Generic Name: Mechanism of Indication Contraindication Adverse Reaction Nursing Responsibilities

Action
spironolactone

Edema Contraindicated in CNS: headache, To enhance absorption, give drug

Potassium- patients drowsiness, lethargy, with meals.
Brand Name: sparing diuretic; Hypertension hypersensitive to confusion, ataxia.
antagonizes drug. Protect drug from light.
Aldactone, Diuretic- GI: diarrhea, gastric
Novospiroton†, aldosterone in induced Monitor electrolyte levels, fluid
the distal Contraindicated in bleeding, ulceration,
Spiractin‡ hypokalemia those with anuria, cramping, gastritis, intake and output, weight, and blood
tubules, pressure.
increasing To detect acute or progressive vomiting.
sodium and primary renal insufficiency, Monitor elderly patients closely, who
Classification: or hyperkalemia. GU: inability to
water excretion. hyperaldostero maintain erection, are more susceptible to excessive
Potassium Sparing nism Use cautiously in menstrual disturbances. diuresis.
Diuretic To manage patients with fluid Inform laboratory that patient is
or electrolyte Hematologic:
primary agranulocytosis. taking spironolactone because drug
hyperaldostero imbalances, may interfere with tests that measure
Dosage: nism impaired renal Metabolic: digoxin level.
function, or hepatic hyponatremia,
25mg Heart failure, disease. hyperkalemia, Drug is less potent than thiazide and
as adjunct to dehydration, mild loop diuretics and is useful as an
ACE inhibitor Use with extreme adjunct to other diuretic therapy.
caution in pregnant acidosis.
Form: or loop Diuretic effect is delayed 2 to 3 days
diuretic, with women. Skin: urticaria, when used alone.
tablet or without hirsutism,
cardiac maculopapular Maximum antihypertensive response
glycoside eruptions. may be delayed for up to 2 weeks.

Route: Watch for hyperchloremic metabolic

Hirsutism in Other: gynecomastia,
women breast soreness, drug acidosis, which may occur during
oral Premenstrual fever, anaphylaxis. therapy, especially in patients with
syndrome hepatic cirrhosis.

Acne vulgaris Breast cancer has been reported in

Frequency: some patients taking spironolactone,
Familial male although a causal relationship hasn't
precocious been established.
puberty

Color:

Generic Name: Mechanism of Indication Contraindication Adverse Reaction Nursing Responsibilities

Action
felodipine

Hypertension Contraindicated in CNS: headache, Monitor blood pressure for

Unknown. A patients dizziness, paresthesia, response.
Brand Name: dihydropyridine- hypersensitive to asthenia.
derivative drug. Monitor patient for peripheral
Agon SR‡, CV: peripheral edema, edema, which appears to be
Plendil, Plendil calcium channel
blocker that Use cautiously in chest pain, palpitations, both dose- and age-related.
ER‡, Renedil† patients with heart flushing. It's more common in patients
prevents entry of
calcium ions into failure, particularly taking higher doses,
those receiving beta EENT: rhinorrhea, especially those older than
vascular smooth- pharyngitis.
Classification: muscle and blockers, and in age 60
cardiac cells; patients with GI: abdominal pain,
Calcium Channel impaired hepatic
Blocker shows some nausea, constipation,
selectivity for function. diarrhea.
smooth muscle
compared with Musculoskeletal: muscle
cardiac muscle.
 Dosage: cramps, back pain.

10mg Respiratory: upper

respiratory tract
infection, cough.
Form: Skin: rash.
Tablet

Route:

P.O.

Frequency:

OD

Color:

Generic Name: Mechanism of Indication Contraindication Adverse Reaction Nursing Responsibilities

