Drug Card Manuscript

PAIN MED.
MED Name/class
Mild Pain
Tylenol
(Acetaminophen)
NSAIDS:
Safe dose/Route/ Freq
Motrin
(Ibuprofen)
Toridol (Ketorolac)
Moderate Pain
OPIOID ANALGESICS
Norco (Hydrocodone)
Children (general): 10
to 15 mg per kg of
body weight, every 4 to
6 hours, to a maximum
of 65 mg/kg in 24
hours.
Adults: 325 mg to 650
mg every 4 to 6 hours
to a maximum of 4,000
mg in 24 hours.
10-40 mg every 4-6

hours
7.5-10mg (oral) every

4-6 hours
Vicodine
(Hydrocodone)
SE
4-6 pain
Analgesia for moderate
to severe acute pain
Alternative to Narcotic
Analgesic
Intramuscular Dose
Regular 30-120mg
Low 15-60mg
Intravenous Dose
Regular 30mg
Low 15mg
Oral Dose
Maximum 40mg
Regular 10-20mg
Low 10mg
10-80mg (oral)
Oxycontin
(Oxycodone HCl)
Percocet (Oxycodone)
Severe Pain
OPIOID ANALGESICS
Dilaudid
(Hydromorphone)
Adults: Oral 325-650

mg every 4-6 hours.
(maximum daily dose is
4 grams)Suppository
650mg every 4-6 hours.
Children: Oral 40-650
mg every 4
hoursSuppository 80325 mg every 4-6 hours
depending on age.
Uses (Goals)
Relief of signs and
symptoms of rheumatoid
arthritis and
osteoarthritis
Relief of mild to
moderate pain
Treatment of primary
dysmenorrhea
Fever reduction
Unlabeled uses:
Prophylactic for migraine;
abortive treatment for
migraine
Headache
Chest pain,
Hepatic toxicity and
failure, jaundice
Acute kidney failure,
renal tubular necrosis
Rash
fever
Lightheadedness
Dizziness
Drowsiness
Nausea
Vomiting
Constipation
RN Consider
Assess pain
Assessmusculoskeletal
status: ROMbefore dose
and 1 hr. after
Monitor liver function
studies
Monitor renal function
studies
Monitor bloodstudies:
CBC,Hgb, Hct,proteome
if patient is on longterm therapy
Check I&O ratio
Assesshepatotoxicity Assess
forallergicreactions,
visualchanges
andototoxicity
Identify prior drug
history
Identify fever:length of
time inevidence
andrelatedsymptoms
BP ____ HR ____
Postural Hypotension
N/V
Pain ___ /10 (PQRST)
Pt. Teaching
Administer in the
morning with a full glass
of water at least 60 min
before the first
beverage, food, and
medication of the day.
Patient must stay up
right for 60min after
taking the tablet to
avoid potentially serious
esophageal erosion
Do not exceed
recommended dose; do
not take for longer than
10 days.
Take the drug only for
complaints indicated; it
is not an antiinflammatory agent.
Action
Inhibits prostaglandin
synthesis by decreasing
the activity of the
enzyme, cyclooxygenase,
which results in
decreased formation
prostaglandin
precursors.
Drug 2 Drug Interaction

Therefore drugs that
increase the action of
liver enzymes that
metabolize
acetaminophen [for
example, carbamazepine
(Tegretol), isoniazid
(INH, Nydrazid, and
Laniazid), rifampin
(Rifamate, Rifadin, and
Rimactane)] reduce the
levels of acetaminophen
and may decrease the
action of
acetaminophen. Doses
of acetaminophen
greater than the
recommended doses are
toxic to the liver and
may result in severe liver
damage. The potential
for acetaminophen to
harm the liver is
increased when it is
combined with alcohol
or drugs that also harm
the liver.
Dizzy >no standing

N/V > call nurse
Inform patient that
hydrocodone and
acetaminophen may
cause dizziness and
drowsiness.
Advise patient to avoid
hazardous activities until
drugs CN effects are
known.
Advise patient to change
position slowly to
minimize effects of
orthostatic hypotension
Management of
moderate to severe
pain.
Binds to opiate
receptors in the CNS
Alters the perception of
ad response to painful
stimuli, while producing
generalized CNS
depression
Avoid alcohol and other

CNS depressants while
receiving morphine.
Do not use OTC drug
unless approved by
physician
Do not smoke or
Binds to opiate receptors

in the CNS
Alters the perception of
and response to painful
stimuli while producing
generalized CNS
depression
High risk of CNS

depression with alcohol,
antidepressant,
antihistamines, and
sedative/hypnotics
including
benzodiazepines and
Anticholinergic:
Increased risk of ileus,
sever constipation and
urine retention.
Antidiarrheal: Increased
risk of CNS depression
and severe constipation.
Barbiturate anesthetics:
Possibly increased
respiratory and CNS
depression.
2.5-10mg (oral)
1mg IV Q 4-6 hours prn

Peak 15-30min
Onset 10-15min
Duration 2-3 hour
7-10 pain
PCA pump
Symptomatic relief of
sever, acute and chronic
pain after non-narcotic
analgesics have failed
and preanasthetic
Constipation
Dizziness
Hypotension
Blurred vision
Nausea and vomiting
Urine Retention
BP ____ HR ____
Postural Hypotension
N/V
Pain ___ /10 (PQRST)
Morphine
Allergy to Sulfa Drugs
Page 2
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PAIN MED.
MED Name/Class
Safedose/Rout
(Morphine)
Adult: (PO) 10-30mg q4h

(IV) 2.5-15mg q4h
(IM/SC) 5-20mg (PR) 1020mg
(Fentanyl)
0.5-1mcg/kg/dose, may
repeat after 30-60min.
(Demerol)
100 mg/ 2mL
Uses/Goals
SE
RN Consider
medication
Used to relieve dyspnea
of acute left ventricular
failure and pulmonary
edema and pain of MI.
Pt Teaching
Anti-Anxiety
>Benzodiazepines<
Ativan (Lorazopam)
adult: PO 26 mg/d in
divided doses (max: 10
mg/d)
geriatric: PO 0.51 mg/d
(max: 2 mg/d)
child: PO/IV 0.05 mg/kg
q48h (max: 2 mg/dose)
Management of anxiety
disorders and for shortterm relief of symptoms
of anxiety. Also used for
preanesthetic medication
to produce sedation and
to reduce anxiety and
recall of events related to
day of surgery; for
management of status
epilepticus.
Drowsiness
Headache
Hyper/hypotension
Nausea and vomiting
> Barbiturates<
Phenobarbitol
15-120 mg/day PO
divided BID/TID
Sedative (oral or
parenteral)
Hypnotic, short-term (up
to 2 wk.) treatment of
insomnia (oral or
parenteral)
Long-term treatment of
generalized tonic-conic
and cortical focal seizures
(oral)
Vertigo
CNS Depression
Nausea and vomiting
Constipation / diarrhea
ambulate without
assistance after
receiving drug. Bedside
rails are advised
Use caution or avoid
tasks requiring alertness
(e.g. Driving a car) until
response to drug is
known since drug may
cause drowsiness,
dizziness, or blurred
vision
Do not breast feed while
taking this drug
Do not drive or engage
in other hazardous
activities for a least 24
48 h after receiving IM
injection of lorazepam.
Do not drink largevolumes of coffee.
Anxiolytic effects of
lorazepam can
significantly be altered
by caffeine.
Do not consume
alcoholic beverages for
at least 2448 h after an
injection and avoid
when taking an oral
regimen.
Notify physician if
daytime psychomotor
function is impaired; a
change in regimen or
drug may be needed.
Terminate regimen
gradually over a period
of several days. Do not
stop long-term therapy
abruptly; withdrawal
may be induced with
feelings of panic, tonic
clonic seizures, tremors,
abdominal and muscle
cramps, sweating,
vomiting.
Be aware that SL
administration has more
rapid absorption than
PO, and bioavailability
compares to IM use.
Do not administer intraarterially; arteriospasm,
gangrene may result.
Give IM injections of
undiluted drug deep
into muscle mass,
monitor injection sites.
Do not use solutions
that are discolored or
contain a precipitate.
Protect drug from light,
and refrigerate oral
solution.
Keep equipment to
maintain a patent
airway on standby when
drug is given IV.
Monitor patient
responses, blood levels
(as appropriate) if any of
the above interacting
drugs are given with
phenobarbital; suggest
alternative means of
contraception to
women using hormonal
contraceptives.
Do not administer intraarterially; may produce
arteriospasm,
thrombosis, gangrene.
Administer IV doses
This drug will make you

