Maste Med Sheet

ABRH Suppository Trade: Ativan 1mg. Benadryl 12.
5mg, Haldol 2mg, Reglan 10mg Class: Combination medication
Action: cobination med to treat anxitey, agitation, restlessness, and antiemetic Rationale: anxiety, agitation, restlessness
Q4h PRN
acetaminophen Trade: Tylenol #3 Class: Antipyretics, non-opioid analgesics
Action: Inhibits the synthesis of prostaglandins that may serve as mediators of pain & fever primarily in CNS Rationale:
PO 650 mg q 4 hr prn.
acetaminophen Trade: Tylenol Class: nonopioid analgesics / antipyretics
Action: Inhibits synthesis of prosteglandins, which are mediators of pain and fever. Give for mod pain. Rationale:
PRN PO Q4h 2 Tab=650mg MAX DOSE: should not exceed 4g acetaminophen
acetaminophen diphenhydramine Trade: Tylenol PM Class: nonopioid analgesics / antipyretics
Action: Inhibits synthesis of prosteglandins, which are mediators of pain and fever. Give for mod pain. Rationale:
PO 2 tabs HS Acetaminophen 500mg Diphenhydramine 25mg MAX DOSE: should not exceed 4g acetaminophen
Assessment: Pain type, location, intensity prior to and 1 hr following PO, Subcut, IM and 5 min after IV start. BP, HR, RR periodically. Bowel function. Physical and psychological dependence and tolerance. With sustained-release morphine additional short-acting opioid doses needed. Adverse Effects: Sedation, decreased respirations, altered consciousness, visual and auditory sensory disturbed. Teach: May cause drowsiness or dizziness, orthostatic hypertension. Avoid alcohol. Deep breathe q2h. Administration: Assessment: Heart rate, respiration rate, & pulse, also assess pain for type, location & intensity prior to given med. (Davis p 113) Adverse Effects: Hepatic failure, hepatotoxicity, renal failure, neutropenia, pancytopenia, leucopenia, rash, urticaria. Teach: Not to take more than 4 g in 24 hr period & give with a full glass of water. May cause constipation. Administration: PO no more than 4 g in 24 hr & drink plenty of water and fluids. Assessment: history of alcohol use; overall health status; pain type, location and intensity pre & 30 min- 1 hr. post med; Teach: take as directed, excessive use/hepatoxicity, renal or cardiac dammage Adverse Effects: Hepatic failure, hepatotoxicity (overdose); renal failure (high doses / chronic use) Teach: Report if pain not controlled; check label of OTC meds; avoid alcohol; to not take more than recommended; take as directed. Administration: as ordered with a full glass of water. Assessment: history of alcohol use; overall health status; pain type, location and intensity pre & 30 min- 1 hr. post med; shouldn't drive Adverse Effects: Hepatic failure, Drowiness, hepatotoxicity (overdose); renal failure (high doses / chronic use) Teach: take as directed, excessive use/hepatoxicity, renal or cardiac dammage Administration: as ordered with a full glass of water.
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acetazolamide Trade: Diamox Class: anticonvulsant, antiglaucoma agent, diuretics, ocular hypotensive agent Pharm: carbonic anhydrase inhibitors
acetylsalicylic acid Trade: Aspirin Class: Salicylates
Action: inhibition of carbonic anhydrase in the eye results in decreased secretion of aqueous humor. Inhibition of renal carbonic anhydrase, resulting in self limiting urinary excretion of Na+, K+,HCO3, and H2O. CNS inhibition of carbonic anhydrase and resultant diuresis may decrease abnormal neuronal firing. Alkaline diuresis prevents precipitation or uric acid or cystine in the urinary tract. Rationale: Action: Produce analgesia and reduce inflammation and fever by inhibiting the production of prostaglandins. Rationale:
Assessment: hypokalemia, intraocular pressure, seizures, altitude sickness, edema Adverse Effects: depression, tiredness, weakness, anorexia, metallic taste, hyperchloremic acidosis, weight lose. Teach: take as directed, report numbness of tingling, drowsiness, Administration:
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acyclovir Trade- Zovirax ClassificationsAntivirals, purine analogues
Action- Interferes with viral DNA synthesis Rationale:
Assessment: Patients who have asthma, allergies, and nasal polyps or who are allergic to tartrazine are at an increased risk for developing hypersensitivity reactions. Pain: Assess pain and limitation of movement; note type, location, and intensity before and at the peak (see Time/Action Profile) after administration. Fever: Assess fever and note associated signs (diaphoresis, tachycardia, malaise, chills). Adverse Effects: GI BLEEDING, dyspepsia, epigastric distress, nausea, abdominal pain, anorexia, hepatotoxicity, vomiting Teach: Instruct patient to take salicylates with a full glass of water and to remain in an upright position for 15-30 min after administration. Administration: Assessment- Assess lesions before and during therapy, Monitor neurological status in patients with herpes encephalitis. LabsMonitor BUN, Serum Creatinine and CCR before and during therapy. Adverse Effects- seizures, dizziness, headache, diarrhea, N&V, renal failure, steven johnsons syndrome, thrombotic thrombocytopenic purpura/ hemolytic uremic syndrome Teach- Take as directed, use of additional creams or lotions may delay healing, this is not a cure however it will help with the symptoms. Condoms should be used during sexual contact and no sexual activity with
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lesions are present. Contact health provider if symptoms persists. Encourage yearly pap smears in woman. Administration:
albumin (human) Trade: normal human serum albumin Class: volume expanders albuterol Trade: Proventil Class: Bronchodilators Pharm: adrenergic Albuterol Trade: Ventolin Class: Bronchodilator (B-2 Adrenergic)
Action: Provides colloidal oncotic pressure, which serves to mobilize fluid from extravascular tissues back into the intravascular space. Requires concurrent administration of appropriate crystalloid. Rationale: Action: Binds with bets-2 receptors in airway smooth muscle- relaxes airway smooth muscle, bronchodilation Rationale: Action: Binds with beta-2 receptors in airway smooth muscles relaxes airway smooth muscles - Bronchodilation Rationale:
albuterol Trade: Albuterol Class: Bronchodilator (B-2 Adrenergic)
Action: Binds with beta-2 receptors in airway smooth muscles relaxes airway smooth muscles - Bronchodilation Rationale:
PRN Inhale neb 2.5mg=3mL Q2H
Assess: vital signs, I&O, vascular overload SE: Pulmonary Edema, fluid overload, hyper/hyptension, N&V, tachycardia, flushing Teach: Explain purpose of this solution. Report signs and symptoms of hypersensitivity reaction. Admin: follow manufacturers recommendations for administration. Assessment: lung sounds, RR for relief. HR, BP Adverse Effects: tachycardia, hypertension, nervousness, restlessness, tremor, HA, N/V. Teach: avoid caffeine and smoking Administration: PO and Inhaln allow 1 minute between puffs, use first if using other inhalers and allow 5 minutes before giving other inhalers. Assess: lung sounds, Resp rate for relief Adverse Effects: increased pulse and B/P, nervousness, restlessness, tremor, headache, insomnia, chest pain, palpitations, n & v Teach: avoid caffeine & smoking Admin: Allow 1 min. between puffs (rule for all inhalers) Use 1st if using other inhalers & allow 5 min before giving other inhalers Assess: lung sounds, Resp rate for relief Adverse Effects: increased pulse and B/P, nervousness, restlessness, tremor, headache, insomnia, chest pain, palpitations, n & v Teach: avoid caffeine & smoking Admin: Allow 1 min. between puffs (rule for all inhalers) Use 1st if using other inhalers & allow 5 min before giving other inhalers
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allopurinol Trade: Zyloprim Class: antigout agents, antihyperuricemics Pharm: xanthine oxidase inhibitors
Action: Inhibits the production of uric acid by inhibiting the action of xanthine oxidase. Rationale:
alprazolam Trade: Xanax Class: Antianxiety agents Pharm: benzodiazepines amiodarone Trade: Cordarone Class:antidysrhythmi cs
Action: Acts at many levels in the CNS to produce anxiolytic effect, cause CNS depression. Relief of anxiety Rationale: Ordered to relieve anxiety
PO Q8h 0.25mg=1tab
Assessment: I&Os. Decreased kidney function can cause toxic effects. Maintains adequate fluid. Monitor for joint pain and swelling. Addition of colchicine or NSAIDs may be necessary for acute attacks. Prophylactic doses of colchicine or an NSAID should be administered concurrently during the first 3-6 mo of therapy because of an increased frequency of acute attacks of gouty arthritis during early therapy. Adverse Effects: hypotension, flushing, hypertension, bradycardia, and heart failure drowsiness Teach: Take as directed. Drowsiness. Avoid driving or other activities requiring alertness. Report skin rash, blood in urine, or influenza symptoms. Avoid alcohol Administration: Assessment: degree of anxiety, drowsiness, light headedness, dependence Adverse Effects: dizziness, drowsiness, lethargy, HA, diarrhea, N/V Teach: Take as directed, drowsiness, dizziness, avoid grapefruit juice, avoid alcohol Administration: PO Q8h Assess: BP, bowel function SE: constipation, loss of appetite, Headache, decreased sex drive, difficulty falling asleep or staying asleep, flushing, dry eyes, changes in ability to taste and smell, changes in amount of saliva Teaching: dont drink grapefruit juice, avoid excess exposure to sun, tell Dr about ALL meds & herbals youre taking, can cause vision problems, liver damage or lung problems, remains in your system for several months, do not stop taking without talking to Dr Admin: take at same time q day, may take with or without food Assessment: Monitor BP, assess fasting glucose, monitor mental status Adverse Effects: suicidal thoughts, lethargy, sedation, arrythmias Teach: may cause drowsiness and blurred vision Administration: PO
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Action: Used to treat and prevent certain types of serious, life-threatening ventricular arrhythmias (a certain type of abnormal heart rhythm when other medications did not help or could not be tolerated. It works by relaxing overactive heart muscles Rational:
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amitriptyline Trade: Elavil Class: antidepressants Pharm: tricyclic
Action: Potentiates the effect of serotoin and norepinephrine in the CNS. Rationale:
50mg=1 tab PO bedtime
Therapeutic Effects: Adverse Effects:
antidepressants
amitriptyline Trade: Elavil Class: Anitdepressants Pharm: Tri-cyclics
Action: Increases serotonin & norepinephrine Rationale:
amlodipine Trade: Norvasc Class: antihypertensiives Pharm: calcium channel blockers
amoxapine Trade: Asendin Class: Anitdepressants Pharm: Tri-cyclics
Action: Inhibits transport of calcium into myocardial and vascular smooth muscle cells resulting in inhibition of excitation-contraction coupling and subsequent contraction. Systemic vasodilation resulting in decrerased frequency and severity of attacks of angina. Rationale: Action: Increases serotonin & norepinephrine Rationale:
PO 10 mg daily 10mg=1Tab
Assessment: As stated previously, BP lying/standing, Cardiac assessment, High overdose potential limit quantity available to patient Adverse Effects: Anticholinergic effects, Orthostatic hypotension, Cardiac abnormalities, Wt gain, Photosensitivity, Increase suicide risk, Sedation Teach: Increase fluids/fiber, Take at HS, Exercise, sensible eating, Sunscreen, No suicide contract, No alcohol, caution driving Administration: Assessment: BP HR before giving and after, I&O, Adverse Effects: HA, dizziness, fatique, peripheral edema, hypotension Teach: Take as directed, avoid large amounts of grapefruit juice, dizziness, avoid alcohol, Administration: PO daily
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amoxicillin Trade: Amoxil Class: anti-infective, antiulcer agent Pharm: aminopenicillins
Action: Binds to bacterial cell wall causing death. Action is broader than penicillins Rationale:
Adult: PO 250-500 mg q8hr or 500-875 mg q12hr not to exceed 2-3 g/day. 2 g 1 hr prior to procedure Peds: >3mo: 25-50 mg/kg/day. 50 mg/kg 1 hr before procedure
Assessment: As stated previously, BP lying/standing, Cardiac assessment, High overdose potential limit quantity available to patient Adverse Effects: Anticholinergic effects, Orthostatic hypotension, Cardiac abnormalities, Wt gain, Photosensitivity, Increase suicide risk, Sedation Teach: Increase fluids/fiber, Take at HS, Exercise, sensible eating, Sunscreen, No suicide contract, No alcohol, caution driving Administration: Assessment: for infection, obtain a history before giving, signs of anaphylaxis, specimens for culture and sensitivity, monitor bowel function Adverse Effects: Seizures, diarrhea, N/V, rashes, pseudomembranous colitis Teach: take drug around the clock and finish meds, female pt and oral
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Renal impairment: adult PO 250-500 mg q12hr or q24hr.
contraception, signs of superinfection, allergy, stool and diarrhea. Administration: peds calculate and measure doses accurately.
amoxicillin/ clavulanate Trade- Augmentin Classaminopenicillins/beta lactmase inhibitors
Action- Binds to bacterial cell wall causing cell death: spectrum of amoxicillin is broader than penicillin. Clavulanate resists action of beta lactamase an enzyme produced by bacteria that is capable of inactivating some penicillins RationaleAction: Binds to bacterial cell wall resulting in cell death, broader spectrum then penicillin. Bactericidal action. Rationale: IVPB 3Gm Q6h
ampicillin/sulbactam Trade: ampicillin/ sulbactam Class: anti-infectives Pharm: aminopenicillins/beta lacamase inhibitor Ampicillin-sulbactam + NaCl 0.9% Class: anti-infectives Pharm: aminopenicillins/beta lactamase inhibitors
Assessment- infection, signs and symptoms of anaphylaxis, obtain specimens for culture and sensitivity, monitor bowel function Adverse Effects- Seizures, pseudomembranous colitis, diarrhea, rashes, anaphylazis and serum sickness Teach- take as directed, report signs of super infection, notify dr if diarrhea abdominal cramping, fever or blood stools occur Administration: Assessment: Infection, obtain history, culture and sensitivity, Adverse Effects: seizures, diarrhea, N/V rashes, pain Teach: Signs of superinfection, may affect oral contraceptives Administration: IV
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Action: Binds to bacterial cell wall, resulting in cell death bactericidal action Rational:
Assess: s&sx of infection, obtain hx,obtain specimens for C&S before therapy SE: seizures, anaphylaxis, diarrhea, rashes Teach: report signs of superinfection, notify Dr if fever, diarrhea, or if stool contains blood, pus or mucus
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antoprazole Trade: Protonix Class: antiulcer Pharm: proton-pump inhibitor
Action: Binds to an enzyme in the presence of acidic gastric pH, preventing the final transport of hydrogen ions into the gastric lumen. Rationale:
40mg/ 1 tablet oral BID
Assessment: Assess routinely for epigastric or abdominal pain and for frank occult blood in stool, emesis, or gastric aspirate. Adverse Effects: may decrease absorption of drugs requiring acid pH,HA, hyperglycemia, abd pain. Teach: avoid alcohol, aspirins or NSAIDs, report black tarry stools. Administration: PO and IV
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Arginine intensive drink mix Trade: Arginaid Class: nutritional suppliment aripiprazole Trade: Abilify Class: antipsychotics, mood stabilizers Pharm: dihydrocarbostyril
Action: provides protein through L-arginine with vitamins C & E to promote wound healing. Rationale: Action: Psychotropic activity may be due to agonist activity at dopamine D2 and serotonin 5-HT1Areceptors and antagonist activity at the 5HT2A receptor. Also has alpha1 adrenergic blocking activity. Rationale: Decreased manifestations of senile psychotic condition.
artifiical tears Trade: Class: sterile buffered isotonic solutions/ointments aspirin/dipyridamole Trade- Aggrenox ClassSalicylates/ platelet adhesion inhibitors
Action: Keeps the eyes moist with isotonic solutions and wetting agents in the management of dry eyes due to lack of tears; also provides lubrication for artificial eyes. Rational: Tear film insufficiency Action- Aspirin- produce analgesia and reduce inflammation and fever by inhibiting the production of prostaglandins dipyridamole- decreases platelet aggregation by inhibiting the enzyme phosphodiesterase Rationale:
Assessment: Need for added protein Adverse Effects: Teach: take as directed Administration: Mix with water, appropriate for lactose free, gluten free, kosher and sugar free diets. FOR PARENTERAL USE ONLY. NOT FOR GALACTOSEMIA. Assess: mental status, suicidal thoughts, wt/BMI/orthos/BMI periodically, observe for hoarding or cheeking, akathisia (restlessness or desire to keep moving) and extrapyramidal side effects, tardive dyskinesia, neuroleptic malignant syndrome (fever, muscle rigidity, altered mental status, respiratory distress, tachycardia, seizures, diaphoresis, hypertension or hypotension, pallor, tiredness, loss of bladder control) Adverse Effects: drowsiness, extrapyramidal reactions, constipation, tremor, SUICIDAL THOUGHTS, AGRANULOCYTOSIS, NEUROLEPTIC MALIGNANT SYNDROME Teach: take as directed; extrapyramidal symptoms and tardive dyskinesia; change positions slowly; drowsy; lightheaded; notify hcp if suicidal thoughts/tendencies or any other abnormal negative behavior; avoid extreme temperatures Administration: PO: Administer once daily without regard to meals. Assess: eye for redness, irritation, moistness Adverse Effects: photophobia, transient blurred vision, eye discomfort Teach: may cause sensitivity to light, blurred vision, or irritation Administration: instill drop into inner canthus of ordered eye Assessment- Monitor BP and Pulse Adverse Effects- Dipyridamole- dizziness, headache, hyptension, nausea Aspirin- GI Bleeding, dyspepsia, epigastric distress, nausea, exfliative dermatitis, stevens Johnson syndrome, toxic epidermal necrolysis, anaphylaxis, laryngeal edema Teach- Take as directed, change positions slowly, avoid alcohol use, report unusual bleeding of gums, bruising, black tarry stools Administration- give with a full glass
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of water at least 1 hr before or 2 hr after meals for faster absorption.
atenolol Trade: Tenormin Class: antianginals, antihypertensives Pharm: beta blocker
Action: Blocks stimulation of beta1 adrenergic receptors. Rationale:
100mg/tablet oral QD
atorvastin Trade: Lipitor Class: lipid lowering agents Pharm: HMG-CoA reductase inhibitor. Statin azithromycin Trade: Zithromax Class: agents for atypical mycobacterium, antiinfectives Pharm: macrolides
Action: Inhibits an enzyme, 3hydroxy-3-methylglutaryl-coenzyme A reductase, which is responsible for catalyzing an early step in the synthesis of cholesterol. Lowers total and LDL cholesterol and triglycerides. Rationale: Action: Inhibits protein synthesis at the level of the50S bacterial ribosome. Bacteriostatic action against susceptible bacteria. Rationale:
PO HS 40 mg = 1 tab
Adults: PO 500 mg 1st dose, 250 mg/day 4 days or more. Peds: PO 10 mg/kg max dose 500 mg/dose
baclofen Trade: Lioresal Class: muscle relaxants
Action: used to treat spacticity & hyperactive reflexes, hiccups, & alcohol dependence & withdrawal by inhibiting withdrawal symptoms & cravings Rational:
10-20 mg pills Can take fronm 10100mgto be effective but usually 60-80 is too much for most
Assessment: Monitor BR, HR, I/O, daily weights, assess routinely for CHF Adverse Effects: hypotension, fatigue, weakness, bradycardia, CHF, pulmonary edema Teach: Take biweekly BP, ensure enough meds through holidays, report any significant signs, change positions slowly, and consult MD prior to taking OTC cold meds. Administration: PO Assessment: Dietary history, monitor liver function, labs, Chol HDL LDL Triglycerides Adverse Effects: dizziness, drowsiness, HA, weakness, chest pain, peripheral edema, leg cramps, constipation, diarrhea. Teach: take as directed, follow diet, call dr if unexplained weakness, avoid OTC drugs and herbal Administration: PO HS daily Assessment: Infection, wounds, BP, specimen for culture and sensitivity, signs of anaphylaxis, bowel function Adverse Effects: Dizziness, drowsiness, fatigue, HA, hypotension, palpitations, abdominal pain, diarrhea, N/V, StevenJohnson syndrome, toxic epidermal necrolysis Teach: take as directed, drowsiness, dizziness, do not take with food or antacids, report chest pain, diarrhea or bloody stools Administration: PO do not take with food or antacids. Assess: baseline vitals, renal & liver fxn, monitor for therapeutic drug response SE: drowsiness, dizziness, GI disturbances, HA, lightheadedness, weakness Teach: donot drive or operate machinery, take with food, taper to avoid rebound spasms, may cause drowsiness Admin: do not take with hx of Glaucoma or Myasthenia Gravis
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Benefiber SF PWD 477
Action: Nutritional fiber additive for bulking up stool. Prevention of constipation. Rationale:
Class: wheat dextrin, a natural soluble fiber
Each serving of Benefiber Powder provides 3 grams of soluble fiber. And for your convenience, Benefiber Powder is available in various sized canisters and premeasured stick packs for individual servings.
Assessment: Dietary needs. Abdominal masses Adverse Effects: Flatus, diarrhea, cramping Teach: adds fiber to daily diet and aids in moving of the bowels. Administration: added to water and drank
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benzocaine Trade: Orajel Class: anesthetics (topical/local)
Action: Inhibit initiation and conduction of sensory nerve impulses. Rationale:
benzonatate Trade: Tessalon Perles Class: cough suppressant bisacodyl Trade Name: Dulcolax Class: Therapeutic: Laxative
Action: anesthetic action on stretch receptors in lungs. Rationale:
Assess: type, location, and intensity of pain; integrity of involved skin and mucous membranes Adverse Effects: ALLERGIC REACTIONS INCLUDING ANAPHYLAXIS. Teach: avoid contact with eyes; notify hcp l if erythema, rash, or irritation at site of administration occurs; Administration: Topical: Apply to gums by rubbing gel on with fingers or cotton swab. Assessment: LOC, bowel function, Adverse Effects: sedation, headache, dizziness, constipation, N&V. Teach: may cause dizziness, rise slowly Administration: Swallow whole, do not break or chew. MAX 6 caps. per day. Route and Dose: PO (Enteric available) Adults & Children >12 5-15mg (up to 30mg) as a single dose. Suppository 5-10 mg Assessment: Check for abdominal distention, bowel sounds, usual bowel function, color, consistency, and amount of stool produces. Adverse Effects: Abdominal cramps, nausea, diarrhea, rectal burning. Teach: PO do not crush/chew enteric coated med. Take on empty stomach for more rapid results. Administration: Suppository can be given at time of a BM if desired. Retain suppository for 15-30 min. Laxatives are for short term. Prolonged therapy may cause electrolyte imbalance & dependence. Increase fluid intake. Assessment: eye pressure Adverse Effects: eye irritation, drowsiness, dizziness, dry mouth, h/a, weakness, muscle pain Teach: take as directed; avoid concurrent use with MAOIs; technique for admin Administration: inner canthus of each eye;
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Action: Alters Fluid & electrolyte transport, producing fluid accumulation in the colon. Stimulates peristalsis. Evacuation of the colon. Rationale:
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Brimonidine ophthalmic Class: sympathomimetic selective alphaadrenergic agonist
Action: formation aqueous humor (for tx glaucoma) Rationale:
of of
Adverse Effects:
do not touch tip of applicator to eye
budesonideformoterol Trade: Symbicort Class: bronchodilator formoterol glucocorticosteroid budesonide
Action: budesonide has antiinflammatory action in the airways, in symptoms and fewer asthma exacerbations formoterol, a selective longacting 2-agonist (LABA) bronchodilator, results in rapid and long-acting relaxation of bronchial smooth muscle in patients with reversible airways obstruction Rationale: Pt has COPD Action: Inhibits the reabsorption of sodium and chloride from the loop of Henle and distal renal tubule. Increases renal excretion of water, sodium chloride, mag, potassium, and calcium. Rationale: 1mg tab PO daily
bumetanide Trade: Bumex Class: diuretics Pharm: loop diuretics
bupivacaine Trade: Marcaine Class: Epidural local anesthetics, anesthetics (topical/local) buPROPion Trade: Wellbutrin SR Class: antidepressants, smoking deterrents Pharm: aminoketones
Action: Alters the influx of sodium and the efflux of potassium in neurons, slowing or stopping pain transmission. Rationale:
Action: Decreases neuronal reuptake of dopamine in the CNS. Diminished neuronal uptake of serotonin and norepinephrine. Diminished depression and decrease cigarette craving. Rationale:
PO 2 tabs. 150 mg/tab daily 0900
A: respiratory status and lung sounds AE: headache, otitis media T: rinse mouth with water after treatment to decrease risk of developing local candidiasis; avoid smoking, known allergens, and other respiratory irritants; notify hcp if sore throat or mouth occurs A: Inhaln: Allow at least 1 min between inhalations Intranasal: Clear nasal passage by blowing nose prior to use, shake canister gently before use. PO: May administer without regard to meals, do not chew, crush or break open capsule, swallow whole. Do not administer with grapefruit juice. Assessment: Assess fluid status, BP, assess for tinnitus and hearing loss, electrolyte imbalance symptoms Adverse Effects: dehydration, hypokalemia, hypomagnesemia, hypovolemia, metabolic alkalosis Teach: take as directed, water for othrostatic hypotension, contact md if muscle weakness, monitor glucose for DM pts Administration: PO, IM, IV Assessment: sedation during procedure and return of sedation after procedure. Unwanted motor and sensory deficit. Adverse Effects: seizures, cardiovascular collapse, N&V, urinary retention Teach: Notify nurse if signs and symptoms of systemic toxicity occur. Request assistance during ambulation. Administration: Bupivacaine safety not established in children <18yr Assessment: Monitor mood changes Adverse Effects: Seizures, suicidal thoughts/ behavior, agitation. HA, dry mouth, N/V, tremors Teach: Take as directed, may impair judgment, watch for suicidal tendencies, avoid alcohol, frequent mouth rinses, smoking should be stopped by the second
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week, stop taking and contact heath professional if suicidal thought appear. Administration: PO 2 tabs of 150mg to make 300mg dose daily. 0900
buspirone Trade: Buspar Class: antianxiety agent
Action: Binds to serotonin and dopamine receptors in the brain. Increases norepinephrine metabolism in the brain. Rationale:
10mg=1 tab PO daily
butorphanol Trade: Stadol Class: Opioid analgesics Opioid agonists/antagonists
Action: Binds to opiate receptors in the CNS. Alters the perception of and response to painful stimuli, while producing generalized CNS depression. Decrease in severity of pain Rationale:
IM 2 mg q3-4 hrs as needed. IV 1mg q3-4 hr as needed. Intranasal 1 mg (1 spray in 1 nostril)
calcium carbonate Trade: Tums Extra strength Class: Mineral and electrolyte replacements/ supplements Calcium/Vitamin D Trade: calcitriol Class: vitamin Pharm: fat-soluble vitamin
Action: Essential for nervous, muscular, and skeletal systems. Cell membrane and capillary permeability. Control of hyperphosphatemia in ESRD. Rationale: Action: Vitamin D and calcium help with the absorption of calcium and decreases parathyroid hormone concentration Rationale:
PO 3 tabs AC
