I.

Major Drug Therapeutic Common Action Adverse effect Indication/s Nursing interventions Other important
classification Classification Generic Names information

Cardiovascular Drugs Cardiotonic Digitoxin, Digoxin • Increase the force of Bradycardia, Congestive heart 1. Take apical pulse for full Narrow range
glycosides cardiac contraction arrhythmias failure minute. Record and report between therapeutic
• Decrease heart rate Fatigue, muscle tachyarrhythmias significant changes in rate or and toxic doses
weakness, agitation rhythm Calcium salts are
Hallucinations 2. Monitor serum levels of contraindicated
Anorexia, nausea, potassium and drug and
yellow-green halos monitor EKG
around visual 3. Assess for these symptoms
images 4. Teach how to take pulse and
what signs to report

Coronary Nitroglycerin, • Dilate coronary arteries Headache Angina 1. Treat with Tylenol Protect this drug from
vasodilators Nifedipine, • Decrease cardiac Orthostatic 2. Tolerance usually develops light, moisture and
Diltiazem workload hypotension 3. monitor vital signs heat
Tachycardia 4. teach to stand up, move Sublingual tablet
Flushing slowly taken at the first sign
Palpitations 5. teach client to lie down if of angina pain
dizzy Client should sit or lie
down
May repeat table
every 5 minutes 3
time if needed
Call doctor if no relief
Topical drug
measured on ruled
application paper and
applied to non hairy
area
Antiarrhythmics Lidocaine, • Decreased cardiac Bradycardia Prevention or 1. Remain with client during Narrow therapeutic
Procainamide conduction Tachycardia treatment of atrial infusion Tachycardia index
hydrochloride, Hypotension or ventricular 2. Monitor EKG, BP and heart Do not confuse
Propranolol arrhythmias rate and rhythm lidocaine with
hydrochloride, including those epinephrine used for
Quinidine gluconate secondary to MI local topical
and digitalis toxicity anesthesia
IV dose of Inderal
much smaller than
PO dose
Antiarrhythmics Verapamil • Calcium blocker Headache Atrial arrhythmias 1. Treat with Tylenol
 • Decrease cardiac Constipation 2. Increase dietary fiber, fluid
conduction Dizziness intake and eTreat with Tylenol
Heart failure 3. Increase dietary fiber, fluid
intake and exercise
Angiotension- Capotopril, • Prevents production of Dry cough Hypertension 1. treat with Tylenol
converting enalapril, benazepril angiotension II, causing Drop in BP during Management of 2. increase dietary fiber, fluid
enzyme inhibitors system vasodilation first 1-3 hours CHF intake and exercise
following first dose 3. advise clients to change
Dizziness, position slowly
orthostatic 4. monitor BP, weight, signs to
hypotension CHF resolution
Antihypertensives Hydralazine • Relaxes smooth muscle Tachycardia, Hypertension; 1. monitor heart rate and Compliance is
hydrochloride, palpitation congestive heart rhythm biggest problem
prazosin Orthostatic failure 2. teach client to stand up, take because side effects
hydrochloride hypotension stairs and move around slowly are worse than the
Headache, dizziness 3. treat with Tylenol. Teach disease
Nausea, vomiting, client to lie down if dizzy Side effects can be
diarrhea, anorexia 4. give with meals minimized by
Weight gain 5. give diuretic if needed adjusting dose or
changing drugs
Compliance may be
increased by giving
drugs qd rather than
several times daily
Antihypertensive Methyldopa • Sympatholytic Drowsiness, Hypertension 1. teach client that drug may
sedation cause drowsiness and to stand
Orthostatic up, take stairs and move
hypotension around slowly
Nausea, vomiting 2. give with meals
Dry mouth 3. provide fluids, hard candy
Edema, weight gain 4. weigh daily
5. give diuretic if needed
Agents for Fluid and Thiazides and Chlorothiazide, • Inhibit sodium Hypokalemia Hypertension 1. monitor intake and output, Give in the morning
Electrolyte Balance thiazide-like hydrochlorothiazide, absorption In the kidney Altered glucose Edema weight and potassium level to prevent nocturia
diuretics chlorthalidone, • Increase excretion of metabolism 2. teach client to increase High risk of digitalis
quinethazone sodium and water dietary potassium intake toxicity due to
3. observe for signs of potassium depletion
hypokalemia
4. monitor blood sugar
5. observe for signs of
hyperglycemia
Loop diuretics Furosemide, • Inhibit sodium and Fluid and electrolyte Edema 1. monitor intake and output, Give in the morning
