Medications Generic / Trade Dose/Route/ Time (Frequency) Class/Rationale for the patient Contraindication Mechanism of action

Onset of action Common side effects / food and drug Interaction SE: Confusion, epidural or spinal hematoma, fever, paralysis, stroke Interactions: cefamandole, cefoperazone, cefotetan, plicamycin, valproic acid: Possibly increased risk of hemorrhage NSAIDs; oral anticoagulants; platelet aggregation inhibitors, such as aspirin, and ticlopidine; thrombolytics, such as streptokinase, and urokinase: Possibly increased risk of bleeding SE: Hearing loss, tinnitus Interaction: ACE inhibitors: Decreased Nursing considerations

Enoxapain (Lovenox)

30mg, 0.3ml SubQ daily Injection

Antithrombotic/ Patient is taking this medication to prevent DVT

Active major bleeding; hypersensitivity to benzyl alcohol (if only the multidose vial is available), enoxaparin, heparin (including low-molecularweight heparins), or pork products; thrombocytopenia and positive antiplatelet antibody test while taking lowmolecular-weight heparins

Potentiates the action of antithrombin III, a coagulation inhibitor. By binding with antithrombin III, enoxaparin rapidly binds with and inactivates clotting factors (primarily thrombin and factor Xa). Without thrombin, fibrinogen can¶t convert to fibrin and clots can¶t form

Use enoxaparin with extreme caution in patients with a history of heparin-induced thrombocytopenia or increased risk of hemorrhage. Use cautiously in those with bleeding diathesis, diabetic retinopathy, hepatic or renal impairment, recent GI ulceration or hemorrhage, or uncontrolled hypertension. Expect delayed elimination in elderly patients and those with renal insufficiency. Don't crush timedrelease or controlled -release aspirin tablets

Aspirin (acetylsalicylic acid)

325mg, 1 tab oral

Anti-inflammatory, antiplatelet, antipyretic/ Patient is taking this medication for antiplatelet

Hypersensitivity to aspirin, allergy to tartrazine dye, asthma, bleeding problems (such as hemophilia), peptic

Aspirin inhibits platelet aggregation by interfering with the production of throm-boxane A2, a substance that stimulates platelet

prophylactics

ulcer diseas

aggregation.

antihypertensive effect unless antacids, urine directed. alkalinizers: Ask about tinnitus. Decreased aspirin This reaction effectiveness usually occurs anticoagulants: when blood aspirin Increased risk of level reaches or bleeding; prolonged exceeds maximum bleeding time for therapeutic effect. SE: infection at the site of injection, venous thrombosis or phlebitis extending from the site of injection, extravasation, and hypervolemia. Be aware that hypertonic (1.8%) and hypotonic (0.45%) saline solutions exist. Ensure appropriat e concentrat ion before use.

N5 9 % Normal Saline

1,000 Ml, IV , 100ml/hr

Isotonic expander/ patient is taking this medication to increase blood volume before giving any vasopressin

Severe Hypertens ion Pulmonary edema

Normal Saline is a sterile, nonpyrogenic solution for fluid and electrolyte replenishment.

Interactions: Compatible with most, if not Check individual medications before administration.

Vanomycin

700mg IV, Q36H

Antibiotic/ Patient is taking this medication for her infection and pneumonia

Hypersensitivity to vancomycin or its components, hypersensitivity to corn or corn products when vancomycin is given with dextrose solutions

-Inhibits bacterial RNA and cell wall synthesis; alters permeability of bacterial membranes, causing cell wall lysis and cell death.

SE: anxiousness, dizziness, fatigue, fever, headache, Interactions: Phenobarital: decreased amount of circulating montelukast

-Be aware that drug should not be given for acute asthma attack ot status asthmaticus -Be are that montelukast should not be abruptly substituted for inhaled or oral cosrticosterioids, expect to taper corticosteroid disease gradually. -Monitor patient for adverse reactions, such as cardiac and pulmonary symptoms

Dronedarone (Hydrochloride ) 400mg Tab Class I or III antiarrhythmics/ Patient is taking this medication for his heart condition .

Decrease alkaline phosphatase levels may signal onset of hypercalcemia. hypercalemia. Insulin aspart (Novolog) 2 units INJ sub AC Blood sugar: 114 -Insulin coverage Q6H Antidiabetc agent / patient has a history of diabetes mellitus Hypersensitivity to insulin asparte -lower blood glucose by stimulating glucose reuptake in skeletal muscle and fat. parathyroid hormone levels. inhibiting hepatic glucose production. serum creatinine. decrease efficacy especially with chronic mineral oil use. urticaria Interaction: beta blockers may alter glucose metabolism. alkaline phosphatase.000 In Units cap) Dose/Route/ Time (Frequency) 50. anorexia. vomiting. 24hour urine calcium periodically. 000 Int/units =1 cap. Nursing considerations Hypersensitivity. oral. weakness Interactions: use with mineral oil may cause oral fat soluble vitamin malabsorption. anemia. malaise. combo with thiazide may increase risk of hypercalcemia. hyperphosphatemia. nausea.Medications Generic / Trade Ergocalciferol (Vitamin D2 50. once. now Class/Rationale for the patient Fat-soluble vitamin/ patient¶s vitamin D2 level is low thus this supplement will correct this fat soluble Contraindication Mechanism of action Onset of action Stimulates intestinal calcium and phosphorus absorption. sitmulates bone mineralization Common side effects / food and drug Interaction SE: headache. mask hypoglycemia -Watch for signs and symptoms of hypoglycemia and hyperglycemia and know what to do if they occur . vitamin D toxicity -Monitor BUN. urinary calcium/creatinine ratio. SE: hypoglycemia. prolong hypoglycemia.

