NAME OF DRUG MECHANISM DOSAGE INDICATIONS CONTRAINDICATIONS SIDE EFFECTS NURSING

OF ACTION RESPONSIBILITIES
Generic name: Reversibly inhibits Dosage: To treat mild to  Hypersensitivity to CNS: headache, Before administration:
Donepezil acetylcholinesterase 23 mg moderate donepezil, piperidine dizziness, vertigo,1. Note for possible drug
hydrochloride and Alzheimer’s derivatives, or their fatigue, interactions
improves Frequency: disease components depression, 2. Monitor patient’s vital
Brand name: acetylcholine’s 23 mg tab aggression, signs
Aricept concentration at OD irritability, 3. Make sure the patient
cholinergic restlessness, receives the right
Classification: synapses. Raising Route: nervousness, dosage
Acetylcholinesterase acetylcholine Oral paresthesia, 4. Watch closely for
inhibitor level in the cerebral insomnia, increased
Antidementia cortex may improve abnormal dreams, bronchoconstriction in
cognition. tremor, aphasia, patients with history of
Donepezil becomes seizures asthma or COPD.
less effective CV: chest pain, 5. Assess cardiovascular
as Alzheimer’s bradycardia, status. Drug may cause
disease progresses hypertension, bradycardia from
and hypotension, increased vagal tone.
number of intact vasodilation, 6. Monitor closely for
cholinergic neurons atrial signs and symptoms of
declines fibrillation, heart GI ulcers and bleeding,
block especially if patient
EENT: cataracts, takes NSAIDs
blurred vision, eye concurrently.
irritation, sore
7. Take safety
throat precautions if patient is
GI: nausea, dizzy or has other
vomiting, adverse CNS reactions.
diarrhea,
anorexia, During administration:
bloating, 1. Advise patient to
epigastric pain, take drug at
bedtime with or
without food.
fecal 2. Instruct patient to
incontinence, GI allow orally
bleeding disintegrating
GU: urinary tablet to dissolve
frequency, under tongue and
increased then follow with a
libido, bladder glass of water.
outflow 3. Tell patient not to
obstruction split, crush, or
Metabolic: chew 23-mg tablet.
dehydration
Musculoskeletal: After administration:
muscle cramps, 1. Inform patient that
arthritis, bone drug may slow the
fracture heart rate, leading to
Respiratory: fainting episodes.
dyspnea, 2. Instruct patient to
bronchitis immediately report
Skin: pruritus, signs or symptoms of
urticaria, GI ulcers (“coffee-
bruising, ground” vomitus,
diaphoresis, rash, black tarry stools, and
flushing abdominal pain), or
Other: toothache, irregular heartbeat.
decreased 3. As appropriate, review
appetite, all other significant
weight loss, hot and life-threatening
flashes, influenza adverse reactions and
interactions, especially
those related to the
drugs mentioned above
 NAME OF MECHANISM OF DOSAGE INDICATIONS CONTRAINDICATIONS SIDE EFFECTS NURSING
DRUG ACTION RESPONSIBILITIES
Generic name: Reduces Dosage: To treat mild to  Hypersensitivity to CNS: Aggression, Before administration:
Galantamine acetylcholine 24 mg moderate galantamine asthenia, 1. Before giving, make sure
hydrobromide metabolism by Alzheimer’s type hydrobromide or its depression, patient is well hydrated,
competitively and Frequency: dementia components dizziness, to minimize GI upset.
Brand name: reversibly inhibiting 24 mg tab  severe hepatic or renal dysgeusia, 2. Assess fluid intake and
Razadyne the OD impairment (creatinine fatigue, fever, output to ensure
brain enzyme clearance less than 9 headache, adequate hydration,
Classification: acetylcholinesterase. Route: ml/min/1.73 m2) hypersomnia, which helps reduce GI
Cholinesterase Acetylcholine- Oral insomnia, upset.
inhibitor producing neurons lethargy, 3. Monitor cognitive status.
Antidementia degenerate in the malaise, 4. Evaluate patient for
brains of patients somnolence, cardiac conduction
with stroke, suicidal abnormalities. Assess
Alzheimer’s ideation, syncope, pulse regularly for
disease. Inhibition tremor bradycardia.
of CV: AV block, 5. Observe for bleeding
acetylcholinesterase bradycardia, tendencies.
increases the chest pain, MI, 6. Assess for depression
amount myocardial and suicidal ideation.
of acetylcholine, ischemia 7. Inform patient and
which is needed for EENT: Blurred family members that
nerve vision, rhinitis drug isn’t a cure for
impulse GI: Abdominal Alzheimer’s disease
transmission. pain, anorexia, During administration:
diarrhea, 1. Give medication
elevated liver after dinner
enzymes, After administration:
flatulence, GI 1. Recommend frequent,
bleeding, small servings of healthy
hepatitis, food and adequate fluids
indigestion, to minimize GI upset.
nausea, 2. Tell patient or caregiver
vomiting to watch for and report
GU: Hematuria, signs and symptoms of
incontinence, depression.
renal failure 3. Advise patient or
or insufficiency, caregiver to establish
UTI effective bedtime
HEME: Anemia routine.