Assessment: assess anxiety level before and during therapy Adverse Effects: dizziness, weakness, HA, chest pain, palpitations, tachycardia, numbness, sweating Teach: caution about dizziness, avoid alcohol, notify MD if any abnormal movements occur (dystonia, invonluntary movements) Administration: Assessment: Pain type, location, intensity prior to and 1 hr following PO, Subcut, IM and 5 min after IV start. BP, HR, RR periodically. Bowel function. Physical and psychological dependence and tolerance. Adverse Effects: Confusion, dysphoria, hallucinations, sedation, nausea, sweating Teach: take as directed. May cause drowsiness and dizziness, and orthostatic hypertension. Avoid alcohol. Deep breathe q2h. Administration: Check MAX dose, Keep Narcan available for toxicity/overdose. Assessment: Hypocalcemia, BP, HR, N/V for toxicity Adverse Effects: Cardiac arrest, arrhythmias, constipation, phlebitis Teach: Do not take enteric-coated tablets 1 hr after taking, may cause constipation, avoid alcohol. Administration: PO AC to bind with Phos Assessment: assess for calicium/vit D deficiency, for bone pain and weakness, signs of hypocalcemia, labs Adverse Effects: dizziness, dyspnea, malaise, pancreatitis Teach: review diet, avoid antacids containing magnesium Administration: PO
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Calcium 600mg/vit D 400mg 1 Tab twice daily
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captopril Trade: Capoten Class: antihypertensives Pharm: ACE inhibitors
Action: ACE inhibitors block the conversion of angiotension I to the vasoconstrictor angiotension II. They also prevent the degradation of bradykinin and other vasodilatory prostaglandins. They increase rennin levels and decrease aldosterone levels. (systemic vasodilation) Rationale: Action: Levodopa is converted to dopamine in the CNS where it serves as a neurotransmitter. Carbidopa prevents peripheral destruction of levodopa. Rationale: Relief of tremor and rigidity in Parkinsons syndrome
Assessment: Assess BP, HR and vitals frequently, assess for signs of angioedema, monitor weight, monitor labs (bun, creatinine, lytes, cbc), labs Adverse Effects: HA, cough, hypotension, taste disturbances, wkness, agranulocytosis, angioedema. Teach: avoid salt substitutes, notify DR if rash, mouth sores, sore throat, fever, swelling in hands/feet occur, change position slowly, and monitor BP weekly. Administration: PO Assess: parkinsonian symptoms(rigidity, pill rolling, twisting, drooling, tremors); bp and pulse; hepatic and renal function (AST, ALT, bili, alk. phos., LDH, protein, BUN, creatinine) Adverse Effects: involuntary movements, n/v Teach: Do no tdouble dose; eating food after admin will GI upset but avoid high protein d/t impaired levodopa; sleepy, drowsy, dizzy; change positions slowly; oral hygiene for dry mouth; may darken saliva, urine, or sweat; notify hcp if palpitations, urinary retention, involuntary mvmts, severe n/v, behavioral changes Administration: PO: admin on a regular schedule. Do not crush or chew controlledrelease tabs but they may be halved Assessment: BP, I&O, toxicity and overdose Adverse Effects: Dizziness, fatque, weakness, diarrhea, constipation, hyperglycemia Teach: take as directed, teach how to check pulse and BP, drowsiness, dizziness, monitor glucose, Administration: With food Assessment: for infection, obtain a history before giving, signs of anaphylaxis, specimens for culture and sensitivity, monitor bowel function Adverse Effects: Seizures, diarrhea, N/V, rashes, pseudomembranous colitis, StevenJohnson syndrome Teach: take drug around the clock and finish meds, signs of superinfection, allergy, stool and diarrhea. Administration: peds calculate and measure
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carbidopa/levidopa Trade: Sinemet Class: antiparkinson agent Dopamine agonist
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carvedilol Trade: Coreg Class: antihypertensive Pharm: beta blocker cefazolin Trade: Ancef Class: anti-infective Pharm: first generation cephalosporins
Action: Blocks stimulation of beta1 and beta2 adrenergic receptor sites. Decreased Heart rate and BP. Improves cardiac output slowing progression of CHF and decreased death. Rationale: Action: Binds to cell membrane causing cell death. moderate to severe infections Rationale:
PO daily 12.5 mg tab with food check BP HR
Adverse Effects:
Adult IM IV, mod to severe infections 500 mg 2 g q6-8hr max dose 12 mg/day. mild infections 250-500 mg q8hr Peds: IM IV 16.7-33.3 mg/kg q8hr max dose 6 g/day. 25 mg/kg 30 minutes before procedure
Adverse Effects:
doses accurately.
cefoxitin Trade: Mefoxin Class: anti-infective Pharm: second generation cephalosporins
Action: Bind to bacterial cell wall membrane, causing cell death. Similar to that of firstgeneration cephalosporins but have increased activity against several gram-negative pathogens Rationale:
2gm=50ml IV pre-op once
cefpodoxime Trade: Vantin Class: anti-infectives Pharm: 3rd gen cephalosporins ceftazidime Trade: Fortaz, Tazicef Class: Anti-infectives 3rd generation cephalosporins ceftriaxone Trade: Rocephin Class: anti-infectives Pharm: 3rd generation cephalosporins
Action: Bactericidal action against susceptible bacteria Rational:
Assessment: Assess for infection, signs of anaphylaxis, bowel function, send specimen for C/S Adverse Effects: seizures, pseudomembranous colitis, diarrhea, rashes, pain, phlebitis, anaphylaxis, serum sickness Teach: take as directed, educate about signs of superinfection, caution use with alcohol Administration: IM, IV Assess: for infection, s&sx of anaphylaxis SE:seizures, N&V, diarrhea, rashes Teach: report signs of superinfection Admin: do not admin within 2 hr before or after antacid or H2 receptor antagonist Assessment: Infection at beginning and during tx. Obtain culture, ask for allergies, monitor bowel function and assess for anaphylaxis. Adverse Effects: Seizure, HA, pseudomembranous colitis, N/V, diarrhea, bleeding Teach: Administration: IM or IV Assessment: BP/ wound, urine, stool, obtain history, specimen for culture and sensitivity, signs of anaphylaxis, bowel function, peds jaundice. monitor prothrombin time Adverse Effects: Seizures, HA, pseudomembranous colitis, Steven-Johnson syndrome, anaphylaxis, serum sickness Teach: Take as directed, correct doses, report signs of superinfections. call doctor if diarrhea develops Administration: IM, IV
Adverse Effects:
Action: Bind to bacterial cell wall membrane, causing cell death. Treatment of infection Rationale:
IM, IV adults/child >12 max dose 6g/day Sever infections 2g q8
Adverse Effects:
Action: Binds to bacterial cell wall membrane causing death. Bactericidal action against susceptible bacteria. Rationale:
Adults: IM, IV most infections 1-2 g q1224 hr Peds: IM, IV most infections 25-37.5 mg/kg q12 or 50-75 mg/kg q24 hr max dose 2g/day
Adverse Effects:
celecoxib Trade: Celebrex Class: antirheumatics, NSAID cephalexin Trade- Keflex Class 1st generation cephalosporin chlorhexidine topical Trade: Hibiclens Class: topical antiseptic chlorpromazine Trade: Thorazine Class: TYPICAL ANTIPSYCHOTICS Pharm: Phenothiazines
Action: inhibits the enzyme COS-2. This enzyme is required for the synthesis of prostaglandins. Has analgesic, anti-inflammatory, and antipyretic properties Rationale: Action- binds to bacterial cell wall membrane causing cell death Rationale-
Assessment: ROM and degree of swelling, allergy to sulfonamides, asa, NSAIDS Adverse Effects: GI bleeding, exfoliative dermatitis, Stevens-Johnson syndrome, toxic epidermal necrolysis Teach: know S/S of GI bleed, do not take if planning pregnancy Administration: Assess- incection, S&S of anaphylaxis, bowel function Adverse Effects- seizures, pseudo membranous colitis, diarrhea, N&V, rashes Teach- take as directed, notify doctor with diarrhea Administration: Assess: skin and wound SE: blistering, peeling, severe burning, itching, redness, skin rash, swelling, Teach: Rinse skin before applying. Avoid eyes, ears, mouth, nose, rectum, or vagina Admin: wash wound on coccyx then pack wet/dry 2x a day Assessment: I&O, Urinary retention; especially in elders, vitals, Wt. Administer medications as needed for EPS, Check EKG for Mellaril due to cardiotoxicity, Mellaril is contraindicated w/ drugs that lengthen QT Intervals, CBC, Liver function tests, ocular exams periodically Adverse Effects: Anticholinergic effects, Extrapyramidal Symptoms (EPS), High EPS, Moderate anticholinergic Teach: Drink 2-3L fluids QD, sugarless gum or candy for dry mouth, high fiber diet, good oral hygiene, Sunscreen, Rise slowly, No alcohol, Caution driving, Report EPS, Report any symptoms immediately Administration: Assessment: Monitor mood changes, suicidal thoughts, sexual dysfunction, mental changes. Adverse Effects: Suicidal thoughts, apathy, confusion, drowsiness, insomnia, weakness, abdominal pain, anorexia, diarrhea, dry mouth, dyspepsia, flatulence, increase saliva, N/V. Teach: Take as directed, avoid alcohol, may
Adverse Effects: Therapeutic Effect-
Adverse EffectsTherapeutic Effects: Adverse Effects:
Action: fights bacteria. Killing or preventing the growth of bacteria on the skin Rationale: Pt. has wound on foot, cellulitis Action: Dopamine receptor antagonists Rationale:
Adverse Effects:
citalopram Trade: Celexa Class: antidepressant Pharm: selective serotonin reuptake inhibitors
Action: selectively inhibits reuptake of serotonin in CNS. Antidepressant. Rationale:
PO 40mg tab daily
Adverse Effects:
cause drowsiness, dizziness, changepositions slowly, frequent mouth washes Administration: PO daily
citalopram Trade: Celexa Class: Antidepressant Pharm: SSRI
Action: Blocks reuptake of serotonin, Increasing available serotonin at receptor site, Anti anxiety, Antidepressant Rationale:
clindamycin Trade: Cleocin Class: Anti-infectives
Action: Inhibits protein synthesis in susceptible bacteria at the level of the50s ribosome. Bactericidal Rationale:
300 mg 50mL Q8 next dose 14:00 IV
clomipramine Trade: Anafranil Class: Anitdepressants Pharm: Tri-cyclics
Clonazepam Trade: Klonopin Class: benzodiazepines
Action: CNS depressant used as sedative, hypnotic, anxiolytic, & antiseizure activity. Used for petit mal seizures Rational:
Assessment: Assess for symptoms of serotonin syndrome, In low doses decrease anxiety Adverse Effects: Increase suicide risk as depression lifts, Prozac may increase blood levels of statins, Potentiates other medications that use same enzymes (except Celexa), Insomnia, nausea, anorexia, headache, restlessness, decreased libido Serotonin syndrome, BP, HR, fever, muscle rigidity, coma, death MED EMERGENCY Teach: Black Box Warning, Give with food for nausea, Do not stop abruptly Administration: Assessment: Signs of infection, VS, specimen for culture and sensitivity, monitor bowel, hypersensitivity. Adverse Effects: Dizziness, HA, vertigo, arrhythmias, hypotension, diarrhea Teach: Take asdirected, call Dr. if diarrhea or abdominal cramping begins, superinfection, bitter taste with IV Administration: IV 14:00 hr Assessment: As stated previously, BP lying/standing, Cardiac assessment, High overdose potential limit quantity available to patient Adverse Effects: Anticholinergic effects, Orthostatic hypotension, Cardiac abnormalities, Wt gain ,Photosensitivity, Increase suicide risk, Sedation Teach: Increase fluids/fiber, Take at HS, Exercise, sensible eating, Sunscreen, No suicide contract, No alcohol, caution driving Administration: Assess: vitals, esp RR, liver & renal fxn, hx & onset of sleep disorder, anxiety, or seizure activity SE: drowsiness, lethargy, hangover effect, dizziness, N&V, anxiety, irritability
Adverse Effects:
Adverse Effects:
Adverse Effects:
clonidine Hcl Trade: Catapres Class: antihypertensive clopidogrel Trade: Plavix Class: antiplatelet agents Pharm: platelet aggregation inhibitors
Action: fights bacteria. Killing or preventing the growth of bacteria on the skin Rationale:
Action: Inhibits platelet aggregation by irreversibly inhibiting the binding of ATP to platelet receptors Rationale:
clorazepate Trade: Tranxene Class: anticonvulsants, sedative/hypnotics Pharm: benzodiazepines
Action: CNS to produce anxiolytic effect and CNS depression. Produces skeletal muscle relaxation. Relief of anxiety. Sedation. Prevention of seizures Rationale:
PO 3.75mg 1 tab Q12hr 0900
cocorticioid Trade: Beta methasone Class: Systemic
Action: Stimulate fetal lung maturation by promoting release of enzymes that induce production or release of lung surfactant. Rationale: Give to prevent or reduce the severity of respiratory distress syndrome in pre-term infants between 24 & 34 weeks of gestation.
6 mg IM * 4 doses 12 hours apart.
Assess: skin and wound SE: blistering, peeling, severe burning, itching, redness, skin rash, swelling, Teach: Rinse skin before applying. Avoid eyes, ears, mouth, nose, rectum, or vagina Admin: wash wound on coccyx then pack wet/dry 2x a day Assessment: Symptoms of stroke, peripheral vascular disease, or MI, signs of thrombotic thrombocytic purpura (thrombocytopenia, microangiopathic hemolytic anemia, neurologic findings, renal dysfunction, fever). May rarely occur, even after short exposure (<2 wk). Requires prompt treatment. Adverse Effects: depression, dizziness, fatigue, headache. GI BLEEDING, abdominal pain Teach: Take as directed. Take missed doses as soon as possible unless almost time for next dose; do not double doses. Notify health care professional promptly if fever, chills, sore throat, or unusual bleeding or bruising occurs. Instruct patient to avoid taking OTC medications containing aspirin or NSAIDs without consulting health care profession Administration: Assessment: Drowsiness, unsteadiness, dependence, notable changes in behavior, anxiety/mental status, seuizures, toxicity/ overdose. Adverse Effects: Suicidal thoughts, dizziness, drowsiness, lethargy, HA, mental depression, N/V, Resp depression. Teach: Take as directed, avoid alcohol, drowsiness, unsteadiness, dependence, unusual bleeding or tiredness, seizures Administration: PO 3.75mg 1 tab Q12hr 0900 Assessment: Lung sounds and blood glucose levels. Adverse Effects: Possible maternal infection, pulmonary edema, may worsen maternal condition.Teach: To watch for signs of pulmonary edema Administration: IM 6 mg * 4 doses 12 hours apart. Do not give if woman has infection. Use in women with PPROM not recommended.
Adverse Effects:
Adverse Effects:
Adverse Effects:
codeine Trade: Tylenol #3 Class: Allergy, cold & antitussive, opioid analgesics
Action: Binds to opiate receptors in the CNS. Alters the perception of & response to painful stimulus while producing generalized CNS depression. Decreases cough reflex, decrease GI motility. Rationale:
PO 15-60 mg q 3-6 hrs or prn.
Codeine Trade: Paveral Class: opioid analgesics P: opioid agonists cyanocobalamin Trade: Vitamin B12 Class: antianemics, vitamins Pharm: water soluble vitamins cyclobenzaprine Trade: Flexeril Class: skeletal muscle relaxants, central acting
Action: Binds to opiate receptors in the CNS, alters perception of & response to painful stimuli Rational: Action: Coenzyme for medabolic processes, including fat and carbohydrate metabolism and protein synthesis. Required for cell production and hematopoiesis. Rationale: Action: Reduces tonic somatic muscle activity at the brainstem. Reduction in muscle spasm and hyperactivity without loss of function. Rationale: 1000mcg=1mL IM
Assessment: BP/ P/ RR before & after administration. Assess bowel functions & pain for type, location & intensity. Adverse Effects: Confusion, sedation, hypotension, constipation, nausea, vomiting. Teach: may cause drowsiness & dizziness. Cough & deep breathe frequently & do oral hygiene, aware of poss. constipation. Administration: PO 15-60 mg q 3-6 hrs drink plenty of fluids. Assess: BP, pulse,resp, bowel fxn, pain SE: confusion, sedation, hypotension, constipation, N&V Teach: how & when to ask for pain med, maycause drowsiness & dizziness, chg position slowly, turn, C&DB q2hr Assessment:Vit B!@ deficiency, monitor plasma folic acid iron levels. Adverse Effects: HA, cyanokit, dizziness, memory impairment, restlessness, hypertension, erythema, rash, red urine. Teach: encourage pt to comply with diet, eat foods high in B12, not to exceed RDA of vitamins Administration: IM 1mL Assessment: pain, stiffness, ROM, sedation and weakness. Adverse Effects: Dizziness, drowsiness, confusion, fatigue, dry mouth, N/V, constipation Teach: Take as directed, may cause dizziness, drowsiness, blurred vision, avoid alcohol, increase fluids to avoid constipation, good oral hygiene. Administration: PO Assess: eye for irritation (redness, inflammation, tearing) Adverse Effects: irritation, blurred vision Teach: may cause irritation or blurred vision Administration: invert to obtain uniform opaque appearance prior to use
Adverse Effects:
Adverse Effects:
Adult: PO 10 mg 3 times daily not exceeding 60 mg/day. Extended release 1530 mg once daily
Adverse Effects: Therapeutic Effects: Adverse Effects:
cyclosporine Trade: Restasis Class: immunomodulator
Action: tear production when the cause of dry eye is inflammation secondary to keratoconjunctivitis sicca. Rationale:
darifenacin Trade: Enablex Class: Antispamodics Urinary tract Pharm: anticholinergics
Action: Acts as a muscarinic Receptor antagonist Antagonizes bladder smooth muscle contraction Rationale: Urinary incontenance
Assess- voiding pattern AE- constipation, dry mouth Teach- take as directed, do not share med Administration:
Adverse Effects:
desipramine Trade: Norpramin Class: Anitdepressants Pharm: Tri-cyclics
desvenlafaxine Trade: Prestiq Q Class: Antidepressants Pharm: SNRI diazepam Trade: Valium Class: antianxity, anticonvulsants Pharm: benzodiazepine digoxin Trade: Lanoxin Class: antiarrhythmics, inotropics (digitalis glycosides)
Action: increase serotonin & norepinephrine Rationale:
Assessment: As stated previously, BP lying/standing, Cardiac assessment, High overdose potential limit quantity available to patient Adverse Effects: Anticholinergic effects, Orthostatic hypotension, Cardiac abnormalities, Wt gain, Photosensitivity, Increase suicide risk, Sedation Teach: Increase fluids/fiber, Take at HS, Exercise, sensible eating, Sunscreen, No suicide contract, No alcohol, caution driving Administration: Assessment: Serotonin Syndrome, Increased bleeding risk with ASA, NSAIDS Adverse Effects: Hypertension, Anticholinergic Teach: No tryptophan or St. Johns Wort Administration: 5mg.1ml IV Q6Prn Assessment: BP, HR, RR pre and post tx, assessIV site for phlebitis and venous thrombosis, assess anxiety, mood, behavior. Adverse Effects: dizziness, drowsiness, lethargy, resp depression, hypotension Teach: Advise of S/E, avoid alcohol, avoid abrupt withdrawals Administration: PO, IM, IV, Rect Assessment: Apical pulse and BP, edema, lung sounds for rales/crackles, DIG Level Adverse Effects: ARRHYTHMIAS, bradycardia, DIG TOXICITY (anorexia, n&v, yellow vision) Teach: r/t lab draws to monitor for toxicity. Administration: Withhold dose and notify DR. if pulse rate is <60 bpm in an adult. Have second practitioner independently check original order and dose calculations. Monitor therapeutic drug levels. DIGIBIND is
Adverse Effects:
Action: Depresses the CNS, probably by potentiating GABA, an inhibitory neurotransmitter. Skeletal muscle relaxant. Rationale:
Adverse Effects:
Action: Increases the force of myocardial contraction. Prolongs refractory period of the AV node. Decreases conduction through the SA and AV nodes. Rationale: arrythmia
Adverse Effects:
antidote
diltiazem Trade: Cardizem Class: antianginal, antiarrhythmics, antihypertensive Pharm: calcium channel blocker diphenhydramine Trade: Benadryl Class: Allergy, cold and cough remedies, antihistamines, antitussives diphenoxylate/ atropine Trade: Lomotil Class: antidiarrheal anticholinergic
Action: Inhibits transport of calcium into myocardial and vascular smooth muscle cells, resulting in inhibition of excitation-contraction coupling and subsequent contraction. Rationale: Action: Antagonizes the effects of histamine at H1 receptor sites. CNS depressant and anticholinergic properties. Reielf of acute dystonic reactions. Rationale: Action: Inhibits excessive GI motility. Atropine added to discourage abuse. Rationale: Diarrhea-colitis
360mg= 2tab PO daily
Assessment: monitor BP, HR, I/O, assess for chf signs, monitor potassium Adverse Effects: cough, dyspnea, peripheral edema, chf, blurred vision, steven-johnson syndrome,arrhythmias Teach: avoid grapefruit, monitor pulse, orthostatic hypotension, maintain good dental hygeine Administration: Assessment: Sedation, treatment and prevention of anaphylaxis, extrapyramidal reactions, insomnia Adverse Effects: Drowsiness, dizziness, HA, anorexia, dry mouth, constipation, N/V. Teach: Take as directed, may cause drowsiness, dry mouth, sleep techniques, avoid alcohol, Administration: IV push Q6 Assess: frequency and consistency of stools; bs; F/E; skin turgor Adverse Effects: dizziness, constipation Teach: Take as directed. Do not dbl doses. Drowsy. Oral care for dry mouth. Avoid alcohol and other CNS depressants. Inform hcp if diarrhea persists, or if fever, abd pain or palpitations Administration: PO: with food if GI upset occurs. Tabs may be crushed and given with fluid of choice. Assess- Monitor BP and P Adverse Effects-dizziness, headache, hypotension, nausea Teach- change positions slowly, may cause orthostatic hypotension, notify if an unusual bleeding bruising occur. Admin- give with full glass of water at least 1 hr before meals or 2 hr after meals for faster absorption. If GI irritation occurs, may be administered with or immediately after meals. Tablets may be crushed mixed with food if pt has difficulty swallowing.
Adverse Effects:
IV push 25mg=0.5mL. Give 12.5mg-25mg Q6
Adverse Effects:
Adverse Effects:
dipyrimale Trade- Persantine Class- Platelet adhesion inhibitor
Action- Decreases platelet aggregation by inhibiting the enzyme phosphodiesterase Rationale-
Adverse Effects-
divalproex sodium Trade: Depakote Class: anticonvulsants, vascular headache suppresants docusate sodium Trade: Colace Class: Therapeutic: Laxative
Action: Increased levels of GABA, an inhibitory neurtransmitter in the CNS. Suppression of seizure activity. Rationale: Ordered to suppress seizures Action: Promotes water into stool Resulting in softer fecal mass. Rationale:
PO HS 500mg 2tabs
Assessment: Seizures, bipolar disorders, migraines, Adverse Effects: Suicidal thoughts, N/V, agitation ,dizziness, insomnia, sedation, confusion, diarrhea Teach: Take as directed, drowsiness, dizziness, avoid alcohol, Administration: PO HS Assessment: Check for abdominal distention, bowel sounds & bowel frequency, stool color, consistency & amount of stool passage. Adverse Effects: Throat irritations, mild cramps, rash Teach: Laxatives are used short term. Prolonged use may lead to dependence. Take with a full glass of water. Administration: OP/Oral: Tablets/Capsules/Liquid Assessment: Cognitive function, HR, minimental status exams Adverse Effects: HA, diarrhea, n/v Teach: Take daily and as directed, may take week for results, notify Dr if N/V, diarrhea, change in stool Administration: PO daily Assessment: monitor vitals, orthostatic hypotension, I/Os Adverse Effects: dizziness, HA first dose orthostatic hypotension Teach: may cause drowsiness, change position slowly, contact md prior to OTC cold meds useage Administration: PO Assessment: As stated previously, BP lying/standing, Cardiac assessment, High overdose potential limit quantity available to patient Adverse Effects: Anticholinergic effects, Orthostatic hypotension, Cardiac abnormalities, Wt gain ,Photosensitivity, Increase suicide risk, Sedation Teach: Increase fluids/fiber, Take at HS, Exercise, sensible eating, Sunscreen, No suicide contract, No alcohol, caution driving Administration:
Adverse Effects:
Adult/Child >12 PO 50-400mg in 1-4 divided doses.
Adverse Effects:
donepezil Trade: Arigept Class: anti-alzheimer Pharm: cholinergics doxazosin Trade: Cardura Class: antihypertensives Pharm: peripherally acting antiadrenergics doxepin Trade: Sinequan Class: Anitdepressants Pharm: Tri-cyclics
Action: inhibits acetycholinesterasre thus improving cholinergic function by making more acetylcholine available Rationale: Action: Dilates both arteries and veins by blocking postsynaptic alpha1adrenergic receptors Rationale:
10 mg Tab PO HS
4mg=1 tab PO bedtime
Adverse Effects:
Adverse Effects:
doxercalciferol Trade- Hectorol Class- Fat soluble vitamin
doxycycline Trade: Vibramycin Class: anti-infective Pharm: tetracyclines
Action- cholecalciferol requires activation in the liver and kidneys to create the active form of Vit D. doxercalciferol and ergocalciferol require activation in the liver to create the active form of Vit D RationaleAction: Inhibits bacterial protein synthesis of the 30S bacterial ribosome. Bacteriostatic against susceptible bacteria Rationale: Pt has pneumonia and has allergies to sulfa drugs Action: Inhibits serotonin/ norepinephrine reuptake. Decrease depressive symptomatology, neuropathic pain, and anxiety. Rationale:
Assessment- bone pain, weakness, vit deficiency, observe pt for evidence of hypocalcemia. Adverse Effects- dizziness, malaise, dyspnea Teach-diet high in calcium, avoid antacids containing magnesium, follow up. Administration: 1 Tab PO Q12 Assessment: infection, cultures, bowel function, increased alkaline phosphatase and BUN. Adverse Effects: dizziness, vestibular reactions pseudomenbranous colitis, N/V, photosensitivity. Teach: take as directed, avoid milk, dizziness, use sunscreen, S/S super infection Administration: Assessment: Sexual dysfunction, BP, appetite, notable changes inbehavior, depression, suicidal thoughts. Adverse Effects: Neuroleptic malignant syndrome, seizures, suicidal thoughts, fatigue, drowsiness, insomnia, hepatotoxicity, decreased appetite, constipation, dry mouth, N/V, diarrhea. Teach: Take at same time every day, watch for anxiety, drowsiness, and mental changes, avoid alcohol. Administration: PO 30 mg 3 tabs for 90 mg daily 0900 Assessment: Serotonin Syndrome, Increased bleeding risk with ASA, NSAIDS Adverse Effects: Hypertension, Anticholinergic Teach: No tryptophan or St. Johns Wort Administration: Assessment: Assess wob, lung sounds, hr, rr pre and post treatment. Monitor PFT and observe for paradoxical wheezing. Adverse Effects: nervousness, tremor, chest pain, palpitation Teach: Take meds as needed and contact doctor if symptoms are not relieved by nebs. Administration: via nebulizer
Therapeutic EffectsAdverse Effects-
Adverse Effects:
duloxetine Trade: Cymbalta Class: antidepressant Pharm: selective serotonin/ norepinephrine reuptake inhibitors
PO 30 mg 3 tabs for 90 mg daily 0900
Adverse Effects:
duloxetine Trade: Cymbalta Class: Antidepressants Pharm: SNRI duoneb Trade: albuterol, atrovent Class: bronchodilator Pharm: adrenergic, anticholinergic
Action: Dilates bronchial smooth muscle Rationale:
3ml neb q4wa and q1hr prn
Adverse Effects:
Duoneb (albuterolipratropium Trade: Proventil Class: bronchodilators enoxaparin Trade: Lovenox Class: Anticoagulants, antithrombotic Pharm: antithrombotic epoetin Trade- Epogen Class- Hormones
Action: Binds to beta2adrenergic receptors in airway smooth muscle, leading to activation of adenyl cyclase and increased levels of cyclic3', 5'-adenosine monophosphate (cAMP) Rationale: Action: Prevention of DVT and PE. Rationale:
40 mg 1x Sub-Q deep in tissue.
Assess: lung sounds, pulse, B/P SE: nervousness, restlessness, tremor, chest pain, palpitations, N&V, hypokalemia Teach: notify Dr. if SOB is not relieved. Allow 5 min to elapse before admin. Other inhalant meds, Admin: with meals to minimize gastric irritation Assessment: Signs of bleeding, hemorrhage, Homan signs, chills, fever, Adverse Effects: Brushing at injection site, dizziness, HA, insomnia, N/V Teach: do not rub injection site, watch for bleeding. Administration: Sub-Q in abdomen. Assessment- monitor BP, symptoms of anemia, dialysis shunts (thrill and bruit) Adverse Effects- Seizures, CHF, MI, Stroke, Thrombotic Events, Hypertension Teach-Explain why giving med, notify Dr if signs of blood clots, occur, dietary restrictions, meds and dialysis, teach ways to prevent self injury in pt at risk for seizures Administration: Assessment: Assess for infection at beginning of and during treatment. Obtain history of any reactions to penicillins, cephalosporins, or carbapenems. Obtain C/S prior to treatment. Adverse Effects: seizures, pseudomembranous colitis, N/V, anaphylaxis. Teach: advise pt to report signs of superinfection and allergy, notify MD if ever and diarrhea occur. Administration: IM or IV Assessment: assess for sensitivity, assess infection pre, during and post treament Adverse Effects: seisure, anaphylaxis, pseudomembranous colitis Teach: report signs of super infection, notify md if stool contains pus, mucus, or blood Administration: IV