ethacrynate chloride rearbsorption in imbalance Pulmonary edema weight and serum electrolytes to prevent nocturia
 sodium, ethacrynic the kidney Hypokalemia 2. teach clients to increase High risk of digitalis
acid • Increase excretion of Hyponatremia dietary potassium intake toxicity due to
sodium and water Hypochloremia 3. observe for signs of potassium depletion
Hypocalcemia Hypokalemia Lasix is similar in
Dehydration 4. teach clients to stand up, appearance to
Orthostatic take the stairs and move slowly digoxin
hypotension
Carbonic Acetazolamide • Promote urinary Acidosis Edema 1. use for short-term treatment
anhydrase excretion of sodium, Hypokalemia Glaucoma or use intermittent
inhibitor diuretics potassium, bicarbonate, administration schedule
and water 2. monitor intake and output,
weight and serum electrolytes
3. teach client to increase
dietary potassium intake
4. observe for signs of
hypokalemia
Miscellaneous Spinorolactone, • Increased excretion of Hyperkalemia Edema 1. monitor intake and output, May be used in
diuretics triamterene water and sodium Hypertension weight and serum electrolytes combination with
• Reduces potassium 2. teach client to avoid potassium depleting
excretion excessive dietary potassium diuretics
Miscellaneous Mannitol • Increased osmotic Fluid and electrolyte Oliguria 1. monitor vital sign including IV solution may
diuretics pressure of glomerular imbalances Edema central venous pressure hourly crystalize.
filtrate Transient plasma Increased 2. insert Foley, record urine Redissolve before
• Increased excretion of volume increase intraocular output hourly infusing by warming
water and electrolytes Pulmonary edema pressure 3. monitor weight, intake and bottle and shaking
Cellular dehydration Increased output and serum sodium and
intracranial potassium
pressure
Electrolyte Potassium chloride • Necessary for cardiac Cardiac arrhythmias, Hypokalemia 1. give IV infusions as dilute
replacement drugs contration, renal function heart block, cardiac solution infused slowly
and transmission of nerve arrest 2. monitor EKG and serum
impulses potassium levels
3. give oral dose with meals
and plenty of fluids
Penicillin Amoxicillin, • Bactericidal Hypersensitivity: Gram (+) cocci & 5. Obtain client history Resistant strains may
Antimicrobial Agents Ampicillin, • Inhibits cell wall rash, urticaria, some Gram (-) 6. Observe for hypersensitivity develop
Cloxacillin synthesis anaphylaxis cocci 7. Take meds as ordered
8. Give 1-2 hours before meals
or 2-3 hours after meals for
best absorption
Cephalosphorins Cefazolin, • Both bactericidal and Hypersensitivity • Gram (+) cocci 1. Obtain client history •May cause false
Cephalexin, bacteriostatic Local irritation at & some Gram (-) 2. Change IV sites after 3 days positive urine
Cephalotin sodium injection site cocci 3. Caution in patients w/ renal glucose test
 • Inhibits cell wall • Prophylaxis problem • Excreted
synthesis before operation unchanged in urine
Aminoglycosides Gentamicin, • Both bactericidal and Renal toxicity • serious bacterial 1. Weigh client to obtain
Neomycin, bacteriostatic Ototoxicity infections baseline renal function
Tobramycin, Inhibits cell wall synthesis • Bowel sterility studies
Streptomycin before 2. Monitor output, urinalysis,
gastrointestinal BUN and creatinine levels
surgery 3. Increase fluid intake
4. Evaluate client’s hearing
before and during
medication
Sulfonamides Sulfisoxazole

Central nervous Non-Narcotic Apirin • Analgesic Prolonged bleeding Arthritis 1. Teach client who takes Contraindicated for
System Drugs Analgesics • Antipyretic time Mild pain large doses for a long children under 18
• Anti-inflammatory Nausea, vomiting, GI fever time to watch for signs years old because
distress of bleeding use of aspirin for
2. Give with meals, milk children has been
or antacids linked to reye’s
syndrome
Narcotic Codeine sulfate • Alter perception of pain Respiratory Moderate to severe 1. Monitor respirations Naloxone is used to
Analgesics Meperidinine depression pain before and during reverse narcotic-
hydrochloride Hypotension. treatment induced respiratory
Morphine sulfate Bradycardia 2. Monitor BP and pulse depression
Sedation, clouded 3. Teach client to avoid
sensorium, euphoria activities that require