Other: 4. Caution caregiver to
Dehydration, prevent patient from
hypersensitivity performing hazardous
reactions, activities until adverse
hypokalemia, reactions are known.
weight loss 5. As appropriate, review
all other significant
adverse reactions and
interactions, especially
those related to the drugs
mentioned above
 NAME OF MECHANISM DOSAGE INDICATIONS CONTRAINDICATIONS SIDE EFFECTS NURSING
DRUG OF ACTION RESPONSIBILITIES
Generic name: May slow the Dosage: To treat mild to  Hypersensitivity to CNS: depression, Before administration:
Rivastugmin decline of 6 mg moderate dementia carbamate dizziness, 1. Monitor patient’s
Tartrate cognitive derivatives, headache, nutritional and hydration
function Frequency: rivastigmine, or their confusion, status
Brand name: in patients with 6 mg tab OD components insomnia, 2. Assess vital signs and
Exelon Alzheimer’s psychosis, cardiovascular status. Stay
disease by Route: hallucinations, alert for chest pain and
Classification: increasing Oral anxiety, tremor, peripheral edema.
Cholinesterase acetylcholine drowsiness, 3. Inform caregiver that drug
inhibitor concentration at fatigue, syncope, initially may worsen CNS
Antidementia cholinergic asthenia impairment. Recommend
transmission CV: chest pain, appropriate safety
sites. This action hypertension, measures.
prolongs and peripheral edema 4. Monitor respiratory status
exaggerates the EENT: rhinitis, of patient
effects of pharyngitis During administration:
acetylcholine that GI: nausea, 1. Teach patient and
are otherwise vomiting, family how to
blocked by diarrhea, administer oral
toxic levels of constipation, solution, if prescribed,
anticholinergics. abdominal pain, emphasizing need to
The flatulence, use the oral dosing
cognitive decline eructation, syringe provided.
in these patients dyspepsia, Explain that dose may
is anorexia be swallowed directly
partially related GU: urinary tract from the syringe or
to cholinergic infection, urinary mixed into a small
deficits along incontinence glass of water, cold
neuronal Musculoskeletal: fruit juice, or soda;
pathways back pain, joint stirred; and then drink.
projecting from pain, 2. Explain that oral drug
the bone fractures should be taken with
basal forebrain to Respiratory: food to reduce adverse
the cerebral upper respiratory GI effects.
cortex and infection, cough,
hippocampus that bronchitis After administration:
are involved in Skin: rash, 1. Closely monitor cognitive
memory, diaphoresis status, particularly
attention, Other: weight memory. Report
learning, and loss, pain, flulike significant decline or
cognition symptom improvement.
2. Assess temperature. Watch
for fever and other signs
and symptoms of
infection.
3. Tell caregiver that
memory improvement
generally is subtle and that
drug works by preventing
further memory
loss.
4. Inform caregiver that drug
commonly causes nausea,
vomiting, decreased
appetite, and weight loss,
especially at start of
therapy.
5. Advise caregiver to watch
for and report weight loss,
dehydration, and signs and
symptoms of GI bleeding
6. As appropriate, review all
other significant adverse
reactions and interactions,
especially those related to
the drugs mentioned above
 NAME OF MECHANISM DOSAGE INDICATIONS CONTRAINDICATIONS SIDE EFFECTS NURSING
DRUG OF ACTION RESPONSIBILITIES
Generic name: Relaxes the Dosage: To treat overactive  Advance chronic CNS: Dizziness, Before administration:
Mirabegron detrusor smooth 25 mg bladder with kidney disease fatigue, headache 1. Monitor blood pressure
muscle during symptoms of urge  Severe uncontrolled CV: Atrial and other vital signs
Brand name: the storage phase Frequency: urinary hypertension fibrillation, 2. Note intake and output
Myrbetriq of the urinary 25 mg tab incontinence,  Hypersensitivity to hypertension, 3. Use mirabegron cautiously
bladder fillvoid OD urgency, and mirabegron or its elevated LDH in patients with bladder
Classification: cycle by urinary frequency components levels, outlet obstruction and in
Beta-3 activating the Route: palpitations, patients taking
adrenergic beta-3 Oral tachycardia antimuscarinic drugs for
agonist adrenergic EENT: Dry the treatment of this
Bladder receptor, which mouth, glaucoma, condition because the drug
relaxant increases nasopharyngitis, may cause urinary
bladder capacity. rhinitis, sinusitis retention
With increased GI: Abdominal 4. Warn patient that drug
bladder distention or pain, may increase blood
capacity, urge constipation, pressure. Encourage
sensation is diarrhea, patient to have his blood
decreased, which dyspepsia, pressure checked
in turn decreases elevated regularly, especially if he
urinary liver enzymes, has hypertension.
frequency. gastritis, nausea During administration:
GU: Bladder pain, 1. Instruct patient to take
cystitis, mirabegron with water
nephrolithiasis, and to swallow tablet
prostate cancer, whole.
urinary retention, 2. Caution patient not to
UTI, chew, divide, or crush
vaginal infections, tablets prior to
vulvovaginal ingesting.
pruritis 3. Instruct patient to take
MS: Arthralgia, mirabegron as
back pain directed. If a dose is
missed, take as soon
SKIN: Pruritis, as remembered unless
rash, Stevens- >12 hrs since missed
Johnson dose. If >12 hrs since
syndrome missed dose, omit
Other: Influenza- dose and take next
like infectio dose at scheduled
time.
