK level (discontinue
concentration of  -cold- Sinusitis,
like drug with marked
high-density pharyngitis.  elevations of CPK or if
lipoproteins symptoms Skin: Rash.
such as runny myopathy is suspected).
(HDLs),  Monitor carefully for
associated with nose, blocked
nose or digoxin toxicity with
decreased risk concurrent digoxin use.
of CAD sneezing
 -
constipation Patient & Family Education
 -
diarrhea  Report promptly any of
 
the following:
Unexplained muscle
pain, tenderness, or
weakness, especially with
fever or malaise;
yellowing of skin or
eyes; stomach pain with
nausea, vomiting, or loss
of appetite; skin rash or
hives.
 Do not take drug during
pregnancy because it may
cause birth defects.
Immediately inform
physician of a suspected
or known pregnancy.
 Inform physician
regarding concurrent use
of any of the following
drugs: erythromycin,
niacin, antifungals, or
birth control pills.
 Minimize alcohol intake
while taking this drug.
 Do not breast feed while
taking this drug.

Generic - -used to  - Side effects of -no known Contraindications/warnings/inter

Name: provide vitamin treat or Impaired ren multivitamins adverse effects actions
Multivitami s that are not prevent al function include:
ns taken in through vitamin  - Should be avoided in patients
 the diet. deficiency Nephrolithias
Brand due to poor is  - with known alcohol intolerance,
Name/s: diet, certain Constipation Hypersensitivity to
illnesses, or  -Dark preservatives, colorants, or
- Folgard, during stools additives including tartrazine,
Natalins Rx, pregnancy.  - saccharin, and aspartame (oral
Nestabs Vitamins Nausea forms)
CBF, are  -
Nestabs FA important Vomiting
building  -
blocks of Abdominal
the body pain
and help
keep you in 
good health

References:

1. https://www.nhs.uk/medicines/
2. https://www.rxlist.com
3. www.robholland.com/Nursing/Drug_Guide/data/monographframes/A080.html
4. Mc-Graw Hill Nurse’s Drug Handbook, 7th Edition