PHARMACOLOGY REVIEW GUIDE
I. Categories of Medications
Know the actions, use, serious side effects and specific nursing measures for
administration of the following frequently ordered medications or categories of
medications
Cardiovascular/Antiarrhythmics
Beta Blockers eg. metoprolol
(Lopressor); atenolol (Tenormin)
ACE inhibitors – eg. enalapril
(Vasotec)
Digoxin (Lanoxin)
Nitroglycerine: transdermal
patch & paste
Adrenergics – dopamine
infusion (Intropin)
Verapamil (Veracaps SR)
Antidiabetic Agents
Insulins: Regular, & NPH
Humalog, Humulin, Lantus
Metformin (Glucophage)
Glyburide (Diabeta)
Insulin Pen use
Analgesics/Narcotics
Hydromorphone (Dilaudid)
Morphine sulfate & MS Contin
Oxycodone-acetaminophen.
(Percocet)
Diuretics
Hydrochlorothiazide (Esidrix)
Spironolactone (Aldactone)
Furosemide (Lasix )
Hormones – levothyroxine
(Synthroid)
Agents for Depression/Sedation
Fluoxetine (Prozac)
Lorazepam (Ativan)
Anti-infectives/Anti-fungals
Ampicillin
Cefazolin (Ancef/Kefzol)
Gentamicin sulfate (Garamycin)
Vancomycin
Anti-inflammatory Agents
Prednisone/methylprednisolone
Dexamethasone (Decadron)
NSAIDS – eg.Ibuprophen, Aleve
Cox-2 Inhibitors- eg Celebrex
Anticoagulants/Hematologic Agents
Heparin sodium
Warfarin sodium (Coumadin)
Enoxaparin sodium (Lovenox)
Dalteparin sodium (Fragmin)
Antiulcer/Antiemetics
Famotidine (Pepcid)
Omeprazole (Prilosec)
Ondansetron (Zofran)
Flumazenil (Romazicon)
Antiseizure High Alert Medications: Identified by
Phenytoin sodium (Dilantin) TJC (The Joint Commission) --
concentrated KCL, concentrated NaCl,,
Antidotes insulin, heparin
Protamine Sulfate
Naloxone HCl (Narcan) Herbal Interactions: anticoagulants and
Vitamin K (Aquamephyton) ginko biloba

II. Important to Know:

1. Medication administration based on RN standards of practice.
2. How to administer intramuscular injections – variations by weight, size, age.
3. Nursing responsibilities for first-dose of any medication.
4. Nursing documentation for PRN medications.
5. How to draw up and administer insulin subcutaneously and how to use an insulin
pen.
6. Heparin/Lovenox/Fragmin injection techniques and sites
7. Specific lab values to be monitored for patients on Lovenox/Fragmin, Heparin,
Coumadin, Vancomycin
8. How to apply topical/ transdermal medication/patches
9. IV push medications
10. How to administer eye and ear drops – adults and pediatric
11. How to administer sustained release (SR, LX, LA etc.) tablets/capsules
12. Distinguish S/S of hypoglycemia & the interventions for treating it.
13. Measures for effective pain management – dosing schedule, documentation, use
of appropriate pain scale eg. FLACC, BPS, CPOT, Wong-Baker, Numeric.
14. Safety measures for administration of TPN (total parenteral nutrition)
15. How to administer meds via NG tube
16. IV administration of diluted KCl only via central line or large vein
17. Monitoring for IV infiltration of vesicants (e.g. Dopamine)
18. Heparin Infusion weight-based dosages

III. Conversions
1 kg = 1000 gm 1 liter = 1000 ml 1 oz = 30 ml
1 gm = 1000 mg 1 kg = 2.2 lbs 1 tbsp = 3 tsp
1 mg = 1000 mcg 1 tsp = 5 ml 1 inch = 2.54 cm
IV. Policies - The following SBHCS policies apply to the administration of
medication and must be followed at all times.
TOPIC GOLDEN RULES ADDITIONAL INFORMATION
PAIN Patients must receive adequate If the medications ordered are not
pain control. controlling the patient’s pain, a new
order should be obtained from the
physician. Don’t let the patient suffer.

Pain assessment, interventions, Documentation includes: pain

and outcomes must be
documented completely
assessment, treatment, comfort level
achieved (the pain goal for that
patient), interventions when treatment
is inadequate, and new outcomes
from those interventions

DOUBLE To identify each patient Forms of identification include the

IDENTIFICA- receiving medication, the nurse
TION must use 2 forms of
identification.
TELEPHONE All telephone orders must be
ORDERS completely read back and
verified to the physician as
soon as they are recorded on
the medical record and
BEFORE they are executed.
patient’s ID BAND (a must!); asking
the patient his name, the MR number,
date of birth, phone number, photo
license, etc.
The order read back and verification
includes the patient’s name, date and
time of the order, the name of the
med, the dose, the route, the
frequency of administration, any
parameters or criteria for
administration.

VERBAL Verbal orders can only be An emergency situation is one in

ORDERS accepted in an emergency which the health of the patient would
situation. be compromised if there were a delay
in administering the medication.

For accuracy, all verbal orders
must be read back and verified
to the Physician completely as
soon as they are written in the
medical record.
ANNOTATION Correct & complete written
FOR orders are required for each
WRITTEN medication to be administered.
ORDERS
If any part of an order is
missing, unclear, illegible,
The order read-back and verification
includes the patient’s name, date and
time of the order, the name of the
med, the dose, the route, the
frequency of administration, any
parameters or criteria for
administration.
a. Use a leading zero in front of the
decimal dose of a medication.
Correct: 0.35 mg Incorrect .35 mg
b. Do Not use a ‘trailing zero’ after a
whole number dose of a medication
 includes unacceptable
abbreviations, or does not
conform to the patient’s
condition, the nurse must
contact the physician to correct
the problem or clarify the order
before administering the
medication.
MISSED Whenever a medication dose
MEDICATION has been missed, the nurse
DOSES should contact the physician to
clarify what is best for the
patient.
Correct: 4mg Incorrect: 4.0 mg
c. Never use a range of doses or
times.
Correct: Percocet 1 tab. po q4h
Incorrect: Percocet 1-2 tabs q 3-4
hours.
When a medication dose is missed
eg. the patient is off the unit, the
nurse should not assume that the
patient can wait until the next dose is
due. The decision about the missed
dose belongs to the physician.

DANGEROUS Certain previously-acceptable WRONG RIGHT

ABBREVIA- abbreviations CAN NO
TIONS LONGER BE USED in the U Units
medical record. IU International Units

ug Micrograms, mcg
The TJC and hospital policy
now prohibits their use. QD/OD Daily

QOD Every other day

If these abbreviations appear in sc or sq Subcutaneously

a medication order, the order
must be clarified with the QID Four times a day
physician and rewritten
correctly. MS/MSO4 Morphine sulfate
(morphine)

MgSO4 Magnesium sulfate

OS/OD/OU Left/right/both eyes

AS/AD/AU Left/right/both ears