Therapeutic Effect:
Adverse Effects:
Action- stimulates erythropoiesis (production of red blood cells) Rationale-
Adverse Effects-
ertapenem Trade: Ivanz Class: anti-infectives Pharm: carbapenems
Action: Bactericidal action against susceptible bacteria. Rationale:
1g/60ml IV Q24hr
Adverse Effects:
ertapenem Trade: Invanz Class: anti-infectives Pharm: carbapenems
Action: Bactericidal action against susceptible bacteria. Rationale: R/T sepsis
1 Gm IVPB Q24
erythromycin Trade: Erythrocin Class: anti-infective Pharm: macrolides
Action: Suppresses synthesis at the level of the 50S bacterial ribosome. Rationale:
1000mg 3 doses preop PO
escitalopram Trade: Lexapro Class: Antidepressant Pharm: SSRI
estradiol Trade: Estrace Class: hormones
Action: estrogen promotes growth and development of female sex organs and the maintenance of secondary sex characteristics in women Rationale: hormone replacement for hysterectomy
Assessment: Assess for infection, send specimen for C/S, monitor liver function, may cause false levels in AST ALT and alkaline phosphatase. Adverse Effects: QTS prolongation, ventricular arrhythmias, N/V, phlebitis. Teach: take as directed, may cause stomach upset, contact MD if have darkened urine, yellow eyes, pale stools, superinfection. Administration: PO, IV Assessment: Assess for symptoms of serotonin syndrome, In low doses decrease anxiety Adverse Effects: Increase suicide risk as depression lifts, Prozac may increase blood levels of statins, Potentiates other medications that use same enzymes (except Celexa), Insomnia, nausea, anorexia, headache, restlessness, decreased libido Serotonin syndrome, BP, HR, fever, muscle rigidity, coma, death MED EMERGENCY Teach: Black Box Warning, Give with food for nausea, Do not stop abruptly Administration: Assess: BP before and periodically; I/O and weekly weight; frequency and severity of menopausal symptoms Adverse effects: HA, intolerance to contact lenses; edema, HTN, nausea, wt changes, amenorrhea, dysmenorrhea, erectile dysfunction, testicular atrophy, oily skin, gynecomastia, breast tenderness, MI, THROMBOEMBOLISM Teach: take as directed, do not double dose, immediate D/C may cause withdrawal bleeding, report s/s of fluid retention, thromboembolic disorders, mental depression, hepatic dysfunction, use sunscreen Admin: PO: with or immediately after food to GI upset
Adverse Effects:
Adverse Effects:
Adverse Effects:
ezetimibe Trade: Zetia Class: lipid-lowering agents
Action: Inhibits absorption of cholesterol in the small intestine. Rationale: Pt has high cholesterol
Assess: diet history, fat consumption SE: Angioedema, nausea,cholecystitis, pancreatitis Teach: should be used in conjunction with diet restrictions. Females notify if they are pregnant. Report any unexplained muscle pain, tenderness or weakness Admin: give without regard to meals
Adverse Effects:
famotidine Trade: Pepcid Class: antiulcer agents Pharm: histamine H2 antagonists
Action: Inhibits the action of histamine at the H2 receptor site located primarily in gastric parietal cells, resulting in inhibition of gastric acid secretion. Healing and prevention of ulcers. Rationale:
Adults: PO 150-300 mg once daily at bedtime. IV IM 50 mg q6-8hr Peds: PO 2 mg/kg/day in two doses. IV, IM 24 mg/kg/day divided q6-8hr up to 200 mg/day
fenofibrate Trade: Lofibra T: lipid-lowering agents P: fibric acid derivatives fenofibric acid Trade: Trilipix Class: lipid lowering agent Pharm: fibric acid derivatives fentanyl Trade: Duragesic Class: Opioid analgesic, anesthetic
Action: Fenofibric acid primarily inhibits triglyceride synthesis TE: lowering of cholerterol & triglycerides with subsequent decreased risk of pancreatitis Rational: Action: activates the peroxisome proliferator activated receptor resulting in increased lipolysis and elimination of triglycerides from plasma. Increases production of HDL and improvments in lipid profiles with lowered triglycerides. Rationale: Action: Binds to opiate receptors in CNS altering the response to and perception of pain. Rationale: Po daily 0800 am 135mg
Assessment: abdominal pain, occult blood in stool, monitor CBC, may cause false neg results in skin test Adverse Effects: Confusion, dizziness, drowsiness, hallucinations, HA, arrhythmias, diarrhea, N/V agranulocytosis, aplastic anemia. Teach: take as directed, take OTC not at max dose, avoid smoking, may cause drowsiness, dizziness, avoid alcohol , ASA, and NSAIDS, food may cause irritation, increase fluids and fiber to avoid constipation, report tarry black stools. Administration: Take at bedtime without food. Assess: diet hx, esp fat consumption, cholelithiasis SE: fatigue/weakness Teach: use in conj with diet modification, notify HCP if unexplained muscle pain, tenderness, weakness, esp if accompanied by fever or malaise Assessment: Diet Hx, cholelithiasis, serum AST, ALT, CK Adverse Effects: HA, diarrhea, N/V, myalgia Myopathy/rhabdomyolysis, Teach: Take as directed, used with diet, female pt check pregnancy status, Administration: PO daily
Adverse Effects:
Adverse Effects:
25mg patch Transdermal
Assessment: Pain type, location, intensity, BP, HR, RR, dependence, bowel function Adverse Effects: Confusion, sedation, weakness, bronchoconstriction, respiratory depression, constipation, dry mouth, N/V, sweating.
adjuncts Pharm: opioid agonists
Teach: Dont take with grapefruit juice, good oral hygiene, avoid alcohol, orthostatic hypotension, drowsiness, dizziness, application and disposal of med. Administration: Patch placed on skin, back, abdomen, and date. Action: Mineral found in hemoglobin, myoglobin, and many enzymes. Enters the bloodstream and transported to the organs of the reticuloendothelial system where it is separated out and becomes part of iron stores. Prevention/treatment of iron deficiency Rationale: PO 120-240 mg/day in 2-4 divided doses. Prophylaxis 4-6 mg/day. Assessment: Nutritional status and dietary history. Bowel function. Rash, pruritus, laryngeal edema, wheezing. Adverse Effects: Seizures, hypotension, nausea, constipation, dark stools, diarrhea, epigastric pain. Teach: Explain purpose of iron therapy. Comply with medication regimen. Take missed dose as soon as possible. Stools may be dark. Follow a diet high in iron. Administration: PO and for prophylaxis use.
Adverse Effects:
Ferrous sulfate FeSO4 Trade: Apo-Ferrous Sulfate, ED-IN-SOL, Fe50, Feosol, Feratab, Fer-gen-sol, FerIn-Sol, Fer-Iron, Fero-Grad, Novoferrosulfa, PMS Ferrous Sulfate, Slow FE Class: Antianemics Iron supplement fexofenadine Trade: Allegra Class: allergy, cold, and cough remedies, antihistamines finasteride Trade: Propecia Class: hair regrowth stimulants Pharm: androgen inhibitors flecainide Trade: Tambocor Class: Antiarrhythmic
Adverse Effects:
Action: Antagonizes the effects of histamine 1 (H1) receptors, drying effect on the nasal mucosa. Decreased sneezing, rhinorrhea, itchy eyes, nose, and throat associated with seasonal allergies. Rationale: Action: Inhibits the enzyme 5alpha-reductase, which is responsible for converting testosterone to its tent metabolite 5-alphadihydrotestosterone in prostate, liver, and skin. Decrease hair loss. promote hair regrowth Rationale: Action: Slow conduction in cardiac tissue altering transport of ions across cell membrane. Suppression of arrhythmias Rationale: Pt has AV block and bundle block AEB six second strip.
PO daily 180mg = 1 tab
Assessment: S/S allergies, lung sounds, Adverse Effects: dyspepsia, drowsiness, fatigue, dysmenorrheal. Teach: take as directed, drowsiness, Administration: PO daily
Adverse Effects:
PO daily pt to take own medication
Assessment: Prostatic hyperplasia, digital rectal exam during therapy Adverse Effects: decreased libido, volume of ejaculate, and erectile dysfunction. Teach: take as directed, volume of ejaculate may decrease, follow up exams. Administration: PO daily with or without food. Assessment: Monitor ECG, BP, I&O's, increased alkaline phosphatase and BUN. Toxicity Adverse Effects: Dizziness, blurred vision, arrhthmias, chest pain CHF Teach: Take as directed, dizziness, call DR. for SOB chest pain. Administration:
Adverse Effects:
100 mg 1 Tab Q12
Adverse Effects:
fluconazole Trade: Diflucan Class: antifungals (systemic) Pharm:
Action: Inhibits synthesisof fungal sterols, a necessary component of the cell membrane. Rationale:
(> 14days: 6mg/kg initially, then 3mg/kg/day for at least 2 wks) 20mg/0.5ml QD
flunisolide Trade: Flonase Class: Antiinflammatories Pharm: corticosteroids fluoroquinolone Trade:Gatifloxacin ,Zymar Class: antibiotic
Action: Locally acting antiinflammatiory and immune modifier. Decrease symptoms of allergic and nonallergic rhinitis Rationale:
1 Spray 50mcg nasal spray
Assessment: Assess infected area and monitor CSF cultures pre and during therapy. Monitor liver function pre and during therapy. Adverse Effects: hepatotoxicity, stevenjohnson syndrome, n/v, diarrhea Teach: Take at the same time each day, notify health professional if rash, fever, or diarrhea becomes pronounced, or if bruising occurs. Administration: PO or IV Assessment: Nasal stuffiness, nasal mucus, growth rate if child using Adverse Effects: Dizziness, HA, N/V, Nasal irritation, nasal congestion, dry mouth Teach: Take as directed, not to exceed doses, correct technique, gently blow nose, anaphylaxis shock Administration: Nasal spray Assess- infection in eye, heart rate, potassium levels AE- Bad taste in the mouth; blurred vision; eye discharge; headache; irritation, pain, dryness, or redness of the eyes; itchy eyes; tearing; watery eyes Teach- use at the same time, do not touch tip of the bottle Administration: Assess: heart rate, potassium levels AE- headache ;seizure, arrhythmia, hepto toxicity, steven johnson, Teach: maintain fluids, report s/s superinfection, bloody stool, Administration: Assessment: Assess for symptoms of serotonin syndrome, In low doses decrease anxiety Adverse Effects: Increase suicide risk as depression lifts, Prozac may increase blood levels of statins, Potentiates other medications that use same enzymes (except Celexa), Insomnia, nausea, anorexia, headache, restlessness, decreased libido Serotonin syndrome, BP, HR, fever, muscle rigidity, coma, death MED EMERGENCY Teach: Black Box Warning, Give with food for nausea, Do not stop abruptly
Adverse Effects:
Adverse Effects:
Action: stopping the production of proteins that bacteria need to survive Rationale: Use to treat eye infections
Adverse Effects:
fluoroquinolone Trade: Cipro Class: antibiotic fluoxetine Trade: Prozac/ Sarafem Class: Antidepressant Pharm: SSRI
Action: stopping the production of proteins that bacteria need to survive Rationale:
Adverse Effects:
Administration:
fluphenazine Trade: Prolixin Class: TYPICAL ANTIPSYCHOTICS Pharm: Phenothiazines
Action: Dopamine receptor antagonists Rationale:
fluticasone Trade: Flovent Class: CORTICOSTEROIDS Pharm:
Action: Potent, locally acting anti-inflammatory and immune modifier. Decreased frequency and severity of asthma attacks. Improves asthma symptoms Rationale:
Fluticasone/ salmeterol Trade: Advair 250/50 Class: broncohodilators/ steroid
Action: bronchodilator and anti-inflammatory reducing the work of breathing. Rationale:
Oral inhale daily
Assessment: I&O, Urinary retention; especially in elders, vitals, Wt. Administer medications as needed for EPS, Check EKG for Mellaril due to cardiotoxicity, Mellaril is contraindicated w/ drugs that lengthen QT Intervals, CBC, Liver function tests, ocular exams periodically Adverse Effects: Anticholinergic effects, Extrapyramidal Symptoms (EPS), High EPS, Moderate anticholinergic Teach: Drink 2-3L fluids QD, sugarless gum or candy for dry mouth, high fiber diet, good oral hygiene, Sunscreen, Rise slowly, No alcohol, Caution driving, Report EPS, Report any symptoms immediately Administration: Assessment: Monitor respiratory status and lung sounds. Pulmonary function tests may be assessed periodically during and for several months after a transfer from systemic to inhalation corticosteroids. Assess patients changing from systemic corticosteroids to inhalation corticosteroids for signs of adrenal insufficiency Adverse Effects: headache, dysphonia, hoarseness, Teach: Advise patient to take medication as directed. Advise patients using inhalation corticosteroids and bronchodilator to use bronchodilator first and to allow 5 min to elapse before administering the corticosteroid, unless otherwise directed by health care professional. Administration: Assessment: RR, Res status, before during and after admin Adverse Effects: Drymouth, glaucoma, urinary retention, angoedema, constipation Teach: Take as directed, used for maintence , proper cleaning, rinse mouth after med Administration: Inhale
Adverse Effects:
Adverse Effects:
Adverse Effects:
fluvoxamine Trade: Luvox Class: Antidepressant Pharm: SSRI
folic acid Trade: Folate, Vit B Class: antianemic, Vitamin Pharm: water soluble vitamin fondaparinux Trade: Arixtra Class: anticoagulants Pharm: active factor X inhibitors formoterol Trade: Symbicort Class: Bronchodilators Pharm: adrenergic furosemide Trade: Lasix Class: diuretics Pharm: loop diuretic
Action: Required for protein synthesis and RBC and WBC production and platelets. Needed for fetal development. Restoration and maintenance of normal hematopoiesis Rationale: given to increase blood production R/T illness. Action: Binds selectively to antithrombin III. This binging potentiates the neutralization of active factor X. Interruption of the coagulation cascade resulting in inhibition of thrombus formation Rationale: Action: Produces accumulation of cyclic adenosine monophosphate at beta-adrenergic receptors, resulting in relaxation of airway smooth muscle. Bronchodilation Rationale: Given to clear lungs R/T history of asthma Action: Inhibits the reabsorption of sodium and chloride from the loop of Henle and distal renal tubule. Rationale:
PO daily 2mg-2tabs
Assessment: Assess for symptoms of serotonin syndrome, In low doses decrease anxiety Adverse Effects: Increase suicide risk as depression lifts, Prozac may increase blood levels of statins, Potentiates other medications that use same enzymes (except Celexa), Insomnia, nausea, anorexia, headache, restlessness, decreased libido Serotonin syndrome, BP, HR, fever, muscle rigidity, coma, death MED EMERGENCY Teach: Black Box Warning, Give with food for nausea, Do not stop abruptly Administration: Assessment: Megaloblastic anemia, monitor plasma, decreased Hgb, RBC, Hct. Adverse Effects: Rash, confusion, malaise, difficultly sleeping. Teach: follow diet, food rich in folic acid, follow dosing for vitamins, follow up exams Administration: PO Assessment: Bleeding and hemorrhage, tarry stools, hematuria Adverse Effects: confusion, dizziness, HA, hypotension, constipation, diarrhea, N/V Teach: signs of unusual bleeding or bruising, avoid NSAIDs Administration: SubQ Assessment: lung sounds, RR for relief. HR, BP Adverse Effects: tachycardia, hypertension, nervousness, restlessness, tremor, HA, N/V. Teach: avoid caffeine and smoking Administration: PO and Inhaln allow 1 minute between puffs. Assessment: Assess fluid status, monitor weights, I/O, edema, BP, lung sounds, HR, assess for tinnitus and hearing loss Adverse Effects: headache, vertigo, dehydration, hypokalemia, hypocalcemia, hyponatremia, hypovolemia, metabolic alkalosis Teach: Take missed dose ASAP, do not double, avoid OTC meds, monitor weight gain, change position slowly
Adverse Effects:
Adverse Effects:
SubQ daily 2.5mg= 0.5mL
Adverse Effects:
Inhale 2 Puffs med provided by RRT
Adverse Effects:
40mg/ tablet oral QAM
Adverse Effects:
Administration: PO, IM, IV
gabapetin Trade: Neurontin Class: analgesic adjuncts, therapeutic, anticonvulsants, mood stabilizers gentamicin Trade: Cidomycin Class: Ant-infectives aminoglycosides
Action: May affect transport of amino acids across and stabilize neuronal membranes. Decreased seizures Rationale: Given to decrease seizures Action: Inhibits protein synthesis in bacteria at level of 30S ribosome Rationale:
PO HS 600 mg 2tab PO 0900 300mg daily as taken at home.
Assessment: Behavior changes, seizures, migraines, Adverse Effects: : Suicidal thoughts, N/V, agitation, dizziness, insomnia, sedation, confusion, diarrhea Teach: take as directed, do not take within two hours of antacids, dizziness, drowsiness Administration: PO Assessment: assess pt for infection, obtain a history, obtain specimens for C&S, and monitor I&O, Evaluate 8th cranial nerve throughout therapy. Monitor blood levels periodically during therapy, timing of blood levels is important in interpreting results. Draw blood for peak levels 30 min after IV infusion is completed. Peak levels should not exceed 10mcg/ml Adverse Effects: ataxia, ototoxicity, nephrotoxicity Assessment: S/S of hypoglycemic reactions). Allergy to sulfonamides. Patients on concurrent beta-blocker therapy may have very subtle signs of hypoglycemia Adverse Effects: dizziness, drowsiness, headache, weakness. constipation, cramps, diarrhea, photosensitivity, hypoglycemia. Teach: Take at same time each day. Take missed doses as soon as , hypoglycemia and hyperglycemia with. Dizziness or drowsiness. Avoid driving or other activities requiring alertness until response to medication is known. Avoid alcohol. Use sunscreen and protective clothing to prevent photosensitivity reactions. Emphasize the importance of routine followup exams. Administration:
Adverse Effects:
Adverse Effects:
glipizide Trade: Glucotrol Class: antidiabetics Pharm: sulfonylureas
Action: Lower blood glucose by stimulating the release of insulin from the pancreas and increasing the sensitivity to insulin at receptor sites Rationale:
Adverse Effects:
glucagon Trade: GlucaGen Class: pancreatic
Action: stimulates hepatic production of glucose Rationale:
guaifenesin Trade: Robitussin Class: Allergy, cold, and cough remedies, expectorant
Action: reduces viscosity of tenacious secretions by causing respiratory tract fluid. Rationale:
2 teaspoons PO Q4h
Assessment: hypoglycemia; nutritional status; n/v after admin Adverse Effects: n/v; anaphylaxis Teach: s/s hypoglycemia; correct technique to prepare, draw up and admin; rcv oral glucose when consciousness returns; position pt on side until fully alert Administration: use only clear water-like solution. Admin supplemental carbs IV or PO to increase glucose levels Assessment: lung sounds, frequency and type of cough, secrections Adverse Effects: dizziness, HA, N/V, diarrhea Teach: Cough effectively, avoid OTC meds, dizziness, avoid smoking Administration: PO
Adverse Effects:
Adverse Effects:
guaifenesin Trade: Robitussin (sugarfree) Class: Allergy, cold, and cough remedies, expectorant gummy multivitamin Trade: multivitamin Class: Vitamin
Action: reduces viscosity of tenacious secretions by causing respiratory tract fluid. Rationale:
2 teaspoons PO Q4h
Assessment: lung sounds, frequency and type of cough, secrections Adverse Effects: dizziness, HA, N/V, diarrhea Teach: Cough effectively, avoid OTC meds, dizziness, avoid smoking Administration: PO Assessment: Abdominal pain, stool consistency Adverse Effects: Skin rashes, abdominal pain, change in stool color and consistency. History of clotting, anemia, and reactions to minerals. Teach: Take with food or milk. Do not take more than prescribed. Eat a balanced diet. Possible drug interactions. Avoid alcohol. Administration: PO take with food or milk. Do not take more than prescribed. Assess: mental status, positive and negative symptoms of schizo., BP (lay, sit, stand), monitor for hoarding, I/O, daily wts, fluid intake and bowel function, tardive dyskinesia, neuroleptic malignat syndrome Adverse effects: extrapyramidal rxs, blurred vision, dry eyes, constipation, dry mouth, seizures, agranulocytosis, neuroleptic malignant syndrome Teach: extrapyramidal S/E, tardive
Adverse Effects:
Action: Provides minerals such as folic acid , and to provide a source of nutrition Rationale:
Adverse Effects:
haldoperidol Trade: Haldol Class: Antipsychotic
Action: Alters effect of dopamine on the CNS. Also has anticholinergic and alphaandrenergic blocking activity Rationale: anxiety, agitation, restlessness
Adverse Effects:
dyskinesia, drowsiness, change pisitions slowly, avoid alcohol, use sunscreen,oral care Admin: PO: with food or water/milk IM: slowly, keep recumbent for at least 30 min following hemabate Trade: Prostaglandin F 2a Class: Prostaglandin Action: Decrease hemorrhaging of uterus. Contraction of uterus. To manage postpartum hemorrhaging. Rationale: 0.25 mg IM or intramyometrically every 15-90 min. up to 8 doses. Assessment: The fundus for boggyness & monitor vaginal bleeding. Adverse Effects: H/A , nausea, & vomiting, fever, tachycardia, hypertension, diarrhe Teach: The patient to massage her fundus & to tell the nurse if feel blood pooling on the pad. Administration: 0.25 mg IM do not give to asthma or hypersensitive patient Assessment: Bleeding, hemorrhage, black tarry stools, hematuria, BP, evidence of thrombosis, hypersensitivity, injection sites, aPTT, platelet count, hyperkalemia, toxicity and overdose. Adverse Effects: Drug induced hepatitis, alopecia, rashes, bleeding, anemia, and thrombocytopenia, local pain at injection site, osteoporosis, fever, and hypersensitivity. Teach: watch unusual bleeding, avoid aspirin or NSAIDS, medication regimen prior to treatment, should carry identification card for anticoagulant therapy. Administration: IV or SubQ Assessment: Adverse Effects: Hypersensitivity to yeast. Local soreness. Teach: Administration: IM two dose series separated by about 4 months. Therapeutic Effects:
Adverse Effects:
heparin Trade: Calcilean, Calciparine, Hepalean, Heparin Leo, Hep-Lock, Heplock U/P Class: anticoagulants Pharm: antithrombotic
Action: Potentiates the inhibitory effect of antithrombin on factor Xa and thrombin. Prevention of thrombus formation and extension of existing thrombi. Rationale:
5000 units= 0.5 HS
Adverse Effects:
Hepatitis B vaccine Trade: HepB, EngerixB, Recombivax HB Class:
Action: Builds antibodies Rationale: To prevent the spread of Hep B.
0.5 mL IM at 0, 1-2, and 6-18 months. Same dose for pt 0-19 yr.
Adverse Effects:
hydralazine Trade: Apresoline Class: vasodilators
Action: Promote vasodilation which increases blood flow to the extremities Useful in treatment of peripheral vascular diseases & disorders that cause occlusion & spasms of arterial & venous vessels Rational:
Assess: baseline vitals, extremities for adequate blood flow SE: N&V, rash, dizziness, syncope, weakness, tremors, chest pain Teach: rise slowly, proper foot care, takes 6 weeks to 3 months, avoid alcohol
Adverse Effects:
hydrochlorothiazide Trade: Hydrodiuril Class: diuretics, antihypertensive Pharm: thiazide diuretics hydrocodone/ acetaminophen Trade: Vicodin, Norco, Lortab Class: opioid analgesic/ allergy cold & cough Pharm: opioid agonist/ nonopioid analgesic combinations Hydrocortisone Trade: Epifoam; Anusol HC. Class: anti-inflaffitory (steroidal) (corticosteroids topical)
Action: Increases excretion of sodium and water by inhibiting sodium reabsorption in the distal tubule. Rationale:
25mg=1 tab PO daily
Action: Binds to opiate receptors altering perception and response to pain. Depresses CNS. Decrease severity of moderate pain and suppression of the cough reflex. Rationale:
Adults: PO 2.5 10 mg q3hr prn. Check total amount of acetaminophen. (max 4g/day) Peds: PO 2-13 yrs 0.14 mg/kg q4-6hr analgesic. Antitissive 6-12 yrs 2.5 mg/kg q4-6hr
Action: Suppress normal immune response and inflammation. Rationale:
hydromorphine Trade: Dilaudid Class: Allergy, cold, cough remedies, opioid agonists.
Action: Binds to opiate receptors in the CNS. Alters the perception of and response to painful stimuli, while producing generalized CNS depression. Suppresses the cough reflex via a direct central action. Rationale:
PO 4-8 mg q3-4 hr. IM SubQ 1.5 mg q3-4 hr as needed. IV 0.2-30 mg/hr depending on previous opioid use.
Assessment: monitor BP I/O daily WT , notify MD of symptoms of electrolyte imbalance. Adverse Effects: hypokalemia, hypotension, weakness, pancreatitis Teach: monitor WT, change position slowly, report muscle weakness, discuss dietary potassium requirements. Administration: PO or IV Assessment: B/P; pulse; respirations; level of sedation, bowel function; pain type, location and intensity pre & 1 hr. post med; Adverse Effects: confusion; dizziness; sedation; hypotension; constipation; nausea; dyspepsia; respiratory depression; H/A; Teach: change position & get up slowly, drink plenty of fluids (prevent constipation), urinate often, report troublesome side effects. Administration: If RR less than 10, assess level of sedation. As ordered, with food or milk to reduce GI upset. (have Narcan available for toxicity / overdose) Assessment: affected skin before and daily during therapy; degree of inflammation & pruritis; Notify HCP if S&S of infection (increased pain, erythema & purulent exudates) develop. Adverse Effects: dryness; allergic contact dermatitis; atrophy; edema; folliculitits; maceration; irritation; secondary infection. Teach: correct administration technique; Avoid using cosmetics, bandages, dressings or other skin products on affected area unless directed by HCP; Consult HCP for S&S of infection. Administration: Ointment,creams Assessment: Pain type, location, intensity prior to and 1 hr following PO, Subcut, IM and 5 min after IV start. BP, HR, RR periodically. Bowel function. Physical and psychological dependence and tolerance. Assess cough and lung sounds. Adverse Effects: Confusion, sedation, hypotension, constipation Teach: Take as directed. May cause drowsiness and dizziness, and orthostatic hypertension. Avoid alcohol. Deep breathe q2h. Importance of aggressive prevention
Adverse Effects:
Adverse Effects:
Adverse Effects:
Adverse Effects:
of constipation. Administration: Check MAX dose, Keep Narcan available for toxicity/overdose. Take with food or milk.
hydroxyine Trade: Vistaril Class: antianxiety agent, antihistamines, sedative/hypnotics hydroxyurea Trade: Hydrea Class: antineoplastics Pharm: antimetabolites hyoscyamine Trade: Levsin Class: antispasmodic
Action: CNS depressant at the subcortical level of CNS. Has anticholinergic, antihistaminic, and antiemetic properties. Blocks histamines Given to stop itching. Rationale:
PO 25mg=1 tab QID
Assessment: sedation, degree of itching, N/V, mental status. Adverse Effects: drowsiness, dry mouth, HA, weakness, dizziness Teach: take as directed, drowsiness, dizziness, avoid alcohol, Administration: PO
Adverse Effects:
Action: Reduction of painful crises in sickle cell anemia and decreased need for transfusions. Rationale: Given for reduction of pain for sickle cell crises Action: Inhibits muscarinic effect of Ach in smooth muscle, secretory glands, and the CNS. Helps decrease secretions with decreased GI and GU symptomology and increased heart rate. Rationale: copious secretions Action :Inhibits synthesis of prosteglandins pain, inflammation mild to moderate pain Rationale: Action: Inhibits cell wall replication in bacteria-Prophylaxis against organisms-Required by law. Prevents opthalmia neonatorum/of mothers w/gonorrhea & chlamydia infection Rationale:
500mg cap PO daily
Assessment: anorexia, diarrhea, N/V, leukopnea. Adverse Effects: anorexia, diarrhea, N/V, leukopnea. Teach: Report s/s to health care provider Administration: PO daily Assess: VS, I/O in elderly or surgical pts, abd distention and BS Adverse effects: blurred vision, nausea, anaphylaxis Teach: drowsy, oral hygiene, impairs heat regulation, may cause hesitancy and retention in BPH Admin: PO: 30 min before meals Assessment: pain, type, location, intensity Adverse Effects: Gi complicationsbleeding/headache/diziness/NV/drowsiness Teach: take w/full glass of water and remain upright for 15-30 min, avoid alcohol, aspirin, acetaminophen Administration: take as directed Assessment: irritation, redness Adverse Effects: irritation/24-48 hrs-blurred vision Teach: used for prophylaxis, allergies may occur, treat bacterial eye infections provides relief from discomfort such as redness, pain, discharge and itching while it prevents the spread of infection to others Administration: as directed