After administration:
1. Monitor for signs and
symptoms of angioedema
(swelling of face, lips,
tongue and/or larynx).
Discontinue mirabegron
and treat symptomatically.
2. Tell patient to notify
prescriber if he
experiences a decrease in
urinary output despite a
normal intake
3. May cause dizziness.
Caution patient to avoid
driving or other activities
requiring alertness until
response to medication is
known.
4. Advise patient to notify
health care professional if
difficulty emptying
bladder occurs.
 NAME OF MECHANISM DOSAGE INDICATIONS CONTRAINDICATIONS SIDE EFFECTS NURSING
DRUG OF ACTION RESPONSIBILITIES
Generic name: Omeprazole Dosage: To provide short-  diarrhea from an CNS: Agitation, Before administration:
Omeprazole interferes with 40 mg term treatment of infection with asthenia, 1. Note for possible drug
gastric acid active benign gastric Clostridium difficile dizziness, interactions
Brand name: secretion by Frequency: ulcer bacteria drowsiness, 2. Encourage patient to avoid
Losec (CAN) inhibiting the 40 mg tab  inadequate vitamin fatigue, headache, alcohol, aspirin products,
hydrogen OD To decrease acidity B12 psychic ibuprofen, and foods that
Classification: potassium - in stomach  low amount of disturbance, may increase gastric
Proton-pump adenosine Route: magnesium in the somnolence secretions during therapy.
inhibitor triphosphatase IV blood CV: Chest pain, 3. Tell him to notify all
Antiulcer (H + K + -  liver problems hypertension, prescribers about
ATPase) enzyme  a type of kidney peripheral prescription drug use.
system, or inflammation called edema 4. Monitor patient’s vital
proton pump, in interstitial nephritis EENT: Anterior signs
gastric parietal  subacute cutaneous ischemic optic 5. Make sure the patient
cells. lupus erythematosus neuropathy, receives the right dosage
Normally, the  systemic lupus optic atrophy or
proton pump uses erythematosus, an neuritis, stomatitis During administration:
energy ENDO: 1. Give omeprazole
autoimmune disease
from hydrolysis Hypoglycemia before meals,
 osteoporosis, a
of adenosine GI: Abdominal preferably in the
condition of weak
triphosphate pain, constipation, morning for once-
bones
to drive hydrogen diarrhea, daily dosing. If
(H+) and chloride  a broken bone Clostridium needed, also give an
(Cl−)  CYP2C19 poor difficile- antacid, as prescribed.
out of parietal metabolizer associated After administration:
cells and into the  Hypersensitivity to diarrhea, 1. Because drug can
stomach drug and its contents dyspepsia, interfere with absorption
lumen in elevated liver of vitamin B12, monitor
exchange for function patient for macrocytic
potassium (K+), anemia.
which leaves the
stomach lumen tests, flatulence, 2. Advise patient to notify
and hepatic prescriber immediately
enters parietal dysfunction or about abdominal pain or
cells. After this failure, diarrhea.
exchange, indigestion, 3. Instruct patient to report
H+ and Cl− nausea, bothersome or
combine in the pancreatitis, prolonged side effects,
stomach to vomiting including skin problems
form GU: Interstitial (itching, rash) or GI
hydrochloric acid nephritis effects (nausea, diarrhea,
(HCl), as shown HEME: vomiting, constipation,
below left. Agranulocytosis, heartburn, flatulence,
Omeprazole anemia, hemolytic abdominal pain).
irreversibly anemia, 4. If omeprazole is given
blocks leukopenia, with antibiotics, watch
the exchange of leukocytosis, for diarrhea from
intracellular H+ neutropenia, Clostridium difficile. If
and pancytopenia, diarrhea occurs, notify
extracellular K+, thrombocytopenia prescriber and expect to
as shown below MS: Back pain, withhold drug and treat
right. By bone fracture with fluids, electrolytes,
preventing H+ RESP: Cough protein, and an antibiotic
from entering the SKIN: photo effective against C.
stomach sensitivity, difficile
lumen, pruritus, rash,
omeprazole keeps Stevens-Johnson
additional HCl syndrome, toxic
from forming. epidermal
necrolysis,
urticaria
Other:
angioedema,
hypomagnesemia,
hyponatremia