 Action

simvastatin . CNS: headache,

asthenia.
Inhibits HMG- To reduce risk Contraindicated in . Use drug only after diet and other
CoA reductase, of death from patients hypersensitive GI: abdominal pain, nondrug therapies prove
Brand Name: an early (and CV disease and to drug and in those constipation, ineffective. Patient should follow a
Lipex‡, Zocor rate-limiting) CV events in with active liver diarrhea, dyspepsia, standard low-cholesterol diet during
step in patients at disease or conditions flatulence, nausea, therapy.
cholesterol high-risk for that cause unexplained vomiting.
biosynthesis. coronary persistent elevations of Obtain liver function test results at
Classification: events transaminase levels. Respiratory: upper start of therapy and then
respiratory tract periodically. A liver biopsy may be
HMG-CoA To reduce total Contraindicated in infection. performed if enzyme elevations
Reductase inhibitors and LDL pregnant and breast- persist.
cholesterol feeding women and in
levels in women of Simvastatin 40 mg daily
Dosage: patients with childbearing age. significantly reduces risk of death
homozygous from coronary heart disease,
20mg Use cautiously in nonfatal MIs, stroke, and
familial
hypercholester patients who consume revascularization procedures.
olemia substantial quantities
Form: of alcohol or have a
Heterozygous history of liver
Tablet familial disease.
hypercholester
olemia
Route:

P.O.
Frequency:

HS

Color:

Generic Name: Mechanism of Indication Contraindication Adverse Nursing Responsibilities

Action Reaction

omeprazole Symptomatic Contraindicated in Dosage adjustments may be

Inhibits activity gastroesophageal reflux patients CNS: headache, necessary in Asian patients
of acid (proton) disease (GERD) without hypersensitive to dizziness, and patients with hepatic
Brand Name: pump and binds esophageal lesions drug or its asthenia. impairment.
to hydrogen- components.
Losec†‡, potassium Erosive esophagitis and GI: diarrhea, Omeprazole increases its
Prilosec, Zegerid adenosine accompanying symptoms Zegerid is abdominal pain, own bioavailability with
triphosphatase caused by GERD contraindicated in nausea, vomiting, repeated doses. Drug is
at secretory patients with constipation, labile in gastric acid; less
Pathologic hypersecretory metabolic alkalosis flatulence. drug is lost to hydrolysis
Classification: surface of conditions (such as Zollinger-
gastric parietal because drug increases
Proton Pump cells to block Ellison syndrome)
inhibitors formation of
gastric acid. Duodenal ulcer (short-term
treatment)
Dosage: Helicobacter pylori infection
and duodenal ulcer disease, to
40mg eradicate H. pylori with
clarithromycin (dual therapy)
Form: H. pylori infection and
duodenal ulcer disease, to
Tablet eradicate H. pylori with
clarithromycin and
amoxicillin (triple therapy)
Route: Short-term treatment of active
P.O. benign gastric ulcer
and hypocalcemia. Musculoskeletal: gastric pH.
back pain.
Use cautiously in Zegerid contains 460 mg
patients with Respiratory: sodium per dose in the form
Bartter's syndrome, cough, upper of sodium bicarbonate.
hypokalemia, and respiratory tract
respiratory alkalosis. infection. Gastrin level rises in most
patients during the first 2
Long-term Skin: rash. weeks of therapy.
administration of
bicarbonate with
calcium or milk can
cause milk-alkali
syndrome.

Frequent heartburn (2 or more

days a week)
Frequency:

O.D. AM

Color:
Generic Name: Mechanism of Indication Contraindication Adverse Reaction Nursing Responsibilities
Action

amoxicillin and Lower respiratory Contraindicated in CNS: agitation, Before giving drug, ask patient
clavulanate Prevents bacterial tract infections, otitis patients anxiety, insomnia, about allergic reactions to
potassium cell-wall synthesis media, sinusitis, skin hypersensitive to confusion, penicillin. However, a negative
during replication. and skin-structure drug or other behavioral changes, history of penicillin allergy is no
(amoxycillin and Increases infections, and UTIs penicillins and in dizziness. guarantee against an allergic
clavulanate amoxicillin caused by those with a history reaction.
potassium) effectiveness by susceptible strains of of amoxicillin- GI: nausea,
inactivating beta- gram-positive and related cholestatic vomiting, diarrhea, Obtain specimen for culture and
lactamases, which gram-negative jaundice or hepatic indigestion, sensitivity tests before giving
Brand Name: destroy organisms dysfunction. gastritis, stomatitis, first dose. Therapy may begin
amoxicillin. glossitis, black pending results.
Community- Contraindicated in hairy tongue,
acquired pneumonia patients receiving enterocolitis, Give drug at least 1 hour before
Augmentin, or acute bacterial hemodialysis and pseudomembranous a bacteriostatic antibiotic.
Augmentin ES- sinusitis caused by those with creatinine colitis,
600, Augmentin Each Augmentin XR tablet
H. influenzae, M. clearance less than mucocutaneous contains 29.3 mg (1.27 mEq) of
XR, Clavulin† catarrhalis, H. 30 ml/minute. candidiasis, sodium.
parainfluenzae, abdominal pain.
Klebsiella Use cautiously in Augmentin XR isn't indicated for
Classification: pneumoniae, patients with other GU: vaginitis, treating infections caused by S.
methicillin- drug allergies vaginal candidiasis. pneumoniae with penicillin
Anti- infective (especially to minimum inhibitory
susceptible Hematologic:
Staphylococcus cephalosporins) concentration (commonly known
because of possible anemia,
aureus, or S.
cross-sensitivity and thrombocytopenia, as MIC) 4 mcg/ml or greater.
Dosage: pneumoniae with
in those with thrombocytopenic If large doses are given or
reduced
625 mg susceptibility to mononucleosis purpura, therapy is prolonged, bacterial or
penicillin because of high risk eosinophilia, fungal superinfection may occur,
of maculopapular leukopenia, especially in elderly, debilitated,
Form: rash. agranulocytosis. or immunosuppressed patients.

