Generic: Dalteparin Brand Name: Fragmin

Classification: Anticoagulant/anti-thrombotic. Low-molecular weight heparin.

Therapeutic use: Prevention of thrombus formation (VTE, DVT, PE in surgical/medical or
cancer patients). Prevent ischemic complications (unstable angina and non-ST-segment-
elevation MI).
Action: Potentiate inhibitory effect of antithrombin on factor Xa and thrombin.
Safe dosage: Extended treatment of symptomatic VTE in cancer patients: 200 IU/kg (do not
exceed 18,000 IU) once daily for first 30 days, followed by 150 IU/kg once daily for months
2 to 6.
Onset Peak Duration
Rapid 4 hours Up to 24 hours
Patient teaching: Correct self-injection, care, and disposal of equipment. Report S/S of
unusual bleeding, bruising, dizziness, itch, rash, fever, swelling, or SOB. Do NOT take
aspirin or NSAID’s.
Adverse reactions: Anemia. Constipation, N&V, & edema.
Contraindications: Hypersensitivity to heparin or pork, active major bleeding, hx of HIT,
& regional anesthesia during treatment for unstable angina/non-Q-wave MI.
Precautions: Severe hepatic or renal disease, women under 45 kg or men under 57 kg,
retinopathy (HTN or diabetic), untreated HTN, & geriatrics
Interactions: Drugs that affect platelet function and coagulation (warfarin, aspirin,
NSAID’s, thrombolytics). Arnica, chamomile, clove, feverfew, garlic, ginger, ginkgo, &
ginseng.
Nursing Assessment: S/S of bleeding/hemorrhage. Evidence of additional or ↑ thrombosis
(heat, pain, discoloration). Vitals & labs. Bleeding precautions.
Labs: CBC, platelets, & stools for occult blood [periodical monitoring for all patients]. Anti-
Xa [patients who are obese or have renal dysfunction]. AST & ALT (may ↑)

Vallerand, A.H., Sanoski, C.A., & Deglin, J.H. (2015). Davis’s drug guide for nurses. (14th
ed.). Philadelphia, PA: F.A. Davis Company. Page: 634
 Generic: Diphenhydramine Brand Name: Benadryl
Classification: Antihistamine (allergy), cold and cough remedy, & antitussive.
Therapeutic use: ↓ symptoms of histamine reactions (anaphylaxis, season/perennial allergic
rhinitis, allergic dermatoses). Prevent motion sickness
Action: Antagonizes the effect of histamine at H1-receptor sites; doesn’t bind/inactivate
histamine & causes significant CNS depression & anticholinergic effects
Safe dosage: 25-50 mg q4-6hr. Do NOT exceed 300 mg/day.
Onset Peak Duration
15 to 60 minutes 2 to 4 hours 4 to 8 hours
Patient teaching: Dry mouth prevention. Avoid CNS depressant medications. Avoid OTC
products with diphenhydramine (↑ effects).
Adverse reactions: Drowsiness, anorexia, & dry mouth.

Contraindications: Hypersensitivity, acute asthma attacks, breastfeeding, & known alcohol

intolerance (liquid products).

Precautions: Severe liver disease, angle-closure glaucoma, seizures, BPH, PUD,

hyperthyroidism, & ↓ dose for geriatrics (↑ risk of AE).

Interactions: Antihistamines, alcohol, opioid analgesics, sedative/hypnotics, TCA, MAOI,

kava-kava, valerian, & chamomile.

Nursing Assessments: LOC (older adults—confusion, sedation). Vitals & labs. Degree &
severity of symptoms. Respiratory assessment
Labs: Skin response to allergy tests (may ↓) – D/C 4 days before allergy test.

Vallerand, A.H., Sanoski, C.A., & Deglin, J.H. (2015). Davis’s drug guide for nurses. (14th
ed.). Philadelphia, PA: F.A. Davis Company. Page: 431
 Generic: Dutasteride Brand Name: Avodart
Classification: Androgen inhibitor (BPH agent)
Therapeutic use: Management of symptoms of BPH alone or with tamsulosin
Action: Inhibit enzyme 5-alphareductase, responsible for converting testosterone to 5-alpha-
dihydrotestosterone in prostate gland.
Safe dosage: 0.5 mg once daily
Onset Peak Duration
Unknown 1 to 2 weeks Unknown
Patient teaching: Take at the same time every day. Volume of ejaculate may be decreased
during therapy. Avoid donating blood for at least 6 months after last dose. Potential increase
risk in high-grade prostate cancer.
Adverse reactions: Depressed mood, PROSTATE CANCER, ↓ libido, & erectile
dysfunction.
Contraindications: hypersensitivity. Cross-sensitivity.
Precautions: hepatic impairment.
Interactions: ritonavir. Ketoconazole. Verapamil. Ciprofloxacin. CYP3A4 enzyme inhibitors.
Nursing Assessments: Symptoms of prostatic hyperplasia (hesitancy, incomplete emptying,
interruption of stream, force strength, dribbling, flow, pain, urgency). Digital rectal
examination. Vitals & labs
Lab: PSA.