Ibuprofen Trade: Motrin Class:nonopioid analgesic Ilotycin Trade: Erythromycin Ointment Class: antibiotic
400-800mg 3 to 4 times daily not to exceed 3200mg daily
dose: ribbon of 0.5%route: below conjunctival sac of each eye, inner to outer/within 1 hr after birth
Adverse Effects:
imipenem/ Cilastatin Trade: Primaxin Class: anti-infective
Action: Imipenem binds to the bacterial cell wall, resulting in cell death. Rationale:
imipramine Trade: Tofranil Class: Anitdepressants Pharm: Tri-cyclics
influenza vaccine injection Trade: Afluria, Fluarix, Flulaval, Fluvirin, Fluzone Class: vaccine
Action: Prevention of influenza Protect against the three most common influenzas for that year. To prevent patient from getting sick. Rationale:
IM 0.5mL
Insulin (long acting) glargine, detemir Trade: Lantus, Levemir Class: antidiabetics, hormones Pharm: pancreatics
Action: lowers blood glucose by stimulating glucose uptake in skeletal muscle and fat, inhibiting hepatic glucose production. Control of hyperglycemia in diabetic pt. Rationale:
Lantus (glargine) onset 1.1 hrs, peak none, duration >24 hrs. Levemir (detemir) onset I hr, peak none, duration 24 hrs.
Assess: vital signs, obtain specimens for C&S, S&S of anaphylaxis SE: seizures, pseudomembranous colitis, D&V&N, rash Teach: Notify Dr. if fever and diarrhea occur, especially if stool contains blood, pus or mucus. Admin: rapid infusion may cause N&V. slow infusion Assessment: As stated previously, BP lying/standing, Cardiac assessment, High overdose potential limit quantity available to patient Adverse Effects: Anticholinergic effects, Orthostatic hypotension, Cardiac abnormalities, Wt gain, Photosensitivity, Increase suicide risk, Sedation Teach: Increase fluids/fiber, Take at HS, Exercise, sensible eating, Sunscreen, No suicide contract, No alcohol, caution driving Administration: Assessment: Hypersensitivity to eggs/egg products, pregnancy, chronic pulmonary disorder, cardiovascular, renal, hepatic, immunosuppresed, aspirin therapy. Sever illness, hx Guillain-Barre Adverse Effects: Local soreness, fever, myalgia, possible neurologic toxicity. Intranasal: upper respiratory congestion, malaise. Teach: Immunosuppression may decrease antibody response to injection and increase risk of viral transmission with intranasal route Administration: IM Assessment: hypoglycemia, body weight, allergic reactions, blood glucose q 6 hr, toxicity and overdose Adverse Effects: hypoglycemia, anaphylaxis Teach: Proper technique for administration, mixing technique, controls not cures diabetes, proper testing, nutritional guidelines, consult Dr about alcohol use and N/V, signs and symptoms of hypoglycemia Administration: SubQ
Therapeutic Effect:
Adverse Effects:
Adverse Effects:
Adverse Effects:
Adverse Effects:
insulin (mixtures) NPH/regular Trade: Humulin 50/50, Humulin 70/30, Humalog: 75/25 Novolog: 70/30 (aspart protamine + aspart) Class: antidiabetics, hormones Pharm: pancreatics insulin (short acting), regular (injection concentrated) Trade: Humulin R, Humulin R U-500, Novolin R. Class: antidiabetics, hormones Pharm: pancreatics insulin aspart, lispro, rDNA origin (rapid acting) Trade: Novalog(aspart), Humalog(lispro) Class: antidiabetics, hormones Pharm: pancreatics ipratropium Trade: Atrovent Class: bronchodilator Pharm: anticholinergic
Humulin 50/50 onset hr, peak 3-5 hr, duration up to 24 hrs. Humulin 70/30 onset hr, peak 4-8 hrs, duration up to 24 hrs. Novolog: 70/30 onset <15 min, peak 1-4 hr, duration 24 hr Humalog: 75/25 onset <15 min, peak 30-90 min, duration up to 24 hrs Regular (R) onset 1hr, peak 4-10 hr, duration 14-18 hrs.
Assessment: hypoglycemia, body weight, allergic reactions, blood glucose q 6 hr, toxicity and overdose Adverse Effects: hypoglycemia, anaphylaxis Teach: Proper technique for administration, mixing technique, controls not cures diabetes, proper testing, nutritional guidelines, consult Dr about alcohol use and N/V, signs and symptoms of hypoglycemia Administration: SubQ 0.5-1 unit/kg/day
Adverse Effects:
Action: lowers blood glucose by stimulating glucose uptake in skeletal muscle and fat, inhibiting hepatic glucose production. Rapid onset with shorter duration and should be used with long acting insulin. Control of hyperglycemia in diabetic pt. Rationale: Action: Inhibits cholinergic receptors in bronchial smooth muscle, resulting in decreased concentrations of cuclic guanosine monophosphate, which produce local bronchodilation Rationale:
Aspart onset 10-20 min, peak 1-3 hr, duration 3-5 hr Lispro onset 15 min, peak 1-1.5 hr, duration 3-4 hr
Duoned 3ml solution Q6
Assessment: hypoglycemia, body weight, allergic reactions, blood glucose q 6 hr, toxicity and overdose Adverse Effects: hypoglycemia, anaphylaxis Teach: Proper technique for administration, mixing technique, controls not cures diabetes, proper testing, nutritional guidelines, consult Dr about alcohol use and N/V, signs and symptoms of hypoglycemia Administration: Subcut, IV. Adult IV 0.1 unit/kg/hr. Peds loading dose 0.1 unit/kg/hr Assessment: hypoglycemia, body weight, allergic reactions, blood glucose q 6 hr, toxicity and overdose Adverse Effects: hypoglycemia, anaphylaxis Teach: Proper technique for administration, mixing technique, controls not cures diabetes, proper testing, nutritional guidelines, consult Dr about alcohol use and N/V, signs and symptoms of hypoglycemia, Administration: Subcut into abdominal wall rotating injection sites Assessment: assess for allergy to atropine and belladonna alkaloids, assess breath sounds, HR, RR, WOB pre and post treatment. Adverse Effects: HA, nervousness, cough, palpitations Teach: use as directed, rinse mouth post tx to avoid dry mouth. Administration: neb or mdi
Adverse Effects:
Adverse Effects:
Adverse Effects:
irbesartan Trade: Avapro Class: antihypertensive Pharm: angiotensin II receptor antagonists
Action: Blocks vasoconstrictor and aldosterone-producing effects of angiotensin II receptor sites including vascular smooth muscle and the adrenal glands. Rationale:
150mg tab PO daily
isocarboxazid Trade: Marplan Class: Antidepressants Pharm: MAO INHIBITORS
Action: Inhibits enzyme monoamine oxidase which increases norepinephrine, dopamine, serotonin Rationale:
Isosorbide mononitrate Trade: Monoket, Imdur Class: antianginals Pharm: nitrates ketorolac Trade: Toradol Class: nonsteroidal anti-inflammatory agent, nonopioid analgesic (pyrroziline carboxylic acid)
Action: Produce vasodilation. Decreases left ventricular end-diastolic volume (preload). Rationale:
30mg/tablet oral QHS
Action: Inhibits prostaglandin synthesis, produces peripherally mediated analgesia. Rationale:
Oral therapy only as continuation of parenteral therapy, parenteral should not exceed 20 doses / 5 days. Total duration of therapy by all routes should not exceed 5 days.
Assessment: Assess BP, HR,WT, edema for CHF. Monitor refills and assess for signs of angioedema. Adverse Effects: dizziness, hypotension,angioedema Teach: Avoid salt substitutes with potassium and foods high in potassium, avoid sudden position changed (hypotension) may cause dizziness avoid activities that require alertness, ask MD prior to taking OTC cold meds. Administration: PO Assessment: Headache, insomnia, Wt gain Hypoglycemia, High BP, convulsions, coma Adverse Effects: Cannot be taken with any other psychotropic drug, Minimum washout time is 2-5 weeks, Need tyramine free diet, Hypertensive crisis occurs with tyramine foods, narcotics, general anesthesia Teach: Compliance with tyramine free diet: avoid aged cheese, smoked/processed meats, red wines, yeast, fava beans, bananas, avocado, OTC meds Administration: Assessment: Assess location, duration, intensityand precipitating factors of angina pain, monitor BP, HR routinely Adverse Effects: HA, hypotension, tachycardia, syncope, flushing Teach: Avoid OTC or herbal products, HA common side effect, avoid alcohol, change positions slowly, and avoid driving until S/E known. Administration: SL or PO Assessment: pain before &1-2 hr after administration, cross sensitivity, asthma, ASA allergy, nasal polyps, rhinitis & urticaria. Adverse Effects: drowsiness, asthma, dyspnea; GI bleed; renal toxicity, exfoliative dermatitis; toxic epidermal necrolysis; anaphylaxis; Stevens-Johnsons Syndrome; Teach: drowsiness; Take exactly as directed; not longer than 5 days; rash, itching, edema, visual disturbances, tinnitus, wt. gain, black stools, persistent HA, or flu-like symptoms occur. Avoid use of alcohol, ASA, other NSAIDs, acetaminophen, or other OTC meds without
Adverse Effects:
Adverse Effects:
Adverse Effects:
Adverse Effects:
consulting HCP. Administration: PO)
labetalol Trade: Trandate Class: antianginal, anyihypertensive Pharm: beta blocker
Action: Blocks beta 1, 2 , and alpha 1 receptor sites. Alpha 1 blocking may cause orthostatic hypotension. Rationale:
10 mg=2 ml IV prn give over 1-2 minutes for BB sys > 185 or diastol > 110; followed by continuous infusion
lactase Trade: Lactaid Class: digestive enzyme lactulose Trade: Kristalose Class: laxatives Pharm: osmotics lansoprazole Trade: Prevacid Class: antiulcer agents Pharm: proton-pump inhibitors latanoprost Trade: Xalatin Class: Prostaglandin agonist
Action: provides additional digestive enzymes for lactose digestion reducing gas & discomfort. Rationale: Action: Increases water content and softens stool. Lowers the pH of the colon, which inhibits the diffusion of ammonia from the colon into the blood, thereby reducing blood ammonia levels Rationale: Action: Binds to enzyme in the presence of acidic gastric pH, preventing the final transport of hydrogen ions into the gastric lumen. lessoned acid reflux, healing duodenal ulcers and esophagitis. Rationale: Action: Management of openangle glaucoma Rationale: 30ml PO Q4PRN
Assessment: Monitor BP and pulse frequently, monitor I/O, may increaseBUN, K lipoprotein and triglycerides Adverse Effects: fatigue, weakness, arrhythmias, bradycardia, CHF, pulmonary edema, orthostatic hypotension, erectile dystunction Teach: Do not abruptly withhold meds may cause arrhythmias, notify MD if pulse slows, DIB, dizziness, whzing, cold feet, rash fever occur Administration: IV Assessment: need for product. Adverse Effects: Anaphylaxis Teach: use as directed. Swallow with first bite or drink of dairy. Administration: with dairy products Assessment: assess for abd distention, bowel sounds, bowel function, assess stool color and consistency. Adverse Effects: belching, cramps, distention, flatulence Teach: encourage bulk in pt diet, caution may cause S/E Administration: PO or rectal Assessment: Abdominal pain, blood in stool, monitor INR, may increase serum creatinine and electrolyte levels. Adverse Effects: Dizziness, HA, diarrhea, N/V. Teach: Take as directed, avoid alcohol, dizziness, beware of dark tarry stools Administration: PO 30 mg 1 tab BID 0900 before meals Assessment: local irriation, foreign body sensatin, Adverse Effects: local irriation, foreign body sensatin, increased eyelash growth, increased brown pigmentation. Teach: local irriation, foreign body sensatin, increased eyelash growth, increased brown
Adverse Effects:
Adverse Effects:
PO 30 mg 1 tab BID 0900
Adverse Effects:
0.005% eye drop 1 drop in the right eye HS
Adverse Effects:
pigmentation. Administration: one drop HS
levalbuterol Trade: Xopenex Class: bronchodilator Pharm: anticholinergic levofloxacin Trade: Levaquin, Novo-Levofloxcin Class: anti-infectives Pharm: fluoroquinolones
Action: Binds to beta 2adrenergic receptors in airway smooth muscle leading to activation of adenylcyclase and increased levels of cyclic 3-5 adenosine monophosphate Rationale: Pt has SOB Action: Inhibit bacterial DNA synthesis by inhibiting DNA gyrase. Death of susceptible bacteria. Rationale:
Assessment: breath sounds, HR, RR, WOB pre and post treatment. Adverse Effects: HA, nervousness, cough, palpitations Teach: Proper use of neb, avoid OTC, take first before other nebs Administration: neb Adults: PO IV 250-750 mg q24hr most infections. Renal impairment: PO IV 750 mg/day. Assessment: BP, wound, WBC, specimen for culture and sensitivity, signs of anaphylaxis, bowel function, prothrombin time Adverse Effects: Dizziness, HA, insomnia, acute psychoses, confusion, drowsiness, arrhythmias, hepatiotoxicity, pseudomembranous colitis, Steven-Johnson syndrome, anaphylaxis Teach: Risk for infection Administration: PO,IV Assessment: BP, HR, blood and urine glucose, toxicity and overdose Adverse Effects: Nervousness, HA, insomnia, N/V, hypotension, diarrhea Teach: take as directed, does not cure, do not change brands, take with water Administration: Inject IM
Adverse Effects:
Adverse Effects:
levothyroxine Trade: Synthroid Class: Hormones Pharm: Thyroid preparations
lidocain Trade: Xylocaine Class: anasthetics (topical)
Action: Replacement or supplementation to endogenous thyroid hormones. Increases metabolic rate of body tissues, promotes gluconeogenesis, increase utilization and mobilization of glycogen stores, and contains T4 and T3. Replacement in hypothyroidism to restore normal hormonal balance. Rationale: Action: produces local anesthesia by inhibiting transport of ions across neuronal membranes, preventing initiation and conduction of normal nerve impulses. Rationale:
50 mcg=1.25mL inject IM
Adverse Effects:
Assessment: degree of numbness of affected part. S&S of irritation. Adverse Effects: stinging, contact dermatitis, burning, erythema, allergic reaction including ANAPHYLAXIS. Overuse can cause systemic reaction. Teach: do not exceed recommended dose. Use only as directed. Administration: Apply to affected area 2-3x daily.
Adverse Effects:
liquid protein Trade: ProMod Class: Liquid Protein
Action: A protein source for inadequate protein intake. Rationale:
100 Cal and 10 g of protein per oz . Hydrolyzed collagen as a protein source. Glycerine as a carbohydrate source
lisinopril Trade: Prinivil, Zestril Class: antihypertensives Pharm: ACE inhibitors
Action: ACE inhibitors block the conversion of angiotension I to the vasoconstrictor angiotension II. They also prevent the degradation of bradykinin and other vasodilatory prostaglandins. They increase rennin levels and decrease aldosterone levels. (systemic vasodilation) Rationale: Action: Inhibits peristalsis and prolongs transit time by a direct effect on nerves. Reduces fecal volume. Used with chronic diarrhea associated with inflammatory bowel disease. Rationale: Action: Blocks peripheral effects of histamine released during allergic reactions. Rationale:
5mg/ 1 tablet oral Q12hr
Assessment: Need for extra protein, lack of nutrition, Adverse Effects: Not a source for weight loss Teach: Medical food that provides a concentrated source of protein for people with increased protein needs. Indications include wounds, protein-energy malnutrition (PEM), involuntary weight loss: One 1-oz serving = 1 starch + 1 very-lean meat exchange Administration: Assessment: Assess BP, HR and vitals frequently, assess for signs of angioedema, monitor weight, monitor labs (bun, creatinine, lytes, cbc) Adverse Effects: HA, cough, hypotension, taste disturbances, wkness, agranulocytosis, angioedema. Teach: avoid salt substitutes, notify DR if rash, mouth sores, sore throat, fever, swelling in hands/feet occur, change position slowly, and monitor BP weekly. Administration: IV or oral Assessment: Frequency and consistency of stools and bowel sounds prior and during therapy. Assess fluid and electrolytes balance and skin turgur Adverse Effects: Constipation, drowsiness, dry mouth, N/V Teach: Take as directed, do not drive, do not double doses, avoid alcohol Administration: PO Assessment: Assess allergic symptoms and lung sounds. Adverse Effects: drowsiness, dry mouth, rash, wt gain Teach: use sunscreen, good oral care important, avoid alcohol Administration: Assessment: Assess degree of anxiety pre and post med delivery, assess fall risks, check renal and hepatic function with continued therapy Adverse Effects: dizziness, drowsiness, lethargy, apnea, cardiac arrest, bradycardia, hypotension
Adverse Effects:
Adverse Effects:
loperamide Trade: Imodium, Class: antidiarrheals
Adults 4mg initially, then 2mg after each loose stool. Maintencance dose usually 4-8mg/day.
Adverse Effects:
loratadine Trade: Claritin Class: antihistamines
10mg= 1 tab daily
Adverse Effects:
lorazepam Trade: Ativan Class: anesthetic, antianxiety, sedative/hypnotics
Action: Depresses the CNS, probably by potentiating GABA, an inhibitory neurotransmitter. Rationale:
1mg/tablet oral PRN
Adverse Effects:
Pharm: benzodiazepine
Teach: take as directed, taper to decrease withdrawl symptoms, avoid alcohol. Administration: PO, SL, IM, IV routes available
losartan Trade: Cozaar Class: antihypertensive, angiotensin II receptor antagonist lovastatin Trade: Altoprev, mevacor Class: lipid lowering agent. (HMG-CoA reductase inhibitors)
ACTION: blocks vasoconstrictor and aldosterone producing effects of angiotensin II at receptor sites, including vascular smooth muscle and adrenal glands Rational: Action: inhibits enzyme, 3hydroxy-3-methylglutarylcoenzyme A reductase, which is responsible for catalyzing an early step in synthesis of cholesterol. >Lowers total cholesterol LKL & trig. Rationale:
ASSESS: monitor BP, P, I&Os, symptoms of CHF, and angioedema SE: dizziness, hypotension, angioedema Teaching: avoid high Na and K foods, no OTC or herbal meds w/o doc consent.
Adverse Effects:
magnesium citrate Trade: Citrate of Magnesia Class: mineral and electrolyte, laxatives Pharm: salines magnesium hydroxide Trade: Phillips Milk of Magnesia, Dulcolax Magnesia Tablets, Phillips Magnesia Tablets Class: Mineral and electrolyte replacements/ supplements, laxatives.
Action: Essential for the activity of many enzymes. Are osmotically active in GI tract, drawing water into the lumen and causing peristalsis. Rationale:
300ml,PO, liquid, once
Assessment: muscle tenderness, dietary hx. Liver fx including AST q6mos. (3X normal should be d/cd or reduced) Adverse Effects: blurred vision; abd. Cramps, constipation, diarrhea, flatus, heartburn Teach: notify health care if unexplained muscle pain, tenderness, or weakness occurs. Administration: with food at evening meal. Ex-release @ H.S. Assessment: Assess patient for abd distention, bowel sounds and pattern, consistency, color, and amount of stool. Adverse Effects: diarrhea, flushing, sweating Teach: used for short term therapy pre-op purposes, may cause electrolyte imbalance. Administration: PO Assessment: Abdominal distention, presence of bowel sounds, usual bowel function. Color, consistency, and amount of stool produces. Adverse Effects: Flushing, sweating, diarrhea Teach: Must be chewed thoroughly b4 swallowing followed with half glass of water. Shake well. Administration: Give on empty stomach for more rapid results and drink half cup of water with med.
Adverse Effects:
Adverse Effects:
Action: Antacid and laxative Replacement in deficiency states. Evacuation of the colon. Rationale:
PO 2-4 Tablespoons with half glass of water. PO 200-400 mg/day in 3-4 divided doses.
Adverse Effects:
magnesium hydroxide Trade: Maalox Class: antiulcer agents antacid Magnesium Sulfate Class: Mineral and electrolyte replacements/supple ments
Action: Neutralize gastric acid following dissolution in gastric contents. Rationale: ulcerative colitis
Action: Central nervous system depressant; relaxes smooth muscles, including uterus. Suppresses contractions Rationale:
maprotiline Trade: Ludiomil Class: Anitdepressants Pharm: Tri-cyclics
measles, mumps, rubella vaccines MMR Trade: Many Drug names Class: Immunization pediatric vaccine Medroxy Progesterone Trade: Depa-Provera Class: Antineoplastics contraceptive
Action: Provide immunity for measles, mumps, rubella Pediatric immunization vaccine Rationale:
0.5 mL subcut at 1215 months and at 4-6 yrs.
Action: Secretory changes in the endometrium, increase in basal body temperature, histologic changes in vaginal epithelium, relaxation of uterine smooth muscle, mammary alveolar tissue growth, pituitary inhibition, & withdrawal bleeding in the
PO 2.5 5 mg daily With 0.625 mg conjugated estrogen.
Assess: Antacid: Assess for heartburn and indigestion as well as location, duration, character, and precipitating factors of gastric pain Adverse Effects: constipation, diarrhea Teach: Administration: PO: chew thoroughly before swallowing. Follow with glass of water. Antacid effect, administer 13 hr after meals and at bedtime. Assessment: Obtain baseline before administration and then before and after each increment. Adverse Effects: Hot flashes, sweating, nausea, and vomiting. Teach: Notify physician if intolerable adverse reactions occur. Calcium Gluconate (1g=10 ml of 10% solution) is available for emergency administration to reverse Magnesium sulfate toxicity. Assessment: As stated previously, BP lying/standing, Cardiac assessment, High overdose potential limit quantity available to patient Adverse Effects: Anticholinergic effects, Orthostatic hypotension, Cardiac abnormalities, Wt gain, Photosensitivity, Increase suicide risk, Sedation Teach: Increase fluids/fiber, Take at HS, Exercise, sensible eating, Sunscreen, No suicide contract, No alcohol, caution driving Administration: Assessment: Allergic reactions and soreness at injection site. Adverse Effects: Burning, stinging, pain at injestionsite, arthritis/arthralgia, fever, encephalitis Teach: Caution for pt with allergies to egg, gelatin, neomycin, severe immunosuppression. Administration: SubQ injection Assessment: BP, usual menstruation history, monitor intake/output ratios & weekly weight. Monitor hepatic function. Adverse Effects: Depression, retinal thrombosis, pulmonary embolism, blood clots. Teach: to take the med at the same time every day. Do oral hygiene & self breast examination, & yearly physical.
Adverse Effects:
Adverse Effects:
Adverse Effects:
Adverse Effects:
hormones
presence of estrogen Rationale:
Administration: PO 2.5 5 mg daily with 0.625 mg conjugated estrogen.
melatonin Trade: Class: hormone
Action: the time it takes to fall asleep and may the duration of sleep Rationale: insomnia
memantine Trade: Namenda Class: antiAlzheimers agent
Action: bBinds to CNS NMDA receptor sites, preventing binding of glutamine, an excitatory neurotransmitter Rationale:
meperidine Trade: Demerol Class: Opioid analgesics Opioid agonists
Action: Binds to opiate receptors in the CNS. Alters the perception of and response to painful stimuli, while producing generalized CNS depression. Rationale:
PO, IM, and Subcut: analgesia-50 mg q3-4 hr, may be increased as needed (no more than 600mg/24hr). PCA-10 mg with a range 1-5 mg incremental dose, recommended lockout intervals is 6-10 min.
mesalamine Trade: Asacol Class: GI antiinflammatories--therapeutic
Action: Reduction in the symptoms of IBD Rational:
Assess: sleep patterns Adverse Effects: may sex drive in men; morning sedation/drowsiness; hypoglycemia Teach: alternative relaxation methods for sleep; ; nticoagulants or antihypertensives; caution with diabetes or hypoglycemia; caution with seizure disorders Administration: at bedtime Assessment: cognitive function(memory, attention, reasoning, language, ability to perform simple tasks) Adverse Effects: dizzy, fatigue, HA, HTN, wt gain, anemia Teach: caregivers on how and when to admin; dizzy; cognitive improvement may take months; degenerative process is not reversed Administration: PO: without regard to food; do not dilute oral solution Assessment: Pain type, location, intensity prior to and 1 hr following PO, Subcut, IM and 5 min after IV start. BP, HR, RR periodically. Bowel function. Physical and psychological dependence and tolerance. Adverse Effects: May increase plasma amylase and lipase concentrations. Use Narcan for toxicity. Teach: Therapeutic value prior to admin. Regular doses more effective than PRN. PO dose is 50% less effective as parenteral. DC gradually after long-term use. PO dose with food. Administration: PO as ordered; check MAX dose, Keep Narcan available for toxicity/overdose. With food or milk o.k. Assess: allergies to sulfonamides 7 sallicylates, I&O SE: HA, anaphylaxis Teach: may cause drowsiness, do not change brands
Adverse Effects:
Adverse Effects:
mesalamine Trade: liadla Class: GI antiinflammatories--therapeutic mesoridazine Trade: Serentil Class: TYPICAL ANTIPSYCHOTICS Pharm: Phenothiazines
Action: Reduction in the symptoms of IBD Rational:
Assess: allergies to sulfonamides 7 sallicylates, I&O SE: HA, anaphylaxis Teach: may cause drowsiness, do not change brands Administration: Assessment: I&O, Urinary retention; especially in elders, vitals, Wt. Administer medications as needed for EPS, Check EKG for Mellaril due to cardiotoxicity, Mellaril is contraindicated w/ drugs that lengthen QT Intervals, CBC, Liver function tests, ocular exams periodically Adverse Effects: Anticholinergic effects, Extrapyramidal Symptoms (EPS), High EPS, Moderate anticholinergic Teach: Drink 2-3L fluids QD, sugarless gum or candy for dry mouth, high fiber diet, good oral hygiene, Sunscreen, Rise slowly, No alcohol, Caution driving, Report EPS, Report any symptoms immediately Administration: Assessment- assess pt for pain muscle stiffness, and range of motion before and periodically during therapy Adverse Effects- drowsiness, dizziness, nausea Teach- take as directed, change positions slowly to minimize orthostatic hypotension, advise pt to avoid concurrent use of alcohol or other CNS depressants while taking med. Instruct pt to notify health care professional if skin rash or yellowish discoloration of the skin or eyes occur. Administration- provide safety measures as indicated. Supervise ambulation and transfer of patient
Adverse Effects:
metaxalone Trade- Skelaxin Class- Skeletal muscle relaxants
Action- Skeletal muscle relaxation probably a result of CNS depressing. Rationale:
Therapeutic Effect-
Adverse Effects-
metformin Trade: Glucophage Class: antidiabetics Pharm: biguanides
Action: Maintenance of blood glucose. Decrease hepatic glucose production and increased intestinal absorption. Increases sensitivity to insulin. Rationale:
Assessment: When combined with oral sulfonylureas, observe for signs and symptoms of hypoglycemic reactions Adverse Effects: abdominal bloating, diarrhea, nausea, vomiting, unpleasant metallic taste Teach: Instruct patient to take metformin at the same time each day, as directed Administration: Assess: PAIN prior to and 1-2 hr after admin; BP,P,RR prior; if RR<10 assess level of sedation; bowels; hx of heart disease, arrythmia Adverse Effects: confusion, sedation, hypotension, constipation Teach: how and when to ask for pain meds; drowsy; dizzy; notify hcp if shallow breathing, extreme tiredness or sleepiness, blurred vision, inability to talk, think, or walk normally, feelings of faintness, dizziness, or confusion; change positions slowly; avoid alcohol and other CNS depressants Administration: PO: with food or milk to GI upset Assessment: BP, HR, RR, and uterine response frequently. Assess for ergotism (cold, numb fingers and toes, chest pain, N/V, HA, muscle pain, weakness). Adverse Effects: May cause decrease of serum prolactin levels. N/V, HA, cramps, diaphoresis. Teach: Take as directed. May cause menstrual-like cramps. Avoid smoking. Administration: IV in acute cases. Do not take double doses and skip missed doses. Assessment: monitor mood, vitals, provide rest periods. monitor platelets and CBC. Adverse Effects: HTN, palpitations, insomnia, sudden death Teach: may cause dizziness, take prior to 6pm, weekly weights, avoid caffeine Administration: PO and transdermal
Adverse Effects:
methadone Trade: Methadose Class: opiod analgesic Opiod agonist
Action: binds to opiate receptors in the CNS altering perception of and response to painful stimuli Rationale: pain
Adverse Effects:
methylergonovine Trade: Methergine Class: Oxytocic Ergot alkaloid
