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					                                                                                                                                                                             Page 1 of 99
Updated 7/21/04
This is a huge list that was compiled from the work of numerous students. Designed to be a resource for care plan drug lists, there are duplicates of popular drugs
or drugs that have more than one use. Use at your own risk.
Drugs are listed here alphabetically by generic name, trade name, or both. Try searching for both names before going to the trouble of making a new entry.
To find a drug on this list, press the key combination Ctrl-F (Control-F), type the name of the drug you are looking for and press enter. Each subsequent time you
press enter the next entry of the drug will be shown.
Some drugs may be listed many times in the Side Effects and Nursing Implications, which can be aggravating when using Ctrl-F. To limit the search to the first
column (Drug Name), highlight that column by clicking the column's top gridline or border. The column will turn black to show it is selected. Then press Ctrl-F.
Other useful key combinations are Ctrl-Home and Ctrl-End.
Drug Name                   Class                            Actions                           Indications                    Side Effects                    Nursing implications

6-mercaptopurine 6MP        Antimetabolite, antineoplastic tumor-inhibiting properties         remission induction remis-     hepatotoxicity oral lesions     make sure patient stays hy-
                                                           probably due to interference        sion consolidation and main-   resembling thrush, bone         drated well do frequent
                                                           with purine nucleotide syn-         tenance therapy of acute       marrow depression , immu-       mouth care because of poss-
                                                           thesis and hence with RNA           leukemia ( lymphatic myelo-    nosuppression , hyperurice-     ible sores do frequent blood
                                                           and DNA synthesis leading           genous and acute myelomo-      mia , cancer                    test to follow drug effects
                                                           to cell death                       nocytic                                                        CBC, Hgb, renal and liver
                                                                                                                                                              function

Abciximab                   Inhibits platelet aggregation    Adjunct to aspirin and hepa-                                     Bleeding, including intra-      Monitor for S&S of: bleeding;
(ReoPro)                    by preventing fibrinogen, von    rin for the prevention of acute                                  cranial, retroperitoneal, and   hypersensitivity.
                            Willebrand's factor, and other   cardiac ischemic complica-                                       hematemesis; thrombocyto-       Monitor Hgb, Hct, platelet
                            molecules from adhering to       tions in patients undergoing                                     penia                           count, PT, APTT, INR, every
                            GPIIb/IIIa receptor sites of     percutaneous transluminal                                                                        2–4 h during first 24 h.
                            the platelets.                   coronary angioplasty                                                                             Bleeding precautions.
                                                             (PTCA).
                                                                                                                                                             Page 2 of 99
Drug Name                    Class                           Actions                            Indications   Side Effects                     Nursing implications

Accuzyme Ointment           Indicated for debridement of     Papain, the proteolytic en-                      Generally well tolerated and     Avoid cleansing with hydro-
                    6       necrotic tissue and liquefac-    zyme from papaya, is a po-                       non-irritating. A transient      gen peroxide solution as it
Papain-Urea 1.1 x10 Unit/gm tion of slough in acute and      tent digestant of nonviable                      "burning" sensation may be       may inactivate the papain.
                            chronic lesions such as          protein matter but is harm-                      experienced by a small per-
                            pressure ulcers, varicose        less to viable tissue. In Ac-                    centage of patients upon         Apply directly to the wound,
                            and diabetic ulcers, burns,      cuzyme, papain is combined                       applying Accuzyme. Occa-         cover with appropriate dress-
                            postoperative wounds, pilo-      with urea, a denaturant of                       sionally, the profuse exudate    ing, secure into place.
                            nidal cyst wounds, carbun-       proteins. Pharmacologic stu-                     from enzymatic digestion         Daily or twice daily applica-
                            cles and miscellaneous           dies have shown that the                         may irritate the skin. In such   tions are preferred.
                            traumatic or infected            combination of papain and                        cases, more frequent dress-
                            wounds.                          urea result in twice as much                     ing changes will alleviate       Irrigate the wound at each
                                                             digestive activity as papain                     discomfort until exudate de-     redressing to remove any
                                                             alone.                                           creases.                         accumulation of liquefied
                                                                                                                                               necrotic material.
                                                                                                                                               Papain may be inactivated
                                                                                                                                               by the salts of heavy metals
                                                                                                                                               such as lead, silver and mer-
                                                                                                                                               cury. Contact with medica-
                                                                                                                                               tions containing these metals
                                                                                                                                               should be avoided.

Acetaminophen                Nonnarcotic Analgesic; Non-     May block pain impulses                          N&V, abd. pain, hepatoxicity,    Liver function test, renal
                             salicylate, Paraminophenol      peripherally that occur in                       stimulation, drowsiness, leu-    function, CBC, fever or pain,
                             Derivate Use antipyretic,       response to inhibition of                        kopenia, anemia, thrombocy-      I&O, chronic poisoning, he-
                             analgesic, treat viral infec-   prostaglandin synthesis: an-                     topenia, pancytopenia, rash,     patotoxicity, allergic reaction
                             tions                           tipyretic action from inhibition                 angioedema, anaphylaxis
                                                                                                                                               Peak: 0.5–2 h. Duration: 3–
                                                             of prost CNS
                                                                                                                                               4h

Acetaminophen (Tylenol)      non-narcotic analgesic          produces analgesia, reduces                      hepatotoxic                      monitor ALT, AST
                                                             fever by direct action of hy-
650 mg PO q 8 h              relief for mild pain            pothalamus                                       elevation of ALT, AST            monitor for S/S of hepatotox-
                                                                                                                                               icity

Acetazolamide (diamox )      Carbonic anhydrase inhibitor, Inhibits CNS carbonic anhy- Antileptic             Sedation, paresthesia, pan-      Caution with diabetes and
                             diuretic, CNS agent, anticon- drase, which retards abnor-                        cytopenia, hyperglycemia,        obstructive pulmonary dis-
                             vulsant                       mal discharge from CNS                             muscle weakness                  ease. give with food, does
                                                           neurons, inhibits carbonic                                                          not dissolve in fruit juice
                             Use: treat glaucoma, reduce anhydrase activity in the
                             seizure activity,             proximal convoluted tubule,
                                                           preventing the formation of
                                                           carbonic acid, which en-
                                                           hances diuresis, inhibits
                                                           aqueous humor production to
                                                           lower intraocular pressure of
                                                           glaucoma.
                                                                                                                                                                           Page 3 of 99
Drug Name                     Class                          Actions                         Indications                     Side Effects                    Nursing implications

Adriamycin, Doxorubicin hy-   antibiotic antineoplastic      interferes with DNA and RNA Hodgkin’s, Wilms tumor, and arrhythmias, acute left ven-            cardiac function test, ade-
drochloride                                                  synthesis                   other types of cancer       tricular failure, irreversible          quate hydration, premed with
                                                                                                                     cardiomyopathy, leukopenia,             antiemetics, never give drug
                                                                                                                     thrombocytopenia, anaphy-               IM or SQ, CBC, WBC, moni-
                                                                                                                     laxis, cellulitis, tissue slough-       tor for signs of heart failure
                                                                                                                     ing, complete alopecia, tran-           and dc if noted, wear protec-
                                                                                                                     sient red urine, GI effects             tive equipment when han-
                                                                                                                                                             dling

Albumin                       blood derivative               expands blood volume            hypovolemic shock, hypopro- ha, vascular overload, <BP,         use caution in pts with se-
                                                                                             teinemia, hyperbiltinomr, os back pain, altered respira-        vere hypertension, low car-
                                                                                                                          tions, chills, fever, urticaria,   diac reserve, hypervolemia,
                                                                                                                          pulmonary edema, increased         pulmonary edema, and hy-
                                                                                                                          salivation, N&V                    poalbuminemia with peri-
                                                                                                                                                             pheral edema, watch for he-
                                                                                                                                                             morrhage or shock, VS,
                                                                                                                                                             watch for vascular overload, I
                                                                                                                                                             & O's,

Albuterol                     To relieve bronchospasm        Inhibits histamine release by                                   Hypersensitivity reaction.      Monitor therapeutic effec-
                              associated with acute or       mast cells.                                                     Tremor, anxiety, nervous-       tiveness which is indicated
                              chronic asthma, bronchitis,                                                                    ness, restlessness, convul-     by significant subjective im-
                              or other reversible obstruc-                                                                   sions, weakness, headache,      provement in pulmonary
                              tive airway diseases.                                                                          hallucinations. Palpitation,    function within 60–90 min
                                                                                                                             hypertension, hypotension,      after drug administration. Lab
                                                                                                                             bradycardia, reflex tachycar-   tests: Periodic ABGs, pulmo-
                                                                                                                             dia. Blurred vision, dilated    nary functions, and pulse
                                                                                                                             pupils. Nausea, vomiting.       oximetry.

Albuterol                     Bronchodilator, Increased      Causes Bronchodilation By                                       Bronchospasm, Heartburn,        VS, Respiratory Function,
                              Ability To Breathe Due To      Action B2 Receptors By In-                                      Palpations Tachycardia,         Monitor For Evidence Of
                              Bronchodilation                creasing Levels Of Cyclic                                       Restlessness                    Allergic Reactions

Albuterol (Proventil)         beta2 adrenergic               b2 stimulation to dilate        Respiratory                     causes  hyperthyroid           tachycardia, bad taste, dry
                              use: bronchodilation           bronchiole smooth muscle                                        excess use=rebound bron-     mouth, dizzy, hyperactivity
                                                                                                                             chial spasm, monitor hr, K+,
                              reduce airway
                              resistance

Albuterol (salbutamol, Proven- sympathomimetic               Stimulates beta-2 receptors     bronchial asthma, bronchos-     dry mouth, excitement, dizzi-   Obtain Hx and assess CNS
til, ventolin)                                               of the bronchi, leading to      pasm due to bronchitis or       ness, cough, wheezing, pal-     status, document lung
                                                             bronchodilation, minimal        emphysema, bronchitis, in-      pitations, BP changes, an-      sounds, CXR, PFT's, note air
                                                             beta-1 activity                 vestigational use includes      gioedema, flushing, sweat-      hunger, document symptom
                                                                                             using in adjunct to treat se-   ing, muscle cramps              characteristics, monitor VS,
                                                                                             rious acute hyperkalemia in                                     ABGs, observe for allergic
                                                                                             hemodialysis clients                                            responses
                                                                                                                                                                            Page 4 of 99
Drug Name                     Class                          Actions                        Indications                    Side Effects                       Nursing implications

Aldactone spironolactone      potassium sparing diuretic     blocks the reabsorption of     used with patients with CHF dizziness headache cramp-             monitor to see if drug is
                                                             sodium and water in the ren-   used for hypertension usually ing diarrhea impotence              working monitor for hypoten-
                                                             al tubule while sparing po-    in combination with other                                         sion
                                                             tassium                        drugs

Allopurinol, APO-Allopurinol, Antigout.                      Reduces uric acid production Use: treat gout, prevention of   drowsiness, ha, paresthesia,       Take with food, check uric
Capurate, Purinol, Zyloprim                                  by inhibiting xanthine oxi-  uric acid nephropathy during     peripheral neuropathy, neuri-      acid levels, I & O and should
                                                             dase                         chemo, hyperuricemia             tis, epitaxis, GI effects, renal   be at least 2L of urine output
                                                                                          caused by malignancies,          failure, uremia, hepatitis,        daily (slightly alkaline), pe-
                                                                                          recurrent calcium oxalate        hepatic necrosis, aplastic         riodically monitor CBC, and
                                                                                          calculi                          anemia, thrombocytopenia,          hepatic, and renal function,
                                                                                                                           leukopenia                         avoid sunlight, avoid purine
                                                                                                                                                              foods (anchovies, sardines,
                                                                                                                                                              salmon, dried peas and
                                                                                                                                                              beans, asparagus, cauliflow-
                                                                                                                                                              er, mushrooms, peppers,
                                                                                                                                                              spinach

Alprazolam (xanax)            Treatment of anxiety           Produces anxiolytic effect o                                  Dizziness, drowsiness, le-         Assess for reduction of an-
                                                             CNS.                                                          thargy, mental depression          xiety during drug therapy
                                                                                                                                                              Monitor CBC, liver and renal
                                                                                                                                                              function. May cause  Hct
                                                                                                                                                              and neutropenia.

Alprazolam (Xanax)            anxiolytic, benzodiazepine     CNS depressant appears to                                     drowsiness, sedation, tachy- Supervise ambulation and/or
                                                             act at the limbic, thalamic,                                  cardia, hypotension, dyspnea side rails up.
0.5 mg PO q 6 h               used to control pt’s anxiety   and hypothalamic levels of
                                                             the CNS.                                                                                         Monitor labs during pro-
                                                                                                                                                              longed therapy.

Amiodarone hydrochloride      Cardiovascular agent, class  Acts directly on all cardiac     Cardiac Medication             GI upset, sinus arrest, cardi-     Correct hypokalemia & hy-
(Cordarone)                   III anti-dysrhythmic         tissue, prolongs duration of                                    ogenic shock, vision               pomagnesia prior to adminis-
                                                           action potential and refrac-                                    changes, anorexia, N&V,            tration, give consistently with
                              Use: treat non-exertional    tory period without affecting                                   hepatoxicity, pneumonitis,         respect to meals, monitor BP
                              angina, slow HR, + inotropic membrane action potential                                       slate blue skin pigmentation       with infusion for hypotension,
                              to increase contractility +                                                                                                     monitor liver function labs
                              dromotropic to increase im-                                                                                                     and respiratory status, peri-
                              pulse conduction velocity                                                                                                       pheral neuropathy.

Amiodarone hydrochloride      Cardiovascular agent, class  Acts directly on all cardiac                                    GI upset, sinus arrest, cardi-     Correct hypokalemia dn hy-
(Cordarone)                   III antidysrhythmic          tissue, prolongs duration of                                    ogenic shock, vision               pomagnesia prior to adminis-
                                                           action potential and refrac-                                    changes, anorexia, n&v, he-        tration, give consistently with
                              Use: treat non-exertional    tory period without affecting                                   patoxicity, pneumonitis, slate     respect to meals, monitor bp
                              angina, slow HR, + inotropic membrane action potential                                       blue skin pigmentation             with infusion for hypotension,
                              to increase contractility +                                                                                                     monitor liver function labs
                              dromotropic to increase im-                                                                                                     and respiratory status, peri-
                              pulse conduction velocity                                                                                                       pheral neuropathy.
                                                                                                                                                        Page 5 of 99
Drug Name                Class                           Actions                          Indications   Side Effects                      Nursing implications

Amitriptyline (Elavil)   Tricyclic antidepressant        Inhibits reuptake of synaptic                  Lowers gastric acid secre-        Monitor EPS, seizures, give
                                                         serotonin and norepinephrine                   tion, anticholinergic and se-     with food at night, change
                         Use-treat depression, anxiety                                                  dation, EPS, metallic taste,      positions slowly, blue-green
                                                                                                        seizures, hypotension,            urine

Amitriptyline (Elavil)   TCA antidepressant- used to Inhibits serotonin uptake                          drowsiness, sedation, dizzi-      Institute safety measures/fall
                         treat pt’s depression.      from synaptic gap, also inhi-                      ness, orthostatic hypoten-        precautions for pt.
50 mg PO q d                                         bits norepinephrine reuptake.                      sion, constipation, dry mouth,
                                                                                                        urinary retention, bone mar-      Monitor BP and pulse in pts
                                                                                                        row depression                    with preexisting CV disease.
                                                                                                                                          Assess for orthostatic hypo-
                                                                                                                                          tension.
                                                                                                                                          Monitor I/O, including bowel.

Amlodipine (Norvasc)     Anti-hypertensive calcium       increases myocardial con-                      Headache, peripheral ede-         Monitor VS, ECG, CBC, ren-
                         channel blocker                 tractility, CO is increased,                   ma, hallucinations, paresthe-     al and LFTs, reduce dose
                                                         pronounced decrease in pe-                     sia, dyspepsia, flatulence,       with cirrhosis, observe for
                                                         ripheral vascular resistance                   loose stool, hypotension,         chest pain, SOB, dizziness,
                                                                                                        cardiac failure, tinnitus, dip-   swelling, irregular pulse
                                                         Hypertension, alone or in                      lopia, anorexia
                                                         combination wit other antihy-                                                    Monitor BP and pulse, Moni-
                                                         pertensive, chronic stable or                                                    tor ECG periodically. Monitor
                                                         vasospastic (Prinzmetal's                                                        I&O ratios, weight, assess for
                                                         variant )angina                                                                  signs of CHF (peripheral
                                                                                                                                          edema, rales/crackles, dysp-
                                                                                                                                          nea, JVD).

Amoxicillin (Amoxil)     Broad spectrum antibiotic       Inhibition of the enzyme in                    N&V, diarrhea, rash edema,        Check labs for liver en-
                                                         cell wall synthesis = Bacteri-                 stomatitis, lethargy, twitch-     zymes, assess for adequate
                                                         cidal                                          ing, depression, increased        urine output, increase fluid
                                                                                                        bleeding times, superinfec-       intake, take on an empty
                                                                                                        tions, blood dyscrasias, he-      stomach
                                                                                                        molytic anemia, bone mar-
                                                                                                        row depression, resp. de-
                                                                                                        pression, agranulocytosis
                                                                                                                                                              Page 6 of 99
Drug Name                     Class                           Actions                          Indications   Side Effects                       Nursing implications

Amphotericin B (Amphocin,     Antifungal. Used intrave-     Fungistatic antibiotic: alters                   Hypersensitivity (skin rashes,     Use caution in pts with im-
Fungizone)                    nously for a wide spectrum of cell permeability and there-                     fever, dyspnea), fever, chills,    paired renal function, only
                              potentially fatal systemic    fore fungal cell death occurs.                   headache, cardiac arrest,          really used in pts with pro-
                              fungal (mycotic) infections                                                    loss of hearing, nausea, vo-       gressive and possibly fatal
                                                            Systemic fungal infections,                      miting, diarrhea, nephrotoxic-     fungal infections, be alert for
                                                            GI Candida albicans, oral                        ity, dry skin                      infusion related reactions
                                                            and perioral candidal infec-                                                        such as fever, shaking chills
                                                            tions                                                                               <BP, HA, dyspnea, that may
                                                                                                                                                occur 1-3 hrs after infusion,
                                                                                                                                                doses vary with different
                                                                                                                                                amphotericin B preps, may
                                                                                                                                                pre-medicate, I & O, CBC
                                                                                                                                                weekly, BUN weekly, monitor
                                                                                                                                                K, monitor for ototoxicity,
                                                                                                                                                During therapy periodic CBC,
                                                                                                                                                liver function tests. Febrile
                                                                                                                                                reactions (fever, chills, head-
                                                                                                                                                ache, nausea), Monitor I&O
                                                                                                                                                and weight. Report promptly
                                                                                                                                                any evidence of hearing loss


Ampicillin                    Broad spectrum anti – infec- Interferes with cell wall repli-                  Lethargy, hallucinations,          Sensitivity to pen and ceph.,
                              tive; Aminopennicilin        cation of susceptible organ-                      anxiety, depression, twitch-       WBC, C&S, allergic reac-
                                                           isms, the cell wall rendered                      ing, coma, convulsion, N&V,        tions, urine output (nephro-
                                                           osmotically unstable, swells,                     diarrhea, psuedomembran-           toxicity )renal studies, urina-
                                                           bursts from osmotic pressure                      ous colitis, oliguria, proteinu-   lysis, AST, ALT, CBC, Hct,
                                                                                                             ria, hematuria, bone marrow        electrolytes, bowel pattern,
                                                                                                             depression, rash, urticaria,       bleeding, overgrowth of in-
                                                                                                             anaphylaxis                        fection

Ampicillin sodium/Sulbactam   antibiotic, penicillin, broad   Irreversibly inhibits beta-                    pain, thrombophlebitis, diarr-     Monitor CBC, cultures, liver
sodium (Unasyn)               spectrum                        lactamases, broad spectrum.                    hea, dysuria, urinary reten-       and renal function studies,
                                                                                                             tion, epistaxis, mucosal           Monitor urinary output and
                                                              infections caused by Staph,                    bleeding, candidiasis              serum K+ levels, monitor for
                                                              E. coli, Klebsiella, pneumo-                                                      fever
                                                              niae, Enterobacter, Acineto-
                                                              bacter; intra-abdominal infec-
                                                              tions, gynecologic infections
                                                                                                                                                         Page 7 of 99
Drug Name                   Class                            Actions                          Indications   Side Effects                   Nursing implications

Ancef (Cefazolin sodium)    Antibiotic; first generation     Bactericidal action                            discomfort with IM adminis-    evaluate IV site for phlebitis,
                            cephalosporin;                                                                  tration, occasional nausea,    monitor bowel activity and
1000 mg IV q 8 hours                                         Treatment of respiratory tract                 serum sickness reaction,       stool consistency, notify MD
                                                             infections, GU infections,                     diarrhea; anorexia, abdomin-   of diarrhea
infuse over 30 minutes                                       skin and skin structure infec-                 al cramps;
0800                                                         tions due to S. aureus, strep;
                                                             bone and joint infection, en-
                                                             docarditis;
                                                             Preferred first generation
                                                             cephalosporin for peri-
                                                             operative prophylaxis;


Anzemet (dolasetron mesy-   antiemetic                       selective serotonin 5-Ht3        post-op NV    arrhythmias, ha, dizziness,    VS, safety issues, i/o, moni-
late)                                                        receptor antagonist that                       drowsiness, hypotension,       tor food intake incase it de-
                                                             blocks the action of seroto-                   HTN, anorexia                  creases, be aware of cp or
                                                             nin, thus preventing seroto-                                                  cardiac disturbances,
                                                             nin from stimulating the vo-
                                                             miting reflex

Argatroban (Novastan)       Anticoagulant                    Capable of inhibiting the ac-                  Fever, sepsis, hypotension,    Monitor PT, PTT, INR, Hgb,
                                                             tion of both free and clot-                    cardiac arrest, vent. tachy,   & Hct.
10 mg IV                    Used to keep blot clots from bound thrombin. Reversibly                         N/V/D, GI bleed, hematuria,
                            forming since pt. is allergic to binds to the thrombin active                   decreased Hgb/Hct, dysp-       Monitor cardiovascular sta-
                            heparin.                         site, thereby blocking the                     nea, UTI                       tus.
                                                             thrombogenic activity of                                                      Monitor for bleeding.
                                                             thrombin.
                                                                                                                                           Monitor stool for blood.

Ascorbic Acid (Vitamin C)   Water-soluble vitamin essen-     Increases protection me-                       Nausea, vomiting, heartburn, Be aware that parenteral
                            tial for synthesis and main-     chanism of the immune sys-                     diarrhea, or abdominal        vitamin C is incompatible
1 TAB / 500mg / PO /BID     tenance of collagen and in-      tem, thus supporting wound                     cramps (high doses).          with many drugs. · Consult
                            tercellular ground substance     healing. Necessary for                                                       pharmacist for compatibility
                            of body tissue cells, blood      wound healing and resis-                       Mild soreness at injection    information
                            vessels, cartilage, bones,       tance to infection.                            site; dizziness and temporary
                            teeth, skin, and tendons.                                                       faintness with rapid IV ad-
                            Humans are unable to syn-                                                       ministration.
                            thesize in the body; therefore
                            it must be consumed daily.
                                                                                                                                                                      Page 8 of 99
Drug Name                Class                         Actions                             Indications                Side Effects                      Nursing implications

Aspirin                  NSAID: antipyretic and anal- Analgesic: aspirin inhibits the mild pain fever, inflammatory   Angioedema, GI bleeding,          Use cautiously in pts with GI
                         gesic anti-inflammatory,      synthesis of prostaglandins conditions to reduce risk of       Hepatitis, Leukopenia,            lesions and impaired hepatic
(acetylsalicylic acid)                                 important mediators of in-     recurrent TIAs                  Reye’s syndrome, Thrombo-         or renal function.
325 mg PO QD                                           flammation                                                     cytopenia aspirin toxicity they
                                                                                                                      are fever coma cardiovascu-       Monitor ASA levels.
                         Antiplatelet: Reduction of MI Anti-Coagulant: inhibits the
                         Risk                                                                                         lar collapse nausea heart-        Monitor CBC, BUN, Cr, and
                                                       platelet aggregation this at-                                  burn occult blood loss
                                                       tributive to the inhibition of                                                                   PT/PTT/INR.
                                                       platelet synthesis of throm-
                                                       boxane

Aspirin (ASA)            Antiplatelet—used to aid in   Inhibition of platelet aggrega-                                Respiratory alkalosis, hyper-     Monitor for s/s of bleeding
                         the free movement of blood    tion is attributable to the inhi-                              pnea, tachypnea, hemorr-
                         due to the hyperlipidemia     bition of platelet synthesis of                                hage, pulmonary edema,            Monitor for gastric upset
81mg PO QD                                             thromboxane A2, a potent                                       convulsions, tetany, nausea,      Monitor client for hearing
                                                       vasoconstrictor and inducer                                    dyspepsia, heartburn, epiga-      changes
                                                       of platelet aggregation. This                                  stric discomfort, anorexia,
                                                       effect occurs at low doses                                     hepatotoxicity, occult blood      Monitor for renal and kidney
                                                       and lasts for the life of the                                  loss, hemostatic defects,         function
                                                       platelet (8 days).                                             dizziness, tinnitus, difficulty
                                                                                                                      hearing, nausea, vomiting,
                                                                                                                      diarrhea

Atenolol                 Cardiovascular System         A beta-blocker that selective-                                 sinus bradycardia, CHF,           check apical pulse before
                                                       ly blocks beta1 adrenergic                                     bronchospasm                      giving
(Tenormin)               Beta blocker Antihyperten-    receptors; decreases cardiac
                         sive                          output, peripheral resistance,                                                                   Monitor BP and HR routinely
                         Control of HTN                and cardiac oxygen con-                                        Dyspnea, Fever, Heart fail-       NEVER give with COPD
                                                       sumption; depresses renin                                      ure, Hypo-tension, Intermit-      patients
                                                       secretion.                                                     tent claudication
                                                                                                                                                                            Page 9 of 99
Drug Name                        Class                           Actions                         Indications                 Side Effects                     Nursing implications

Atenolol (Tenormin)              Non-selective B adrenergic      block catecholamine          Hypertension, long term        increased HR, stroke, arr-       GI upset-give with food
                                 blocking                                                     treatment of angina pectoris   hythmias, thrombosis of ren-
                                                                 stimulation of B (heart ) B  due to coronary atheroscle-    al or mesenteric arteries,       prophylactic post MI, apical
                                 Use: treat angina, prevent      (lung )o decrease Card outp, rosis, acute MI; investiga-    edema, asthma like symp-         pulse
                                 MI, anxiety, antidysrhyth-                                   tional in prophylaxis mi-      toms, dizziness, slurred
                                 mics, vascular headaches        BP&HR, renin activity                                                                        >60, caution w/ hyperthyroid-
                                                                                              graine, alcohol withdrawal     speech, thrombocytopenia,        ism,
                                                                                              syndrome, situational anxie-   joint and muscle pain
                                                                                              ty, ventricular arrhythmias                                use sugarless gum, eye sa-
                                                                                                                             Hypotension, bradycardia,   line
                                                                                                                             CHF, wheezing, hy-
                                                                                                                             po/hyperglycemia, withdraw- caution w/ Ca channel block-
                                                                                                                             al rebound effect,          ers

                                                                                                                             bronchoconstriction, head-
                                                                                                                             ache, cold hands & feet,
                                                                                                                             dreams, heartburn, dry
                                                                                                                             mouth, congestion caution w/
                                                                                                                             Ca channel blocker

Ativan (lorazepam)               Benzodiazepine; sedative;       Inhibits neurotransmitter                                   mild drowsiness, sedation,       Dilute w/ an equal amount of
                                 central nervous system          GABA; most potent benzo-                                    lethargy, fatigue, light head-   compatible solution (normal
                                 agent; anxiolytic               diazepine .                                                 edness, anger, hostility, ma-    saline or D5 ); can give undi-
                                                                                                                             nia, restlessness, crying,       luted deep into muscle; have
                                                                                                                             delirium, headache, slurred      airway equipment near; fall
                                                                 relieves anxiety, produces                                  speech, stupor, tremor, eu-      risk
                                                                 sedation; reduces N/V                                       phoria, visual disturbances,
                                                                                                                             constipation, diarrhea, dry
                                                                                                                             mouth, N&V, fever

Atorvastatin                     Adjunct to dietary therapy in   Inhibits synthesis of choles-                               Abdominal cramps, constipa- Monitor dietary intake, par-
                                 the management of primary       terol with effect of lowering                               tion, diarrhea, flatus, heart- ticularly fat consumption.
(Lipitor)                        hypercholesterolemia and        total cholesterol & LDL.                                    burn, rashes, rhabdomyoly-
                                 mixed dyslipidemias             HDL and  VLDL, Choles-                                   sis ( acute, fulminating, po-
                                                                 terol, &  Triglycerides                                    tentially fatal disease that
                                                                                                                             destroys skeletal muscle as
                                                                                                                             evidenced by myoglobinemia
                                                                                                                             and myoglobinuria.)

Atorvastatin calcium (Lipitor)   Cardiovascular agent, antili-   Inhibits hmg coenzyme A        GI                           Rhabdomyolysis, myalgia          Monitor liver studies, choles-
                                 pidemic agent, hmg CoA          which is essential for hepatic                                                               terol, assess muscle pain
                                 reductase agent, use: to        production of cholesterol,                                                                   and cpk, can cause digoxin
                                 lower serum cholesterol         increases # of hepatic recep-                                                                toxicity, jaundice, avoid
                                                                 tors for LDL, thus increasing                                                                ETOH
                                                                 uptake and catabolism of
                                                                 LDL
                                                                                                                                                                           Page 10 of 99
Drug Name                     Class                              Actions                         Indications                    Side Effects                  Nursing implications

Atropair                      anticholinergic                    belladonna alk, block musca- Colinergic                        caution:preg c, narow glau-   initial bradycardia for
                                                                 rinic                                                          coma
Atropine                      use:                                                                                                                            1-2 min post IV,
                                                                 response to Ach                                                paralytic ileus
                              treat GI, bile disorders,                                                                                                       monitor: VS, I/O, retention,
                                                                 incr HR                                                        side/adv:dry mouth, consti-   bowel
                              mydriasis cycloplegia                                                                             pation
                                                                                                                                                                sounds, use gum for dry
                              for diagnstic, pre-op                                                                             tachycardia, blur vision, fever mouth
                              cholinergc effects, treat                                                                                                       avoid heat
                              sinus bradycardia,                                                                                                              blue eyed more sensitive
                              peptic ulcr, parkinsons,
                              antidote for cholinergic toxici-
                              ty

atropine sulfate (Atropine)   Anticholinergic, antimusca-        Depresses CNS, decrease                                        Ventricular fibrillation      Monitor vital signs, monitor
                              rinic                              AV conduction, antisecretory,                                                                rate, rhythm and quality of
                                                                 increases HR and cardiac                                                                     HR and respiration, monitor
                                                                 output, reduces secretions:                                                                  BP and temperature for
                                                                 urine, tears, and saliva, re-                                                                changes,
                                                                 duces bowel, GI tract move-
                                                                 ment                                                                                         May cause orthopedic hypo-
                                                                                                                                                              tension- watch ambulation,
                                                                                                                                                              monitor I&O

Atrovent                      Anticholinergic Bronchodila- Blocks Vagally                                                       Nervousness, Dizziness,       Adequate Hydration
                              tor Associated With COPD                                                                          Headache Blurred Vision,
                                                                                                                                Cough, Dizziness
 Atrovent                      Bronchodilator                    Local site specific effects     Maintenance therapy in          Cough, Blurred vision,        Monitor respiratory status,
                                                                 on larger central airways       COPD; including chronic         acute eye pain, worsening     auscultate lungs before
 (Ipratopium Bromide)          Autonomic nervous system          preventing bronchospasms        bronchitis; and emphyse-        of Narro-angle Glaucoma,      and after inhalation
                               agent                                                             ma, nasal spray for peren-      bitter taste, Skin rash
                                                                                                 nial rhinitis and symptomat-    hives, epistaxis, urinary     Report treatment failure to
                                                                                                 ic relief of rhinorrhea from    retention                     physician
                                                                                                 the common cold
                                                                                                                                 Headache
                                                                                                                                                                        Page 11 of 99
Drug Name                     Class                          Actions                          Indications                Side Effects                      Nursing implications

Atrovent (Ipratropium bromide cholinergic blocking drug      chemically related to atro-    bronchodilation in COPD,     cough, nervousness, drowsi-       Document type, onset, cha-
)Neb PRN                                                     pine, antagonizes the action including chronic bronchitis   ness, dryness of oropharynx,      racteristics of symptoms, any
                                                             of acetylcholine; prevents the and emphysema                constipation, blurred vision,     other agents used and the
                                                             increase in intracellular le-                               urinary difficulty, paresthe-     results, stop smoking, may
                                                             vels of cyclic guanosine mo-                                sias                              experience a bitter taste and
                                                             nophosphate which is                                                                          dry mouth, avoid contact with
                                                             caused by the interaction of                                                                  the eyes
                                                             acetylcholine with muscarinic
                                                             receptors in bronchial
                                                             smooth muscle, leads to
                                                             bronchodilation site specific

Attapulgite PO Q2H 30 ML      Antidiarrheal; Hydrous mag- Decrease gastric motility,          Laxative                   Chronic constipation              Assess bowel pattern, moni-
                              nesium aluminum silicate    water content of stool; ad-                                                                      tor for dehydration
Kaopectate                                                sorbent, demulcent

AUGMENTIN 875MG PO            Antibiotic, penicillin–        Bactericidal: inhibits synthe-                              Lethargy, hallucinations,         Monitor client for s/s of ana-
Q12H                          ampicillin type- given for the sis of cell wall of sensitive                               seizures Glossitis, stomatitis,   phylaxis
                              pneumonia                      organisms, causing cell                                     gastritis, sore mouth, furry
                                                             death.                                                      tongue, black ―hairy‖ tongue,     Monitor client’s WBC count
                                                                                                                         nausea, vomiting, diarrhea,       Monitor client for s/s of infec-
                                                                                                                         abdominal pain, bloody di-        tion
                                                                                                                         arrhea, enterocolitis, pseu-
                                                                                                                         domembranous colitis, non-        Monitor breath sounds to
                                                                                                                         specific hepatitis Nephritis      note improvement
                                                                                                                         Anemia, thrombocytopenia,         Monitor for GI upset
                                                                                                                         leukopenia, neutropenia,
                                                                                                                         prolonged bleeding time
                                                                                                                         Rash, fever, wheezing, ana-
                                                                                                                         phylaxis Superinfections

Avandia (rosiglitazone ma-    antidiabetic and glucagon      lowers glucose levels by         dm                         ha, fatigue, edema, hyper-     monitor BG, lab values b/c it
leate)                                                       improving insulin sensitivity                               glycemia, anemia, back pn, decreases hemoglobin, as-
                                                                                                                         upper respiratory tract infec- sess for edema, lung sounds
                                                                                                                         tion

Avandia (rosiglitazone ma-    antidiabetics and glucagon     lowers glucose levels by         dm                         ha, fatigue, edema, hyper-     monitor VS, lab values b/c it
leate)                                                       improving insulin sensitivity                               glycemia,anemia, back pain, decreases hemoglobin, as-
                                                                                                                         upper respiratory tract infec- sess for edema, lung sounds
                                                                                                                         tion
                                                                                                                                                                 Page 12 of 99
Drug Name             Class                          Actions                          Indications                    Side Effects                   Nursing implications
 Avelox                Anti-infective; Antibiotic     Synthetic, broad spectrum       Treatment of acute bac-         Dizziness, headache            Monitor for effectiveness in
                                                      antibiotic; Bacteriacidal       terial sinusitis, acute bac-                                   eradicating infection;
 (Moxifloxacin HCl)    Quinolone                      against gram+ and gram –        terial exacerbation of          n/d abdominal pain, vomit-
                                                      organisms                       chronic bronchitis, commu-      ing, taste perversion          Notify physician of any
                                                                                      nity-acquired pneumonia,                                       CNS effects, hypersensitiv-
                                                                                                                      Abnormal liver tests           ity reac;
                                                                                      skin and skin structure
                                                                                      infections                      Dyspepsia                      C& S before initiation and
                                                                                                                                                     baseline serum K+




Azithromycin          anti-infective; macrolide anti- A macrolide antibiotic that                                    CNS: Headache, dizziness.
(Zithromax)           biotic                          reversibly binds to the ribo-
                                                      somal of susceptible micro-                                                                 Drug: antacids may de-
                                                      organisms and consequently                                                                  crease peak level of azithro-
                                                                                                                     GI: Nausea, vomiting, diarr- mycin.
                                                      inhibits protein synthesis                                     hea, abdominal pain; hepato-
                                                                                                                     toxicity, mild elevations in Food: Food will decrease
                                                                                                                     liver function tests.        the amount of azithromycin
                                                                                                                                                  absorbed by 50%.


                                                                                                                                                    Monitor for and report loose
                                                                                                                                                    stools or diarrhea, since
                                                                                                                                                    pseudomembranous colitis
                                                                                                                                                    must be ruled out.


                                                                                                                                                    Monitor PT and INR closely
                                                                                                                                                    with concurrent warfarin use.

Barbital              sed/hypnotic                   inhibit nerve transmission to Sedative-hypnotic                 caution:preg D, lactation,     may be crushed, im in lg
                                                     CNS                                                                                            muscle,
Phenobarbital         long barbiturate                                                                               addiction to sed/hypnotics
                                                     limits seizure by increasing                                                                   discard if cloudy or precipi-
100-300 mg/d PO       anticonvulsive                                                                                 impaired hepatic, renal, resp, tate,
                                                     stimuli threshold
200-600 mg/d IV       use: treatment of tonic-                                                                       extreme pain, dibilitation,    use reconstituted iv solution
                                                     onset slow absorption                                           hyprthyd                       w/in
                      clonic seizure, partial
                                                     duration 2-6 HR IV                                              side/adv-drowsy, headache, 30 min. Ck injection site for
                      seizures, pre-op                                                                               dizzy
                                                     20-45% protein bound                                                                         extravasation
                      anxiolytic                                                                                     ataxia, syncope, sedation,
                                                                                                                                                  not analgesic
                                                                                                                     constipation, nausea, brady-
                                                                                                                     cardia
                                                                                                                     dyspnea, paradox excite-
                                                                                                                     ment
                                                                                                                                                                           Page 13 of 99
Drug Name                     Class                          Actions                          Indications                    Side Effects                     Nursing implications

BCG (bacillus calmette gue-   Antineoplastic, biological     BCG stimulates reticuloendo- Antineoplastic                     N&V dizzy, ha, weakness,         use sub-Q, percutaneous, or
rin)                          response modifier, vaccine     thelial system to produce                                       fever, diarrhea, dic, flu like   intervesical only, provider
                                                             macrophages that do not                                         syndrome                         should avoid skin contact
                              Use: treat bladder cancer,     allow mycobacterium to mul-                                                                      monitor for cough, fever,
                              TB immunization                tiply. Causes local inflamma-                                                                    chills, severer malaise
                                                             tory response when treating
                                                             bladder cancer that leads to
                                                             the destruction of cancer
                                                             cells

Beclomethazone (vanceril)     Corticosteroid                  Reduce inflammatory re-      Steroid                           Hypertension, peptic ulcer,   Rinse mouth after use, ad-
                                                              sponse in bronchial walls by                                   heart failure, hyperglycemia, minister oral form with food,
                              Use: prevent or treat inflam- suppression of WBCs and                                          cough, thrush, fragile skin,  taper off dose
                              mation of the respiratory tract immune system                                                  adrenal suppression

Benadryl, Diphenhydramine     antihistamine                  competes with histamine for      Parkinson’s disease, allergy   drowsiness, confusion, in-       extreme caution in pts with
                                                             H1 receptor sites on effector    symptoms, nighttime sleep      somnia, HA, vertigo, sz,         asthma, COPD, hyperplasia,
                                                             cells, prevents but does not     aid, nonproductive cough,      thrombocytopenia, anaphy-        intraocular pressure, hyper-
                                                             reverse histamine mediated       sedation                       lactic shock, GI effects,        thyroidism, CV disease, and
                                                             responses, provides local                                       blurred vision, fatigue, in-     >BP, dc 4 days prior to skin
                                                             anesthesia by preventing                                        coordination, tremors, res-      testing, alternate injection
                                                             initiation and transmission of                                  tlessness, agranulocytosis       sites, teach pts to avoid al-
                                                             nerve impulses, suppresses                                                                       cohol
                                                             cough reflex by direct effect
                                                             in the medulla

Benazepril (Lotensin)         ace inhibitor, used to control lowers blood pressure by                                        headache, dizziness, fatigue, Monitor labs for hyperkale-
                              pt’s hypertension              inhibition of the angiotensin-                                  hyperkalemia, oliguria, cough mia.
40 mg PO q d                                                 converting enzyme and thus
                                                             by decreasing angiotensin II                                                                     Monitor for hypotension.
                                                             and aldosterone secretion.

Benzonatate (Tessalon)        Antitussive                    Decreases frequency and                                         Drowsiness, mild dizziness       Auscultate lung sounds q2h.
                                                             intensity of nonproductive
                                                             cough without inhibiting CNS                                                                     Assess frequency and quality
                                                                                                                                                              of cough.
100 mg PO q8h     PRN
DO NOT CRUSH
(max dose=600mg/24h)

Bimatoprost (Lumigan)         Antiglaucoma                   Selectively mimics the ef-    reduce elevated intraocular conjunctival hyperemia, ocu-           store in orig container at 15-
                                                             fects of the naturally occur- pressure in open angle glau- lar blurring/dryness, photo-          25 C/ 59-77 F; do not let tip
                                                             ring prostamides, acts to     coma or ocular hypertension phobia, allergic conjunctivitis        of eye dropper come in con-
                                                             lower IOP by increasing out-                                                                     tact with any eye or sur-
                                                             flow of aqueous humor                                                                            rounding tissue, may be
                                                             through the trabecular net-                                                                      used with other topical oph-
                                                             work and uveoscleral routes                                                                      thalmic medications
                                                                                                                                                                            Page 14 of 99
Drug Name                      Class                          Actions                         Indications                     Side Effects                     Nursing implications

Bisacodyl (Dulcolax )          Stimulant laxative             Induces peristalsis by bowel Laxative                           Cramping, diarrhea, fluid and Monitor F&E, stool consis-
                                                              stimulation, expands intes-                                     electrolyte disturbances,     tency, do not take with anta-
                               Use: treat constipation,       tinal volume by increasing                                      especially K and Ca           cids or milk
                               Bowel cleansing before         membrane permeability
                                                                                                                                                               Monitor continued need for
                               Medical procedure                                                                                                               use of drug- usually produc-
                                                                                                                                                               es 1-2 soft formed stools
                                                                                                                                                               daily.
                                                                                                                                                               Monitor electrolyte balance.

Bleomycin, blenoxane           antibiotic antineoplastic       Antineoplastic. Action un-                                     stomatitis, anorexia, NV,        use caution in pts with renal
                                                               known, thought to inhibit                                      diarrhea, pulmonary fibrosis,    problems, pulmonary func-
                               use: treat hodgkins disease DNA and RNA and protein                                            anaphylactoid reacitons,         tion test, and respiratory test
                               and other cancers, malignant synthesis                                                         erythema, hyperpigmenta-         should be performed before
                               pleural effusion, and preven-                                                                  tion, acne, alopecia, pneu-      every test, watch for fever,
                               tion of recurrent pleural effu-                                                                monitis, hyperuricemia           don't use adhesive dressings
                               sions                                                                                                                           on skin

Brimonidine Tartrate (Alpha-   Antiglaucoma agent
gan)
0.15% Opth Sol
OS / BID

Bumetanide (Bumex)             Loop diuretic                  inhibits reabsorption of both   edema associated with CHF,      dehydration, circulatory col-    Monitor electrolytes, liver and
                                                              sodium and chloride in the      nephrotic syndrome, hepatic     lapse, reduced blood vo-         renal function studies, as-
                                                              proximal tubule and the as-     disease; adjunct to treat       lume, vascular thrombosis        sess for hypokalemia, moni-
                                                              cending loop of Henle; may      acute pulmonary edema,          and embolism, ECG                tor VS, monitor I&Os, assess
                                                              promote phosphate excretion     especially in clients refrac-   changes, muscle cramps,          hearing for ototoxicity
                                                                                              tory to other diuretics         photosensitivity

Bumetanide (bummed)            Loop diuretic                  inhibits reabsorption of both   edema associated with CHF,      dehydration, circulatory col-    Monitor electrolytes, liver and
                                                              sodium and chloride in the      nephrotic syndrome, hepatic     lapse, reduced blood vo-         renal function studies, as-
                                                              proximal tubule and the as-     disease; adjunct to treat       lume, vascular thrombosis        sess for hypokalemia, moni-
                                                              cending loop of Henle; may      acute pulmonary edema,          and embolism, ECG                tor VS, monitor I&Os, assess
                                                              promote phosphate excretion     especially in clients refrac-   changes, muscle cramps,          hearing for ototoxicity
                                                                                              tory to other diuretics         photosensitivity

Bupivicaine                    CNS agent, local anesthetic    Decreases Na influx into cell. Anesthesia Medication            Vasodilation, hypotension,       Monitor BP, IV fluids, hypo-
                                                              Induces blockade of sensory                                     maternal and fetal bradycar-     tension, pulse, FHR
                               Use: induces local anesthe-    nerve impulse without as                                        dia, dizzy, drowsy, respirato-
                               sia, often by epidural route   much blockade of motor                                          ry depression, blurred vision,   For 30 min post initiation and
                                                              nerve impulse                                                   N&V                              q 30 min thereafter. During
                                                                                                                                                               labor, turn mother on her
                                                                                                                                                               side, stop infusion and admi-
                                                                                                                                                               nister O2 with complications
                                                                                                                                                                       Page 15 of 99
Drug Name                   Class                          Actions                        Indications                     Side Effects                    Nursing implications

Bupropion hydrochloride     Antidepressant, misc. smok- Not known; weakly blocks          short term (6 weeks or less     headache, seizures, consti-     document indications for
(Wellbutrin SR, Zyban)      ing deterrent               neuronal uptake of epi, sero-     )treatment of depression; aid   pation, weight gain, ECG        therapy, presenting beha-
                                                        tonin, and dopamine, exerts       to stop smoking, may be         abnormalities, chest pain,      viors, and duration, note hx
                                                        moderate anticholinergic and      combined with a nicotine        urinary frequency, painful      of seizures, recent MI, buli-
                                                        sedative effects, but only        transdermal system              erection, cutaneous tempera-    mia or anorexia nervosa,
                                                        slight hypotension                                                ture disturbances               monitor weight, EKG, liver
                                                                                                                                                          and renal function, reduce
                                                                                                                                                          dose if renal/liver dysfunc-
                                                                                                                                                          tion, assess mental stability

Busulfex, Myleran           Alkylating drug                Antineoplastic. Action un-                                     unusual tiredness or weak-      handle carefully, and label
                                                           known, thought to cross link                                   ness, sz, leukopenia, throm-    properly, give with antiemetic
                                                           strands of cellular DNA, in-                                   bocytopenia, irreversible       and keep pt an antiemetic
                                                           terferes with RNA transcrip-                                   pulmonary fibrosis, alopecia,   schedule, sz precautions and
                                                           tion, causing imbalance of                                     amenorrhea, GI effects          adm dilantin to prevent,
                                                           growth that leads to cell                                                                      avoid IM injections to de-
                                                           death. Not specific to cell                                                                    crease bleeding, use caution
                                                           type.                                                                                          if pt has received chemo or
                                                                                                                                                          radiation, monitor pt re-
                                                                                                                                                          sponse, monitor uric acid,
                                                           Indicated for chronic myelo-                                                                   anticipate blood or blood
                                                           cyte leukemia                                                                                  product transfusions

Calan (Verapamil)           unknown, calcium channel       chronic A-fib                                                  dizziness, HA, asthenia,     be very mindful when giving
                            blocker that inhibits calcium                                                                 transient hypotension, heart to elderly, monitor vs, ecg,
                            ion influx across cardiac and                                                                 failure, bradycardia, v-fib, safety issues
                            smooth muscle cells there-                                                                    peripheral edema, constipa-
                            fore decreases myocardial                                                                     tion, and nausea
                            contractility and o2 demand--
                            dilates coronary arteries, and
                            arterioles

Calcium carbonate          Antacid, Electrolyte replace- Neutralizes stomach acid,  GI                                    Acid rebound, constipation,     Take 1 HR pc, and take 1
                           ment agent                    increases lower esophageal                                       mood and mental changes,        HR before and 2 hrs after
PG 1000mg tidsusp 250mg/ml                               sphincter tone                                                   polyuria, renal calculi, milk   meds,
                           Use:treat acid indigestion
1250mgcaco3=500mg Ca                                                                                                                                      Flush peg tube c 50 ml h2o
                                                                                                                                                          before and after administra-
                                                                                                                                                          tion, monitor Ca, constipa-
                                                                                                                                                          tion, avoid prolonged inges-
                                                                                                                                                          tion c vitamin D
                                                                                                                                                                 Page 16 of 99
Drug Name                       Class                           Actions                          Indications        Side Effects                    Nursing implications

Calcium carbonate               Effectively relieves symp-      Rapid-acting antacid with                           GI: Constipation or laxative Note number and consisten-
                                toms of acid indigestion and    high neutralizing capacity                          effect, acid rebound, nausea, cy of stools, monitoring for
(Tums)                          useful as a calcium supple-     and relatively prolonged du-                        eructation, flatulence, vomit- constipation.
                                ment.                           ration of action. Decreases                         ing, fecal concretions.
                                                                gastric acidity, thereby inhi-
                                                                biting proteolytic action of                                                        Lab tests: Determine serum
                                                                pepsin on gastric mucosa.                           Metabolic: Hypercalcemia        and urine calcium weekly in
                                                                                                                    with alkalosis, metastatic      patients receiving prolonged
                                                                                                                    calcinosis, hypercalciuria,     therapy and in patients with
                                                                                                                    hypomagnesemia, hypo-           renal dysfunction.
                                                                                                                    phosphatemia (when phos-
                                                                                                                    phate intake is low).
                                                                                                                                                    Record amelioration of
                                                                                                                                                    symptoms of hypocalcemia
                                                                                                                    CNS: Mood and mental
                                                                                                                    changes.
                                                                                                                                                    Observe for S&S of hyper-
                                                                                                                                                    calcemia in patients receiv-
                                                                                                                    Urogenital: Polyuria, renal     ing frequent or high doses, or
                                                                                                                    calculi.                        who have impaired renal
                                                                                                                                                    function

Capoten                                                         Acts as a ACE-inhibitor, pre-                       Chest pain, Hemorrhage,         Use cautiously in pts with
                                                                venting the conversion of                           Hyperkalemia, Hypertensive      impaired renal function.
(captopril)                     ACE Inhibitor Antihyperten-     Angiotensin I to Angiotensin                        crisis, Orthostatic hypoten-
                                sive                            II, thought causing de-                             sion, Palpitations, Tachycar-   Obtain baseline ALT, AST,
12.5 mg PO TID                                                                                                                                      BUN, Cr, and electrolytes
                                                                creased peripheral resis-                           dia
                                                                tance, decreasing blood
                                HTN                             pressure and effects of CHF.

Captopril (Capoten )Enalapril Ace inhibitors,                   Block conversion of angi-      Cardiac Medication   Cough, fever, sore throat      Used with lasix and digoxin,
(Vasotec )lisinopril (Prinivil )                                otensin 1 to angiotensin 2,                                                        postural hypotension, moni-
                                  use: vasodilation to reduce   decrease BP by blocking                             Hypotensio (first dose )hy-    tor BP, K+, CBC, fever, re-
                                 afterload by dilation peri-    vasoconstriction of peripheral                      perK with poor renal function, port cough
                                 pheral arteries                arteries                                            dry mouth
                                                                                                                                                                    Page 17 of 99
Drug Name                   Class                        Actions                        Indications                    Side Effects                    Nursing implications

Carbidopa-Levodopa (Sine-   Antiparkinsonism agent;      Carbidopa prevents peri-       Parkinson’s disease            Choreiform and involuntary      Monitor VS; supervise ambu-
met)                                                     pheral metabolism of levo-                                    movements; increased hand       lation; monitor for therapeutic
                            Anticholinergic agent;       dopa and thereby makes                                        tremors; ataxia; weakness;      effects and adverse reac-
                            Autonomic nervous system     more levodopa available for                                   fatigue; orthostatic hypoten-   tions closely; monitor intra-
                            agent;                       transport to the brain. Carbi-                                sion; blepharospasm; ano-       ocular pressure with glauco-
                                                         dopa does not cross the                                       rexia; vomiting; severe de-     ma pts; monitor diabetics
                                                         blood-brain barrier and does                                  pression including suicidal     blood sugars & hgbA1c;
                                                         not affect metabolism of le-                                  tendencies; tachycardia;        monitor CBC, h & h, potas-
                                                         vodopa in the brain. Levodo-                                  HTN; urinary retention;         sium, liver & kidney function;
                                                         pa is the metabolic precursor                                                                 early signs of over-
                                                         of dopamine, a catechola-                                                                     dose=muscle twitching &
                                                         mine neurotransmitter. Levo-                                                                  spasmodic winking; report s
                                                         dopa restores dopamine                                                                        & s of on-off phenome-
                                                         levels in the extrapyramidal                                                                  non(swings in intensity of
                                                         center-action unknown                                                                         motor symptoms); monitor
                                                                                                                                                       for mental status change

Carisoprodol (soma)         skeletal muscle relaxant,    Decrease muscle tone and       muscoskeletal and neurolog- coma, shock-like syndrome,         Note causes of loss of sei-
                            centrally-acting             involuntary movement by an     ic disorders associated with respiratory depression, loss      zure control, assess extent of
                                                         unknown mechanism, de-         muscle spasms, hyperreflex- of muscle tone                     muscoskeletal and neurolog-
                                                         press spinal polysynaptic      ia, and hypertonia, manage-                                    ic disorder, document mental
                                                         reflexes                       ment of cerebral palsy and                                     status, maintain low excitabil-
                                                                                        multiple sclerosis                                             ity and CNS stimulation

Carisoprodol (Soma)         skeletal muscle relaxant,    Decrease muscle tone and       musculoskeletal and neuro-     coma, shock-like syndrome, Note causes of loss of sei-
                            centrally-acting             involuntary movement by an     logic disorders associated     respiratory depression, loss zure control, assess extent of
                                                         unknown mechanism, de-         with muscle spasms, hyper-     of muscle tone               musculoskeletal and neuro-
                                                         press spinal polysynaptic      reflexia, and hypertonia,                                   logic disorder, document
                                                         reflexes                       management of cerebral                                      mental status, maintain low
                                                                                        palsy and multiple sclerosis                                excitability and CNS stimula-
                                                                                                                                                    tion

Carvedilol (coreg)          ANS beta adrenergic block-   Selective alpha block,         Cardiac Medication             Hypotension, bradycardia,   GI upset-give with food
                            ing agent                                                                                  CHF, wheezing, hy-
                                                         block catecholamine                                           po/hyperglycemia, withdraw- prophylactic post MI, apical
                            Use: treat angina, prevent                                                                 al rebound effect,          pulse
                            MI, anxiety, antidysrhyth-   stimulation of B (heart ) B
                            mics, vascular headaches     (lung )o decrease Card outp,                                  bronchconstriction, head-   >60, caution w/ hyperthyroid-
                                                                                                                       ache                        ism, can cause hypoglyce-
                                                         BP&HR, renin activity                                                                     mia
                                                                                                                       cold hands&feet, dreams,
                                                                                                                                                   use sugarless gum, eye sa-
                                                                                                                       heartburn, drymouth, con-   line, monitor liver functions,
                                                                                                                       gestn                       stop med with hepatic insuf-
                                                                                                                                                   ficiency
                                                                                                                       caution w/ Ca chan blocker
                                                                                                                                                   caution w/ Ca channel block-
                                                                                                                                                   ers
                                                                                                                                                          Page 18 of 99
Drug Name                   Class                             Actions                           Indications   Side Effects                   Nursing implications

cefazolin sodium (Kefzol)   antibiotic/                       binds to peniciialn-binding                     anaphylaxis, diarrhea          infuse over 10-60 minutes
                                                              sites on cell walls of susepti-
                                                              ble bacteria. inhibits bacteri-                                                monitor in’s and out’s.
400 mg, IV q8h                                                al wall synthesis.                                                             monitor for changes in bun
                                                                                                                                             and serum creatinine.
                            urinary tract infection
                                                                                                                                             report onset of diarrhea.

Cefepime HCl                4th-gen cephalosporin anti-       Effectively treats pneumo-                      Hypersensitivity Rxn: (chills, Infuse over 30 min
(Maxipime)                  biotic is similar to third-       nia, skin and soft tissue in-                   fever, skin rash, urticaria,
                            generation with broad gram-       fections, febrile neutropenia,                  shock-like state)               May cause false-positive
                            negative and gram-positive        respiratory tract, intra-                                                       urine glucose test with
                            coverage. Inhibits the third      abdominal infections, and                       GI: Antibiotic-associated       Clinitest
                            and final stage of bacterial      urinary tract infections by                     colitis, diarrhea, nausea, oral
                            cell wall synthesis, thus kill-   reducing or eliminating signs                   moniliasis, vomiting, elevated With concurrent high-dose
                                                              and symptoms of infection.                      liver function tests (ALT,      aminoglycoside therapy,
                            ing the bacteria (bactericid-                                                                                     closely monitor for nephro-
                            al).                                                                              AST).
                                                                                                                                              toxicity and ototoxicity.
                                                                                                              CNS: Headache, fever.
                                                                                                                                              Monitor for S&S of superin-
                                                                                                              Skin: Phlebitis, pain, inflam- fection or pseudomembran-
                                                                                                              mation, rash, pruritus, urtica- ous colitis
                                                                                                              ria,
                                                                                                                                              Monitor for S&S of hyper-
                                                                                                              Urogenital: Vaginitis.          sensitivity Report their ap-
                                                                                                                                              pearance promptly and dis-
                                                                                                                                              continue drug.
                                                                                                                                                                            Page 19 of 99
Drug Name                    Class                           Actions                           Indications                   Side Effects                      Nursing implications

Cefotaxime sodium            Active against a wide variety   Broad-spectrum semi-                                            Fever, nocturnal perspiration,    Determine previous hyper-
                             of gram-negative bacteria       synthetic third-generation                                      inflammatory reaction at IV       sensitivity reactions to ce-
(Kefzol)                     including most of the Entero-   cephalosporin antibiotic. Pre-                                  site, phlebitis, thrombophlebi-   phalosporins and penicillins
                             bacteriaceae. Effectively       ferentially binds to one or                                     tis; pain, induration, and ten-   before therapy is initiated.
                             treats bone and joint infec-    more of the penicillin-binding                                  derness at IM site, superin-
                             tions, CNS infections, gyne-    proteins (PBP) located on                                       fections.                      Monitor I&O rates and pat-
                             cologic infections and go-      cell walls of susceptible or-                                                                 terns: Report change in I&O
                             norrhea, lower respiratory      ganisms. This inhibits third                                                                  in patients with impaired ren-
                             tract infections, intra-        and final stage of bacterial                                                                  al function or with chronic
                                                                                                                             GI: Nausea, vomiting, diarr- UTI or who are receiving
                             abdominal infections, skin      cell wall synthesis, thus kill-                                 hea, abdominal pain, colitis, high dosages or an aminog-
                             and urinary tract infections,   ing the bacterium.                                              pseudomembranous colitis, lycoside concomitantly.
                             and is used for surgical                                                                        anorexia.
                             prophylaxis to reduce or                                                                                                      Monitor for Superinfection
                             eliminate infection.
                                                                                                                                                               Report onset of fever, diarr-
                                                                                                                             Skin: Rash, pruritus.             hea promptly. If diarrhea is
                                                                                                                                                               mild, discontinuation of cefo-
                                                                                                                                                               taxime may be sufficient. If
                                                                                                                                                               diarrhea is severe, suspect
                                                                                                                                                               antibiotic-associated pseu-
                                                                                                                                                               domembranous colitis, (may
                                                                                                                                                               occur in 4–9 d or as long as
                                                                                                                                                               6 wk after cephalosporin
                                                                                                                                                               therapy is discontinued).

Ceftin (Cefuroxime axetil,   cephalosporin antibiotic        inhibits synthesis of bacterial dermatologic infections, UTI, HA, dizziness, lethary, NV,         monitor vs, lab values, cul-
Zinnat)                                                      cell wall causing cell wall     septicemia, meningitis, bone diarrhea, bone marrow de-            tures, monitor for signs of
                                                             death                           and joint infections          pression, anaphylaxis, pn at        anaphylaxis, injection site,
                                                                                                                           site, increased PTT &INR,           **no alcohol for three days
                                                                                                                           anemia

Ceftriaxone sodium           Infections caused by sus-       Broad spectrum antibiotic.                                      Fever, chills, itching (pruri-    Determine history of hyper-
                             ceptible organisms in lower                                                                     tus), pain, inflammation of       sensitivity reactions to ce-
(Rocephin)                   respiratory tract, skin and     Inhibits bacterial reproduc-                                    vein followed by clot due to      phalosporins and penicillins.
                             skin structures, urinary tract, tion thus killing bacteria.                                     prolonged immobilization
                             bones and joints; also intra-                                                                   (phlebitis at IV site).           Inspect injection sites.
                             abdominal infections, pelvic                                                                                                      Lab tests: Perform culture
                             inflammatory disease, un-                                                                                                         and sensitivity tests before
                             complicated gonorrhea, me-                                                                                                        initiation of therapy and pe-
                             ningitis, and surgical prophy-                                                                                                    riodically during therapy.
                             laxis.                                                                                                                            Periodic coagulation studies
                                                                                                                                                               (PT and INR) should be
                                                                                                                                                               done.

Celebrex (Celecoxib)         nonsteroidal anti-              inhibits prostaglandin syn-     treat acute pain, relief of    GI bleeding, diverticulitis,       Observe for GI bleeding,
                             inflammatory drug, COX-2        thesis, primarily by inhibiting signs and symptoms of          palpitations, stiff neck, peri-    weight gain, swelling of peri-
                             inhibitor                       cyclooxygenase-2                rheumatoid arthritis in adults pheral edema                       phery, chest pain, or SOB
                                                                                             and of osteoarthritis
                                                                                                                                                                      Page 20 of 99
Drug Name                    Class                         Actions                           Indications               Side Effects                      Nursing implications

Celebrex (Celecoxib)         Neurological System           inhibits prostaglandin syn-                                 GI bleeding, diverticulitis,      Observe for GI bleeding,
                                                           thesis, primarily by inhibiting                             palpitations, stiff neck, peri-   weight gain, swelling of peri-
                             nonsteroidal anti-            cyclooxygenase-2                                            pheral edema                      phery, chest pain, or SOB
                             inflammatory drug, COX-2
                             inhibitor

Celecoxi (Celebrex )bid      Nonsteroidal anti-            Inhibits prosglandin synthe-                                Fatigue, anxiety, depression, Assess for pain (arthritis )
                             inflammatory                  sis by decreasing enzyme                                    tachycardia, MI, fluid reten- Monitor blood counts, de-
Rofecoxi (Vioxx )qd                                        needed for biosynthesis;                                    tion, tinnitus, blurred vision, crease platelets
                                                           analgesic, anti-inflammatory ,                              N&V, anorexia, dry mouth,
                                                           antipyretic, properties                                     GI bleeding, Nephrotoxicity,
                                                                                                                       oiguria, UTI

celecoxib (celebrex)         cns agent, analgesic, cox-2   inhibits prostaglandin syn-                                 upper respiratory tract infec- monitor vitals
                             inhibitor/                    thesis by inhibiting                                        tion
                                                                                                                                                      monitor hct , hgb, alt, AST,
                                                           cox-2                                                       headache, dyspepsia, diarr- bun, and creatinine
                                                                                                                       hea
                                                                                                                                                      monitor for pain relief


                             pain relief

Celecoxib PO QD 200 mg       Nonsteroidal anti-            Inhibits prosglandin synthe-                                Fatigue, anxiety, depression, Assess for pain (arthritis )
                             inflammatory                  sis by decreasing enzyme                                    tachycardia, MI, fluid reten- Monitor blood counts, de-
                                                           needed for biosynthesis;                                    tion, tinnitus, blurred vision, crease platelets
                                                           analgesic, anti-inflammatory ,                              N&V, anorexia, dry mouth,
                                                           antipyretic, properties                                     GI bleed, UTI Nephrotoxicity,
                                                                                                                       oiguria,

Celexa (citalopram hydrobro- antidepressant                potentiates serontonergic       treatment of depression par- dizziness insomnia tremor        monitor effects
mide)                                                      activity in the CNS by inhibit- ticularly effective in major nausea dry mouth sinusitis
                                                           ing neuronal reuptake of        depressive disorders
                                                           serotonin resulting in antide-
                                                           pressant effect with little ef-
                                                           fect on norepinephrine or
                                                           dopamine reuptake

CellCept                     Immunosuppressive             inhibits T and B lymphocyte                                 N/V/D, decrease in white          No antacids
                                                           proliferation responses,                                    blood cells and platelets,
(mycophenolate mofetil)      Prophylaxis of organ trans-   blocks antibody formation,                                  anemia                            CBC, monitor for signs &
                             plants                        blocks cytotoxic T cell gen-                                                                  symptoms of sepsis
                                                           eration

Cetirizine HCl (Zyrtec)      antihistamine/                h1 histamine-receptor anta-                                 no major side effects,            monitor for reactions with
                                                           gonist                                                                                        other protein-bound medica-
                                                                                                                                                         tions.
10 mg. po qd at 2300                                                                                                   common minor side effects:
                                                                                                                       drowsiness, headache, seda-
                             allergy symptoms                                                                          tion                        monitor for sedation
                                                                                                                                                               Page 21 of 99
Drug Name                Class                        Actions                       Indications                    Side Effects                   Nursing implications

Chlorambucil, leukeran   Alkylating drug              Cross links strands of cellular chronic lymphocytic leuke-   seizures, neutropenia, bone    reduce initial dose if given 4
                                                      DNA, interferes with RNA         mia, malignant lymphomas    marrow suppression, throm-     wks after a full course of
                                                      transcription, causing imbal- including Hodgkin's disease    bocytopenia, myelosuppres-     radiation or myelosuppres-
                                                      ance of growth that leads to                                 sion, hepatotoxicity, pulmo-   sive drugs, or if platelet or
                                                      cell death. Not specific to cell                             nary fibrosis, secondary ma-   leukocyte counts are low,
                                                      type                                                         lignancies, srthyema multi-    CBC with Diff, monitor for
                                                                                                                   forme                          neutropenia which may not
                                                                                                                                                  occur until after 3rd wk, mon-
                                                                                                                                                  itor uric acid, anticipate blood
                                                                                                                                                  transfusions and RBC re-
                                                                                                                                                  placement, infection control
                                                                                                                                                  for decreased WBC pts,
                                                                                                                                                  avoid IM injections, sz pre-
                                                                                                                                                  cautions

Chlorambucil, leukeran   Alkylating drug            Cross links strands of cellular Atineoplastic                  seizures, neutropenia, bone    reduce initial dose if given 4
                                                    DNA, interferes with RNA                                       marrow suppression, throm-     wks after a full course of
                         Use: chronic lymphocytic   transcription, causing imbal-                                  bocytopenia, myelosuppres-     radiation or myelosuppres-
                         leukemia, malignant lym-   ance of growth that leads to                                   sion, hepatotoxicity, pulmo-   sive drugs, or if platelet or
                         phomas including Hodgkin's cell death. Not specific to cell                               nary fibrosis, secondary ma-   leukocyte counts are low,
                         disease                    type                                                           lignancies, srthyema multi-    CBC with Diff, monitor for
                                                                                                                   forme                          neutropenia which may not
                                                                                                                                                  occur until after 3rd wk, mon-
                                                                                                                                                  itor uric acid, anticipate blood
                                                                                                                                                  transfusions and RBC re-
                                                                                                                                                  placement, infection control
                                                                                                                                                  for decreased WBC pts,
                                                                                                                                                  avoid IM injections, sz pre-
                                                                                                                                                  cautions

Chlorambucil, Leukeran   Alkylating drug              Cross links strands of cellular chronic lymphocytic leuke-   seizures, neutropenia, bone    reduce initial dose if given 4
                                                      DNA, interferes with RNA         mia, malignant lymphomas    marrow suppression, throm-     wks after a full course of
                                                      transcription, causing imbal- including Hodgkin's disease    bocytopenia, myelosuppres-     radiation or myelosuppres-
                                                      ance of growth that leads to                                 sion, hepatotoxicity, pulmo-   sive drugs, or if platelet or
                                                      cell death. Not specific to cell                             nary fibrosis, secondary ma-   leukocyte counts are low,
                                                      type                                                         lignancies, erthyema multi-    CBC with Diff, monitor for
                                                                                                                   forme                          neutropenia which may not
                                                                                                                                                  occur until after 3rd wk, mon-
                                                                                                                                                  itor uric acid, anticipate blood
                                                                                                                                                  transfusions and RBC re-
                                                                                                                                                  placement, infection control
                                                                                                                                                  for decreased WBC pts,
                                                                                                                                                  avoid IM injections, sz pre-
                                                                                                                                                  cautions
                                                                                                                                                              Page 22 of 99
Drug Name                      Class                          Actions                           Indications   Side Effects                       Nursing implications

Chlorhexidine Gluconate        Chlorhexidine gluconate is a   Studies have shown Chlor-                       No life-threatening side ef-       Explain that chlorhexidine
                               germicidal mouthwash. It       hexidine gluconate to be                        fects are expected. (SOB;          gluconate is not to be swal-
(Peridex 0.12%--blue liquid    reduces bacteria in the        effective in reducing the inci-                 closing of the throat; swelling    lowed. Swish it around the
Periogard 0.12%----blue liq-   mouth. .                       dence of bacterial pneumo-                      of the lips, face, or tongue; or   mouth and spit it out.
uid)                                                          nia                                             hives).
                                                                                                                                                 Use chlorhexidine gluconate
                                                              Chlorhexidine gluconate is                                                         after brushing
                                                              commonly used to treat gin-
20 mL, Swish and Spit, Q12H                                   givitis (swelling, redness, and                                                    Do not dilute the solution
                                                              bleeding of the gums).                                                             with water or any other liquid.
                                                                                                                                                 Avoid eating, drinking, and
                                                                                                                                                 rinsing for at least 1 hour
                                                                                                                                                 after using chlorhexidine
                                                                                                                                                 gluconate.

Cicplatin (platinol)           Antineoplastic, alkylating     Produces DNA cross linking Atineoplastic        Ottotoxic, neuro and nephro-       Hydrate with 1-2 L fluids be-
                               agent                          of rapidly dividing cells, pre-                 toxic, peripheral neuropathy,      fore dose, wear gloves, EKG
                                                              venting DNA, RNA, and pro-                      seizures, ha, blurred vision,      pre and during test, renal
                               Use: treat cancer              tein synthesis                                  marked N&V, myelosuppres-          function test before each
                                                                                                              sion, hypo Mg+, hypo Ca++,         course of meds.
                                                                                                              SIADH

Ciprofloxacin                  Urinary anti-infective; fluoro- Interferes with conversion of                  Headache, dizziness, fati-         Sensitivity to Penicillin and
                               quinolone antibacterial         intermediate DNA fragments                     gue, insomnia, depression,         cephalosporins, Monitor
(Cipro)                                                        into high molecular weight                     restlessness, nausea, con-         WBC. Nephrotoxic: monitor
                                                               DNA in bacteria; DNA gyrase                    stipation, increased AST,          I/O. BUN, Cre., urinalysis,
                                                               inhibitor                                      ALT, flatulence, heartburn,        AST, ALT, electrolytes, bo-
                                                                                                              vomiting, diarrhea, Candia-        wel pattern, bleeding, over-
                                                                                                              sis, dysphagia, rash, urtica-      growth of infection
                                                                                                              ria, photosensitivity, flushing,
                                                                                                              fever, chills, tremor, arthral-
                                                                                                              gia, tendon rupture

Ciprofloxacin                  Treatment of UTI Infection     Broad spectrum bacteriocidal                    Dizziness, drowsiness, in-         Patients should maintain fluid
                                                              antibiotic.                                     somnia, headache, abdo-            intake of 1.5-2.0 L/day to
(Cipro)                                                                                                       minal pain, diarrhea, nausea.      prevent crystalluria.
                                                                                                              Seizures, arrhythmias, pseu-
                                                                                                              domembranous colitis infec-        Do not take antacids within 6
                                                                                                              tion. Anaphylaxis, Steven          hours before taking Cipro.
                                                                                                              Johnson syndrome                   Assess for signs of superin-
                                                                                                                                                 fection, rash.
                                                                                                                                                                       Page 23 of 99
Drug Name                     Class                         Actions                         Indications                 Side Effects                      Nursing implications

Ciprofloxacin / D5W           anti-infective, quinolone anti- broad spectrum bactericidal                               superinfections, N/V/D            Urinalysis, monitor I&O –
                              biotic                          angent that inhibits DNA-                                                                   keep well hydrated
premix fluid                                                  gyrase (DNA repliction in                                 local burning and discomfort
                                                              bacteria)




Citalopram (Celexa)           SSRI                          Inhibits reuptake of synaptic                               Sweating, CNS effects, joint      Dose increments over 1
                                                            serotonin                                                   and muscle pain, hypoten-         week, 2-4 week onset, not
                              Use-treat depression                                                                      sion, sexual dysfunction,         with maoi’s, monitor flu-
                                                                                                                        gynecomastia                      id/electrolytes, CBC, hepatic,

Citalopram Hydrobromide       antidepressant                potentiates serontonergic       treatment of depression par- dizziness insomnia tremor        monitor effects
                                                            activity in the CNS by inhibit- ticularly effective in major nausea dry mouth sinusitis
(Celexa)                                                    ing neuronal reuptake of        depressive disorders
                                                            serotonin resulting in antide-
                                                            pressant effect with little ef-
                                                            fect on nor epinephrine or
                                                            dopamine reuptake

Clindamycin (HCL, Palmitate, Anti – infective; Lincomycin   Binds to 50S subunit of bac-                                Rash, urticaria, pruritus, ery-   Assess renal system (drug
phosphate)                   derivative                     terial ribosomes; suppresses                                thema, pain, abscess, at          excreted via kidnerys )BC,
                                                            protein synthesis                                           injection site, N&Vabd pain ,     C&S, allergic reactions, urine
                                                                                                                        diarrhea, increased AST,          output, AST, ALT, BUN,
                                                                                                                        ALT jaundice, vaginitis, uri-     creatinine, Hct, bilirubin,
                                                                                                                        nary frequency, leukopenia,       electrolytes, bowel pattern,
                                                                                                                        eosinophilia, agranulocyto-       bleeding, overgrowth of in-
                                                                                                                        sis, thrombocytopenia, po-        fection
                                                                                                                        lyarthritis,

Clonazepam (klonopin )        CNS agent Benzodiazepine      Inhibits spike, wave forma-     Sedative-hypnotic           Drowsiness, behavioral            Monitor Mental status, mood,
                              derivative                    tion in absence seizures.                                   changes, Palpitation, saliva-     affect blood dyscrasias, fev-
                                                                                                                        tion, Nausea, constipation,       er, sore throat, bruising,
                              Use: anticonvulsant                                                                       pancytopenia , respiratory        jaundice, epistaxis, blood
                                                                                                                        depression, urinary retention     level, seizure, renal studies,
                                                                                                                                                          hepatic studies, physical
                                                                                                                                                          withdrawal, eye problems,
                                                                                                                                                          toxicity
                                                                                                                                                                       Page 24 of 99
Drug Name                        Class                         Actions                         Indications              Side Effects                      Nursing implications

Clonidine                        Anti-hypertensive             Stimulates alpha adrenergic                              dry mouth, withdrawal phe-        Monitor I&O ratios, weight,
                                                               receptors in CV centers of                               nomenon,                          Assess for edema.
(Catapres)                       Central A-agonist, (adrener- the brainstem inhibiting car-
                                 gic)                          dioaccelleration and vaso-                                hypotension, constipation,       Monitor BP and pulse.
                                                                                                                        drowsiness, sedation,
                                 Use:inhibits vasoconstriction constriction centers
0.1 mg PO q4h                    and cardiac acceleration
PRN for SBP >160

Clopidogrel Bisulfate (Plavix)   antiplatelet agent            inhibit platelet receptor                                prolonged bleeding time           monitor for bleeding, stool
                                                                                                                                                          blood
75mg Tab, PO, QD                 use: inhibit clot growth      binding                                                  headache, hypertension
                                                                                                                                                          avoid NSAID stomach irritant
                                                                                                                        edema, inc cholesterol, fever

Clozapine (Clozeril)             Atypical antipsychotic, CNS   Dopamine and serotonin          Atypical Antipsychotic   Sedation, tachycardia anti-   CBC, EKG, Change dosage
                                 agent                         receptor block in limbic re-                             cholinergic, agranulocytosis, slowly
                                                               gion of brain                                            seizures, fever, EKG
                                 Use-treat psychotic symp-                                                              changes                       Change positions slowly
                                 toms, schizophrenia
                                                                                                                                                      Monitor for increased risk
                                                                                                                                                      seizures, avoid ETOH

codeine phosphate- acetomi- opiate agonist, analgesic/         binds at natural opiod recep-                            minor side effects; dizziness, monitor for pain relief,
nophen                                                         tors                                                     pruritis constipation, drowsi-
                                                                                                                        ness                           supervise ambulation
2 orders:
                                                                                                                                                       monitor for nausea
10 ml po q6h elixir prn

                                 pain
12.5 gt q4   prn

Colchicines (novocolchine)       Anti-gout agent               Reduces migration of leuko- Anti-Gout                    Confusion, muscle weak-           Caution low therapeutic in-
                                                               cytes to synovial fluid to inhi-                         ness, N&V, diarrhea, agranu-      dex, monitor CBC, Hgb,
                                 Use: prophylaxis or treat-    bit inflammation and reduce                              locytosis, bone marrow sup-       electrolytes, Cr, I/O, urinaly-
                                 ment of acute gout            pain and swelling of gouty                               pression                          sis, Multiple peaks, give with
                                                               arthritis                                                                                  milk or food, encourage flu-
                                                                                                                                                          ids IV with NS, extravasation
                                                                                                                                                          is painful, stop drug when
                                                                                                                                                          pain is relieved

copaxane (Galtiramer ace-                                      unknown, thought to modify      MS                       dreams, anxiety, agitation,       **only SQ, after administra-
tate)                                                          processes responsible for                                diarrhea, vomiting, stomatitis,   tion be mindful of CP, palpi-
                                                               pathogenesis of MS                                       urinary urgency, yeast infec-     tations, anxiety, dyspnea--
                                                                                                                        tions, wt gain, increased rr,     these signs are usually self
                                                                                                                        dyspnea, vaginal hemorr-          limiting and reversed shortly
                                                                                                                        hage                              after adm. Monitor VS, re-
                                                                                                                                                          assess LS
                                                                                                                                                                   Page 25 of 99
Drug Name                    Class                          Actions                       Indications                 Side Effects                    Nursing implications

Cozaar losartan              antihypertensive               block the binding of angi-    treatment of hypertension   headache dizziness syncope take without regard to meals,
                                                            otensin 2 to specific tissue                              hypotension diarrhea abdo- monitor BP monitor for hypo-
                                                            receptors fornd in the vascu-                             minal pain nausea cough    tension
                                                            la smooth muscle which
                                                            blocks the vasoconstritive
                                                            effect thus leading to de-
                                                            crease in Bp

Critic acid topical paste    Skin protector/                                                                          N/A


1 application with daiper    diaper rash
change

Cyclosporine (sandimmune,    Immunosuppressant            Selective and reversible inhi- Atineoplastic                Gingival hyperplasia, in-       avoid Tacolimus, intensive
neoral)                                                   bition of helper T-                                         crease body and facial hair,    dental care, monitor blood
                             Use: suppress the immune lymphocyts, which normally                                      neuro, nephro, hepatotoxic,     sugar closely, monitor bun,
                             system to prevent transplant stimulate antibody production                               causes hyperglycemia            cr, AST, alt, ldh, neuro
                             rejection


Cytoxan, Cyclobastin, Cytox- Antineoplastics                cross links strands of cellular Atineoplastic             cardiotoxicity with very high   use caution with pts pre-
an, Lyophilized, Procytox                                   DNA, and interferes with                                  doses of doxorubicin, leuko-    viously treated for cancer,
                             Use: treat Hodgkins and mul-   RNA transcription causing an Hodgkins and multiple mye-   penia, thrombocytopenia,        don't give at bedtime due to
                             tiple myeloma, and other       imbalance and cell death.       loma, and other cancers   hepatoxicity, pulmonary fi-     infrequent urination and may
                             cancers                        Not specific to cell cycle                                brosis with high doses, sec-    lead to cystitis, dc if cystitis
                                                                                                                      ondary malignant disease,       develops, monitor urine for
                                                                                                                      anaphylaxis, GI effect          blood, CBC, renal and liver
                                                                                                                                                      function, monitor closely for
                                                                                                                                                      leukopenia, monitor uric acid,
                                                                                                                                                      may have false positive for
                                                                                                                                                      TB, and pap smear, avoid IM
                                                                                                                                                      if WBC <, anticipate blood
                                                                                                                                                      transfusions

D 5%w                        Fluid replacement              IV ECF replacement            IV Fluid                    Irritation at IV site           Monitor IV site q2h
Iv 25ml drip prn             Caloric agent                                                                            Hyperglycemia                   Monitor I/O
                             Use: maintain hydra-                                                                     Fluid volume excess
                             tion/glucose

D5 1/2 NS c 20 KCL           Iv solution with electrolyte   fluid replacement and elec-                                                               monitor for signs of fluid
                             added                          trolyte replacement therapy                                                               overload and hyperkalemia,
                                                                                                                                                      monitor vital signs
                                                                                                                                                                          Page 26 of 99
Drug Name                    Class                           Actions                          Indications                   Side Effects                     Nursing implications

D5 nacl 0.45% with 20 meq K IV hydration fluid, hypertonic   IV addition of hypertonic sa- IV Fluid                         Over hydration- pulmonary        Monitor iv site for infiltration,
in 1000ml                                                    line and electrolyte solutions                                 edema, adventitious breath       irritation, phlebitis
                            Use: restore fluid/electrolyte   to restore vascular volume                                     sounds
                            imbalance                        and serum electrolyte con-
                                                             centrations to normal levels

D50%w                        Fluid replacement               IV ECF replacement               IV Fluid                      Irritation at IV site            Monitor IV site q2h
Iv 50ml drip prn             Caloric agent                                                                                  Hyperglycemia                    Slow rate infusion
Max rate 10ml/min            Use: maintain hydra-                                                                           Fluid volume excess              Monitor I/O
                             tion/glucose
Per sliding scale