Vallerand, A.H., Sanoski, C.A., & Deglin, J.H. (2015). Davis’s drug guide for nurses. (14th
ed.). Philadelphia, PA: F.A. Davis Company. Page: 471
 Generic: Doxycycline Brand Name: Adoxa, Atridox, Doryx,
Doxycin, Monodox, Oracea, &
Vibramycin
Classification: 2nd generation tetracycline antibiotic
Therapeutic use: Infections; when penicillin is contraindicated, acne, uncomplicated adult
urethral/endocervical/rectal infection, acute intestinal amebiasis, exposure to anthrax, malaria
prophylaxis, rosacea, & periodontal disease
Action: Bacteriostatic—inhibits protein synthesis of susceptible bacteria, causing cell death
Safe dosage: 40 mg/day PO in AM with full glass of water on an empty stomach for up to 9
months

Onset Peak Duration

1 to 2 hours 1.5 to 4 hours 12 hours
Patient teaching: Take without food, unless GI upset occurs. Use extra (external)
contraceptives. Photosensitivity risk. REPORT rash, itching, difficulty breathing, dark urine,
light-colored stool, or pain at injection site (if IV).
Adverse reactions: Discoloration & inadequate calcification of teeth, phototoxic reaction,
rash, anorexia, N&V, diarrhea, & glossitis
Contraindications: Hypersensitivity
Precautions: Renal/hepatic impairment & pregnancy/lactation
Interactions: Antacids, iron, alkali, barbiturates, carbamazepine, phenytoin, digoxin, food or
dairy products, & cultures
Nursing Assessments: S/S of infection. C&S before starting.
Lab: Urinalysis, BUN, liver fx tests, renal fx tests, & culture

Vallerand, A.H., Sanoski, C.A., & Deglin, J.H. (2015). Davis’s drug guide for nurses. (14th
ed.). Philadelphia, PA: F.A. Davis Company. Page: 1178
 Generic: Diltiazem Brand Name: Cardizem, Dilacor,
Cartia, Taztia, & Tiazac
Classification: Antianginal, antiarrhythmic (class IV), antihypertensive, & CCB
Therapeutic use: HTN, angina pectoris, vasospastic/Prinzmetal angina, SVT, & rapid
ventricular rates in atrial flutter or fibrillation
Action: Inhibits transport of calcium into myocardial & vascular smooth muscle cells,
resulting in inhibition of excitation-contraction coupling & subsequent contraction (systemic
vasodilation = ↓ BP; coronary vasodilation = ↓ frequency & severity of angina)
Safe dosage: 30 to 120 mg TID or QID OR 60 to 120 mg BID as SR capsules OR 180 to 240
mg 1x/day as CD or XR capsules or LA tablets (up to 360 mg/day)
Concurrent Simvastatin therapy: Dose should not exceed 240 mg/day

Onset Peak Duration

PO: 30 minutes PO: 2 to 3 hours PO: 6 to 8 hours
PO-SR: Unknown PO-SR: Unknown PO-SR: 12 hours
PO-CD, XR, LA: Unknown PO-CD, XR, LA: 14 days PO-CD, XR, LA: Up to 24 hr
IV: 2 to 5 minutes IV: 2 to 4 hours IV: Unknown
Patient teaching: Avoid large amounts of grapefruit juice. OH risk. Monitor pulse & hold if
HR is below 50 bpm. May cause drowsiness or dizziness. May cause drowsiness or dizziness.
Good oral hygiene & see dentist regularly to prevent gingival hyperplasia. Photosensitivity
risk. Additional HTN interventions. Monitor BP weekly.
Adverse reactions: Peripheral edema, angina, dizziness, & flushing
Contraindications: Hypersensitivity, sick sinus syndrome, 2nd or 3rd degree AV block (unless
pacemaker in place), systolic BP ↓ 90 mmHg, & recent MI or pulmonary congestion
Precautions: Severe hepatic impairment & geri (↓ dose)
Interactions: Fentanyl, other antihypertensive agents, alcohol, quinidine, NSAID, statins,
digoxin, beta blockers, pheno-derivatives, cyclosporine, lithium, & grapefruit juice
Nursing Assessments: Monitor BP & pulse/VS and labs. Monitor ECG during prolonged
therapy. Monitor I/O & daily weight/fluid status assessment. Assess for S/S of fluid overload.
Assess angina (location, duration, intensity, & causative factors). Cardiopulmonary
assessment
Lab: Serum potassium, renal function, & hepatic function