Action: Stimulates uterine and vascular smooth muscle. Prevention and treatment of postpartum or post abortion hemorrhage caused by uterine atony or subinvlution. Rationale:
IV for emergencies only 5 mL of 0.9% NaCL. Rate 0.2 mg 1 hr. PO 200-400 mcg q6-12 hr for 2-7 days.
Adverse Effects:
methylphenidate Trade: Ritalin Class: CNS stimulant
Action: Produces CNS and respiratory stimulant. Increase attention span. Rationale:
20mg=1 tab PO daily
Adverse Effects:
methylprednisolone Trade: Solu-medrol Class: antiasthmatic, corticosteroids Pharm: corticosteroids (systemic)
Action: Suppress inflammation and normal immune response, suppress adrenal function. Rationale: Ordered to inhibit the inflammatory response.
IV With NaSo 0.9% 1.8 mL Q12H 8mg=0.2mL MAX DOSE 0.5-1.7mg/kg/day divided in two doses Q12h
metoclopramide Trade: Reglan, Thiamine Class: antiemetic
metoprolol Trade: Lopressor Class: antianginals, antihypertensives Pharm: beta blocker
Action: Blocks dopamine receptors in chemoreceptor trigger zone of CNS. Stimulates motility of upper GI tract and accelerates gastric emptying. Decreased N/V, symptoms of gastric stasis, and easier passage of nasogastric tube into small bowel. Rationale: Action: Blocks stimulation of beta1 (myocardial) adrenergic receptors. Does not usually affect beta2 adrenergic sites. Rationale:
PO, IV 1-2 mg/kg 30 min before chemotherapy. Adults: PO, IM,IV max dose 0.5 mg/kg/day. Peds: 0.1-0.2 mg/kg/dose repeat 68 hrs if needed
Assessment: adrenal function, Is & Os, level of consciousness, HA, Crohns disease, serum electrolytes and glucose Adverse Effects: Depression CNS, euphoria, HA, increased intracranial pressure in children, hypertension, anorexia, N/V, acne, decreased wound healing, ecchymoses, fragility, hirsutism, petechiae, adrenal suppression, hypoglycemia, muscle wasting, osteoporosis Teach: proper dose, immunosuppressant, adrenal insufficiency, Prelone syrup refrigerated, avoid vaccinations, effects on body image, eat high protein diet. Administration: PO check max dose Assessment: Bowel sounds, N/V, abdominal distention, extrapyramidal side effects. Adverse Effects: drowsiness, extraptramidal reactions, restlessness, neuroleptic malignant syndrome, constipation, diarrhea. Teach: Take as directed, peds teach parents proper dose, drowsiness, avoid alcohol and other CNS depressants Administration: PO, IV, IM Assessment: Monitor BP, ECG, and pulse, monitor vials and I/Os, assess frequency and characteristics of angina. Adverse Effects: Fatigue, wkness, bradycardia, CHF, pulm edema, hypotension, constipation, diarrhea, increased liver enzymes. Teach: Check pulse and BP biweekly, avoid driving until response known, change positions slowly, abrupt with drawl may cause arrhythmias. Administration: PO or IV available Assessment: assess for infection, obtain cultures for C/S, monitor neuro status, I/O Adverse Effects: seizures, dizziness, HA, aseptic memingitis, encephalopathy, abd pain, nausea Teach: don't use alcohol while taking med, take as directed, inform of S/E, may cause metallic taste, urine may turn dark, Administration: PO or IV
Adverse Effects:
Adverse Effects:
25mg/1tablet oral Q6 hrs (hold SBP <100, HR <55)
Adverse Effects:
metronidazole Trade: Flagyl Class: anti-infectives, antiprotozoals, antiulcer agent Pharm:
Action: Disrupts DNA and protein synthesis in susceptible organisms. (anerobic bacteria most susceptible) Rationale:
500mg=100ml IV Q8
Adverse Effects:
mexiletine Trade: Mexitil Class: Local anesthetic, antiarrhythmic
Action: Effective in the suppression of induced ventricular arrhythmias. Inhibits the inward sodium current, thus reducing the rate of rise of the action potential Rationale:
miconazile Trade: Fungoid, Lotrimin, Micatin Class: topical antifungals Pharm:
Action: Affect the synthesis of fungal cell wall, allowing leakage of cellular contents. Rationale:
1 App powder topical QID
miconazole Trade Desenex Class: antifungal (topical)
Action: affect the synthesis of the fungal cell wall, allowing leakage of cellular contents Rationale:
midazolam Trade: Versed Class: antianxiety agent, sedative/hypnotics Pharm: benzodiazepines midorine Trade: ProAmatine Class: vasopressors
Action: Produces generalized CNS depression, inhibitory neurotransmitter. Short-term sedation. Rationale:
Adults >12: IV 1-2.5 mg may increase or decrease dose. IM 0.07-0.08 mg/kg Peds: IV 0.0025-0.05 mg/kg max dose 10 mg. IM 0.1-0.15 mg/kg max dose 10 mg/dose
Action: Activation of alpha-1 adrenergic receptors in arteries and veins. Increase in vascular tone and blood pressure. Rationale:
Assessment: BP, pulse, ECG Adverse Reactions: Allergic rxn (swelling of lips, tongue, face, closing throat), new or worse heartbeat pattern, wheezing, coughing, chest pain, unusual bleeding, dizzy, drowsy Teach: Do not skip doses, change dose, or d/c without DR; may cause dizziness, drowsiness, or blurred vision; Administration: PO: with a full glass of water and food/milk to GI upset Assessment: Assess skin and mucous membranes before and during therapy; look for skin irritation that may indicate a need to discontinue medication. Adverse Effects: Local burning, itching, local hypersensitivity reactions, redness, stinging. Teach: Apply as directed, may stain skin, may cause skin irritation, report lack of response to therapy to MD. Administration: Topically Assess: involved areas of skin and mucous membranes before and frequently during therapy. SE: burning, itching, local hypersensitivity rx, redness, stinging Teach: apply as directed for full course of therapy, even if feeling better. Avoid the eyes. Report increased skin irritation. Admin: apply small amt to cover affected area completely. Assessment: Level of consciousness, level of sedation, BP, HR, RR, toxicity and overdose(use romazicon) Adverse Effects: Agitation, drowsiness, excess sedation, HA, blurred vision, apnea, laryngospasm, RR depression, cardiac arrest Teach: med will decrease mental recall of procedure, drowsiness, dizziness, avoid alcohol Administration: IV. IM Assess: supine and sitting blood pressure prior to and during therapy, pattern of urinary output Adverse Effects: supine hypertension, urinary urge/retention/frequency, dysuria, piloerection, pruritus, paresthesia Teach: Take as directed. First dose upon
Adverse Effects:
Adverse Effects:
Therapeutic Effect:
Adverse Effects:
Adverse Effects:
rising, second dose at midday, third dose before evening meal and at least 4 h before bedtime; do not double dose Administration: PO: Do not administer after last meal or within 4 hr of bedtime. Mineral oil Class: Laxative Action: Decreases intestinal absorption Rationale: Assessment: Abd. Distention, pain, ileostomy drainage Adverse Effects: Teach: purpose of administration Administration: 30 mg PO HS Assessment: Mental status, Wieght and BMI, BP and HR, seizure activity. Adverse Effects: Drowiness, constipation, drymouth, increased appetite, weight gain Teach: Take as directed, drowsiness, dizziness, Change position slowly, Administration: PO HS Assessment: No-suicide contract, Sunscreen, Cardiac assessment, BP lying/standing, Seizure assessment Adverse Effects: Increase suicide risk as depression lifts, Takes 7-14 days for effect Sedating, Anticholinergic effects, Photosensitivity, Cardiac abnormalities, Wt. gain, orthostatic hypotension Teach: Delayed onset to improve mood, Caution driving, Increase fluids/fiber, Sunscreen Administration: Assessment: Maternal vital signs and health status, fetal heart rate/pattern, status of pregnancy such as cervical opening and signs of labor. Adverse Effects: Nausea, vomiting, diarrhea, fever. Teach: Insure informed consent, Void before procedure, maintain a supine position w/ lateral tilt or side-lying position for 30-40 min after administration Therapeutic Effects: Adverse Effects:
mirtazapine Trade: Remeron Class: Antidepressant Pharm: tetracyclic antidepressant
Action: Potentiates the effects of norepinephrine and serotonin, antidepressent. Rationale:
mirtazapine Trade: Remeron Class: Antidepressant Pharm: tetracyclic antidepressant
Adverse Effects:
misoprostol Trade Name: Cytotec Class: Therapeutic: Antiulcer agents, cytoprotective agents
Action: Prostaglandin E1 ripens the cervix, making it softer and causing it to begin to dilate and efface; Stimulates uterine contractions. Induces labor Rationale:
Adverse Effects:
monetasone Trade: Elocon Class: antiinflammatories (steroidal) Pharm: corticosteroids (topical) montelukast Trade: Singulair Class: allergy, cold, cough remedies, bronchodilators Pharm: leukotriene antagonists mann
Action: Suppress normal immune response and inflammation. Suppression of dermatologic inflammation and immune processes. Rationale:
Topical 45 Gm daily
Assessment: affected skin before and daily during therapy. Adverse Effects: burning, edema, hypersensitivity reaction, secondary irritation, adrenal suppression Teach: use as directed, correct technique of medication Administration: Topical 45 Gm daily Assessment: Lung sounds, changes in behavior, Adverse Effects: Suicidal thoughts, agitation, depression Teach: take as directed, directly into mouth, not used to treat acute attacks of asthma Administration:
Adverse Effects:
Action: antagonizes the effects of leukotrienes, which mediate the following: airway edema, smooth muscle constriction , altered cellular activity. results in decreased inflammatory process, which is part of asthma and allergic rhinitis Rationale: Pt has asthma Action: Binds to opiate receptors in the CNS. Alters the perception of and response to painful stimuli, while producing generalized CNS depression. Rationale:
Adverse Effects:
PO starting dose 30 mg q3-4 hr or 0.3 mg/kg/dose. IM or Subcut 4-10 mg q3-4 hr. IV continuous infusion 0.01-0.04 mg/kg/hr. Epidural 5 mg/day for first 60 min then increase 1-2 mg but not exceeding 10 mg/day.
morphine Trade: Roxanol Class: Opioid analgesics Opioid agonist
Action: Binds to opiate receptors in the CNS. Alters the perception of and response to painful stimuli, while producing generalized CNS depression. Rationale:
Assessment: Pain type, location, intensity prior to and 1 hr following PO, Subcut, IM and 5 min after IV start. BP, HR, RR periodically. Bowel function. Physical and psychological dependence and tolerance. With sustained-release morphine additional short-acting opioid doses needed. Adverse Effects: Sedation, decreased respirations, altered consciousness, visual and auditory sensory disturbed. Teach: May cause drowsiness or dizziness, orthostatic hypertension. Avoid alcohol. Deep breathe q2h. Administration: PO as ordered; check MAX dose, Keep Narcan available for toxicity/overdose. With food or milk o.k. Assessment: Pain type, location, intensity prior to and 1 hr following PO, Subcut, IM and 5 min after IV start. BP, HR, RR periodically. Bowel function. Physical and psychological dependence and tolerance. With sustained-release morphine additional short-acting opioid doses needed. Adverse Effects: Sedation, decreased respirations, altered consciousness, visual and auditory sensory disturbed. Teach: May cause drowsiness or dizziness, orthostatic hypertension. Avoid alcohol. Deep breathe q2h. Administration: PO as ordered; check MAX
Adverse Effects:
Adverse Effects:
dose, Keep Narcan available for toxicity/overdose. With food or milk o.k.
multivitamin Trade: Thera Tab Class: Vitamin
Action: Provides minerals such as folic acid , and to provide a source of nutrition Rationale:
PO with food or glass of milk at same time of day, taken every day. 1 Tab daily
multivitamin Trade: Centrum SR Class: Vitamin
Action: Provides minerals such as folic acid, and to provide a source of nutrition. Rationale:
mycophenolate motetil Trade: CellCept Class: Immunosuppressant
nadolol Trade: Corgard Class: antianginals, antihypertensives Pharm: Beta blocker
Action: Inhibits the enzyme inosine monophosphate dehydrogenase, which is involved in purine synthesis. This inhibition results in suppression of T and B lymphocyte proliferation. Prevention of transplanted organ rejection Rationale: Action: Blocks stimulation of Beta1 and Beta2 receptor sites. Decreased HR and BP Rationale: Pt has Hx of HTN
Assessment: Abdominal pain, stool consistency Adverse Effects: Skin rashes, abdominal pain, change in stool color and consistency. History of clotting, anemia, and reactions to minerals. Teach: Take with food or milk. Do not take more than prescribed. Eat a balanced diet. Possible drug interactions. Avoid alcohol. Administration: PO take with food or milk. Do not take more than prescribed. Assessment: Abdominal pain, stool consistency Adverse Effects: Skin rashes, abdominal pain, change in stool color and consistency. History of clotting, anemia, and reactions to minerals. Teach: Take with food or milk. Do not take more than prescribed. Eat a balanced diet. Possible drug interactions. Avoid alcohol. Administration: PO take with food or milk. Do not take more than prescribed. Assessment: symptoms of organ rejection, monitor labs, CBC, AST, ALT, LDH, BUN Adverse Effects: dizziness, HA, insomnia, tremors, cough, pleural effusion, hypertension, peripheral edema, anaphylaxis Teach: Take at same time every day, avoid grapefruit juice, importance of lab draws Administration: PO Assessment: BP, hr, I&O's, angina, BS Adverse Effects: fatigue, weakness, arrhythmias, bradycardia, CHF, PE, erectile dysfunction Teach: Take as directed, no abrupt withdrawal, Check HR, BP, dizziness, orthostatic hypotension, Administration:
Adverse Effects:
Adverse Effects:
Adverse Effects:
20 MG 1 Tab PO 2100 Hold HR<55 SBP<100
Adverse Effects:
nalbuphine Trade: Nubain Class: Opioid analgesics Opioid agonists/analgesic
Action: Binds to opiate receptors in the CNS. Alters the perception of and response to painful stimuli, while producing generalized CNS depression. Decrease in severity of pain Rationale:
IM deep into welldeveloped muscle and rotate sites. IV 10-20 mg/ml over 3-5 min.
Assessment: Pain type, location, intensity prior to and 1 hr following PO, Subcut, IM and 5 min after IV start. BP, HR, RR periodically. Bowel function. Physical and psychological dependence and tolerance. Adverse Effects: Dizziness, headache, sedation, dry mouth, N/V, clammy feeling, sweating. Teach: When to ask for meds. Change position slowly. Frequent mouth rinses and good oral hygiene along with sugarless gum decrease dry mouth. Avoid alcohol. Deep breathe q2h. Administration: Check MAX dose, Assessment: acute withdrawal syndrome which may include, but is not limited to, the following signs and symptoms: body aches, fever, sweating, runny nose, sneezing, piloerection, yawning, weakness, shivering or trembling, nervousness, restlessness or irritability, diarrhea, nausea or vomiting, abdominal cramps, increased blood pressure, tachycardia. In the neonate, opioid withdrawal may also include: convulsions; excessive crying; hyperactive reflexes Adverse Effects :hypotension, hypertension, ventricular tachycardia and fibrillation, dyspnea, pulmonary edema, and cardiac arrest Teach: Reason for use
Adverse Effects:
naloxone Trade: Narcan Class: Opioid Antagonist
Action: indicated for the complete or partial reversal of opioid depression, including respiratory depression, induced by natural and synthetic opioids Rationale:
initial dose of 0.4 mg to 2 mg of NARCAN may be administered intravenously. If the desired degree of counteraction and improvement in respiratory functions are not obtained, it may be repeated at two- to three-minute intervals.
Adverse Effects:
naproxen Trade: Aleve Class: nonopioid analgesic, nonsteroidal antiinflammatory, antipyretic
Action: Inhibits prostaglandin synthesis, decreased pain, decrease fever, suppress inflammation Rationale:
500mg=2 tab PO daily
Administration: as directed Assessment: pts with asthma, aspirin allergy, and nasal polyps, increased risk of hypedrsensity Adverse Effects: dizzy, drowsiness, ha, constipation Teach: take with full glass of water, sit upright 15-30mins post, do not use with alcohol, wear sunscreen Administration:
Adverse Effects:
neomycin Trade: Neo-Fradin Class: anti-infective Pharm: aminoglycoside
Action: Inhibits protein synthesis in bacteria at level of 30S ribosome. Rationale:
1000mg 3 doses preop PO
Assessment: Assess for infection, obtain specimens for C/S, monitor I/O, assess hearing function, Adverse Effects: ataxia, ototoxicity, nephrotoxicity, Teach: Report signs of hypersensitivity, drink plenty of fluids, take as directed, may cause N/V Administration: PO, IM Assessment: Assess for signs up niacin deficiency (pellagra-dermatitis, stomatitis, glossitis, anemia, N/V) Adverse Effects: GI upset, hepatotoxicity, flushing of the face and neck, pruritus Teach: report signs of dark urine, light grey colored stool, loss of appetite, severe stomach pain, yellow skin Administration: PO as ordered Assessment: evaluate smoking history, monitor withdrawal symptoms, evaluate progress in smoking cessation Adverse Effects: HA, insomnia, tachycardia, burning at patch site Teach: explain purpose of patch, encourage participation in smoking cessation, instruct on proper patch disposal Administration: transdermal Assessment- Monitor BP and P, monitor I&O Adverse Effects- headache, peripheral edema, arrhythmias, CHF, flushing, Stevens Johnson Syndrome Teach- take as directed, monitor pulse if <50 contact dr. may cause drowsiness, dizziness, change positions slowlyorthostatic hypertension Administration: Assessment: BP and HR before therapy, during dose titration, and periodically during therapy. Monitor ECG periodically during prolonged therapy. I&Os and daily weight. Assess for signs of CHF (peripheral edema, rales/crackles, dyspnea, weight gain, jugular venous distention) Adverse Effects: headache, peripheral edema, bradycardia, chest pain, hypotension, palpitations, syncope, tachycardia. flushing, Teach: Take medication as directed, even if
Adverse Effects:
niacin Trade: Niaspan Class: lipid-lowering agents, vitamins Pharm: water soluble vitamin nicotine transdermal Trade: Nicotine Class: smoking deterrents
Action: Required as coenxymes (for lipid metabolism). Large doses decrease lipoprotein and triglyceride synthesis by inhibiting the release of free fatty acids from adipose tissue and decreasing hepatic lipoprotein synthesis. Rationale: Action: Provides a source of nicotine during controlled withdrawal from smoking Rationale:
100mg/ tablet oral QC
Adverse Effects:
1 patch 14mg transdermal daily
Adverse Effects:
nifedipine Trade- Adalat CC Class- antianginals, antihypertensive
Action- Inhibits calcium transport into myocardial and vascular smooth muscle cells, resulting in inhibition of excitation contraction coupling and subsequent contraction RationaleAction: Inhibits calcium transport into myocardial and vascular smooth muscle cells, resulting in inhibition of excitation-contraction coupling and subsequent contraction. Systemic vasodilation, resulting in decreased blood pressure. Coronary vasodilation, resulting in decreased frequency and
Adverse Effects:
niphedipine Trade: Procardia Class: : antianginals, antihypertensives Pharm: calcium channel blockers
Adverse Effects:
severity of attacks of angina. Rationale:
nitroglycerin
Class: antianginals
Action: Increases coronary blood flow by dilating coronary arteries and improving collateral flow to ischemic regions. Rationale:
norepinephrine Trade: Levophed Class: vasopressors
nortriptyline, protriptyline Trade: Pamelor Class: Anitdepressants
Action: Stimulates alphaadrenergic receptors located mainly in blood vessels, causing constriction of capacotance and resistance vessels. Has minor betaadrenergic activity (myocardial stimulation). Increased blood pressure, increased cardiac output. Rationale: Action: Increases serotonin & norepinephrine Rationale:
feeling well. Take missed doses as soon as possible unless almost time for next dose; do not double doses. Discontinued gradually. Instruct monitoring pulse. Instruct patient to contact health care professional if heart rate is <50 bpm. Avoid grapefruit or grapefruit juice. Change positions slowly orthostatic hypotension. Drowsiness or dizziness. Avoid driving or other activities requiring alertness until response to the medication is known. Administration: Assessment: Assess location, duration, intensity, and precipitating factors of patient's anginal pain. Monitor BP and HR before and after administration. Patients receiving IV nitroglycerin require continuous ECG and BP monitoring. Adverse Effects: dizziness, headache, CV: hypotension, tachycardia, Teach: Take as directed, orthostatic hypotension. First dose should be taken while in a sitting or reclining position, avoid alcohol . headache is a common. Notify health care professional if dry mouth or blurred vision occurs. . Acute Anginal Attacks: Dose may be repeated if pain is not relieved in 5-10 min. Call health care professional or go to nearest emergency room if anginal pain is not relieved by 3 tablets in 15 min. Administration: Assessment: BP Q2-3 minutes until stabilized and q5 min thereafter, EKG, I&O's , IV site Adverse Effects: Anxiety, dizziness, HA, iinsomnia, restlessness, tremor, weakness, dyspnea, arrhythmias, bradycardia, HTN, metabolic acidosis, fever Teach: Report HA, dixxiness, dyspnea, chest pain, or pain at IV site. Administration: IV Assessment: As stated previously, BP lying/standing, Cardiac assessment, High overdose potential limit quantity available to patient Adverse Effects: Anticholinergic effects, Orthostatic hypotension, Cardiac abnormalities, Wt gain, Photosensitivity,
Adverse Effects:
Adverse Effects:
Pharm: Tri-cyclics
Increase suicide risk, Sedation Teach: Increase fluids/fiber, Take at HS, Exercise, sensible eating, Sunscreen, No suicide contract, No alcohol, caution driving Administration: Action: Affects the synthesis of the fungal cell wall, allowing leakage of cellular contents. Rationale: Apply four times daily Assessment: Inspect involved area of skin and mucous membranes before and frequently during therapy. Adverse Effects: Local itching, hypersensitivity, redness, and stinging. Teach: Apply as directed for full course of therapy, may stain fabric, skin, or hair. Administration: Apply small amounts to cover affected area. Assessment: infection, specimen for culture and sensitivity, anaphylaxis shock, bowel function, Adverse Effects: Seizures, dizziness, HA, insomnia, arrhythmias, anaphylaxis Teach: take as directed, maintain fluid intake, may cause dizziness and drowsiness, Administration: Ottis ear drops SE: altered taste, rash
Adverse Effects:
nystatin Trade: Mycostatin Class:antifungals (topical) Pharm:
Adverse Effects:
ofloxacin Trade: Floxin Class: anti-infectives Pharm: fluoroquinolones
Action: Inhibit bacterial DNA synthesis causing death of susceptible bacteria Rationale:
Ear drops 0.3%=5mL 5 drops Right ear bid ordered 0900 400mg/day max dose
Adverse Effects:
Omega-3 polyunsat Fatty acids Trade:Omega 500 Class: lipid lowering agents Pharm: fatty acids omeprazole Trade: Prilosec, Prilosec OTC, Losec Class: antiulcer agent. Pharm: proton-pump inhibitor
Action: Lowering of triglycerides Rational:
Adverse Effects:
Action: Binds to enzyme on gastric parietal cells in the presence of acidic pH preventing transport of hydrogen ions into the gastric lumen. To assist in healing of ulcers Rationale:
20 mg once daily PO with breakfast. 20mg=1Cap
Assessment: Epigastric or abdominal pain, blood instool, emesis, or gastric aspirate. Adverse Effects: Dizziness, drowsiness, fatigue, HA, weakness, abdominal pain Teach: Take as directed, full course of therapy, may cause drowsiness, dizziness, ask Dr about other OTC meds, avoid alcohol, report black tarry stools. Administration: PO with a full glass of water.
Adverse Effects:
ondansetron Trade: Zofran Class: Antiemetic 5-HT3 antagonists
Action: Blocks effects of serotonin at 5-HT3-receptor sites in vagal nerve terminals and chemoreceptor trigger zone in CNS. To relieve N/V following surgery. Rationale: Action: Binds to opiate receptors in the CNS. Alter the perception of and response to painful stimuli, while producing generalized CNS depression. Rationale:
IV 4 mg q4hr or PRN for N/V
oxycodone Trade: Oxycotin Class: opioid analgesic Pharm: opioid agonists
5mg tablet oral Q3 hr PRN, or 10mg (two 5mg tablets) Q3 hr PRN
oxycodone/ acetaminophen Trade- Percocet Classification- Opioid analgesic/ agonist
Action- Binds to opiate receptors in the CNS alters the perception and response to painful stimuli while producing generalized CNS depression, decreases pain Rationale-
oxytocin Trade: Pitocin Class: Uterine-active agent
Action: Stimulate labor at term and secondarily to stimulate milk flow. Used to help control postpartum bleeding. Rationale: To induce labor and milk flow.
IV 10 units in 1000 mL of fluid given 1-2 milliunits/min. IM for postpartum 3-10 units to control bleeding.
Assessment: N/V, abdominal distension, bowel sounds involuntary movement Adverse Effects: Headache, constipation, diarrhea Teach: PT and/or family to notify health care professional immediately if involuntary movement of eyes, face, of limbs occurs Administration: IV after surgery Assessment: Assess type, location, and intensity of pain pre and post med delivery. Assess BP, pulse, RR prior and during treatment. Assess bowel function. Prolonged use may lead to dependence. Adverse Effects: confusion, sedation, dizziness, hallucinations, resp depression, flushing, sweating, constipation Teach: Teach pain how and when to ask for pain meds. Advise pt to call for assistance when ambulating, change positions slowly to reduce orthostatic hypotension, and turn cough, and deep breathe every 2 hours. Administration: PO or rectal Assessment- type location and intensity of pain, monitor BP pulse and respirations, asses level of sedation, Adverse Effects- confusion, sedation, respiratory depression, constipation Teach- how and when to ask for pain meds, dont increase the dosage without consulting health care, caution patient that it can be a potential drug of abuse, may cause drowsiness, avoid driving, Administration: Assessment: Contractions and dilation. Postpartum assess Lucia. BP, HR frequently and fetal HR. Monitor dilation of cervix and progression of contractions. Adverse Effects: Drastic increase in contraction med stopped. Egrotism: vomiting, diarrhea, unquenchable thirst, tingling, itching, coldness of skin. Weak or rapid pulse, confusion, and unconsciousness. Teach: Contractions should be more intense than normal. May stimulate cramping. Administration: IV to stimulate contraction and IM to help with postpartum bleeding.
Adverse Effects:
Adverse Effects:
Adverse Effects
Adverse Effects:
pancrelipase Trade: Creon Class: digestive agent Pharm: pancreatic enzymes pantoprazole Trade: Protonix Class:antiulcer agents (proton pump inhibitors) paroxetine Trade: Paxil Class: Antidepressant Pharm: SSRI
Action: Increased digestion of fats, carbohydrates, and proteins in the GI tract Rationale:
PO 3 Caps AC 12000 unit caps
Action: Binds to an enzyme in the presence of acidic gastric pH. Diminished accumulation of acid in the gastric lumen w/ lessened acid reflux. Rationale: Action: Blocks reuptake of serotonin, Increasing available serotonin at receptor site, Anti anxiety, Antidepressant Rationale:
Assessment: nutritional status, stools for high fat content, allergies to pork Adverse Effects: abdominal pain, diarrhea, N/V stomach cramps Teach: Take before meals, crew and swallow quickly, tell Dr if joint pain, swelling of legs. Administration: POI before meals Assessment: pain, blood in stool. Adverse Effects: headache Teach: follow dietary guidelines. Administration: without regard to food. DO NOT break, crush or chew Assessment: Assess for symptoms of serotonin syndrome, In low doses decrease anxiety Adverse Effects: Increase suicide risk as depression lifts, Prozac may increase blood levels of statins, Potentiates other medications that use same enzymes (except Celexa), Insomnia, nausea, anorexia, headache, restlessness, decreased libido Serotonin syndrome, BP, HR, fever, muscle rigidity, coma, death MED EMERGENCY Teach: Black Box Warning, Give with food for nausea, Do not stop abruptly Administration: Assessment: I&O's and daily weights, mental status, suicidal tendencies, Obsessive compulsive behaviors, panic attacks, Adverse Effects: Anxiety, dizziness, drowsiness, headache, insomnia, weakmess, constipation, diarrhea, dry mouth, ejaculatory disturbances Teach: Take as directed, drowsiness, dizziness, suicidal tendencies, avoid alcohol. Administration: PO Assessment: I&O, Urinary retention; especially in elders, vitals, Wt. Administer medications as needed for EPS, Check EKG for Mellaril due to cardiotoxicity, Mellaril is contraindicated w/ drugs that lengthen QT Intervals, CBC, Liver function tests, ocular exams periodically
