NURSING

DRUG INDICATION ACTION SIDE EFFECTS PATIENT TEACHING

INTERVENTION
Date ordered: Moderate to severe Centrally acting CNS & GI -Assess type, location, -May be taken with or
8/14/2010 pain analgesic not disturbances. and intensity of pain without food
Generic Name: chemically related to Nausea, dizziness, before and 2-3 hr -Advice patient to
Tramadol HCl 37.5 opiods but binds to somnolence. (peak) after avoid alcohol and
mg, paracetamol 325 mu-opiod receptors Asthenia, fatigue, hot administration. OTC medications
mg and inhibits reuptake flushes, constipation, -Assess BP & RR without medical
Brand Name: of norepinephrine diarrhea, flatulence, before and advice
Tramal and serotonin dry mouth, pruritus, periodically during -Warn ambulatory
Classification: increased sweating, administration. patients to be careful
Analgesics (Opioid) tinnitus. -Prevention of when getting out of
Dosage: constipation should bed or walking or
50 mg Q4° be instituted with refrain from
Remarks: increased intake of performing activities
PRN for severe pain fluids that require alertness
-Monitor patient for until CNS effects are
seizures. May occur known.
within recommended -Instruct patient to
dose range. change positions
-Overdose may cause slowly to prevent
respiratory depression orthostatic
and seizures. hypotension.
-Maintain adequate -Instruct patient to
respiratory exchange. monitor for and
-Encourage patient to report occurrence of
cough and breathe drug induced adverse
deeply every 2 hr to reaction
prevent atelactasis
and pneumonia.
Reference:
PPD’s Nursing Drug
Guide pg.36

NURSING
DRUG INDICATION ACTION SIDE EFFECTS PATIENT TEACHING
INTERVENTION
Date ordered: Serious anaerobic Inhibits bacterial Nausea, vomiting, -Assess site of -Take drug with 8 oz
8/14/2010 infection especially protein synthesis by abdominal cramps, infection or acne; skin of water; give with
Generic Name: those caused by binding to the 50s skin eruptions, color, lesions; BP, meals for GI
Clindamycin Bacteroides fragilis. subunit of the erythema, urticaria, adventitious symptoms
Brand Name: Alternative to ribosomes skin rashes sounds; bowel -Do not crush, chew
Clindal penicillin in some sounds, output, liver capsule
Classification: severe staphylococcal evaluation; complete -Advise patient to
Lincosamide and streptococcal blood count, renal and report sore throat,
Antibiotic infections. liver function test fever, fatigue; may
Dosage: -Monitor urine output; indicate
150mg Q6° if decreasing, notify superimposed
Remarks: physician (may infection
Discontinued indicate nephro- - Advise patient to
toxicity) take drug at equal
-Assess bowel intervals around the
patterns daily; if clock to maintain
diarrhea occurs, blood levels
discontinue drug; may
indicate pseudomem-
branous colitis
-Monitor for bleeding
if in long-term therapy
Reference:
PPD’s Nursing Drug
Guide pg.114-116

NURSING
DRUG INDICATION ACTION SIDE EFFECTS PATIENT TEACHING
INTERVENTION
Date ordered: Treatment of Blocks the Diarrhea and -Assess patient’s -If you are being
8/14/2010 hypertension vasoconstrictive and angioedema, condition before treated for high blood
Generic Name: aldosterone-secreting sinusitis, pharyngitis, therapy and regular pressure, keep using
Telmisartan effects of angiotensin upper respiratory thereafter to monitor Micardis even if you
Brand Name: II by selectively tract infection; back drug effectivenesss feel fine. High blood
Micardis blocking the binding pain -Obtain baseline renal pressure often has no
Classification: of angiotensin II to and liver status before symptoms. You may
Antihypertensive, the ATI receptor in therapy: BUN, Crea, need to use blood
angiotensin II many tissue AST, ALT and bilirubin pressure medication
receptor blocker (vascular smooth -Administer drug for the rest of your
Dosage: muscle and adrenal without regards to life.
80 mg OD gland) meal -Avoid drinking
Remarks: -Monitor for possible alcohol. It can lower
Hold drug induced adverse your blood pressure
reactions and may increase
some of the side
effects of Micardis.
-Do not use
potassium
supplements or salt
substitutes while you
are taking Micardis,
unless your doctor
has told you to.
-Avoid getting up too
fast from a sitting or
 lying position, or you
may feel dizzy. Get
up slowly and steady
yourself to prevent a
fall.

Reference:
PPD’s Nursing Drug
Guide pg.342-343

NURSING
DRUG INDICATION ACTION SIDE EFFECTS PATIENT TEACHING
INTERVENTION
Date ordered: Treatment of Competitively and Allergic reaction: -Obtain history of -Do not stop abruptly
8/14/2010 hypertension (used selectively blocks hives; difficulty patients underlying -Report any changes
Generic Name: alone or in stimulation of beta 1- breathing; swelling of condition in mood affect,
Atenolol combination with adrenergic receptor your face, lips, (hypertension, angina, especially severe
Brand Name: other drugs), angina within vascular tongue, or throat. previous MI) depression and/or
Therabloc pectoris resulting smooth muscle to Serious side effects: -Monitor drug fatigue
Classification: from coronary produce negative slow or uneven effectiveness: -May enhance
Beta-adrenergic atherosclerosis, acute chronotrophic and heartbeats; feeling hypertension (blood sensitivity to cold
blocking agent MI positive inotropic light-headed, pressure) -with initiation of
Dosage: activity (decrease fainting; feeling short -Assess or adverse therapy or change in
50 mg OD heart rate, cardiac of breath, even with reaction dosage stress
output, peripheral mild exertion; -Check for baseline in importance of
resistance, cardiac 02 swelling of ankles or renal, liver function returning as
consumption). It also feet; nausea, tests before therapy scheduled for
decreases renin- stomach pain,loss of begins evaluation of drug
aldosterone- appetite, dark urine, response. Keep log of
angiotensin system clay-colored stools, HR and BP.
at high doses and jaundice; depression;
inhibits beta2- or cold feeling in your
receptors in bronchial hands and feet.
system at higher Less serious side
doses effects may include:
decreased sex drive,
impotence, or
difficulty having an
orgasm;sleep
problems (insomnia); Reference:
PPD’s Nursing Drug
tired feeling; or
Guide pg.256-257
anxiety, nervousness. PDR Nurse’s Drug
Handbook pg.88-89
 NURSING
DRUG INDICATION ACTION SIDE EFFECTS PATIENT TEACHING
INTERVENTION
Date ordered: Treatment of Selectively Hypotension, -Observe for -Take 1 hr before
8/14/2010 hypertension suppresses rennin tachycardia, chest precipitous drop in BP meals, on an empty
Generic Name: angiotensin- pain, palpitations, within 3 hours after stomach; food
Captopril aldosterone system; pruritus, initial dose if on interferes with drug
Brand Name: inhibit ACE; prevents hyperkalaemia. diuretic therapy and absorption
Capoten conversion of Proteinuria; low-salt diet. -Report any fever,
Classification: angiotensin I to angioedema, skin -If BP falls rapidly, skin rash, sore throat,
Antihypertensive, angiotensin II rashes; taste place supine; have mouth sores, fast or
angiotensin disturbance, saline infusion irregular heartbeat,
synthesis (ACE nonproductive cough, available. chest pain, or cough.
inhibitor) headache. -Check for proteinuria -Loss of taste may be
Dosage: Potentially Fatal: monthly for 9 mo experienced for the
25 mg SL Neutropenia, usually during therapy. first 2-3 months,
Remarks: occurs within 3 mth -Withhold potassium- report if
PRN BP≥160/90 of starting therapy sparing diuretics; persists/interferes
mmHg especially in patients hyperkalemia may with nutrition.
with renal occur several months -Carry ID and a list of
dysfunction or after administration of medications currently
collagen diseases. spironolactone and prescribed.
Hyperkalaemia. captopril. -Avoid OTC agents
Anaphylactic without approval.
reactions. Reference:
PPD’s Nursing Drug
Guide pg.264-265
PDR Nurse’s Drug
Handbook pg.165-168

NURSING
DRUG INDICATION ACTION SIDE EFFECTS PATIENT TEACHING
INTERVENTION
Date ordered: Skin and soft tissue Inhibits bacterial cell -Note indication for -Avoid alcohol and
8/14/2010 infections, bone and wall, synthesis therapy, onset and any alcohol-
Anaphylactoid
Generic Name: joint infections and rendering cell wall characteristics of containing products
reaction eg shock,
other intraabdominal osmotically unstable, symptoms and culture during and for 72
diarrhea, nausea &
infections leading to cell death results hours after last dose;
Cefoperazone Na 1 g, vomiting,
-Note any PCN/ATX an antabuse-like
sulbactam Na 0.5g pseudomembranous
sensitivity: assess for reaction may occur.
Brand Name: colitis. Maculopapular
bruising, hematuria, -Report any unusual
Sulperazone rash, urticaria,
black stools, or S&S of bruising/bleeding,
pruritus. Stevens-
Classification: bleeding diarrhea, or lack of
Johnson syndrome.
Cephalosporins 3rd -Obtain baseline response.
Headache,
Generation coagulation studies
hypotension,
Dosage: and monitor: drug
leucopenia,
15 grams Q12° may cause
 hematuria & hypoprothrombinemia
vasculitis. . Assess need for
prophylactic vitamin K
administration
(usually 10 mg/week)
-With skin lesions,
inspect lesions
closely, noting size,
location and extent of
involvement
-Assess for excessive Reference:
alcohol use. Reduce PPD’s Nursing Drug
dose with liver or Guide
pg.95-96
biliary tract disease. PDR Nurse’s Drug
Handbook pg.190-191

NURSING
DRUG INDICATION ACTION SIDE EFFECTS PATIENT TEACHING
INTERVENTION
Date ordered: Treatment & Provides or eplaces Allergic reactions, GI -Give on an empty -Note: Ascorbic acid
8/15/2010 prevention of Fe- elemental iron, an effects, stomach if possible increases absorption
Generic Name: deficiency & essential component hyperbilirubinemia, because oral iron of iron. Consuming
FeSo4 concomitant folic acid in formation of acneform vulgaris preparations are best citrus fruit or tomato
Brand Name: deficiency w/ hemoglobin in red deterioration or absorbed then (i.e., juice with iron
Iberet associated deficient blood cell acneform exanthema between meals). preparation (except
Classification: intake or increased development. eruption, bright -Do not crush tablet the elixir) may
Antianemics need for vit B- yellow urine or empty contents of increase its
Dosage: complex in discoloration, capsule when absorption.
1 tab OD nonpregnant adults flushing, dizziness or administering. -Be aware that milk,
faintness, peripheral -Do not give tablets eggs,
sensory or capsules within 1 or caffeine beverages
neuropathies, stone h of bedtime. when taken with the
formation, -Do not use iron preparation may
crystalluria & discolored tablets. inhibit absorption.
oxalosis, black -Store in tightly -Be aware that iron
discoloration of stool. closed containers preparations cause
and protect from dark green or black
moisture. Store at stools.
15°–30° C (59°–86° -Report constipation o
F) r diarrhea to
physician; symptoms
may be relieved by
adjustments in
dosage or diet or by
change to another
 iron preparation.
Reference:
PPD’s Nursing Drug
Guide
pg.463-464
http://www.medpill.info/
ferrous-sulfate

NURSING
DRUG INDICATION ACTION SIDE EFFECTS PATIENT TEACHING
INTERVENTION
Date ordered: Duodenal and gastric Suppress gastric Headache, dizziness, -Give before patient -Report any changes
8/18/2010 ulcer. secretion by inhibiting fatigue GI: Diarrhea, eats in urinary elimination
Generic Name: Gastroesophageal hydrogen/ potassium abdominal pain, -Lab tests: Monitor such as pain or
Omeprazole reflux disease ATPase enzyme nausea, mild urinalysis for discomfort associated
Brand Name: including severe system in the gastric transient increases in hematuria and with urination, or
Omepron erosive esophagitis parietal cell: liver function proteinuria. Periodic blood in urine.
Classification: (4 to 8 wk characterized as a tests. Urogenital: H liver function tests -Report severe
Antacid, Antireflux treatment). gastric acid pump ematuria, with prolonged use. diarrhea; drug may
Dosage: inhibitor, since it proteinuria. Skin:Ras need to be
20 mg OD-HS blocks the final step h. discontinued.
of acid production Reference:
PPD’s Nursing Drug
Guide
pg.502
http://www.medpill.info/
omeprazole
DRUG INDICATION ACTION SIDE EFFECTS NURSING PATIENT TEACHING
INTERVENTION
Date ordered: Constipation Causes an influx of -Assess patient’s
8/18/2010 fluid in the intestinal condition before
Flatulence, diarrhea, -May be taken with or
Generic Name: tract by increasing therapy
Lactulose nausea, vomiting without food (May be
the osmotic pressure -Monitor for possible taken w/ meals to
Brand Name:
Classification: within the intestinal adverse GI reactions reduce GI discomfort.
Laxative, Purgatives lumen. Bacterial -Monitor for increased For constipation & the
Dosage: metabolism of the glucose level in production of soft
30 ml OD-HS drug to lactate and diabetic clients stools).
Remarks: other acids which are -Give with full glass -Notify physician of
Hold if BM ≥2x/day only partially of water, juice or constipation is not
absorbed in the distal milk to increase relieved or if
ileum and colon palatability symptoms of
augments the osmotic electrolyte imbalance
effects of lactulose. occur.
The distention of -Inform that diarrhea
colon due increased may indicate
fluid enhances overdosage
 intestinal motility and
secretion. These
result to the passage
of soft stools.
Decrease in the
luminal pH further
increase motility and
secretion. Lactulose
also lowers intestinal
absorption of Reference:
PPD’s Nursing Drug
ammonia presumably Guide
due to increased pg.497-498
http://www.medpill.info/
utilization of ammonia lactulose
by intestinal bacteria.

NURSING
DRUG INDICATION ACTION SIDE EFFECTS PATIENT TEACHING
INTERVENTION
Date ordered: Treatment of Inhibits sodium and Symptomatic -Use cautiously in -Advise patient to
8/14/2010 Edema due to chloride reabsorption hypotension, patients with hepatic take drug with food
Generic Name: cardiac, hepatic & at the proximal dehydration, cirrhosis and in those to prevent GI upset,
renal disease, burns; hemoconcentration allergic to and to take drug in
Furosemide tubules, distal
mild to moderate ; hypokalemia, sulfonamides. morning to prevent
Brand Name: tubules and -To prevent nocturia, nocturia.
HTN, hypertensive hyponatremia,
Lasix ascending loop of give P.O. and I.M. -Advise patient to
crisis, acute heart metabolic acidosis;
Classification: failure, reduced Henley leading to preparations in the immediately report
increase of blood
Diuretics urinary output due to excretion of water lipid levels, urea, morning. Give second ringing in ears,
Dosage: gestoses, together with uric acid; reduced dose in early severe abdominal
20 mg Q8° chronic renal sodium, chloride, and glucose tolerance; afternoon. pain, or sore throat
failure, nephrotic hearing disorders, -Alert: Monitor and fever; these
Remarks: potassium.
syndrome. tinnitus; weight, blood symptoms may
Hold if systolic BP is pressure, and pulse indicate furosemide
<100 pancreatitis, GI
symptoms; rate routinely with toxicity.
anaphylactic & long-term use and - Tell patient to check
anaphylactoid during rapid diuresis. with doctor or
reactions; -Monitor fluid intake pharmacist before
cutaneous and output and taking OTC drugs.
reactions (eg serum electrolyte, -Teach patient to
itching, urticaria, BUN, and carbon avoid direct sunlight
bullous eruptions, dioxide levels and to use protective
erythema frequently. clothing and a
multiforme, -Watch for signs of sunblock because of
hypokalemia, such as risk of
exfoliative
muscle weakness and photosensitivity.
dermatitis); fever,
 vasculitis, cramps.
interstitial -Monitor blood uric
nephritis; hemolytic acid level, especially
or aplastic anemia, in patients with a
leukocytopenia, history of gout.
agranulocytosis, Monitor elderly
thrombocytopenia, patients, who are
paresthesia, especially susceptible
photosensitivity; to excessive diuresis,
Reference:
nephrolithiasis because circulatory
PPD’s Nursing Drug
collapse and Guide
thromboembolic pg.295-297
complications are http://www.medpill.info/
furosemide
possible.

NURSING
DRUG INDICATION ACTION SIDE EFFECTS PATIENT TEACHING
INTERVENTION
Date ordered: Prevention of angina. Increases supply of Headache, -Give first dose in -Do not crush or chew
8/18/2010 Not indicated for oxygen to the heart hypotension w/ morning on arising sustained release
Generic Name: acute attacks. by dilating both the dizziness & nausea. and second dose 7 h tablets. May break
Tachycardia. later with twice daily tablets in two and
Isosorbide arteries and veins
dosing regimen. Give take with adequate
mmononitrate which supply the in morning on arising fluid (4–8 oz).
Brand Name: heart itself with once daily -Do not withdraw
Imdur dosing. drug abruptly; doing
Classification: -Store sustained so may precipitate
Coronary vasodilator release tablets in a acute angina.
Dosage: tight container. -Maintain correct
-Monitor cardiac dosing interval with
60 mg OD
status, frequency and twice daily dosing.
Remarks:
severity of angina, -Note: Geriatric
Give once side drip is and BP. patients are more
consumed -Assess for and report susceptible to the
possible S&S of possibility of
toxicity, including developing postural
orthostatic hypotension.
hypotension, -Avoid alcohol ingesti
syncope, dizziness, on and aspirin unless
palpitations, light- specifically permitted
headedness, severe by physician.
headache, blurred Reference:
PPD’s Nursing Drug
vision, and difficulty
Guide
breathing. pg.304-305
-Lab tests: Monitor www.mims.com
serum electrolytes
 periodically.

NURSING
DRUG INDICATION ACTION SIDE EFFECTS PATIENT TEACHING
INTERVENTION
Date ordered: Reduction of the Inhibits HMG-COA Abdominal pain, -Ensure that patient -Take drug in the
8/18/2010 risk of CHD death, reductase enzyme, constipation & has tried a evening. -Do not
Generic Name: major vascular & which reduces flatulence. Asthenia cholesterol-lowering drink grapefruit juice
coronary diet regimen for 3– while using this drug.
Simvastatin cholesterol synthesis; & headache. Nausea,
events, stroke, 6 mo before -Have periodic blood
Brand Name: this enzyme is diarrhea, rash, beginning therapy. tests.
Zocor hospitalization needed for dyspepsia, pruritus,
for angina - Give in the evening; -This drug cannot be
Classification: cholesterol alopecia, dizziness, highest rates of taken during
pectoris &
Dyslipidemic agent developing production muscle cramps, cholesterol synthesis pregnancy; using
Dosage: peripheral myalgia, pancreatitis, are between barrier contraceptives
40 mg OD-HS macrovascular paresthesia, midnight and 5 AM. is recommended.
complications. -Advise patient that -You may experience
peripheral
Reduce the need for this drug cannot be these side effects:
neuropathy, vomiting taken during Nausea (eat frequent
revascularization & anemia. Rarely,
procedures, pregnancy; advise small meals);
jaundice, hepatitis, patient to use barrier headache, muscle
peripheral & other
non-coronary rhabdomyolysis, contraceptives. and joint aches and
revascularization myopathy, -Arrange for regular pains (may lessen);
procedures & slows hypersensitivity follow-up during long- sensitivity to light
progression term therapy. (use a suncreen and
syndrome. Very
of coronary Consider reducing wear protective
rarely, hepatic dose if cholesterol clothing).
atherosclerosis in failure. Memory
patients who are falls below target. -Report severe GI
Impairment, upset, changes in
hypercholesterolem
insomnia. vision, unusual
ic.
bleeding or bruising,
dark urine or light-
colored stools, fever,
muscle pain, or
soreness.
Reference:
PPD’s Nursing Drug
Guide
pg.338-339
web.squ.edu.om

NURSING
DRUG INDICATION ACTION SIDE EFFECTS PATIENT TEACHING
INTERVENTION
Date ordered: Treatment of A fluoroquinolone antibiotic Headache, -Do not give with -Drink fluids liberally
8/14/2010 superficial ocular that inhibits DNa gyrase, an dizziness, insomnia, h meals. unless
Generic Name: infections caused enzyme necessary for allucinations. GI: Nau Avoid administering contraindicated.
Ofloxacin by susceptible bacterial DNA replication sea, vomiting, mineral supplements -Be aware that
diarrhea, GI or vitamins with iron dizziness or light-
Brand Name: organism and some aspects of its
discomfort. Urogenit or zinc within 2 h of headedness may
Floxin transcription, repair, al: Pruritus, pain, drug. occur; use
Classification: recombination, and irritation, -Do not give antacids appropriate caution.
Antibiotic transposition. burning, vaginitis, with magnesium, -Avoid excessive
fluoroquinolones vaginal discharge, aluminum, sunlight or artificial
Dosage: dysmenorrhea, or sucralfate within 4 ultraviolet light
200 mg BID menorrhagia, dysuria, h before or 2 h after because of the
urinary drug. possibility of
frequency.Skin: Pruri -Lab tests: Do C&S phototoxicity.
tus, tests prior to initial
rash. Other: Cartilag dose. Treatment may
e erosion. be implemented
pending results.
-Determine history of
hypersensitivity
reactions
to quinolones or other
drugs before therapy
is started.
Withhold ofloxacin
and notify physician
at first sign of tendon
pain, a skin rash, or
other allergic
reaction.
-Monitor for seizures,
especially in patients
with known or
suspected CNS
disorders.
-Discontinue ofloxacin
and notify physician Reference:
PPD’s Nursing Drug
immediately if seizure Guide
occurs. pg.338-339
-Assess for signs and www.medpill.info/ofloxa
symptoms of cin
superinfection