Tablet Use cautiously in Other: Alert: Don't interchange the oral

breast-feeding hypersensitivity suspensions because of varying
women; it's reactions, clavulanic acid contents.
unknown if drug (anaphylaxis, rash,
Route: appears in breast urticaria, pruritus, Augmentin ES-600 is intended
milk. angioedema), only for children ages 3 months
P.O. to 12 years with persistent or
overgrowth of
Use cautiously in nonsusceptible recurrent acute otitis media.
hepatically impaired organisms, serum
Frequency: patients, and monitor Avoid use of 250-mg tablet in
sickness-like children weighing less than 40
the hepatic function reaction.
BID kg (88 lb). Use chewable form
of these patients.
instead.

Alert: Both 250- and 500-mg

Color:
film-coated tablets contain the
same amount of clavulanic acid
(125 mg). Therefore, two 250-
mg tablets aren't equivalent to
one 500-mg tablet. Regular
tablets aren't equivalent to
Augmentin XR.

This drug combination is

particularly useful in clinical
settings with a high prevalence
of amoxicillin-resistant
 organisms.

After reconstitution, refrigerate

the oral suspension; discard after
10 days.

Look alike-sound alike: Don't

confuse amoxicillin with
amoxapine.

Generic Name: Mechanism of Indication Contraindication Adverse Reaction Nursing Responsibilities

Action

enalaprilat Hypertension Contraindicated in CNS: headache, Closely monitor blood

May inhibit patients dizziness, fatigue, pressure response to drug.
enalapril maleate ACE, preventing To convert from hypersensitive to vertigo, asthenia,
conversion of I.V. therapy to drug and in those syncope. Look alike-sound alike:
angiotensin I to oral therapy with a history of Similar packaging and
Brand Name: angiotensin II, a CV: hypotension, chest labeling of enalaprilat
To convert from angioedema related to pain, angina pectoris. injection and pancuronium, a
potent oral therapy to previous treatment
vasoconstrictor. with an ACE neuromuscular-blocking
I.V. therapy GI: diarrhea, nausea, drug, could result in a fatal
Amprace‡, Less angiotensin inhibitor. abdominal pain,
II decreases To manage medication error. Check all
Renitec‡,
Vasotec peripheral symptomatic Use cautiously in vomiting. labels carefully.
arterial heart failure renally impaired
resistance, patients or those with GU: decreased renal Monitor CBC with
decreasing Asymptomatic aortic stenosis or function (in patients differential counts before and
Classification: left ventricular with bilateral renal during therapy.
aldosterone hypertrophic
ACE inhibitor secretion, dysfunction cardiomyopathy. artery stenosis or heart
failure). Diabetic patients, those with
reducing sodium impaired renal function or
and water Hematologic: bone heart failure, and those
Dosage: retention, and marrow depression. receiving drugs that can
lowering blood increase potassium level may
20mg pressure. Respiratory: dyspnea, develop hyperkalemia.
dry, persistent, tickling, Monitor potassium intake
nonproductive cough. and potassium level.
Form: Skin: rash.
Tablet Other: angioedema.

Route:

P.O.