1 tab. dizziness. ileus Inhibits phosphate absorption in the intestine by binding dietary phosphate. which are SE: anxiousness. or severe GI disorder (including severe constipation) because drug prevents phosphate absorption.Give other drugs at least 1 hour before or 3 hours after sevelamer to prevent interaction. tetracyclines. -Monitor blood pressure frequently. thereby lowering serum phosphorus level. constipation (severe). thrombosis Nasopharyngitis Abdominal pain. -Be aware that severe hypophosphatemia may occur in-patient with dysphagia. -Monitor serum phosphorus level to determine drug¶s effectiveness. fecal impaction. digoxin. indigestion. nausea. ileus. theophylline. diarrhea. oral Qevening Antiasthmatic/ Patient is diagnosed with hospital acquired pneumonia as -Hypersensitive to drug/class -antagonized receptor for cysteinyl leukotrienes. liothyronine. fever Hypertension. intestinal obstruction oir perforation.Sevelamer (Sevelamer HCL 800mg cap Oral TID Antihyperphosphatemic/ patient has a history of end stage renal disease Fecal impaction. to detect imbalance Montelukast (Singulair) 10mg. hypotension. SE: Headache. -Be aware that drug should not be given for acute asthma attack ot status . hypophosphatemia. quinolones. vomiting Interactions: antiarrhythmics. fatigue. levothyroxine. warfarin: Possibly altered absorption of these drugs . flatulence. especially bicarbonate and chloride. . GI obstruction.Monitor other serum electrolyte levels. major GI tract surgery. anticonvulsants. hypersensitivity to sevelamer or its components.

. bronchilator / Patient¶s chest X-ray shows pulmonary congestion with left inferior lung infiltrate . asthma. GI bleeding. peptic ulcer disease Preventing clotting by keeping the platelet aggregating substance from forming. hearing loss. occult bleeding Interaction: increase effects with anticoagulants -Monitor patients closely because they may be more susceptible to aspirin¶s toxic effects. Allergy to tartrazine dye.shown in the chest-X-ray which shows pulmonary vascular congestion. Patient is taking this medication to prevent asthma produced by arachidonic acid metanolim and released from mast cells. Interactions: Phenobarital: decreased amount of circulating montelukast asthmaticus -Be are that montelukast should not be abruptly substituted for inhaled or oral cosrticosterioids. bleeding problems (such as hemophilia). headache. SE: tinnitus. fever. such as cardiac and pulmonary symptoms Ipratripium (Atrovent) 0. -Monitor patient for adverse reactions.5mg-2. expect to taper corticosteroid disease gradually.5ml Anticholinergic.

heparin inhibits factor Xa and prevents the conversion of prothrombin to thrombin SE: Chills. severe thrombocytopenia. uncontrolled bleeding. headache. stroke Interaction: aminoglycosides: Additive or synergistic effects against some Obtain blood. peripheral neuropathy Interactions: Antihistamines. Patient is taking this medication for prophylactic. At low doses. nicotine. -Hypersensitive to heparin or its components. or GI ulce Piperacillin (Tazobactam) 2. sulfinpyrazone: Increased platelet inhibition and risk of bleeding -Use heparin cautiously in alcoholics. seizures. fever. lethargy. and patients with mild hepatic or renal disease or a history of allergies. sputum. or other samples for culture and sensitivity testing. enhancing antithrombin III¶s inactivation of the coagulation enzymes thrombin (factor IIa) and factors Xa and XIa. Expect to begin piperacillin therapy before results are available. menstruating women. digoxin. or their components Binds to specific penicillin-binding proteins and inhibits the third and final stage of bacterial cell wall synthesis by interfering with an autolysin inhibitor. platelet aggregation inhibitors. Be aware that sunlight may darken . before giving piperacillin. penicillins. as ordered. dizziness. except in DIC Binds with antithrombin III. asthma. especially women.Heparin 5000 units/ml Injection 1 mL Anticoagulant /Patient has a history of coronary artery disease. headache. tetracyclines: Decreased anticoagulant effect of heparin aspirin. Uninhibited autolytic enzymes destroy the cell wall and result in SE: Dizziness. fever. patients over age 60. hallucinations. NSAIDs.25gm=1 vial IV Push Ampicillin/ Patient has pneumonia with lower respiratory tract infection Hypersensitivity to cephalosporins.

possibly mutual inactivation piperacillin powder for dilution but won¶t alter drug potency.cell lysis. . bacteria.