Adverse Effects:
paroxetine hydrochloride Trade: Paxil Class: Antianxiety, antidepressant Pharm: selective serotonin reuptake inhibitor perphenazine Trade: Trilafon Class: TYPICAL ANTIPSYCHOTICS Pharm: Phenothiazines
Action: Inhibits neuronal reuptake of serotonin. Decreased panic attacks, improvement of posttraumatic stress disorder Rationale:
PO 40 mg Tab HS
Adverse Effects:
Adverse Effects:
pfizerpen Trade: penicillin G Class:: anti-infectives
phenazopyridine Trade: Class: nonopiod analgesic Urinary tract analgesic phenelzine Trade: Nardil Class: Antidepressants Pharm: MAO INHIBITORS
Action: Bind to bacterial cell wall, resulting in cell death. Rationale: Active against: Most gram-positive organisms, including many streptococci (Streptococcus pneumoniae, group A betahemolytic streptococci), staphylococci (non penicillinase-producing strains) and Bacillus anthracis, Some gramnegative organisms, such as Neisseria meningitidis and N. gonorrhoeae (only penicillin susceptible strains) Action: acts locally on the urinary tract mucosa to produce analgesic or local anesthetic effects Rationale: bladder hypertonicity
IM, IV (Adults): Most infections15 million units q 46 hr. IM, IV (Children): 833316,667 units/kg q 4 hr; 12,55025,000 units/kg q 6 hr; up to 250,000 units/kg/day in divided doses, IV (Infants >7 days): 75,000 units/kg/day in divided doses every 8 hr;
Adverse Effects: Anticholinergic effects, Extrapyramidal Symptoms (EPS), High EPS, Moderate anticholinergic Teach: Drink 2-3L fluids QD, sugarless gum or candy for dry mouth, high fiber diet, good oral hygiene, Sunscreen, Rise slowly, No alcohol, Caution driving, Report EPS, Report any symptoms immediately Administration: Assessment: Assess for infection previous use of and reactions to penicillins Observe patient for signs and symptoms of anaphylaxis Adverse Effects: CNS: SEIZURES. GI: diarrhea, epigastric distress, nausea, vomiting, . GU: interstitial nephritis. Derm: rash, urticaria. Hemat: eosinophilia, leukopenia. Local: pain at IM site, phlebitis at IV site. Misc: ALLERGIC REACTIONS INCLUDING ANAPHYLAXIS AND SERUM SICKNESS, superinfectionTeach: finish drug completely ,report signs of superinfection, fever and diarrhea notify health care professional if symptoms do not improve Administration: As directed Assess: urgency, frequency, pain on urination; renal function periodically Adverse Effects: bright orange urine Teach: may be stopped during therapy once pain is relieved but must still take antibiotics; discolors urine and may stain clothes or soft contact lenses Administration: PO: with or without food to GI upset. DO NOT CRUSH BREAK OR CHEW TABLET Assessment: Headache, insomnia, Wt gain Hypoglycemia, High BP, convulsions, coma Adverse Effects: Cannot be taken with any other psychotropic drug, Minimum washout time is 2-5 weeks, Need tyramine free diet, Hypertensive crisis occurs with tyramine foods, narcotics, general anesthesia Teach: Compliance with tyramine free diet: avoid aged cheese, smoked/processed meats, red wines, yeast, fava beans, bananas, avocado, OTC meds Administration:
Adverse Effects:
Adverse Effects:
phenytoin Trade: Dilantin Class: antiarrhythmics (group IB), anticonvulsants Pharm: hydantoins
Action: Diminished seizure activity. Termination of ventricular arrhythmias. Rationale:
phosphate/ biphosphate Trade: Fleet Enema Class: laxative (saline)
Action: Causes water retention and stimulation of peristalsis. Stimulates motility and inhibits fluid and electrolyte absorption from the small intestine Rationale: constipation
Assessment: Oral hygiene, hypersensitivity syndrome (fever, skin rash, lymphadenopathy). May lead to renal failure, rhabdomyolysis, or hepatic necrosis; may be fatal. Seizures: Assess location, duration, frequency, and characteristics of seizure activity. EEG may be monitored periodically throughout therapy. BP, ECG, and respiratory function continuously Arrhythmias: Monitor ECG continuously during treatment of arrhythmias. Adverse Effects: ataxia, agitation, confusion, dizziness, drowsiness, diplopia, nystagmus. hypotension tachycardia. gingival hyperplasia, nausea Teach: Take as directed. Abrupt withdrawal may lead to status epilepticus. Drowsiness or dizziness. Avoid driving or other activities requiring alertness until response to medication is known. Avoid alcohol, OTC medications, or herbal medications concurrently with phenytoin without consulting health care professional. Good dental hygiene Advise diabetic patients to monitor blood glucose carefully and to notify health care professional of significant changes. Advise patient not to take phenytoin within 2-3 hr of antacids. Advise female patients to use an additional nonhormonal method of contraception during therapy. Instruct patient to notify health care professional if pregnancy is planned or suspected. Administration: Assess: fever, abd distention, bs, pattern of bowel function; color, consistency, and amt of stool Adverse Effects: dizziness, ha, ARRYTHMIA, cramping, n/v, abdominal bleeding, abdominal pain Teach: short term tx only; high sodium content careful if on Na restriction; do not take oral form of this med w/in 2h of other meds; other forms of bowel regulation Administration: do not admin at HS or late in the day; Rect: position pt on left side with knee slightly flexed. D/C if resistance is met.
Adverse Effects:
phytonadione (Vitamin K) Trade: AquaMEPHYTON; Konakion; Class: antidotes, vitamin. (fat- soluble vitamin)
Action: required for hepatic synthesis of blood coagulation factors II (prothrombin), VII, IX, & X. Rationale: Due to lack of flora in GI tract of neonate med is administered to promote clotting & prevent hemmorhagic disease in newborn.
0.5 1 mg (0.25 0.5 ml) dose intramuscular within 2hr of birth. (may be repeated if infant shows bleeding tendancies)
Piperacillin/ tazobactam Trade: Zosyn Class: anti-infective, Extended spectrum penicillins polycarbophil Trade: Fiber-Lax Class: antidiarrheals, laxatives Pharm: bulk-forming agent polyethylene glycol electrolyte Trade: GoLytely Class: laxative Pharm: osmotics potassium chloride Trade: Many brand names Class: Mineral and electrolyte replacements/ supplements
Action: Piperacillin:Binds to bacterial cell wall membrane, causing cell death. Spectrum is extended compared with other penicillins. Tazobactam: Inhibits beta actamase, an enzyme that can destroy penicillins. Rationale: Action: treatment of constipation or diarrhea that may be associated with diverticulosis or irritable bowel syndrome. Rationale:
Assessment: Gestational age and muscle mass. Adverse Effects: Edema; erythema; painat injection site (rare); (reports of hemolysis, jaundice, & hyperbilirubinemia particularly in preterm infants) Teach: Vitamin K injection is routine in newborns in U.S.; baby will produce own vitamin k typically by 8 days of age. Administration: middle 1/3 of vastuslateralis w/ 25 gauge 5/7-7/8 in needle. Inject @ 90 dg. Angle, aspirate & inject slowly. Rub gently with dry guaze &Observe for signs of bleeding at site. Assess: for infection, vital signs, s&s of anaphylaxis SE: seizures, pseudomembranous colitis, diarrhea, rashes, pain, phlebitis at IV site, hypersensitivity reactions, serum sickness, fever. Teach: report any signs of infection, notify Dr. if fever and diarrhea occur. Admin: with Nacl Assessment: bowel function, hypersensitivity, abd pain, N/V, dysphagia Adverse Effects: abdominal fullness Teach: bowel function and diet Administration: PO BID
Adverse Effects:
Therapeutic Effect:
Adverse Effects:
Adverse Effects:
Action: Acts as an osmotic agent, drawing water into the lumen of the GI tract. Rationale:
4000ml, PO, sol, once
Action: Maintain acid-based balance, isotonicity, and electrophysiologic balance of the cell. Rationale:
IV 30 mcg/165mL
Assessment: abd distention, bowel sounds, function, stool color, amount, and consistency Adverse Effects: diarrhea, abdominal fullness, bloating Teach: Drink 240ml ever 10 minutes until 4L consumed or fecal discharge is clear. Administration: PO Assessment: S/S of hypokalemia, BP,HR,RR, Adverse Effects: abdominal pain, diarrhea, flatulence, N/V Teach: Take as directed, Gi irritation, avoid salt, encourage compliance with diet. Administration: IV
Adverse Effects:
pramipexole Trade: Mirapex Class: Dopamine agonist
Action: Stimulates dopamine receptors in the stratum of the brain Rationale:
pramoxine Trade: Proctofoam Class: anti-inflaffitory (steroidal) (corticosteroids topical)
Action: Suppress normal immune response and inflammation. Rationale:
1 appl topical bedtime
pravastatin Trade: Pravachol Class: lipid lowering agents Pharm: HMO-CoA reductase inhibitors prednisolone Trade: Prelone Class: antiasthmatic, corticosteroids Pharm: corticosteroids (systemic)
Action: Inhibit an enzyme, 3hydrooxy-methylglutatyl-coenzyme A reductase, catalyzing an early step in the synthesis of cholesterol. lowers total and LDL cholesterol Rationale: Action: Suppress inflammation and normal immune response, suppress adrenal function. Rationale:
20mg=1tab at bedtime
Assessment: asses for confusion or hallucinations. Monitor ECG and blood pressure periodically throughout therapy. Asses for drowsiness and sleep attacks, asses sleep patterns and frequency of restless leg disturbances Adverse Effects: Sleep attacks, amnesia, dizziness, drowsiness, hallucinations, weakness, constipation, dry mouth, dyspepsia, nausea. Teach: Change positions slowly, skin exams, advice if any new or increased gambling sexual or other intense urges occur. Administration: administer with meals to minimize nausea, usually resolves with continued therapy. Assessment: affected skin before and daily during therapy; degree of inflammation & pruritis; Notify HCP if S&S of infection (increased pain, erythema & purulent exudates) develop. Adverse Effects: dryness; allergic contact dermatitis; atrophy; edema; folliculitits; maceration; irritation; secondary infection. Teach: correct administration technique; Avoid using cosmetics, bandages, dressings or other skin products on affected area unless directed by HCP; Consult HCP for S&S of infection. Administration: Ointment,creams Assessment: dietary history, monitor liver function Adverse Effects: dizziness, HA, weakness, chest pain, edema, abdominal cramps, constipation, diarrhea, flatus, heartburn, rashes. Teach: take as directed, avoid OTC and herbal, Administration: AT bedtime (HS) Assessment: adrenal function, Is & Os, level of consciousness, HA, Crohns disease, serum electrolytes and glucose Adverse Effects: Depression CNS, euphoria, HA, increased intracranial pressure in children, hypertension, anorexia, N/V, acne, decreased wound healing, ecchymoses, fragility, hirsutism, petechiae, adrenal suppression, hypoglycemia, muscle
Adverse Effects:
Adverse Effects:
Adverse Effects:
Adults: PO 120-180 mg/day. Peds: PO 0.1-2 mg/kg/day divided dose, max dose 80 mg/day
Adverse Effects:
wasting, osteoporosis Teach: proper dose, immunosuppressant, adrenal insufficiency, Prelone syrup refrigerated, avoid vaccinations, effects on body image, eat high protein diet. Administration: PO check max dose prednisone Trade: Deltasone Class: Corticosteroids Action: In pharmacologic doses, all agents suppress inflammation and the normal immune response. Rationale: Assessment: adrenal insufficiency (hypotension, weight loss, weakness, nausea, vomiting, anorexia, lethargy, confusion, restlessness) before and periodically during therapy, I&O and daily weights, peripheral edema, steady weight gain, rales/crackles, or dyspnea. Notify health care professional if these occur. Children should have periodic evaluations of growth. Adverse Effects: depression, euphoria hypertension. anorexia, nausea, vomiting. acne, decreased wound healing, ecchymoses, fragility, hirsutism, petechiae. adrenal suppression, Teach: Take as directed. Take missed doses as soon as remembered unless almost time for next dose. Do not double doses. Stopping the medication suddenly may result in adrenal insufficiency (anorexia, nausea, weakness, fatigue, dyspnea, hypotension, hypoglycemia). If these signs appear, notify health care professional immediately. Corticosteroids cause immunosuppression and may mask symptoms of infection. Avoid people with known contagious illnesses and to report possible infections immediately. Administration: Assessment: May decrease platelet count, monitor for suicidal thoughts, assess pain, and seizures. Adverse Effects: suicidal thoughts, dizziness, drowsiness, dry mouth, edema Teach: report unexplained muscle pain, dont dc abruptly, avoid driving if effects of med unknown, may cause wt gain, avoid CNS depressants Administration: PO Therapeutic Effects:
Adverse Effects:
pregabalin Trade: Lyrica Class: analgesics, anticonvulsants Pharm: nonopioid analgesics, GABA analogues
Action: Binds to calcium channels in CNS tissues which regulate neurotransmitter release. Doesn't bind to opioid receptors. Rationale:
75mg
Adverse Effects:
prenatal multivitamin Trade: Many bands Class: Vitamin
Action: Provides minerals such as folic acid to the mother and fetus. To provide a source of nutrition during pregnancy. Rationale:
PO with food or glass of milk at same time of day, taken every day.
prochlorperazine Trade: Compro, Compazine Class: antiemetics, antipychotics Pharm: phenothiazines
Action: Alters the effects of dopamine in the CNS. Posesses significant antichollinergic and alphaadrenergic blocking activity Rationale:
5mg=1ml IV Q4 PRN
promethazine Trade: Histantil, Promethacon, Phenergan Class: Antiemetic, antihistamines, sedative/hypnotics Pharm: phenothiazines t
Action: Blocks the effects of histamine, inhibitory effect on the chemoreceptor trigger zone in medulla = antiemetic. Alters dopamine CNS. CNS depression. Rationale:
25mg 3 times a day PO. 25mg=1 Tab
Assessment: Abdominal pain, stool consistency Adverse Effects: Skin rashes, abdominal pain, change in stool color and consistency. History of clotting, anemia, and reactions to minerals. Teach: Take with food or milk. Do not take more than prescribed. Eat a balanced diet. Possible drug interactions. Avoid alcohol. Administration: PO take with food or milk Assessment: monitor BP, ECG, HR, RR, assess LOC, monitor for akathisia and extrapyramidal effects, assess for N/V, anxiety and fluid intake and bowel function. Adverse Effects: neuroleptic malignant syndrome, extrapyramidal reactions, blurred vision, dry eyes, constapation, dry mouth Teach: Avoid abrupt withdrawl, change positions slowly, avoid alcohol and sun exposure, avoid antacids for two hrs, may turn urine pink, follow good oral hygeine. Administration: PO, IM, IV, Rect Assessment: BP, HR, RR frequently, sedation, extarpyramidal side effects (restlessness, muscle spasms, rigidity, tremors, drooling), N/V. Adverse Effects: Confusion, disorientation, sedation, dizziness, hypertension, hypotension, bradycardia, tachycardia, constipation Teach: Dose schedule, drowsiness, good oral hygiene, orthostatic hypotension, avoid alcohol. Administration: PO 3 times daily Assessment: resp status, pulse, BP continuously; cuases apnea 60 sec; patent airway; level of sedation/LOC; wake up and assess neuros but keep light dose (do not dc abruptly); propofol infusion syndrome (severe met acidosis, hyperkalemia, lipemia, cardiac and renal failure) Adverse Effects: bradycardia, hypotension, burning, pain, stinging, apnea, propofol infusion syndrome Teach: mental recall of procedure; drowsy/dizzy; avoid alcohol and other CNS depressants Administration: IV only; over 3-5 min; cont
Adverse Effects:
Adverse Effects:
Adverse Effects:
Action: Short acting hypnotic. Mechanism of action is unknown. Produces amnesia. No analgesic properties. Rationale:
Adverse Effects:
ifusion based on pt weight
propoxyphene napsylate/acetomino phen. Trade: Darvocet N100 Class: opioid analgesic (opioid agonist/ nonopioid analgesic combination)
Action: used in mild to moderate pain. Binds to opiate receptors in CNS to alter perception of and response to painful stimuli. Produces general CNS depression. Rationale:
Max dosage: no more than 100 mg. q 4hr/ 600 mg day also check total amount of acetaminophen. (100 mg propoxyphene napsylate = 65 mg propoxyphene hydrochloride (Darvon), which does not contain acetomiophen. SEE dose for DARVON in book. (1069)
propranolol Trade: Inderal Class: antianginals, antiarrhythmics (Class II), antihypertensives, vascular headache suppressants Pharm: beta blockers
Action: Blocks stimulation of beta1(myocardial) and beta2 (pulmonary, vascular, and uterine)-adrenergic receptor sites. Decreased heart rate and blood pressure. Suppression of arrhythmias. Prevention of MI Rationale:
Assessment: B/P; pulse; respirations; level of sedation, bowel sounds & function; pain type, location and intensity pre & 2 hr. post med; Adverse Effects: respiratory depression, sedation,: confusion; dizziness; constipation; nausea; weakness; hypotension. Teach: Avoid grapefruit juice; turn cough & deep breathe q2hr.; how & when to ask for pain meds; change position & get up slow; lots of fluids (constipation); Take as directed and avoid alcohol & other CNS depressants; contact HCP before taking other Rx, OTC or herbal products. Administration: PO as ordered; check MAX dose, Keep Narcan available for toxicity/overdose. With food or milk o.k. Assessment: BP, HR . Abrupt withdrawal may precipitate life-threatening arrhythmias, hypertension, or myocardial ischemia. Tapered down over a 2 week period before discontinuation. Adverse Effects: fatigue, weakness, anxiety, dizziness, drowsiness, insomnia, memory loss, mental depression, mental status changes, nervousness, nightmares. blurred vision, dry eyes, nasal stuffiness. bronchospasm, wheezing. erectile dysfunction, Teach: Take medication as directed. Check pulse daily and BP biweekly. Hold dose and contact health care professional if pulse is <50 bpm or BP changes significantly. Drowsiness or dizziness. Avoid driving or other activities that require alertness until response to the drug is known. Change positions slowly Ask health care professional before taking any OTC medications or herbal products. Diabetic patients should closely monitor blood glucose, weakness, malaise, irritability, or fatigue occurs. May mask tachycardia and
Adverse Effects:
Adverse Effects:
increased blood pressure as signs of hypoglycemia, but dizziness and sweating may still occur. Administration:
protriptyline Trade: Vivactil Class: Anitdepressants Pharm: Tri-cyclics
Prozac and Zyprexa combo Trade: Symbyax Class: Antidepressant Pharm: SSRI
psyllium Trade: Metamucil Class: Laxative Pharm: bulk-forming agents quetiapine Trade: Seroquel
Action: combines with water in the intestinal content to form a gel or viscous solution that promotes peristalsis and reduce transit times. Relief and prevention of constipation. Rationale: Hx of constipation Action: Acts by serving as an antagonist of dopamine and serotonin. Rationale:
1 pack PO daily
Assessment: As stated previously, BP lying/standing, Cardiac assessment, High overdose potential limit quantity available to patient Adverse Effects: Anticholinergic effects, Orthostatic hypotension, Cardiac abnormalities, Wt gain, Photosensitivity, Increase suicide risk, Sedation Teach: Increase fluids/fiber, Take at HS, Exercise, sensible eating, Sunscreen, No suicide contract, No alcohol, caution driving Administration: Assessment: Assess for symptoms of serotonin syndrome, In low doses decrease anxiety Adverse Effects: Increase suicide risk as depression lifts, Prozac may increase blood levels of statins, Potentiates other medications that use same enzymes (except Celexa), Insomnia, nausea, anorexia, headache, restlessness, decreased libido Serotonin syndrome, BP, HR, fever, muscle rigidity, coma, death MED EMERGENCY Teach: Black Box Warning, Give with food for nausea, Do not stop abruptly Administration:: Assessment: abd distention, bowel function, stool color and consistency. Adverse Effects: bronchospasms, abd cramping, N/V Teach: encourage other forms of bowel control, avoid straining, avoid with abd pain Administration: Assess: mental status, suicidal tendencies, wt, observe to ensure swallowed and not cheeked or hoarded; wt; extrapyramidal side effects ; tardive dyskinesia (involuntary rhythmic movement of mouth, face, and extremities); neuroleptic malignant syndrome (fever, respiratory distress, tachycardia, seizures, diaphoresis,
Adverse Effects:
Adverse Effects:
Adverse Effects:
Class: antipsychotics, mood stabilizers
ranitidine Trade: Zantac Class: antiulcer Pharm: histamine H2 antagonists ranolazine Trade: Ranexa T: antianginals
Action: Inhibits the action of histamine at the H2-receptor site located primarily in the gastric parietal cells, resulting in inhibition of gastric acid secretion. Rationale: Action: Does not decrease BP or HR, remainder of mechanism is not known, decreased freq of angina Rational:
9mg/0.6ml BID
refresh Trade: Optium Class: artificial tears Pharm: isotonic solutions Renal Caps
Action: add lubercant to eyes to prevent dry eyes Rationale:
1 drop in each eye once a day
hypertension or hypotension, pallor, tiredness). Adverse Effects: dizziness, wt gain, NEUROLEPTIC MALIGNANT SYNDROME, SEIZURES Teach: report extrapyramidal SE; change positions slowly; drowsy; avoid extremes in temp; notify hcp if thoughts of suicide , agitation, trouble sleeping, panic attacks, acting on dangerous impulses; notify hcp if sore throat, fever, unusual bleeding or bruising, or rash. Administration: PO: May be administered without regard to food. Extended-release tablets should be swallowed whole, do not crush, break, or chew. Assessment: Assess for epigastric or abdominal pain and frank or occult blood in stool, emesis, or gastric aspirate. Adverse Effects: confusion, arrhythmias, diarrhea, agranulocytosis, aplastic anemia Teach: Take as directed, avoid smoke because it interferes with the histamine antagonists, report onset of tarry stools Administration: Assess: location, duration, intensity, precipitating factors of chest pain, ECG at baseline (effects on QT interval) SE: dizziness, tinnitus, HA, dry mouth, N&V, constipation, palpitations Teach: avoid grapefruit juice, may cause dizziness/light-headedness, may cause chg in EKG, inform HCP before taking OTC or herbal Assessment: underline issues, dietary such as eating more fish and proper sleep. Adverse Effects: red eyes, burning Teach: blink more often, proper sleep, eat more fish, Administration: one drop in each eye Assessment: Vitamin deficiency , Renal disease, HD Adverse Effects: Folic acid may mask the symptoms of pernicious anemia in that hematologic remission may occur while neurological manifestations progress Teach: Take med after HD to prevent the removal from bleed stream. Administration: PO
Adverse Effects:
Adverse Effects:
Adverse Effects:
Class: Vitamins
Action: Renal Caps is indicated in the wasting syndrome of chronic renal failure; uremia and impaired metabolic functions of the kidney. Renal Caps ia also highly effective as a stress vitamin. Rationale: PT has ESRD and
has HD x3/week
Resource juice Class: nutritional supplemen reteplase Trade: Retavase class: thrombolytics
Action: Adds nutrition to a daily diet. Rationale: Lack of nutritional intake
6oz juice box with morning and HS meds
Assessment: need for additional nutrition Adverse Effects: not a source of primary diet need or to be used as a weight-loss supplement Protein 12%, Carbohydrate 88%, Fat 0%, free water 79% ASSESS: vitals & monitor for acute chg, recent hx of trauma or stroke as tx may be contraindicated, labsesp. Pt, Ptt, INR, & CNC. HTN & evidence of acute bleeding which may contraindicate tx SE: bleeding Teaching: avoid NSAIDs which may increase risk of bleeding, report sx of bleeding, dizziness, lightheadedness, HA, rash or itching, or palpitations Admin: antidote is aminocaproic acid Assessment: assess for vit A deficiency, for bone pain and weakness, Adverse Effects: dizziness, dyspnea, malaise, pancreatitis Teach: review diet, avoid antacids containing magnesium Administration: PO Assessment: Mental status, assess weight, mood changes, BP, extrapyramidal side effects Adverse Effects: aggressive behavior, dizziness, HA, sleep duration, insomnia, sedation, constipation, diarrhea, dry mouth Teach: Take as directed, extrapyramidal side effects, Administration: PO HS Assessment: Cognitive function(memory, attention, reasoning, language, ability to perform simple tasks) Adverse Effects: weakness, anorexia, N/V/D Teach: take at regular intervals(PO); how to use oral syringe; dizzy; notify hcp of N/V anorexia or wt loss; may take weeks to months for improvement but does not cure; correct application, rotation, and discarding
Therapeutic Effects: Protein 5.6 Adverse Effects: No S/S noticed or reported Therapeutic Effects:
ACTION: used to disintegrate blood clots quicker. Promotes conversion of plasminogen to plasmin which helps to break down fibrin in a blood clot Rationale:
Adverse Effects:
retinol Trade: Vitamin A Class: vitamin Pharm: fat-soluble vitamin risperidone Trade: Risperdal Class: antipsychotics, mood stabilizers Pharm: benzisoxazoles rivastigmine Trade: Exelon Class: antiAlzheimers agent
Action: Vitamin A helps form and maintain healthy skin, teeth, skeletal and soft tissue, mucus membranes, and skin Rationale: ordered to replace deficiency Action: Antagonizing dopamine and serotonin in the CNS. Decreased symtoms of psychoses, bipolar mania, or autism Rationale: Ordered to aid in controlling schizophrenia. Action: Enhances cholinergic function by reversible inhibition of cholinesterase. Does not cure. Rationale: Pt has dementia
PO daily 10,000 units 1 Tab
PO 2 tab 4mg HS
Adverse Effects:
Adverse Effects:
(transdermal) Administration: PO Transdermal
ropinirole Trade: Requip Class:anti parkinson agent Pharm: dopamine agonists rosiglitazone Trade: Avandia Class: antidiabetics Pharm: thiazolidinediones
Action: Stimulates dopamine receptors in the brain Rationale:
1mg tablet QHS
Action: Decreased insulin resistance, resulting in glycemic control without hypoglycemia. Rationale:
rosuvastatin Trade: Crestor Class: lipid-lowering Pharm: HMG-CoA reductase inhibitors Salictlates Trade: aspirin Class: nonopioid analgesic, antipyretic Pharm: salicylates
Action: Inhibit an enzyme, which is responsible for catalyzing an early step in synthesis of cholesterol Rationale:
20mg= 2 tab PO bedtime
Action: Produces analgesia and reduce inflammation and fever by inhibiting the production of prostaglandins, decreases platelet aggregation. Rationale:
81mg=1 tab PO daily
Assessment: assess BP, pt drowsiness and sleep attacks, Adverse Effects: sleep attacks, dizziness, suncope, confusion, orthostatic hypotension, constipation, dyspepsia, n/v Teach: take as directed, change positions slowly, avoid driving until side effects known, avoid alcohol and other CNS depressants Administration: PO Assessment: S/S of hypoglycemia. Edema and signs of CHF (dyspnea, rales/crackles, peripheral edema, weight gain, jugular venous distension).S/S of lactic acidosis (malaise, myalgias, respiratory distress, somnolence, nonspecific abdominal distress). Adverse Effects: CHF, edema. urticaria. hepatitis Teach: Take as directed. Testing of serum glucose and ketones. Administration: Assessment: dietary history, evaluate labs, and monitor liver function Adverse Effects: abd cramps, constipation, diarrhea, flatus, heartburn Teach: notify md if unexplained muscle pain or weakness followed by fever occurs, avoid grapefuit juice Administration: Assessment: pts with asthma, allergies, and nasal polyps are at risk for developing hypersensitivity reactions. assess pain, fever, monitor hematocrit Adverse Effects: GI bleed, dyspepsia, epigastric distress, N/V, steven-johnson syndrome, laryngeal edema, anaphylaxis Teach: take with full glass of water, report tinnitus, bleeding gums, black tarry stools, caution use with other NSAIDS and alcohol Administration: PO