D5W and Lactated Ringers     Fluid replacement isotonic      IV ECF replacement               IV Fluid                      Irritation at IV site            Monitor IV site q2h
Solutions
                             Caloric agent                                                                                  Hyperglycemia                    Monitor I/O
1000ml IV drip
                             Use: maintain hydra-                                                                           Fluid volume excess
                             tion/glucose

Dacarbazine, DTIC, DTIC-     antineoplastics                 unknown, thought to cross        Hodgkin’s, metastatic malig- facial paresthesia, GI effects,   use caution in pts with im-
Dome                                                         links strands of DNA and         nant melanoma                leukopenia, thrombocytope-        paired bone marrow function
                             Use: Hodgkins, metastatic       interferes with RNA synthe-                                   nia, anaphylaxis, flu syn-        and those with renal and liver
                             malignant melanoma              sis, not specific to cell type                                drome, phototoxicity, alope-      problems, avoid IM if plate-
                                                                                                                           cia                               lets are <, anticipate blood
                                                                                                                                                             transfusions, CBC, platelet
                                                                                                                                                             counts

Dalmane                      sed/hypnotic                    cns depressant, active meta- Sedative-hypnotic                 caution:preg X, lactation,       residual drowsiness com-
                                                             bolite                                                         sleep apnea,                     mon,
Flurazepam                   benzodiazepine
                                                             onset 15-45 min.                                               narrow glaucoma,                 dependence, no alcohol
15-30mg hs PO                use:short term treatmnt                                                                        child<15yr,
                                                             duration 7-8 hr. causing
                             of insomnia                                                                                    impaired hepatic, rena, l
                                                             hypnotic sleep & anticonvul-                                   resp,
                                                             sion
                                                                                                                            side/adv-headache, dizzy
                                                                                                                            ataxia, memory loss,
                                                                                                                            vision change, nausea
                                                                                                                            paradox rage

Darvocet                     narcotic analgesic              acts as agonist at specific relief of mild to moderate         dizziness sedation nausea        take drug with food monitor
                                                             opioid receptors in the CNS pain                               vomiting constipation            for safety precautions when
(Propoxyphene Napsylate)                                     to produce analgesia eupho-                                                                     taking this drug
                                                             ria sedation
                                                                                                                                                                             Page 27 of 99
Drug Name                       Class                         Actions                           Indications                    Side Effects                     Nursing implications

Darvocet-N                      narcotic analgesic            Relief of mild to moderate                                       dizziness sedation nausea        take drug with food monitor
                                                              pain. Acts as agonist at spe-                                    vomiting constipation            for safety precautions when
(Propoxyphene Napsylate)                                      cific opiod receptors in the                                                                      taking this drug
                                                              CNS to produce analgesia
                                                              euphoria sedation

Decadron                        Hormone & synthetic substi- intense anti inflammatory                                          bowel perforation                monitor bowel sounds
                                tute                        activity, prevents accumula-
(Dexamethasone acetate)                                     tion of inflammatory cells at
                                Adrenal corticosteroid      sites of infection, decreased
                                                            phagocytosis, decreased
                                                            capillary permeability

Deltasone                       Immunosuppressive             decreases inflammation by                                        mood swings delayed              Na+, K+, I&O, monitor for
                                                              supression of migrating po-                                      wound healing, increased         rash, edema, hyperglycemia
(Prednisone)                    Adrenal corticosteroid-       lymorphonuclear white blood                                      blood sugar, increased bp,
                                glucortoid                    cells, fibroblasts, and lysomal                                  cataracts, large joint aches,
                                Prophylaxis of organ trans-   stabilization                                                    increase in cholesterol,
                                plants                                                                                         wieght gain, ulcers

Demerol hydrochloride (Me-      opioid analgesic              binds to receptors to relieve     analgesic for moderate to      should only be used for a few    high fiber, high fluid diet,
peridine hydrochloride)                                       pain                              severe pain, useful in minor   doses due to toxic break-        hypotension, drowsiness,
                                                                                                surgery, preop medication      down, causes local tissue        resp. depression, fall preven-
                                                                                                                               irritation, may cause anxiety,   tion, switch to another opioid
                                                                                                                               tremors, and seizures            after few doses

Dexamethason (decadron)         synthetic adrenocortical ste- It is a potent anti-              Steroid                        bloody or black, tarry stools Monitor K+, weight, I&O,
                                roid                          inflammatory agent used to                                       confusion, excitement, res- assess for infection and fev-
                                                              reduce inflammation                                              tlessness, a false sense of   er, edema, mental status
                                Use: anti-inflammatory                                                                         well-being eye pain, de-
                                                                                                                               creased or blurred vision, or
                                                                                                                               bulging eyes

Dextran (high molecular wt.),   electrolyte                   expands plasma volume via plasma expander                        thrombophlebitis, nasal con-     assess hydration prior to
Dextran 75, Gendex 75                                         colloidal osmotic effect,                                        gestion, NV, >specific gravi-    giving, draw blood before,
                                                              drawing fluid from interstitial                                  ty, and > viscosity of urine,    monitor urine flow rate during
                                                              to intravascular space, pro-                                     fluid overload, anaphylaxis,     therapy, watch for circulatory
                                                              viding fluid replacement                                         urticaria, arthralgia            overload, monitor hemoglo-
                                                                                                                                                                bin, monitor BS before and
                                                                                                                                                                during, low and high molecu-
                                                                                                                                                                lar wt dextrans are not inter-
                                                                                                                                                                changeable
                                                                                                                                                                               Page 28 of 99
Drug Name                      Class                              Actions                           Indications                   Side Effects                    Nursing implications

Dextran (low molecular wt. )   electrolyte                        expands plasma volume via         plasma expander, prophylax-   thrombophlebitis, NV, ana-      assess hydration prior to
dextran 40, gentran 40                                            colloidal osmotic effect,         is of venous thrombosis,      phylaxis, tubular stasis and    giving, draw blood before,
                                                                  drawing fluid from interstitial   hemodiluent in extracorpo-    blocking, increased urine       monitor urine flow rate during
                                                                  to intravascular space, pro-      real circulation              viscosity                       therapy, watch for circulatory
                                                                  viding fluid replacement                                                                        overload, monitor hemoglo-
                                                                                                                                                                  bin, monitor BS before and
                                                                                                                                                                  during, low and high molecu-
                                                                                                                                                                  lar wt dextrans are not inter-
                                                                                                                                                                  changeable

Dextrose 5% and NaCl 0.45      isotonic fluid replacement/        replaces lost fluids and elec-                                  N/A                             Monitor I/O
% with potassium chloride                                         trolytes along with potassium
                                                                                                                                                                  monitor for fluid overload
                                                                                                                                                                  monitor blood potassium
                                                                                                                                                                  level
                               KVO

Diabinese (Chlorpropamide)     antidiabetic agent                 stimulates insulin release        adjunct to diet to lower blood anorexia, nausea, vomiting,    give drug before breakfast
                                                                  form functioning Beta cells in    glucose in patients with non- epigastric discomfort, heart-   monitor glucose levels to
                                                                  the pancreas may improve          insulin dependent diabetes burn hypoglycemia,                 assure drug is working moni-
                                                                  binding between insulin re-       mellitus type 2                                               tor for signs of hypoglycemia
                                                                  ceptors or increase the num-
                                                                  ber of insulin receptors

Dicyclomine hydrochloride      Anticholinergic, antispas-         Relieves smooth muscle                                          All are dose related, ha, dry   Monitor I/O, safety
(Bentyl)                       modic                              spasms, tertiary amine with                                     mouth constipation. de-
                                                                  antispasmodic properties                                        creased sweating, drowsy
                               Use: treat irritable bowel
                               syndrome

Digitoxin                      digitalis glycoside use: to incr   inhibit ATPase to keep            Cardiac Medication            anorexia, vision change         longer 1/2 life than digoxin
                               CO, decr O2 demand of car-         phase 2 Na+ in cell longer,                                     (blue-
                               diac tissue. Treat CHF, treat      thus inotropic + increases
                               dysrhythmias eliminated by         cardiac contractility dromo-                                    green ) bradycardia,
                               liver use with kidney disease      trophic - chronotropic -                                        dysrhythmias
                                                                                                                                                                    Page 29 of 99
Drug Name                     Class                              Actions                        Indications          Side Effects                      Nursing implications

Digoxin                       digitalis glycoside use: to incr   inhibit ATPase to keep         Cardiac Medication   anorexia, vision change           apical pulse must be >60,
                              CO, decr O2 demand of car-         phase 2 Na+ in cell longer,                         (blue- green ) bradycardia,       with
Lanoxin                       diac tissue. Treat CHF, treat      thus inotropic + increases                          dysrhythmias
                              dysrhythmias eliminated by         cardiac contractility dromo-                                                          no dysrhythmias or hold
                              kidney use with liver disease      tropic - chronotropic                                                                 dose,
                                                                                                                                                       initial loading dose of 1
                                                                                                                                                       mg/24hr
                                                                                                                                                       0.5-2.0 ng/ml therapeutic
                                                                                                                                                       serum
                                                                                                                                                       0.125-.025mg/day normal
                                                                                                                                                       dose-
                                                                                                                                                       restrict Na+, monitor weight
                                                                                                                                                       monitor K+, Na+, check
                                                                                                                                                       trough
                                                                                                                                                       antidote=digoxin immune fab

Digoxin (lanoxin)             cardiac glycoside (reduces         effective in treating CHF,                          MI, hypokalemia, digitalis        check ECG prior to admin.,
                              preload )has long half life        slows HR, increases cardiac                         toxicity, therapeutic level .8-   know K+ level prior to ad-
                              (48-72hr                           contractility, slows conduc-                        2ug/ml                            min., know Dig. Level prior to
                                                                 tion through AV node, en-                                                             admin., apical pulse 60-100,
                                                                 hances parasympathetic                                                                assess for Dig. Toxicity: ano-
                                                                 effect, mild diuretic                                                                 rexia, confusion, dysrhyth-
                                                                                                                                                       mias, fatigue and muscle
                                                                                                                                                       weakness, admin. At the
                                                                                                                                                       same time every day

digoxin (Lanoxin)             Cardiovascular agent, car-         Increases cardiac output,                           AV block, nausea                  Take apical pulse for full
                              diac glycoside, antiarrhyth-       slows heart rate, decreases                                                           minute, must be >60bpm,
                              mic                                conduction velocity from SA                                                           note rhythm and quality of
Therapeutic (0.8-1.5 ng/ml)                                      to AV                                                                                 pulse, monitor for anorexia,
                                                                                                                                                       N&V, visual disturbances,
                                                                                                                                                       monitor I&O, chest for rales,
                                                                                                                                                       and edema

Digoxin (Lanoxin)             cardiac glycoside(reduces       effective in treating CHF,                             MI, hypokalemia, digitalis        check ECG prior to admin.,
                              preload) has long half life(48- slows HR, increases cardiac                            toxicity, therapeutic level .8-   know K+ level prior to ad-
                              72hr                            contractility, slows conduc-                           2ug/ml                            min., know Dig. Level prior to
                                                              tion through AV node, en-                                                                admin., apical pulse 60-
                                                              hances parasympathetic                                                                   100,assess for Dig. Toxicity:
                                                              effect, mild diuretic                                                                    anorexia, confusion, dys-
                                                                                                                                                       rhythmias, fatigue and mus-
                                                                                                                                                       cle weakness, admin. At the
                                                                                                                                                       same time every day
                                                                                                                                                             Page 30 of 99
Drug Name                    Class                             Actions                          Indications   Side Effects                      Nursing implications

Digoxin (Lanoxin)            Anti-arrhythmic. Increases        Increases force and velocity                   hypotension, anorexia,      Cautious use in renal insuffi-
                             contractility of pt’s heart.      of myocardial systolic con-                    weakness, AV block, drowsi- ciency.
0.125 mg PO q d                                                traction. Decreases conduc-                    ness, dizziness
                                                               tion velocity through the AV                                                Take apical pulse before
                                                               node. Increases contractility                                              admin, should be above 60.
                                                               of heart muscle.                                                                 Monitor I/O, esp. in patients
                                                                                                                                                with renal insufficiency.
                                                                                                                                                Monitor serum dig levels
                                                                                                                                                closely.
                                                                                                                                                Monitor for s/s toxicity.

Dilantin                     Anti convulsant                   Inhibits spread of seizure       Antileptic    V Fib, insomnia, drowsiness,      Toxic levels, mental status,
                                                               activity in motor cortex by                    blurred vision, hepatitis,        seizure, BUN, RBC, Hct,
                                                               altering ion transport                         nephritis, SJS, hypokalemia,      Hgb, ALT, AST, eye prob-
                                                                                                              N&V, anorexia, HA, confu-         lems, allergic reaction, he-
                                                                                                              sion                              patic studies, assess physi-
                                                                                                                                                cal withdrawal symptoms

Dilaudid (hydromorphone)     narcotic/opioid analgesics        unknown, binds with opiate pain                bradycardia, respiratory de-      monitor respiratory function,
                                                               receptors in the CNS, alter-                   pression, bronchospasms,          safety issues, monitor VS,
                                                               ing both perception of and                     blurred vision, diplopia, seda-   have Narcan available in
                                                               emotional response to pain.                    tion, somnolence, dizziness,      case of overdose, give be-
                                                               Also suppresses the cough                      euphoria, **physical depen-       fore pain is intense,
                                                               reflex by direct action on the                 dence
                                                               cough center in the medulla

Diphenhydramine              Antihistamine, H1 antagonist Binds H1 receptor and                 Respiratory   Anticholinergic effects, dizzy, Give with food, monitor HR,
                                                           blocks histamine release                           HA, tingling, tachycardia,      BP, safety, avoid ETOH,
(Benadryl )                  Use: control bronchial secre-                                                    hypo-hypertension, tinnitus, increase fluid intake
                             tions, cough                                                                     blurred vision, GI upset
25mg PG qhs PRN


Diphenhydramine (benadryl)   Temporary symptomatic re-         Antihistamine with significant                 Drowsiness, dizziness,            Monitor cardiovascular status
                             lief of various allergic condi-   anticholinergic activity.                      headache, fatigue, disturbed      especially with pre-existing
                             tions                                                                            coordination, tingling, heavi-    cardiovascular disease. Mon-
                                                                                                              ness and weakness of              itor for adverse effects espe-
                                                                                                              hands, tremors, euphoria,         cially in children and the old-
                                                                                                              nervousness, restlessness,        er adult. Supervise ambula-
                                                                                                              insomnia, confusion, (espe-       tion and use side-rails as
                                                                                                              cially in children), excite-      necessary. Drowsiness is
                                                                                                              ment, fever, tachycardia, dry     most prominent during the
                                                                                                              mouth, nausea, epigastric         first few days of therapy and
                                                                                                              distress, anorexia, vomiting,     often disappears with contin-
                                                                                                              constipation, or diarrhea.        ued therapy.
                                                                                                                                                                               Page 31 of 99
Drug Name                         Class                          Actions                           Indications                     Side Effects                   Nursing implications

Diphenhydramine HCL               antihistamine                  competes with histamine for                                       drowsiness, confusion, in-     extreme caution in pts with
                                                                 H1 receptor sites on effector                                     somnia, HA, vertigo, sz,       asthma, COPD, hyperplasia,
(Benadryl)                                                       cells, prevents but does not                                      thrombocytopenia, anaphy-      intraocular pressure, hyper-
                                                                 reverse histamine mediated                                        lactic shock, GI effects,      thyroidism, CV disease, and
                                                                 responses, provides local                                         blurred vision, fatigue, in-   >BP, dc 4 days prior to skin
                                                                 anesthesia by preventing                                          coordination, tremors, res-    testing, alternate injection
                                                                 initiation and transmission of                                    tlessness, agranulocytosis     sites, teach pts to avoid al-
                                                                 nerve impulses, suppresses                                                                       cohol
                                                                 cough reflex by direct effect
                                                                 in the medulla

Diphenoxylate hydrochloride       GI agent, antidiarrheal        Synthetic narcotic similar to GI                                  Ha, sedation, blurred vision, Can crush and give with fluid
with atropine sulfate (lomotil)                                  meperidine, dispensed with                                        paralytic ileus               of choice, report abominal
                                  Use: treat diarrhea            atropine to discourage                                                                          distension, or decreased
                                                                 abuse, inhibits mucosal re-                                                                     peristalsis, monitor for dehy-
                                                                 ceptors responsible for peris-                                                                  dration
                                                                 taltic reflex

Dipyridamole (Persantine)         antiplatelet agent             inhibit platelet receptor                                         Headache, dizzy, peripheral Give on empty stomach,
                                                                                                                                   dilation, hypotension, N&V, protect IV from direct light
                                  non-nitrate vasodilator        binding, mild inotropic action,                                   flushing
                                                                 little to no effect on BP and
                                  use: inhibit clot growth asso- peripheral arteries
                                  ciated with prosthetic heart
                                  valves, selective vasodilation
                                  of coronary arteries

Dipyridamole (Persantine,         anticoagulant, platelet adhe- Inhibition of red blood cell       as an adjunct to Coumadin       GI intolerance, weakness,      Document mental status,
Novo-Dipiradol)                   sion inhibitor                uptake of adenosine, an in-        anticoagulants in preventing    angina or aggravation of       skin color and cardiopulmo-
                                                                hibitor of platelet reactivity,    post-op thromboembolic          angina, peripheral vasodila-   nary findings, Monitor VS,
                                                                inhibition of platelet phos-       complications, reduce risk of   tion                           ECG, CBC, PT, PTT, and
                                                                phodiesterase which leads to       stroke in clients who have                                     INR
                                                                accumulation of cAMP within        had a stroke or TIA
                                                                platelets, mild vasodilation

Divalprolex sodium                Manic episodes associated      Decreased Manic Behavior                                          Indigestion, N/V, hepatotox-   Assess mood, ideation, and
                                  with bipolar disorder                                                                            icity                          behavior frequently.
(Depakote)

Docusate (colace)                 Stool Softener (not a laxa-    Emulsifying and wetting           to lessen strain of defecation Nausea, abd pain and            Take with full glass of water,
                                  tive)                          properties, detergent action      in persons with hernia or CV cramps, diarrhea, bitter taste,   Monitor electrolytes, I&O,
100 mg PO BID                                                    lowers surface tension, per-      diseases, constipation asso- F/E imbalance                     assess for abd pain and
                                  Use: soften stool              mitting fats and water to pe-     ciated with dry, hard stool,                                   cramps
                                                                 netrate stool and soften it       bedridden clients

Docusate sodium (Dulcolax)        Laxative, emollient, stool     acts by lowering the surface Prevent or treat constipation Cramping, diarrhea, nausea            Assess for constipation, bo-
                                  softener                       tension of the feces and      (dry, hard stool);                                                 wel sounds, abdominal dis-
10 mg suppository q 12 hour                                      promoting penetration by                                                                         tention, and normal patter of
PRN                                                              water and fat, thus increas-                                                                     bowel function; withhold if
                                                                 ing the softness of the fecal                                                                    diarrhea develops and notify
                                                                 mass                                                                                             MD
                                                                                                                                                                           Page 32 of 99
Drug Name                     Class                         Actions                            Indications                    Side Effects                    Nursing implications

Dopamine, Intropin, Revimine sympathomimetic, adrener-      stimulates dopaminergic and        to treat shock and correct     ha, ectopic beats, tachycar-    use caution in pts with occlu-
                             gic                            alpha and beta receptors of        hemodynamic imbalances to      dia, angina, palpitations,      sive vascular disease, cold
                                                            the sympathetic nervous            improve perfusion to vital     <BP, NV, elevated urinary       injuries, diabetic endarteritis,
                                                            system, action is dose re-         organs, to increase cardiac    catecholamine levels, ana-      and arterial embolism, and
                                                            lated, large doses cause           output, and to correct hypo-   phylactic reactions, dyspnea,   also those that are pregnant,
                                                            mainly alpha stimulation           tension                        azotemia, >BS,                  taking MAO inhibitors, and
                                                                                                                                                              sulfite sensitivity, give fluid
                                                                                                                                                              prior to vasoconstrictor, fre-
                                                                                                                                                              quently monitor ECG, BP,
                                                                                                                                                              cardiac output, CVP, pulse
                                                                                                                                                              rate, urine output, and color
                                                                                                                                                              and temp of extremities, ti-
                                                                                                                                                              trate drug to effect, acidosis
                                                                                                                                                              decreases effectiveness of
                                                                                                                                                              drug, strict I & O's

Doxozocin (cardura )          Alpha adrenergic antagonist Selective inhibition of alpha Cardiac Medication                    Hypotension, HA, edema,         Give at hs, monitor BP su-
                                                          receptors to produce vasodi-                                        N&V, leukopenia                 pine and standing 2-6 hrs
                              Use: treat hypertension     lation of arteries and veins                                                                        post administration of initial
                                                                                                                                                              dose or increases

Enalapril meleate (Vasotec)   Anti HTN, Ace inhibitor       Suppresses rein angioten-    Cardiac Medication                   Dysrrtymia, HA, tinnitus,       Blood studies, B/P, orthostat-
                                                            sion – aldosterone system to                                      N&V, renal failure, hypoten-    ic hypotension, K+ and Na+,
                              Use:treat hypertension, renal reduce afterload by dilation                                      sion, hyperkalemia, dyspnea,    BUN, creatinine, renal symp-
                              insuffieiency                 of peripheral arteries                                            cough, dry mouth                toms, liver test, edema in
                                                                                                                                                              feet, allergic reactions

Enoxaparin                    Prevention of thromboembol-   Anti-coagulant. Low molecu-                                       Anemia, thrombocytopenia,       Assess for signs of bleeding,
                              ic phenomena, including       lar weight heparinoid used                                        bleeding                        & hemorrhage, unusual
Lovenox                       DVT & pulmonary emboli        for prevention of thrombus                                                                        bruising, tarry black stools,
                              after surgical procedures.    formation.                                                                                        hematuria, Hct or BP,
                                                                                                                                                              guaiac positive stools, urine,
                                                                                                                                                              or nasal aspirate

Enoxaparin sodium             Prevention of thromboembol-   Low Molecular weight hepa-                                        Anemia, thrombocytopenia,        Assess for signs of bleed-
                              ic phenomena, including       rinoid anti-coagulant. As with                                    bleeding                        ing, & hemorrhage, unusual
(Lovenox)                     DVT & pulmonary emboli        heparin, these molecules                                                                          bruising, tarry black stools,
                              after surgical procedures.    enhance the effects of antith-                                                                    hematuria, Hct or BP,
                                                            rombin. Because of the dif-                                                                       guaiac positive stools, urine,
                                                            ferent mechanisms by which                                                                        or nasal aspirate
                                                            antithrombin and heparin
                                                                                                                                                               LMWH’s have a longer
                                                            inhibit factor IIa and factor                                                                     half-life and a more predicta-
                                                            Xa, low-molecular-weight                                                                          ble anticoagulant response
                                                            heparins do not enhance the                                                                       than unfractionated heparin,
                                                            inhibition of factor IIa, but do                                                                  which allows for subcutane-
                                                            enhance inhibition of factor                                                                      ous administration without
                                                            Xa. Xa is required for activa-                                                                    laboratory monitoring.
                                                            tion of prothrombin.
                                                                                                                                                                     Page 33 of 99
Drug Name                    Class                         Actions                         Indications                     Side Effects                 Nursing implications

enoxaparin sodium (lovenox) anticoagulant, blood former,   antithrombotic properties-                                      Anemia, hemorrhage, dysp-    monitor aptt and tt.
                            low molecular weight hepa-     prevents conversion of fibrin                                   nea, thrombocytopenia, an-
                            rin/                           to fibrinogen and prothrom-                                     gioedema                     monitor cbc and platelet
                                                           bin to thrombin                                                                              count,
30mg, sq, q12h

                                                                                                                                                        monitor for S&S of bleeding

                             prophylatic fo DVT


Enoxaparin/Lovenox injection Blood formers; coagulators;   Anti-coagulant. Low molecu-     acute and extended prophy-      Angioedema, hemorrhage,      Assess for signs of bleeding,
                             anticoagulants; low molecu-   lar weight heparinoid used      laxis of DVT after surgery in   pain and inflammation at     & hemorrhage, unusual
30 mg SQ q 12 hours          lar weight heparin            for prevention of thrombus      those at risk for thromboem-    injection site; abnormal     bruising, tarry black stools,
0800                                                       formation; Does not affect PT   bolic complications including   LFT’s; rash                  hematuria, Hct or BP;
                                                           and aPTT;                       severely restricted mobility;                                guaiac positive stools, urine,
                                                                                           with warfarin for inpatient                                  or nasal aspirate; get base-
                                                                                           treatment of DVT with and                                    line coagulation studies;
                                                                                           without pulmonary embolism;                                  monitor CBC, platelet count
                                                                                           with aspirin to prevent
                                                                                           ischemic complications of
                                                                                           unstable angina and non-Q-
                                                                                           wave MI;

Epogen                       Biologic modifer              Decrease anemia with in-        Endocrine                       Seizure, HA, coldness, bone BUN, CR, I&O, HCT, CNS
                                                           creased RBC                                                     pain,                       symptoms, Assess during
1000 units SQ MWF            Increase RBC                                                                                                              hemodialysis, HGB, WBC,

Epogen, epoetin, eprex       imunomodulation               acts as a growth factor and anemia due to chemo, zido-          sz, ha, hyperuricemia,       monitor BP, monitor hemato-
                                                           as a differentiating factor    vudine therapy, or end stage     hyperkalemia, hyperphos-     crit, may need heparin to
                                                           enhancing RBC production renal disease                          phatemia, arthralgia, sob,   prevent clotting during dialy-
                                                           by acting on erythroid tissues                                  cough, pyrexia               sis treatment, CBC, uric acid
                                                           in bone marrow                                                                               levels, supplement iron
                                                                                                                                                                           Page 34 of 99
Drug Name                   Class                          Actions                          Indications                      Side Effects                     Nursing implications

EPSOM SALT                  GI agent, Replacement, Sa- replenishes Mg depletion                                              complete heart block, respi-     plasma level
                            line Cathartic, anticonvulsant                                                                   ratory paralysis, flushing
(Magnesium Sulfate)

                            decreased Mg from vomit-
                            ing/drug s/to relieve acute
                            constipation




Erythromycin                Anti infective; Macrolide      Binds to 50S ribosomal sub-                                       Dysrhythmias, hearing loss,      WBC, C&S, allergic reac-
                                                           units of susceptible bacteria                                     tinnitus, N&V, diarrhea, he-     tions, urine output, BUN,
                                                           an suppresses protein syn-                                        patotoxicity, abd pain, stoma-   creatinine, AST, SLT, CBC,
                                                           thesis                                                            titis, heartburn, anorexia,      Hct, electrolytes, bowel pat-
                                                                                                                             pruritus, vaginitus, monilia-    tern for diarrhea, overgrowth
                                                                                                                             sis, rash, urticaria, throm-     of infection
                                                                                                                             bophlebitis, anaphylaxis

erythromycin                macrolide antibiotic           bacteriostatic or bactericidal   acute infections caused by
                                                           in susceptible bacteria binds    sensitive strains of strepto-
                                                           to cell membrane causing         coccus pneumonia used for
                                                           change in protein function       Uris LRIs skin and soft tissue
                                                           leading to cell death            infection caused by group a
                                                                                            Bata hemolytic streptococci

Erythromycin eye ointment   Anti infective; Macrolide      Binds to 50S ribosomal sub-                                       Dysrhythmias, hearing loss,      WBC, C&S, allergic reac-
                                                           units of susceptible bacteria                                     tinnitus, N/V, diarrhea, hepa-   tions, urine output, BUN,
                            Use: treat or prevent micro-   an suppresses protein syn-                                        totoxicity, abd pain, stomati-   creatinine,
                            bial infection                 thesis                                                            tis, heartburn, anorexia, pru-   AST,SLT,CBC,Hct, electro-
                                                                                                                             ritus, vaginitus, moniliasis,    lytes, bowel pattern for diarr-
                                                                                                                             rash, urticaria, thrombophle-    hea, overgrowth of infection
                                                                                                                             bitis, anaphylaxis

Escitalpram (Lexapro)       Antidepressant, SSRI           Inhibits reuptake of serotonin                                    Sweating, CNS effects, joint     Dose increments over 1
                                                           to prolong transmission of                                        and muscle pain, hypoten-        week, 2-4 week onset, not
                            Use; treat depression          impulse across neural syn-                                        sion, sexual dysfunction,        with MAOIs, monitor flu-
10mg Tab, PO,QD                                            apse                                                              gynecomastia, dose is mini-      id/electrolytes, CBC, hepatic
                                                                                                                             mized to reduce occurrence       monitoring
                                                                                                                             of side effects
                                                                                                                                                           Page 35 of 99
Drug Name                    Class                            Actions                          Indications   Side Effects                     Nursing implications

Escitalpram Oxalate (Lexa-   Treatment of depression          SSRI. Selectively inhibits the                 Insomnia, diarrhea, nausea       Monitor mood changes
pro)                                                          reuptake of serotonin in the
                                                              CNS.                                                                            Assess for suicidal tenden-
                                                                                                                                              cies, especially during early
                                                                                                                                              therapy.

Ferrous Sulfate              Supplement for iron deficien- Absorbed in GI                                    Constipation, dark tarry         Give on empty stomach,
                             cy anemia                                                                       stools, nausea, heartburn,       better absorbed with acidic
                                                           supplements systemic min-                         anorexia, constipation, diarr-   drink such as orange juice,
                                                           eral iron supply                                  hea, epigastric pain, abdo-      can cause constipation and
40 mg PO QD
                                                                                                             minal distress, black stools.    dark stool .
                                                                                                             Yellow-brown discoloration of
                                                                                                             eyes and teeth.                  Monitor hemoglobin, RBC’s
                                                                                                                                              and hematocrit

Ferrous sulfate              To correct simple iron defi-     Reverse iron deficiency, gas-                                                   Monitor Hgb; Continue iron
                             ciency and to treat iron defi-   tric, esophageal, and other                                                     therapy for 2–3 mos after the
(Fer-In-Sol Drops)           ciency                           tissue changes caused by                                                        hemoglobin level has re-
                                                              lack of iron.                                                                   turned to normal; Monitor
                                                                                                                                              bowel movements as consti-
                                                                                                                                              pation is a common adverse
                                                                                                                                              effect.

Fexofenadine (allegra )      Antihistamine H1 receptor      Antagonize histamine at the        Respiratory   Has no anticholinergic or        Well tolerated with minimal
                             antagonist                     H1 receptor, inhibits bron-                      sedative action, HA, drowsy      side effects
                                                            chospasms and histamine                          fatigue, nausea
                             \use: treat seasonal allergies release from mast cells

Filgrastim                   To decrease the incidence of     Human granulocyte colony-                      Bone pain, hyperuricemia,        Obtain CBC twice weekly
(neupogen)                   infection, as manifested by      stimulating factor (G-CSF)                     fever                            during therapy to monitor
                             febrile neutropenia, to treat    produced by recombinant                                                         neutrophil count and leuko-
Human granulocyte colony-    chronic neutropenia.             DNA technology. Endogen-                                                        cytosis.
stimulating factor (g-csf)                                    ous G-CSF regulates the                        CV: Abnormal ST segment
                                                              production of neutrophils                      depression, MI and arrhyth-
                             Increases neutrophil prolife-    within the bone marrow; not                    mias                             Monitor Hct and platelet
                             ration and differentiation       species specific and primarily                                                  count regularly.
                             within the bone marrow           affects neutrophil prolifera-
                                                              tion, differentiation and se-                  Hematologic: Anemia.
                                                              lected end-cell functional
                                                              activity (including enhanced
                                                              phagocytic activity, antibody-                                                  Monitor temperature q4h.
                                                                                                             GI: Nausea, anorexia.            Incidence of infection should
                                                              dependent killing, and the
                                                              increased expression of                                                         be reduced after administra-
                                                              some functions associated                                                       tion of filgrastim.
                                                              with cell-surface antigens).

                                                                                                                                              Assess degree of bone pain
                                                                                                                                              if present. Consult physician
                                                                                                                                              if non-narcotic analgesics do
                                                                                                                                              not provide relief
                                                                                                                                                                      Page 36 of 99
Drug Name                    Class                           Actions                          Indications                 Side Effects                   Nursing implications

Flomax (Tamsulin hydrochlor- anti-adrenergic blocker         it blocks the alpha1 adrener- treatment of signs and symp-   headache, back pain, post-     monitor for orthostatic hypo-
die)                                                         gic receptors in th prostate, toms of BPH                    ural hypotension, dizziness,   tension monitor to see if
                                                             prosthetic capsule prostatic                                 vertigo, abnormal ejacula-     urine out put has increased,
                                                             urethra and bladder neck                                     tion, amblyopia                advise client of sexual side
                                                             leading to relaxation of blad-                                                              effects and how to deal with
                                                             der and prostate and improv-                                                                them, note PSA levels and
                                                             ing urine flow                                                                              results of digital rectal exam

Flomax (Tamsulin hydrochlo- anti-adrenergic blocker          it blocks the alpha1 adrener- treatment of signs and symp-   headache, back pain, post-     monitor for orthostatic hypo-
ride)                                                        gic receptors in the pros-    toms of BPH                    ural hypotension, dizziness,   tension monitor to see if
                                                             tate,prosthetic capsule pros-                                vertigo, abnormal ejacula-     urine out put has increased,
                                                             tatic urethra and bladder                                    tion, amblyopia                advise client of sexual side
                                                             neck leading to relaxation of                                                               effects and how to deal with
                                                             bladder and prostate and                                                                    them, note PSA levels and
                                                             improving urine flow                                                                        results of digital rectal exam

Fluconazole                  Antifungal properties are       Fungistatic; may also be                                     CNS: Headache.                 Incompatible in Solution with
                             related to the drug effect on   fungicidal depending on con-                                                                Trimethoprim-
(diflucan)                   the fungal cell membrane        centration. Interferes with                                                                 sulfamethoxazole.
                             functioning.                    formation of ergosterol, the                                 GI: Nausea, vomiting, ab-
                                                             principal sterol in the fungal                                                              Monitor for allergic response.
                                                                                                                          dominal pain, diarrhea, in-    Patients allergic to other
                                                             cell membrane that when                                      crease in AST in patients
                                                             depleted interrupts mem-                                                                    azole antifungals may be
                                                                                                                          with cryptococcal meningitis   allergic to fluconazole.
                                                             brane function.                                              and AIDS.
                                                                                                                                                         Lab tests: Monitor BUN, se-
                                                                                                                                                         rum creatinine, and liver
                                                                                                                          Skin: Rash                     function.
                                                                                                                                                         Note: Drug may cause eleva-
                                                                                                                                                         tions of the following labora-
                                                                                                                                                         tory serum values: ALT,
                                                                                                                                                         AST, alkaline phosphatase,
                                                                                                                                                         bilirubin.
                                                                                                                                                         Monitor for S&S of hepato-
                                                                                                                                                         toxicity


Fluconazole (Diflucan )      Antiinfective, antibiotic,      Fungistatic by depleting ma-                                 HA, N&V, AB pain, rash         Administer drug post hemo-
                                                             jor sterol of fungal cell mem-                                                              dialysis, monitor BUN, CR,
                             Antifungal                      brane                                                                                       liver function
                             Use: treat oralpharyngeal
                             and systemic candidiasis
                                                                                                                                                                                  Page 37 of 99
Drug Name                       Class                          Actions                             Indications                     Side Effects                      Nursing implications

Fluconazole (Diflucan)          antifungal                     inhibits the enzyme cytoch-         oropharyngeal and esopha-       dyspepsia, headache, sei-         Obtain baseline cultures,
                                                               rome P-450 in the organism          geal candidiasis, mainten-      zures, hepatic reactions,         renal and LFTs, monitor
                                                               which results in decrease in        ance therapy to prevent cryp-   hypercholesterolemia, hypo-       closely for liver toxicity, moni-
40 mg PO qd                                                    cell wall integrity and extru-      tococcal meningitis in AIDS     kalemia                           tor CBC, monitor VS, mental
                                                               sion of intracellular material,     clients, vaginal candidiasis                                      status Obtain baseline cul-
                                                               leading to cell death                                                                                 tures
                                                               decrease yeast production

Fluoxetine HCl (Prozac )PO      Serotonin reuptake inhibitor   Inhibits reuptake of neuronal                                       Headache, insomnia, rash          Caution diabetes, give in AM
40 mg qd                                                       serotonin                                                           drowsy, N&V, anorexia, wt
                                Use-treat depression                                                                               loss, menstrual irregularity,     2-3 weeks onset therapeutic
                                                                                                                                   anticholinergic effects           effects, monitor Na

Fluphenazine hydrochloride      CNS depression, antipsy-       Block post synaptic dopa-           Typical Antipsychotic           High EPS, low sedation and        Can be given IM for treat-
(Prolixin )chlorpromazine hy-   chotic                         mine receptors in the brain                                         hypotensive effects, convul-      ment q2weeks for noncom-
drochloride (Thorazine)                                                                                                            sions, problems with thermo-      pliant clients.
                                Use-treat psychosis            Block post synaptic dopa-                                           regulation tardive dyskinesia,
                                                               mine receptors in the brain                                         High sedation, EPS and hy-         change positions slowly,
                                CNS depression, antipsy-                                                                                                             avoid overheating and ex-
                                chotic                                                                                             potensive effects, problems
                                                                                                                                   with thermoregulation, weak       treme cold, avoid sunlight
                                Use-treat psychosis and                                                                            anticholinergic, direct cardiac   and ETOH, monitor aims,
                                manic phase of bipolar dis-                                                                        depression                        onset 2-3 weeks
                                order excessive agitation or
                                anxiety, antiemetic


Fluticasone (advair)            Adrenal corticosteroid         Opens airways by reducing           Respiratory                     Masked infection, , dry           Hold powder in with breath.
                                                               chronic inflammation of air-                                        mouth                             Not for acute attacks of
                                anti-inflammatory              way                                                                                                   bronchoconstriction. Rinse
                                                                                                                                   Bad taste                         mouth after use
                                Use:open airways by reduc-
                                ing inflammation

Fluticasone propionate (Flo-    Glucocorticoid                 Regulate the metabolic              Used for anti-inflammatory or   edema, hypokalemic alkalo-        Note mental status, check for
nase, Cutivate, Flovent, Flo-                                  pathways involving protein,         immunosuppressant therapy;      sis, hypokalemia, hypocal-        allergic reactions, monitor
vent Rotadisk)                                                 carbohydrate and fat, anti-         replacement therapy, rheu-      cemia, hypotension, peptic        ECG, electrolytes, BS, UA,
                                                               inflammatory effect because         matic disorders, collagen       ulcers, Cushing's syndrome,       renal and LFTs, document
                                                               of their ability to inhibit pros-   diseases, allergic diseases,    vertigo, cardiac arrhythmias      VS and weight
                                                               taglandin synthesis, inhibit        respiratory diseases, etc.
                                                               accumulation of macrophag-
                                                               es and leukocytes at sites of
                                                               inflammation
                                                                                                                                                                      Page 38 of 99
Drug Name                  Class                           Actions                           Indications                 Side Effects                    Nursing implications

Folic Acid (Vitamin B9)    Vitamin B9 supplement re-       B complex component stimu-                                    Non-toxic; may have flushing monitor VS, loc, and lung
                           quired for nucleoprotein syn-   lates the production of                                       and warmth after IV adminis- sounds **teach pt to eat
(Folacin, Folvite)         thesis and maintenance of       RBC’s, WBCs and platelets                                     tration.                       foods high in folic acid--liver,
                           normal erythropoiesis.          by bone marrow                                                                               oranges, whole wheat, broc-
                                                                                                                         bronchospasms, confusion, coli, brussel sprouts;
                           Use: treat folic acid deficien- Folate deficiency; macrocytic                                 difficulty concentrating, ano-
                           cy, macrocytic anemia asso- anemia; megaloblastic ane-                                        rexia, and nausea…..may        Monitor for improvements in
                           ciated with malabsorption       mia; alcoholism; primary liver                                reduce RBC                     anemic states
                                                           disease; inadequate dietary
                                                           intake; pregnancy;                                                                            Monitor client’s nutritional
                                                                                                                                                         status
                                                                                                                                                         monitor pts on phenytoin for
                                                                                                                                                         subtherapeutic levels;

fosamax (alendronate so-   uncategorized drug              suppresses osteoclast activi- prevention of osteoporosis in   ha, abd pain, nausea, con-      monitor VS, monitor gastric
dium)                                                      ty on newly formed resorp-    post-men. women, old com-       stipation, diarrhea, acid re-   problems esp. due to gastric
                                                           tion surfaces, which reduces pound fractures T-12,            gurgitation, esophageal ulc-    hx, bowel regimen, monitor
                                                           bone turnover. Bone forma-                                    er, vomiting, musculoskeletal   stools
                                                           tion exceeds resorption at                                    pain
                                                           remodeling sites, leading to
                                                           progressive gains in bone
                                                           mass

Furosemide                 Anti-hypertensive and man-      Loop diuretic. Inhibits reab-                                 Dehydration, hyperchlore-       Monitor BP and pulse, I&O,
                                                                          +       -
                           agement of edema second-        sorption of Na and Cl from                                    mia, hypokalemia, hypomag-      weight. Edema, lung
(Lasix)                    ary to CHF.                     the Loop of Henle and Distal                                  nesemia, hyponatremia, hy-      sounds, skin turgor, mucous
                                                           Renal Tubule increasing                                       povolemia, metabolic acido-     membranes. Monitor for
                                                           renal output, thus lowering                                   sis                             symptoms of dehydration.
                                                           BV and BP.

furosemide (Lasix)         Loop diuretic, electrolytic and Diuretic and antihyperten-                                    Hypokalemia, circulatory        Give with food or milk, give
                           water balance agent             sive, inhibits reabsorption of                                collapse, aplastic anemia,      am, store oral in refrigerator,
                                                           sodium and chloride, mag-                                     agranulocytosis                 protect syringes from light,
                                                           nesium and potassium wast-                                                                    watch for possible digoxin
                                                           ing diuretic                                                                                  toxicity due to hypokalemia

Furosemide (Lasix)         Loop diuretic. Anti-            Inhibits reabsorption of NaCl,                                hypokalemia, circ. collapse,    Monitor BP and pulse, I&O,
                           hypertensive and manage-        primarily in the loop of Henle.                               agranulocytosis, orthostatic    weight. Edema, lung
80 mg PO q d               ment of edema                   Anti-hypertensive that de-                                    hypotension, hyponatremia,      sounds, skin turgor, mucous
                                                           creases edema and intra-                                      hypovolemia, hypomagne-         membranes. Monitor for
                                                           vascular volume.                                              semia, hypocalcemia, ele-       symptoms of dehydration
                                                                                                                         vated bun, metabolic acido-
                                                                                                                         sis
                                                                                                                                                                            Page 39 of 99
Drug Name                  Class                            Actions                          Indications                    Side Effects                       Nursing implications

Gabapentin (Neurontin )    CNS agent/ anticonvulsant        GABA neurotransmitter ana-                                      Drowsy, dizzy, tremor,             Do not give with antacids,
                                                            log, effect on neuronal sero-                                   slurred speech, headache,          monitor neurologic signs
                           Use-treat bipolar disorder       tonin metabolism postulated                                     impaired concentration, wt
2-100 mg Capsule TID, PO   and depression                                                                                   gain, N&V, blurred vision


600mg PO, Day

Gabapentin (Neurontin)     Treatment of severe pain         Gabapentin is primarily used                                    Drowsiness, ataxia, anxiety        Assess for location, intensity,
                                                            as an anticonvulsants. It has                                                                      and characteristics of pain
                                                            an unlabeled use in the                                                                            periodically
                                                            treatment of severe pain.

Gatifloxacin (tequin)      Anitibiotic, quinolone           Effects the nucleic acid me-     acute bacterial exacerbation   acute hepatitic necrosis or        Dilute according to package
                                                            tabolism inhibiting DNA-         of chronic bronchitis, acute   failure, fever, chills, tremors,   insert, give by IV infusion
                                                            dependent RNA polymerase         sinusitis, community-          abdominal pain, hemolytic          over 60 mins, do not add
                                                            or inhibition of gyrase (Cells   acquired pneumonia, UTI,       anemia, rash, complete pre-        additives or other medica-
                                                            cannot duplicate or repro-       pyelonephritis, gonorrhea,     scription, avoid activities that   tions or use through same
                                                            duce)                            rectal infections              require mental alertness,          line, flush line before and
                                                                                                                            report hear palpitaitons and       after admin.,
                                                                                                                            fainting

Gatifloxacin (tequin)      Urinary anti-infective; Fluro-   Interferes with conversion of                                   Headache, dizziness, insom-        WBC, C&S, allergic reac-
                           quinolone antibacterial          intermediate DNA fragments                                      nia, paresthesia, tremor,          tions, urine output, BUN,
                                                            into high-molecular weight                                      vasodilation, nausea, consti-      creatinine, AST, ALT CBC,
                                                            DNA in bacteria; DNA gyrase                                     pation, increased AST, ALT,        HCT, electrolytes, bowel
                                                            inhibitor                                                       diarrhea, pseudomembran-           pattern for diarrhea, bleed-
                                                                                                                            ous colitis, rash, urticaria,      ing, overgrowth of infection
                                                                                                                            photosensitivity, flussing,
                                                                                                                            fever chills, dyspnea, pha-
                                                                                                                            ryngitiis

Gel wound dressing         Wound covering
                           Use: protect wound and
                           promote healing

Gentamicin                 Anti-infective; Aminoglyco-      Interferes with protein syn-                                    Confusion, tremors, convul-        WBC, C&S, allergic reac-
                           side                             thesis in bacterial cell by                                     sions, neurotoxicity, vertigo,     tions, urine output, AST,
                                                            binding to ribosomal subunit,                                   hyper- hypotension, palpita-       ALT, CBC, Hct, electrolytes,
                                                            causing misreading of genet-                                    tions, ototoxicity, tinnitus,      bleeding, overgrowth of in-
                                                            ic code; bacterial death                                        N&V, anorexia, Hepatic ne-         fection, weight, I&O, prote-
                                                                                                                            crosis, splenomegaly, oligu-       inuria, VS for hyper – hypo-
                                                                                                                            ria, hematuria, renal dam-         tenstion, IV site for throbocy-
                                                                                                                            age, nephrotoxicity, rash,         topenia, serum peak 30-60
                                                                                                                            alopecia, leukopenia, ane-         after adm, PH, deafness,
                                                                                                                            mia, thrombocytopenia              dehydration
                                                                                                                                                                                  Page 40 of 99
Drug Name                   Class                               Actions                             Indications                      Side Effects                    Nursing implications

gentamicin sulfate          aminoglycoside                      bactericidal inhibits protein       serious infections caused by tinnitus dizziness numbness         monitor for the nausea and
                                                                synthesis in susceptible            susceptible strains of pseu- nausea vomiting anorexia            vomiting give small meals
                                                                strains of gram negative bac-       domonas aeruginosa for       pain irritation locally             monitor signs to see if drug is
                                                                teria appears to disrupt func-      serious infection when caus-                                     working or not culture site
                                                                tional integrity of bacterial ell   ative agent is unknown
                                                                membrane causing cell
                                                                death

Glipizide                   Antidiabetic agent                  Stimulates insulin release                                           Hypoglycemia Anorexia,        Monitor glucose levels
                                                                from functioning beta cells in                                       nausea, vomiting, epigastric
10 MG PO BID-A              Sulfonylurea                        the pancreas; may improve                                            discomfort, heartburn, diarr- Monitor for s/s of hypogly-
                                                                binding between insulin and                                          hea Leukopenia, thrombocy- cemia
                                                                insulin receptors or increase                                        topenia, anemia
                                                                the number of insulin recep-
                                                                tors; more potent in effect
                                                                than first-generation sulfony-
                                                                lureas
                                                           nd
Glipizide (Glucotrol XL )   Antidiabetic, sulfonylurea 2        Stimulates beta cells of pan-                                        N&V, diarrhea, constipation, Do not crush, not with ETOH,
                            generation                          creas to secrete insulin, in-                                        HA, vision disturbance       do not use with diabetic ke-
                                                                creases insulin sensitivity of                                                                    toacidosis, take 30 min p first
                            Use: treat diabetes type 2          receptors, inhibits hepatic                                                                       meal of day, do not substi-
5mg PO QD ,30 min AC
                                                                glucose production                                                                                tute, BS testing is still neces-
                                                                                                                                                                  sary

Glucophage (Metformin hy-   antidiabetic agent                  exact mechanism is not un-          adjunct to diet to lower blood   hypoglycemia, lactic acido-     monitor urine or serum glu-
drochloride)                                                    derstood, possibly increases        glucose in patients with non-    sis, anorexia nausea vomit-     cose levels frequently to de-
                                                                peripheral utilization of glu-      insulin dependent diabetes       ing, epigastric discomfort,     termine effectiveness of drug
                                                                cose increases production of        mellitus type 2 in patients      heart burn diarrhea allergy     and dosage monitor for hy-
                                                                insulin decreases hepatic           greater than or equal to 10                                      poglycemia
                                                                glucose production and al-          years old
                                                                ters intestinal absorption of
                                                                glucose

Glucotrol (glipizide)       antidiabetic agent                  stimulates insulin release          adjunct to diet to loer blood anorexia, nausea, vomiting,        give drug before breakfast
                                                                form functioning Beta cells in      glucose in patients with non- epigastric discomfort, heart-      monitor glucose levels to
                                                                the pancreas may improve            insulin dependent diabetes burn hypoglycemia,                    assure drug is working moni-
                                                                binding between insulin rec-        mellitus type 2                                                  tor for signs of hypoglycemia
                                                                deptors or increase the num-
                                                                ber of insulin receptors

Gold sodium thiomalate      Gold compound                       immunomodulary and anti-                                             Dizzy, sweating, flushing,      Shake well, inject deep mus-
                                                                inflammatory, inhibition of                                          N&V, metal taste, hepatitis,    cle with patient recumbent
                            Use: treat acute rheumatoid         prostaglandid synthesis                                              agranulocytosis, aplastic       for 30 min, monitor urine for
                            arthritis, felty’s syndrome                                                                              anemia, renal disease, alo-     protein, blood, sediment and
                                                                                                                                     pecia, gray or blue skin pig-   skin for purities before each
                                                                                                                                     ment (chrysiasis ) puritis      dose, monitor WBC, RBC,
                                                                                                                                                                     Hbg, platelets, avoid sun-
                                                                                                                                                                     light, slow effects
                                                                                                                                                                    Page 41 of 99
Drug Name                  Class                          Actions                         Indications                   Side Effects                   Nursing implications

Guaifenesin                expectorant                    increase output of the           use for nonproductive cough nv, gi upset, dizziness, h/a,   document pulmonary as-
                                                          resp.tract by reducing the                                   rash                            sess., cough, and sputum
                                                          viscosity and surface tension                                                                prod., document fever, chills.
                                                          of resp.secretions, facilitating                                                             Don't perform activities that
                                                          expectoration                                                                                require mental alertness.

Guaifenesin                expectorant                    increase output of the           use for nonproductive cough N/V, GI upset, dizziness,       Document pulmonary as-
                                                          resp.tract by reducing the                                   rash                            sess., cough, and sputum
(Robitussin syrup)                                        viscosity and surface tension                                                                prod.
                                                          of resp.secretions, facilitating
                                                          expectoration                                                                                Document fever, chills.
200mg PO q4h     PRN                                                                                                                                   Don't perform activities that
                                                                                                                                                       require mental alertness.

Guaifenesin                expectorant                    increase output of the           use for nonproductive cough N/V, GI upset, dizziness,       Document pulmonary as-
                                                          resp.tract by reducing the                                   rash                            sess., cough, and sputum
(Robitussin syrup)                                        viscosity and surface tension                                                                prod.
                                                          of resp.secretions, facilitating
                                                          expectoration                                                                                Document fever, chills.
200mg PO q4h     PRN                                                                                                                                   Don't perform activities that
                                                                                                                                                       require mental alertness.

Guaifenesin PO Q4H, 300 mg Expectorant                    Acts as an expectorant by      Respiratory                    Drowsiness, N&V, anorexia, Assess cough, fluid increase,
                                                          stimulating a gastric mucosal                                 vomiting,
                                                          reflex to increase the produc-
                                                          tion of lung mucus

Halcion                    sed/hypnotic                   CNS depressant, blocks          Sedative-hypnotic             caution:preg X, hypersensi- rapid onset, smoking de-
                                                                                                                        tivity                      creases
Triazolam                  benzodiazepine                 cortical & limbic arousal
                                                                                                                        impaired hepatic, renal, resp effects, withdrawal S&S with
0.125-.25mg/d              use:short term treatmnt        onset 15-30 min.
                                                                                                                        side/adv-headache, dizzy       suddenly stopping drug, no
PO                         of insomnia                    duration 6-8 hr. causing
                                                                                                                        ataxia, memory loss,           alcohol
                                                          hypnotic sleep with
                                                                                                                        vision change, nausea
                                                          few residual day effects
                                                                                                                        paradox rage

Haloperidol (Haldol)       Antipsychotic, CNS depres-     Typical Antipsychotic                                         High EPS effects, low seda- Monitor EKG, change posi-
                           sion                                                                                         tion and hypotension activity tions slowly, avoid overheat-
                                                          Dopamine antagonist                                                                          ing and extreme cold, avoid
                           Use-treat agitated states of                                                                 problems with thermoregula- sunlight and ETOH, monitor
                           psychoses, antiemetic          Ach, Histamine, alpha recep-                                  tion , ventricular dysrhythmia aims, onset 2-3 weeks
                                                          tor antagonist


Haloperidol (Haldol)       antipsychotic                  decreases psychotic manife-                                   acetaminophen (Tylenol)        non-narcotic analgesic
                                                          stations and exerts antiemet-
2mg IV q 6 h               relieve client’s anxiety       ic effect                                                     650 mg PO q 8 h                relief for mild pain
                                                                                                                                                                          Page 42 of 99
Drug Name                   Class                          Actions                          Indications                     Side Effects                     Nursing implications

HCTZ 25MG PO QD             Thiazide diuretic- helps re-   Inhibits reabsorption of so-                                     Dizziness, vertigo, paresthe-    Monitor client’s urinary out-
                            duce blood pressure b re-      dium and chloride in distal                                      sias, weakness, headache,        put
                            moving excess water            renal tubule, increasing the                                     drowsiness, fatigue, leuko-
                                                           excretion of sodium, chloride,                                   penia, thrombocytopenia,         Monitor client’s weight regu-
                                                           and water by the kidney.                                         agranulocytosis, aplastic        larly
                                                                                                                            anemia, neutropenia Orthos-      Teach client to avoid sudden
                                                                                                                            tatic hypotension, venous        changes in position
                                                                                                                            thrombosis, volume deple-
                                                                                                                            tion, cardiac arrhythmias,       Monitor for s/s of dehydration
                                                                                                                            chest pain Nausea, anorexia,     Monitor client’s sodium and
                                                                                                                            vomiting, dry mouth, diarr-      potassium levels
                                                                                                                            hea, constipation, jaundice,
                                                                                                                            hepatitis, pancreatitis Polyu-
                                                                                                                            ria, nocturia, impotence, loss
                                                                                                                            of libido

Heparin                     anticoagulant                  Inhibits thrombus and clot       prevention and treatment of     uncontrolled bleed-              monitor PTT, monitor K+
                                                           formation by blocking the        venus thrombosis; pulmo-        ing;bruising; hyperkalemia;      levels, teach pt. about avoid-
                                                           conversion of prothrombin to     nary embolism; and a-fib with   suppression of renal func-       ing sharp objects, watch for
                                                           thrombin and fibrinogen to       embolization                    tions (long-term high dose       bleeding when brushing
                                                           fibrin the final steps in the                                    therapy)                         teeth, apply pressure to all
                                                           clotting process                                                                                  injection sites, do not give IM
                                                                                                                                                             injections to pt. on heparin

Heparin                     Anticoagulant as prophylaxis Inhibits thrombus and clot                                         Bruising; thrombocytopenia; Monitor client’s PTT levels
                            for DVT                      formation by blocking the                                          elevated AST, ALT levels,
5000U= 0.5mL (10,000 unit                                conversion of prothrombin to                                       hyperkalemia Chills, fever, Monitor client for occult stool
mL)                                                      thrombin and fibrinogen to                                         urticaria, asthma           Monitor client for bruising
SC Q12H                                                  fibrin, the final steps in the                                                                 and evidence of bleeding
                                                         clotting process.


heparin sodium                                             Accelerates formation of                                         Anaphylaxis, Hemorrhage,         Draw baseline PTT
                                                           antithrombin-III-thrombin                                        Thrombo-cytopenia, White
5,000 Units SQ Q12º         Intrinsic Anticoagulant        complex and deactivates                                          clot syndrome                    Do not aspirate before or
                                                           thrombin preventing conver-                                                                       massage after injection
                                                           sion of fibrinogen to fibrin.                                                                     Monitor PTT and platelet
                            DVT Prophylaxis                                                                                                                  count regularly
                                                                                                                                                             Monitor for bruises, pete-
                                                                                                                                                             chiae, hematuria, hemate-
                                                                                                                                                             mesis, or melena
                                                                                                                                                          Page 43 of 99
Drug Name                     Class                         Actions                         Indications   Side Effects                       Nursing implications

Heparin sodium                Prophylaxis (prevents dis-    Strongly acidic, high molecu-                 Spontaneous bleeding, fever,       Lab tests: Baseline blood
                              ease) and treatment of ven-   lar weight mucopolysaccha-                    chills, skin rashes, itching       coagulation tests, Hct, Hgb,
IV 50 u/kg bolus, then 20,000 ous thrombosis and pulmo-     ride with rapid anticoagulant                 and burning sensations of          RBC, and platelet counts
    2
u/m /24 h or 50–100 u/kg q4h nary embolism                  effect.                                       feet, numbness and tingling        prior to initiation of therapy
or 15–25 u/kg/h=range                                                                                     of hands and feet, elevated        and at regular intervals
4,284u-7,140u                                                                                             BP, headache, nasal con-           throughout therapy. Monitor
                                                                                                          gestion, suppressed renal          vital signs. Report fever, drop
                                                                                                          function, injection site reac-     in BP, rapid pulse, and other
Dose: 10,000 units iv flsk                                                                                tions: pain and itching            S&S of hemorrhage. Ob-
      10 units iv qd                                                                                                                         serve all needle sites daily
                                                                                                                                             for inflammation.
      10 units iv flsk


Heparin Sodium                Intrinsic Anticoagulant       Accelerates formation of                      Anaphylaxis, Hemorrhage,           Draw baseline PTT
                                                            antithrombin-III-thrombin                     Thrombo-cytopenia, White
5000 Units/ SQ/ Q8H                                         complex and deactivates                       clot syndrome                      Do not aspirate before or
                                                            thrombin preventing conver-                                                      massage after injection
                              DVT Prophylaxis
                                                            sion of fibrinogen to fibrin.                                                    Monitor PTT and platelet
                                                                                                                                             count regularly
                                                                                                                                             Monitor for bruises, pete-
                                                                                                                                             chiae, hematuria, hemate-
                                                                                                                                             mesis, or melena

Heparin sodium (pork)         Anti-coagulant, used to flush Strongly acidic, high molecu-                 Spontaneous bleeding, Injec-       Lab tests: Baseline blood
                              IV access to prevent throm- lar weight mucopolysaccha-                      tion site reactions: pain, itch-   coagulation tests, Hct, Hgb,
                              bosis.                        ride with rapid anticoagulant                 ing, ecchymoses, tissue irri-      RBC, and platelet counts
                                                            effect. Prepared from bovine                  tation and                         prior to initiation of therapy
                                                            lung tissue or porcine intes-                                                    and at regular intervals
                                                            tinal mucosa.                                                                    throughout therapy.

Heparin Sodium Drip           Cardiovascular System         Accelerates formation of                      Anaphylaxis, Hemorrhage,           Draw baseline PTT
                                                            antithrombin-III-thrombin                     Thrombo-cytopenia, White
25000 Unit in D5W 250mL       Intrinsic Anticoagulant       complex and deactivates                       clot syndrome                      Do not aspirate before or
                                                            thrombin preventing conver-                                                      massage after injection
(100units/mL premix)
                                                            sion of fibrinogen to fibrin.                                                    Monitor PTT and platelet
IV / PRN                      DVT Prophylaxis                                                                                                count regularly
                                                                                                                                             Monitor for bruises, pete-
                                                                                                                                             chiae, hematuria, hemate-
                                                                                                                                             mesis, or melena

Heparin sodium, pork          Anticoagulant                 Block clotting cascade to                     Bleeding,bruising                  Monitor for bruising and
                                                            prevent clot from increasing                                                     bleeding, rotate site
                              Use:treat or prevent DVT,
                              CVA
                                                                                                                                                                                Page 44 of 99
Drug Name                      Class                         Actions                          Indications                         Side Effects                     Nursing implications

Hespan, hetastarch             electrolyte                   expands plasma volume and plasma expander, conti-                    ha, edema of legs and eyes,      use caution in pts with liver
                                                             provides fluid replacement nuous flow centrifugation                 n/v, dilution of clotting fac-   dysfunction, not a substitute
                                                                                        leukapheresis                             tors, fluid overload, muscle     for blood or plasma, monitor
                                                                                                                                  pain, wheezing, fever, urtica-   renal function, dc if allergic
                                                                                                                                  ria                              reaction, when giving for
                                                                                                                                                                   continuous flow centrifuga-
                                                                                                                                                                   tion, usually use one part
                                                                                                                                                                   hetastarch to eight pars ven-
                                                                                                                                                                   ous whole blood

Hydralazine (apresoline)       antihypertensive, vasodilator unknown, a direct-acting         used for hypertension               orthostatic hypotension, ta-     explain to client about or-
                                                             vasodilator that primarily                                           chycardia, edema, angina         thostatic hypotension monitor
                                                             relaxes arteriolar smooth                                                                             BP to see if or how it is work-
                                                             muscle                                                                                                ing. Monitor CBC for de-
                                                                                                                                                                   crease in neutrophil, WBC,
                                                                                                                                                                   platelet and RBC's

Hydrochlorothiazide (Esidrex, Diuretic, thiazide             Promote diuresis by decreas-     Edema, CHF, hypertension,           electrolyte imbalances, pare-    Monitor CBC, glucose, elec-
Ezide, hydrodiuril, Oretic                                   ing the rate at which sodium     premenstrual tension, nephri-       thesias, orthostatic hypoten-    trolytes, Ca, Mg, renal and
                                                             and chloride are reabsorbed      tis, renal failure, hepatic cirr-   sion, MI, photosensitivity,      LFTs, Check uric acid levels,
                                                             by the distal renal tubules of   hosis                               hyperglycemia, blurred vision    Assess skin turgor, mucous
                                                             the kidney, force excretion of                                                                        membranes, extremities,
                                                             additional water, increase                                                                            lung sounds, avoid K+ deple-
                                                             excretion of potassium, and                                                                           tion in cirrhosis and hepatic
                                                             bicarbonate, as well as de-                                                                           encephalopathy
                                                             crease the excretion of cal-
                                                             cium and uric acid

Hydrochlorothiazide (Hydrodi- Thiazide diuretic              Diuretic. Enhances transport                                         Hypokalemia, hypercalce-         Change positions slowly,
uril )                                                       of Na+ ions across renal                                             mia, hypotension mood            monitor electrolytes, (espe-
                              Use: treat edema of CHF,       tubule, causing excretion of                                         changes, weakness, pares-        cially K+ ) bun,
                              hypertension                   Na+, CL, K+, HCO3 and                                                thesia, dry mouth, agranulo-
                                                             water                                                                cytosis                          creatinine, monitor BP, I/O,
25mg, PO, QD, P                renal disease                                                                                                                       may cause hyperglycemia
                                                                                                                                                                   and lose of glucose control


Hydrocodone 5mg/ Acetami-      Opioid with acetaminophen,  Action similar to codeine, but                                         Side effects less than mor-      Monitor respirations
nophen 500 mg                                              more addicting, CNS opioid                                             phine: Constipation, N&V,
                               Use: analgesic for moderate receptor binding                                                       drowsy, resp depressionn,        Monitor for pain relief
(Vicodin / Lortab)             to moderately severe pain
                               and anxiety inhibit cough                                                                          Orthostatic hypotension,         monitor vitals
                                                                                                                                  urinary retention                give with food or milk
                                                             Suppresses cough reflex
2 tab / PRN /
                                                                                                                                                                   monitor bowel elimination
Max APAP=4000 mg/day
                                                                                                                                                            Page 45 of 99
Drug Name                   Class                          Actions                        Indications          Side Effects                    Nursing implications

Hydrocodone 5mg/ Acetami-   Opioid with acetaminophen,  Action similar to codeine, but                         Side effects less than mor-     Monitor respirations
nophen 500 mg                                           more addicting, CNS opioid                             phine: Constipation, N&V,
                            Use: analgesic for moderate receptor binding                                       drowsy, resp depression,        Monitor for pain relief
(Vicodin)                   to moderately severe pain
                            and anxiety inhibit cough   Relief of moderate to mod-                             Orthostatic hypotension,        monitor vitals
2 tabs PO q 6 hours PRN                                 erately severe pain; sup-                              urinary retention               give with food or milk
                                                        press cough

Hydrocolloid dressing       Flexible hydroactive dressing Flexible hydroactive dressing Skin                   Microbial infection masked      Clean wound before applica-
                                                          that controls the asorption of                                                       tion. Leave in place 1-7 days.
(Duoderm )                  Use: local management of      wound fluid exudates by inte-                                                        Discontinue and treat with
                            pressure ulcers, sores with   raction with the exudate                                                             antibiotic for infection
                            diabetes mellitus
wafer 1-5 each PRN

Hydrocortisone              Glucocorticoid and Mineralo- Suppress fibroblast forma-     Steroid                HA, increased ICP, embol-       Give oral drug with food,
                            corticoid, anti-inflammatory tion, reduces capillary per-                          ism, tachycardia, hypergly-     often alternate day regimen,
                                                         meability and dilation, in-                           cemia, menstrual problems, ,    stop gradually, increase dose
                            Use: replacement therapy for creases sensitivity to cate-                          blurred vision, electrolyte     with stress of illness or sur-
                            adrenal insufficiency, sup-  cholamines, promotes Na+                              imbalance, HT, CHF, throm-      gery, monitor wt, CBC, BP,
                            press immune and inflamma- retension and K+ excretion,                             bocytopenia, acne, thin skin,   BS, albumin, electrolytes
                            tory responses               increases glomerular filtra-                          weakness, delayed wound
                                                         tion, promotes protein and fat                        healing, masked infection,
                                                         metabolism of liver                                   muscle wasting, cataracts,
                                                                                                               osteoporosis, hyperglycemia

Hydrocortisone 50 mg IV     Glucocorticoid                 Decrease inflammation          Steroid              Sweating, embolism, tach,    K+, glucose, I&O, edema,
q12h,                                                                                                          edema, fungal infections,    weight, infection, WBC, men-
                                                                                                               diarrhea, N&V, Thrombocy- tal status, inflammation
                                                                                                               topenia, secondary infection

Hydrolazin (alpresoline)    Vasodilator long action        Direct peripheral arteriolar   Cardiac Medication   Hypotension, tachycardia        Take with food, monitor wt,
                                                           vasodilator                                                                         edema, may b e toxic with vit
                            Use: treat HTN by decreas-                                                         Angina, dysrhythmias, ede- B, sexual dysfunction, cau-
                            ing BP and decreasing after-                                                       ma, peripheral neuritis, fever, tion OTC cold meds
                            load                                                                               tingling.GI
                                                                                                               upset

Hydromorphone HCl (Dilau-   Opioid, semi-synthetic      Bind to opioid receptors in                             Side effects less than mor-    IV dilute in at least 5 ml .9ns,
did)                                                    CNS and CSF to inhibit noci-                           phine: Constipation, N&V,       2 mg over 3-5 min, assess
                            Use: analgesic for moderate ceptive pain,                                          drowsy, resp depressn,          baseline resp rate and
                            to severe pain and anxiety                                                                                         rhythm and pupil size, may
                            inhibit cough                                                                      Orthostatic hypotension,        produce reduced sigh lead-
                                                                                                               urinary retension               ing to atelectasis, bowel pro-
                                                                                                                                               tocol, avoid ETOH
                                                                                                                                                                       Page 46 of 99
Drug Name                     Class                       Actions                         Indications                     Side Effects                    Nursing implications

Hydromorphone HCl (Dilau-     Opioid, semi-synthetic      Bind to opioid receptors in                                     Side effects less than mor-     IV dilute in at least 5 ml .9ns,
did)                                                      CNS and CSF to inhibit noci-                                    phine: Constipation, n&v,       2 mg over 3-5 min, assess
                              Use: analgesic for moderate ceptive pain,                                                   drowsy, resp depressn,          baseline resp rate and
                              to severe pain and anxiety                                                                                                  rhythm and pupil size, may
                              inhibit cough                                                                               Orthostatic hypotension,        produce reduced sigh lead-
                                                                                                                          urinary retension               ing to atelectasis, bowel pro-
                                                                                                                                                          tocol, avoid ETOH

Hydromorphone hydrochloride narcotic analgesic            7-10 times more analgesic       analgesia for moderate to       respiratory depression, ap-     document type, location,
(Dilaudid)                                                than morphine with a shorter    severe pain, can be used in     nea, layngospasm, flushing,     onset, and characteristics of
                                                          duration of action; manifests   concentration for those tole-   insomnia, constipation, seda-   symptoms, use a rating scale
                                                          less sedation, less vomiting,   rant to narcotics               tion                            to rate pain; assess for respi-
                                                          and less nausea than mor-                                                                       ratory depression, do not
                                                          phine, although it produces                                                                     stop suddenly with long term
                                                          pronounced resp depression                                                                      use, increase intake of fluids
                                                                                                                                                          and fiber to offset constipat-
                                                                                                                                                          ing effects

Hydromorphone hydrochloride narcotic analgesic            7-10 times more analgesic       analgesia for moderate to       respiratory depression, ap-     document type, location,
(Dilaudid)                                                than morphine with a shorter    severe pain, can be used in     nea, laryngospasm, flushing,    onset, and characteristics of
                                                          duration of action; manifests   concentration for those tole-   insomnia, constipation, seda-   symptoms, use a rating scale
                                                          less sedation, less vomiting,   rant to narcotics               tion                            to rate pain; assess for respi-
                                                          and less nausea than mor-                                                                       ratory depression, do not
                                                          phine, although it produces                                                                     stop suddenly with long term
                                                          pronounced resp depression                                                                      use, increase intake of fluids
                                                                                                                                                          and fiber to offset constipat-
                                                                                                                                                          ing effects

Hydroxide (Milk of Magnesia ) Laxative saline; antacid    Increases osmotic pressure, Laxative                            Muscle weakness, sweating, I&O, constipation, cramping,
30 ml                                                     draws, fluid into colon, neu-                                   confusion, flaccidity, hypo- MG toxicity, thirst, confusion,
                                                          tralizes HCL                                                    thermia, heart block, N&V,   blurred vision, edema in feet,
                                                                                                                          Electrolyte, fluid imbalance

Hydroxyurea, Ddroxia, Hydrea antimetabolities             unknown thought to inhibit      resistant chronic myelocytic GI effects, leukopenia,            monitor BUN, uric acid, crea-
                                                          DNA synthesis                   leukemia, and other cancers thrombocytopenia, bone              tinine levels, blood test every
                                                                                                                       marrow suppression hyper-          2 wks, I & O and keep pt well
                                                                                                                       uricemia, sz, hallucinations,      hydrated, allopurinol is given
                                                                                                                       HA, dizziness, disorientaion,      for prevention of tumor lysis
                                                                                                                       malaise                            syndrome, WBC count, labs
                                                                                                                                                          are expected to be abnormal
                                                                                                                                                          however toxic when neutro-
                                                                                                                                                          phil <2000, platelets <80,
                                                                                                                                                          000, and hemoglobin <4.9
                                                                                                                                                                           Page 47 of 99
Drug Name                     Class                          Actions                         Indications                      Side Effects                    Nursing implications

Hydroxyurea, Ddroxia, Hydrea Antimetabolities                unknown thought to inhibit      Atineoplastic                    GI effects, leukopenia,         monitor BUN, uric acid, crea-
                                                             DNA synthesis                                                    thrombocytopenia, bone          tinine levels, blood test every
                              Use: treat resistant chronic                                                                    marrow suppression hyper-       2 wks, I & O and keep pt well
                              myelocytic leukemia, polycy-                                                                    uricemia, sz, hallucinations,   hydrated, allopurinol is given
                              themia and other cancers                                                                        HA, dizziness, disorientaion,   for prevention of tumor lysis
                                                                                                                              malaise                         syndrome, WBC count, labs
                                                                                                                                                              are expected to be abnormal
                                                                                                                                                              however toxic when neutro-
                                                                                                                                                              phil <2000, platelets <80,
                                                                                                                                                              000, and hemoglobin <4.9

hydroxyurea, Ddroxia, Hydrea antimetabolities                unknown thought to inhibit      resistant chronic myelocytic GI effects, leukopenia,             monitor BUN, uric acid, crea-
                                                             DNA synthesis                   leukemia, and other cancers thrombocytopenia, bone               tinine levels, blood test every
                                                                                                                          marrow suppression hyper-           2 wks, I & O and keep pt well
                                                                                                                          uricemia, sz, hallucinations,       hydrated, allopurinol is given
                                                                                                                          HA, dizziness, disorientation,      for prevention of tumor lysis
                                                                                                                          malaise                             syndrome, WBC count, labs
                                                                                                                                                              are expected to be abnormal
                                                                                                                                                              however toxic when neutro-
                                                                                                                                                              phil <2000, platelets
                                                                                                                                                              <80,000, and hemoglobin
                                                                                                                                                              <4.9

Hydroxyzine                   antianxiety drug antihista-    actions may be due to su-    relief of anxiety and tension drowsiness involuntary motor use caution while driving or
                              mine antiemetic                pressionof subcortical areas associated with psychoneuri- activity including tremor and operating machinery
                                                             of the CNS,                  sis                           convulsions dry mouth

hydroxyzine                   antianxiety drug antihista-    actions may be due to sup- relief of anxiety and tension         drowsiness involuntary motor use caution while driving or
                              mine antiemetic                pression of subcortical areas associated with psychoneu-         activity including tremor and operating machinery
                                                             of the CNS,                   rosis                              convulsions dry mouth

Ibuprofen                     NSAID, analgesic               anti inflammatory analgesic     relief of rheumathoid arthritis dizziness somnolence in-   administer with meals moitor
                                                                                             and osteoarthritis relif of mild somnia nausea dspepsia GI for symptoms of liver dysfun-
                                                                                             to moderate pain fever re-       pain bleeding             citon renal impairment
                                                                                             duction

ibuprofen                     NSAID,analgesic                anti inflammatory analgesic     relief of rheumatoid arthritis   dizziness somnolence in-   administer with meals moni-
                                                                                             and osteoarthritis relief of     somnia nausea dyspepsia GI tor for symptoms of liver dys-
                                                                                             mild to moderate pain fever      pain bleeding              function renal impairment
                                                                                             reduction

Ibuprofen (Motrin or Advil)   Relief of mild to moderate     Prototype of the propionic                                       Prototype of the propionic      Drowsiness, CHF, hyperten-
                              pain;                          acid NSAIDs (cox-1) inhibitor                                    acid NSAIDs (cox-1) inhibitor   sion, impaired hearing, nau-
                                                             with nonsteroidal anti-                                          with nonsteroidal anti-         sea, vomiting, diarrhea, con-
                              Reduction of fever.            inflammatory activity and                                        inflammatory activity and       stipation, decreased Hgb and
                                                             significant antipyretic and                                      significant antipyretic and     Hct, acute renal failure.
                                                             analgesic properties.                                            analgesic properties.
                                                                                                                                                                                 Page 48 of 99
Drug Name                     Class                           Actions                             Indications                     Side Effects                      Nursing implications

Imipenem-Cilistatin sodium    Antiinfective, Beta-lactam      Inhibits cell wall synthesis                                        HA, seizure, dizzy, tremors,      Not c LR, not stable in dex IV
(Primaxin )IV 250mg q12h      antibiotic                                                     rd                                   N&V, pseudomembranous             p 4h
                                                              Broader spectrum than all 3                                         colitis, heart burn, dyspnea
Infuse over 30 min            Use: treat serious intraab-     gen cephalosporins                                                  Increases BUN, CR                 Not for IV push
                              dominal infections resistant
                              to other antibiotics, treat en-                                                                     Decreases Hgb , Hct               If nausea, slow down rate of
                              docarditis                                                                                                                            IV, monitor renal and liver
                                                                                                                                                                    function

Imipramine (tofranil)         Tricyclic antidepressant        Inhibits reuptake of synaptic                                       Sedation, paresthesias, EPS,      increase stage 4 sleep, not
                                                              serotonin and norepinephrine                                        altered EKG, lower seizure        with ECT, not with ETOH ,
                              Use-treat depression, anxiety                                                                       threshold , altered cognition,    monitor EKG, avoid temp.
                                                                                                                                  altered thermal regulation        extremes

Imitrex (Sumatriptan succi-   antimigraine drug               causes vasoconstriction and         treatment of acute migraine     coronary vasospasm in             document headache charac-
nate)                                                         therefore relief of migraine,       attacks with or without aura,   clients with a hx of CAD, life-   teristics including onset, fre-
                                                              selective agonist for a vascu-      acute treatment of cluster      threatening arrhythmias,          quency, type, and duration of
                                                              lar receptor located on crani-      headaches                       flushing, palpitations, throat    symptoms, rate pain, deter-
                                                              al arteries, on the basilar                                         discomfort, GI bleeding, dy-      mine cardiac problems, as-
                                                              artery, and vasculature of the                                      suria, dysmenorrhea, muscle       sess ECG, liver, renal func-
                                                              dura mater                                                          stiffness, hyperglycemia,         tion, monitor VS, expect
                                                                                                                                  hypoglycemia, hypothyroid-        transient increases in BP
                                                                                                                                  ism

Imuran, azathioprine, thio-   immunosuppressant               cross links strands of cellular immunosuppression in kid-           pancreatitis, GI effects, leu-    caution with hepatic pts, give
prine                                                         DNA, and interferes with        ney transplantation, and re-        kopenia, immunosuppres-           before meals, avoid all IM
                                                              RNA transcription causing an fractory rheumatoid arthritis          sion, hepatotoxicity, infec-      injections if platelet is <100,
                                                              imbalance and cell death.                                           tions, arthalgia, myalgia,        000, CBC, and platelet week-
                                                              Not specific to cell cycle                                          thrombocytopenia, myelo-          ly for 1st month and then
                                                                                                                                  suppression, anemia               monthly, monitor for hepatic
                                                                                                                                                                    dysfunction such as clay
                                                                                                                                                                    stool dark urine yellow skin
                                                                                                                                                                    and pruritus and increased
                                                                                                                                                                    hepatic values, don't use in
                                                                                                                                                                    pregnant women for treat-
                                                                                                                                                                    ment of arthritis

Insulin 10u SQ TID, AC        Antidiabetic agent used to      Insulin is a hormone that, by                                       Rash, anaphylaxis or an-          Monitor glucose level prior to
                              help control blood glucose      receptor-mediated effects,                                          gioedema, hypoglycemia;           administration
                              level                           promotes the storage of the                                         ketoacidosis
                                                              body's fuels, facilitating the                                                                        Monitor for s/s/ of hypogly-
                                                              transport of metabolites and                                                                          cemia after administration
                                                              ions (potassium) through cell                                                                         Make sure the client eats
                                                              membranes and stimulating                                                                             shortly after administration
                                                              the synthesis of glycogen
                                                              from glucose, of fats from                                                                            Promote proper nutrition to
                                                              lipids, and proteins from                                                                             help keep glucose levels
                                                              amino acids.                                                                                          under control
                                                                                                                                                                          Page 49 of 99
Drug Name                   Class                           Actions                         Indications                      Side Effects                    Nursing implications

Insulin 2 units SC AC/HS/   Insulin Hormone For Diabet- Increases glucose transport                                          Hypoglycemia, decreased         Monitor for signs of hypogly-
NPH 20u SC BID-Meal         ics When Insulin Insufficien- across muscle and fat cell                                         serum magnesium, potas-         cemia, and allergic reactions,
                            cy Is Present                 membranes to reduce blood                                          sium levels rash uticaria       remember to rotate injection
                                                          glucose level promotes con-                                        stinging and warmth at injec-   sites, remember to use unit
                                                          version of glucose to its sto-                                     tion site                       measurement syringes
                                                          rage form glycogen

Insulin 70/30 human         Antidiabetic, synthetic short   Binds with insulin receptor to Anti-diabetic                     Allergy reaction to insulin     Avoid ETOH, salicylates may
                            and long acting                 transport glucose across cell                                    animal protein                  potentiate hypoglycemic ef-
Novolin                                                     membrane into cell                                                                               fects. Monitor for S&S hy-
                            Use: treat hyperglycemia of                                                                      Hypoglycemic s&s-               po/hyperglycemia
Sliding scale               DM
                                                                                                                             Sweating, tremors, HA, hun-
                                                                                                                             ger,
                                                                                                                             Weakness, circumoral, vision
                                                                                                                             changes, CNS effects

Insulin glargine (Lantus)   Synthetic long acting antidia- long-acting recombinant hu-      treatment of adult/pediatric     Hypoglycemic S&S:            Do not mix with other insulin.
                            betic                          man insulin analog, designed     clients with type 1 diabetes                                  Note onset, other agents
                                                           to have low aqueous solubili-    mellitus or adults with type 2   Sweating, tremors, HA, hun- trialed and outcome, monitor
                                                           ty at neutral pH 4, it is com-   diabetes mellitus who require    ger,                         BS, electrolytes, HbA1c, UA,
                            Use: treat hyperglycemia of pletely soluble                     long-acting insulin to control   Weakness, circumoral, vision micro albumin, liver and ren-
                            DM Type I and Type II                                           hyperglycemia                    changes, CNS effects         al function; adjust dosage
                                                                                                                                                          with hepatic/renal dysfunc-
                                                                                                                                                          tion. salicylates may poten-
                                                                                                                                                          tiate hypoglycemic effects.
                                                                                                                                                          Monitor for S&S hy-
                                                                                                                                                          po/hyperglycemia

Insulin lispro (Humalog)    insulin is clear onset imme-    rapid acting insulin derived    for the use of type 1 diabet-    hypoglycemia , decreased        monitor for signs of hypogly-
                            diate peak 0.5-1.5 hrs dura-    from E. coli that has been     ics who are insulin depen-        serum magnesium, potas-         cemia, and allergic reactions,
                            tion 2-4 hrs                    genetically altered by the     dent                              sium levels rash urticaria      remember to rotate injection
                                                            addition of the gene for insu-                                   stinging and warmth at injec-   sites, remember to use unit
                                                            lin lispro                                                       tion site                       measurement syringes

Insulin Novalog             onset 15 min peak 1-3 hrs       increases glucose transport for the use of type 1 diabet-        hypoglycemia , decreased        monitor for signs of hypogly-
                            duration 3-5 hrs                across muscle and fat cell     ics who are insulin depen-        serum magnesium, potas-         cemia, and allergic reactions,
                                                            membranes t reduce blood dent                                    sium levels rash urticaria      remember to rotate injection
                                                            glucose level promotes con-                                      stinging and warmth at injec-   sites, remember to use unit
                                                            version of glucose to its sto-                                   tion site                       measurement syringes
                                                            rage form glycogen
                                                                                                                                                                  Page 50 of 99
Drug Name               Class                          Actions                           Indications               Side Effects                      Nursing implications

Insulin NPH             Intermediate-acting, cloudy    Lowers blood glucose levels                                 Suspect hypoglycemia if           Give NPH insulin 30 AC AM.
                        suspension of zinc insulin     by increasing peripheral                                    fatigue, weakness, sweating,      If necessary, a second
                        crystals.                      glucose uptake, especially by                               tremor, or nervousness            smaller dose may be pre-
                                                       skeletal muscle and fat                                     occur.                            scribed 30 min before supper
                        2-4hrs Peak 4-10 hrs dura-     tissue, and by inhibiting the                                                                 or at bedtime.
                        tion 10-16 hrs                 liver from changing glycogen                                If insulin was given before
                                                       to glucose. Therapeutic                                     breakfast, a hypoglycemic         Ensure complete dispersion
                                                       effect controls postprandial                                episode is most likely to oc-     by mixing thoroughly by
                                                       hyperglycemia, usually                                      cur between mid-afternoon         gently rotating vial between
                                                       without supplemental doses                                  and dinnertime, when insulin      palms and inverting it end to
                                                       of insulin injection.                                       effect is peaking. Advise to      end several times.
                                                                                                                   eat a snack in mid-afternoon
                                                                                                                   and to carry sugar or candy       Do not shake.
                                                                                                                   to treat a reaction. A snack at   Do NOT mix insulins unless
                                                                                                                   bedtime will prevent insulin      prescribed by physician. In
                                                                                                                   reaction during the night         general, when insulin injec-
                                                                                                                                                     tion (regular insulin) is to be
                                                                                                                                                     combined, it is drawn first.
                                                                                                                                                     Note: Isophane insulin may
                                                                                                                                                     be mixed with insulin injec-
                                                                                                                                                     tion without altering either
                                                                                                                                                     solution. Do NOT mix with
                                                                                                                                                     Lente forms.

Insulin regular         is clear onset 30-60 min. increases gulcose transport for the use of type 1 diabet-        hypoglycemia , decreased          monitor for signs of hypogly-
                        peak 2-4 hrs duration 6-8 hrs across muscle and fat cell      ics who are insulin depen-   srum magnesium, potassium         cemia, and allergic reactions,
                                                      membranes t reduce blood dent                                levels rash uticaria stinging     remember to rotate injection
                                                      glucose level promotes con-                                  and warmth at injection site      sites, remember to use unit
                                                      version of glucose to its soto-                                                                measurement syringes
                                                      rage form glycogen

Insulin regular human   Synthetic short acting anti-   Binds with insulin receptor to                              Allergy reaction to insulin       Avoid ETOH, salicylates may
                        diabetic                       transport glucose across cell                               animal protein                    potentiate hypoglycemic ef-
Sliding scale                                          membrane into cell                                                                            fects. Monitor for S&S hy-
                        Use: treat hyperglycemia of                                                                                                  po/hyperglycemia
SC bid                  DM type II

Insulin, NPH            Mgt. of diabetes mellitus      Lowers blood glucose by                                     Lipodystrophy, hypoglyce-         Assess for signs of hypogly-
                        (NIDDM, Type II)               increasing transport into cells                             mia, anaphylaxis                  cemia and hyperglycemia.
                                                       and promoting hepatic con-
                                                       version of glucose to glyco-
                                                       gen.
                                                                                                                                                       Page 51 of 99
Drug Name                     Class                          Actions                          Indications   Side Effects                  Nursing implications

Insulin, Regular              Synthetic short acting anti-   Binds with insulin receptor to                 Allergy reaction to insulin   Avoid ETOH, salicylates may
                              diabetic                       transport glucose across cell                  animal protein                potentiate hypoglycemic ef-
Regular Sliding Scale                                        membrane into cell                                                           fects. Monitor for S&S hy-
                              Use: treat hyperglycemia of                                                   Hypoglycemic S&S-             po/hyperglycemia
SC ACHS                       DM type II
                                                                                                            Sweating, tremors, HA, hun-
<70 Hypoglycemic Guidelines                                                                                 ger,
70-150=0 Units                                                                                              Weakness, circumpolar, vi-
151-200=2 Units                                                                                             sion changes, CNS effects

201-250=4 Units
251-300=6 Units
301-350=8 Units
351-400=10 Units
401-450=12 Units
>450=14 Units & call HO

Insulin, Regular              Endocrine System               Increases glucose transport                    Anaphylaxis, Hypoglycemia, Monitor blood-glucose levels
                                                             across muscle and fat cell                     Hyperglycemia, Hypokale-   regularly
Vascular Sliding Scale                                       membranes to reduce glu-                       mia, Hypomagnesemia
                                                             cose level. Promotes con-                                                 Always check insulin doses
SC Q6H per                    Antidiabetic replacement                                                                                 with RN
                              therapy for deficient pancrea- version of glucose to glyco-
60-200= 0 Units               tic production of insulin in   gen.                                           Hypoglycemic S&S-             Monitor for s/s of adverse
201-250= 3 Units              Diabetes mellitus                                                             Sweating,tremors ,HA, hun-    effects
                                                                                                            ger, Weak-
251-300= 6 Units                                                                                            ness,circumoral,vision
301-350= 9 Units                                                                                            changes, CNS effects

351-400= 12 Units
>400= 15 units & call

Insulin, Regular                                             Increases glucose transport                    Anaphylaxis, Hypoglycemia, Monitor blood-glucose levels
                                                             across muscle and fat cell                     Hypergly-cemia, Hypokale- regularly
(Novolin-R)                   Antidiabetic                   membranes to reduce glu-                       mia, Hypomagnesemia
                                                             cose level. Promotes con-                                                 Always check insulin doses
2 – 10 Units SQ QAC&HS per                                                                                                             with RN
                                                             version of glucose to glyco-
Vascular Sliding Scale        Diabetes mellitus              gen.                                                                         Monitor for s/s of adverse
                                                                                                                                          effects

Interlukin 2                  Immunosuppressant              Binds to activated lympho-     Atineoplastic   Anemia, polycythemis,         Used as induction therapy,
                                                             cytes, preventing prolifera-                   thrombocytopenis, hypoten-    not continual therapy. Do not
Basilixima ( Simulect)        Use: initial induction therapy tion and limiting activation.                  sion, arrhythmias, GI symp-   shake solution
                              to prevent transplant rejec- This binding inhibits pathway                    toms
                              tion                           in immune response of lym-
                                                             phocytes involved in allograft
                                                             rejection
                                                                                                                                                        Page 52 of 99
Drug Name                     Class                          Actions                         Indications   Side Effects                    Nursing implications

Ipratroprium (Atrovent )in-   Anticholinergic                Blocks action of acetylcho-     Respiratory   Blurred vision, bitter taste,   Monitor blood level, oral
haled                                                        line in bronchial smooth                      Dry mouth, nervous, dizzy,      care, contraindicated with
                              Use: acute bronchodilation     muscle                                        fatigue, HA                     BPH or glaucoma.
                              and acute reduction of bron-
                              chial secretions                                                                                             Wait 5 minutes between
                                                                                                                                           doses, rinse mouth

Irbesartan (Avapro)           Cardiovascular agent, Angi- antagonist of hormone angi-                      tachycardia, cough, edema, 6-12 weeks for full effect
                              otensin II receptor antagonist otensin II of the RAAS sys-                   fatigue, pain, dizzy, diarrhea
                                                             tem. Selectively blocks bind-                 , rash                         monitor BP periodically
                                                             ing of AII to AT1 receptors                                                  BUN, creatinine, K, CBC
                              Use: Hypertension and CHF found in many tissues
                                                             (smooth muxcle, adrenal
                                                             glands) – blocks vasocon-
                                                             striction =antihypertensive
                                                             effect

iron (FeSO4)                  mineral                        provides elemental iron--       anemia        GI upset, constipation, disco- caution with long term use,
                                                             important component of he-                    lored stools, anorexia, tem- adm between meals if possi-
                                                             moglobin                                      porarily stain teeth           ble to decreased absorption
                                                                                                                                          when administered with food,
                                                                                                                                          monitor bum and consider
                                                                                                                                          bowel regimen, monitor he-
                                                                                                                                          moglobin, don’t give with milk
                                                                                                                                          or antacid

Iron (FeSO4)                  mineral                        provides elemental iron--       anemia        GI upset, constipation, disco- caution with long term use,
                                                             important component of he-                    lored stools, anorexia, tem- adm between meals if possi-
                                                             moglobin                                      porarily stain teeth           ble to decreased absoption
                                                                                                                                          when administered with food,
                                                                                                                                          monitor bm and consider
                                                                                                                                          bowel regimen, monitor he-
                                                                                                                                          moglobin, don’t give with milk
                                                                                                                                          or antacid
                                                               +
Iron Polysaccharide (Nu-Iron) Anemia: Low Hgb lab value. Fe is an essential mineral                        Hypotension, nausea, con- Assess bowl function
                                                         found in hemoglobin, myog-                        stipation, dark stools, diarr-
                                                         lobin, and many enzymes.                          hea, epigastric pain, staining Monitor Hgb, Hct, & reticulo-
                                                                                                           at IM site. Anaphylaxis        cyte levels
                                                                                                                                          May cause false positive
                                                                                                                                          Hemoccult test
                                                                                                                                                              Page 53 of 99
Drug Name                      Class                        Actions                         Indications        Side Effects                      Nursing implications

Isosorbide dinitrate (Iisor-   Nitrates                     Venous dilators that increase Cardiac Medication   Postural hypotension head- Give on empty stomach
dil)Nitroglycerine (Nitrodur                                venous blood capacity thus                         ache, dizzy, dry mouth, reflex
)Nitroglycerine (Nitrodisc)    Use: reduce preload, treat   reducing preload. Dilate car-                      tachycardia                    30 min ac or 2 HR pc
                               angina                       diac arteries                                                                     patch-rotate site, need nitrate
                                                                                                                                              free period, not with severe
                                                                                                                                              anemia, icp,
                                                                                                                                                 glaucoma, client sit or recline
                                                                                                                                                 monitor bp, HR baseline and
                                                                                                                                                 1 HR post med administra-
                                                                                                                                                 tion

Isosorbide Mononitrate         Cardiovascular System        Coronary vasodilator. It de-                       Orthostatic hypotension,          Give in AM on arising with
                                                            creases preload and diastolic                      syncope, dizziness, palpita-      once daily dosing. With twice
(Ismo, Imdur SR, Monoket)      Prevention of Angina         pressure with a consequent                         tions, light-headedness, se-      daily dosing regimen, give
                                                            reduction in myocardial oxy-                       vere headache, blurred vi-        first dose in AM and second
                                                            gen consumption. Isosorbide                        sion, and difficulty breathing.   dose 7 h later. Monitor car-
30mg / PO / QD / 0800                                       mononitrate is a long-acting                                                         diac status, frequency and
                                                            metabolite of the isosorbide                                                         severity of angina, and BP.
                                                            dinitrate.
                                                                                                                                                 Do not crush or chew sus-
                                                                                                                                                 tained release tablets. May
                                                                                                                                                 split tabs.
                                                                                                                                                 Withdraw drug abruptly may
                                                                                                                                                 precipitate acute angina

K tabs                         Potassium gluconate          Provides principle intracellu- GI                  Flaccid paralysis, respiratory Give while patient is standing
                                                            lar cation by absorption in                        distress, cardiac depression, or sitting to avoid esophageal
                               Use: treat k+ deficiency     the intestions                                     arrhythmias,                   irritation

Kanamycin sulfate (kantrex)    Anti-infective, antibiotic   bacterialcidal –                                   agranulocytosis, nephrotoxic, monitor baseling culture and
                                                                                                               anaphlaxis, neuromuscular sensitivity
35 mg po bid                                                braod-spectrum, aminogly-                          paralysis, and (rarely) respi-
                                                            coside antibiotic                                  ratory depression              Monitor urinalysis and kidney
                                                                                                                                              function
Conc. 1000mg/3ml               Possible infection – fever                                                                                        Monitor sodium, potassium,
                               and some elevated lab val-                                                                                        calcium, and magnesium
give 0.1 ml                    ues                                                                                                               levels
                                                                                                                                                 keep patient well hydrated
                                                                                                                                                 monitor I&O
                                                                                                                                                 monitor weight
                                                                                                                                                                        Page 54 of 99
Drug Name                     Class                         Actions                          Indications                    Side Effects                   Nursing implications

Kaopectate (Imodium )30 cc    antidiarrheal                 slows intestinal motility by     symptomatic relief of acute    abdominal pain, distention,    document indications for
PO q 8 hours PRN diarrhea                                   acting on the nerve endings      nonspecific diarrhea and of    or discomfort, constipation,   therapy, onset, frequency,
                                                            and/or intramural ganglia        chronic diarrhea associated    dry mouth, N&V, epigastric     and characteristics of symp-
                                                            embedded in the intestinal       with inflammatory bowel dis-   distress, dizziness, fatigue   toms, identify any contribut-
                                                            wall, the prolonged retention    ease                                                          ing causative factors, d/c if
                                                            of the feces in the intestine                                                                  abd distention develops in
                                                            results in reducing the vo-                                                                    clients with acute ulcerative
                                                            lume of the stools, increasing                                                                 colitis
                                                            viscosity, and decreasing
                                                            fluid and electrolyte loss

Kaopectate (imodium)          Antidiarrheal                 slows intestinal motility by   GI                               abdominal pain, distention,    document indications for
                                                            acting on the nerve endings                                     or discomfort, constipation,   therapy, onset, frequency,
                              Use: symptomatic relief of    and/or intramural ganglia                                       dry mouth, N&V, epigastric     and characteristics of symp-
                              acute nonspecific diarrhea    embedded in the intestinal                                      distress, dizziness, fatigue   toms, identify any contribut-
                              and of chronic diarrhea as-   wall, the prolonged retention                                                                  ing causative factors, d/c if
                              sociated with inflammatory    of the feces in the intestine                                                                  abd distention develops in
                              bowel disease                 results in reducing the vo-                                                                    clients with acute ulcerative
                                                            lume of the stools, increasing                                                                 colitisKaopectate (Imodium)
                                                            viscosity, and decreasing
                                                            fluid and electrolyte loss

Kaopectate (Imodium) 30 cc    antidiarrheal                 slows intestinal motility by     symptomatic relief of acute    abdominal pain, distention,    document indications for
PO q 8 hours PRN diarrhea                                   acting on the nerve endings      nonspecific diarrhea and of    or discomfort, constipation,   therapy, onset, frequency,
                                                            and/or intramural ganglia        chronic diarrhea associated    dry mouth, N&V, epigastric     and characteristics of symp-
                                                            embedded in the intestinal       with inflammatory bowel dis-   distress, dizziness, fatigue   toms, identify any contribut-
                                                            wall, the prolonged retention    ease                                                          ing causative factors, d/c if
                                                            of the feces in the intestine                                                                  abd distention develops in
                                                            results in reducing the vo-                                                                    clients with acute ulcerative
                                                            lume of the stools, increasing                                                                 colitis
                                                            viscosity, and decreasing
                                                            fluid and electrolyte loss

KCl: Potassium Chloride (K-   Electrolyte replacement     Major ICF cation, responsible GI                                  Diarrhea, weakness, oliguria, Swallow sitting up, follow
Dur)                                                      for conducting nerve im-                                          ECG changes                   with full glass liquid, monitor
                              Use: treat hypokalemia from pulses                                                                                          LOC, EKG, F?E, weakness
                              N&V
                                                                                                                                                                      Page 55 of 99
Drug Name                   Class                          Actions                           Indications                  Side Effects                   Nursing implications

Labetalol                   Treatment of HTN.              competitively blocks stimula-                                  Hypotension, bradycardia,   monitor b/p at the beginning
                                                           tion of b-adrenergic receptor                                  CHF, wheezing, hy-          of treatment , monitor skin
(Normodyne, Trandate)       beta blocker                   within vascular smooth mus-                                    po/hyperglycemia, withdraw- turgor, assess for edema,
                            decreases blood pressure       cle, produces chronotropic,                                    al rebound effect,
                                                           inotropic activity
                                                                                                                          bronchoconstriction, head-
                                                                                                                          ache
                                                                                                                          cold hands& feet, dreams,
                                                                                                                          heartburn, dry mouth, con-
                                                                                                                          gestion
                                                                                                                          caution w/ Ca channel block-
                                                                                                                          er

Lactulose 30cc PO TID PRN   Laxative / constipation        Increases osmotic pressure        GI                           N&V, anorexia, ABD cramps, Glucose levels, blood in
Constipation                                               in the bowel                                                   flatulence, distention, belch- urine, I&O, electrolytes,
                                                                                                                          ing                            cramping, rec bleeding, mon-
                                                                                                                                                         itor ammonia levels

Lanoxin                                                    Inhibits sodium-potassium                                      Anorexia, Arrhythmias,         Monitor apical pulse prior to
                                                           activated ATP, promoting                                       Blurred vision, Diplopia, Hal- giving Monitor I/O
(digoxin)                   Inotropic Antiarrhythmic       movement of calcium from                                       lucinations, Photophobia                +
                                                           extracellular to intracellular,                                                               Monitor K levels
0.125 mg PO QAM
                                                           strengthening myocardial                                                                      Monitor digoxin levels
                            HTN                            contraction, slowing conduc-
                                                           tion from SA  AV node.

lansoprazole (prevacid)     cns agent, proton-pump inhi- inhibits secretion of gastric                                    diarrhea, abdominal pain.      monitor ofr significant diarr-
                            bitor/                       acid from parietal cells, inhi-                                  constipation, headache         hea or constipation
                                                         bits h+, k=-atpase enzyme
                                                         pumps                                                                                           Monitor cbc, bun, creatinine,
                                                                                                                                                         liver function tests

                            antacid
30 mg, ng, qd                                                                                                                                            give on an empty stomach




Lasix                                                      A loop diuretic that inhibits     To reduce pre-load, reduce   Bone marrow depression,        Monitor weight, VS, BP,
                                                           sodium and chloride reab-         pulmonary edema and peri-    Ototoxicity, Pancreatitis      CDP, and UOP routinely
(furosemide)                Loop Diuretic                  sorption at the proximal and      pheral edema
                                                           distal tubules and the as-                                                                    Monitor I/O, BUN, Cr, CO2,
20 mg IV QD                                                                                                                                              and electrolytes routinely
                                                           cending loop of Henle.
                            Acute Pulmonary Edema                                                                                                        (CMP)
                                                                                                                                                         Monitor for hypokalemia.
                                                                                                                                                                      Page 56 of 99
Drug Name                    Class                       Actions                           Indications                  Side Effects                     Nursing implications

Lasix                        Loop Diuretic               A loop diuretic that inhibits     To reduce pre-load, reduce   Bone marrow depression,          Monitor weight, VS, BP,
                                                         sodium and chloride reab-         pulmonary edema and peri-    Ototoxicity, Pancreatitis        CDP, and UOP routinely
(furosemide)                                             sorption at the proximal and      pheral edema
                                                         distal tubules and the as-                                                                      Monitor I/O, BUN, Cr, CO2,
40 mg PO BID                 Acute Pulmonary Edema                                                                                                       and electrolytes routinely
                                                         cending loop of Henle.
                                                                                                                                                         (CMP)
                                                                                                                                                         Monitor for hypokalemia.

Lasix 80mg PO QD             Diuretic—used to promote    A loop diuretic that inhibits                                  Dizziness, vertigo, paresthe-    Monitor for urine output
                             urination of excess fluid   the reabsorption of sodium                                     sias, xanthopsia, weakness,
                                                         and chloride, this allows for a                                headache, drowsiness, fati-      Monitor labs for electrolyte
                                                         high sodium diuresis                                           gue, blurred vision, tinnitus,   imbalances
                                                                                                                        irreversible hearing loss,       Monitor for hearing changes
                                                                                                                        orthostatic hypotension, vo-
                                                                                                                        lume depletion, cardiac arr-     Monitor edema changes
                                                                                                                        hythmias, thrombophlebi,         Monitor blood pressure
                                                                                                                        photosensitivity, rash, pruri-   changes
                                                                                                                        tus, urticaria, nausea, ano-
                                                                                                                        rexia, vomiting, oral and gas-
                                                                                                                        tric irritation, constipation,
                                                                                                                        diarrhea, acute pancreatitis,
                                                                                                                        jaundice, polyuria, nocturia,
                                                                                                                        glycosuria, urinary bladder
                                                                                                                        spasm, leukopenia, anemia,
                                                                                                                        thrombocytopenia, fluid and
                                                                                                                        electrolyte imbalances, mus-
                                                                                                                        cle cramps and muscle
                                                                                                                        spasms

Latanoprost (Xalatan)        Prostaglandin analog that is Reduces elevated intraocular                                  Headaches, asthenia, flu-like    Ensure that contact lenses
                             thought to reduce intraocular pressure in patients with                                    symptoms, Rash, Conjunc-         are removed prior to installa-
                             pressure (IOP) by increasing open-angle glaucoma                                           tival hyperemia, Occular irri-   tion and not reinserted for 15
0.005% Opth Sol Drops, OS,   the outflow of aqueous hu-                                                                 tation                           min after installation.
QHS (P)                      mor
                                                                                                                                                         Apply only to affected eye(s).
                                                                                                                                                         Ensure that only one drop is
                                                                                                                                                         instilled.
                                                                                                                                                         Do not allow tip of dropper to
                                                                                                                                                         touch eye.
                                                                                                                                                         Wait at least 5 min be-
                                                                                                                                                         fore/after instillation of other
                                                                                                                                                         eye drops.
                                                                                                                                                                         Page 57 of 99
Drug Name                         Class                        Actions                         Indications               Side Effects                       Nursing implications

Leucovoorin calcium (rescue) vitamin and mineral               reduced form of folic acid      Atineoplastic             urticaria, anaphylactoid reac- IV route preferred in pts with
wellcovorin                                                    that is readily converted to                              tions                          GI toxicity, follow schedule of
                             use: treat overdose of folic      other tetrahydrofolic deriva-                                                            drug closely, protect from
                             acid antagonist (methotrex-       tives                                                                                    light and heat
                             ated, trimethoprim, or pyri-
                             methamine ) folate deficient
                             megaloblastic anemia, he-
                             matologic toxicity from pyri-
                             methamine or trimethoprim
                             therapy,

Levothyroxine sodium              Thyroid Product              regulates growth by control- replacement or supplement    arrhythmias, palpitations,         Assess for fatigue, lethargy,
                                                               ling protein synthesis and    therapy in hypothyroidism   cardiac arrest, weight loss,       weight gain, puffy face and
(Eltroxin, Levothroid, Levoxyl,                                regulating energy metabol-                                heat intolerance, dyspnea          eyelids
Synthroid)                                                     ism by increasing the resting
                                                               or basal metabolic rate, in-                                                                 Obtain/monitor ECG, labs
                                                               creases respiratory rate,                                                                    Observe for bleeding,
                                                               body temperature, CO, oxy-                                                                   Monitor VS
75 mcg PO qd                                                   gen consumption, HR, blood
                                                               volume, rate of metabolism

Lidocaine                         antidysrhythmic grp 1B       0 inotropic, 0 chromotro        Cardiac Medication        dizzy, chest pain, dyspnea         IV, not for heartblock,
Xylocaine                         use:treat ventricular        Na channel blocker w/                                     vision, tinnitus                   monitor ECG, BP, electro-
                                                                                                                                                            lytes,
                                  dysrhythmias, treat          affinity for depolarized
                                                                                                                                                            lido-
                                  digoxin toxicity             or ischemic tissue                                                                           caine+epinephrine=anesthet
                                                                                                                                                            c

Lidocaine And Prilocaine          Topical anesthetic on normal Topical anesthetic prior to                               The adverse effects of lido-       Apply a thick layer to skin
(EMLA cream)                      intact skin for local anesthe- SQ injection of GCSF (Neu-                              caine could occur with large       (approximately 1/2 of 5-g
                                  sia                            pogen)                                                  doses or if there is significant   tube per 20–25 cm2 or 2 × 2
                                                                                                                         systemic absorption.               in) at site of procedure.
                                                                                                                                                            Apply an occlusive dressing.
                                                                                                                                                            Do not spread out cream.
                                                                                                                         Edema, soreness, aching,           Seal edges of dressing well
                                                                                                                         numbness, heaviness.               to avoid leakage.
                                                                                                                                                            Apply EMLA cream 1 h be-
                                                                                                                         Hematologic: Methemoglo-           fore routine procedure and 2
                                                                                                                         binemia, especially in infants,    h before painful procedure.
                                                                                                                         small children, and patients       Remove EMLA cream prior
                                                                                                                         with G6PD deficiency.              to skin puncture and clean
                                                                                                                                                            area with an aseptic solution.

                                                                                                                         Skin: Blanching and red-
                                                                                                                         ness, itching, heat sensation.
                                                                                                                                                                                Page 58 of 99
Drug Name                        Class                           Actions                           Indications                      Side Effects                   Nursing implications

LIPITOR 20 MG NG QD              Antihyperlipidemic              Inhibits HMG co-enzyme A,                                          Flatulence, abdominal pain,    Monitor liver function and
                                                                 the enzyme that catalyzes                                          cramps, constipation, nau-     lipid levels
                                 HMG CoA inhibitor               the first step in the choles-                                      sea, dyspepsia, heartburn,
                                                                 terol synthesis pathway, re-                                       liver failure                  Monitor for GI upset
                                                                 sulting in a decrease in se-
                                                                 rum cholesterol, serum
                                                                 LDLs, and increases serum
                                                                 HDLs

Lisinopril                       Anti-hypertensive               ACE inhibitor. Block conver-                                       Cough, hypotension, taste      Monitor BP and pulse, I&O,
                                                                 sion of Angiotensin I to Angi-                                     disturbances, proteinuria,     weight.
Prinivil, Zestril                                                otensin II resulting in system-                                    Agranulocytosis, angioede-
                                                                 ic vasodilatation                                                  ma

Lisinopril (prinivil, zestril, apo- Antihypertensive, ACE inhibi- Believed to suppress the         alone or in combination with     hypotension, stroke, MI,       Monitor VS (BP in both arms
lisinopril)                         tor                           renin-angiotension-              a diuretic to treat hyperten-    CVA, chest sound abnormali-    lying, sitting, standing ) elec-
                                                                  aldosteronee system, pre-        sion, with digitalis and a di-   ties, diarrhea, pulmonary      trolytes, CBC, renal, LFTs,
                                                                  vents the conversion of angi-    uretic for treating CHF not      embolism, hepatitis, blurred   check urine for protein, doc-
                                                                  otension I to angiotension II,   responding to other thera-       vision, diplopia               ument hereditary angioede-
                                                                  decreases peripheral resis-      pies, use within 24 HR of                                       ma, monitor I&Os, serum
                                                                  tance and decreased aldos-       acute MI to improve survial in                                  potassium, monitor weight,
                                                                  terone secretion (leading to     hemodynamically stable                                          assess for hypotension
                                                                  fluid loss)                      clients

Lisinopril (Prinivil, Zestril, Apo- Antihypertensive, ACE inhibi- Believed to suppress the         alone or in combination with     hypotension, stroke, MI,       Monitor VS (BP in both arms
Lisinopril)                         tor                           renin-angiotension-              a diuretic to treat hyperten-    CVA, chest sound abnormali-    lying, sitting, standing), elec-
                                                                  aldosterone system, pre-         sion, with digitalis and a di-   ties, diarrhea, pulmonary      trolytes, CBC, renal, LFTs,
                                                                  vents the conversion of angi-    uretic for treating CHF not      embolism, hepatitis, blurred   check urine for protein, doc-
                                                                  otensin I to angiotensin II,     responding to other thera-       vision, diplopia               ument hereditary angioede-
                                                                  decreases peripheral resis-      pies, use within 24 HR of                                       ma, monitor I&Os, serum
                                                                  tance and decreased aldos-       acute MI to improve survival                                    potassium, monitor weight,
                                                                  terone secretion (leading to     in hemodynamic stable                                           assess for hypotension
                                                                  fluid loss)                      clients

Lopresor                                                         A beta-blocker that selective-                                     Bradycardia, Bronchospasm, Monitor BP and HR routinely
                                                                 ly blocks beta1 adrenergic                                         Diarrhea,
(metoprolol tartrate)            beta-blocker Antihyperten-      receptors; decreases cardiac                                                                    NEVER give with COPD
                                 sive                            output, peripheral resistance,                                     Dyspnea, Fever, Heart fail- patients
50 mg PO Q6º                                                                                                                        ure, Hypo-tension, Intermit-
                                                                 and cardiac oxygen con-
                                                                 sumption; depresses renin                                          tent claudication
                                 HTN                             secretion.

Lopressor                                                        A beta-blocker that selective-                                     Bradycardia, Bronchospasm, Monitor BP and HR routinely
                                                                 ly blocks beta1 adrenergic                                         Diarrhea,
(metoprolol tartrate)            Beta blocker Antihyperten-      receptors; decreases cardiac                                                                    NEVER give with COPD
                                 sive                            output, peripheral resistance,                                     Dyspnea, Fever, Heart fail- patients
25 mg (half tab) / PO / BID /                                                                                                       ure, Hypo-tension, Intermit-
                                                                 and cardiac oxygen con-
                                                                 sumption; depresses renin                                          tent claudication
                                 Control of HTN                  secretion.
                                                                                                                                                            Page 59 of 99
Drug Name                    Class                           Actions                             Indications     Side Effects                  Nursing implications

Loratadin (Claritin)         Antihistamine, H1 receptor      Long acting antihistamine           Respiratory     Dizzy, dry mouth, fatigue,     Give on empty stomach
                             antagonist                      with affinity to selected peri-                     hypotension, tinnitus, blurred
                                                             pheral H1 sites. Blocks his-                        vision                         1 HR ac or 2 HR pc do not
                             Use: treat allergies            tamine release                                                                     eat for 1 hr, avoid ETOH,
                                                                                                                                                safety

lorazepam (ativan)           central nervous system          enhances and binds with                             minor side effects: drowsi-   Monitor respirations
                             agent, anticonvulsant/          GABa receptors in nerve                             ness and sedation
                                                             cells                                                                             monitor cbc and liver tests
                                                                                                                                               supervise ambulation

                             seizures

lorazepam (Ativan)           CNS agent, anxiolytic, seda- Inhibits GABA resulting in                             Drowsiness, sedation          Patient should be educated
                             tive-hypnotic, benzodiaze-   sedative-hypnotic, anxiolytic,                                                       against alcohol ingestion,
                             pine                         and skeletal muscle relaxant                                                         have patent airway equip-
                                                          effects                                                                              ment ready when starting IV,
                                                                                                                                               supervise ambulation, moni-
                                                                                                                                               tor for suicide

Low molecular wt heparin     Anticoagulant                   Block clotting cascade to                           Bleeding, bruising            Monitor for bruising, bleed-
(Lovenox)                                                    prevent clot from increasing                                                      ing, no lab test
                             Use:treat DVT, CVA

LR c 20 KCL                  IV solution with electrolyte    fluid replacement and elec-                         monitor for signs of fluid
                             added                           trolyte replacement therapy                         overload and hyperkalemia,
                                                                                                                 monitor vital signs

Maalox                       Antacid                         Combination of magnesium GI                         Diarrhea, constipation        Take before meals
                                                             and aluminum combine with
(Magnesium Hydroxide-        Use: neutralize acid in sto-    stomach acid to form h2o                                                          Shake well before using
Aluminum Hydroxide)          mach, treatment for GERD,       and a salt, thus neutralizing
                             indigestion                     the acid and increasing sto-
                                                             mach pH

Magnesium Oxide (Mag-Ox)     May also be used as magne-      Causes osmotic retention of                         Diarrhea, abdominal cramps, Monitor for dehydration, hy-
                             sium supplement. Antacid in     fluid, which distends colon,                        nausea; hypermagnesemia pokalemia, and hyponatre-
400mg, PO, QD (M)            low doses and a mild saline     resulting in mechanical sti-                                                    mia drug may cause intense
                             laxative at higher doses.       mulation of peristaltic activity.                                               bowel evacuation.
                                                                                                                                               Lab tests: Check patients on
                                                                                                                                               prolonged therapy periodical-
                                                                                                                                               ly for electrolyte imbalance
                                                                                                                                               (i.e., hypermagnesemia).

Megastrol acetate (Megace)   Antineoplastic, hormone,        Unknown, hypothesized to            Atineoplastic   DVT, HA, breast tenderness, Monitor WT, may potentiate
                             progestin                       stimulate pituitary                                 wt gain                     coumadin, shake well, mon-
                                                                                                                                             itor for DVT, thrombophlebitis
                             Use: pituitary stimulation to
                             increase appetite
                                                                                                                                                                                  Page 60 of 99
Drug Name                      Class                           Actions                           Indications                        Side Effects                     Nursing implications

Meperidin (demerol)            Opioid                          Bind to opioid receptors in                                          Reduced effectiveness after Switch to another analgesic
                                                               CNS and CSF to inhibit noci-                                         few doses due to normeperi- after a few doses
                               Use: analgesic                  ceptive pain                                                         dine metabolite-causing an-
                                                                                                                                    xiety, tremors, seizures

Meropenum (Merrem)             Antiinfective, carbapenem     Broad spectrum antibiotic                                              Rash, anemia, pseudomem- Not for MRSA
                               antibiotic                    that inhibits cell wall synthe-                                        branous colitis, nephro and
                                                             sis, with strong affinity to                                           hepatotoxic,                Reconstitute with sterile wa-
                               Use: treat bacterial meningi- penicillin binding proteins of                                                                     ter, shake and let stand until
                               tis infection                 the bacterial cell wall. resis-                                                                    clear, give over 30 minutes,
                                                             tant to beta-lactamases,                                                                           use within 1 HR or mixing,
                                                                                                                                                                monitor cbc, BUN, Cr, alt,
                                                                                                                                                                AST,

Mesalamine (5-Aminosalicylic Anti-inflammatory                 Acts in the colon to inhibit      Maintaining remission and          anaphylaxis, abdominal pain,     Document charac-
acid )Pentasa, Asacol, Novo-5                                  cyclo-oxygenase and pros-         treatment of mild to mod-          rectal pain, burning, hemorr-    ter/frequency of stools, as-
                                                               taglandin synthesis, resulting    erate active ulcerative colitis,   hoids, vomiting, cold, anorex-   sess abdomen for bowel
                                                               in redution of inflammation of    distal ulcerative colitis, proc-   ia, bloody diarrhea, migriane,   sounds disten-
                                                               colitis; excreted through kid-    tosigmoiditis, proctitis           myocarditis, vasodilation        tion/pain/tenderness, monitor
                                                               neys                                                                                                  chemistries liver and renal
                                                                                                                                                                     functions studies, abdominal
                                                                                                                                                                     films

Metamucil (Psyllium hydro-     laxative, bulk-forming          forms a gelatinous mass with      prophylaxis of constipation, obstruction of the esopha-             take with plenty of water (liq-
philic muciloid,) 15 mL PO q 2                                 water, which adds bulk to the     short-term treatment of con- gus, stomach, small intes-             uid), report lack of response,
hrs PRN indigestion                                            stools and stimulates peris-      stipation, to soften feces   tine, and rectum                       determine length of use and
                                                               talsis                            during fecal impaction                                              underlying causes, deter-
                                                                                                                                                                     mine stool characteristics
                                                                                                                                                                     and frequency

Metformin HCl (Glucphage)      Antidiabetic, Biguanide hy-    Increases receptor insulin                                            HA, dizzy, fatigue, N&V, bit- Give with meals, lasix in-
                               poglucemic agent,              sensitivity, potentiates insulin                                      ter taste, diarrhea, malab-    creases risk of hypoglyce-
                                                              action, enhances glucose                                              sorption of B12 and folic acid mia, iodine radio contrast
                               Use: oral treatment for type 2 transport across skeletal                                                                            dyes can cause lactic acido-
500mg PO bid with meals        diabetes                       muscle cell membranes                                                                                sis and acute renal failure

Methadone HCl (dolophine)      Treatment of severe pain        Binds to opiate receptors in                                         Confusion, sedation, hypo-       Assess for pain reduction.
                                                               the CNS altering the percep-                                         tension, constipation            Progressively higher doses
                                                               tion and response to painful                                                                          may be required to relieve
                                                               stimuli while producing gene-                                                                         pain with long term therapy.
                                                               ralized CNS depression.
                                                                                                                                                                     Assess regularly for BP,
                                                                                                                                                                     Pulse, and Respiratory de-
                                                                                                                                                                     pression (<10/min)
                                                                                                                                                                     Assess bowel function rou-
                                                                                                                                                                     tinely
                                                                                                                                                                             Page 61 of 99
Drug Name                    Class                         Actions                           Indications                     Side Effects                       Nursing implications

Methadone HCL (Dolophine)    Treatment of severe pain      Binds to opiate receptors in                                      Confusion, sedation, hypo-          Assess for pain reduction.
                                                           the CNS altering the percep-                                      tension, constipation              Progressively higher doses
                                                           tion and response to painful                                                                         may be required to relieve
                                                           stimuli while producing gene-                                                                        pain with long term therapy.
                                                           ralized CNS depression.
                                                                                                                                                                 Assess regularly for BP,
                                                                                                                                                                Pulse, and Respiratory de-
                                                                                                                                                                pression (<10/min)
                                                                                                                                                                 Assess bowel function
                                                                                                                                                                routinely

Methotrexan (mexate, MTX)    Antineoplastic, DMARD im- Folic acid antagonist, inter-                                         HA, drowsy, blurred vision,        Not with meals, avoid respi-
                             munosuppressant, antimeta- feres with mitotic process of                                        aphasia, hair loss confusion       ratory and skin exposure,
                             bolite                       proliferating cells, induces                                       hemiparesis, stomtitis, infer-     monitor CBC, liver and renal
                                                          remission slowly                                                   tility, kidney, liver dysfunc-     function, I/O, oral care ulc-
                             Use: treat severe rheumatoid                                                                    tion, fever, increased BS,         ers=toxicity, avoid sunlight
                             arthritis and psoriasis, ad-                                                                    infection, pulmonary fibrosis,
                             junct to maintain immuno-                                                                       bone marrow suppression
                             suppression,

Methotrexate, Folex, Rheu-   antibiotic antineoplastics    binds to dihydrofolate reduc-     burkitts lymphoma, lympho-      arachnoiditis, leukoencepha-       use caution in pts with renal
matrex, Methoblastin                                       tase blocking reduction of        cytic leukemia, meningeal       lopathy, sz, leukopenia,           and liver problems, pulmo-
                                                           folic acid to tetrahydrofolate,   leukemia, breast cancer,        thrombocytopenia, liver toxic-     nary function test, monitor
                                                           a cofactor necessary for pu-      rheumatoid arthritis, psoria-   ity, diabetes, >uric acid, arth-   uric acid, alkalinize urine by
                                                           rine, protein and DNA syn-        sis                             ralgia, myalgia, osteoporosis,     giving sodium bicarb tabs,
                                                           thesis                                                            pulmonary fibrosis, urticaria,     BUN, watch for signs of GI
                                                                                                                             sudden death, stomatitis, GI       bleeding, WBC and platelet
                                                                                                                             bleeding, renal failure            counts, anticipate blood
                                                                                                                                                                transfusions

Methylprednisolone (Solu-    Corticosteroid                  Reduce inflammatory re-      Respiratory                        Hypertension, peptic ulcer,   Rinse mouth after use, ad-
Medrol )parenteral                                           sponse in bronchial walls by                                    heart failure, hyperglycemia, minister oral form with food,
                             Use: prevent or treat inflam- suppression of WBCs and                                           cough, thrush, fragile skin,  taper off dose
                             mation of the respiratory tract immune system                                                   adrenal suppression

Methylprednisolone (Solu-    Corticosteroid                  Reduce inflammatory re-      Steroid                            Hypertension, peptic ulcer,   Rinse mouth after use, ad-
Medrol )parenteral                                           sponse in bronchial walls by                                    heart failure, hyperglycemia, minister oral form with food,
                             Use: prevent or treat inflam- suppression of WBCs and                                           cough, thrush, fragile skin,  taper off dose
                             mation of the respiratory tract immune system                                                   adrenal suppression
                                                                                                                                                                          Page 62 of 99
Drug Name                      Class                        Actions                            Indications                    Side Effects                   Nursing implications

Metoclopramide                 Upper GI stimulant, Stimu-   Increases resting tone of                                         drowsiness, depression, res- Monitor for anxiety and res-
                               lates gastric emptying,      esophageal sphincter, and                                         tlessness, fatigue, dizziness, tlessness
(Reglan)                                                    tone and amplitude of upper                                       anxiety, headache
                                                            GI contractions resulting in                                                                     Monitor pattern of daily bo-
                                                            gastric emptying and accele-                                                                     wel activity and stool consis-
                                                            rated intestinal transit with                                                                    tency
                                                            little effect, on GI secretions.
                                                            Antiemetic action results
                                                            from drug-induced elevation
                                                            of CTZ threshold and en-
                                                            hanced gastric emptying. In
                                                            diabetic gastroparesis, indi-
                                                            cated by relief of anorexia,
                                                            N/V, persistent fullness after
                                                            meals.

Metocloprimide HCl             antiemetic, direct act.      dopamine receptor antagon- GI                                     mild sedation, restless,       incompatible with ampicillin
                                                            ist                                                               headache, rash,
(Reglan)                       cholinergic                                                                                                                   Monitor for anxiety and res-
                                                            elevation of CTZ threshold                                        periorbital swelling, tremors, tlessness
                               use-to accelerate                                                                              involuntary
                                                            increase upper GI contrac-                                                                       Monitor pattern of daily bo-
                               gastric emptying             tion                                                              movements                      wel activity and stool consis-
                                                                                                                                                             tency

Metoprolol                     Anti-hypertensive, anti-     Beta Blocker. Decreases HR                                        Fatigue, weakness, impo-       Administer with or pc meals.
                               anginal                      and BP by blocking stimula-                                       tence, bradycardia, CHF,       Monitor BP, ECG, and pulse
(Toprol XL , Lopressor)                                     tion of beta1 (myocardial)                                        pulmonary edema                frequently during dose ad-
                                                            adrenergic receptors. Selec-                                                                     justment and periodically
                                                            tive for beta1 receptors over                                                                    throughout therapy
                                                            beta2 receptors. Prevents
                                                            cardiac remodeling.

Metoprolol succinate, Meto-     beta-adrenergic blocking     decreases HR, myocardial          alone or with other drugs to   bradycardia, CHF, strokes, Monitor liver and renal func-
prolol tartrate (Toprol XL, Lo- agent                       contractility, and CO              treat hypertension, chronic    edema, fatal MI, weight gain tion studies
pressor)                                                                                       management of angina pec-      or loss, respiratory distress,
                                                                                               toris, treatment of stable,    headaches                      Monitor ECG
                                                            decrease BP                        symptomatic heart failure of                                  Assess vital signs
                                                                                               ischemic, hypertensive, or
                                                                                               cardiomyopathic origin                                        Monitor lung sounds
50 mg PO q6h
                                                                                                                                                             Monitor I&Os and weight
                                                                                                                                                                                  Page 63 of 99
Drug Name                      Class                           Actions                            Indications                      Side Effects                      Nursing implications

Metronidazole                  Trichomonacide amebicede, In anaerobic conditions, me-                                              nausea or appetite loss, dry      Monitor CBC, LFTs, and
                               antiinfective             tronidazole inhibits the DNA                                              mouth, metallic taste, vertigo,   cultures, take with food or
                                                         repair enzymes that normally                                              insomnia, bone marrow, dy-        milk to reduce GI upset, me-
(Flagyl, Protostat, nidagel,                             would repair cells. This                                                  suria, polyuria, incontinence,    tallic taste, assess for CNS
metrocream)                                              means death for anaerobic                                                 candida, ECG abnormalities,       toxicity, unusual bleeding or
                                                         bacteria but no effect on                                                 pruritus                          bleeding, urine may be
                                                         aerobic tissues.                                                                                            brown-normal
                                                               to reduce post-op anaerobic
                                                               infection following surgery,
                                                               infections of abdomen

Mexiletine                     antidysrhythmic grp 1B          Na channel blocker                 Cardiac Medication               paresthesia, rash, tremors        PO, monitor:EKG, chest
                                                                                                                                                                     xray, CBC
Mexitil                        use:treat ventricular                                                                               bleeding
                                                                                                                                                                     pulmonary problems
                               dysrhythmias                                                                                        dizzy, chest pain, dyspnea
                                                                                                                                                                     dental care, decreased heal-
                                                                                                                                   vision, tinnitus                  ing

Miconazole topical cream       Antiinfective antifungal, anti- Broad spectrum antifungal                                           Itching, contact dermatitis       Clean area prior to adminis-
                               biotic                          agent, alters cell wall struc-                                                                        tration,
                                                               ture to promote cell death
                               Use: treat or prevent micro-
                               bial infection, candida

Milk of Magnesia               antacid laxative                as antacid it neutralizes or       upset stomach from hyper-        diarrhea, nausea, perianal        do not give oral drugs within
                                                               reduces gastric acid, as a         acidity from peptic ulcer ga-    irritation                        1-2 hour of antacid adminis-
                                                               laxative it attracts and retains   stritis short term relief form                                     tration
                                                               water in intestinal lumen and      constipation
                                                               distends bowel

Miralax, polyethylene glycol   laxative,                       dissolve 17g in 8 oz of water onset 1hr                                                               do not use with bowel ob-
                                                               and drink qd for up to 2wk                                                                            struciton diarrhea common

Mirtazapine (remeron)          antidepressant, tetracyclic     enhances central noradre-     treatment of depression               somnolence, ataxia, eupho-        Note precipitating events;
                                                               nergic and serotonergic ac-                                         ria, ulcer, dry mouth, gum        monitor ECG, CBC, LFTs,
                                                               tivity perhaps by antagonism                                        hemorrhage, bradycardia,          cholesterol and triglyceride
                                                               at central presynaptic alpha-                                       syncope, migraine, orthostat-     levels, report signs of infec-
                                                               2 adrenergic inhibitory au-                                         ic hypotension                    tion, avoid alcohol
                                                               to/heteroreceptrors, potent
                                                               antagonist

Mirtazapine (Remeron)          Tetracyclic Antidepressant      Antagonist of 5-HT serotonin Antileptic                             Back pain, CNS effects, dry       Not with MAOI’s, ETOH,
                                                               receptors                                                           mouth, sedation                   monitor CBC, liver, glucose,
                               Use-treat depression                                                                                                                  lipid profile
                                                                                                                                                                         Page 64 of 99
Drug Name                      Class                        Actions                           Indications                   Side Effects                    Nursing implications

Monopril (fosinopril sodium)   antihypertensive             antihypertensive action not HTN                                 cva, ha, dizziness, fatigue,    monitor lab values b/c it in-
                                                            clearly defined, thought to                                     hepatitis, musculoskeletal      creases liver, BUN, creati-
                                                            inhibit ACE, preventing con-                                    pain, myalgia, angioedema,      nine, and potassium levels,
                                                            version of angiotensin I to                                     decreased libido, gout, or-     and decreases hemoglobin
                                                            angiotensin II. Potent vaso-                                    thostatic hypotension, tinni-   and hematocrit, VS, orthos-
                                                            constrictor. Reduced forma-                                     tus, pancreatitis, dry mouth,   tatic vitals, safety precau-
                                                            tion of angiotensin II de-                                      abd distention and pain,        tions, sexual considerations
                                                            creases peripheral arterial                                                                     and education, I/O's, safety
                                                            resistance, thus decreasing                                                                     precautions
                                                            aldosterone secretion, which
                                                            reduces sodium and water
                                                            retention and lowers bp

Montelukast (Singulaire)       Bronchodialator              selective leukotrine receptor Respiratory                       Ha, dizzy, fever, ab pain,      Give in the evenings
                                                            antagonist which Inhibits                                       hepatic problems
                               Leukotrine receptor antagon- bronchoconstriction                                                                             Do not swallow chewable
                               ist                                                                                                                          tabs
                               Use: treat                                                                                                                   Not for acute asthmatic at-
                                                                                                                                                            tack
 Montelukast Sodium             Bronchodilator               Selective receptor anta-         Controls asthmatic attacks     Headache,dizziness,             Monitor effectivenessin
                                                             gonist of leukotriene D4         by inhibiting leukotriene      cough, nasal congestion         combo with Phenobarbital
 (Singulair)                    Resp. Smooth Muscle Re-      thus inhibiting bronchocon-      release as well as inflam-     Skin rash, pyuria               or other potent cytochro-
                                laxer                        striction. Leukotrienes are      matory action assoc. with                                      mep450 enzyme inducers
                                                             more important than pros-        the attack. Indicated by                                       carefully;
                                                             taglandins as inflammatory       better control of asthmatic
                                                             agents inducting broncho-        s/s and improved PULM                                          Periodic liver function test
                                                             constriction                     function                                                       (LFT)




Morphine Sulfate               CNS Agent, Narcotic opioid   binds at natural opiod recep-                                   respiratory depression or       Monitor respirations and oth-
                               analgesic/                   tors to inhibit nerve impulses/                                 arrest, cardiac arrest          er VS.
                               Pain relief                                                                                                                  Withhold if RR below 12
2 mg IV Q3H PRN
                                                                                                                                                            Monitor for nausea
                                                                                                                                                            Monitor for hypotension
                                                                                                                                                            Supervise ambulation
                                                                                                                                                            Monitor I&Os
                                                                                                                                                                       Page 65 of 99
Drug Name                     Class                           Actions                      Indications                   Side Effects                     Nursing implications

Morphine Sulfate 2mg IV       Narcotic agonist analgesic— Acts as agonist on specific                                    Light-headedness, sedation,      Monitor client’s vital signs
                              given for acute abd. pain   opioid receptors in the CNS,                                   euphoria, delirium, insomnia,    prior to administration, and
Q4H PRN                                                   which produces euphoria,                                       agitation, anxiety, hallucina-   monitor again after adminis-
                                                          sedation, and analgesia                                        tions, disorientation, drowsi-   tration.       Monitor for
                                                                                                                         ness, lethargy, coma, mood       respiratory depression
                                                                                                                         changes, weakness, head-
                                                                                                                         ache, tremor, convulsions,       Monitor for constipation, and
                                                                                                                         visual disturbances, sup-        give aids as needed
                                                                                                                         pression of cough reflex,        Encourage fluids and mobili-
                                                                                                                         tachycardia, bradycardia,        ty when applicable
                                                                                                                         arrhythmia, palpitations,
                                                                                                                         chest wall rigidity, hyperten-
                                                                                                                         sion, hypotension, orthostatic
                                                                                                                         hypotension, syncope, respi-
                                                                                                                         ratory depression, apnea,
                                                                                                                         circulatory depression, respi-
                                                                                                                         ratory arrest, shock, cardiac
                                                                                                                         arrest

Morphine Sulfate injection    CNS Agent, Narcotic opioid, binds at natural opioid recep- Pain relief for severe to       respiratory depression, respi- Monitor vital signs and respi-
                              analgesic, Pain relief      tors to inhibit nerve impulses/ moderate pain                  ratory arrest, cardiac arrest, rations (hold for <12), pain
2 mg IV q 1 hour PRN                                                                                                     sedation, disorientation       relief, nausea, hypotension,
                                                                                                                                                        I/O’s, constipation; supervise
                                                                                                                                                        ambulation; encourage fluids
                                                                                                                                                        and mobility when applicable


Multivitamin                  Water soluble vitamin nutri-    Absorbed in GI                                             N&V,diarrhea,HA                  With meals
                              tional supplement
                              Use: treat or prevent Vitamin
                              deficiency,

Multivitamin – fat soluble    Nutrition supplement            supplements vitamins which                                 None
drops                                                         may be lacking in diet


1 ml qd

Multivitamin Tablet           supplements vitamins which Absorbed in GI                                                  N&V, diarrhea, HA                With meals
                              may be lacking in diet
1 Tab / PO / QD /0800

Multivitamin, adult, therapeu- Nutrition supplement;          supplements vitamins which Prevention of vitamin defi-     None                             Take with meals
tic, liquid                                                   may be lacking in diet     ciencies; provide extra vita-
                                                                                         mins for increased body
5ml PO q day                                                                             needs
0800
                                                                                                                                                                              Page 66 of 99
Drug Name                         Class                          Actions                         Indications                     Side Effects                    Nursing implications

Mupirocin Calcium 1 appl          Topical antibiotic             Used to treat impetigo                                          Uticaria, redness to site,      Monitor for healing of rash
                                                                 caused by staph and strept
Top QD                                                                                                                                                           Put gauze over ointment to
                                                                                                                                                                 aid in absorption

Mycostatin (Nystatin)             antifungal                     fungistatic and fungicidal      candida infections of skin,     few toxic effects; epigastric   cleanse area before topical
                                                                 against all species of Candi-   mucous membranes, GI            distress, N&V, diarrhea         application, monitor re-
                                                                 da; binds to fungal cell mem-   tract, vagina, and mouth                                        sponse to drug therapy if no
                                                                 branes resulting in altered     (thrush), too toxic for system-                                 response noted do further
                                                                 cellular permeability and       ic infections                                                   cultures to determine causa-
                                                                 leakage of K+ and other es-                                                                     tive organism, ensure that
                                                                 sential intracellular compo-                                                                    patient receives the full
                                                                 nents; unabsorbed nystatin is                                                                   course of therapy to eradi-
                                                                 excreted in feces                                                                               cate the fungus and to pre-
                                                                                                                                                                 vent recurrence, document
                                                                                                                                                                 onset, location, and clinical
                                                                                                                                                                 presentation of symptoms

Mylanta                           Antacid                        Combination of magnesium GI                                     Diarrhea, constipation          Take before meals
                                                                 and aluminum combine with
                                  Use: neutralize acid in sto-   stomach acid to form h2o
                                  mach, treatment for GERD       and a salt, thus neutralizing
                                                                 the acid and increasing sto-
                                                                 mach pH

NaCl 0.9%                         Fluid replacement isotonic     IV ECF replacement              IV Fluid                        Irritation at IV site           Monitor IV site q2h
                                  normal saline
IV 25ml drip PRN                                                                                                                 Fluid volume excess             Monitor I/O

NaCl 0.9%                         isotonic normal saline         Flush prevents blood clots                                      Irritation at IV site           Monitor IV site
                                                                 from occluding IV insertion
IV 1 ml q8h PRN                   flush                          cannula
Saline lock peripheral IV flush

NaCl 0.9%                         isotonic normal saline         Flush prevents blood clots                                      Irritation at IV site           Monitor IV site
                                                                 from occluding IV insertion
IV 1 ml q8h PRN                   flush                          cannula
Saline lock peripheral IV flush
                                                                                                                                                               Page 67 of 99
Drug Name                     Class                            Actions                          Indications   Side Effects                        Nursing implications

Nafcillin Sodium (Unipen)     Penicillinase-resistant peni-    Effective against PCN-                         Drug fever, anaphylaxis (par-       Infuse IV over 20-40 min
                              cillin. Mechanism of bacteri-    resistant strains of S. au-                    ticularly following parenteral
                              cidal action is by interfering   reus. Also active against                      therapy).                           Give PO on empty stomach
                              with synthesis of bacterial      pneumococci and group A                        GI: N&V&D,                          (at least 1 h before or 2 h
                              cell wall.                       beta-hemolytic Streptococci.                   Metabolic: Hypokalemia (with        after meals).
                                                               Ineffective against MRSA.                      high IV doses).
                                                                                                              Skin: Urticaria, pruritus, rash,    Determine prior allergic rxns
                                                                                                              pain and tissue irritation.         to PCN, cephalosporins
                                                                                                              Urogenital: Allergic interstitial   Inspect IV site for inflamma-
                                                                                                              nephritis.                          tory reaction.

                                                                                                                                              Note: Allergic reactions, prin-
                                                                                                                                              cipally rash, occur most
                                                                                                                                              commonly. Nausea, vomit-
                                                                                                                                              ing, and diarrhea may occur
                                                                                                                                              with oral therapy.
Naproxe (naprosyn )ibrupro-   NSAID                            Inhibit prostaglandins                         GI bleeding, tinnitus, bruising Prostaglandin inhibition de-
fen (motrin, advil)                                                                                           and bleeding gums, na+ re- creases menstrual cramps,
                              Use: anti-inflammatory                                                          tention, fluid retention ede-   give with antacid or h2
                              Antipyretic, analgesic                                                          ma, renal damage, dyspnea blocker
                                                                                                              and nausea with elderly,
                                                                                                              CNS delirium, dizzy             d/c 7 d prior to surgery,
                                                                                                                                              give with food, report ringing
                                                                                                                                              in ears, monitor for bleeding,
                                                                                                                                              bruising
                                                                                                                                                  monitor wt, labs, urine out-
                                                                                                                                                  put, CNS

Nateglinide                   Non-Insulin Dependent DM         Lowers blood glucose levels                    Dizziness, Diarrhea, Hypog- Lab tests: Frequent FBS
                              Type II                          by stimulating the release of                  lycemia                     monitoring and HbA1c q3mo
(Starlix)                                                      insulin from the pancreatic                                                to determine effective dose.
60 mg (half 120 tab) /PO /                                     cells of a type 2 diabetic.
                                                                                                                                                  Take only AC to lessen the
1hr-30min AC                                                                                                                                      chance of hypoglycemia

Nefazodone (Serzone)          Antidepressant                   Selectively inhibits reuptake                  CNS effects, anxiety, dry           Monitor CBC, BP, HR, liver,
                                                               of neuronal serotonin                          mouth                               not with ETOH
                              Use-treat depression

Nephrovite 1 tab PO QD                                         indicated for the distinctive                      Numbness of the hands
                                                               nutritional requirements of                         or the feet
                                                               patients treatment for end                         Drowsiness
                                                               stage renal failure, dialysis,
                                                                                                                  Diarrhea
                                                               hyperhomocysteinemia, or
                                                               inadequate dietary vitamin                         Skin rash
                                                               intake.                                            Feeling of swelling of
                                                                                                                   entire body
                                                                                                                                                                             Page 68 of 99
Drug Name                       Class                         Actions                          Indications                      Side Effects                    Nursing implications

Neupogen, filgrastim            immunomodulation              stimulates proliferation and     decrease risk of infection in    ha, weakness, fatigue, GI       use caution in breast feeding
                                                              differentiation of hematopoie-   pts with nonmyeloid malig-       effects, thrombocytopenia,      women, baseline CBC, and
                                                              tic cells, specific to neutro-   nant disease receiving mye-      dyspnea, cough, bone pain,      platelet counts, discard un-
                                                              phils                            losuppressive antineoplas-       alopecia, fever, MI, arrhyth-   used vial don't reuse, blood
                                                                                               tics, congenital neutropenia,    mias                            levels several times per
                                                                                               idiopathic or cyclic neutrope-                                   week,
                                                                                               nia

Neutra-phos powder              Phosphorus replacement                                         Replacement of blood/body                                        Monitor phosphorus and
                                                                                               phosphorus                                                       calcium levels
2 packets dissolved in 75 ml
water; via DHT; q 12 hours
0800


nicotine patch (nicoderm)       cns and ans agent, smoking stimulates and depresses                                             skin irritation, respiratory    monitor for rash at applica-
                                deterent/                  pns and cns                                                          failure, tachycardia, hyper-    tion site, rotate application
                                                                                                                                tension, hypersensitivity       sites, monitor vitals
                                                              increases respirations, heart                                     reaction
                                                              rate, and cardiac output
                                reduce cigarette withdrawal
21 mg, 24HR patch, qd           symptoms                      ganglionic cholinergic agon-
                                                              ist receptor

Nifedipine (Procardia )vera-    Ca+ channel blocker          Inhibit Ca+into vascular and Cardiac Medication                    Constipation,                   Potentiate with B-block
pami (Calan, Isoptin )diltia-                                smooth muclse. Causes sys-
zemhc (Cardizem)                Use:antihypertensive, CHF temic and coronary artery                                              Headache & flushing (vaso- Give with food, monitor BP,
                                antidysrhythmic, prevent MI, vasodilation                                                       dilation )tachycar          wt, resp, edema, sexual dys-
                                angina, vascular headaches                                                                                                  function, caution OTC cold
                                                                                                                                Dysrhythmias, CHF, peri-    meds
                                                                                                                                pheral edemia, GI upset

ninedipine (Procardia)          Cardiovascular agent, anti- Reduces cardiac O2 need,                                            Dizziness, light-headedness,    Monitor bp, withhold if systol-
                                arrhythmic, calcium-channel increase cardiac output, va-                                        headache, facial flushing,      ic <90, in diabetic- monitor
                                blocker                     sodilates coronary and peri-                                        peripheral edema, diarrhea,     blood sugar, monitor for gin-
                                                            pheral vasculature (reduces                                         Hepatotoxicity, MI              gival hyperplasia
                                                            bp)

Nitro patch (nitroglycerin)     Antianginal agent nitrate     relaxes vascular smooth        acute angina prophylaxis of headache restlessness ver-             watch for orthostatic hypo-
                                                              muscle with a resultant de- angina periopeerative hyper- tigho hypotension rash                   tension teaxh client to sit on
                                                              crease in venous return and tension                                                               side of bed before rising to
                                                              decreases in arterial BP                                                                          stand
                                                              which reduces left ventricular
                                                              workload and decrease myo-
                                                              cardial O2
                                                                                                                                                                        Page 69 of 99
Drug Name                      Class                        Actions                        Indications                     Side Effects                    Nursing implications

Nitro patch (nitroglycerin)    Antianginal agent nitrate    relaxes vascular smooth        acute angina prophylaxis of     headache restlessness verti- watch for orthostatic hypo-
                                                            muscle with a resultant de- angina preoperative hyper-         go hypotension rash          tension teach client to sit on
                                                            crease in venous return and tension                                                         side of bed before rising to
                                                            decreases in arterial BP                                                                    stand
                                                            which reduces left ventricular
                                                            workload and decrease myo-
                                                            cardial O2

Nitrodur patch                 nitrate vasodilator          vasodialtion by relaxing       Cardiac Medication              headache, dizzy, blurred        nitrate free nights,
                                                                                                                           vision
Nitroglycerine                 use:antianginal              vascular smooth muscle                                                                         not with severe anemia, icp,
                                                                                                                           dry mouth, tachycardia
                               antihypertensive                                                                                                            glaucoma, client sit or recline
                                                                                                                                                           monitor bp, HR baseline and
                                                                                                                                                           1 HR post med administra-
                                                                                                                                                           tion

Nitrogen mustard, Mustargen antineoplastics                 cross links strands of cellular polycythemia vera, hodgkins,   weakness, vertigo, neurotox-    use caution in pts with se-
                                                            DNA, and interferes with        malignant effusions, leuke-    icity, anaphylaxis, secondary   vere anemia, <neutrophil or
                                                            RNA transcription causing an mia's                             malignant disease, alopecia,    platelet count, monitor CBC,
                                                            imbalance and cell death.                                      >uric acid, thrombocytope-      avoid IM to prevent bleeding,
                                                            Not specific to cell cycle                                     nia, agranulocytosis, mild      monitor uric acid, anticipate
                                                                                                                           anemia, jaundice                blood transfusions, monitor
                                                                                                                                                           for bone marrow suppression

Nitrogen mustard, Mustargen Antineoplastic                  cross links strands of cellular Antineoplastic                 weakness, vertigo, neurotox-    use caution in pts with se-
                                                            DNA, and interferes with                                       icity, anaphylaxis, secondary   vere anemia, <neutrophil or
                               Use: polycythemia vera,      RNA transcription causing an                                   malignant disease, alopecia,    platelet count, monitor CBC,
                               Hodgkin’s, malignant effu-   imbalance and cell death.                                      >uric acid, thrombocytope-      avoid IM to prevent bleeding,
                               sions, leukemia's            Not specific to cell cycle                                     nia, agranulocytosis, mild      monitor uric acid, anticipate
                                                                                                                           anemia, jaundice                blood transfusions, monitor
                                                                                                                                                           for bone marrow suppression

Nitrogen mustard, Mustargen antineoplastic                  cross links strands of cellular polycythemia vera, Hodg-       weakness, vertigo, neurotox-    use caution in pts with se-
                                                            DNA, and interferes with        kin’s, malignant effusions,    icity, anaphylaxis, secondary   vere anemia, <neutrophil or
                                                            RNA transcription causing an leukemia's                        malignant disease, alopecia,    platelet count, monitor CBC,
                                                            imbalance and cell death.                                      >uric acid, thrombocytope-      avoid IM to prevent bleeding,
                                                            Not specific to cell cycle                                     nia, agranulocytosis, mild      monitor uric acid, anticipate
                                                                                                                           anemia, jaundice                blood transfusions, monitor
                                                                                                                                                           for bone marrow suppression

Nitroglycerin sublingual (Nitro vasodilator, coronary       relaxes vascular smooth        acute angina prophylaxis of headache restlessness verti-        watch for orthostatic hypo-
Tab )0.4 mg 1 tab SL q 5 min                                muscle with a resultant de- angina periopeerative hyper- go hypotension                        tension teaxh client to sit on
PRN chest pain                                              crease in venous return and tension                                                            side of bed before rising to
                                                            decreases in arterial BP                                                                       stand
                                                            which reduces left ventricular
                                                            workload and decrease myo-
                                                            cardial O2
                                                                                                                                                                             Page 70 of 99
Drug Name                      Class                         Actions                          Indications                      Side Effects                     Nursing implications

Nitroglycerin sublingual (Nitro vasodilator, coronary        relaxes vascular smooth        acute angina prophylaxis of        headache restlessness verti- watch for orthostatic hypo-
Tab) 0.4 mg 1 tab SL q 5 min                                 muscle with a resultant de- angina preoperative hyper-            go hypotension               tension teach client to sit on
PRN chest pain                                               crease in venous return and tension                                                            side of bed before rising to
                                                             decreases in arterial BP                                                                       stand
                                                             which reduces left ventricular
                                                             workload and decrease myo-
                                                             cardial O2

Nortriptyline (pamelor)        Tricyclic antidepressant      Inhibits reuptake of synaptic                                     Hypotension, anticholinergic Monitor EPS, seizures,
                                                             norepinephrine                                                    effects, stomatitis          change positions slowly
                               Use-treat depression

Norvasc                        Antianginal, calcium channel Inhibits calcium ion influx   Cardiac Medication                   HA, dizziness, somnolence,       I&O, weight, crackles in
                               blocker, anti – HTN          across the cell membrane                                           dysrrthmia, edema, N&V,          lungs, urinalysis, skin turgor,
                                                            during cardiac depolarization                                      rash, flushing, Abd cramps,      mucous membranes, pitting
                                                                                                                               sexual difficulties, anorexia    edema, hypotension, dry
                                                                                                                                                                mouth, B/P, ALT, AST, plate-
                                                                                                                                                                lets, cardiac status

Norvasc                        Cardiovascular agent, Ca+     decreases blood pressure by                                       palpitations, flushing, facial   monitor BP
                               channel blocker               blocking Ca channel cell                                          edema
(Amlodipine)                                                 membrane flux
                                                             increases cardiac output and
                                                             decreases peripheral vascu-
                               antihypertensive              lar resistance

Nystatin mouthwash             Antiinfective, antifungal     Binds to sterols in fungal       GI                               N&V, diarrhea                    Nystatin mouthwash
                                                             membrane, changing per-
6ml qd                         Use: treat fungal infection   meability, cell contents leak                                                                      6ml qd
                               candida                       out
Swish and swallow                                                                                                                                               swish and swallow

Nystatin mouthwash             Antiinfective, antifungal     Binds to sterols in fungal                                        N&V, diarrhea                    Nystatin mouthwash
                                                             membrane, changing per-
6ml qd                         Use: treat fungal infection   meability, cell contents leak                                                                      6ml qd
                               candida                       out
swish and swallow                                                                                                                                               swish and swallow

nystatin topical preparation   antifungal, antiinfectivel/   changes menbrane potential                                        N/A                              Monitor for relief of skin in-
                                                             of fungi, allows leakage of                                                                        fection
(mycostatin)                                                 cellular components
                                                                                                                                                                monitor for redness

                               diaper rash

Ocupress carteolol             bata blocker antihypertensive blocks beta adrenergic re-       management of hypertension       dizziness bradycardia chf        give once a day monitor re-
                                                             ceptors of the sympathetic       reduction of intraocular pres-   cardic arhythmias av blocks      sponse and maintain lowest
                                                             nervous system in the heart      sure in chronic open angle       gastric pain decreased exer-     dose do not discontinus ab-
                                                             thus decreasing the excitabil-   glaucoma                         cise tolerance                   urptly monitor IOP of patients
                                                             ity of the heart reducing Bp                                                                       receiving eye drops
                                                                                                                                                                   Page 71 of 99
Drug Name                   Class                         Actions                           Indications              Side Effects                     Nursing implications

Olanzepine (Zyprexa )       Atypical antipsychotic, CNS   Dopamine and serotonin            Atypical Antipsychotic   Sedation, drowsy, some an-       Monitor for tardive dyskine-
                            agent                         reuptake inhibitor                                         ticholinerg, effects, , head-    sia, Change dosage slowly
                                                                                                                     ache, agitation, weakness, ,
                            Use-treat psychosis                                                                      orthostatic hypotension, joint   Change positions slowly,
                                                                                                                     pain, akathesia, dystonia,       avoid ETOH, before meal,
                                                                                                                     EPS, temp. regulation            don’t chew or crush capsule


Ondansetron (Zofran)        Antiemetic, 5HT3 antagonist Selective serotonin inhibitor                                Dizzy, HA, sedation, GI ef-      Dilute in 50ml D5 or 0.9%NS,
                                                         of CTZ and vagal peripheral                                 fects, dry mouth                 Infuse over 15 minutes, or IV
                            Use: prevent or treat nausea receptors of GI to prevent                                                                   push over 2-5 min, monitor
                            and vomiting                 N&V                                                                                          F/E,

Ondansetron hydrochloride   Antiemetic, prevention of     Blocks the effect of serotonin                             diarrhea, clonic-tonic sei- Monitor LFTs, monitor I&Os,
                            nausea and vomiting           thus blocking the vomiting                                 zures, anaphylaxis, hypoka- assess for other causes
(Zofran)                                                  reflex, not known whether it                               lemia, dysuria
                                                          acts centrally or peripherally

PRN Nausea
4mg, 2mL (2mg/mL) ,IV,
Q6H,


Opioid                      Opioid                      Bind to opioid receptors in                                  Constipation, N&V, drowsy,       Use bowel regimen, change
                                                        CNS and CSF to inhibit noci-                                 resp depressn,                   position slowly,
Morphine sulphate,          Use: analgesic for moderate ceptive pain
                            to severe pain and anxiety                                                               Orthostatic hypotension          Monitor for resp depression,
Ms Contin                                                                                                                                             antidote=narloxon (Narcan)

Opioid                      Opioid                      Bind to opioid receptors in                                  Constipation, n&v, drowsy,       Use bowel regimen, change
                                                        CNS and CSF to inhibit noci-                                 resp depressn,                   position slowly,
morphine sulphate,          Use: analgesic for moderate ceptive pain
                            to severe pain and anxiety                                                               Orthostatic hypotension          Monitor for resp depression,
                                                                                                                                                      antidote=narloxone(Narcan)

Opioid                      Opioid                      Bind to opioid receptors in                                  Constipation, n&v, drowsy,       Use bowel regimen, change
                                                        CNS and CSF to inhibit noci-                                 resp depressn,                   position slowly,
morphine sulphate,          Use: analgesic for moderate ceptive pain
                            to severe pain and anxiety                                                               Orthostatic hypotension          Monitor for resp depression,
ms contin                                                                                                                                             antidote=narloxone(Narcan)

Oxybutynin cl               anticholinergic               inhibits action of acetylcholin                            drowsy, dizzy, restless, blur    tolerence, caution with hot
                                                                                                                     vision, dry                      environmnts
Ditropan                    antispasmotic                 on smooth muscles to inhibit
                                                                                                                     mouth, N&V, constipation,        can cause fever
                            use-to relieve symptm         spasmotic smooth muscle                                    urine retention
                            of void with neurognc                                                                    decreased sweating
                            bladder
                                                                                                                                                                 Page 72 of 99
Drug Name                     Class                         Actions                         Indications               Side Effects                  Nursing implications

Oxycodone and acetamino-      Analgesic                     Attach to opioid receptors                                dizziness, N&V, sedation,     monitor VS, CNS assess-
phen (Tylox, Percocet,                                      located in the CNS to reduce                              constipation                  ment, level of consciousness
                              use: relief of moderate to    pain impulses
                              moderately severe pain

Oxycodone and acetamino-      analgesic                     Attach to specific receptors relief of moderate to mod-   dizziness, N&V, sedation,     Note VS, CNS assessment,
phen (Tylox, Percocet, Rox-                                 located in the CNS to reduce erately severe pain          constipation                  level of consciousness
icet)                                                       pain impulses


5 mg PO q4h      PRN

Oxycodone HCl (Oxycontin)     Synthetic alkaloid with ac-   Active against moderate to                                Light-headedness, dizziness, Sustained release tablet. Do
                              tions similar to morphine.    moderately severe pain. Ap-                               sedation, or fainting.       not crush or split.
10mg SR Tab                   Most prominent actions in-    pears to be more effective in
                              volve CNS and organs com-     relief of acute than long-                                Anorexia, nausea, vomiting,   Psychic and physical depen-
                              posed of smooth muscle. As    standing pain                                             constipation, jaundice,       dence and tolerance may
                              potent as morphine and 10–                                                                                            develop with repeated use.
                                                                                                                      SOB, resp. depression.        The potential for drug abuse
                              12 times more potent than
                              codeine.                                                                                Pruritus, skin rash.          is high.

                                                                                                                      Bradycardia.                  Narcotic overdose potential
                                                                                                                                                    (respiratory depression, cir-
                                                                                                                                                    culatory collapse, extreme
                                                                                                                                                    somnolence progressing to
                                                                                                                                                    stupor or coma).

oxycodone HCl (Roxicodone) narcotic (opiate)/pain           binds at natural opiod recep-                             hepatotxic, respiratory de-   Monitor vitals, esp respira-
                                                            tors                                                      pression                      tions
                                                                                                                                                    monitor liver function tests
                                                                                                                                                    supervise ambulation
                                                                                                                                                    monitor for extreme somno-
                                                                                                                                                    lence

Oxycodone HCl (Roxicodone) Synthetic alkaloid with ac-      Active against moderate to                                Light-headedness, dizziness, Psychic and physical depen-
                           tions similar to morphine.       moderately severe pain. Ap-                               sedation, or fainting.       dence and tolerance may
                           Most prominent actions in-       pears to be more effective in                                                          develop with repeated use.
                           volve CNS and organs com-        relief of acute than long-                                Anorexia, nausea, vomiting, The potential for drug abuse
5mg tab, PO Q6H                                                                                                       constipation, jaundice,
                           posed of smooth muscle. As       standing pain                                                                          is high.
                           potent as morphine and 10–                                                                 SOB, resp. depression.
                           12 times more potent than                                                                                               Narcotic overdose potential
                           codeine.                                                                                   Pruritus, skin rash.          (respiratory depression, cir-
                                                                                                                                                    culatory collapse, extreme
                                                                                                                      Bradycardia.                  somnolence progressing to
                                                                                                                                                    stupor or coma).
                                                                                                                                                                      Page 73 of 99
Drug Name                 Class                          Actions                          Indications                   Side Effects                     Nursing implications

Pantaprozole 40mg PO QD   Acid reducer to reduce gas-    Gastric acid-pump inhibitor:                                   Headache, dizziness, asthe-      Monitor client for gastric up-
                          tric upset                     suppresses gastric acid se-                                    nia, vertigo, insomnia, apa-     set
                                                         cretion by specific inhibition                                 thy, anxiety, paresthesias,
                                                         of the hydrogen/potassium                                      rash, inflammation, urticaria,   Monitor client for bowel
                                                         ATPase enzyme system at                                        pruritus, alopecia, dry skin,    changes
                                                         the secretory surface of the                                   diarrhea, abdominal pain,
                                                         gastric parietal cells; blocks                                 nausea, vomiting, constipa-
                                                         the final step of acid produc-                                 tion, dry mouth, tongue atro-
                                                         tion.                                                          phy, URI symptoms, cough,
                                                                                                                        epistaxis

Pantoprazole              Proton Pump Inhibitor for      Proton Pump Inhibitor. Binds                                   Headache, diarrhea, abdo-        Assess routinely for epigas-
                          treatment of erosive esopha-   to and inactivates the final                                   minal pain, eructation,          tric or abdominal pain and for
(Protonix)                gitis and heartburn symp-      enzyme that transports H+                                      hyperglycemia                    frank or occult blood in stool,
                          toms associated with GERD.     into the gastric lumen dimi-                                                                    emesis, or gastric aspirate.
                                                         nishing accumulation of acid
40 mg PO qd                                              & lessening acid reflux.

Pantoprazole (Protonix)   Anti-ulcer agents (gastric     Binds to an enzyme in the                                      HA. Ab pain                      Assess patient routinely for
                          acid–pump inhibitor)           presence of acidic gastric                                     diarrhea.                        epigastric or abdominal pain
                                                         pH, preventing the final                                       hyperglycemia                    and for frank or occult blood
                          Use: treatment and preven-     transport of hydrogen ions                                                                      in stool, emesis, or gastric
                          tion of gastric ulcers, eso-   into the gastric lumen.                                                                         aspirate.
                          phageal erosion from reflux
                                                                                                                                                          May cause abnormal liver
                                                                                                                                                         function tests, including in-
                                                                                                                                                         creased AST, ALT, alkaline
                                                                                                                                                         phosphatase, and bilirubin.


Paroxetine (Paxil)        SSRI                           Inhibits reuptake of neuronal                                  Headache, sedation, pares-       Not with MAOI’s, gradual
                                                         serotonin                                                      thesias, sexual dysfunction,     increase dose, not with
                          Use-treat depression, anxie-                                                                  dry mouth                        ETOH
                          ty, phobias

paxil (paroxethine)       antidepressant                 unknown, thought to be           depression, ocd, panic, ge-   somnolence, dizziness, in-   VS, fluid intake for dry
                                                         linked to drug's inhibition of   neralized anxiety disorder    somnia, lump or tightness in mouth, bowel regimen, moni-
                                                         CNS neuronal uptake of se-                                     throat, dry mouth, constipa- tor eating habits
                                                         rotonin                                                        tion, appetite changes

Pepcid                    Histamine receptor antagon- Inhibits histamine at h2 re-        GI                            Shock, N&V, HA, dyspnea,         Triclycerides, platelet counts,
                          ist/ Pt. using for GERD     ceptor site in gastric parital                                    fat in lung tissue               liver function, HGB, nutrition-
                                                      cells, which inhibits gastric                                                                      al status
                                                      acid secretion
                                                                                                                                                                       Page 74 of 99
Drug Name                    Class                         Actions                          Indications                  Side Effects                     Nursing implications

Pepcid     (Famotidine)      H2 antagonists                competitively inhibits action prevention or treatment for     headache, malaise, dizzi-        assess allergy to pepcid,
                                                           of H2 at receptor sites of the heartburn                      ness, insomnia, rash, diarr-     assess renal failure, evaluate
                                                           parietal cells decreasing gas-                                hea, constipation, abd. Pain,    liver function, evaluate renal
                                                           tric acid secretion                                           muscle cramp, increase in        function, normal output, se-
                                                                                                                         bilirubin, sexual impotence,     rum bilirubin,admin. Drug at
                                                                                                                         tinnitis, increase BUN and       bedtime, have client report
                                                                                                                         Creatine levels, irritation at   sore throat, unusual bleeding
                                                                                                                         IV site                          or bruising, fever, severe
                                                                                                                                                          headache, joint pain

Perchlorperazine maleate     Control of nausea and vomit- Depresses the chemorecep-                                      extrapyramidal reactions
(Compazine)                  ing.                           tor trigger zone (CTZ) in the                                (akathisia, dystonia or par-
                                                            area postrema of the fourth                                  kinsonism), blurred vison, dry
                                                            ventricle. This mediates                                     eyes, constipation, dry
                             (primarily prescribed for      some impulses that stimulate                                 mouth, photosensitivity, per-
                             management of manifesta- the vomiting center in the                                         sistent tardive dyskinesia,
                             tions of psychotic disorders, medulla.                                                      neuroleptic malignant syn-
                             of excessive anxiety, tension,                                                              drome, agranulocytosis
                             and agitation)
                                                            Alters effects of dopamine in
                                                            the CNS
                                                           Anticholinergic and alpha-
                                                           adrenergic blocking activity,

Perchlorperazine maleate     Control of nausea and vomit- Depresses the chemorecep-                                      extrapyramidal reactions
(Compazine)                  ing.                           tor trigger zone (CTZ) in the                                (akathisia, dystonia or par-
                                                            area postrema of the fourth                                  kinsonism), blurred vison, dry
                                                            ventricle. This mediates                                     eyes, constipation, dry
                             (primarily prescribed for      some impulses that stimulate                                 mouth, photosensitivity, per-
                             management of manifesta- the vomiting center in the                                         sistent tardive dyskinesia,
                             tions of psychotic disorders, medulla.                                                      neuroleptic malignant syn-
                             of excessive anxiety, tension,                                                              drome, agranulocytosis
                             and agitation)
                                                            Alters effects of dopamine in
                                                            the CNS
                                                           Anticholinergic and alpha-
                                                           adrenergic blocking activity,

Percocet                     analgesic                     attaches to specific receptors mild to moderate pain          dizziness, n/v, sedation, and monitor vs,loc,cns changes,
                                                           located in CNS to decrease                                    constipation                  and safety precautions
                                                           pain impulses

Pericolace, Docusate sodium laxative, emollient            acts by lowering the surface     to lessen strain of defecation some degree of abdominal       encourage adequate fluid
(Colace, Dulcolax, Phillips                                tension of the feces and         in persons with hernia or CV discomfort, nausea, mild         intake, assess bowel sounds
Stool Softener) 1 cap PO bid                               promoting penetration by         diseases, constipation asso- cramps, griping, faintness,      for peristalsis. Monitor daily
for constipation                                           water and fat, thus increas-     ciated with dry, hard stool,                                  bowel activity and stool con-
                                                           ing the softness of the fecal    bedridden clients                                             sistency
                                                           mass
                                                                                                                                                                      Page 75 of 99
Drug Name                      Class                         Actions                            Indications              Side Effects                    Nursing implications

Perphenazine (Trilafon)        Antipsychotic, CNS depres-    Block dopamine receptors in Typical Antipsychotic           Less sedation, anticholiner-    Baseline BP, monitor EPS,
                               sion especially hypothalam-   the brain                                                   gic and hypotension, high       CBC, change positions slow-
                               ous                                                                                       EPS, agranulocytosis            ly, avoid overheating and
                                                                                                                                                         extreme cold, avoid sunlight
                               Use-treat psychosis, anti-                                                                                                and ETOH, monitor aims
                               emetic

Phenergan                      antiemetic                    blocks the cholinergic effect prophylaxis of N&V, adjunct dizziness, drowsiness, poor       Monitor for sedation
                                                             of the vomiting center which to analgesics for postop pain coordination, confusion, res-
(Promethazine hydrochloride)                                 are believed to mediate N&V                                tlessness, convulsions,          Monitor for n/v
                                                                                                                        headaches, tremors, blurred      Monitor for s/s of aspiration
                                                                                                                        vision, vertigo, tinnitus, dry
12.5 mg IV q6h    PRN                                                                                                   mouth and nose, resp. de-        Monitor amount of time client
                                                                                                                        pression,                        sleeps
                                                                                                                                                         Monitor labs for dyscrasias
(Stop if complains of pain)
                                                                                                                                                         Monitor for s/s of auditory
                                                                                                                                                         difficulties
                                                                                                                                                         Monitor client’s intake and
                                                                                                                                                         output, and put them on a
                                                                                                                                                         comparison
                                                                                                                                                         Monitor client for diarrhea
                                                                                                                                                         and constipation

phenobarbitol                  central nervous system        inhibits transmission of im-                                cns depression, coma,           crush and mix with fluids
                               agent, anticonvulsant/        pulses in the reticular activat-                            death, respiratory depres-
                                                             ing system                                                  sion, stevens-johnson der-      Monitor respirations
60mg gt q12h-b (home dose)                                                                                               matitis                         monitor for toxicity: ataxia,
                               seizures                                                                                                                  slurred speech, confusion,
                                                                                                                                                         insomnia, irritability


Phenytoin                      Anti convulsant agent neuro- Inhibits spread of seizure                                   V Fib, insomnia, drowsiness,    Toxic levels, mental status,
                               leptic                        activity in motor cortex by                                 blurred vision, hepatitis,      seizure, BUN, RBC, Hct,
(Dilantin)                                                   altering ion transport                                      nephritis, SJS, hypokalemia,    Hgb, ALT, AST, eye prob-
                               Use: treat or prevent seizure                                                             N&V, anorexia, HA, confu-       lems, allergic reaction, he-
                               activity                                                                                  sion                            patic studies, assess physi-
                                                                                                                                                         cal withdrawal symptoms
                                                                                                                                                          Page 76 of 99
Drug Name                   Class                         Actions                          Indications     Side Effects                      Nursing implications

Physostigmine               cholinergic i                 inhibit cholinesterase thus      Colinergic      caution:preg c, copd, hypr-       opthalmic:applied at night,
                                                                                                           thyd, urinary                     occlude
                            use:reverse tricyclic         prolong Ach
                                                                                                           disease, recen tGI urinary        lacrimal sac to prevent sys-
                             antidrpress OD,                                                               surgery                           temic
                            reverse atropine,                                                              bradycard, hypo/hyperten,         absorption
                            treat glaucoma                                                                 CAD,
                                                                                                                                             IV:give undiluted slowly
                                                                                                           recent MI, epilepsy, parkin-
                                                                                                           sons                              blue eyed more sensitive

                                                                                                           adv/side:dizzy, n&v, diahh-
                                                                                                           rea, rash
                                                                                                           incr saliva, sweat, flush, mi-
                                                                                                           osis
                                                                                                           blur vision, urinary freq, bra-
                                                                                                           dycard

Pilocarpine                                               chronic and acute glaucoma                                                         1 to 2 drops up to 6 times a
                                                          treatment of mydriasis                                                             day may be needed based
                                                          caused by drugs direct acting                                                      on patient response
                                                          miotic agent

Pioglitazone (actos)        Antidiabetic hypoglycemic     Increases insulin receptor       Anti-diabetic   HA, myalgia, edema, tooth         Peak 2h, monitor for hypog-
                            agent                         affinity (sensitivity ) decreas-                 disorder, upper respiratory       lycemia, monitor Hgb A1c,
                                                          es liver glucose output                          infection                         decreases oral contraceptive
                            Use: treat type 2 diabetes                                                                                       effectiveness

Piperacillin-Tazobactam     Anti-infective, Beta-lactam   Tazobactam inhibits beta                         HA, fever, N&V, diarrhea,         Monitor CBC, Hgb, Hct, PT,
(Zosyn )                    antibiotic                    lactamases, extends spec-                        pseudomembranous colitis          PTT,
                                                          trum of piperacillin to broad
3.375gm IV q6h3.375g=50ml Use: treat moderate to se-      variety of anaerobic bacteria.                                                     Report loose stool and diarr-
premix                    vere skin suture infections     Short ½ life                                                                       hea

Pipracil / Zoysn            AntiInfective                 broad spectrum penicillin,                       bone marrow depression,           AST, ALT, BUN, urinalysis,
                                                          blocks bacteria cell wall rep-                   N/V/D, pseudomembranous           Protein, Cr
(Piperacillin/Tazobactam)                                 lication = swells, bursts                        colitis, coma, anaphylaxsis
                            peritonitis
                            prophylaxis

Plavix                                                    Inhibits platelet aggregation                    Arthralgia, Edema, Epistaxis, Monitor CBC, PT/PTT
                                                          by inhibiting the binding of                     Hemorrhage, Hypertension,
(clopidogrel bisulfate)     Antiplatelet                  ADP to its platelet receptor,                    Upper Respiratory Infection Monitor for bleeding
75 mg PO QD                                               inhibiting ADP-mediated ac-                                                    Effects last 5 days after last
                                                          tivation and subsequent                                                        dose
                            Prevention of recurrent MI    platelet aggregation. Plate-
                                                          lets are affected for their
                                                          lifespan.
                                                                                                                                                                                Page 77 of 99
Drug Name                      Class                           Actions                           Indications                      Side Effects                     Nursing implications

polyethelene glycol (miralax) laxative/                        Softens stools                                                     N/A                              mix with 4 ounces water
                                                                                                                                                                   give until stools are soft


                               constipation

Potassium chloride (K-Dur,     electrolyte                     used to prevent and correct                                        hyperkalemia, arrhythmias,       Do not crush: may break in
Tri-K, Kaochlor)                                               potassium deficiency (hypo-                                        bradycardia, cardiac arrest,     half.
                                                               kalemia), diabetic acidosis,                                       tingling, paralysis, bleeding,
                                                               metabolic acidosis, clients on                                     ulceration                       Document electrolytes and
                                                               digitalis and diuretics, diarr-                                                                     ECG changes, monitor for
20mEq SR Tab, PO, OTO                                                                                                                                              hypokalemia, hyperkalemia,
                                                               hea
                                                                                                                                                                   Monitor VS, I&Os, Assess for
                                                                                                                                                                   adequate urinary flow, As-
                                                                                                                                                                   sess for abdominal pain, GI
                                                                                                                                                                   bleeding, observe for adrenal
                                                                                                                                                                   insufficiency or tissue break-
                                                                                                                                                                   down


Prednisone                     Glucocorticoid                  Converts to prednisolone in                                        Na+ and K+ retention, HA,        Take with food, avoid caffe-
                                                               liver, synthetic adrenal glu-                                      confusion, psychosis, N&V,       ine and ETOH, often alter-
                               Use: anti-inflammatory anti-    cocorticoid                                                        weakness, delayed wound          nate day regimen, stop grad-
                               neoplastic, immunosuppres-                                                                         healing, masked in fection,      ually, increase dose with
                               sant, treat myasthenia gravis                                                                      muscle wasting, cataracts,       stress of illness or surgery,
                                                                                                                                  osteoporosis, hyperglycemia,     monitor wt, CBC, BP, BS,
                                                                                                                                                                   albumin, electrolytes

Prednisone (deltasone, meti-   glucocorticoid, anti-           not clearly defined . De-      severe inflammation, immu-          vertigo headache hyperten-       do not stop abruptly causes
corten, winpred)               inflammatory                    creases inflammation mainly nosuppression                          sion, edema, pancreatitis,       rebound inflammation give a
                                                               by stabilizing leukocyte lyso-                                     hypokalemia, hyperglycemia,      once daily dose in the morn-
                                                               somal membranes sup-                                               muscle weakness , delayed        ing may need meds to pre-
                                                               presses immune response                                            wound healing, masking of        vent GI irritation monitor BP
                                                               stimulates bone marrow and                                         infection                        Monitor for sudden weight
                                                               influences protein , fat, and                                                                       gain diabetic patients may
                                                               carbohydrate metabolism                                                                             need increased insulin

Prenatal vitamins              Water soluble vitamin nutri-    Absorbed in GI                    GI                               N&V, diarrhea, HA                With meals
                               tional supplement
                               Use: treat Vitamin deficiency

Prevacid (lansoprazole)        antisecretory agent proton      gastric acid pump inhibitor ,     short term treatment of active   headache dizziness diarrhea      administer before meals
                               pump inhibitor                  suppresses gastric acid se-       duodenal ulcer, and gastroe-     abdominal pain nausea vo-        swallow the capsule whole if
                                                               cretion by inhibiting the hy-     sophageal reflux disease,        miting constipation URI          symptoms become uncom-
                                                               drogen potassium ATPase           maintenance therapy for          symptoms                         fortable consult with doctor
                                                               enzyme system , blocks the        healing of erosive esophagi-
                                                               final step of acid production     tis, duodenal ulcers
                                                                                                                                                                       Page 78 of 99
Drug Name                     Class                        Actions                         Indications                     Side Effects                   Nursing implications

Prinivil                      ace inhibitor                inhibits conversion of angio    Cardiac Medication              headache, dizzy, dry cough, causes increased bun, crea-
                                                                                                                                                       tinine
Lisinopril                    antihypertensive             ten1 to angioten2, thus                                         dry mouth, hypotension
                                                                                                                                                       nsaids decr.drug activity
                              use: to lower bp             inhibiting vasoconstriction
                              by decreasing
                              peripheral vas resist

Probenicid (benemid)          Anti-gout agent, sulfonamide Inhibits renal tubule reab-     Anti-Gout                       Hemolytic anemia, aplastic     ASA decreases drug activity,
                                                           sorption of uric acid, pro-                                     anemia, HA, N&V, sore          take with food, may be ad-
                              Use: prophylaxis or treat-   motes excretion of uric acid                                    gums, resp. depression c       junct with colchicine, fluids
                              ment of acute gout, reduces                                                                  toxicity                       3L/d, avoid high purine foods
                              tophi and inhibits new tophi                                                                                                till uric acid level stabilized
                              formation

Procainamide                  antidysrythmic grp 1A        neg dromotropic                 Cardiac Medication              dry mouth, hypotension         cbc, nappa metabolite
Pronestyl                     use: treat atrial            neg inotropic                                                   butterfly rash, system lupus   wax cap in stool
                              dysrhythmias                                                                                 bleeding, cns effects, dental monitor bp, ekg, I/O, cbc,
                                                                                                                                                          electrolyte, kidney&liver func-
                                                                                                                                                          tion

Procarbazine, Matulane, Na-   Antineoplastics              unknown, thought to inhibit     Atineoplastic. Hodgkins, and coma, insomnia, hallucina-        use caution in pts with im-
tulann                                                     DNA and RNA and protein         other cancers                tions, syncope, confusion,        paired renal and liver func-
                              Use: treat Hodgkins, and     synthesis                                                    <BP, nystagmus, photopho-         tion, CBC, platelet counts,
                              other cancers                                                                             bia, GI effects, bleeding ten-    anticipate blood transfusions,
                                                                                                                        dencies, thrombocytopenia,        dc if pt becomes confused or
                                                                                                                        hepatoxicity, leuopenia ane-      paresthesia neuropathies
                                                                                                                        mia, alopecia, herpes out-        develop not with tyramine
                                                                                                                        break                             foods

Procrit (Epoetin alfa recombi- Erythropoietin, human re-   idential amino acid sequence    anemia associated with          hypertension, MI, CVA, sei-    Determine hematocrit twice
nant)                          combinant                   and same biologic effects as    chronic renal failure, reduce   zures, clotted vascular        week, determine CBC and
                                                           endogenous erythropoietin       allogeneic blood transfusions   access, seizures, hyperka-     iron, Assess BP, monitor BP,
                                                           (normally synthesized in the    in surgery clients              lemia, insomnia, DVT, ede-     control hypertension, monitor
                                                           kidney and stimulates RBC                                       ma                             renal function, I&O, electro-
                                                           production )elevates or main-                                                                  lytes
                                                           tains the RBC level, decreas-
                                                           ing need for transfusions
                                                                                                                                                                    Page 79 of 99
Drug Name                    Class                         Actions                         Indications                Side Effects                     Nursing implications

Prograf                      Immunosuppressive             ubgubuts tcells (il2-il3-                                  Tremor, Peripheral tingling, CBC with diff, Blood glucose,
                                                           ilgamma inhibitors) reduces                                high BP, NVD, Mg decrease electrolytes
(tacrolimus, FK506)          Prophylaxis of organ trans-   transplant rejection
                             plants                        …antibody production is
                                                           subdued by creating imbal-
                                                           ance of suppressor t cells.




Promethazine HCl             antiemetic                    blocks the cholinergic effect                              dizziness, drowsiness, poor      Monitor for sedation
                                                           of the vomiting center which                               coordination, confusion, res-
(Phenergan)                                                are believed to mediate N&V.                               tlessness, convulsions,          Monitor for n/v
                                                           Prophylaxis of N&V, Adjunct                                headaches, tremors, blurred      Monitor for s/s of aspiration
                                                           to analgesics for postop pain                              vision, vertigo, tinnitus, dry
                                                                                                                      mouth and nose, resp. de-        Monitor amount of time client
                                                                                                                      pression,                        sleeps
                                                                                                                                                       Monitor labs for dyscrasias
                                                                                                                                                       Monitor for s/s of auditory
                                                                                                                                                       difficulties
                                                                                                                                                       Monitor client’s intake and
                                                                                                                                                       output, and put them on a
                                                                                                                                                       comparison
                                                                                                                                                       Monitor client for diarrhea
                                                                                                                                                       and constipation

Promethazine HCl (Phener-    Antiemetic, H1 receptor an-   Block H1 receptors                                         Constipation, retention, diz- Respiratory status, I&O,
gan )                        tagonist/ antiemetic                                                                     ziness, hypotension, blurred CBC,
                                                                                                                      vision, thrombocytopenia,
25 mg IV PRN

Promethazine hydrochloride   antiemetic                    blocks the cholinergic effect prophylaxis of N&V, adjunct dizziness, drowsiness, poor        Stop if complains of pain
                                                           of the vomiting center which to analgesics for postop pain coordination, confusion, res-
(Phenergan)                                                are believed to mediate N&V                                tlessness, convulsions,           Monitor for sedation, n/v, s/s
                                                                                                                      headaches, tremors, blurred       of aspiration, I/O, diarrhea &
                                                                                                                      vision, vertigo, tinnitus, dry    constipation
12.5 mg IV q6h   PRN                                                                                                  mouth and nose, resp. de-         Monitor for s/s of auditory
                                                                                                                      pression,                         difficulties
                                                                                                                                                              Page 80 of 99
Drug Name                   Class                          Actions                        Indications          Side Effects                      Nursing implications

Propanolol                  B andrenergic antagonst        block catecholamine            Cardiac Medication   Hypotension, bradycardia,   GI upset-give with food
                                                                                                               CHF, wheezing, hy-
Inderal                     use:treat hypertension         stimulation of B (heart ) B                         po/hyperglycemia, withdraw- prophylactic post MI, apical
                                                           (lung )o decrease Card outp,                        al rebound effect,          pulse
                            treat A&V dysrhythmias
                                                           BP&HR, renin activity                               bronchconstriction, head-   >60, caution w/ hyperthyroid-
                            migraine, panic attack                                                                                         ism,
                                                                                                               ache
                                                                                                               cold hands&feet, dreams,          use sugarless gum, eye sa-
                                                                                                                                                 line
                                                                                                               heartburn, drymouth, con-
                                                                                                               gestn                             caution w/ Ca channel block-
                                                                                                                                                 ers
                                                                                                               caution w/ Ca chan blocker

Propoxifylline (trental)    antiplatelet agent              restore microcirculation by                        CNS effects-dizzy, confu-         Onset 2-3 wks, monitor for
                                                            decreasing blood viscosity,                        sion, hypotension                 bleeding
                            use: treat intermittent claudi- making RBC’s pliable
                            cation of PVD                                                                      Blurred vision, decreased
                                                                                                               BP, flushing, dysrhythmias

Propoxyphene nap (Darvon    Narcotic agonist analgesic     Bind to opioid receptors, ½-                        Dizzy, HA, sedation, N&V,         Administer laxative, monitor
)PO 2 tab q6h PRN                                          2/3 strength of codeine, no                         constipation, resp depres-        for safety, fall protection,
                            Use: mild to moderate pain     antitussive effect                                  sion, hypoglycemia c renal        avoid ETOH,
                            relief                                                                             dysfunction, tolerance and
                                                                                                               abuse

Propoxyphene nap (Darvon)   Narcotic agonist analgesic     Bind to opioid receptors, ½-                        Dizzy, HA, sedation, N&V,         Administer laxative, monitor
                                                           2/3 strength of codeine, no                         constipation, resp depres-        for safety, fall protection,
PO 2 tab q6h PRN            Use: mild to moderate pain     antitussive effect                                  sion, hypoglycemia c renal        avoid ETOH,
                            relief                                                                             dysfunction, tolerance and
                                                                                                               abuse

Prostigmin                  cholinergic i                  inhibit cholinesterase thus    Colinergic           caution:preg c, copd, hypr-       ck pulse, caution bradycardia
                                                                                                               thyd, urinary
Neostigmine                 use:treat myasthenia           prolong Ach                                                                           for urine retention, cl should
                                                                                                               disease, recen tGI urinary
                            gravis, to reverse                                                                 surgery                           urinate w/in 1 HR of first
                                                                                                                                                 dose
                            nondepolarz muscle                                                                 bradycard, hypo/hyperten,
                            relaxer, post-op                                                                   CAD,
                                                                                                               recent MI, epilepsy, parkin-
                                                                                                               sons
                                                                                                               adv/side:dizzy, n&v, diahh-
                                                                                                               rea, rash
                                                                                                               incr saliva, sweat, flush, mi-
                                                                                                               osis
                                                                                                               blur vision, urinary freq, bra-
                                                                                                               dycard
                                                                                                                                                                             Page 81 of 99
Drug Name                      Class                          Actions                           Indications                     Side Effects                    Nursing implications

protamine sulfate              antagonist, antidote           heparin antagonist that forms heparin overdose                    bradycardia, circulatory col-   postoperative dose is based
                                                              a physiologically inert com-                                      lapse, acute pulmonary          on coagulation studies, and a
                                                              plex with heparin sodium                                          hypertension, anaphylaxis,      repeat PT in 5 mins, calcu-
                                                                                                                                feeling of warmth, lassitude    late dosage carefully (1mg of
                                                                                                                                                                protamine neutralizes 90-115
                                                                                                                                                                units of heparin depending
                                                                                                                                                                on salt), use caution in pts
                                                                                                                                                                allergic to fish, in vasecto-
                                                                                                                                                                mized or infertile men, and in
                                                                                                                                                                pts taking protamine insulin
                                                                                                                                                                products, watch for sponta-
                                                                                                                                                                neous bleeding especially in
                                                                                                                                                                dialysis pts and those who
                                                                                                                                                                have undergone cardiac sur-
                                                                                                                                                                gery

Protonix                       GI agent, proton pump inhibi- gastric secretion is inhibited                                     severe diarrhea, angioede- Urea breath test 4-6 wks
                               tor                           by blocking of final step of                                       ma, severe skin rash, hyper- later
(pantoprazole)                                               acid production                                                    glycemia
                               short term use treat esopha-                                                                                                  PT, PTT (increased bleed-
                               gitis                                                                                                                         ing)
                                                                                                                                                                AST,ALT, ALK

Provigil (modafinil )(controlled unknown, drug wake, pro-     day time sleepiness, narca-       arrhythmias, cp, htn, hypo- monitor vitals, ecg, and BS, if
substance schedule IV)           motes actions similar to     lepsy                             tension, ha, nervousness,   decrease BP safety precau-
                                 sympathomimetics but does                                      dizziness, insomnia, urine  tions
                                 not release dopamine, or                                       retention, joint disorders,
                                 norepi to produce cns stimu-                                   herpes simplex, increase BS
                                 lation

Prozac (fluoxetine hydrochlo- antidepressant                  acts as an antidepressant by      treatment of depression ,       head ache nervousness in-       administer in the morning if
ride)                                                         inhibiting CNS neuronal up-       obsessive compulsive buli-      somnia drowsiness anxiety       dose of less than 20 mg a
                                                              take of serotonin blocks up-      mia, premenstrual dysphoric     tremor dizziness dry mouth,     day is needed monitor for
                                                              take of serotonin with little     disorder unlabeled for treat-   constipation taste changes      response of therapy for 4
                                                              effect on norepinephrine little   ment of obesity, alcoholism     upper respiratory infection     weeks before increasing
                                                              affinity for muscarinic hista-                                                                    dose watch for rash , mania
                                                              minergic and alpha 1 adre-                                                                        ,seizures severe weight loss
                                                              nergic receptors

Psyllium hydrophilic myceloid laxative, bulk-forming          forms a gelatinous mass with      prophylaxis of constipation, obstruction of the esopha-         take with plenty of water (liq-
(Mylanta, Metamucil)                                          water, which adds bulk to the     short-term treatment of con- gus, stomach, small intes-         uid ) report lack of response,
                                                              stools and stimulates peris-      stipation, to soften feces   tine, and rectum                   determine length of use and
                                                              talsis                            during fecal impaction                                          underlying causes, deter-
                                                                                                                                                                mine stool characteristics
                                                                                                                                                                and frequency
                                                                                                                                                                     Page 82 of 99
Drug Name                    Class                          Actions                           Indications               Side Effects                    Nursing implications

Quetiapine fumarate (Sero-   Atypical antipsychotic, CNS    Dopamine and serotonin            Atypical Antipsychotic    Sedation, somnolence, hypo-     Titrate dose over 4 days,
quel)                        agent                          reuptake inhibitor                                          tension, tachycardia anticho-
                                                                                                                        linergic, weight gain, rash,    Change positions slowly
                             Use-treat psychosis                                                                        rhinits, asthenia, back pain,   Monitor for seizures, CBC,
                                                                                                                        nausea, dry mouth,              liver and thyroid function,
                                                                                                                                                        mental status, BP, EPS
                                                                                                                                                        symptoms avoid ETOH

Quinidine                    antidysrythmic grp 1A          slows Na+ depolarize,             Cardiac Medication        dry mouth, tinnitus, rash       not for heart failure
                             indirect anticholinergic       decrease depolarizatn                                       vision changes, hypotension monitor bp, ekg, I/O, cbc,
                             use:treat ventricular          neg dromotropic -                                           bitter taste, dental            electrolyte, kidney&liver func-
                                                                                                                                                        tion
                             dysrhythmias,                  a adrenergic block                                          anticholinergic effects
                                                                                                                                                        dental care
                             vasodilation                                                                               bleeding
                                                                                                                                                        caution copd

Ramipril (altase)            Ace inhibitors,                Blocks conversion of angi-     Cardiac Medication           Cough, fever, sore throat      d/c diuretic 2-3 days before
                                                            otensin 1 to angiotensin 2,                                                                beginning altase, if cannot
                              use: vasodilation to reduce   decrease BP by blocking                                     Hypotensio (first dose )hy-    d/c diuretic, limit initial dose
                             afterload by dilation peri-    vasoconstriction of peripheral                              perK with poor renal function, to 1.25 mg. , postural hypo-
                             pheral arteries, lowers BP     arteries                                                    dry mouth,                     tension, monitor BP at peak,
                                                                                                                                                       (2-3 HR post med ) K+, CBC,
                                                                                                                                                       fever, report cough, monitor
                                                                                                                                                       BUN and CR

Ramipril (Altase)            Ace inhibitors,                Blocks conversion of angi-                                  Cough, fever, sore throat    d/c diuretic 2-3 days before
                                                            otensin 1 to angiotensin                                                                 beginning altase, if cannot
                              use: vasodilation to reduce   2,decrease BP by blocking                                   Hypotension(first dose)      d/c diuretic, limit initial dose
                             afterload by dilation peri-    vasoconstriction of peripheral
                             pheral arteries, lowers BP                                                                 hyperK with poor renal func- to 1.25 mg. , postural hypo-
                                                            arteries                                                    tion,dry mouth,              tension, monitor BP at peak,
                                                                                                                                                     (2-3 hr post med),
                                                                                                                                                     K+,CBC,fever,report cough,
                                                                                                                                                     monitor BUN and CR

Ranitidine HCl (Zantac)      H2 receptor antagonist         competitively inhibits action duodenal and gastric ulcer,   vertigo, malaise, blurred vi-   caution in pt's with liver dys-
                                                            of H2 at receptor sites of the short term treatment         sion, increased creatinine      function, assess for gi bleed,
                                                            parietal cells decreasing gas-                              levels, leukopenia, elevated    antacids may interfere
                                                            tric acid secretion                                         liver enzymes, anaphylaxis,     with/stager doses, may alter
                                                                                                                        burning and itching at site     valium, glipizide, procaina-
                                                                                                                                                        mide, and warfarin

Reglan                       Cholinergic, antiemetic        gastric muscle contraction,                                 sedation, seizures, constipa- CBC
                                                            relaxes pyloric duodenal                                    tion, agranulocytosis
(Metoclopramide)                                            segments and increases
                             prevent nausea                 peristalsis without stimulating
                                                            secretions
                                                                                                                                                                          Page 83 of 99
Drug Name                  Class                          Actions                            Indications                   Side Effects                      Nursing implications

Restoril (temazepam)       benzodiazepine, sedative-      Thought to affect the limbic       short term treatment of in-   drowsiness, sedation, re-         assess sleep patterns, limit
                           hypnotic                       system and reticular forma-        somnia in clients unable to   bound insomnia, dizziness,        night time disturbances,
                                                          tion to reduce anxiety by          fall asleep, with frequent    confusion, euphoria, weak-        watch for diarrhea, anorexia
                                                          increasing or facilitating the     awakenings during the night   ness
                                                          inhibitory neurotransmitter        and early morning
                                                          activity of GABA

Rifampin (Rifadin)         Suppresses RNA synthesis. Active against Mycobacte-                                             Fatigue, drowsiness, HA,          Give on empty stomach
                           in susceptible bacterial cells. rium tuberculosis, M. leprae,                                   ataxia, confusion, dizziness,     may discolor urine
                                                           Neisseria meningitidis, and a                                   generalized numbness, pain
                                                           wide range of gram-negative                                     in extremities, weakness.         Lab tests: Periodic liver func-
                                                           and gram-positive organ-                                        Visual disturbances, tran-        tion tests are advised. Close-
                                                           isms. It is used in conjunction                                 sient low-frequency hearing       ly monitor patients with he-
                                                           with other antitubercular                                       loss, conjunctivitis.             patic disease.
                                                           agents to treat tuberculosis                                    GI: Heartburn, epigastric         Check prothrombin time daily
                                                           because resistant strains                                       distress, N&V, anorexia, fla-     or as necessary to establish
                                                           emerge rapidly when it is                                       tulence, cramps, diarrhea,        and maintain required anti-
                                                           employed alone.                                                 pseudomembranous colitis,         coagulant activity when pa-
                                                                                                                           pancreatitis.                     tient is also receiving an an-
                                                                                                                           Hypersensitivity Rxn., flu-like   ticoagulant.
                                                                                                                           syndrome.
                                                                                                                           Respiratory: Hemoptysis.
                                                                                                                           Other: brownish-red or
                                                                                                                           orange discoloration of skin,
                                                                                                                           sweat, saliva, tears, and fec-
                                                                                                                           es
Risperidone (Risperdal )   Atypical antipsychotic, CNS    Dopamine and serotonin             Atypical Antipsychotic        Sedation, drowsy, some an-        Change dosage slowly
                           agent                          receptor block in limbic re-                                     ticholinergic, effects, head-
                                                          gion of brain                                                    ache, agitation, weakness, ,      Change positions slowly
                           Use-treat psychotic symp-                                                                       orthostatic hypotension
                           toms                                                                                                                              Monitor for increased risk
                                                                                                                                                             seizures, avoid ETOH

Rofecoxib (Vioxx)          Nonsteroidal anti-             NSAID that acts by inhibiting      relieves signs and symptoms diarrhea, nausea, lower ex-         Monitor for bleed, urticaria,
                           inflammatory, COX-2 inhibi-    prostaglandin synthesis via        of osteoarthritis, acute pain tremity edema, dizziness,         assess for liver/renal dys-
                           tor                            inhibition of cylcooxygenase-      in adults, and treatment of   hypertension, headache            function, monitor lytes, renal
                                                          2                                  dysmenorrhea                                                    and LFTs

Salicylates (aspirin)      Salicylate                     Inhibits cox1 and cox2 en-                                       GI bleeding, tinnitus, bruising d/c 7 d prior to surgery,
                                                          zymes thus inbhibits                                             and bleeding gums
                           Use: anti-inflammatory                                                                                                          give with food, report ringing
                                                          Prostiglandins. Decrease                                                                         in ears, monitor for bleeding,
                           Arthritis-12-18 tab/d          platelet aggregation                                                                             bruising
                           4-6 g
                           Antipyretic, analgesic,
                           Antiembolic small dose
                           325mg or 81 mg/d
                                                                                                                                                                Page 84 of 99
Drug Name                  Class                          Actions                         Indications               Side Effects                   Nursing implications

Salmeterol xinafoate       beta2 adrenergic agonist       b2 stimulation to dilate                                  causes incr hyperthyroid       Not for aqcute asthma at-
                                                                                                                                                   tack, tachycardia,bad
                           use: bronchodilator, smooth    bronchiole smooth muscle                                  excess use=tolerance, re-      taste,dry
                           muscle relaxant                                                                          bound bronch-
Onset 10-20 min                                                                                                                                    mouth, dizzy,hyperactivity
                           reduce airway                                                                            ial spasm                      shake well before inhalation,
Peak 2h
                           resistance                                                                               monitor hr,K+,

Seconal                    sed/hypnotic                   inhibit nerve transmission to Sedative-hypnotic           caution:preg D, lactation,     im in lg muscle, discard if
                                                          cns                                                                                      cloudy
Secobarbital               short barbiturate                                                                        sensitivity to sed/hypnotics
                                                          limits seizure by increasing                                                             follow reconstitution direc-
33-100mg posedate          anticonvulsive                                                                           impaired hepatic, renal, resp, tions
                                                          stimuli threshold
100-200mg IM hypn          use: insomnia,                                                                           extreme pain                   use reconstituted iv solution
                                                          onset 15-30 min PO
                           pre-op hypnosis                                                                          side/adv-drowsy, headache, w/in
                                                          onset 7-10 min IM                                         dizzy                      30 min monitor BP, pulse,
                           anticonvulsive
                                                          onset 1-3 min IV                                          hangover, resp depression  resp

                                                          duration 1-4h PO, 15 min IV                               depressed bp, laryngospasm not analgesic
                                                          20-45% protein bound                                      dypsnea, paradox excite-       monitor for folate, vitamin D
                                                                                                                    ment                           deficiency

Senna-Docusate Sodium      Stool softener                 Sennosides, the active in-    Prophylactic to prevent con- Cramping, diarrhea, nausea    Assess for constipation, bo-
(Senokot-S)                                               gredient, decrease water and stipation/impaction and                                     wel sounds, abdominal dis-
                                                          electrolyte transport out of  treatment of constipation                                  tention, and normal patter of
2 tab PO q HS PRN
                                                          the colon, resulting in  wa-                                                            bowel function; withhold if
give with 8 oz water                                      ter in the stool and  peris-                                                            diarrhea develops and notify
                                                          talsis                                                                                   MD

Sennosides PO BID 187 mg   Laxative stimulant             Stimulates peristlsis by ac-    Laxative                  N&V, anorexia, abd cramps, Blood work, electrolytes,
tab PRN                                                   tion on Auerbach’s plexus,                                discolored urine, alkalosis, I&O, cramping, N&V, MG for
                                                          softens feces by increasing                               tetany                       toxicity, blood ammonia,
                                                          water and electrolytes in
                                                          large intestine

Sertraline (Zoloft)        SSRI                           Inhibits reuptake of synaptic                             Dreams, CNS effects, hypo- Not with maoi’s, monitor flu-
                                                          serotonin                                                 tension, sexual dysfunction, id/electrolytes, suicide risk
                           Use-treat depression, anxie-                                                             gynecomastia, SI, lower sei-
                           ty, phobias                                                                              zure threshhold

Sevelamen HCl 1600mg PO    Calcium-phosphate binder—
                           reduces serum phosphate
TID/ meal                  levels due to ESRD
                                                                                                                                                                           Page 85 of 99
Drug Name                       Class                      Actions                          Indications                        Side Effects                   Nursing implications

Sevelamer HCl                   Electrolytic Balance And   Indicated by a serum                                                Headache, infection, pain.             Give with meals; do
                                Water Balance Agent; Phos- phosphate level ≤6.0 mg/dL.                                                                                 not open or chew
(Renagel)                       phate Binder                                                                                   CV: Hypertension, hypoten-
                                                                                                                               sion, thrombosis.                       capsule.
                                                           Polymer that binds intestinal                                                                              Give other oral
                                                           phosphate; for reduction of                                         GI: Diarrhea, dyspepsia,                medications 1 h
                                                           serum phosphorus in                                                 vomiting, nausea, constipa-             before or 3 h after
                                                           patients with end-stage                                             tion, flatulence.                       Renagel.
                                                           kidney disease.                                                     Respiratory: Increased
                                                                                                                               cough


Simvastatin (Zocor)             Antihyperlipidemic, HMG-   Inhibits an enzyme (3-           Adjunct to diet to reduce          Report unexplained muscle      Monitor cholesterol levels &
                                CoA reductase inhibitor    hydroxy-3methylglutaryl-         elevated total and LDL cho-        pain, tenderness, or weak-     liver function throughout
10 mg / PO / with evening                                  coenzyme A reductase,            lesterol, treatment of isolated    ness, especially if accompa-   therapy. Monitor coagulation
meal                                                       which is responsible for cata-   hypertriglyceridaemia, used        nied by malaise or fever, to   studies with patients receiv-
                                                           lyzing an early step in the      to reduce risk of total mortali-   physician.                     ing concurrent warfarin ther-
                                                           synthesis of cholesterol; lo-    ty in coronary heart disease                                      apy. PT may be prolonged.
                                                           wering of total and LDL cho-                                        Fulminant hepatic necrosis,
                                                           lesterol; slightly increases                                        hepatitis, dysfunction of      Assess for and report unex-
                                                           HDL, and decrease VLDL                                              cranial nerves, hemolytic      plained muscle pain. Deter-
                                                           cholesterol and triglycerides;                                      anemia, angioedema, alope-     mine CPK level at onset of
                                                           slows the progression of                                            cia, increased CPK, AST,       muscle pain.
                                                           CAD                                                                 ALK
                                                                                                                                                              Grapefruit juice may increase
                                                                                                                                                              risk of myopathy

Sodium Hypochlorite Solution,                              A colorless to light yellow                                                                        Carrel's treatment or Carrel-
diluted                                                    liquid with a faint odor of                                                                        Dakin treatment: treatment of
                                                           chlorine, compounded of                                                                            wounds, based on thorough
                                                           sodium hypochlorite solution,                                                                      exposure of the wound, re-
(Dakin's Solution)                                         sodium bicarbonate, and                                                                            moval of all foreign material
                                                           water, each 100 mL contain-                                                                        and devitalized tissue, meti-
                                                           ing 450 to 500 mg of sodium                                                                        culous cleansing, and re-
                                                           hypochlorite; used as a topi-                                                                      peated irrigation with a dilute
                                                           cal anti-infective. It is also                                                                     sodium hypochlorite solution.
                                                           used for wound irrigation,                                                                         The adjacent skin is pro-
                                                           and has been used to irrigate                                                                      tected with petrolatum
                                                           the urinary bladder.                                                                               gauze.
                                                                                                                                                                   Page 86 of 99
Drug Name                     Class                         Actions                            Indications          Side Effects                      Nursing implications

Sodium Polystyrene Sulfonate Electrolytic Balance And       Removes excess potassium                                GI: Constipation, fecal im-       Monitor serum K+ levels.
                             Water Balance Agents; Ca-      from body by exchanging                                 paction (in older adults); ano-   Monitor acid–base balance,
(Kayexalate, SPS Suspen-     tion Exchange                  sodium ion for potassium,                               rexia, gastric irritation, nau-   electrolytes, and minerals in
sion)                                                       particularly in large intestine;                        sea, vomiting, diarrhea (with     patients receiving repeated
                                                            Small amounts of other ca-                              sorbitol emulsions).              doses.
                                                            tions such as calcium and
                                                            magnesium may be lost dur-                              Metabolic: Sodium retention, Observe patient closely for
                                                            ing treatment.                                          hypocalcemia, hypokalemia, early clinical signs of severe
                                                                                                                    hypomagnesemia.              hypokalemia. ECGs are also
                                                                                                                                                 recommended.

Solumedrol, methylpredniso-   corticosteroid                Unknown, decreases in-                                  heart failure, sz, euphoria,      give in am, give deep im and
lone sodium                                                 flammation by stabilizing                               insomnia, psychotic behavior      avoid sc, discard reconsti-
                              Use: treat severe inflamma-   leukocyte lysosomal mem-                                cardiac arrest circulatory        tued after 48 hrs, adjust to
                              tion, immunosuppression,      branes, suppresses immune                               collapse, pancreatitis, GI        lowest effective dose, moni-
                              and shock                     response, stimulates bone                               effect, <K, >BS, carb intoler-    tor pts wt, bp, electrolye le-
                                                            marrow, and influences pro-                             ance, <Ca, hypercholestero-       vels, drug may mask or wor-
                                                            tein, fat, and carb metabol-                            lemia, growth suppression in      sen infections, watch for de-
                                                            ism                                                     children, osteoporosis, de-       pression or psychotic beha-
                                                                                                                    layed wound healing, skin         vior, low sodium high potas-
                                                                                                                    eruptions, acute adrenal in-      sium and protein diet, gradu-
                                                                                                                    sufficiency after increased       ally reduce drug,
                                                                                                                    stress or abrupt withdrawal
                                                                                                                    and can be fatal

Solu-medrol, methylpredniso- Corticosteroid                 unknown, decreases inflam- Antineoplastic, severe in-   heart failure, sz, euphoria,      give in am, give deep im and
lone sodium                                                 mation by stabilizing leuko- flammation, immunosup-     insomnia, psychotic behavior      avoid sc, discard reconsti-
                                                            cyte lysosomal membranes, pression, and shock           cardiac arrest circulatory        tuted after 48 hrs, adjust to
                                                            suppresses immune re-                                   collapse, pancreatitis, GI        lowest effective dose, moni-
                                                            sponse, stimulates bone                                 effect, <K, >BS, carb intoler-    tor pts wt, bp, electrolye le-
                                                            marrow, and influences pro-                             ance, <Ca, hypercholestero-       vels, drug may mask or wor-
                                                            tein, fat, and carb metabol-                            lemia, growth suppression in      sen infections, watch for de-
                                                            ism                                                     children, osteoporosis, de-       pression or psychotic beha-
                                                                                                                    layed wound healing, skin         vior, low sodium high potas-
                                                                                                                    eruptions, acute adrenal in-      sium and protein diet, gradu-
                                                                                                                    sufficiency after increased       ally reduce drug,
                                                                                                                    stress or abrupt withdrawal
                                                                                                                    and can be fatal
                                                                                                                                                                             Page 87 of 99
Drug Name                      Class                           Actions                         Indications                     Side Effects                     Nursing implications

Solu-medrol, methylpredniso- corticosteriod                    unknown, decreases inflam- severe inflammation, immu-           heart failure, sz, euphoria,     give in am, give deep IM and
lone sodium                                                    mation by stabilizing leuko- nosupression, and shock            insomnia, psychotic behavior     avoid sc, discard reconsti-
                                                               cyte lysosomal membranes,                                       cardiac arrest circulatory       tuted after 48 hrs, adjust to
                                                               suppresses immune re-                                           collapse, pancreatitis, GI       lowest effective dose, moni-
                                                               sponse, stimulates bone                                         effect, <K, >BS, carb intoler-   tor pts wt, bp, electrolyte
                                                               marrow, and influences pro-                                     ance, <Ca, hypercholestero-      levels, drug may mask or
                                                               tein, fat, and carb metabol-                                    lemia, growth suppression in     worsen infections, watch for
                                                               ism                                                             children, osteoporosis, de-      depression or psychotic be-
                                                                                                                               layed wound healing, skin        havior, low sodium high po-
                                                                                                                               eruptions, acute adrenal in-     tassium and protein diet,
                                                                                                                               sufficiency after increased      gradually reduce drug,
                                                                                                                               stress or abrupt withdrawal
                                                                                                                               and can be fatal

Sorbitol 30ml PO Q3H           Laxative-- relieve constipa-    Pulls water into the bowel                                      Flatus, belching abd. Pain,      Monitor for bm
                               tion                            allowing bulk to increase,                                      diarrhea
PRN                                                            and stimulates peristalsis                                                                       Encourage fluids
                                                                                                                                                                Assess diet and the need for
                                                                                                                                                                diet changes to promote
                                                                                                                                                                normal bowel habits

Sotalol hydrochloride (Beta-   a nonselective beta blocker     documented, life- threatening   headache dizziness weak-        because of proarrhythmi
pace)                          that drpresses sinus heart      ventricular arrhythmias.        ness bradycardia arrhyth-       events may occur at start of
                               rate slows AV conduction        Maintenance of normal sinus     mias heart failure AV block     therapy patient should e
                               decreases cardiac output        rhythm ( delay in time to re-   PVC's v-tach, v-fib hypoten-    hospitalized with facilities
                               and lovers systolic and dias-   currence of a-fib / a-flutter   sion dyspnea bronchospasm       and personnel availabe for
                               tolic BP                                                                                        cardiac monitoring dosage
                                                                                                                               should be adjusted slowly
                                                                                                                               allowing 2-3 days between
                                                                                                                               dosage increments . Monitor
                                                                                                                               serum elecrolytes regularly
                                                                                                                               watch for hypokalemia

Sotalol hydrochloride (Beta-                                   a nonselective beta blocker     documented, life- threatening   headache dizziness weak-         because of proarrhythmia
pace)                                                          that depresses sinus heart      ventricular arrhythmias.        ness bradycardia arrhyth-        events may occur at start of
                                                               rate slows AV conduction        Maintenance of normal sinus     mias heart failure AV block      therapy patient should e
                                                               decreases cardiac output        rhythm ( delay in time to re-   PVC's v-tach, v-fib hypoten-     hospitalized with facilities
                                                               and lovers systolic and dias-   currence of a-fib / a-flutter   sion dyspnea bronchospasm        and personnel available for
                                                               tolic BP                                                                                         cardiac monitoring dosage
                                                                                                                                                                should be adjusted slowly
                                                                                                                                                                allowing 2-3 days between
                                                                                                                                                                dosage increments . Monitor
                                                                                                                                                                serum electrolytes regularly
                                                                                                                                                                watch for hypokalemia
                                                                                                                                                                     Page 88 of 99
Drug Name                    Class                          Actions                        Indications                  Side Effects                    Nursing implications

Sulfonamides                 Urinary tract antimicrobials   Inhibit bacterial growth =                                  Anorexia, N&V, diarrhea,       Allergic reaction, nephrotox-
                                                            Bacteriostatic                                              rash, stomatitis, fatigue, de- icity or ototoxicity
                                                                                                                        pression, H/A, vertigo, pho-
                                                                                                                        tosensitivity, crystallinuria,
                                                                                                                        kidney stones, leukopenia,
                                                                                                                        thrombocytopenia, bone
                                                                                                                        marrow depression, anemia,
                                                                                                                        Steven-Johnson’s syndrome,
                                                                                                                        renal failure

Synthroid                    thyroid hormone                unknown, stimulates meta- decreased hormone produc- decreased bone density,                 vs, electrolytes, safety is-
                                                            bolism of all body tissues by tion                  arrhythmia, increased HR,               sues, ecg, be especially
                                                            increasing cellular oxidation                       cardiac arrest, fever, nerv-            aware if pt is diabetic or on
                                                                                                                ousness, tremors, insomnia,             coumadin
                                                                                                                diarrhea, vomiting, alters INR
                                                                                                                &PT, may decrease BS

Synthroid 0.125 mg po qd     Thyroid hormone/ Hypothy-      Controls protein synthesis,   Endocrine                     Thyroid storm, HA, tremors, B/P, I&O, weight QD, liver
0900                         roidism                        increase metabolic rate, car-                               anxiety, tachycardia, cardiac panel, PT, ECG,
                                                            diac output, renal flow, O2,                                arrest, sweating, fever, N/D,
                                                            body temp, blood volume                                     hypertension

Tacolimus (prograf )fk 506   Immunosuppressant            Action is greater than cyc-   Atineoplastic                   Nephro, neurotoxic, hyper-      Not with cyclosporine, moni-
                                                          losporine, Selective and re-                                  glycemia, N&V, increase         tor uric acid, glucose, elec-
                             Macrolide antibiotic         versible inhibition of helper                                 body and facial hair, hypo-     trolytes, CNS changes, tre-
                             Use: organ rejection prophy- T-lymphocyts, which normal-                                   magnesia, hypertension          mors
                             laxis                        ly stimulate antibody produc-
                                                          tion

Temazepam PO QHS 15 mg       Sedative hypnotic; Benso-      Produces CNS depression at Sedative-hypnotic                Lethargy, dizziness, anxiety,   Mental status, mood, sleep
                             diazepine                      limbic, thalamic, hypo tha-                                 leukopenia, chest pain, N&V,    pattern, agitation, dizziness,
                                                            lamic levels of CNS;                                        constipation, anorexia, con-    h/a, N&V, suicidal tenden-
                                                                                                                        fusion, irritability            cies, B/P, I&O

Tequin gatifloxacin          antibacterial drug             bacteicidal interfers with     treatment for community        headache dizziness insom-     monitor for drug action moni-
                                                            DNA replication in suscepti-   acquired pneumonia cause nia prolonged QT interval           tor for fever increase in
                                                            ble gram negative and gram     by susceptible strains of      diarhea fever                 WBCs monitor for symptoms
                                                            positive bacteria preventing   streptococcus haedmophilus                                   getting better
                                                            cell reproduction              influenzae, bacteral sinusiti-
                                                                                           streatment of complicated
                                                                                           UTIs

tequin gatifloxacin          antibacterial drug             bactericidal interferes with   treatment for community         headache dizziness insom-    monitor for drug action moni-
                                                            DNA replication in suscepti-   acquired pneumonia cause nia prolonged QT interval           tor for fever increase in
                                                            ble gram negative and gram     by susceptible strains of       diarrhea fever               WBCs monitor for symptoms
                                                            positive bacteria preventing   streptococcus haedmophilus                                   getting better
                                                            cell reproduction              influenzae, bacterial sinusitis
                                                                                           treatment of complicated
                                                                                           UTIs
                                                                                                                                                                        Page 89 of 99
Drug Name                      Class                         Actions                         Indications                 Side Effects                      Nursing implications

Tetracycline                   Broad spectrum anti-          Inhibits protein synthesis,                                 Fever, headache, paresthe-        Assess renal system (drug
                               infective; Tetracycline       and phophorylation in micro-                                sia, dysphagia, glossitis, oral   excreted via kidnerys )BC,
                                                             organisms; bacteriostatic                                   candidiasis, N&V, abd pain,       C&S, allergic reactions, urine
                                                                                                                         diarrhea, anorexia, enteroco-     output, AST, ALT, BUN,
                                                                                                                         litis, hepatotoxicity, flatu-     creatinine, Hct, bilirubin,
                                                                                                                         lence, abd cramps, in-            electrolytes, bowel pattern,
                                                                                                                         creased BUN, neutropenia,         bleeding, overgrowth of in-
                                                                                                                         thrombocytopenia, anemia,         fection, no children under 8,
                                                                                                                         rash, photosensitivity, disco-    no antacids
                                                                                                                         loration of teeth

Teveten eprosartan mesylate antihypertensive angiotensin stlectively blocks the bindig treatment of hypertension         fatigue dizziness hypoten-        monitor BP teach about or-
                            2 receptor antagonist        of angiotensin 2 to specific  alone or incombination with       sion abd pain uri symptoms        thastic hypotension
                                                         tissue receptors found in the other antihypertensives
                                                         vaxcular smooth muscle and
                                                         adrenal gland

teveten eprosartan mesylate    antihypertensive angiotensin selectively blocks the binding treatment of hypertension    fatigue dizziness hypoten-         monitor BP teach about or-
                               2 receptor antagonist        of angiotensin 2 to specific   alone or in combination with sion abd pain urinary symp-        thostatic hypotension
                                                            tissue receptors found in the other antihypertensives       toms
                                                            vascular smooth muscle and
                                                            adrenal gland

Theophylline (Theo-Dur )oral   Methylxanthine                Bronchodilation by increas-     Respiratory                 GI upset, N&V, tachycardia,       Charcoal-broiled foods de-
(Aminophylline )parenteral                                   ing tissue concentration of                                                                   crease ½ life
                               Use: long term bronchodila-   cyclic AMP to prolong adre-                                 Nervous, diuresis
                               tion,                         nergic effect of bronchodila-
                                                             tion

Thiamine (vitamin B1)          Vitamin B                     Water soluble B1 vitamin and    Treatment and prophylaxis of Anaphylaxis, CV collapse,        Teach food sources high in
                                                             a member of B-complex           beriberi, to correct anorexia                                 thiamine such as yeast, pork,
50 mg PO q day                                               group used for thiamine re-     due to thiamine deficiency, in                                beef, liver, wheat and whole
0800                                                         placement                       treatment of neuritis asso-                                   grains, fortified cereals, fresh
                                                                                             ciated with pregnancy, pella-                                 vegetables, dried beans
                                                                                             gra and alcoholism. Usually
                                                                                             given with other B vitamins.



Thioridazid (mellaril )hydroch- Antipsychotic, CNS depres-   Dopamine antagonist Ach,        Typical Antipsychotic       Rarely produces EPS               Monitor EKG, change posi-
loride                          sion                         Histamine, alpha receptor                                                                     tions slowly, avoid overheat-
                                                             antagonist                                                  High sedation, anticholiner-      ing and extreme cold, avoid
                               Use-treat psychoses,                                                                      gic effects,                      sunlight and ETOH, monitor
                               ETOH withdrawal,                                                                          orthostatic hypotension           aims, onset 2-3 weeks
                                                                                                                         problems with thermoregula-
                                                                                                                         tion, ventricular dysrhythmia
                                                                                                                                                                      Page 90 of 99
Drug Name                      Class                          Actions                          Indications                Side Effects                   Nursing implications

Thiothixene (Navane )hy-       Antipsychotic, CNS             Dopamine antagonist Ach,         Typical Antipsychotic      EPS, anticholinergic symp- Periodic CBC, liver ophthal-
drochloride                                                   Histamine, alpha receptor                                   toms, sedation, hypotension, mic test, change positions
                               Depression                     antagonist                                                  convulsions                  slowly, avoid overheating
                               Use-treat psychoses, de-                                                                                                and extreme cold, avoid sun-
                               pression                                                                                                                light and ETOH, monitor
                                                                                                                                                       aims, onset 2-3 weeks

Tizanidine HCl (Zanaflex )     Skeletal muscle relaxant/      alpha-adrenergic agonist , no                               no major side effects       Monitor cardiovascular status
                                                              effect on muscle cells, great-                                                          for hypotension and brady-
                                                              est effect on spinal chord                                  Common minor side effects: cardia.
                                                              polysynaptic afferent activity                              hypotension, dizziness,
2 mg. GT                                                                                                                  somnolence, tiredness, bra- monitor liver function tests
                                                                                                                          dycardia, UTI, dry mouth    (alt, AST)

custom times: 0600, 1600,      seizures                                                                                                                  Monitor with renal impair-
2300                                                                                                                                                     ment, because drug clear-
                                                                                                                                                         ance is reduced.

TMP-SMZ aka BACTRIM            Antiinfective, miscellaneous   SMZ competes with PABA in                                   convulsions, drug fever, al- !interacts with acyclovir
                               sulfonamide                    biosynthesis of bacterial pro-                              lergic myocarditis, hepatitis,
(Trimethoprim sulfamethox-                                    teins combined with TMP                                     renal failure, toxic nephrosis BUN, Cr
azole)                                                        which blocks synthesis of
                               postop - peritonis             tetrahydrofolic acid = 2 con-
                                                              secutive steps in bacterial of
                                                              essential nucleic acids &
                                                              proteins

topical cream                  skin protector/                                                                            N/A                            apply after application of
                                                                                                                                                         nystatin during diaper
                                                                                                                                                         changes
                               diaper rash




Toradol ketorolac trometha-    NSAID analgesic                anti-inflammatory and anal-      short term management of   headache dizziness insom-      monitor renal functions
mine                                                          gesic                            pain up to 5 days          nia dyspepsia GI pain diarr-
                                                                                                                          hea renal impairment

Total Parental Nutrition (TPN) Nutritional Substitute         Provides nutritional supple-                                                               Monitor for irritation at IV site
                                                              mentation to patient to pro-
                                                              vide for vitamins, nutrients,                                                              Monitor for abdominal disten-
                                                              and electrolytes                                                                           tion or GI upset
4 units IV qd
                                                                                                                                                            Page 91 of 99
Drug Name                      Class                          Actions                            Indications   Side Effects                    Nursing implications

Total Parenteral Nutrition     Parenteral nutrition is fre-  The essential components of                       Zantac                          Potential toxicity results from
(TPN) w/ Ranitidine (Zantac)   quently used for patients who parenteral nutrition are:                                                         decreased clearance (elimi-
                               are unable to tolerate feed-                                                    Hypersensitivity reactions,     nation) and therefore pro-
                               ings                          Fluids; carbohydrate; electro-                    anaphylaxis (rare).             longed action; greatest in the
                                                             lytes; protein; lipids; vitamins;                                                 older adult patients or those
IV, QD-1800                                                  and, trace minerals.                                                              with hepatic or renal dysfunc-
                                                                                                               CNS: Headache, malaise,         tion.
                                                                                                               dizziness, somnolence, in-
                                                              Zantac Blocks daytime and                        somnia, vertigo, mental con- Lab tests: Periodic liver func-
                                                              nocturnal basal gastric acid                     fusion, agitation, depression, tions. Monitor creatinine
                                                              secretion stimulated by his-                     hallucinations in older adults. clearance if renal dysfunction
                                                              tamine and reduces gastric                                                       is present or suspected.
                                                              acid release in response to                                                      When clearance is <50
                                                              food, pentagastrin, and insu-                    CV: Bradycardia (with rapid mL/min, manufacturer re-
                                                              lin. Shown to inhibit 50% of                     IV push).                       commends reduction of the
                                                              the stimulated gastric acid                                                      dose to 150 mg once q24h
                                                              secretion.                                                                       with cautious and gradual
                                                                                                                                               reduction of the interval to
                                                                                                               GI: Constipation, nausea,
                                                                                                                                               q12h or less, if necessary.
                                                                                                               abdominal pain, diarrhea.
                                                                                                                                                Be alert for early signs of
                                                                                                                                               hepatotoxicity (though low
                                                                                                               Skin: Rash.                     and thought to be a hyper-
                                                                                                                                               sensitivity reaction): jaundice
                                                                                                                                               (dark urine, pruritus, yellow
                                                                                                               Hematologic: Reversible         sclera and skin), elevated
                                                                                                               decrease in WBC count,          transaminases (especially
                                                                                                               thrombocytopenia.               ALT) and LDH.
                                                                                                                                                Long-term therapy may lead
                                                                                                                                               to vitamin B12 deficiency.

Tramadol                       Treatment of moderate to       Opiate analgesic. Binds to                       Dizziness, headache, som-       Assess pain type, location,
                               severe pain.                   mu-opioid receptors inhibit-                     nolence, constipation, nau-     and intensity 2-3 HR (peak)
(Ultram)                                                      ing reuptake of serotonin and                    sea                             after administration
                                                              norepinephrine in the CNS

Tramadol HCl (Ultram )PG       Analgesic, opioid agonist      Centrally acting opiod agon-                     Dizzy, hypotension, confu-      safety
50mg q4h PRN                                                  ist. Inhibits uptake of seroto-                  sion,
                               Use: pain relief               nin and norepinephrine                                                          Less respiratory depression
                                                                                                               Palpitations constipation, dry that morphine
                                                                                                               mouth
                                                                                                                                              Dose reduction with renal
                                                                                                                                              impairment

Trazodone (Desyrel)            Antidepressant                 Sedative-hypnotic, Selective-                    Hypotension, weight gain,       Food increases absorption.
                                                              ly inhibits reuptake of neu-                     sedation, erectile dysfunc-     Maintain constant drug/food
                               Use-treat depression           ronal serotonin                                  tion, decreased REM and         ratio, avoid ETOH
                                                                                                               increased stage 4 sleep
                                                                                                                                                                        Page 92 of 99
Drug Name                    Class                         Actions                         Indications                    Side Effects                     Nursing implications

Trazodone (Desyrel)          Antidepressant                Blocks reuptake of serotonin                                   Varying amounts of sedation
                                                           at presynaptic membrane in                                     of CNS, drowsy, hypoten-
                             Use: treat depression with or CNS,                                                           sion, dry mouth, photosensi-
                             without anxiety, treat ETOH                                                                  tivity
                             dependence


Trental (pentoxifyllin)      hemorhelogic agent            reduces RBC aggregation         intermittent claudication to   dizziness headache, angina       Monitor patient for angina,
                                                           and local hyperviscosity de-    improve function and symp-     chest pain arrhythmia hypo-      arrhythmias administer drug
                                                           creases platelet aggregation    toms (unlabeled use is cere-   tension rash dyspepsia nau-      with meals swallow tablets
                                                           decreases fibrinogen con-       brovascular insufficiency to   sea                              whole monitor signs of im-
                                                           centration in the blood pre-    improve psychopathologic                                        proving claudication take
                                                           cise mechanism of action is     symptoms, diabetic vascular                                     precautions to prevent inju-
                                                           not known                       disease                                                         ries because of dizziness

Triamc-Silver Sulfadiazine   Silver Sulfadiazine has broad Prevention and treatment of                                    Pain (occasionally), burning,    Discontinue occlusive dress-
Cream                        antimicrobial activity         sepsis in second- and third-                                  itching, rash, reversible leu-   ing and start appropriate
(Triamcinolone-Silvadene     including many gram-           degree burns.                                                 kopenia, folliculitis,           antimicrobial treatment if a
Cream)                       negative and gram-positive                                                                   hypertrichosis,                  local infection develops at
                             bacteria and yeast                                                                           hypopigmentation.                site of application. Consult
                             Triamcinolone is a corticoste-                                                                                                physician.
                             roid with anti-inflammatory
                             activity 7–13 times more
                             potent than that of hydrocor-
                             tisone.

Triazolam (halcion)          Sedative-hypnotic, benzo-     decreases sleep latency,        insomnia (short-term man-      rebound insomnia, head-          Document indications for
                             diazepine                     increases the duration of       agement, not to exceed 1       ache, decreased coordina-        therapy, assess mental sta-
                                                           sleep, and decreases the        month ) may be beneficial in   tion, psychologic and physi-     tus, monitor CBC and LFTs,
                                                           number of awakenings            treating transient insomnia    cal dependence, N&V              initiate safety precautions,
                                                                                           from sudden change in sleep                                     assess for tolerance and
                                                                                           schedule                                                        dependence, monitor for
                                                                                                                                                           CNS toxic effects

Tylenol (Acetaminophen)      antipyretic and analgesic     reduces fever by acting di-     fever; pain management in     myocardial damage with            allergy impaired hepatic
                                                           rectly on the hypothalamic      patients with musculoskeletal doses of 5-8 grams a day;         function; not an anti-
                                                           heat regulating center to       pain; pain from cold and flu hepatic toxicity; rash and         inflammatory
                                                           cause vasodilation and                                        fever
                                                           sweating which helps dissi-
                                                           pate heat

Uniphyl (Theophylline)       bronchodilator                stimulates the CNS, directly    symptomatic relief, preven-    shakiness, restlessness,         offer emotional support (an-
                                                           relaxes the smooth muscles      tion of bronchial asthma,      tachycardia, trembling, mild     xiety due to dyspnea), moni-
                                                           of the bronchi and pulmonary    reversible bronchospasm,       diuresis, insomnia               tor rate, depth, quality and
                                                           blood vessels, inhibits ute-    increasing vital capacity                                       rate of pulse. Assess lung
                                                           rine contractions, stimulates                                                                   sounds for rhonchi, wheez-
                                                           gastric acid secretions, in-                                                                    ing, rales. Monitor arterial
                                                           crease the rate and force of                                                                    blood gasses.
                                                           contraction of the heart
                                                                                                                                                            Page 93 of 99
Drug Name                     Class                           Actions                          Indications   Side Effects                      Nursing implications

Urecholine                    cholinergic D                   ACh mimic, muscarinic effect Colinergic        caution:preg c, copd, hypr-       monitor:vs, resp 30-60min p
                                                              on                                             thyd, urinary                     injec
Duvoid                        use:treat postop urine
                                                              GI, bladde (contract sm                        disease, recen tGI urinary        take w/wout meals, never
Bethanecholine                increase, GI motility (non-     musc)                                          surgery                           IVorIM
                              obstructive)
                                                                                                             bradycard, hypo/hyperten,         ortho hypotensn, monitor I/O
                                                                                                             CAD,
                                                                                                                                               antidote=atropine
                                                                                                             recent MI, epilepsy, parkin-
                                                                                                             sons
                                                                                                             adv/side:dizzy, n&v, diahh-
                                                                                                             rea, rash
                                                                                                             incr saliva, sweat, flush, mi-
                                                                                                             osis
                                                                                                             blur vision, urinary freq, bra-
                                                                                                             dycard

Ursodiol (Actigall or urso)
25 mg po tid


Conc. 20mg/ml
give 1.25 ml

Valcyte                       Anti-Infective                  prevents repliction of HCV                     Decreased WBC, anemia,            hold drug if <500 neutrophils
                                                              by selective inhition of viral                                                   per cubic mm or if HgB <8
(valganciclovir)              antiviral, synthetic nucleoside DNA synthesis                                                                    g/dL
                              analog, antiinfective
                                                                                                                                               CBC with diff
                              prevent cytomegaloviral
                              infection
                                                                                                                                                                      Page 94 of 99
Drug Name           Class                            Actions                          Indications                       Side Effects                     Nursing implications

Valium              anxiolytic                       cns depressant, anxiolytic       Sedative-hypnotic                 caution:preg D, shock, coma, may be crushed, withdrawal,
                                                                                                                        alcohol                      no
Diazepam            anticonvulsive/ use:             onset 30-60 min PO, 1-5 min
                                                     IV                                                                 decresd vs, not in 14 days of alcohol, deep im injection in
2-10mg bid-qid      alcohol withdrawl,                                                                                  maoi                          large
                                                     duration 15 min-1HR IV, 3
15-30mg/d sr        status epilepticus,              HR PO                                                              impaired hepatic, renal, resp muscle, iv single infused
PO                  pre-op anxiolytic,                                                                                                                drug
                                                      shorter rem & stage 4,                                            side/adv-headache, dizzy
                    muscle spasm of                                                                                                                   close to injecion site, slow
                                                      but longer total sleep                                            ataxia, confusion, urinary    injectn
                    cerebral palsy, anxiolt                                                                             problems
                                                                                                                                                      monitor VS with parenteral
                                                                                                                        vision change, nausea         use,
                                                                                                                        paradox rage, laryngospasm cbc, liver function, smoking

                                                                                                                                                         decreases effects of drug

Valium (diazepam)   benzodiazepine antianxity        acts mainly at the limbic sys-   management of anxity dis-         mild drowsiness initally seda-   given oral onset 30-60 min
                    agent skeletal muscle relax-     tem and reticulr formation,      orders or for short term relief   tion depression lethargy fati-   peak 1-2 hrs duration 3 hrs
                    ant centrally acting             may act in spinal cord and at    os symptoms of anxiety            gue disorientation restless-     monitor BP pulse rate respi-
                                                     supraspinal sites to produce     muscle relaxant adjunct for       ness confusion bradycardia       rations maintain patient in
                                                     skeletal muscle relaxation       felief of reflex skeletal mus-    tachycardia constipation in-     bed for 3 hrs if given paren-
                                                                                      cle spasm due to local pa-        continence urinary retention     teral taper dosage gradualy
                                                                                      thology ( inflammatio of mus-     changes in libido                after long term use take drug
                                                                                      cles )secondary to trauma                                          with food to avoid stomach
                                                                                                                                                         upset

Vancomycin          Anti-infective; tricyclic glyco- Inhibits bacterial cell wall                                       Cardiac arrest, ototoxicity,   I&O, renal system, WBC,
                    peptide                          synthesis                                                          tinnitus, Nausea, Nephrotox- C&S, auditory function, B/P,
                                                                                                                        icity, increased BUN, leuko- respiratory status,
                    Use: treat microbial infection                                                                      penia, fatal uremia, chills,
                                                                                                                        fever, rash, thrombophlebitis,
                                                                                                                        pruritus, necrosis, wheezing,
                                                                                                                        dyspnea, anaphylaxis
                                                                                                                                                                                Page 95 of 99
Drug Name                    Class                            Actions                            Indications                      Side Effects                     Nursing implications

Vancomycin                   Anti-infective; tricyclic glyco- Acts by interfering with cell                                       Ototoxicity; Nephrotoxicity.     I&O, renal system, WBC,
                             peptide                          membrane synthesis in mul-                                                                           C&S, auditory function, B/P,
(Vancodin)                                                    tiplying organisms.                                                 Hypersensitivity reactions       respiratory status,
                             Prepared from Streptomyces                                                                           (chills, fever, skin rash,
                             orientalis, with bactericidal    Parenterally for potentially                                        urticaria, shock-like state),    Monitor BP and heart rate
                             and bacteriostatic actions.      life-threatening infections in                                      anaphylactoid reaction with
                                                              patients allergic, nonsensi-                                        vascular collapse,               Monitor urinalysis, kidney &
                             Active against many gram-        tive, or resistant to other less                                    superinfections, severe pain,    liver functions, and hemato-
                             positive organisms, including toxic antimicrobial drugs.                                             thrombophlebitis at injection    logic studies periodically.
                             group A beta-hemolytic           Used orally only in Clostri-                                        site, generalized tingling
                             Streptococci, Staphylococci, dium difficile colitis (not ef-                                                                          Notify physician promptly of
                                                                                                                                  following rapid IV infusion..    ringing in ears.
                             Pneumococci, Enterococci, fective by oral route for
                             Clostridia, and Corynebacte- treatment of systemic infec-                                            GI: Nausea, warmth.            Monitor serial tests of van-
                             ria. Gram-negative organ-        tions).                                                             Other: Injection reaction that comycin blood levels (peak
                             isms, mycobacteria, and                                                                                                             and trough) (serum levels of
                             fungi are highly resistant.                                                                          includes hypotension
                                                                                                                                  accompanied by flushing and 60–80 mcg/mL are asso-
                                                                                                                                  erythematous rash on face      ciated with ototoxicity)
                                                                                                                                  and upper body (―red-neck      Monitor I&O: Report changes
                                                                                                                                  syndrome‖) following rapid IV in I&O ratio and pattern. Oli-
                                                                                                                                  infusion.                      guria or cloudy or pink urine
                                                                                                                                                                 may be a sign of nephrotox-
                                                                                                                                                                 icity (also manifested by
                                                                                                                                                                 transient elevations in BUN,
                                                                                                                                                                 albumin, and hyaline and
                                                                                                                                                                 granular casts in urine).

Vancomycin hydrochloride     Antibiotic, misc.                appears to bind to bacterial                                        Shock, cardiac arrest,           Assess renal and auditory
(Vancocin, Vancoled)                                          cell wall, arresting its synthe-                                    wheezing, urticaria, tissue      functions (include 8th CN
                                                              sis and lysing the cytoplas-                                        irritation, sudden drop in BP,   function ) monitor CBC, cul-
                                                              mic membrane by a mechan-                                           ototoxicity                      tures, and renal function,
                                                              ism different from that of                                                                           reduce dose with renal dys-
                                                              PCN and cephalosporins;                                                                              function
                                                              may also inhibit RNA synthe-
                                                              sis

Venlafaxine hydrochloride    Antidepressant                   A potent inhibitor of the up-      treatment of depression,         seizures, suicide attempts,      Monitor CBC, serum lipid
(Effexor)                                                     take of neuronal serotonin         prevention of major depres-      anxiety, somnolence, hyper-      levels, renal and LFTs, re-
                                                              and norepinephrine in the          sive disorder relapse, chronic   tension, vasodilation, tachy-    duce dose with hepatic/renal
                                                              CNS and a weak inhibitor of        treatment of generalized         cardia, dyspepsia, flatulence,   impairment; Monitor HR and
                                                              the uptake of dopamine             anxiety disorder; investiga-     dysphagia, rectal hemorr-        BP
                                                                                                 tional: treat hot flashes in     hage, acne, hypothyroidism
                                                                                                 women who survive breast
                                                                                                 cancer

Vicoden, Lorcet, Anexia (Hy- Analgesic, class 3 controlled Produces analgesic activity Relief of moderate to severe Hepatic necrosis, N&V, co-                     Monitor for OD, Monitor VS,
drocodone bitartrate and Ace- substance                    by an action on the CNS via pain                         ma, clammy skin, hypoten-                      and mental status, note on-
taminophen)                                                opiate receptors, produced                               sion, bradycardia, apnea                       set, location, and characte-
                                                           by both peripheral and cen-                                                                             ristics of symptoms
                                                           tral mechanisms
                                                                                                                                                                      Page 96 of 99
Drug Name                       Class                         Actions                      Indications                  Side Effects                     Nursing implications

Vicodin                         Analgesic                     Pain                                                      Liver Failure Constipation,      Monitor Lab Values, Bowel
                                                                                                                        Nausea                           Elimination Pattern

Vinblastine, velban, velbe      antineoplastics               arrests mitosis in metaphase, Atineoplastic: Hodgkin's,   depression, paresthesia,         give antiemetic before drug,
                                                              blocking cell division        malignant lymphoma          peripheral neuropathy,           use caution in hepatic pt,
                                Treat: Hodgkin's, malignant                                                             numbness, loss of deep ten-      monitor for acute bronchos-
                                lymphoma                                                                                don reflex, muscle pain,         pasms, assess bowel activity
                                                                                                                        weakness, GI effect, CVA,        and give laxatives and stool
                                                                                                                        MI, leukopenia, thrombocy-       softeners prn, don't give no
                                                                                                                        topenia, acute bronchos-         more than 7 days due to
                                                                                                                        pasms, apopecia, irritation at   leukopenia, neuro checks,
                                                                                                                        site                             monitor bilirubin, this drug is
                                                                                                                                                         less neurotoxic than vincris-
                                                                                                                                                         tine and don't confuse the
                                                                                                                                                         two, dc urine retention drugs
                                                                                                                                                         a few days prior to giving
                                                                                                                                                         drug

Vincristine (Oncovin)           Antineoplastics              arrests mitosis in metaphase, Atineoplastic : Hodgkin's, sz, coma, intestinal necrosis      use caution in pts with hepat-
                                                             blocking cell division        malignant lymphoma, Wilms and all other GI effects, leu-      ic and neuro problems and
                                Use: treat Hodgkin's, malig-                               tumor                      kopenia, thrombocytopenia,         those with infection, 5mg are
                                nant lymphoma, Wilms tumor                                                            acute bronchospasms, ane-          for multiple dose not single,
                                                                                                                      mai, phlebitis, cellulitis at      monitor for acute broncho
                                                                                                                      injection, jaw pn, muscle          spams, check uric acid le-
                                                                                                                      weakness and cramps, peri-         vels, maintain hydration, I &
                                                                                                                      pheral neuropathy, loss of         O, support pt with walking,
                                                                                                                      deep tendon reflexes, pares-       frequent neuromuscular
                                                                                                                      thesia, wristdrop and foot-        checks, refrigerte drug, moni-
                                                                                                                      drop                               tor for urine retention, IV use
                                                                                                                                                         only

Vistaril, Atarax (Hydroxyzine   antihistamine, antianxiety,   Anti-anxiety, nonbenzodia-   relief of anxiety, tension,  drowsiness, dry mouth,           (IM) significant tissue dam-
pamoate, Hydroxyzine hy-        antispasmodic, antiemetic,    zepine                       pruritus caused by allergic  marked discomfort with IM        age, thrombosis, IM may be
drochloride)                    antipruritic                                               conditions, preop and postop injections,                      given undiluted, inject deep
                                                                                           sedation, control of muscle                                   IM into gluteus maximus
                                                                                           spasms, nausea and vomit-
                                                                                           ing

Vitamin B complex /vitamin C Water soluble vitamin nutri- Absorbed in GI                   GI                           N&V, diarrhea, HA                With meals
                             tional supplement
PG 1 tab qd
                             Use: treat Vitamin deficiency
                                                                                                                                                                                  Page 97 of 99
Drug Name                     Class                           Actions                            Indications                      Side Effects                       Nursing implications

Vitamin K                     vitamin and mineral             an antihemorrhagic factor          hypoprothromvinemia sec-         dizziness, flushing, transient     check brand name for adm
                                                              that promotes hepatic forma-       ondary to vit. K malabsorp-      <BP after IV adm., rapid and       route restrictions, iv is more
                                                              tion of active coagulation         tion, drug therapy or exces-     weak pulse, diaphoresis,           rapid but shorter lived than
                                                              factors                            sive vit A dosage, hypoproth-    erythema, anaphylaxis reac-        IM or sc, iv route can be fatal
                                                                                                 romvinemia secondary to          tion usually after to rapid of a   so use only when other
                                                                                                 effect of oral anticoagulants,   bolus                              routes are not feasible, sc is
                                                                                                 prevention of hemorrhagic                                           the preferred, monitor pt and
                                                                                                 disease of newborn, preven-                                         inr, vit k does not reverse
                                                                                                 tion of hypoprothromvinemia                                         heparin,
                                                                                                 related to vit K deficiency in
                                                                                                 long-term parenteral nutrition

Warfarin                      Cardiovascular System           Anti-coagulant. Prevention of                                       Cramps, nausea, dermal             Assess for signs of bleeding,
                                                              thrombolytic events by inter-                                       necrosis, fever, bleeding          & hemorrhage, unusual
(Coumadin)                    Prophylaxis and treatment of ference with hepatic synthe-                                                                              bruising, tarry black stools,
                              venous thrombosis, pulmo- sis of vitamin K dependent
                                                                                                                                                                     hematuria, Hct or BP,
                              nary embolism, atrial fibrilla- clotting factors (II, VII, IX, &
                                                                                                                                                                     guaiac positive stools, urine,
                              tion with embolization          X)                                                                                                     or nasal aspirate

Warfarin (Coumadin, Warfi-    anticoagulant                   inhibits vitamin K-dependent       pulmonary embolism asso-         hematuria excessive men-           monitor PT and INR monitor
lone)                                                         activation of clotting factors     ciated with deep vein throm-     strual bleeding hemorrhage         patient for bleeding gums,
                                                              II,VII,IX and X formed in the      bosis, MI prosthetic heart       prolonged PT INR fever             bruises, petechiae, nose-
                                                              liver                              valves chronic atrial fib        headache                           bleeds half-life effect is 36-
                                                                                                                                                                     44 hrs effects can be neu-
                                                                                                                                                                     tralized by vitamin K

White petrolatum (Puralube)   Use: restores moisture and      White petrolatum (Puralube         GI                               Use: restores moisture and         White petrolatum (Puralube
                              reduces irritation to the eye   )1 app qd                                                           reduces irritation to the eye      )1 app qd
1 app qd

Xanax (alprazolam)            antianxiety, benzodiazepine     enhances action of inhibitory      management of anxiety dis-       muscular incoordination            drowsiness usually disap-
                                                              neurotransmitters in the           orders associated with de-       (ataxia ) lightheadedness,         pears during continued ther-
                                                              brain, producing anxiolytic        pression, panic disorders,       transient mild drowsiness,         apy, avoid tasks that require
                                                              effect due to CNS depres-          Improves mood, relieves          slurred speech (particularly       alertness, motor skills until
                                                              sant action                        cramps, prevents insominia       in elderly, debilitated            response to drug is estab-
                                                                                                 with premenstrual syndrome                                          lished

Xopenex                       Bronchodialator                 Opens airway by relaxing           Respiratory                      Tachycardia, dry mouth             Inhale deeply
                                                              smooth muscle
                              Use: open airways                                                                                   Bad taste

Zafirlukast (accolate )       Leukotreine inhibitor           Block inflammatory mediator Respiratory                             Inhibits metabolism of warfa- Monitor PT, oral care
                                                              leukotreine                                                         rin (coumadin )nausea
                              Use: long term inhibition of
                              inflammatory response
                                                                                                                                                                                 Page 98 of 99
Drug Name                          Class                         Actions                          Indications                      Side Effects                     Nursing implications

Zantac 150 mg PO bid               H2 receptor antagonist        Competitively inhibits action                                     Vertigo, malaise, leukopenia,    Caution in pt's with liver dys-
                                                                 of H2 at receptor sites of the                                    anaphylaxis, burning and         function, assess for GI bleed,
0800                                                             parietal cells decreasing gas-                                    itching at site; constipation,   antacids may interfere
                                                                 tric acid secretion                                               nausea, abdominal pain;          with/stager doses, may alter
                                                                                                                                                                    valium, glipizide, procaina-
                                                                 Prophylaxis; treatment of                                                                          mide, and warfarin; monitor
                                                                 active duodenal ulcers and                                                                         for hepatotoxicity;
                                                                 GERD; heartburn;

Zebeta                             beta-adrenergic blocking      Combine reversibly with be-      alone or with other drugs to     bradycardia, CHF, cold ex-       Monitor liver and renal func-
                                   agent                         ta-adrenergic receptors to       treat hypertension, chronic      tremities, strokes, edema,       tion studies, ECG, and vital
                                                                 block the response to sym-       management of angina pec-        fatal MI, sudden death syn-      signs, monitor lung sounds,
                                                                 pathetic nerve impulses,         toris, treatment of stable,      drome, flatulence, dry mouth,    monitor I&Os, and weight
                                                                 circulating catecholamines,      symptomatic heart failure of     distortion of taste, weight
                                                                 decreases HR, myocardial         ischemic, hypertensive, or       gain or loss, respiratory dis-
                                                                 contractility, and CO            cardiomyopathic origin           tress, vivid dreams, head-
                                                                                                                                   aches

Zestril Prinivil, apo-lisinopril   antihypertensive              blocks the production of an-     treatment for hypertension       head ache dizziness insom-       monitor for and teach about
                                                                 giotensin 1 to angiotensin 2     alone or in combination with     nia orthostatic hypotension      orthostatic hypotension
                                                                 which is a vasoconstrictor       thiazide diuretics treatment     gastric irritation nausea di-    watch for gastric irritation
                                                                 which causes a decrease in       for patient with in 24 hrs of    arrhea angioedema cough          monitor BP to see if drug is
                                                                 BP                               acute MI to improve survival                                      working
 Zetia                             Cardiovascular Agent; Anti-    Inhibits absorption of cho-      Lowers total cholesterol         Fatigue; arthralgia, back        Monitor baseline and peri-
                                   Lipemic                        lesterol at the small intes-     and low density lipid cho-       pain, myalgia, dizziness,        odic lipid profile and LFT’s ;
 (Ezetimibe)                                                      tinal lining, BUT not in the     lesterol; method of action is    headache, abdominal pain,        adhere to Statin monitoring
                                                                  liver; and does not in-          complimentary to STA-            diarrhea, pharyngitis, sinu-     schedule;
                                                                  crease bile acid excretion.      TINS                             sitis, cough
                                                                  Decreases amount of in-                                                                            Monitor for unexplained
                                                                  testinal cholesterol availa-                                                                       muscle pain;
                                                                  ble to the liver                                                                                    Monitor closely Px’s that
                                                                                                                                                                     take both Zetia and Cyc-
                                                                                                                                                                     losporine


Zinc (Orazinc)                     mineral                       natural element that is es-                                       dietary supplement to treat or   Vomiting, nausea. Do not
                                                                 sential for growth and tissue                                     prevent zinc deficiencies        exceed prescribed dosage
                                                                 repair                                                            used for delayed wound           take with food avoid taking it
220mg Capsule, PO,QD,                                                                                                              healing associated with defi-    with bran and or high fiber
                                                                                                                                   ciency                           food may interfere with ab-
                                                                                                                                                                    sorption take drug with food

Ziprasidone (Geodon)               Atypical antipsychotic. CNS   Dopamine and serotonin           Atypical Antipsychotic           Cardiac dysrythmias, seda-       Monitor EKG, causes long qt
                                   agent                         receptor block in limbic re-                                      tion, some anticholinerg,        interval, Change positions
                                                                 gion of brain                                                     effects, , headache, agita-      slowly, avoid ETOH
                                   Use-treat psychosis                                                                             tion, weakness, , orthostatic
                                                                                                                                   hypotension, EPS, temp.
                                                                                                                                   regulation
                                                                                                                                                               Page 99 of 99
Drug Name                    Class                  Actions                          Indications                   Side Effects                   Nursing implications

Zocor simvastatin            Anti-hyperlipidemic    inhibits the first step in the   adjucnt ot diet in treatent of headache flatulence abdo-        monitor liver function and
                                                    cholesterol synthesis path-      elevated total chelestrol and minal pain nausea cramps         renal functions take in the
                                                    way resulting in a decrease      LDL chelestrol                 constiation liver failure acute evening report sever GI up-
                                                    in serum cholesterol                                            renal failure                   set

Zofran (Ondansetron hydroch- antiemetic             Blocks the effect of serotonin prevention of nausea and        diarrhea, clonic-tonic sei- Monitor LFTs, monitor I&Os,
loride)                                             thus blocking the vomiting     vomiting                        zures, anaphylaxis, hypoka- assess for other causes
                                                    reflex, not known whether it                                   lemia, dysuria
                                                    acts centrally or peripherally

Zolpiden tartrate (Ambien)   CNS agent, sedative-   Non-benzodiazepine hypnot-                                                                    give immediately before bed-
                             hypnotic/              ic prescribed for short-term                                                                  time
                                                    treatment of insomnia                                          CNS depression, drowsi-
                                                                                                                   ness, dry mouth                do not give immediately after
                                                                                                                                                  a meal
5 mg, PO, QHS                                                                                                                                     monitor vitals & respirations
                             sedation, sleep


Zosyn (Piperacillin sodium   antibiotic             beta-lactamase inhibitor         recommended for appendici- rash, nausea, vomiting, GI        monitor for signs of allergies
and Tazobactam sodium)                              used in combination with         tis, peritonitis, nosocomial, disturbances, anaphylaxis
                                                    broad spectrum penicillin        pneumonia and PID
                                                    powder for injection

				
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