Vallerand, A.H., Sanoski, C.A., & Deglin, J.H. (2015). Davis’s drug guide for nurses. (14th
ed.). Philadelphia, PA: F.A. Davis Company. Page: 425/426
 Generic: Dexamethasone Brand Name: Decadron
Classification: Systemic corticosteroid & anti-asthmatic
Therapeutic use: Used systemically & locally in a wide variety of chronic diseases including
inflammatory, allergic, hematologic, neoplastic, & autoimmune disorders; in conjunction with
other immunosuppressants in prevention of organ rejection in transplant surgery, & asthma.
Action: Suppress inflammation, normal immune response, & numerous intense metabolic
effects. Little mineralocorticoid activity. Replacement therapy in adrenal insufficiency.
Safe dosage: PO/IM/IV: Anti-inflammatory—0.75 to 9 mg/day q6-12h
Airway edema/extubation—0.5 to 2 mg/kg/day q6h
Cerebral edema—10 mg IV, then 4 mg IM/IV q6h until response achieved. Then, switch to
PO & taper over 5 to 7 days

Onset Peak Duration

PO: Unknown PO: 1 to 3 hours PO: 2.75 days
IM/IV: Rapid IM/IV: Unknown IM/IV: 2.75 days
Patient teaching: Immunosuppression. REPORT severe abdominal pain or tarry stools, OR if
exposed to measles or chicken pox. Coping mechanisms (emotional). Encourage a ↑ protein,
calcium, potassium; & ↓ sodium & carb diet. Avoid alcohol.
Adverse reactions: (More common with high doses & long-term therapy) HTN, nausea, ↓
healing, fragility, adrenal suppression, osteoporosis, & Cushingoid appearance.
Contraindications: Active untreated infection
Precautions: Long-term therapy, hypothyroidism, immunosuppression, & cirrhosis
Interactions: Thiazide or loop diuretics, insulin or oral hypoglycemics, hormonal
contraceptives, NSAIDs, live-virus vaccines, & antacids.
Nursing Assessments: I/O, peripheral edema, & weight. S/S of adrenal insufficiency (fatigue,
weakness, anorexia, weight ↓). Respiratory assessment. Administer in the AM (coincides with
natural cortisone secretion).
Lab: Electrolytes, BG, WBC, & cholesterol. Long term use: CBC, electrolytes, & BG.

Vallerand, A.H., Sanoski, C.A., & Deglin, J.H. (2015). Davis’s drug guide for nurses. (14th
ed.). Philadelphia, PA: F.A. Davis Company. Page: 353
 Generic: Diazepam Brand Name: Valium
Classification: Antianxiety agents, anticonvulsants, sedative/hypnotics, skeletal muscle
relaxants (central acting), & benzodiazepines
Therapeutic use: Management of anxiety & sedation; Tx of seizures; Skeletal muscle
relaxants; & Management of alcohol withdrawal.
Action: Depresses CNS by potentiating GABA (inhibitory), produces skeletal muscle
relaxation; Relief of anxiety; sedation; amnesia; skeletal muscle relaxation (↓ seizures
activity)
Safe dosage: 2 to 10 mg 2 to 4x/daily

Onset Peak Duration

30 to 60 minutes 1 to 2 hours Up to 24 hours
Patient teaching: May cause drowsiness, clumsiness, or unsteadiness—avoid driving or other
activities requiring alertness until response is known.
Adverse reactions: Drowsiness, dizziness, lethargy, hangover, slurred speech, respiratory
distress, constipation, diarrhea, weight gain, rashes, & pain (IM sites).
Contraindications: Hypersensitivity, comatose, myasthenia gravis, severe pulmonary
impairment, sleep apnea, hepatic dysfunction, CNS depression, & angle-closure glaucoma
Precautions: Severe renal impairment, hx of suicide attempts or drug dependence, &
debilitated. Geriatric: ↑ risk for falls & cause prolonged sedation
Interactions: CNS depressants, levodopa, Kava-kava, valerian, or chamomile.
Nursing Assessments: Vitals, mental status, degree of anxiety, & level of sedation.
Lab: Hepatic function & CBC; transaminase & ALP (may ↑)

Vallerand, A.H., Sanoski, C.A., & Deglin, J.H. (2015). Davis’s drug guide for nurses. (14th
ed.). Philadelphia, PA: F.A. Davis Company. Page: 414