Adverse Effects:
Adverse Effects:
Adverse Effects:
Adverse Effects:
salmeterol Trade: Serevent Diskus Class: bronchodilator; adrenergic
Action: produces accumulation of cyclic adenosine monophosphate at beta2-adrenergic receptors. Rationale:
scopolamine Trade: TransdermScop Class: antiemetics Pharm: anticholinergics Senna plus Trade: Senokot/ Docusate Class: laxatives Pharm: stimulant laxatives
Action: Inhibits the muscarinic activity of acetylcholine. Corrects imbalance of acetylcholine and norepinephrine in CNS which is responsible for motion sickness. Reduction of N/V. Rationale: Action: Stimulant increased peristalsis and aiding in the evacuation of the bowels. Promotes water into stool Resulting in softer fecal mass. Rationale:
Transdermal Patch 1.5 mg
Assessment: LS, pulse and BP before; paradoxical bronchospasms and hypersensitivity rxn; Adverse Effects: headache Teach: if using powder, never exhale into device and hold in level horizontal position; not for acute symptoms; do not use addtln salmeterol for exercise induced bronchospasm; hcp if no relief or if condition worsens Administration: Inhaln: discard diskus when every blister has been used or 6wk have passed. Do not use spacer with powder for inhaln. Assessment: S/S urinary retention, HR, pain,N/V Adverse Effects: drowsiness, blurred vision, tachycardia, dry mouth, urinary hesitancy Teach: take as directed, drowsiness, blurred vision, avoid alcohol, good oral hygiene. Administration: transdermal patch Assessment: abdominal distention, presence of bowel sounds, bowel function, color consistency and amount produced. Adverse Effects: Cramping, diarrhea, discoloration of urine, electrolyte abnormalities, laxative dependence. Teach: short term use only, teach increasing bulk in diet and increase fluid intake to assist with bowel function, may change urine color, avoid laxatives with abdominal pain. Administration: PO BID Assessment: abdominal distention, presence of bowel sounds, bowel function, color consistency and amount produced. Adverse Effects: Cramping, diarrhea, discoloration of urine, electrolyte abnormalities, laxative dependence. Teach: short term use only, teach increasing bulk in diet and increase fluid intake to assist with bowel function, may change urine color, avoid laxatives with abdominal pain. Administration: PO BID
Adverse Effects:
Adverse Effects:
sennosides Trade: Senokot Class: laxatives Pharm: stimulant laxatives
Action: Stimulant increased peristalsis and aiding in the evacuation of the bowels Rationale:
PO BID 1 Tab, hold for loose stools. 187mg= 1 tab
Adverse Effects:
sensipar Trade: Cinacalcet Hypocalcemics Calcimimetic agent sertraline Trade: Zoloft Class: antidepressant Pharm: selective serotonin reuptake inhibitor sertraline Trade: Zoloft Class: Antidepressant Pharm: SSRI
Action: Increases sensitivity of calcium-sensing receptors located on the surface of chief cells of parathyroid gland to levels of extracellular calcium Rationale: Decreases serum calcium Action: Inhibits neuronal uptake of serotonin in CNS. potentiating the activity of serotonin. decreased panic attacks, OCD and depression Rationale: Action: Blocks reuptake of serotonin, Increasing available serotonin at receptor site, Anti anxiety, Antidepressant Rationale:
Assess- lab values, hypocalcemia AE- N/V, hypocalcemia Teach- take as directed, report s/s of hypocalcemia to Dr. Administration: PO daily 25mg Assessment: suicidal tendencies, depression, OCD, panics attacks, Adverse Effects: Dizziness, drowsiness, fatigue, HA, insomnia, drymouth, sexual dysfunction Teach: take as directed, watch for suicidal tend, avoid alcohol, Administration: PO daily Assessment: Assess for symptoms of serotonin syndrome, In low doses decrease anxiety Adverse Effects: Increase suicide risk as depression lifts, Prozac may increase blood levels of statins, Potentiates other medications that use same enzymes (except Celexa), Insomnia, nausea, anorexia, headache, restlessness, decreased libido Serotonin syndrome, BP, HR, fever, muscle rigidity, coma, death MED EMERGENCY Teach: Black Box Warning, Give with food for nausea, Do not stop abruptly Administration: Assess: BP Bowel function SE: hypotension, hypertension, N&V,dyspepsia, diarrhea, constipation, flatulence Teach: Take as directed Admin: use in adult pts in stage 4 or 5 chronic renal failure on hemodialysis Assessment: for abdomen pains, distention & bowel sounds prior to & throughout therapy. Assess frequency of belching & passage of flatus. Adverse Effects: No AE. Teach: Proper diet & exercise. Administration: Liquid/Chewable PO/Oral: take after meals or at bed time.
Adverse Effects:
Adverse Effects:
sevelamer Trade: Renagel Class: antidepressant
simethicone Trade: Maalox, Mylanta Degas or Extra Strength Gas Ex Class: Anti-flatulent
Action: phosphate binding drug used to prevent hyperphosphatemia in patients with chronic renal failure. When taken with meals, sevelamer binds to dietary phosphate and prevents its absorption Rational: Action: Causes the coalescence of gas bubble. Does not prevent formation of gas. Passage of gas through GI tract: belching or flatus. Rationale: Passage of gas through GI tract allowing belching or passing flatus to relieve discomfort.
Adverse Effects:
Adult: PO 40-125 mg after meals/bed time up to qid (4 X daily/up to 500 mg/day). Children 2-12 yrs. 40 mg (up to 4 X daily)
Adverse Effects
simvastatin Trade: Zocor Class: lipid lowering agents Pharm: HMO-CoA reductase inhibitors sodium citrate Trade: Bicitra Class: antiurolithics Pharm: alkalinizing agent
Action: Inhibit an enzyme, 3hydrooxy-methylglutatyl-coenzyme A reductase, catalyzing an early step in the synthesis of cholesterol. lowers total and LDL cholesterol Rationale: Ordered to lower LDL Action: Converted to bicarbonate in the body, resulting in increased blood pH. Prevention of aspiration pneumonitis during surgical procedures. Rationale:
20mg=1tab at bedtime
Dose: 60 mg PO
sodium polystyrene sulfonate Trade: Kayexalate Class: spironolactone Trade: Aldactone Class: Diuretics Pharm: Potassium sparing diuretics sucralfate Trade: Carafate Class: anti-ulcer agents (GI protectants)
Action: Used to treat increased amounts of K in the body Rational:
Assessment: dietary history, monitor liver function, labs, Chol HDL LDL Triglycerides Adverse Effects: dizziness, HA, weakness, chest pain, edema, leg cramps, constipation, diarrhea, flatus, heartburn, rashes. Teach: take as directed, avoid OTC and herbal, Administration: AT bedtime (HS) Assessment: Assess for signs of alkalosis (confusion, irritability, paresthesia, tetany, altered breathing) or hypernatremia (edema, weight gain, hypertension, tachycardia, fever, flushed skin, irritability) throughout therapy. Monitor pts with renal dysfunction. Adverse Effects: Diarrhea, fluid overload, hypernatremia, hypocalcemia, metabolic alkalosis, tetany. Teach:Take as directed, dont double dose. Monitor urine and avoid salty foods for pt taking long-term therapy. Administration: PO solution. More palatable if chilled. Adjust dose to urine pH. Contains 1 mEq sodium and 1 mEq bicarbonate/mL solution. Assess: K levels SE: constipation, diarrhea, upset stomach, N&V Teach: inform Dr of meds you are taking & if on Na restricted diet, store at room temp away from excess heat & moisture Assessment: I&O, bp if given with hypertension drugs, S/S hypokalemia, BUN, Adverse Effects: hyperkalemia, dizziness, N/V, HA, arrhytmias Teach: Take asdirected, avoid salt, dizziness, Administration: daily Assessment: routinely for abd pain & bloody stool Adverse Effects: constipation, gastric discomfort Teach: continue with tx even if feeling better, do not double dose, increase bulk, fluid and exercise, get routine exams Administration: on empty stomach 1h before meals and at HS, give antacids 30
Therapeutic Effects: Not able to assess without lab work. Adverse Effects: diarrhea
Adverse Effects:
Action: Inhibition of sodium reabsorption in kidney while saving potassium and hydrogen ions. Weak diuretic and antihypertensive response Rationale: Action: aluminum salt of sulfated sucrose reacts with gastric acidto form a thick paste which selectively adheres to ulcer surface. > protection of ulcers w/ subsequent healing. Rationale:
PO 25mg=1tab daily
Adverse Effects:
Adverse Effects:
min before or after,
sulfasalazine Trade: Class: antirheumatic, gastrointestinal antiinflammatories
Action: locally acting antiinflammatory action in the colon Rationale: ulcerative colitis
sumatriptan Trade: Imitrex Class: 5 HT1 agonists
Action: Acts as a selective agonist of 5-HT1 at specific vascular serotonin receptor sites, causing vasoconstriction in large intracranial arteries Rationale:
Assess: allergy to sulfonamides and salicylates; I/O; Inf Bowel Disease: abd pain amd freq, quantity and consistency of stool Rheum. Arthritis: ROM, degree of swelling and pain in affected joints Adverse Effects: ha,anorexia, n/v/d, rashes, AGRANULOCYTOSIS, APLASTIC ANEMIA, SERUM SICKNESS, STEVENS-JOHNSONS SYNDROME Teach: Dizzy; notify hcp if sore throat, skin rash, fever, mouth sores, unusual bleeding/bruising, wheezing, fever, or hives; sunscreen; orange-yellow urine; notify hcp if symptoms do not improve Administration: PO: after meals or with food to GI upset, with a full glass of water Assess: monitor BP, assess pain AE: dizziness, vertigo, tingling, warm sensation, injection site reaction,chest pain. Teach: take as soon as symptoms appear, 2nd injection may be used. Avoid driving, alcohol Administration: dont crush tablets, if injection give just below the skin I drop in each eye once a day Assessment: underline issues, dietary such as eating more fish and proper sleep. Adverse Effects: red eyes, burning Teach: blink more often, proper sleep, eat more fish, Administration: one drop in each eye, alow two minutes between different types of drops Assessment: HA, seizures, mental status, BP, monitor labs, Adverse Effects: dizziness, HA, insomnia, tremors, cough, pleural effusion, hypertension, peripheral edema, anaphylaxis Teach: Take at same time every day, avoid grapefruit juice, importance of lab draws, Administration: PO
Adverse Effects:
systane
Action: works with the tears to prevent dry eyes. Rationale:
Class: eye lubricant
Adverse Effects:
tacrolimus Trade: Prograf Class: Immunosuppressant
Action: Inhibit T-lymphocyte activation. Prevention of transplanted organ rejection. Rationale:
Adverse Effects:
Tamsulosin Trade: Flomax Class: Pharm: peripherally acting antiadrenergic temazepam Trade: Restoril Class: sedative/hypnotics Pharm: benzodiazepines terazosin Trade: Hytrin Class: antihypertensives
Action: Decreases contractions in smooth muscle of the prostatic capsule g preferentially binding to alpha1-adrenergic receptors. Rationale: treatment for BPH Action: CNS generalized depression, relief of insomnia Rationale:
10 mg=1 tab PO Qbedtime
PO Cap at bedtime 15mg cap, 1-2 cap
Action: Dilates both arteries and veins by blocking postsynaptic alpha1adrenergic receptors. Decreases contractions in smooth muscle of the prostatic capsule Rationale: Action: B2 Adrenergic agonist relaxes smooth muscle, inhibiting uterine activity and causing Bronchodilation Rationale: Given to a woman to suppress preterm labor & give opportunity to begin administering antenatal glucocorticoids to accelerate fetal lung maturuity. Action: Vitamin B1 is required for carbohydrate metabolism. Rationale: ordered to replace deficiency Sub Q injection 0.25 mg q 20-30min. for up to 3 hrs.
terbutaline Trade: Brethine Class: B2 Adrenergic agonist
thiamine Trade: Vitamin B1 Class: vitamin Pharm: water-soluble vitamin
PO daily 100mg 1 Tab
Assessment: assess for symptoms of prostatic hyperplasia, after first dose assess for orthostatic hypotension, monitor I/O Adverse Effects: HA, dizziness, orthostatic hypotension Teach: may cause dizziness, change position slowly, consult md prior to OTC med use Administration: oral Assessment: Mental status, orientation, sleep patterns, may lead to dependence. Adverse Effects: Hangover, dizziness, drowsiness, blurred vision, constipation, N/V Teach: Take as directed, may cause daytime drowsiness or dizziness, avoid driving and alcohol, devote 8hr to sleep with drug Administration: PO at bedtime Assess: B/P, pulse, orthostatic reaction, I&O ratios, daily weight, edema SE: dizziness, h/a, weakness, nasal congestion, nausea, 1st dose orthostatic hypotension, drowsiness, tachycardia, edema Teach: weigh self 2x weekly, assess feet and ankles for fluid retention Admin: daily dose at bedtime.. Assessment: Pulse, BP, respiration for increase & insertion site for infections Adverse Effects: Shortness of breath, coughing, nasal stuffiness, pulmonary edema, tachycardia, tachypenia, nausea, vomiting. Ensure Calcium glucose available Teach: Who to call if problem or concerns arise, & to assess BP, respirations & insertion site for infections. Administration: Sub Q Assessment: assess for vit B1 deficiency, Adverse Effects: dizziness, dyspnea, malaise, pancreatitis Teach: review diet, avoid antacids containing magnesium Administration: PO
Adverse Effects:
Therapeutic Effect:
Adverse Effects:
Adverse Effects:
Adverse Effects:
thioridazine Trade: Mellaril Class: TYPICAL ANTIPSYCHOTICS Pharm: Phenothiazines
timolol Trade: Apo-Timol Class: antihypertensive, vascular headache suppressants Pharm: beta blocker timolol ophthalmic Class: beta-blocker
Action: Blocks stimulation of beta1 and beta2 adrenergic receptor sites. Decrease heart rate and blood pressure, prevention of MI, and decrease frequency of migraine headaches. (Eyedrops) relieves pressure in the eye related to glaucoma Rationale: Action: formation of aqueous humor (for glaucoma tx) Rationale:
Assessment: I&O, Urinary retention; especially in elders, vitals, Wt. Administer medications as needed for EPS, Check EKG for Mellaril due to cardiotoxicity, Mellaril is contraindicated w/ drugs that lengthen QT Intervals, CBC, Liver function tests, ocular exams periodically Adverse Effects: Anticholinergic effects, Extrapyramidal Symptoms (EPS), High EPS, Moderate anticholinergic Teach: Drink 2-3L fluids QD, sugarless gum or candy for dry mouth, high fiber diet, good oral hygiene, Sunscreen, Rise slowly, No alcohol, Caution driving, Report EPS, Report any symptoms immediately Administration: Assessment: BP, HR, I&O's, headaches, toxicity, hyppotension Adverse Effects: Fatigue, weakness, erectile dysfunction Teach: Pulse >50, take as directed, biweekly blood pressures, orthostatic BP, diabetics monitor Blood Sugar closely Administration:
Adverse Effects:
Adverse Effects:
tiotropium Trade: Spiriva Class: broncohodilators Pharm: anticholinergics
Action: Acts as anticholinergic by selectively and reversibly inhibiting M3 receptors in smooth muscle of airways. Decreased incidence and serverity of bronchospasm. Rationale: Res has COPD and helps with breating
Oral inhale daily
Assessment: eye pressure Adverse Effects: conjunctivitis, visual aczuity, ocular burning, rash, bronchospasm Teach: technique for admin. Administration: inner canthus of each eye; do not touch tip of applicator to eye Assessment: RR, Res status, before during and after admin Adverse Effects: Drymouth, glaucoma, urinary retention, angoedema, constipation Teach: Take as directed, used for maintence, proper cleaning, rinse mouth after med Administration: Inhale
tizanidine Trade: Zanaflex Class: antispasticity agents (centrally acting) adrenergics
Action: Reduces spasticity by increasing presynaptic inhibition of motor neurons. Rationale:
tolterodine SR Trade: Detrol LA T: urinary tract antispasmotics P: anticholingergics topiramate Trade: Topamax Class: anticonvulsants, mood stabilizers
Action: Acts as a competitive muscarinic receptor antagonist resulting in inhibition of cholinergically medicated bladder contraction, decreased urinary freq, urgency, & urge incontinence Rational: Action: Blockage of sodium channels inneurons, enhancement of gammaaminobutyrate, inhibitory neurotransmitter, preventionof activation of excitatory receptors. Rationale:
Assess: muscle spasicity, bp and pulse, drowsiness, dizziness, liver function tests before and at 1, 3, and 6 mo of therapy. May cause in serum glucose, alkaline phosphatase, AST, and ALT levels. Adverse Effects: anxiety, depression, dizziness, sedation, weakness, abdominal pain, diarrhea, dry mouth, dyspepsia, hypotension, rash, skin ulcers, sweating, back pain, myasthenia, paresthesia, fever Teach: may cause dizziness and drowsiness; change positions slowly; avoid alcohol and other CNS depressants Administration: PO: May be taken without regard to meals. Assess: pt for urinary freq, urgency, & urge incontinence SE: HA, dizziness, dry mouth Teach: take exactly as directed, may cause dizziness & blurred vision
Adverse Effects:
Adverse Effects:
PO 25mg tab, give 50mg=2tab BID 1100
tramadol Trade: Ultram Class :analgesics
Action: Binds to mu-receptors, inhibits the reuptake of serotonin and norepinephrine in the CNS, decrease pain Rationale:
PO 50 mg 1 Tab Q8hr 1600
tranylcypromine Trade: Parnate Class: Antidepressants Pharm: MAO
Assessment: Changes in behavior, seizures, migraines, Adverse Effects: Dizziness, drowsiness, fatigue, impaired concentration/memory, nervousness, speech problems, sedation, abnormal vision, N/V Teach: Take as directed, may decease sweating and increase body temp, dizziness, drowsiness, maintain fluid intake 2000-3000mL, avoid alcohol. Administration: PO BID Assessment: S/S of HF, Pulmonary hypersensitivity reactions, Adverse Effects: Dizziness, HA, somnolence, constipation, N/V Teach: Call DR if shortness of breath, HA, Contraception effects, not to receive vaccinations Administration: PO Assessment: Headache, insomnia, Wt gain Hypoglycemia, High BP, convulsions, coma Adverse Effects: Cannot be taken with any other psychotropic drug, Minimum washout time is 2-5 weeks, Need tyramine free diet, Hypertensive crisis occurs with tyramine foods, narcotics, general
Adverse Effects:
Adverse Effects:
INHIBITORS
anesthesia Teach: Compliance with tyramine free diet: avoid aged cheese, smoked/processed meats, red wines, yeast, fava beans, bananas, avocado, OTC meds Administration: Action: Alters the effects of serotonin in the CNS. Antidepressant action over several weeks of use. Rationale: PO HS 2 tabs 100 mg to make 200mg. Assessment: Monitor BP, sexual dysfunction, depression, mental status, suicidal tendencies, pain and location. Adverse Effects: Suicidal thoughts, drowsiness, hypotension, dizziness, confusion, fatigue, HA, nightmares. Teach: Take as directed, drowsiness, dizziness, change position slowly, avoid alcohol, frequent mouth rinses Administration: Take HS to avoid daytime drowsiness Assessment: No-suicide contract, Sunscreen, Cardiac assessment, BP lying/standing, Seizure assessment Adverse Effects: Increase suicide risk as depression lifts, Takes 7-14 days for effect Sedating, Anticholinergic effects, Photosensitivity, Cardiac abnormalities, Wt. gain, orthostatic hypotension Teach: Delayed onset to improve mood, Caution driving, Increase fluids/fiber, Sunscreen Administration: Assess: I/O, daily wt, s/s hypokalemia (weakness, fatigue, arrhythmia, polyuria, polydipsia), hyperkalemia (fatigue, muscle weakness, confusion, dyspnea) Adverse effects: hypokalemia Teach: take at same time each day, monitor weights biweekly & notify hcp of sig change, ortho hypo, use sunscreen, report muscle weakness, cramps, n/v/d or dizziness to hcp, take even if feeling better Admin: at same time each day, PO: with food or milk to GI upset Assessment: I&O, Urinary retention; especially in elders, vitals, Wt. Administer medications as needed for EPS, Check EKG for Mellaril due to cardiotoxicity, Mellaril is contraindicated w/ drugs that lengthen QT Intervals, CBC, Liver function tests, ocular exams periodically
Adverse Effects:
trazodone Trade: Desyrel Class: Antidepressant
Adverse Effects:
trazodone Trade: Desyrel Class: Antidepressant Pharm: tetracyclic antidepressant
Adverse Effects:
triamterene Trade: Class: diuretic, potassium sparing
Action: inhibition of sodium reabsorption in the kidney while saving potassium and hydrogen ions Rationale: HTN, used to fluid volume BP
Adverse Effects:
trifluoperazine Trade: Stelazine Class: TYPICAL ANTIPSYCHOTICS Pharm: Phenothiazines
Adverse Effects:
trimethoprim/ sulfamethoxazole Trade: Bactrim Class: anti-infectives, antiprotozoals Pharm: folate antagonists, sulfonamides
Action: combination inhibits the metabolism of folic acid in bacteria Rationale:
PO, IV mild to mod infections 6-12 mg TMP/kg/day divided q12hr. serious infections 15-20 mg TMP/kg/day/ divided q6-8hr
trimipramine Trade: Surmontil Class: Anitdepressants Pharm: Tri-cyclics
Tucks Witch Hazel Pad Witch Hazel 50%
Action: aids in protecting irritated anorectal areas, discomfort in perineal area. Rationale:
UTI-Stat Class: UTI prevention
Action: Helps support urinary tract health. Aids in reducing symptomatic UTIs when used in conjunction with hydration and hygiene programs Rationale:
Adverse Effects: Anticholinergic effects, Extrapyramidal Symptoms (EPS), High EPS, Moderate anticholinergic Teach: Drink 2-3L fluids QD, sugarless gum or candy for dry mouth, high fiber diet, good oral hygiene, Sunscreen, Rise slowly, No alcohol, Caution driving, Report EPS, Report any symptoms immediately Administration: Assessment: for infection, obtain a history before giving, specimens for culture and sensitivity, inspect IV site, allergy to sulfonamides, Is and Os, urine output of 1200-1500 mL/day to prevent crystalluria and stone formation. Adverse Effects: fatigue, hallucinations, HA, insomnia, mental depression, diarrhea, N/V, pseudomembranous colitis, hepatic necrosis, Steven-Johnson syndrome Teach: take drug around the clock and finish meds, signs of superinfection, allergy, stool and diarrhea, use sunscreen, watch for rash or sore throat. Administration: PO and IV watch for dose/kg Assessment: As stated previously, BP lying/standing, Cardiac assessment, High overdose potential limit quantity available to patient Adverse Effects: Anticholinergic effects, Orthostatic hypotension, Cardiac abnormalities, Wt gain ,Photosensitivity, Increase suicide risk, Sedation Teach: Increase fluids/fiber, Take at HS, Exercise, sensible eating, Sunscreen, No suicide contract, No alcohol, caution driving Administration: Assess: pain of area Adverse Effects: rectal bleeding Teach: clean affected area with mild soap, warm water, rinse. External use only Administer: externally to affected area up to 6 times daily or after each bowel movement. Assess: urinary frequency, pain, urgency Adverse Effects: may increase effects of warfarin therapy Teach: report s/s infection; hygiene Administration: Can be mixed with hot or cold beverages.
Adverse Effects:
Adverse Effects:
Therapeutic Effect: Adverse Effects:
vancomycin Trade: Vancocin Class: anti-infectives
Action: Binds to bacterial cell wall resulting in cell death. Bactericidal action against susceptible bacteria. Rationale:
Adults: IV 500 mg q6hr or 1 g q12hr up to 4 g/day. PO 125500 mg q 6hr Peds: IV 40 mg/kg/day divided q 6-8 hr. max dose 1 g/dose. PO 40 mg/kg/day not to exceed 2 g/day
Assessment: Infection, wounds, BP, specimen for culture and sensitivity, signs of anaphylaxis, bowel function Adverse Effects: Ototoxicity, hypotension, N/V, nephrotoxicity, phlebitis, anaphylaxis Teach: Take as directed, report hypersensitivity, tinnitus, vertigo, or hearing loss. Administration: IV, PO take as directed Assess: mental status and mood changes, bp, appetite, nutritional intake, weight SE: abnormal dreams, anxiety, dizziness, h/a, insomnia, weakness, nerviousness, abdominal pain, weight loss, anorexia, constipation, chills, N&V&D Teach: notify if pregnant, may cause drowsiness. Importance of follow up exams Admin: with food Assessment: Serotonin Syndrome, Increased bleeding risk with ASA, NSAIDS Adverse Effects: Hypertension, Anticholinergic Teach: No tryptophan or St. Johns Wort Administration:
Adverse Effects:
venlafaxine Trade: Effexor Class: antidepressant, antianxiety venlafaxine Trade: Effexor Class: Antidepressants Pharm: SNRI verapamil Trade: Covera-HS, Ispotin Class: antianginals, antiarrhythimics, antihypertensives, vascular HA suppressants. Pharm: calcium channel blockers Vit D3 Trade: Cholecalciferol Class: vitamins Pharm: fat sol vit
Action: Inhibits serotonin and norepinephrine reuptake in the CNS. Rationale: Pt has anxiety and hx of depression
Adverse Effects:
Action: Inhibits the transport of calcium into myocardial and vascular smooth muscle cells resulting in inhibition of excitation-contraction coupling and subsequent contraction. Decrease SA and AV conduction and prolongs AV node refractory period in conduction tissue. Rationale: Action: Treatment & prevention of deficiency states, particularly bone manifestations Rational:
NG tube 120 mg=3 tab 40mg=1 Tab Q8hr
Assessment: BP, HR, I&O, location and type of pain, Monitor EKG, potassium levels Adverse Effects: Anxiety, confusion, HA, jitteriness, nervousness, arrhythmias, CHF, chest pain, edema Teach: Take as directed, avoid large amounts of grapefruit juice, drowsiness, dizziness, good hygiene, avoid alcohol Administration: NG tube Q8H
Adverse Effects:
Assess: bone pain & weakness, evidence hypocalcemia (paresthesia, muscle twitching, laryngospasm, colic, cardiac arrhythmias, Chvosteks or Trousseaus sign) SE: dizziness, malaise, dyspnea, pancreatitis
Adverse Effects:
Vitamin C (Ascorbic acid) Class: water soluble vitamin (supplements
Action: required for growth & tissue repair for all parts of the body necessary for collagen formation. Antioxidant. Rationale:
Assessment: Adverse Effects: stomach upset, diarrhea (>2000 mg/day) Teach: balanced diet, consume vit C daily body does not store it Administration: daily-
Adverse Effects:
Vitamin D Compounds Trade: calcitriol Class: vitamin Pharm: fat-soluble vitamin warfarin Trade: Coumadin Class: anticoagulants Pharm: coumarins
Action: Vitamin D helps with the absorption of calcium and decreases parathyroid hormone concentration Rationale:
Calcium 250mg/vit D 125 unit= 1 cap PO BID
Action: Interferes with hepatic synthesis of vitamin K dependent clotting factors. Prevention of thromboembolic events. Rationale:
Adult: PO, IV 2-5 mg/day for 2-4 days. Adjust to INR results. Peds: loading dose 0.2 mg/kg (max dose: 10 mg) for 2-4 days adjusting to INR results
zinc sulfate Trade: Orazinc Class: mineral & electrolyte replacements/supple ments Pharm: trace metals zolpidem Trade: Ambien Class: Therapeutic: sedative/hypnotic
Action: Replacement in deficiency states Rational:
Assessment: assess for vit D deficiency, for bone pain and weakness, signs of hypocalcemia Adverse Effects: dizziness, dyspnea, malaise, pancreatitis Teach: review diet, avoid antacids containing magnesium Administration: PO or IV Assessment: Signs of bleeding/hemorrhage, increased thrombosis, PT/INR response, monitor hepatic function, stool and urine occult blood, toxicity and overdose Adverse Effects: Cramps, N/V, dermal necrosis, bleeding, fever. Teach: Take as directed, take missed dose asap, avoid food high in vitamin K (antidote for warfarin),use soft tooth brush, report all unusual bleeding. Administration: PO or IV Assess: monitor progression of deficiency symptoms (impaired wound healing, growth retardation, decreased sense of smell/taste) during tx Admin: with food to decrease GI irritation, with caffeine, dairy prod, or bran may impair absorption
Adverse Effects:
Adverse Effects:
Action: Produces CNS depression by binding to GABA receptors. Have no analgesic properties. Rationale: Induction of sleep
PO: 10mg QHS
Assessment: Assess mental status, sleep patterns, and potential for abuse, chest pain Adverse Effects: daytime drowsiness, dizziness, hallucinations, anaphylactic reactions Teach: Take as directed, not recommended for longer than 7-10 days of use, advise pt to go to bed right after use, avoid driving, and notifify health care with any anaphylactic signs Administration:
Adverse Effects:

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ABRH Suppository Trade: Ativan 1mg. Benadryl 12.

5mg, Haldol 2mg, Reglan 10mg Class: Combination medication

acetaminophen Trade: Tylenol #3 Class: Antipyretics, non-opioid analgesics

acetaminophen Trade: Tylenol Class: nonopioid analgesics / antipyretics

PRN PO Q4h 2 Tab=650mg MAX DOSE: should not exceed 4g acetaminophen

acetaminophen diphenhydramine Trade: Tylenol PM Class: nonopioid analgesics / antipyretics

acetylsalicylic acid Trade: Aspirin Class: Salicylates

acyclovir Trade- Zovirax ClassificationsAntivirals, purine analogues

Action- Interferes with viral DNA synthesis Rationale:

albuterol Trade: Albuterol Class: Bronchodilator (B-2 Adrenergic)

PRN Inhale neb 2.5mg=3mL Q2H

amitriptyline Trade: Elavil Class: antidepressants Pharm: tricyclic

50mg=1 tab PO bedtime

Therapeutic Effects: Adverse Effects:

amitriptyline Trade: Elavil Class: Anitdepressants Pharm: Tri-cyclics

Action: Increases serotonin & norepinephrine Rationale:

amlodipine Trade: Norvasc Class: antihypertensiives Pharm: calcium channel blockers

amoxapine Trade: Asendin Class: Anitdepressants Pharm: Tri-cyclics

amoxicillin Trade: Amoxil Class: anti-infective, antiulcer agent Pharm: aminopenicillins

Renal impairment: adult PO 250-500 mg q12hr or q24hr.

amoxicillin/ clavulanate Trade- Augmentin Classaminopenicillins/beta lactmase inhibitors

antoprazole Trade: Protonix Class: antiulcer Pharm: proton-pump inhibitor

40mg/ 1 tablet oral BID

of water at least 1 hr before or 2 hr after meals for faster absorption.

atenolol Trade: Tenormin Class: antianginals, antihypertensives Pharm: beta blocker

Action: Blocks stimulation of beta1 adrenergic receptors. Rationale:

baclofen Trade: Lioresal Class: muscle relaxants

Benefiber SF PWD 477

Class: wheat dextrin, a natural soluble fiber

benzocaine Trade: Orajel Class: anesthetics (topical/local)

Action: Inhibit initiation and conduction of sensory nerve impulses. Rationale:

Action: anesthetic action on stretch receptors in lungs. Rationale:

Adverse Effects: Therapeutic Effects:

Brimonidine ophthalmic Class: sympathomimetic selective alphaadrenergic agonist

Action: formation aqueous humor (for tx glaucoma) Rationale:

do not touch tip of applicator to eye

budesonideformoterol Trade: Symbicort Class: bronchodilator formoterol glucocorticosteroid budesonide

bumetanide Trade: Bumex Class: diuretics Pharm: loop diuretics

PO 2 tabs. 150 mg/tab daily 0900

Adverse Effects: Therapeutic Effects:

buspirone Trade: Buspar Class: antianxiety agent

10mg=1 tab PO daily

butorphanol Trade: Stadol Class: Opioid analgesics Opioid agonists/antagonists

IM 2 mg q3-4 hrs as needed. IV 1mg q3-4 hr as needed. Intranasal 1 mg (1 spray in 1 nostril)

Adverse Effects: Therapeutic Effects:

Calcium 600mg/vit D 400mg 1 Tab twice daily

captopril Trade: Capoten Class: antihypertensives Pharm: ACE inhibitors

carbidopa/levidopa Trade: Sinemet Class: antiparkinson agent Dopamine agonist

PO daily 12.5 mg tab with food check BP HR

cefoxitin Trade: Mefoxin Class: anti-infective Pharm: second generation cephalosporins

2gm=50ml IV pre-op once

Action: Bactericidal action against susceptible bacteria Rational:

Adverse Effects: Therapeutic Effects:

IM, IV adults/child >12 max dose 6g/day Sever infections 2g q8

Adverse Effects: Therapeutic Effect-

Adverse EffectsTherapeutic Effects: Adverse Effects:

Action: selectively inhibits reuptake of serotonin in CNS. Antidepressant. Rationale:

PO 40mg tab daily

citalopram Trade: Celexa Class: Antidepressant Pharm: SSRI

clindamycin Trade: Cleocin Class: Anti-infectives

300 mg 50mL Q8 next dose 14:00 IV

clomipramine Trade: Anafranil Class: Anitdepressants Pharm: Tri-cyclics

Action: Increases serotonin & norepinephrine Rationale: