Drug NAME Drug Class/Family Action Indication How to Take Contradictions Adverse Effects Interventions

alprazolam(Xanax) ANTIANXIETY:
BENZODIAZEPINES
enhance action of GABA, Depresses CNS,
Short Acting
Anxiety, aggregation, pre-op, muscle relaxant,
sedation, depression, sleep induction
PO NO NO: CNS depressants, alcohol, opioids, MAOIs,
Cimetidine, Kava, valerian
Flumazenil/Remascon as antidote to OD
Mild & infrequent: Headache, drowsiness, dizziness, Vertigo,
Lethargy- fall hazard elderly. Hangover effect
OD: somnolence, confusion, coma, diminished reflexes
TEACH: NO grapefruit juice, taper off slowly
* hypotension & respiratory depression if taken w/CNS depressant
captopril (Capoten) ACE INHIBITORS decrease production angiotensin II >
vasodilation, BP is reduced.
treatment of HTN and HF. check BP first AVOID: PREGGO or LACTATION
NO: NSAIDS, indomethacin, Ka supplements, salt subs, or
diuretics
A dry, persistent cough but generally well tolerated
mild and transient: ab pain, C, D, N, V, fainting, loss of appetite,
rash, fatigue, headache, numberless in feet

Carafate (Sucralfate) ANTIUCLER -
PROTON PUMP Inhibitor
IS NOT antacid; contains
aluminum
adheres to & protects surface of ulcer by
forming a barrier
inhibits pepsin activity in gastric juices
reduce ulcer pain, ulcer heal, prevention
stress ulcers
SHORT TERM/8 weeks: cannot prevent new
ulcers fromdeveloping
1-2 hours before meal

AVOID: Chronic renal failure, preggo/lactation, kid
NO: SMOKING, antacids; cimetidine; digoxin; dicyclomine;
ketoconazole; levothyroxine; phenytoin; quinidine;
ciprofloxacin; tetracycline; and theophylline.
C, N, V, Dry mouth, ab pain, dyspepsia
RISK of aluminumtoxicity w/aluminum-containing antacids
TEACH: shake suspension WELL before pouring; continue prescribed
regimen to ensure complete healing; Antacids separate doses by 30 minutes
MONITOR: severe, persistent constipation, ab pain, renal function, fluids &
electrolyte gastric pH >5
diclofenac (Voltaren) NSAIDS inhibits prostaglandin synthesis; analgesic &
anti-inflammatory
Reduce fever or inflammatory process,
musculoskeletal disorders; mild to moderate
pain
w/meals w/8oz h20
must remain upright for 30

miss dose w/in 2 hours
AVOID: renal or liver disease, asthma, peptic ulcer, bleeding
disorders, SLE, caution in elderly

NO: Beta blocks, Aspirin, Diuretics, anticoagulants, Alcohol
Ab pain, N, gastritis, black tarry stools, weakness, dizziness, HF,
bleeding RINGING IN ears, rash - can impair kidney function
MONITOR: CBC, renal & liver function tests
REPORT: if temp doesn't subside/bleeding occurs or inflammation does not
decrease
TEACH: discontinue 5-7 days before major procedure or surgery
ONLY first 2 trimesters, no breastfeeding, USE sunscreen,
Digoxin(Lanoxin)


CARDIAC GLYCOSIDES strengthening myocardial contraction
prolongs refractory period
HF or Atrial Fibrillations NO IF AP <60, >110 NO NO: HERBS St. johns, Loop Diuretics, antifungals,
macrolides, tetracycline
AVOID: hypothyrdoisim, hypokalemia,
KA+, N, V, D, or appetite loss, visual disturbances, bradycardia,
arrhythmias, heart block

diphenhydramine
(Benadryl)
ANTIHISTAMINES
H1 RECEPTORS
Blocks histamine release at H1 receptors Allergic disorder; anaphylactic; blood
transfusion reaction; motion sickness
take w/food, NO: alcohol, CNS depressant, Ketoconazole, MAOIS Dry mouth GI upset, bronchospasm, arrhythmias, & anticholinergic
effects. DROWINESS
MONITOR: VS, I&O.
TEACH: secretions thick, use humidifier, drink 8 glasses of water for motion
sickness 30-60 minutes prior motion sickness.
dopamine
(Inotropin)
VASOPRESSORS
ADRENERGICS
additional pumping strength by stimulating
the heart muscle

treat heart conditions, when need heart
pumping strength increased, can be used in
improving kidney blood supply Shock,
increased perfusion, hypertension, COPD, RDS
in infants
injection, IV 0.5 to 2
mcg/kg/min
AVOID: v. fib, uncorrected tachyarrhythmia,
pheochromocytoma
NO: MAOIS, Phenytoin, Tricyclic antidepressants, phenytoin,
alpha & beta blockers, diuretics, ergot alkaloids, inhaled
anesthetics
Ventricular fibrillation, asthmatics episodes, anaphylactic reactions
, arterial embolism, PVD, headache, anxiety, palpitations,
tachycardia, HTN, angina, vasoconstriction, N, C, D. Necrosis,
gangrene w/prolonged use, dyspnea
BBW: watch infusion site very carefully

MONITOR: during infusion frequently look at ECG, BP, cardiac output,
central venous pressure, pulmonary artery, HR, urine output, color/temp of
limbs
enoxaparin
(Lovenox)
ANTICOAGULANTS
LOW-MOLECULAR WEIGHT
HEPARINS
Accelerates antithrombin III-thrombin
complex. deactivates thrombin, preventing
fibrinogen -> fibrin.
Prevent PE & DVT; complications related to
clotting after surgery
SQ, rotate sites- leave bubble
in syringe
DONT MIX W/OTHER DRUGS
BBW: Patients receive epidural/spinal anesthesia
NO: Anticoagulants, antiplatelet, NSAIDs, SSRI, HEPARIN,
garlic, gingko, ginger, ginseng
OD: use protamine sulfate
fever, confusion, N, edema, anemia, bleeding, cardiac toxicity,
ecchymosis, thrombocytopenia, erythema @injection site,
angioedema,
AVOID foods Vitamin K/ Aspirin MONITOR for abnormal bleed/bruise
REPORT: blood in urine, stool, skin,
TEACH: use soft-toothbrush, & electric razor over blade
BASELINE: blood tests prior
Furosemide (Lasix) LOOP DIURETICS inhibiting sodium, chloride & h20
reabsorption in loop Henle
used by pts with CHF, edema, HTN, renal
dysfunction- channel excessive fluids out
AMw/8oz of water AVOID: in patients preggo or breastfeed
NO: NSAIDS- Sucralfate (Carafate), lithium
hypotension, dehydration, dizziness, ringing in ears, photobia, rash,
pancreatitis, N, D, ab pain. Increase blood sugar & uric acid
TEACH: drink 8 glasses of water a day, Ka supplements, beware of dizziness,
should be part of healthy lifestyle
hydrochlorothiazide
(HydroDIURIL)
THIAZIDE DIURETIC Inhibit tubular reabsorption of sodium,
chloride, & H2O in distal portion of ascending
of Loop of Henle
Edema associated w/HF, cirrhosis, w/ascites &
some types of renal impairment HTN
AMw/ food, 2nd dose 4 hrs.
prior bed
NO: Amphotericin B, corticosteroid, antidiabetics,
antihypertensive, opioids, barbs, cardiac glycosides,
colestipol, NSAIDS, Dandelion, LICORICE, alcohol, Diazoxide,
LithiumBumetanide, ethacrynic acid, furosemide, torsemide
Dehydration, Dizziness, drowsiness, Cramping, N, V, hypotension,
hypokalemia, hypokalemia,
MONITOR: glucose, K+ , weight, I & o, electrolytes, digoxin toxicity
TEACH: discontinue use of prior to parathyroid function tests, check w/ dr
be OTC,
levothyroxine
(Synthroid)
THYROID increase the metabolic rate, oxygen
consumption & body growth.
hormone replacement for cretinism,
hypothyroidism, myxedema
w/8 oz. of water;
30-60 minutes b4 breakfast
NO: Oral Anticoagulants, digitalis glycosides, hypoglycemics,
estrogens, phenobarbital, phenytoin, fosphenytoin, AVOID:
hyperthyroidismor MI
V,D, weight loss, tachycardia, palpitations, angina, nervousness,
tremors, irritability, insomnia, menstrual irregularities, sweating
heat intolerances
do NOT switch brands, NEVER used w/weight loss drugs or stop abruptly,
Take several weeks for full effects Doses MICROGRAMS.
MONITOR: T3, T4 & TSH levels , pulse BASELINE: vitals, weight
lorazepam
(Ativan) ****
BENZODIAZEPINES

potentiate the effects of GABA, depress the
CNS
Anxiety, insomnia fromanxiety, prep
sedation, status epileptics, pre-op, muscle
spasms
PO, IV, IM

no skipping or double dose

AVOID: breathing problems, glaucoma, kidney or liver
disease, depression, suicidal thoughts, or addiction
NO: CNS depressants, Digoxin, Kava, Alcohol
drowsiness, sedation, hypotension, visual disturbances, nasal
congestion, ab discomfort, N, change in appetite
OD: Flumazenil (Romazicon)
MONITOR: hepatic, renal, hematopoietic function, addiction Rapid IV may
result in apnea, hypotension, bradycardia, or cardiac arrest
DO NOT: stop drug abruptly
nitroglycerin VASODILATORS
NITRATES
Reduces cardiac O2 by decreasing preload &
afterload by + blood flow
Prevent angina (ex release);
Treat angina pain (sublingual)
30 minutes b4 or 1-2 hrs. after
meal,

AVOID: hypotension, volume depletion, early MI, severe
anemia, ICP, angle-closure glaucoma, orthostatic hypotension
NO: antihypertensive, Heparin, alcohol,
Vasodilation, decreased cardiac output, venous pooling,
hypotension, blurred vision, throbbing headache, D, F, increase HR
TEACH: Take SL table as first signs of attack- place under tongue and then sit
and rest, may be repeated ever 5 minutes for max of 3 doses- no relief SEEK
MEDICAL ASSISTANCE- after one dose
omeprazole
(Prilosec)
ANTIUCLER
PROTON PUMP INHIBITORS
inhibits proton pump activity by binding to
hydrogen-potassiumadenosine
triphosphates.
Suppresses gastric acid
GERD, erosive esophagitis, duodenal ulcer,
Helicobacter pylori, gastric ulcer, frequent
heartburn, Laryngitis
DO NOT crush
AM1hr b4 meal

*NO breast-feeding;
AVOID: children, liver disease COPD, risk osteoporosis
NO: Digoxin, Phenytoin, Warfarin, azole antifungals, benzos,
diazepam, fosphenytoin, Rifampin, Salicylates, Gingko balboa,
St Johns, smoking, alcohol, NSAIDs, acidic/excessive dairy
Dizziness, headache, ab pain, C, D, N, V, flatulence, back pain,
cough, rash
ADVERSE: angina, tachycardia, bradycardia; palpitation, URI

CULTURAL- Asians & patients hepatic impairment need lower dose
MONITOR: magnesiumlevels, abnormal heart rate, palpitations, muscles
spasms, tremors, or seizures. , GI bleeding.

ondansetron
(Zofran)
ANTIEMETICS
SELECTIVE SEROTONIN
RECEPTOR ANTAGONISTS
serotonin receptor antagonist;
chemoreceptor trigger zone in PNS on nerve
terminals of vagus nerve
Anti-nausea; preggo, surgery, chemo PO, IM, or IV NO: Apomorphine, Antibiotics/antifungals, Furosemide,
Cimetidine * meds alter hepatic or renal function should be
monitored carefully to prevent complications

Arrhythmia, chest pain C,D, Urine retention, Hypoxia, rash,
pruritus, chills, injection site reaction, dizziness, fatigue, headache
TEACH: Immediately contact provider symptoms of abnormal heart rate or
rhythm
oxycodone ** ANALGESIC,
NARCOTIC/OPIOID

Combines w/opiate receptors in the CNA.
Reduces stimuli fromsensory nerve endings;
pain threshold is increased.
Moderate to severe pain, pre-op, antitussive
effects
DO NOT mix with BARBS, hold
RESP <12
after meals or w/milk

AVOID: breastfeeding, severe asthma, breathing problems,
blockage in stomach or intestines,
NO: ALCOHOL, CNS depressants, MAOIS,
BBW: antifungals & antibiotics-macrolides

Dizzy, Drowsy, Drug dependency, Decreased GI peristalsis & urine
output, decreased BP, Depressed respirations, N, V, Euphoria
MONITOR: urine output, bowel sounds, VS, pain
TEACH: dont stop abruptly, do not drive/heavy machinery, change positions
slowly
phenytoin (Dilantin) ANTICONVULSANTS Reduces motor cortex activity by altering
transport of ions. stabilize neural impulses.
grand mal & complex partial seizures; DO NOT MIX w/OTHER
DRUGS,

NO: Anticoagulants, corticosteroids, oral contraceptives,
antihistamines, theophylline, quinidine, Rifampin,
Acetaminophen, Cimetidine, Fluconazole, Isoniazid,
Sulfonamides, Cyclosporine, Disulfiram, Atracurium,
cisatracurium, pancuronium, rocuronium, vecuronium,
alcohol, antacids
N, V, headache, confusion, Rash, dizziness, drowsiness, gingival
hyperplasia, Acne, hirutism OD S&S: Ataxia, dysarthria, nystagmus,
encephalopathy, hyperflexia, lethargy, nausea, slurred speech,
tremor, vomiting, com, hypotension, circulatory & respiratory
depression
TEACH: DO NOT stop abruptly, urine may pink, red, brown, importance of
GOOD ORAL: Maintain seizure precautions, as needed; Rash> slowly stop
drug
MONITOR: drug level-therapeutic ran 10-20 mcg/mL, lab renal & liver
function
ALERT: doubling dose doesnt double level, may cause toxicity;
piperacillin/tazobact
am(Zosyn)
ANTIBIOTICS
EXTENDED-SPECTRUM
PENCILLINS
inhibits cell-wall synthesis during

Appendicitis, peritonitis, catheter-related
blood infection, Moderate to severe
infections
Injection, Shake until dissolved,
reconstitute saline or sterile
H20, infuse over 30
mins

AVOID: bleeding tendencies, uremia, hypokalemia, &
allergies
NO hormonal contraceptives, oral anticoagulants,
seizures, arrhythmia, leukopenia, neutropenia, anaphylaxis,
thrombocytopenia, pseudomembranous colitis Headache, N,V,
pruritus, phlebitis @IV site,
MONITOR: hematologic & coagulation parameters, super infection,
REPORT: any adverse reactions, of IV sites discomfort
OBTAIN: sensitivity tests before giving meds
TEACH: maintain healthy diet, report diarrhea, signing bleeding
prednisone
(Deltazone)
CORTICOSTEROIDS
ADRENOCORTICOIDS
anti-inflammatory properties; suppress
immune response. ACTS like cortisol; opens
airways, strengthens immune system
All ages; anti-inflammatory;
immunosuppressant; dermatological
disorders replacement in adrenal cortical
insufficiency (Asthma, COPD), emphysema,
Migraine)
AMw/food or milk NO: Digoxin, NSAIDS, insulin, oral antidiabetics, vaccines,
loop/thiazide diuretics
AVOID: breast feeding, HTN, osteroporis, DM,
Hypothyroidism, HF, TB, Herpes Simples, GI ulcer, recent MI
buffalo hump, cushing-like syndrome, headaches, increased BP,
HR, appetite, not healing quickly, N,V, Dry moth, coughing, GI
upset seizures, HF, pancreatitis, hypocalcaemia, hypokalemia,
acute adrenal insufficiency, hypoglycemia
MONITOR: VS, BP, weight, blood glucose, electrolytes, EKG, &TB
TEACH: follow visits and labs are essential, avoid infection, taper off
medicine gradually, avoid crowds & known infections, diet lowin
sodium/high protein , high vitamin D, protein and Ka. DONT overuse, weight
self daily
propranolol (Inderal) BETA-ADRENERGIC
BLOCKERS
Works on Beta Receptors B1 heart, B2 Lungs-
infers with them; lower BP, dilation
angina, decrease risk of death after MI, HTN,
adjunct therapy, prevention of migraine, TBI,
Check BP & AP prior
TAKE w/food
NO: Alcohol, ma huang, cocaine, cardiac glycosides, insulin,
oral antidiabetics, lidocaine
AVOID: asthma, COPD, sinus cardia, heart block first degree,
DM
bradycardia, hF, AV block, bronchospasm, fatigue, lethargy, fever,
vivid dreams, depression, light-headiness, dizziness, insomnia,
hypotension, CDNV, rash
drug masks signs shock & hypoglycemia. May interfere w/glaucoma
screening, take EVEN if feel better. AVOID stopping, suddenly rebound
HTN, NO hot tubs, showers, excessive heat or exercise
MONITOR A.A. for therapeutic effects, may need dose adjustments.
Regular Insulin
(Humulin R)
ANTIDIABETICS ^ glucose transport across muscle & fat cells
reduce glucose levels. Helps glucose >
glycogen;
Mild diabetic ketoacidosis; newly diagnoses
diabetes type I; DMII; control of
hyperglycemia; hyperkalemia
check glucose prior giving;
best 30 minutes prior to meal;
Swirl vials,

MAOIS, alcohol, drugs, smoking,, beta blockers, sulfonylureas,
t. diuretics, glucocorticoids
Swelling, erthyrmea, pruritus, hypoglycemia, D, V, TEACH: lifelong treatment, not cure, important measure doses; Regularly
check your blood CARRY medical ID @all times, VERY important to follow
diet, exercise & keep to regular dosage schedule
DO NOT SWITCH INSULINS

salmeterol
(Serevent)
BETA2 ADRENERGIC
AGONISTS
BRONCHODILATORS
stimulates beta receptors in the lung; relaxes
bronchial smooth muscle, increase vital
capacity; decrease airway resistance
Asthma, bronchitis, emphysemas, relief of
bronchospasm, COPD
Caution against overuse
1-3 min between two puffs,
shaken 5 sec b4 use, NO
double dose if missed
NO: antiarrhythmic, Beta agonists, CYP3 inhibitors, Diuretics,
MAOI, tricyclic depressants

AVOID: breastfeeding, hypersensitivity
nervousness, tremors, restlessness, insomnia, headache, N, V,
tachycardia, irregular heart beat, HTN, dysrhythmia, bronchospasm
MONITOR: breathe sounds, levels of confusion or restlessness, vitals signs,
and check for dysrhythmias, tachycardia


simvastatin (Zocor) ANTILIPEMIC,
HMG CoA Reductase
inhibitors Statins
works by inhibit the cholesterol synthesis,
potent LDL reducer
to reduce LDLs & decrease risk of heart
attacks & strokes. USED IN diabetics, stroke,
CHD, cerebrovascular disease, peripheral
vessel disease
usually in evenings NO: digoxin, warfarin, niacin, hepatic drugs, rifampin, bile
acid sequestrans, amiodrarone, diltiazem, macrolides,
verapamil, cyclosporine, Antifungals, St Johns, red yeast rice,
grapefruit juice, eucalyptus, jin buhuan or kava
AVOID: liver compromised or preggo/breast feeding
Muscle weakness (rhabodomyolysis) Headache, NVCD, DF, Fast
heartbeat, ab pain, indigestion, gas
TEACH: must used in conjunction w/diet, weightless, exercise; may need
Vitamin supplements (fat-soluble)
NEVER discontinue abruptly; reports of cognitive impairment Usually not
serious & reversible upon discontinuation- 3 weeks symptoms wear off after
discontinued; followa diet restricted in saturate fat & cholesterol
REPORT: muscle pain right away

vancomycin
(Vancocin)
ANTIBIOTICS
Bactericidal
bacterial wall synthesis by binding to a cell
wall precursor

treatment of serious infection; MRSA,
endocarditis, colitis, Staphylococcal
Enterocolitis, ClostridiumDifficle (GRAM
POSTIVE)

evaluate iv site for phlebitis

DO NOT give IM
Neurotoxic drugs, Nephrotoxic drugs, Ototoxic drugs
AVOID: impaired renal & hepatic function, hearing loss, or
allergies other antibiotics

NV, taste alterations, Red-man syndrome,
Nephrotoxicity, Ototoxicity, Tinnitus,
TEACH: Report ANY ringing in ears, adverse reactions immediately
PRIOR: baseline for hearing & kidney
MONITOR: for super infections, Rudolph syndrome, urine output, fluid
intake, fever, WBC
Warfin (Coumadin) ANTICOAGULANTS
COUMADIN DEVRIATES
Inhibits vitamin K dependent activation of
clotting factors formed in the liver. Decreases
vitamin K absorptions/synthesis by bacterial
flora of large intestine

PREVENT clotting Pulmonary embolism, DVT,
MI, rheumatic HD w/heart valve damage,
prosthetic heart valves, chronic atrial
fibrillation
w/hold drug & call prescribe
at once in event of fever or
rash
GIVE same time every day.
DRAWblood for baseline
BEFORE therapy
NO: Acetaminophen, amiodarone, anabolic steroids, azole
antifungals, danazol, fibric acids, NSAIDS, thyroid drugs,
barbs, sulfa, sulfinpyrazone, lansoprazole, methyltestoresron,
metronidazole, nalidixic acids, fluoxymestreron,
fluoroquinolones, ginkgo, ginseng, Green tea, ST Johns wort,
Coenzyme Q10, CRANBERRY JUICE, alcohol

BLEEDING, severe headache, hepatitis, anaphylactic reactions
DNV, ab pain, gas, rash, pruritus, dermatitis, chills, allergic
reactions, necrosis &purple toes
syndrome
DRUG STOPPED if evidence of necrosis, gangrene, D,
intestinal flora imbalances, or stestorrhea,
TEACH: Eat consistent diet containing vitamin K
CONSULT DR: b4 taking herb therapy, vaginal cream/suppositories, any OTC
NSAIDS s
TEACH: CARRY card identifying increased bleeding
BBW: tell patient & family to watch for signs of bleeding or abnormal
bruising & call prescriber at once if they appear

zolpidem(Ambien) NONBARBITURATES
SEDATIVE-HYPNOTICS
interact with GABA receptor in your brain that
gives hypnotic effect, CNS depressor
short-termtreatment of insomnia Take w/8 oz. H20
DO NOT take, unless can get 7-
8 hours asleep

NO Antifungals, antidepressants, Rifampin, antipsychotic ,
alcohol, CNS depressants
AVOID elderly, psychosis, seizure, preggo, lactating, <18
Daytime drowsiness, sluggish lethargy, heart palp, N V C D
,Headache, dry mouth, nose/throat irritation,
AMdrowsiness or hangover effect,
NOT for long-termtreatment,