ECG is recommended -Teach patient to report unusual fatigue Hypersenstive to drug/class. diarrhea. renal impairment. Acid/ Base/patient is taking this supplement since she is on NPO diet to prevent hypokalemia Contraindication Mechanism of action Onset of action Phosphorous is an essential component and participant in physiologic systems and reaction Common side effects / food and drug Interaction SE: abdominal pain. inhibiting hepatic glucose production. Insulin aspart (Novolog) 5 units INJ sub AC -Insulin coverage Q6H Antidiabetc agent / patient has a history of diabetes mellitus type 2 Hypersensitivity to insulin asparte -lower blood glucose by stimulating glucose reuptake in skeletal muscle and fat. hyperphosphatemia. or acidosis. prolong hypoglycemia.Medications Generic / Trade Potassium phosphate Dose/Route/ Time (Frequency) IV 42./hr for 6 hours once a day Class/Rationale for the patient Genitourinary. renal impairment. mask hypoglycemia -Watch for signs and symptoms of hypoglycemia and hyperglycemia and know what to do if they occur .5 ml. SE: hypoglycemia. urticaria Interaction: beta blockers may alter glucose metabolism. furesomide Nursing considerations -Monitor plasma potassium levels in patients with cardiac disease. nausea/vomiting. weakness Interactions: may increase risk of hyperkalemia with ACE inhibitor. monitor of acid-base balance. hyperkalemia. confusion.

incompatible with multiple antibiotic-administer drugs separately . amino acid derivative/ patient just had a CT with radioconstrate therefore this medication will help reduce the radiocontrast induced renal dysfunction Hypersensitive to drug/class/compone nt Except for acetaminophen overdose tx duse. -Caution if inadequate cough -caution in patients with asthma and GI bleeding risk Decreases the buildup of a hepatotoxic metabolite and degrades mucus. glucose and electrolytes -Notify HCP if nausea. Ag. copper. stomach. constipation. pain. - . vomiting or urticaria occurs.Unexplained elevated LFTs -Inhibits 3 hydroxy-3methyglutarylcoe nzyme A (HMGCoA) reductase to reduce cholesterol levels SE: weakness. myopathy. ECG. clear airway before aerosol administration -Monitor LFTs. allowing easier mobilization and can prevent radiocontrastinduced renal dysfunction SE: bronchospasm (inhaled) drowsiness Interactions: discolor with rubber. Rosuvastain (Rosuvastatain) 10 mg TAB oral Qbedtime Antilipemic HMGCoA reductase inhibitor/Patient has a history of high cholesterols -Hypersensitive to drug/class -Hepatic disease . diarrhea Interactions: Avoid Atorvastatin duplicate therapy due to increase risk of elevated LFTs.Acetylcysteine (Mucomyst) 600mg cap BID Mucolytic. rhabdomyolysis -Do not stop using rosuvastain without first talking to the doctor.Inform patient of increase productive cough. iron.

. bleeding problems (such as hemophilia). SE: tinnitus. GI bleeding. Patient is taking this drug to prevent heart disease. asthma. peptic ulcer disease Preventing clotting by keeping the platelet aggregating substance from forming. occult bleeding Interaction: increase effects with anticoagulants -Monitor patients closely because they may be more susceptible to aspirin¶s toxic effects.Acetylsalicylic acid (Aspirin) 81 mg oral once a day oral Analgesics / Patient has history of high cholesterol levels. hearing loss. Allergy to tartrazine dye.

Levetiracetam (KepPRA) 250 mg Tab Anticonvulsant/ patient has a history of seizure and epilepsy Hypersensitivity to levetiracetam or its components Protect against secondary generalized seizure activity by preventing coordination of epileptiform burst firing. increased risk of bleeding with NSAIDs Nursing considerations -use motrin with extreme caution in patients with a history of ulcer disease or GI bleeding -Be aware of serious GI tract ulcerations Anti-inflammatory and analgesic /P patient has a history of arthritis Coronary artery bypass graft surgery. the enzyme needed to synthesize prostaglandins. alcohol. depersonalization & dizzines Interaction: Keppra may increase the effects of other drugs such as antidepressant. -Assess compliance during first 4 weeks of therapy. & asthma. Expect to taper dosage gradually. headache. Common side effects / food and drug Interaction SE: dizziness. known hypersensitivity to ibuprofen. nervousiness Interactions: possibly increased renal effects with acetaminophen.Medications Generic / Trade Ibuprofen (Motrin 600mg tab) Dose/Route/ Time (Frequency) 600mg tab as needed Class/Rationale for the patient Contraindication Mechanism of action Onset of action Blocks the activity of cyclooxygenase. ataxia. SE: anger. antihistamines and sedatives. . confusion. when adverse reactions are most common -Stopping drug may increase seizure activity.