Nausea, vomiting, alertness
constipation
Anticonvulsants Phenytoin sodium • Inhibits spread of Ataxia Grand mal seizure 1. Determine if ataxia is a Do not mix with 5%
seizure activity Gingival hyperplasia symptom of the dextrose because
disease or a toxic precipitation will
effect of the drug occur
2. Teach client to avoid
activities that require
alertness
3. Use only clear
solutions for infusion
4. Good oral hygine and
regular dental care
Autonomic Nervous Cholinergic Benztropine • Parasympatholytic Anticholinergic Parkinson’s 1. Provide fluids, hard Elderly patients
System Drugs Blockers mesylate, biperiden Blurred vision disease candy. Ice chips particularly sensitive
hydrochloride, Dry mouth Extra pyramidal 2. Increase dietary fiber, to sideeffects
 procyclidine Constipation symptoms fluid intake and Can produce
hydrochloride, Urinary retention associated with exercise euphoria and have
trihexphenidyl Orthostatic antipsychotics 3. Monitor intake and abuse potential
hydrochloride hypotension output
drowsiness 4. Monitor BP
5. Teach client to avoid
activity that requires
alertness
Gastrointestinal Antacids Aluminum • Reduce acid in GI tract Constipation Peptic ulcers 1. Record amount and
Drugs hydroxide • Decrease pepsin Hypernatremia consisting of stools
Calcium carbonate activity Hypermagnesemia 2. increase
Aluminum hypophosphatemia
magnesium
complex
Antiemetics Prochlorperazine • Acts centrally by Drowsiness, Nausea and 1. Teach client to avoid
maleate blocking dizziness vomitting activities that require
Trimethobenzamide chermoreceptor trigger alertness
hydrochloride zone, which acts on
vomiting center
Ulcer Medications propantheline • Anticholinergic Drowsiness, Peptic ulcer 1. Teach client to avoid
dizziness, blurred activities that require
vision alertness
Hormonal Agents Steroids Cortisone acetate • Anti-inflammatory Adrenal
Dexamethasone insufficiency
prednisone Allergic
inflammation,
edema,
immunosupression
Insulins Semilente regular • Facilitates transport of Hypoglycemia Diabetes mellitus 1. Give orange juice or Refrigeration is
insulin glucose into cells hyperglycemia candy PO recommended but
Lente NPH • Lowers serum glucose 2. Give rapid acting not required
Ultralente level insulin
Protamine
Sulfonylureas Tolbutamide • Increase insulin release hypoglycemia Adult onset, non- 1. Teach client to take in
Chlorpropamide from the pancreas hepatotoxicity insulin dependent morning to avoid
tolazamide Diabetes mellitus hypoglycemic reaction
at night
2. 2. Avoid OTS
medications and
alcohol
Hematologic Agents Hematinics Ferrous sulfate • Source of iron Nausea, Iron deficiency 1. Absorption best if given Vitamin C may
replacement constipation,black anemia between meals increase absorption
stool 2. 2. For GI upset, give

Anticoagulants Heparin sodium • Prevents conversion of
fibrinogen to fibrin, and
prothrombin
Antineoplastics • Act by many different
mechanisms, most
affected DNA synthesis
or function
Obstetrics Oxytocics oxytocin • Stimulates contractions
of the uterus
Uterine Relaxants Ritrodine • Inhibits contraction of
hydrochloride uterine smooth muscle
Uterine Relaxants Terbutaline sulfate • Relaxes uterine smooth
muscle
with meals or orange
juice
3. 3. Teach client to
increase dietary fiber,
fluid intake and
exercise
hemorrhage Hrombosis 1. Monitor platelet count IV absorption is more
Pulmonary 2. Monitor partial regular than
embolism thromboplastintime subcutaneous
Myocardial (PTT) injection
infarction 3. Avoid salicylates PTT should be 1.5 or
4. Observe for bledding 2 times control value
gums, bruises, nose Anttagonist is
bleeds, and petechiae protamine sulfate
Many caused bone Cancer 1. Assess for signs of
marrow depression, Chemotheraphy infection
nausea, vomiting 2. Monitor platelet count
and mouth ulcers 3. Monitor IV site
carefully, ensure
patency, follow
protocols for infiltration
to prevent tissue,
ulceration and necrosis
4. Wear gloves, masks,
gowns while handling
or preparing
medication; discard
equipment in
designated containers
Hypotension Induction of labor 1. Monitor uterine contractions, Use only when pelvis
Tachycardia fetal blood pressure, heart rate is adequate, vaginal
bradycardia or and fetal heart rate delivery is indicted,
tachycardia 2. Monitor intake and output fetus is mature, and
Decreased urine fetal position is
