PC Drug Medication Prep Sheet

Chlorehxidine Topical (GLUC 0.12 oral solution) 15ml PO BID Classification/Physiology: Topical anti-infective agent. Catatonic compound and antibacterial activity of the drug result of attraction between positive charged chlorehxideine and negative bacterial surface. Chlorhexidine reacts with the microbial cell surface destroying the cell membrane, killing the cell. Purpose For Patient: Local anti-infective to eliminate bacteria in oral cavity Usual Dosage: 15 mL twice daily after brushing. Oral rinse should be retained for 30 seconds then expectorated after rinsing. Main Side Effects: Staining of teeth and tongue, alteration of taste perception, bitter taste, and dryness. Main Nursing Indications: sterilized preparation should be used and prepared at time of administration Lab Values to Check: N/A Effectiveness: Elimination of bacteria present in oral cavity Enoxaparin (Lovenox) 40mg=0.4 ml SubQ Q24 hours Classification/Physiology: Lovenox acts as an anticoagulant by enhancing the inhibition rate of clotting proteases by antithrombin III impairing normal hemostasis and inhibition of factor Xa. Low molecular weight heparins have a small effect on the activated partial thromboplastin time and strongly inhibit factor Xa. Purpose for Patient: DVT prophylaxis Usual Dosage: 40 mg once daily; continue until risk of DVT has diminished (6-11 days) Main Side Effects: Nausea, diarrhea, fever, swelling in hands or feet, mild pain or irritation where medicine was injected. Report: Unusual Bleeding, easy bruising, bleeding from wounds or needle injections Main Nursing Indications: Monitor pt. closely for S&S of bleeding. Monitor pt. for Hyperkalemia (can suppress aldosterone production), Monitor for thrombocytopenia by checking platelets routinely. Use with caution in elderly b/c of delayed elimination Lab Values to Check: Platelets, Occult Blood, Serum Creatine, anti-Xa levels (in patients who are obese, renal insufficient or pregnant) Effectiveness: No evidence of DVT

AMPicillin sulbactam (Unasyn) 3g IV Q6H Classification/Physiology: Inhibits bacterial cell wall synthesis by binding to one or more of the penicillin-binding proteins (PBPs) which in turn inhibits the final transpeptidation step of peptidoglycan synthesis in bacterial cell walls, thus inhibiting cell wall biosynthesis. Purpose of Patient: For susceptible soft tissue infection Usual Dosage: I.M., I.V.: 1500-3000 mg every 6 hours, (maximum: 12g), I.V. over 15-30 minutes Main Side Effects: local pain at injection site, emesis, dyspepsia, diarrhea, and rash Main Nursing Implications: Monitor for hypersensitivity reactions (urticaria, anaphylaxis), monitor for appearance of rash (dull red, maculipapular rash), and monitor for superinfection from prolonged use (CDAD). Adjust dose for renal function. Lab Values to Check: GFR, BUN & CRT Effectiveness: WBC count rises, infection subsides Senna 2 Tab PO QAM Classification/Physiology: Stimulant laxative. MOA not known. Commonly thought that the stimulant laxatives induce defecation by stimulating propulsive peristaltic activity of the intestine through local irritation of the mucosa Purpose of Patient: Constipation Usual Dosage: 15 mg once daily Main Side Effects: Dyspepsia, nausea, diarrhea, abdominal discomfort, or discolored urine. Main Nursing Implications: May discolor urine or feces; liquid syrups contain 7% alcohol. Take tab with a glass of water. 2 hours before and 2 hours after any medications. Lab Values to Check: Monitor for fluid/electrolyte imbalance (esp. in elderly) (NA, P, USA) Effectiveness: Patient passes consistent bowel movements Docusate 100mg=1 Cap PO BID Classification/Physiology: (Sulfactant) Reduces surface tension of the oil-water interface of the stool resulting in enhanced incorporation of water and fat allowing for stool softening

Purpose of Patient: Stool softener in patients who should avoid straining during defecation and constipation associated with hard, dry stools Usual Dosage: Oral: 50-500 mg/day in 1-4 divided doses Main Side Effects: gastrointestinal cramping, bitter taste, throat irritation Main Nursing Implications: liquid should be given with milk, fruit juice, or infant formula to mask the bitter taste. Do not use if abdominal pain, nausea, or vomiting are present. Laxative use should be used for a short period of time (<1 week) Lab Values to Check: Decreases Potassium and Chloride. Look out for electrolyte imbalances (K, NA, USG) Effectiveness: Patient passes unstrained stools Insulin Aspart: (Novolog) 4 Unit= 0.04 ML SubQAC Midscale SubQ AC and Nightscale SUBQ HS Classification/Physiology: Insulin acts via specific membrane-bound receptors on target tissues to regulate metabolism of carbohydrate, protein, and fats. Target organs for insulin include the liver, skeletal muscle, and adipose tissue. Insulin stimulates hepatic glycogen synthesis. Purpose of Patient: to stabalize blood glucose levels. Avoid hyperglycemia, and hypoglycemia. Usual Dosage: Initial dose: 0.5-1.0 units/kg/day in divided doses. Conservative initial doses of 0.2-0.4 units/kg/day may be recommended to avoid the potential for hypoglycemia Main Side Effects: Patient may experience hypoglycemia, nausea, weight gain, or application site irritation Main Nursing Implications: Lab Values to Check: Blood glucose levels, Serum glucose, A1C test Effectiveness: Patient will remain within realms of normal glucose levels (70-120) Hydromorphone (Dilaudid): 1mg=1 ML IV Classification/Physiology: Opiate Agonist: Binds to opioid receptors in the CNS, causing inhibition of ascending pain pathways, altering the perception of and response to pain. Produces generalized CNS depression Purpose of Patient: management of moderate to severe pain

Usual Dosage: 0.5-1 mg/dose every 3-4 hours as needed; usual initial adult dose: 0.5 mg/dose. Patients with prior opiate exposure may tolerate higher initial doses. Main Side Effects: dizziness, drowsiness, impaired coordination, or blurred vision, loss of appetite, nausea, vomiting, Main Nursing Implications: Double check ordered dose and labeled medication. Give up to 2 mg over 2-3 minutes. Dilute with 10 mL NSS or sterile water; may be given undiluted through free-flowing I.V. Dilaudid can have a profound effect on respirations and the central nervous system (CNS). Do a focused assessment on respirations, heart rate, blood pressure and mental status. Increase frequency of vital signs depending on patients condition. Observe for hypotension, apnea, decreased respirations, changes in mental status, constipation. Lab Values to Check: Monitor vital signs/neurologic status closely Effectiveness: patient reports little to no pain