abdominal pain. heparin drug will decrease anticoagulant effects. somnolence. opiord analgesic will increased orthostatic hypotension . especially during first 3 months -monitor therapeutic oxcarbazepine levels during initiation and . SE: dizziness.0. tremor. and press edge to seal. Apply patch to hairless area. cerebral hemorrhage Interact with nitrate receptors in vascular smooth muscle cell membrane. medication will relieve chest pain.use nitroglycerin cautiously in elderly patients/ Don¶t break or crush ER tablets or capsules. Acute MI (SL). 150 mg table oral Oxcarbazepine (Trileptal) Anticonvulsant/Patie nt had a history of seizure Hypersensivity to carbamazepine. Have patient sawllow them whole with a full glass of water. valproic acid decreased blood oxcarbazepine level. increase blood levels of Phenobarbital and phentoin felodipine -monitor serum sodium level for signs of hyponatremia. headache Interactions: Carbamazepine. insomnia.2 mg/hr patch Nitroglycerin Antianginal. SE: anxiety. syncope Interactions: any acetycholine and norepinephrine will decreased therapeutic effects of these drugs. antihypertensive/ patient has chest pain thus. nausea. phenytoin. dizziness. angle-closure glaucoma. or their components Halt seizures by closing or blocking sodium channels in neuronal cell membrane. -Open transdermal match immediately before use. phenobarital. oxcarbazepine.

GI bleeding. . occult bleeding Interaction: increase effects with anticoagulants -Monitor patients closely because they may be more susceptible to aspirin¶s toxic effects. Acetylsalicylic acid (Aspirin) 81 mg oral once a day oral Analgesics / Patient has chest pain and high cholesterol level. Allergy to tartrazine dye. Patient is taking this drug to prevent heart attack. hearing loss. asthma.titration. peptic ulcer disease Preventing clotting by keeping the platelet aggregating substance from forming. bleeding problems(such as hemophilia). SE: tinnitus.

or uncontrolled hypertension.Medications Generic / Trade Dose/Route/ Time (Frequency) Class/Rationale for the patient Contraindication Mechanism of action Onset of action Common side effects / food and drug Interaction SE: Confusion. platelet aggregation inhibitors. thrombocytopenia and positive antiplatelet antibody test while taking lowmolecular-weight heparins Potentiates the action of antithrombin III. heparin (including lowmolecular-weight heparins). peptic Aspirin inhibits platelet aggregation by interfering with the production of throm-boxane A2. By binding with antithrombin III. antiplatelet. oral anticoagulants. and ticlopidine.4ml subQ Antithrombotic/ Patient is taking this medication to prevent DVT Active major bleeding. recent GI ulceration or hemorrhage. bleeding problems (such as hemophilia). Aspirin (acetylsalicylic acid) 81mg. antihypertensive effect This reaction . and urokinase: Possibly increased risk of bleeding SE: Hearing loss. Use cautiously in those with bleeding diathesis. 0. such as streptokinase. valproic acid: Possibly increased risk of hemorrhage NSAIDs. cefoperazone. Expect delayed elimination in elderly patients and those with renal insufficiency. diabetic retinopathy. inhibitors: Decreased Ask about tinnitus. enoxaparin rapidly binds with and inactivates clotting factors (primarily thrombin and factor Xa). such as aspirin. asthma. a substance that stimulates platelet Don't crush timedrelease or controlled-release aspirin tablets Interaction: ACE unless directed. or pork products. stroke Interactions: cefamandole. epidural or spinal hematoma. enoxaparin. antipyretic/ Patient is taking this medication for antiplatelet Hypersensitivity to aspirin. 1 tab oral Anti-inflammatory. allergy to tartrazine dye. hepatic or renal impairment. cefotetan. thrombolytics. tinnitus Nursing considerations Enoxapain (Lovenox) 40 mg. paralysis. a coagulation inhibitor. fibrinogen can¶t convert to fibrin and clots can¶t form Use enoxaparin with extreme caution in patients with a history of heparin-induced thrombocytopenia or increased risk of hemorrhage. hypersensitivity to benzyl alcohol (if only the multidose vial is available). fever. plicamycin. Without thrombin.

Methylprednisolone (Solumedrol) 40mg. prolonged bleeding time usually occurs when blood aspirin level reaches or exceeds maximum for therapeutic effect. hypersensitivity to methylprednisolone or its components. antacids. restlessness and drowsiness Interactions: Increase risk of serotonin syndrome with sertraline.M. urine alkalinizers: Decreased aspirin effectiveness Anticoagulants: Increased risk of bleeding.prophylactics ulcer disease aggregation. To treat GERD by binding to intracellular glucocorticoid receptors and suppressing inflammatory and immune responses SE: dystonic reaction common with high doses. venlafaxine -Monitor for extrapyramidal effects . 1mL IV INJ Q8H Steroid ant0inflammatory / patient is taking this medication to preventive symptoms of GERD Fungal infection. fluid retention. idiopathic thrombocytopenic purpura (I.

psychotic disorders. weakness. hepatic dysfunction. Interactions: Anticholinergics: Increased anticholinergic effects. SE: Abnormal gait. arrhythmias. altered thermoregulation. atrial flutter.Be alert for and immediately report to prescriber signs of neuroleptic malignant syndrome. coronary artery disease. tachyarrhythmias/ Patient has a history of atrial fibrillation Action: slows and strengthens the force of myocardial contraction by prolonging the refractory period f the atrioventricular (AV) node SE: fatigue. Carvedilol (Coreg 12. and acute agitation Blood dyscrasias. bradycardia. cerebral arteriosclerosis. 1. altered thermoregulation Antihypertensives: Increased effects of both drugs. akathisia. agitation.Olanzapine (Zyprexa) 25m oral QBedtime Antipyschotic / Patient is taking this to prevent schizophrenia. Vomiting Interactions: increase effects with alprazolam. bone marrow depression. amiodarone. inotropic agent/cardiac glycoside Use/Rationale: treatment of atrial fibrillation. coma. nausea. headache.5mg Tab) Class: Antihypertensive agent/Beta-adrenergeic receptor blocker (beta-blockers . Digoxin (Digoxin 0. hypersensitivity to olanzapine or its components -May achieve its antipsychotic effects by antagonizing dopamine and serotonin receptors.125mg Tab) Class: Antiarrhythmic agent. highdose CNS depressants. and CHF. increased risk of hypotension . beta-blockers and NSAIDs Contraindication: drug hypersensitivity 2. azoleantifungals.

MAOIs 3. essential for nerve conduction. weakness. peripheral edema. bradycardia. Interactions: increase with K+ sparing diuretics. chest pain. nervousness. resulting in inhibition of excitation of muscle. Ditiazem (Cardizem) 120 mg/24 hours CD cap Class: antianginal agent. antiarrhythmic agent (Class IV). hypotension Interaction: use with cimetidine may increase risk of bradycardia. weakness. nervousness. hyperglycemia Interactions: increase effects with cimetidine. salt substitutes 4. antihypertensive agent and calcium channel blockers Use/rational: treatment of hypertension and arrhythmias/ Patient is on this medication for hypertension and atrial fibrillation. Clonidine. essential for contraction of cardiac skeletal and smooth muscle SE: confusion. use with amiodarone may increase risk of hypotension. bradycardia . restlessness. Prevention of MI and decrease of mortality in clients with recent MI/ Patient is taking this medication because of his history of hypertension and heart problems Action: blocks stimulation of beta1 adrenergic receptors. anxiety. Do not usually affect beta2 adrenergic receptor site if cardioslective SE: fatigue.Use/Rationale: treatment of hypertension. depression. Potassium chloride (Potassium chloride 20 mEq/15ml Liq 15ml) Class: mineral and electrolyte replacement and or supplement Use/Rational: Treatment and prevention of depletion of mineral and electrolytes/ Patient is taking this medication due to hypokalemia Actions: maintains acid-base balance. mask hypoglycemia. confusion. SE: nervousness. bradycardia. ECG changes. Actions: inhibit transport of calcium into myocardial and vascular smooth muscle cells. arrhythmias. weakness.

mask hypoglycemia. azoleantifungals. hyperglycemia Interactions: increase effects with cimetidine. Do not usually affect beta2 adrenergic receptor site if cardioslective SE: fatigue. atrial flutter. tachyarrhythmias/ Patient has a history of atrial fibrillation Action: slows and strengthens the force of myocardial contraction by prolonging the refractory period f the atrioventricular (AV) node SE: fatigue. inotropic agent/cardiac glycoside Use/Rationale: treatment of atrial fibrillation.1. Vomiting Interactions: increase effects with alprazolam. nausea. depression. MAOIs 3. Clonidine. beta-blockers and NSAIDs 2. Carvedilol (Coreg 12. amiodarone. weakness. arrhythmias.5mg Tab) Class: Antihypertensive agent/Beta-adrenergeic receptor blocker (beta-blockers Use/Rationale: treatment of hypertension. nervousness. headache. bradycardia. Digoxin (Digoxin 0. and CHF. anxiety. bradycardia. weakness. Prevention of MI and decrease of mortality in clients with recent MI/ Patient is taking this medication because of his history of hypertension and heart problems Action: blocks stimulation of beta1 adrenergic receptors.125mg Tab) Class: Antiarrhythmic agent. Potassium chloride (Potassium chloride 20 mEq/15ml Liq 15ml) .

bradycardia. salt substitutes 4. peripheral edema. antiarrhythmic agent (Class IV). weakness. nervousness. essential for nerve conduction. hypotension Interaction: use with cimetidine may increase risk of bradycardia. ECG changes. Ditiazem (Cardizem) 120 mg/24 hours CD cap Class: antianginal agent. confusion. Actions: inhibit transport of calcium into myocardial and vascular smooth muscle cells. bradycardia .Class: mineral and electrolyte replacement and or supplement Use/Rational: Treatment and prevention of depletion of mineral and electrolytes/ Patient is taking this medication due to hypokalemia Actions: maintains acid-base balance. arrhythmias. resulting in inhibition of excitation of muscle. Interactions: increase with K+ sparing diuretics. SE: nervousness. use with amiodarone may increase risk of hypotension. essential for contraction of cardiac skeletal and smooth muscle SE: confusion. restlessness. weakness. chest pain. antihypertensive agent and calcium channel blockers Use/rational: treatment of hypertension and arrhythmias/ Patient is on this medication for hypertension and atrial fibrillation.