output favorable
Hypotension Premature labor 1. Monitor blood pressure and
hypertension pulse
2. Heart rate and fetal heart
rate
Nervousness Premature labor 1. Monitor blood pressure and Use cautiously in
Tremors pulse clients with diabetes,
Headache 2. Heart rate and fetal heart heart disease and
rate hypertension
 Anticonvulsants Magnesium sulfate • Anticonvulsant Respiratory Primary 1. Hold drug if respirations less Antidote is calcium
ddepression intracerebral than 16/12 gluconate
Heart block hemorrhage 2. Monitor for arrhythmias
Circulatory collapse 3. Monitor intake and output
Increased 4. Observe for neuromuscular
magnesium or respiratory depresiion
Antidotes Calcium gluconate • Needed for Bradycardia Hypermagnesemia 1. Monitor pulse Contraindicated in
nervous Arrhythmias 2. Monitor for arrhythmias digitalized clients
musculoskeletal Venous irritation 3. Assess IV site
enzyme reactions,
cardiac
contraction, blood
coagulation. And
endocrine and
exocrine
secretions
Estrogens Estradiol • Hormone needed Hypoglycemia Prevent 1. Observe glucose in diabetics
for adequate Dizziness, postpartum breasts 2. Monitor weight
functioning of hypotension engorgement 3. Report headache, chest pain
female Nausea, vomiting
reproductive Appetite increase,
system; inhibits weight gain
ovulation embolism
• Promotes calcium
use in bone
structure
Narcotic Naloxone • Interferes with Rapid pulse Treatment of 1. Monitor respiratory rate and
Antagonists narcotic Drowsiness, narcotic induced depth of neonate
absorption at nervousness depression of
narcotic receptor Nausea, vomitting neonate
sites
Anti-Inflammatory Betamethasone • Corticosteroid GI Stimulate lung 1. Monitor temperature Do not abruptly
Drugs distress,hemorrhage, development in 2. Monitor blood pressure, discontinue; adrenal
pancreatitis infant report chest pain crisis can occur
Poor wound healing
CNS depression,
flushing, sweating
Thrombocytopenis
Hypertension, circ.
Collapse, embolism
Eye Medications Miotics • Pupilllary Myopia Glaucoma 1.Usually disappears after 10- Pressed inner
constriction Blurred vision Surgical 40 days of treatment canthus for a minute
 procedures on the or two to decrease
eye systemic absorption
Mydriatics Pupillary dilatation, Blurred vision Acute inflammation 1.Warn client about temporary
cycloplegia Photphobia of the eye blurring of vision
Diagnostic 2.Dark glasses
procedure 3.Teach client not to drive until
vision clear
Anti-anxiety agents Benzodiazepine CNS depression
Compounds Muscle relaxant
anticonvulsant
Sedating CNS depresant Preopretive
Antihistamines medication
Anxiolytics buspirone Unknown Relief of short trem 1.Teach 2-3 week lag time
anxiety before therapeutic effect
achieved
2.Monitor BP, pilse
Beta-Blockers Propranolol Non-selective B-blocker Dizziness, confusion Anxiety disoreders 1.Observe carefully
Clonidine Hypotension, Narcotic 2.Monitor when out of bed
bradycardia withdrawal 3.Monitor BP, pulse
Dry mouth convulsions 4.Increase fluids
Drowsiness,
sedation
Sedative- Flurazepam Produces CNS depression Drowsiness, Sleep disturbance 1.Observe carefully
Hypnotics Termazepam and sedation dizinnes, of anxiatey 2.Advice caution when out of
Triazolam lighthedeadness Short term use bed
only 3.Suicide assessment
4.Obtain emergency medical
tretament
Anti-depressant Tetracyclic Amoxapine Blocks re-uptake of Agranulocytosis depression 1.Monitor CBC
agents Antidepressants Maprotiline norepinephrine and Hypotension 2.Caution to stand up slowly
serotonin into nerve Paralytic ileus 3.Observe for nausea and
endings vomitting
Tricyclic Imipramine Blocks re-uptake of Agranulocytosis Major depressive 1.Monitor CBC
Antidepressants Desipramine norepinephrine and Hypotension disorders 2.Caution to stand up slowly
Amitriptyline serotonin into nerve Paralytic ileus Agoraphobia 3.Observe for nausea and
nortriptyline endings Panic disorders vomitting
Obsessive
compulsive
disorder
Psychogenic pain
disoreder
MAO Inhibitors Beacuase of
dietary restrictions,
 use as second line
antidepressant if
other
antidepressants
not effective
Mood stabilizers Mood Stabilizers Lithium carbonate Alters Na, K, and ion Bipolar disorder,
transport in nerve; manic phase
interferes with balance of Major depression
epinephrine and serotonin Aggressive
in CNS, thereby affecting conduct disorder
emotional responses