drowsy and less anxious;
do not try to get up after
youhave received this
drug (request assistance
to sit up or move
around).
Take this drug exactly as
prescribed; this drug is
habit forming; its
effectiveness
infacilitating sleep
disappears after a short
time.
Do not take this drug
Action
Suppresses the cough

reflex via a direct central
action.
Pain Control

phenothiazines.
Most potent of the

available
benzodiazepines. Effects
(anxiolytic, sedative,
hypnotic, and skeletal
muscle relaxant) are
mediated by the
inhibitory
neurotransmitter GABA.
Action sites: thalamic,
hypothalamic, and limbic
levels of CNS.
Increased CNS depression

with alcohol and other
sedating medications,
such as barbiturates and
opioids
Decreased effectiveness
with theophyllines
General CNS depressant;

barbiturates inhibit
impulse conduction in
the ascending RAS,
depress the cerebral
cortex, alter cerebellar
function, depress motor
output, and can produce
excitation, sedation,
hypnosis, anesthesia,
and deep coma; at sub
hypnotic doses, has
anticonvulsant activity,
making it suitable for
long-term use as an
Increased serum levels

and therapeutic and toxic
effects with valproic acid
Increased CNS depression
with alcohol
Increased risk of
nephrotoxicity with
methoxyflurane
Increased risk of
neuromuscular excitation
and hypotension with
barbiturate anesthetics
Page 3
PAIN MED.
MED Name/Class
Safedose/Rout
Uses/Goals
SE
RN Consider
slowly.
Administer IM doses
deep in a large muscle
mass (gluteus maximus,
vastus laterals) or other
areas where there is
little risk of
encountering a nerve
trunk or major artery.
Pt Teaching
Action
longer than 2 wk. (for

insomnia), and do not
increase thedosage
without consulting the
prescriber.
antiepileptic.
GI : SBO, GERD, Ulcers, Gastritis

MED Name/class
PPI (proton pump inhibitor)
Prazole
Protonix (pantoprazole)
Prilosec (omeprazole)
Adult 20-80mg
20mg PO Q12
H2 Blockerstidine
Uses (Goals)
Stress Ulcers
GERD
Gastritis
Absence of epigastric pain
Fullness
Pain
SE
Headache
Diarrhea
Abdominal pain
Nausea
Vomiting
Insomnia
Hyperglycemia
RN Consider
Assess for epigastric or
abdominal pain and
occult blood in stool
emesis or gastric aspirate
Known hypersensitivity,
hypocalcaemia or if
taking any meds that
interact with this drug.
Treatment and
prevention of heartburn,
acid indigestion, and sour
stomach.
Dizziness
Arrhythmias
Drowsiness
Headache
Nausea
Anti-Acids
(Tums)
2-4 teaspoons (10-20 mL)

4 times a day taken
20min to 1 hr. after meals
and at bedtime or as
directed by the physician.
Relieve heartburn
Major symptom of gastro
esophageal reflux disease
or acids indigestion.
Treatment of ulcers
Upset stomach
Vomiting
Stomach pain
Belching
constipation
Pt Teaching
Report severe diarrhea
If patientsdiabetic may
cause hyperglycemia
Avoid hazardous
activities as dizziness may
occur
Avoid salicylates,
ibuprofen
ETOH- may cause GI
irritation
Assess patient for

epigastric or abdominal
pain and frank or occult
blood in the stool,
emesis, or gastric
aspirate.
Nurse should know that
it may cause falsepositive results for urine
protein; test with
sulfosalicylic acid.
Inform patient that it
may cause drowsiness or
dizziness.
Inform patient that
increased fluid and fiber
intake may minimize
constipation.
Advise patient to report
onset of black, tarry
stools; fever, sore throat;
diarrhea; dizziness; rash;
confusion; or
hallucinations to health
care professional
promptly.
Observe 10 rights in
drug administration to
avoid medication errors.
Monitor and record pain
scales to serve as
Instruct patient to avoid

caffeine, alcohol, harsh
spices, and black pepper
because it may aggravate
the underlying
Action
Blocks final step of acid
production
Inhibits H+/K+ ATPas in
gastric parietal cell
suppressing gastric
secretion.
Binds to an enzyme on
gastric parietal cells in the
presence of acidic gastric
PH.
Preventing the final
transportation of
hydrogen ions into the
gastric lumen.

Contraindicated in
hypersensitivity, metabolic
alkalosis and hypocalcaemia.
Pantoprazole serum levels w/
meds: diazepam, flurezepam,
triazolam, clarithromycin,
phenytoin
Absorption w/meds: calcium
carbonate, vit B12, sucralfate.
Blding w/ warfarin
Hypersensitivity, Cross-sensitivity
may occur; some oral liquids
contain alcohol and should be
avoided in patients with known
intolerance.
Aluminum hydroxide may form

complexes withcertain drugs e.g.,
tetracyclines,digoxin
andvitamins, resulting in
decreased absorption. Thisshould
Blocks HCl production

Turns down Volume of
Stomach Acid production
Neutralizes Stomach Acids

20-30min.
Page 4
GI : SBO, GERD, Ulcers, Gastritis

MED Name/Class
Safedose/Rout
Uses/Goals
(Suspension)
SE
RN Consider
resulting from excessive

acidity.
Stool Softeners
Colace (docusate
sodium)
Bisacodyl (Dulcolax)
100mg PO BID
5-15 mg tablets
10 mg suppository
Prevention of
constipation.
Used as enema to soften
fecal impaction
Promotes incorporation
of water into stool,
resulting in softer fecal
mass.
May also promote
electrolyte and water
secretion.
Abdominal Pain
Nausea
Vomiting
baseline data and to

determinethe
effectiveness of the drug.
Give drug 20 min- 1 hour
after meal to counteract
the hydrochloric acid
production by
neutralizing the acidity.
Administer with at least
8 ounces of water to
enhance absorption
Monitor stool
consistency to prevent
diarrhea and
constipation. `
Assess for abdominal
distention, presence of
bowel sounds, and usual
pattern of bowel
function.
Asses color, consistency
and amount of stool
produced.
Pt Teaching
Anti-Emetic
Zofran (Ondansetron)
0.12 mg/kg or 32mg

single dose
Treatment for nausea and

vomiting
Prevent symptoms of
gastric static and
esophageal reflux.
Headache
Dizziness
Diarrhea
Constipation
Abdominal Pain
Compazine
(Prochlorperazine)
Reglan
(metoclopramide)
Assess for nausea,

vomiting, abdominal
distention and bowel
sounds prior to and
following administration.
Assess patient for
extrapyramidal effect
periodically
Assess patient BP

be borne in mind when
concomitantadministration is
considered.
Advice patients that

laxatives should be used
only for short-term
therapy.
Encourage patient to use
other forms of bowel
regulation, such as
increasing bulk in the
diet, increasing fluid
intake and increasing
mobility.
Advice patient not to use
laxative when abdominal
pain, nausea, vomiting or
fever is present.
Advice patient not to
take docusate within 2
hour of other laxatives.
Promotes incorporation
of water into stool,
resulting in softer fecal
mass, may also promote
electrolyte and water
secretion into the colon.
Electrolyte imbalance
Advice patient to notify

health care professional
immediately if
involuntary movement of
eyes, face or limbs occur.
Blocks the effects of

serotonin at 5ht receptor
sites located in vagal
nerve terminals and the
chemoreceptor trigger
zone in the CNS.
Decreases incidence and
severity of nausea and
vomiting.
May be affected by drugs

altteringthe activity of liver
enzymes.
May cause transient increase in
serum bilirubin, AST and ALT
levels.
PO: 2.5mg-10mg max

40mg/day
IM: 0.1-10mg max
40mg/day
IV: 2.5-10mg max
40mg/day
Rectal: 25mg bid
IV not recommended for
children
10mg q6-8hour
Action
GIcondition.
Instruct patient to
increase fiber and fluid
intake and regular
physical activity to help
ease constipation.
Instruct patient to eat
banana if diarrhea
occurred.
Canbeusedastranquilizerfornonpsychoticanxiety,butotherdrugsma
y have more favorable side effect
prole (e.g., benzodiazepines)
Restlessness
Anxiety
Depression
Irritability
Hyper/hypotension
Page 5
CARDIAC: CHF, MI, HTN, ^cholesterol

MED Name/class
ACE Inhibitor PRIL
Prinivil, Zestril (Lisinopril)
Capoten (Captopril)
dose/Route/Freq
MAX Daily
Uses (Goals)
SE
2.5-40mg
40mg/day
0.3-25mg PO
Hypertension
Management of
congestive heart
failure (CHF)
Reduces the risk of
death or development
of CHF after
myocardial infarction
(MI)
Slows the progression
of left ventricular
dysfunction into overt
heart failure
Used to decreased the
progression of diabetic
neuropathy
Insomnia
Vertigo
Weakness
Cough
Hypotension
Chest pain
Tachycardia
RN Consider
Pt. Teaching
Action
Advice patient take

the med same time
daily.
Change position
slowly
Decreased
antihypertensive
effects if taken with
indomethacin
Exacerbation of cough
if combined with
capsaicin
Take drug without

regard to means
Report fever chills,
dizziness and
pregnancy.
Selectively blocks the

binding of angiotensin II to
specific tissue receptors
found in thevascular
smooth muscle and
adrenal gland; this action
blocks the
vasoconstriction effect
of the
renin\u2013angiotensin
system as well as the
release of aldosterone,
leading to decreasedBP;
may prevent the vessel
remodeling associated
with the development of
Atherosclerosis.
Block Altosterone in
R.A.A.S decrease total
body fluid
BP
Mild diuretic that acts
on the distal tubule to
inhibit sodium exchange
for potassium, resulting
inincreased secretion of
sodium andwater
conservation of
potassium.
Analdosterone
antagonist
Manifests a
slightantihypertensiveef
ARB angiotensin block

Valsartan
Candesartan
Losartan
1 tab daily; 25100mg/d

16mg once daily
Aldactone(Spironolactone)
2-32
mg/day as
a single
dose or
divided
into 2
daily
doses
Treatment of
hypertension, alone or
in combination with
other
antihypertensive.
Treatment of heart
failure in patients who
are intolerant of
angiotensin-converting
enzyme (ACE_
inhibitors.
Decrease BP
Take Pressure Off
L Ventricle of heart
Treat high blood
pressure. Lowering high
blood pressure helps
prevent strokes, heart
attacks, and kidney
problems. It is also
used to treat swelling
(edema)
Headache
Dizziness
Hypotension
Diarrhea
URI Symptoms
BP_____
HR_____
Administer
without regard
to meals.
Ensure that
patients is not
pregnant before
beginning
therapy
Check blood
pressure before
initiation of
therapy and at
regular intervals
throughout
therapy.
Lab tests:
Monitor serum
electrolytes
(sodium and
potassium)
especially during
early therapy;
monitor digoxin
level when used
100-200
mg/dayPO for
edema;100400mg/day PO
for
hyperaldostero
nism; 50-100
mg/day PO for
hypertension
Pediatric :3.3
mg/kg/day PO
100mg/day PO
BID
Inspra (Eplerenone)
25-50mg/day
Headache
diarrhea,
cramps,
drowsiness,
rash,
nausea,
vomiting,
impotence,
irregular menstrual
periods,
irregular hair growth
Stops Angiotensin 1 to
converting to Angiotensin
2 in the R.A.A.S
Decrease B/P
Excretion of sodium and
water and retention of
potassium
Assess Vital Signs

before giving Rx.
Monitor BP and
pulse frequently
during initial
dose adjustment
Monitor weight
and assess lungs
for rales/crackles
Assess for
peripheral
edema, jugular
venous
distention
50mg OD
Aldosterone Antagonist
360mg/day
H/O AngioEdema
Mod-severe
aortic stenosis
Systolic BP <90,
Cr>3.0
K+ >5.5
BP_____
HR_____
Be aware that the

maximal diuretic
effect may not
occur until third day
of therapy and that
diuresis may
continue for 23 d
after drug is
withdrawn.
Report signs of
hypernatremia or
hyperkalemia (see
Appendix F), most
likely to occur in
patients with severe
cirrhosis.
Contraindicated with
hypersensitivity to
valsartan, pregnancy
(use during second
Or third trimester can
cause injury or even
death to fetus),
lactation.
Use cautiously with
hepatic or renal
dysfunction,
hypovolemic
Increased hyperkalemia
with potassium
supplements, ACE
inhibitors, diets rich in
potassium.
Decreased diuretic
effect with salicylates
Decreased
hypoprothrombinemic
effect of anticoagulants
Page 6

MED Name/Class
Loop Diuretics
Lasix (Furosemide)
Safedose/Rout
for 4 weeks
20mg/tab
Bumex(Bumetanide)
0.5-1mg/day
Demadex (Torsemide)
5-20mg/day
5-20mg/day
Thiazide Diuretics
Hydrochlorothiazide
(Metolazone)
MAX daily
10mg/day
80mg/day
Uses/Goals
SE
RN Consider
Pt Teaching
concurrently.
Assess for signs
of fluid and
electrolyte
imbalance, and
signs of digoxin
toxicity.
Monitor daily
I&O and check
for edema.
Report lack of
diuretic response
or development
of edema; both
may indicate
tolerance to
drug.
Weigh patient
under standard
conditions
before therapy
begins and daily
throughout
therapy. Weight
is a useful index
of need for
dosage
adjustment. For
patients with
ascites, physician
may want
measurements of
abdominal girth.
Avoid replacing
fluid losses with
large amounts of
free water
Action
fect. Interferes with
synthesis of
testosterone and
mayincrease formation
of estradiol from
estrogenthus leading to
endocrine abnormalities
Treatment of edema
associated with CHF,
hepatic cirrhosis, and
renal disease.
Hypertension.
orthostatic
hypertension
thrombophlebitis
chronic aortitis
vertigo
headache
BP_____ HR_____
Weights
(trending)
1___2 ___3 ___4
___
K+ ____
Assess patient's
underlying
condition.
Monitor for renal,
cardiac,
neurologic, GI,
pulmonary
manifestation of
hypokalemia.
Assess fluid
volume.
s/s Hypo K+
Posteral Syncope
advise patient
totake drug with
food toprevent GI
upsetinform patient
of possibleneed for
potassium
ormagnesium
supplements
For pain on
integumentary
structures, myalgia,
neuralgia, headache,
dysmenorrhea, gout.
BP_____ HR_____
Assess for pain:
type, location and
pattern
Note for asthma
Record intermittent
therapy on a
calendar, or use
prepared dated
envelopes. Take drug
heartburn
Thirst
fever
dimness of vision
Inhabits sodium and

chloride reabsorption
at the proximal tubules,
distal tubules and
ascending loop of
Henley leading to
excretion of water
together with sodium,
chloride and potassium.
Diuretic
antihypertensive.
Inhibits reabsorption of
sodium and chloride in
distal renal tubule,
increasing the
Excretion of sodium,
Cross-sensitivity with
thiazides and
sulfonamides may occur
Taking insulin with

Hydrochlorothiazide
may cause high blood
sugar (hyperglycemia.
Page 7

MED Name/Class
Safedose/Rout MAX daily
Uses/Goals
Arthritis, SLE, acute
rheumatic fever
SE
RN Consider
asthma like symptoms
Monitor renal,LFTs
and CBC
Determine history
of peptic ulcers or
bleeding
tendencies.
early so increased
urination will not
disturb sleep. Drug
may be taken with
food or meals if GI
upset occurs.
Weigh yourself on a
regular basis, at the
same time and in the
same clothing;
Record weight on
your calendar.
chloride, and water by

the kidney.
Take with meals if

upset stomach
occurs.
Block Ca+ channels of cell

inhabits the movement of
calcium ions across the
membranes of cardiac
and arterial muscle cells
inhabits trans
membranecalcium flow,
which results in the
depression of impulse
formation in specialized
cardiac pacemaker cells
osteoporosis
Ca+ Channel Block

PINES
Norvasc (Amlodipine)
Beta Block
Zabeta (Bisoprolol)
Coreg (Carvedilol)
Lopressor Metroprolol
CHR
Angina
hypertension
5mg/tab OD
1.25mg
3.125mg x 2
12.5 25mg
10mg
25 50mg x
2
If >85kg
200mg x
1
CHF
Tachycardia
Management of
hypertension, used
alone or with other
antihypertensive
agents
Dizziness
headache
Peripheral edema
Flushing rush
Nausea
Abdominal discomfort
Pharyngitis
Dizziness
Vertigo
Bardycardia
CHF
Cardiac Arrhythmias
Rush
Monitor patients
BP, cardiac
rhythm, and
output.
Pt Teaching
Action
Baseline weight,
skin condition,
neurologic
status, P, BP,
ECG, R,kidney
and liver function
tests, blood and
urine glucose
Do not stop taking

this drug unless
instructed to do so
by a health care
provider.
Avoid over-thecounter
medications.
Avoid driving or
dangerous activities
if dizziness,
weakness occur.
These side effects
may occur:
Dizziness, lightheadedness, loss of
appetite,
nightmares,
depression, and
sexual impotence.
Report difficulty
breathing, night
cough, swelling of
extremities, slow
pulse,
Confusion,
depression, rash,
fever, sore throat.
Blocks beta-adrenergic
receptors of the
sympathetic nervous
system in the heart and
juxtaglomerular
apparatus (kidney), thus
decreasing the excitability
of the heart, decreasing
cardiac output and
oxygen consumption,
decreasing the release of
renin fromthe kidney, and
lowering blood pressure.
The body breaks down

(metabolizes)
amlodipine using liver
enzymes known as CYP
3A4 enzymes. Drugs
known as CYP 3A4
inducers speed up the
activity of these
enzymes, causing the
body to metabolize
amlodipine too quickly.
This may make
amlodipine less
effective.
Increased effects with
verapamil,
anticholinergic
Increased risk of
orthostatic hypotension
with prazosin
Possible increased BPlowering effects with
aspirin, bismuth
subsalicylate,
magnesium salicylate,
sulfinpyrazone,
hormonal
contraceptives
Decreased
antihypertensive
effects with NSAIDs
Possible increased
hypoglycemic effect of
insulin
Page 8

MED Name/Class
Inotropic
Cardiac Glycosides
Lanoxin (Digoxin)
0.125mg x 1
0.125
mg
0.25mg
x1
Nitrates VASODILATOR
Nitro (Nitroglycerin)
0.2-0.6 mg SL q
5 minutes
3doses
in 15
minutes
Blood Thinners
(anti-coagulants)
Uses/Goals
Heart failureSupraventricular
arrhythmiasEmergency heart
failure
MI, /CAD
Treatment of angina
pectoris
SE
RN Consider
Headache
Weakness
Drowsiness
visual disturbances
mental status change
Arrhythmias
GI upset, anorexia
Dig Toxic0.82.0ng/ml
Low K+ levels (^dig
toxic)
BP_____ HR_____
EKG
Monitor apical
pulse for 1 minute
before
administering.
Administer as
indicated.
Check dosage and
preparation
carefully.- Avoid
giving with meals;
this will delay
absorption
Headache
Restlessness
Nausea Vomiting
Hypotension
Tachycardia
Viagra
BP_____ HR_____
Monitor blood
pressure and heart
rate on a regular
basis
Dizziness
Headache
Observe patients
receiving
Pt Teaching
Instruct patient not
to stop taking drug
without notifying
physician.
Instruct to report
slow or irregular
pulse, rapid weight
gain, loss of
appetite, nausea,
diarrhea, vomiting,
blurred or yellow
vision, unusual
tiredness or
weakness, swelling
of the ankles, legs or
fingers, difficulty
breathing.
Weigh patient every
other day.
Instruct to have
regular medical
check-ups, which
may include blood
tests, to evaluate
effects of drug.
Do proper
documentation.
NO Viagra (Vascular
Collapse)
Instruct patient to
take medication
while sitting down
and to change
positionsslowly.
Instruct patient to
allow tablets to
dissolve under
tongue, and not to
chewer swallow
sublingual tablets.
Instruct patient to
seek emergency
help promptly if
chest pain is
unresolved after 15
minutes.
Instruct patient not
to change brands
without
consultingprescriber
. Instruct patient to
keep tablets in
original, air-tight
container
Protect from injury
and notify Dr of
Action
Digoxin is a cardiac
glycoside which has
positive inotropic activity
characterized by an
increase in the force of
myocardial contraction. It
also reduces the
conductivity of the heart
through the
atrioventricular (AV)
node. Digoxin also exerts
direct action on vascular
smooth muscle and
indirect effects mediated
primarily by the
autonomic nervous
system and an increase in
vagal activity
effectiveness reduced
by phenytoin,
neomycin,sulphasalazin
e, kaolin, pectin,
antacids and inpatients
receiving radiotherapyMetoclopramide may
alter the absorption of
solid dosage forms of
digoxin- Blood levels
increased by calcium
channel blockers,
spironolactone,
quinidine and calcium
salts.- Electrolyte
imbalances such as
hypokalemiaand
hypomagnesaemia(e.g.
admin of potassiumlosing diuretics,
corticosteroids) can
increase the risk of
cardiac toxicity
Reduces cardiac oxygen

demand by decreasing
leftventricularpressure
and systemicvascular
resistance; dilates
coronaryarteries
andimproves collateral
flow to ischemic regions
Viagra
ASA:
Prevent bleeding by
Use of heparin, ASA,

Tylenol,
Page 9

MED Name/Class
ASPRIN (anti-platelet)
Heparin (Heparin Sodium)
Lovenox (enoxaparin)
81mg Q Day
325mg CP
150=10,000
U/kg IV
40mg SQ daily
Uses/Goals
Coumadin (Warfarin)
2.5 mg/1 tab

OD
Anticoagulation for
purposes of stroke,
PE, deep venous
thrombosis,
prophylaxis for
venous thrombosis,
acute MI
Prophylaxis and Tx of
venous thrombosis
and pulmonary
embolism and to
prevent
thromboembolic
complications arising
from cardiac and
vascular surgery,
frostbite, and during
acute stage of MI.
Also used in Tx of
disseminated
intravascular
coagulation (DIC),
atrial fibrillation with
embolization, and as
anticoagulant in
blood transfusions,
estracorporealcirculat
ion, and dialysis
procedures
Prevention o
thrombus formation
Systemic
anticoagulation for
prevention of
ischemic or
thrombotic events
Prevents further
extension of formed
existing clot,
prevention of new
clot formation, and
secondary
thromboembolic
complications. And
for treatment of
hyperkalemia.
SE
RN Consider
Insomnia
Constipation
N/V
Urinary Retention
Bleeding
Anemia
Thrombocytopenia
parenteral drug
carefully; closely
monitor BP and
vital signs.
Observe older
adults closely
during period of
brisk diuresis.
Sudden
alteration in fluid
and electrolyte
balance may
precipitate
significant
adverse
reactions. Report
symptoms to
physician.
Monitor for S&S
of hypokalemia.
Monitor I&O
ratio and
pattern. Report
decrease or
unusual increase
in output.
Pt Teaching
pink, red, dark

brown or cloudy
urine, red or dark
brown vomitus; red
or black stools,
bleeding gums or
oral mucosa;
ecchymosis,
hematoma,
epistaxis, bloody
sputum; chest pain;
abdominal or
lumbar pain or
swelling; unusual
increase in
menstrual flow;
pelvic pain; severe
or continuous
headache, faintness,
or dizziness
Menstruation may
be somewhat
increased and
prolonged;
Learn correct
technique for SC
admin if discharged
from hospital on
heparin
Engage in normal
activities such as
shaving with a
safety razor in the
absence of a low
platelet count.
Alcohol and
smoking may alter
the response to
heparin and are not
advised
Do not take aspirin
or any other OTC
meds without the
Dr approval
Action
inactivation of
thrombin formation,
inhibition of formation
of fibrin
Heparin:
exerts direct effect on
blood coagulation
(clotting) by enhancing
the inhibitory actions
of antithrombin III on
several factors
essential to normal
blood clotting, thereby
blocking the
conversion of
prothrombin
tothrombin and
fibrinogen to fibrin.
Drug
2 Drug Interaction
glucocorticoids,
sulfonamides,
cephalosporinsincrea
se effects of warfarin.
Phenobarbital,
tegrtol, Dilantin, oral
contraceptives
decreases
anticoagulation
effects.
Coumadin:
Warfarin is used to
treat blood clots (such
as in deep vein
thrombosis-DVT or
pulmonary embolusPE) and/or to prevent
new clots from forming
in your body.
Preventing harmful
blood clots helps to
reduce the risk of a
stroke or heart attack
Page 10
MED Name/class
Insulin
Rapid Acting LOG
Apidra (Glusine)
Aspart (Novolog)
Lispro (Humalog)
Short Acting LIN
Humalin/Novolin R
ONSET/ Peak/ Duration
Intermediate (cloudy)
NPH
1-2HR ONSET
6-10 hr. PEAK
DURATION
4 Hr. ONSET
NO PEAK
18 24 Hr. DURATION
Long Act
Glargine (Lantus)
Detremir (Levemir)
MED Name/class
Anti-Diabetic
(Metformin) Glucophage
15min ONSET
30 - 90 min PEAK
4-6 hour DURATION
Uses (Goals)
Diabetes Mellitus
Regulate sugar in your bloodstream
30 60 min ONSET
2-4 hr. PEAK
DURATION
500-1000mg
Max. 2000mg/day (child)
2500mg/day (adult)
Insulin & Diabetic

RN Consider
Assess patient
periodically for
symptoms of
hypoglycemia (anxiety;
restlessness; mood
changes; tingling in
hands, feet, lips or
tongue; chills; cold
sweats; confusion; cool
pale skin; difficulty in
concentration;
drowsiness; excessive
hunger; headache
Monitor body weight
Roll NPH to mix
Uses (Goals)
SE
improve
glycemiccontrolling
clients with type
2diabetes
Diarrhea
Nausea
Unpleasant metallic taste.
Extended-Release form
used to treat type2
diabetes as initial therapy
Asses for symptoms of

hypoglycemia.
Monitor body weight.
RN Consider
Assess for patients history
of diabetes
Monitor patients blood
glucose before and after
giving medications.
Assess for
hypersensitivity to
Metformin
Assess Patients renal
function
Monitor sign and
symptoms of
hypoglycemic reaction.
Pt. Teaching
Hypoglycemia
H.A.N.D.W.A.S.H
Headache
Altered
Nervousness
Disoriented
Anxiety
Shaky
Action
Lowers blood glucose by
stimulating glucose
uptake in skeletal muscle
and fat and inhibiting
hepatic glucose
production.
Insulin also inhabits
lipolysis and proteolysis
and enhances protein
synthesis.
A rapid-acting insulin
with more rapid onset
and shorter duration
than human regular
insulin; should be used
with intermediate or
long acting insulin.

Lantus/Lefemir
NO MIXING!!!! With
other insulins
Beta blockers may block
some of the signs and
symptoms of
hypoglycemia and delay
recovery from
hypoglycemia
(Lopressor)
Alcohol may decrease
insulin requirements.
Pt. Teaching
Action
Inform the patient of

potential
risks/advantages of
therapy and of alternative
modes of therapy
Do not discontinue this
medication without
consulting your health
care provider.
Monitor urine or blood
for glucose and ketones
as prescribed.
Do not use this drug
during pregnancy; if you
become pregnant, consult
with your
Health care provider for
appropriate therapy.
Decreases heptic glucose

production
Decreases intestinal
glucose absorption.
Increases sensitivity to
insulin.
decongestants can make

metformin less effective,
increasing your chance of
high blood sugar
(hyperglycemia)
Page 11
MED Name/class
Bronchodilators
Beta 2 Agonist
Proventil (Albuterol)
Methylaxthine
Theophylline
(Elixophyllin)
PO (Adults and Children

more than 12 years): 24 mg 3-4 times a day or
4-8 mgof extended
dose tablets twice a
day.
1.4 mg poq12h
Maintenance 3mg/kg q
8hr.
RESPIRATORY: COPD (Asthma, Emphysema, Chronic Bronchitis) Restrictive Airway Disease

Uses (Goals)
SE
RN Consider
Pt. Teaching
To control and prevent
Restlessness
Relief and prevention of
Do not exceed
reversible airway
bronchospasm in
recommended dosage;
cardiac arrhythmias
obstruction caused by
patients with reversible
adverse effects or loss
palpitation
asthma or chronic
obstructive
of effectiveness may
sweating
obstructive pulmonary
airway disease
Result. Read the
nausea & vomiting
disorder (COPD)
instructions that come
Inhalation: Treatment
Quick relief for
with respiratory
of acute attacks of
bronchospasm
inhalant.
bronchospasm
For the prevention of
These side effects may
Prevention of exerciseexercise-induced
occur: Dizziness,
induced bronchospasm
bronchospasm4. Longdrowsiness, fatigue,
Unlabeled use: Adjunct
term control agent for
headache (use
in treating serious
patients with chronic or
caution if driving or
hyperkalemia in dialysis
persistent
performing tasks that
patients;
bronchospasm
require alertness);
seems to lower
nausea, vomiting,
potassium
change in taste (eat
concentrations when
small, frequent meals);
inhaled by patients on
rapid heart rate,
hemodialysis
anxiety, sweating,
Flushing, insomnia.
Report chest pain,
dizziness, insomnia,
weakness, tremors or
irregular heartbeat,
difficulty breathing,
productive cough,
failure to respond to
usual dosage
Bronchospasm of COPD
Nausea Vomiting
Monitor theophylline
Take this drug exactly
blood levels
as prescribed
Bronchial asthma
Palpitation
Monitor I&O
Avoid excessive intake
Chronic bronchitis
Hyperglycemia
of coffee, tea, cocoa,
Assess for signs of
Anxiety
cola, and chocolates.
toxicity: irritability,
Insomnia
Have frequent blood
insomnia, restlessness,
tremors
test to monitor drug
effects and ensure safe
Monitor respiratory
and effective dosage.
rate, rhythm and dept.
Assess for allergic
reaction.
Action
in low doses, acts
relatively selectively at
beta2-adrenergic
receptors to cause
bronchodilator and
vasodilation; at higher
doses, beta2 selectivity
is lost, and the drug
Acts at beta2 receptors
to cause typical
sympathomimetic
cardiac effects.

Increased
sympathomimetic
effects with other
sympathomimetic drugs
Increased risk of
toxicity, especially
cardiac, when used with
theophylline,
aminophylline,
oxtriphylline
Decreased
bronchodilating effects
with beta-adrenergic
blockers (eg,
propranolol)
of insulin, oral
hypoglycemic drugs
Decreased serum levels
and therapeutic effects
of digoxin
Anti - Cholinergic
Ipratropium Inhaler
(Atrovent,Apovent,Aerov
ent)
2 inhalations (36 mcg)

qid.
Bronchodilator for
maintenance treatment
of bronchospasm
associated with COPD
(solution, aerosol),
chronic bronchitis, and
emphysema
Nasal spray:
Symptomatic relief of
rhinorrhea associated
with perennial rhinitis,
Nausea
GI distress
Dry mouth
Dyspnea
bronchitis
Back pain
Chest pain.
Asses History of
hypersensitivity to
atropine
Asses skin color lesion
texture
BP, P, R adventitious
sounds
Bowel sounds
Use as an inhalation
product
Side effect may occur
Report rash, eye pain,
difficulty voiding,
palpitation, vision
changes
Relaxes bronchial
smooth muscle, causing
bronchodilator and
increasing vital capacity
that has been impaired
by bronchospasm and
air trapping; actions
may be mediated by
inhibition of
phosphodiesterase,
which increases the
concentration of cyclic
adenosine
monophosphate; in
concentrations that may
be higher than those
reached clinically, it also
Inhibits the release of
slow-reacting substance
of anaphylaxis and
histamine.
STOPS(inhibits)
secretion from serous
and seromucous glands
lining the nasal mucosa.
Anticholinergic,
chemically related to
atropine, which blocks
vagally mediated
reflexes
By antagonizing the
action of acetylcholine.
Drinking alcohol can

increase the level of
theophylline in your
blood, which can cause
dangerous side effects.
It is best to avoid
alcohol while taking
theophylline.
Page 12
MED Name/Class
Anti-Inflam Agents
Corticosteroids
Prednisone
(Deltasone/Flovent)
Mast Cell Stabilizer

CromolynSodium
(Intal
Rynacrom)
SE
RN Consider
Pt Teaching
Uses/Goals
common cold
Replacement therapy in
^Blood sugar & Infection
Assess physical weight,
Do not immediately
adrenal cortical
T, reflexes and grip
stop taking the
^ Edema (retain Na+)
insufficiency
strength,
affect
and
corticosteroid, need to
Wt gain
orientation, P, BP,
be tapered OFF,
Hyperkalemia associated
bloating
peripheral perfusion,
ADRENAL crisis may
with cancer
moon face
prominence of
occur
Short-term management
superficial veins, R,
Avoid exposure to
of various inflammatory
Adventitious sounds,
infections.
and allergic disorders,
serum electrolytes,
Report unusual weight
such as
blood glucose.
gain, swelling of the
rheumatoid arthritis,
extremities, muscle
collagen diseases (e.g.,
weakness, black or tarry
SLE), dermatologic
stools, fever, prolonged
diseases (e.g.,
sore throat, colds or
pemphigus), status
other infections,
asthmatics, and
worsening of the
autoimmune disorders
disorder for which the
Hematologic disorders:
drug is being taken
thrombocytopenia
purpura,
erythroblastopenia
Ulcerative colitis, acute
exacerbations of
multiple sclerosis and
palliation in some
leukemias and
lymphomas
Trichinosis with
neurologic or myocardial
involvement
Safedose/Rout
10mg/5ml OD on full
stomach
involvement
Treats asthma, COPD, Hay
Fever or Chronic
inflammation of the major
pathways of the respiratory
tract (bronchioles/
bronchi)
Inhalers or Nasal spray
H/A
Trouble Swollowing
Skin itchy
Muscle pain
Ensure proper use of

inhailer
(exhale completely before
inhailing drug with admin of
inhailor)
Respiratory assessment
Lung Sounds
Educate
MEDS WORK SLOWLY
2-6 weeks to become
effective
Causes bronchodilator
Action
Inhabitations of
leukocyte infiltration at
the site of inflammation
Interference in the
faction of mediators of
inflammatory response,
and suppression of
humeral immune
responses.
Increased therapeutic
and toxic effects with
troleandomycin,
ketoconazole
Increased therapeutic
and toxic effects of
estrogens, including
hormonal
contraceptives
Risk of severe
deterioration of muscle
strength in myasthenia
gravis patients who
also are receiving
ambenonium,
edrophonium,
neostigmine,
pyridostigmine
Decreased steroid blood
levels with barbiturates,
phenytoin, rifampin
of salicylates
Prevents allergy and

inflammation Reaction from
releasing histamines that
cause allergic inflammation
DO NOT USE for immediate

allergy relief or acute
asthma attack
SE: Runny Nose, Throat
irritation, HA
CALL DR. if white sores in
throat OR swelling tough
Leukotrine Rec. Antagonist

zafirlukast (Astra,
Accolate)
(Singulair)
ADULTS AND CHILDREN

> 12 YR
20 mg PO bid on an
empty stomach.
PEDIATRIC PATIENTS
5\u201311 YR
10 mg PO bid on an
empty stomach
Leukotriene modifiers
reduce inflammation in
the lung tissue
treatment of bronchial
asthma
Headache
Dizziness
Nausea
diarrhea
abdominal pain
Vomiting
Ensure that drug is taken

continually for optimal
effect.
Do not administer for
acute asthma attack or
acute bronchospasm.
Take this drug on an

empty stomach, 1 hr.
before or 2 hr. after
meals.
Take this drug regularly
as prescribed; do not
stop taking it during
symptom-free periods;
do not stop taking it
without consulting your
health care provider.
Do not take this drug for
acute asthma attack or
Selectively and
competitively blocks
receptor for leukotriene
D4 and E4, components
of SRS-A, thus blocking
airway edema, smooth
muscle constriction, and
cellular activity
associated with
inflammatory process
that contribute to signs
and symptoms of
asthma.
Increased risk of
bleeding with warfarin
Potentially for increased
effects and toxicity of
calcium channelblockers, cyclosporine.
Decreased effective with
erythromycin,
theophylline.
Page 13
MED Name/Class
Safedose/Rout
Uses/Goals
150 to 375 mg is
administered SC every 2
or 4 weeks
Anti-Allergic
Xolair (Omalizumab)
SE
moderate to sever
persistent asthma who
have a positive skin test
otinvitro reactivity to a
perennial aeroallergen
and whose symptoms
are inadequately
controlled with inhaled
corticosteroids.
RN Consider
POST OP (Blood & Bones)

RN Consider
MED Name/class
Uses (Goals)
SE
Blood
1-2 units over 2-4 hours

(faster admin will neg. affect
kidneys)
Anemia
Blood loss S/P Sx
Allergic Rx
Lysed cells
Death
Fe+ (iron)
PO:
ADULTS, ELDERLY: 2-3
mg/kg/day or 50-100mg
elemental iron 2 time/day
up to 100mg 4time/day.
CHILDREN: 3 mg/kg/day
elemental iron in 1-3
divided doses
prevention or treatment
of iron deficiency anemia
due to inadequate diet,
malabsorption pregnancy,
and blood loss
Mild, transient nausea

Heartburn
Anorexia
Constipation
Diarrhea
Easy Bruising
Increased r/f bleeding
Fever
Rhinitis
Hyperkalemia
Irritation
Mild Pain
Blood Thinners
(anti-coagulants)
ASA
Heparin (Heparin Sodium)
Lovenox (Enoxaparin)
81mg Q Day
325mg CP
SQ 5,000 10,000 UNITS
Adults: Initially, 5,000
units by I.V. bolus; then
20,000 to 40,000
units/day by I.V. infusion
with pump. Titrate hourly
rate based on PTT results
(every 4 to 6 hours in the
early stages of
treatment).
Children: Initially, 50
units/kg I.V.; then 25
units/kg/hour or 20,000
units/m
2 daily by I.V. infusion
pump.
40 mg once daily SQ
Clot Prevention, ^CMS

Boost Circulation
prophylaxis and Tx of
venous thrombosis and
pulmonary embolism and
to prevent
thromboembolic
complications arising
from cardiac and vascular
surgery, frostbite, and
during acute stage of MI.
Also used in Tx of
disseminated
intravascular coagulation
(DIC), atrial fibrillation
with embolization, and as
anticoagulant in blood
transfusions,
estracorporealcirculation,
and dialysis procedures
Prevention of
DVT/Pulmonary
Embolism
Assess lung sounds and

RR, assess for allergic
reactions within 2 hr of
first injection, monitor
for injection site
reactions.Solution is
viscous and maytake 510 sec. to administer
Wheezing
tightness in your cheat
skin rash
feeling anxious
Swelling face, lips,
tongue
H/H _____ RBC____

BP____ HR____ TEMP____
VS before
VS 15 min into
VS Q 30 min
VS After
Assess for clinical
improvement, record of
relief of symptoms
(fatigue, irritability,
pallor, paresthesia, and
headache).
Check:
H/H: ___
Plt, ___
INR ___
(2.0-3.0 Therp. Warforin)
PTT: ___
NO Give: GI Bleed, Ulcers
APTT
Pt Teaching
acute bronchospasm;
Take daily
Use flow meter to every
AM to track lung
copasity from day to day
Action
Inhibits binding of IgE
toreceptors on mast
cells andeosinophils,
preventing of mediators
of theallergic response.
Alsodecreases amount
of IgEreceptors on
basophils.

CI in hypersensitivity
and acute
bronchospasm
Pt. Teaching
Action
Benadryl
Cortisone
Back pain, Diff breathing,
Rapid HR s/s RX
O (Universal Donor)
AB (universal Reciever)
Rh + (receives everyone +/Rh (ONLY receives Neg.)
A-A
B-B
O O & GIVE TO ALL,
AB-Recieves ALL
Expect stools to darken in

color.
If gastrointestinal
discomfort occurs, take
after meals or with food.
Do not take within 2
hours of antacids because
it prevents absorption
- Black Stool (call PMD)
- Easy Bruising & Bleeding
- Brush teeth slowly to
prevent bleeding gums
- NO shaving with Razors
- Safety!
essential component in
the formation of
hemoglobin, myoglobin
andenzymes. It is
necessary for effective
erythropoiesis and
transport or utilization of
oxygen
exerts direct effect on
blood coagulation
(clotting) by enhancing
the inhibitory actions of
antithrombin III on
several factors essential
to normal blood clotting,
thereby blocking the
conversion of
prothrombintothrombin
and fibrinogen to fibrin
Doxycycline,
mycophenolate,
penicillamine, or thyroid
hormones
(eg,levothyroxine)
Antihistamines
Digoxin
Tetracycline
Page 14
MED Name/Class
Coumadin (Warfarin)
Safedose/Rout
2.5-10mg per day for 2-4
days then adjust daily
dose by results of
prothrombin time or INR
Uses/Goals
SE
RN Consider
Pt Teaching
Action
Management of
Myocardial infarction:
decreases risk of death,
decreases risk of
subsequent MI
Page 15
ANTI-INFECTIVES
`MED Name/class
Penicillin
Amoxil (Amoxicillin)
Uses (Goals)
SE
Infections of the resp.

tract,
skin and skin
structures,
Para nasal sinuses,
genitourinary tract,
otitis media,
sinusitis
Meningitis.
UTI
Adult: 250-500mg every

8hours
Children: 2040/mg/kg/day divided
dosage given every 8
hours
Polycillin (Ampicillin)
20-500mg
Geocillin (Carbenicillin
Indanyl Sodium)
382 to 764 mg
Zosyn
(Piperacillin/Tazobactam)
3.375-4.5g every 6 hours
Bicillin (Penicillin G
Sodium)
1-4mL
Action
Allopurinol: increased
risk of rash
chlothromycins, sulfonamides
tetracyclines: Reduced
bactericidal effect of
amoxicillin
Methotrexate:
Increased risk of
methotrexate
Obtain pt.shas of
allergy.
Assess pt. for any s/s
of infection
Asses for pt.s
sensitivity to
penicillin or other
cephalosporins
Assess for allergic
reaction during
therapy.
Assess for bowel
pattern
Teach patient to
report adverse
reactions.
Notify prescriber if
infection worsens or
doesnt improve after
72 hours
Prevents bacterial cell wall

synthesis during replication
NO
AMINOGLYCO
IV TUBING
Bactocil (Oxacillin
Sodium)
Keflex (Cefalexin)
Duricef, Ultracef
(cefadroxil)
nd
>2 Gen<
Mandol(Cefamandole)
Cefzil(Cefprozil)
Zinacef, Ceftin (Cefuroxime)

rd
>3 Gen<
Cefizox (Ceftizoxime)
Rocephin (Ceftriaxone)
Claforan (cefotaxime)
Tetracyclines
Doryx (Doxycycline)
Pt. Teaching
Cephalosporins
st
>1 Gen<
Ancef (cefazolin)
Dizziness
Nausea and vomiting
Diarrhea
Abdominal pain
RN Consider
Achromycin
(Tetracycline)
Terramycin
(Oxytetracline)
`MED Name/class
Macrolides
Zithromax (Azithromycin)
IV/IM 0.5-1 g 6-12 hrly.

Max: 6 g/day, up to 12
g/day in severe
infections.
500mg 1cap q6hrs
1 g/day P.O. or 500 mg
P.O. q 12 hours
Staphylococcus
Infections
-Lower Lungs
- Bones Infections
- Blood Infections
Respiratory tract
infections
Skin and skin structure
infections
Bone and joints
infections
Acne
H. Pylori
Gonorrhea
Certain types of
pneumonia
Lyme disease
Uses (Goals)
URI
GU
Mild moderate nausea,
SE
Nausea
Vomiting
abdominal pain
Loss of appetite
Mild diarrhea
Nausea
Stomach cramps
Vomiting
250 to 500 mg, every 8

hours, PO
125-500mg
IM/IV 1-2g max of 3-4g
1-2 g IV/IM qDay or
divided BID for 4-14
days depending on
type and severity of
infection
1 to 2 g IV/IM q8hr
200mg once daily PO

Adult: 500mg PO bid
Child: 25-50mg/kg PO
qid
PO: Onset-Rapid, Peak
2-3hours; Duration 6-12
hours
Dizziness
Vestibular reaction
Diarrhea
Nausea and vomiting
Photosensitivity
Be alert of adverse
reactions and drug
interaction.
This drug should be
used extremely
carefully because of
its potent
vasoconstrictor
action. IV use may
induce sudden
hypertension and
cerebrovascular
accidents. As a last
resort, give IV slowly
over several minutes
and monitor blood
pressure closely.
Tell patient to take

entireamount of drug
exactly asprescribed,
even after he
feelsbetter.
Advise patient to
notify prescriber if
rash develops or signs
and symptoms of
super infection
appear.
Inform patient not to
crush, cut,or chew
extendedreleasetablets.
Bind to bacterial cell wall

membrane,causing cell death.
** ALLERGY: PENICILLIN*
NO PENECILLIN
IV TUBING
Assess patient for

infection (vital signs,
appearance of
wound, sputum,
urine, and stool;
WBC) at beginning of
and throughout
therapy
Sun screen d/t making

skin sensitive to
sunlight
Yellow Teeth
NO dairy
NO Iron
NO antiacids
Not with food
Inhibits bacterial protein synthesis

at the level of the 30s bacterial
ribosome.
RN Consider
Assess skin color,
GI output
Bowel sounds
Pt. Teaching
Take the full course
prescribed.
Do not take with
Action
Azithromycinblockstranspeptidation
by binding to50s ribosomal subunit
of susceptible organismsand
No DAIRY
NO IRON
NO Anti-acids
10-50mg/kg
500mg/daily for 3 days.

Coumadin
Theophylline
Prednisone
Page 16
MED Name/Class
Safedose/Rout
Uses/Goals
500mg 1tac Bid PO
Biaxin (Clarithromycin)
(E-Mycin) Erythromycin
Aminoglycosides
Garamycin (Gentamicin)
Kantrex (kanamycin)
Mycifradin (Neomycin)
Fluroquinolones
Cipro (ciprofloxacin)
Levaquin (lomefloxacin)
(Floxin)
vomiting, abdominal
pain, dyspepsia,
flatulence, diarrhea,
cramping; angioedema,
cholestasis jaundice;
dizziness, headache,
vertigo, somnolence;
transient elevations of
liver enzyme values
250mg every 8 hours PO
Adult: IV/IM 1.52

mg/kg loading dose
followed by 35
mg/kg/d in 23 divided
doses Intrathecal 48
mg preservative free
q.d. Topical 12 drops of
solution in eye q4h up to
2 drops q1h or small
amount of ointment
b.i.d. or t.i.d.
Child: IV/IM 67.5
mg/kg/d in 34 divided
doses Intrathecal >3 mo,
12 mg preservative free
q.d.
Neonate: IV/IM 2.5
mg/kg q1224h
500mg BID Per Orem

250-750mg Q 24 hr.
Oral Adults 600-1800

mg/day in 2-4 equal
doses. Childn>1 mth 8-25
mg/kg/day in 3-4 equal
doses
IM/IV
AdultSeriousinfections
2400-2700 mg in 2-4
equal doses. Less
complicated infections
1200-1800 mg/day in 3-4
equal doses.
Childn>1mth 20-40
mg/kg in 3-4 equal doses.
Neonates <1 mth 15-20
mg/kg in 3-4 equal doses.
Parenteral use
restricted to treatment
of serious infections of
GI, respiratory, and
urinary tracts, CNS,
bone, skin, and soft
tissue (including burns)
when other less toxic
antimicrobial agents
are ineffective or are
contraindicated. Has
been used in
combination with
other antibiotics. Also
used topically for
primary and secondary
skin infections and for
superficial infections of
external eye and its
adnexa.
Resp:
GU
Bone
Skin
Infections
SE
RN Consider
dyspepsia
Diahhrea
NEPHRO TOXICITY
Tennatus (ringing in
ears)
Skeletal muscle
weakness
Apnea
Nausea
Vomiting
Diarrhea
Difficulty sleeping
headache
nausea, vomiting
stomach upset, gas
unusual taste
vaginal irritation
Pt Teaching
antacids.
May exp. side effects
Report severe or watery
diarrhea,
nausea/vomiting0
Perform C&S and

RENAL function (BUN/
Creat) prior to first
dose and periodically
during therapy;
therapy may begin
pending test results.
Determine creatinine
clearance and serum
drug concentrations at
frequent intervals,
particularly for patients
with impaired renal
function, infants (renal
immaturity), older
adults, and patients
receiving high doses or
therapy beyond 10 d,
patients with fever or
extensive burns,
edema, obesity.
Assess for level of pain
relief and administer
prn dose as needed
but not to exceed the
recommended total
daily dose.
Monitor vital signs and
assess for orthostatic
hypotension or signs of
CNS depression.
Discontinue drug and
notify physician if S&S
of hypersensitivity
occur.
Assess bowel and
bladder function;
report urinary
frequency or retention.
Use seizure
precautions for
patients who have a
history of seizures or
who are concurrently
using drugs that lower
the seizure threshold.
Monitor ambulation
and take appropriate
safety precautions.
Weekly Blood Draws

To check
Peak & trough levels
(TOXICITY LEVELS
&Theraputic range)
Action
disrupting RNA-dependent protein
synthesis at the chain elongation
step
Broad-spectrum aminoglycoside
antibiotic derived from
Micromonospora purpose. Action
is usually bactericidal.
Report:
- Tennatus (ringing in ears)
may indicate Kidney
toxicity

Dopamine
Contraindicated with
hypersensitivity to
azithromycin,
erythromycin, or any
macrolide antibiotic
History of
hypersensitivity to or
toxic reaction with any
aminoglycoside
antibiotic. Safe use
during pregnancy
(category C) or
lactation is not
established
NO
PENECILLIN
IV TUBING
Exercise caution with

potentially hazardous
activities until response
to drug is known.
Understand potential
adverse effects and
report problems with
bowel and bladder
function, CNS
impairment, and any
other bothersome
adverse effects to
physician.
Do not breast feed
while taking this drug.
Inhibition of topoisomerase(DNA
gyrase) enzymes, which inhibits
relaxation of super coiled DNA and
promotes breakage of double
stranded DNA
Do not take with

Cisapride, droperidol,
some medicines for
irregular heart rhythm.
NOT WITH FOOD
NO MILK
NO IRON
NOT WITH FOOD

NO MILK
NO IRON
Page 17

`MED Name/class
Sulfanamides
Bactrim, Septra
(TrimethoprimSulfamethoxazole)
The Others:
Vancocin (vancomycin)
Flagyl(Metronidazole)

Tab 2 tab Forer tab. 1
tab infant & children TM
6 mg &SMZ 30 mg/kg
body wt daily. To be
given in bid. Gonorrhea
5 tab bid or 2 forte
tab bid for 1 day.
Uses (Goals)
Resp tract,
renal GIT,
GUT.
Osteomyelitis,
pneumocystis carinii
pneumonia,
toxoplasmosis,
actinomycetoma,
acute brucellosis,
nocardiosis
SE
Treat a severe
intestinal condition
known as Clostridium
difficile-associated
diarrhea.
Treats only bacterial
infections of the
intestines.
2 g/day IV divided q612hr; may increase based

on body weight or to
achieve higher trough
values, increase toxicity >4
g/day
Zyvox (Linezolid)
Capsules: 375 mg
Injection: 5mg/mLOral
suspension:200mg/5ml
Tablets:200mg, 250mg,
400mg, 500mg
Topical gel: 0.75 %, 1%
Clindamycin(Cleocin)
600mg every 12 hour for

14-28 days
Oral
150-300mg q6hr.
IV
600mg/day in 2-4equal
doses
up to 4.8g/day UV ir IM
Fatigue
Nausea
Vomiting
diarrhea
Crystalluria
Toxic epidermal
Chills
Drug fever
Rash
Eosinophilia
Reversible neutropenia
RN Consider
Assess for infection
(vital signs;
appearance of
wound, sputum,
urine, and stool;WBC)
at beginning and
during therapy.
Obtain specimens for
culture and sensitivity
before initiating
therapy.
Inspect IV site
frequently. Phlebitis
is common.
Monitor CBC and
urinalysis periodically
during therapy
Pt. Teaching
Instruct patient to
notify health care
professional if rash, or
fever and diarrhea
develop, especially if
diarrhea contains
blood, mucus, or pus.
Advise patient not to
treat diarrhea without
consulting health care
professional.
Caution patient to use
sunscreen and
protective clothing to
prevent
photosensitivity
reactions.
Assess patient for

infection
Vital signs
appearance of wound,
sputum, urine, and
stool
WBC
Beginning of and
throughout therapy.
Allergy to medication
monitor I/O
Instructed patient on
range of Vancomycin
toxicity (toxicity is
reported at levels
sustained above 80 to
100 mcg/ml). Patient
verbalized
understanding of
instructions given.
Instructed patient on
Vancomycin adverse
effects such as:
erythroderrma,
thrombocytopenia,
neutropenia,
ototoxicity, and
nephrotoxicity. Patient
verbalized
understanding of
instructions given.
VANCOMYCIN>>>>>>>
RED MANS
SYNDROME:
(NOT A ALLERGY
RX)infusing too rapidly
may cause REDDING of
skin, NOT a adverse
RX, only a Side Effect
Action
Interferes with bacterial growth by
inhibiting bacterial folic acid
synthesisthrough competitive
antagonism of PABA.
Treatment of potentially lifethreatening infections when less

toxic anti-infective are
contraindicated. Particularly useful
in staphylococcal infections,
including:endocarditis, meningitis,
osteomyelitis, and pneumonia
septicemia, soft-tissue infections in
patients who have allergies to
penicillin or its derivatives or when
sensitivity testing demonstrates
resistance to methicillin.

Oral Anticoag./
Diuretics
no work
K+ Supplements
Anta-Acids & Ca+ Block
Ototoxic and
nephrotoxic drugs
(aspirin,
aminoglycosides,
cyclosporine cisplatin,
loop diuretics): no
depolarizing
neuromuscular
blocking agents:
general anesthetics.
hypotensive symptoms.
Patient verbalized
understanding of
instructions given.
Page 18

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PAIN MED.

Safe dose/Route/ Freq

10-40 mg every 4-6

7.5-10mg (oral) every

Adults: Oral 325-650

Drug 2 Drug Interaction

Dizzy >no standing

Avoid alcohol and other

Binds to opiate receptors

High risk of CNS

1mg IV Q 4-6 hours prn

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Adult: (PO) 10-30mg q4h

100 mg/ 2mL

This drug will make you

Suppresses the cough

Drug 2 Drug Interaction

Most potent of the

Increased CNS depression

General CNS depressant;

Increased serum levels

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longer than 2 wk. (for

Drug 2 Drug Interaction

GI : SBO, GERD, Ulcers, Gastritis

Safe dose/Route/ Freq

2-4 teaspoons (10-20 mL)

Assess patient for

Instruct patient to avoid

Drug 2 Drug Interaction

Aluminum hydroxide may form

Blocks HCl production

Neutralizes Stomach Acids

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GI : SBO, GERD, Ulcers, Gastritis

resulting from excessive

baseline data and to

0.12 mg/kg or 32mg

Treatment for nausea and

Assess for nausea,

Drug 2 Drug Interaction

Advice patients that

Advice patient to notify

Blocks the effects of

May be affected by drugs

PO: 2.5mg-10mg max

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CARDIAC: CHF, MI, HTN, ^cholesterol

Drug 2 Drug Interaction

Advice patient take

Take drug without

Selectively blocks the

ARB angiotensin block

1 tab daily; 25100mg/d

Assess Vital Signs

Be aware that the

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CARDIAC: CHF, MI, HTN, ^cholesterol

Drug 2 Drug Interaction

Inhabits sodium and

Taking insulin with

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CARDIAC: CHF, MI, HTN, ^cholesterol

Safedose/Rout MAX daily

H/H _ RBC