Non-Psychotic Medications Dose/Route/ Time (Frequency) Class/Rationale for the patient Range / Therapeutic Levels Mechanism of action Onset of action Common side effects / food and drug Interaction Nursing considerations Acetylsalicylic acid (Aspirin) 325 mg oral once a day Analgesics / Patient had a history of coronary artery disease. SE: tinnitus. 5% w/w Permethrin topical (Elimite cream) 60mg tropical once a day Scabicides/patient had a intense rash on his upper shoulder 10 to 30mg Acts on nerve cell membrane of the louse or mite to disrupt the Na+ sodium channel current that regulates the polarization of the membrane SE: Itching. Patient was taking this drug to prevent heart attack. 10 to 30 mg/dl Preventing clotting by keeping the platelet aggregating substance from forming. swelling Interaction: no known drug -avoid contact with the eyes. flushing eyes thoroughly with water if medication accidently gets in eyes . occult bleeding Interaction: increase effects with anticoagulants -Monitor elderly patients closely because they may be more susceptible to aspirin s toxic effects. hearing loss. mild burning or stinging. GI bleeding. redness.

5 % to 1 % Acts as anti-inflammatory action. lactation . may mask symptoms infections Clindamycin 150mg q 6h Antibiotic /patient had a rash on his upper shoulder 150-450 mg PO Binds to 50S ribosomal subunit. telaprevir -teach patient to not use alcohol. hepatic or renal dysfunction. abdominal pain. urticaria Interaction: Increased: neuromuscular blockade with neuromuscular blocking agents Decreased GI absorption with Determine if patient is allergic to clindamycin.5 % topical apply as needed Corticosteriod /patient had a rash on his upper shoulder 0. jaundice. interfering with protein synthesis SE: diarrhea. acne or changing in color Interaction: Avoid alefacept.interaction Hydrocortisone cream 0. nausea. history of asthma or other allergies. growth hormone. inhibits multiple inflammatory cytokines. produces multiple glucocorticoid SE: Drying or cracking of the skin. rash. abrupt D/C of drug. pruritus. vomiting. take with food. avoid virus vaccines.

kaolin. aluminum salts .

bradycardia. insomnia. anxiety. Atypical antipsychotic medication/ Patient was prescribed for this medication due to his mixed episodes associated with bipolar disorder and major depression Action blocks dopamine and serotonin 5-HT2 receptors in the brain. blurred vision. dizziness Interactions: increase effect with azole antifungals SE: headache. grapefruit may increase drug level. weight gain Interaction: increase effect with ketoconazole. -Monitor patient for symptoms of metabolic sydrome -watch for life threatening medical emergency such as Neuroleptic Malignant Syndrome: severe extrapyramidal: severe muscle rigidity. dry mouth. constipation Interactions: increase -Never stop drug abruptly -Monitor vital signs carefully for tardive dyskinesia. Dopamine and serotonin antagonist -Watch for evidence of neuroleptic malignant syndrome. insomnia. and beta blockers -Combining triptans with an SSRI or an SSNRI may cause serotonin syndrome. . headache.Psychotic Medications Generic / Trade Dose/Route/ Time (Frequency) Class/Rationale for the patient Range / Therapeutic Levels No therapeutic level Mechanism of action Onset of action Common side effects / food and drug Interaction SE: Confusion. somnolence. sexual dysfunction Interaction: increase effect with azole antifunals. decrease effect with carbamazepine. weight gain. No therapeutic level Action: inhibit reuptake of serotonin SE: somnolence. hallucinations. Helping balance cholinergic activity SE: dilated pupils. insomnia. Nursing considerations Quetiapine (Seroquel) 300mg oral once a day Atypical Antipsychotic/Patient was taking this medication to treat his bipolar affective disorder. thus this medication would help to prevent feelings of suicidal. anxiety. Signs and symptoms include restlessness. 2 mg oral twice a day Benztropine (Congentin) Anticholinergic medication/Patient was taking this drug to prevent EPS side effect No therapeutic level Block central cholinergic receptors. and cogwheeling 10 mg oral twice a day Aripiprazole (Abilify) No therapeutic level 20 mg oral twice a day Citalopram (Celexa) Antidepressant and SSRI/ Patient had symptoms of depression. cimetidine.

Benzodiazepine for Anxiety 1.effect with Amantadine. myalgia 1. Alert: anaphylaxis and angiooedema may occur as 2. 1mg oral Q4H 1. Use of this drug may lead to abuse and addiction. EPS. Side effect Major nursing responsibilities Rationale for this client GENERIC (TRADE) 1. phenothiazine Prescrib ed dose Psychiatric Rx(w/refs) Usual Dose range Class/Purpose 1. SE: headache. Action: works via postsynaptic GABA receptors SE: memory impair. Lorazepam (Ativan) 1. Monitor hepatic. Patient is diagnosed of anxiety. respiratory depression 2. and hematopoietic function. Don t stop drug abruptly 1. renal. dizziness. This medication is used to treat symptoms of anxiety. Patient has insomnia . 2. Indication: short term treatment for insomnia Action: hypnotic agent. Indication: treat anxiety. indication 2. 1-10 MG/D PO 1. dizziness. Action 3.

dystonia 3. Indication: schizophrenia Action: antagonizes dopamine D2 receptors serotonin 5HT2A receptors SE: akathisia. lengthening QT interval.Zolpidem(Ambien) 2. Use drug for only short time management and need sleep pill at night to make sure he has plenty of sleep. Antipsychotic/to treat schizophrenia 3. 5-10MG PO 2. 3-12MG PO 3. 10mg oral Bedtime 2. 3. Patient has a long history of schizophrenia and paranoid type . Monitor closely.2. 3. Sedative agent/ for insomnia early as first dose. 3mg ER tab oral Q morning 3. ECG changes. monitor patient for atypical ventricular tachycardia such as torsades de pointes. paliperidone (Invega) 3.

nervousness 4. mood stablizer/ to prevent mania episodes.4. 1000mg oral Qbedtim e 4. SE: dizziness. 1251000MG ORAL QBEDTIME 4. This medication is given to help control anxiety and mania episode . headache. Indication: mania.Divalproex sodium(Depakote ER) 4. for mood stabilizing 4. platelet count. mood stabilzer Action: inhibit GABA NT. and PT and INR before starting therapy 4. obtain liver function test results.

Indication: short term treatment for insomnia Action: hypnotic agent SE: headache. 5-10MG PO 2. Monitor closely. Indication: to treat anxiety. 3. dizziness. 10mg oral Bedtime PRN 2. Benzodiazepine for Anxiety 1. renal. Patient has frequent episode of anxiety and stress. This medication is used to treat symptoms of anxiety. Action 3. myalgia. Don t stop drug abruptly 1. hypotension. Sedative agent/ for insomnia 2. Use drug for only short 2. and hematopoietic function. 1. dizziness. Alert: anaphylaxis and angiooedema may occur as early as first dose. 1mg oral Q4H PRN 1. Action: works via postsynaptic GABA receptors SE: confusion. Side effect Major nursing responsibilities Rationale for this client GENERIC (TRADE) 1. Indication: schizophrenia Action: antagonizes dopamine D2 receptors serotonin 5-HT2A receptors SE: less EPS. 1-10 MG/D PO 1. dry mouth EPS. Patient is diagnosed with bipolar affective disorder and in order to prevent . Lorazepam (Ativan) 1. Use of this drug may lead to abuse and addiction. 2.PSYCHIATRIC MEDICATIONS ONLY Prescribeddose Psychiatric Rx(w/refs) Usual Dose range Class/Purpose 1. Monitor hepatic. indication 2. more ant-cholinergic effect 2. nausua.

Atypical Antipsychotic/to treat schizophrenia 3. Clozapine (Clozaril) (FazaClo) . patient needs to have plenty of sleep. reduce risk of recurrent suicidal behavior 4. 25-50MG MAX Q2 WEEK 3.Zolpidem(Ambi en) 4. time management. Action: binds to dopamine receptors SE: akinesia. mania episode. Indication: treat schizophrenia . 3. Watch for agranulocytosis and metabolic syndrome. Risperidone (Risperdal Consta) 4. 4. akathisia. weight gain and drooloing 4. Atypical Antipsychotic/ to treat schizophrenia. weakness. Watch for metabolic syndrome and anticholinergic effect. Patient has a long history of auditory hallucination. mania and hallucination 3. 150400MG PO BID ORRAL 4. 3. This patient is on Clozapine to reduce the risk of suicidal behavior from bipolar affective disorders. 400mg oral 4.2. 25 mg IM Q2 weeks 3.

Side effect Major nursing responsibilities Rationale for this client . Action 3.Prescribed dose Psychiatric Rx(w/refs) Usual Dose range Class/Purpose 1. indication 2.

110 MG/D PO 2. Risperidone 1. 3MG TAB QBEDTIME (Risperdal Consta) 1. Use of this drug may lead to abuse and addiction. Patient has a long history of auditory hallucination. Benzodiazepine for Anxiety 2. dry mouth EPS. hypotension. tab oral Q6 H interval PRN 2. 2550MG MAX Q2 WEEK 1. dizziness. Watch for metabolic syndrome and anticholinergic effect. This medication is used to treat symptoms of anxiety.GENERIC( TRADE) 1. Don t stop drug abruptly 2. . 2.Lorazepam (Ativan) 2. Patient has frequent episode of anxiety and stress. Indication: schizophrenia Action: antagonizes dopamine D2 receptors serotonin 5-HT2A receptors SE: less EPS. and hematopoietic function. Atypical Antipsychotic/to treat schizophrenia 1. renal. 1mg=1 tab. more ant-cholinergic effect 2. 1. . 1. Action: works via postsynaptic GABA receptors SE: confusion. Monitor hepatic. Indication: to treat anxiety.

.

SE: abdominal pain. peptic ulcer disease Reduces cardiac output and tachycardia. second or third degree atrioventricular block or sick sinus syndrome Inhibits calcium. serum creatinine raised Carvediol (coreg) 12. risk of adverse effects. AV block. glucose level depression since carvediol may altered Interaction: increase effects blood glucose with cimetidine. sodium and potassium channels and is an alpha. asthenia. which reduce blood pressure and cardiac workload Interactions: Amiodarone: combo may increase levels of both drugs. heart failure. -monitor Liver function tests. may increase risk of QT prologation. asthma. clonidine level and MAOIs.and beta adrenergic receptor antagonist.Medications Generic / Trade Dose/Route/ Time (Frequency) 400mg tab oral bimeals Class/Rationale for the patient Contraindication Mechanism of action Onset of action Common side effects / food and drug Interaction Nursing considerations Dronedarone (Multaq) Antiarrhythmics / Patient is taking this medication for coronary artery disease Bradycardia of less than 50 beats per minute. especially during 6 months of treatment -monitor electrolytes at baseline .5 mg Tab bimeal Beta-blockers/ Patient is taking this medication to reduce cardiac ouput Hypersensitivity to aspirin. edema. bleeding problems (such as hemophilia). allergy to tartrazine dye. cardiac arrhythmias SE: Angina. -Monitor blood bradycardia. causes vasodilation and decreases peripheral vascular resistance.

5 inhalation) 2 putts INH BID inhaler Gluccorticoid or antiasthmatic / Patient is taking this medication to help him manage better breathing Hypersensitive to drug/ class and systemic fungal infection To manage symptoms of seasonal or perennial allergic rhinitis SE: Amnesia. asthenia. itraconazole. bacterial. or ocular herpes simplex. ketoconazole. caution if tapering systemic steroids To prevent or treat asthma SE: anxiousness. asthenia.Montelukast (Singular) 10 mg Tab Q evening Antiasthmatic/ Patient is diagnosed with pulmonary edema and Chest Xray shows congestion. fever. erythromycin. . fatigue. or systemic viral infection. other CYP3A4 inhibitors: Possibly increased blood budesonide level Use budesonide cautiously if patient has tubercular infection. dizziness. dizziness fatigue and fever Interactions: Gemfibrozil: Combdo may increase montelukast levels risk of adverse effects -drug should not be given for acute asthma attack Budesonide-Formoterol (Symbicott 160/4. untreated fungal. headache Interactions: Drugs clarithromycin. Patient is taking this medication to prevent asthma Hypersensitive to drug/class Caution if severe asthma.

.

second or third degree atrioventricular block or sick sinus syndrome Inhibits calcium. peptic ulcer disease Reduces cardiac output and tachycardia. clonidine level and MAOIs. glucose level depression since carvediol may altered Interaction: increase effects blood glucose with cimetidine.5 mg Tab bimeal Beta-blockers/ Patient is taking this medication to reduce cardiac ouput Hypersensitivity to aspirin. SE: abdominal pain. heart failure. edema. may increase risk of QT prologation. risk of adverse effects. cardiac arrhythmias SE: Angina. sodium and potassium channels and is an alpha.and beta adrenergic receptor antagonist. especially during 6 months of treatment -monitor electrolytes at baseline . allergy to tartrazine dye. serum creatinine raised Carvediol (coreg) 12. -Monitor blood bradycardia. bleeding problems (such as hemophilia). asthma. -monitor Liver function tests. AV block. causes vasodilation and decreases peripheral vascular resistance. which reduce blood pressure and cardiac workload Interactions: Amiodarone: comb may increase levels of both drugs.Medications Generic / Trade Dose/Route/ Time (Frequency) 400mg tab oral bimeals Class/Rationale for the patient Contraindication Mechanism of action Onset of action Common side effects / food and drug Interaction Nursing considerations Dronedarone (Multaq) Antiarrhythmics / Patient is taking this medication for coronary artery disease Bradycardia of less than 50 beats per minute. asthenia.

dizziness. caution if tapering systemic steroids To prevent or treat asthma SE: anxiousness. fever. ketoconazole. or ocular herpes simplex. bacterial. itraconazole.5 inhalation) 2 putts INH BID inhaler Gluccorticoid or antiasthmatic / Patient is taking this medication to help him manage better breathing Hypersensitive to drug/ class and systemic fungal infection To manage symptoms of seasonal or perennial allergic rhinitis SE: Amnesia. fatigue. asthenia. asthenia. Patient is taking this medication to prevent asthma Hypersensitive to drug/class Caution if severe asthma. or systemic viral infection. untreated fungal. . erythromycin.Montelukast (Singular) 10 mg Tab Q evening Antiasthmatic/ Patient is diagnosed with pulmonary edema and Chest Xray shows congestion. other CYP3A4 inhibitors: Possibly increased blood budesonide level Use budesonide cautiously if patient has tubercular infection. headache Interactions: Drugs clarithromycin. dizziness fatigue and fever Interactions: Gemfibrozil: Combdo may increase montelukast levels risk of adverse effects -drug should not be given for acute asthma attack Budesonide-Formoterol (Symbicott 160/4.