Frequency:

OD

Color:
Generic Name: Mechanism of Indication Contraindication Adverse Nursing Responsibilities
Action Reaction
isosorbide dinitrate

Acute Contraindicated in To prevent tolerance, a nitrate-free

Not completely anginal patients with CNS: headache, interval of 8 to 12 hours per day is
Brand Name: known. attacks (S.L. hypersensitivity or dizziness, recommended. The regimen for
Apo-ISDN†, Thought to isosorbide idiosyncrasy to weakness. isosorbide mononitrate (1 tablet on
Cedocard SR†, reduce cardiac dinitrate nitrates and in those awakening with the second dose in 7
oxygen demand only) with severe CV: orthostatic hours, or 1 extended-release tablet
Dilatrate-SR, Isordil, hypotension,
Isordil Tembids, by decreasing hypotension, angle- daily) is intended to minimize nitrate
preload and closure glaucoma, tachycardia, tolerance by providing a substantial
Isordil Titradose, palpitations,
Isoket, Isomonit afterload. Drug increased nitrate-free interval.
also may intracranial ankle edema,
increase blood pressure, shock, or fainting, Monitor blood pressure and intensity
flow through acute MI with low flushing. and duration of drug response.
isosorbide the collateral left ventricular
mononitrate EENT: S.L. Drug may cause headaches, especially
coronary filling pressure. burning. at beginning of therapy. Dosage may
vessels. be reduced temporarily, but tolerance
Use cautiously in GI: nausea,
patients with blood usually develops. Treat headache with
Imdur, ISMO, vomiting. aspirin or acetaminophen.
Isotrate ER, Monoket volume depletion
(such as from Skin: cutaneous Methemoglobinemia has been seen
diuretic therapy) or vasodilation, with nitrates. Symptoms are those of
rash. impaired oxygen delivery despite
Classification: mild hypotension. adequate cardiac output and adequate
arterial partial pressure of oxygen.

Dosage:

1 tab

Form:

Tablet

Route:

P.O.

Frequency:

TID

Generic Name: Mechanism of Indication Contraindication Adverse Reaction Nursing Responsibilities

Action

Lactulose Constipation Patients who Abdominal Monitor for possible adverse GI

Causes an require a low discomfort reaction: nausea, vomiting, abdominal
 influx of fluid Salmonellosis lactose diet. associated with cramps, diarrhea, flatulence and
in the intestinal flatulence and distention.
Brand Name: tract by Treatment of Galactosaemia or intestinal cramps
increasing the hepatic disaccharide Monitor fluid and electrolyte status:
osmotic encelopathy deficiency. Nausea, vomiting, Urine output, input and output ratio to
Duphalac, Lilac, pressure within diarrhea on identify fluid loss, hypokalemia and
Intestinal prolonged use hypernatremia.
Actilax, Lac-dol, the intestinal obstruction.
Gen-Lac-Liq, lumen. Monitor for increased glucose levels
Acilac, Cholac in diabetic patients.

Classification:

Dosage:

2 tbsp 30 cc

Form:

Liquid

Route:

P.O.
Frequency:

HS

Color:

Generic Name: Mechanism of Indication Contraindication Adverse Reaction Nursing Responsibilities

Action

bisoprolol Hypertension Untreated Tiredness, dizziness, Monitor blood pressure before

Preferentially and myocardial failure slight headache, and periodically during
competitively Coronary heart perspiration, sleep treatment. Assess apical/radial
blocks stimulation disease Shock disturbances, pulse before drug
Brand Name:
of beta1-adrenergic Stable chronic Atrioventricular depression. administration. Note rate,
receptor within moderate to blocks II and III rhythm, and quality and report
cardiac muscle Occasionally marked significant changes (pulse
Concore, Ziac, severe heart blood pressure (BP)
(decrease rate of SA failure Sick sinus <50b/p).
Bicor, Bispro, node discharge, syndrome decreases, slow pulse
Monocor, Zebeta increases recovery Angina rate, AV conduction Obtain baseline renal and liver
time), slows pectoris Disturbed stimulus disturbances. function before starting therapy.
conduction of AV conduction between
SA node and atrium Monitor for possible drug
Classification: node, decreases Bradycardia Rarely GI induced adverse reaction:
heart rate, which disturbances and skin
decreases O2 Hypotension reactions. CNS: asthenia, fatigue,
dizziness, headache, vivid
Dosage: Consumption in Bronchial asthma dreams, depression, insomnia
5mg myocardium; Advanced
decreases rennin- CV: bradycardia, peripheral
peripheral edema, chest pain, heart failure
aldosterone- circulatory
angiotensium disturbances EENT: pharyngitis, rhinitis,
Form: system; inhibits sinusitis
Tablet beta2- receptors in
bronchial and GI: nausea, vomiting, diarrhea,
vascular smooth dry mouth
muscle at high
Route: Musculoskeletal: arthralgia
doses
P.O. Respiratory: cough, dyspnea

Skin: sweating

Frequency:

BID

Color:
Generic Name: Mechanism Indication Contraindication Adverse Nursing Responsibilities
of Action Reaction

Folic acid Used in Folic acid should Assess patient’s folic acid deficiency
Provides/ treatment and never be given alone or Rarely, before starting therapy.
replaces prevention of in conjunction with gastrointestinal
elemental iron, the folate inadequate amounts of disturbances and Assess patient for (megaloblastic
Brand Name: anemia) weakness, fatigue, dyspnea,
an essential deficiency B12 for the treatment hypersensitivity
component in state. of undiagnosed reactions. shortness of breath and activity
formation of megaloblastic anemia, intolerance.
Enhancid, hemoglobin in Also used in since folic acid may
Folacid, Folart, Identify drugs currently taken:
red blood cell women of produce a alcohol, oral contraceptive, estrogens,
Folicard, Purifol development. child-bearing hematopoietic response
potential and glucocorticoids, carbamazepine,
in patients with a hydantoins and trimethoprim. These
pregnant megaloblastic anemia
women to drugs may cause increased folic acid
Classification: due to vit B12 use by the body and contribute to the
protect against deficiency without
neural tube deficiency.
preventing aggravation
defects in their of neurological Monitor folate levels (6-15 mcg/mL),
Dosage:
offspring. symptoms. This Hgb, Hct and reticulosite count before
1 cap masking of the true and throughout therapy.
deficiency state can
lead to serious Monitor for possible drug induced
neurological damage, adverse reactions:
Form:
such as subacute CNS: general malaise
combined degeneration
of the cord. GI: bitter taste, anorexia, flatulence
Route:
Respiratory: bronchospasm
P.O.
 Others: allergic reactions (rash,
pruritus, erythema)
Frequency:

OD afterlunch

Color:

Generic Name: Mechanism of Indication Contraindication Adverse Nursing Responsibilities

Action Reaction

erythropoietin Management of anemia Hypersensitivity to Monitor renal studies:

Mimics effect associated with chronic mammalian cell- Hypertension, urinalysis, protein, blood, BUN,
of renal failure in dialysis derived products tachycardia, creatinine; input-output ratio;
Brand Name: erythropoietin and predialysis patients; or human albumin, clotted vascular report drop in output to
which functions they may reduce or uncontrolled access. <50mL/hr.
as a growth obviate the need for hypertension.
factor and as blood transfusions in Headache, Assess for CNS symptoms:
Epokine, differentiating these patients. Also, seizures. coldness, sweating, pain in long
Eposino, Eprex, factor, used in the management bones
Renogen, Nausea, vomiting,
enhancing RBC of chemotherapy- diarrhea. Assess CV status: BP and
Aranesp production; induced anemia in
 drug is patients with non-
developed by myeloid malignant
Classification: recombinant disease.
DNA
technology. May also be used in
patients with moderate
anemia (but no iron
Dosage: deficiency) before
elective surgery to
increase the yield of
blood collected for
autologous blood
Form: transfusion.
May also be used in such
patients to reduce the need
for allogenic blood
Route: transfusion.
Shortness of during treatment; hypertension
breath. may occur rapidly ;eading to
hypertension encephalopathy,
Allergy, skin antihypertensives may be
rashes and needed
urticaria, fever,
paresthesia, Monitor serum iron levels,
arthralgia. ferritin, transferring levels; iron
therapy may be needed to
prevent recurring anemia
Monitor blood studies: BUN,
creatinine, uric acid, platelets,
WBC, phosphorus, potassium,
bleeding time; Hct, Hgb,
RBCs,reticulocytes should be
checked in chronic renal failure

SQ

Frequency:

Color: