common medication list - moser

7/31/2019 Common Medication List - Moser

1/34

Medication

Brand/GenericMechanism of Action Indications Assessment Contraindications Side Effects

Lactulose, Kristalose

Synthetic disaccharide used

for constipation. Bacteria in

the colon degrade lactulose

into lactic acid and formic

acid which causes increase in

osmotic pressure which in

turn, softens the stool by

promoting stool water

content.

Constipation. Hepatic

encephalopathy:

treatment and

prophylaxis

Improves GI motility so monitor the

bowel movements. Monitor serum

electrolytes (K, Cl, and CO2)

Low-glucose diet

requirement

GI: bloating, diarrhea,

epigastric pain, flatulence,

nausea, vomiting

Muscle: Cramps

Endrocrine:

Hypernatremia,

Hypokalemaia

Colace

Docusate

Draws liquid into the colon

and thus softening the stool.

Constipation Care Decrease abd discomfort and pain

Bowel movement 12-72 hours

Reassess if rectal bleeding or no

bowel movement after laxative

Hypersensitivity to

docusate products.

Concomitant use of

mineral oil.

Intestinal

obstruction

Acute abd pain with

N/V

Abnormal taste in the

mouth (Bitter)

Nausea

Muscle cramps

Polyethylene Glycol 3350

Miralax

Is an osmotic agent that

causes retention of water in

the stool which increases

bowel movements. It

appears to have no effect on

active absorption or

secretion of glucose or

electrolytes

Constipation Decrease abd pain and discomfort

Bowel movement 2 to 4 days

Check electrolyte imbalance after

prolonged use.

Hypersensitivity to

any component such

as polyethylene

glycol

Bowel obstruction

Diarrhea, Flatulence,

nausea, stomach cramps,

swollen abd

Amoxicillin/ clavulanate

Augmentin

Semisynthetic beta-lactam

antibiotic. Clavulanic acid, a

beta-lactamase inhibitor,

protects amoxicillin against

degradation and extends the

antibiotic spectrum

compared to amoxicillin

alone.

Acute otitis

Pneumonia

Lower resp tract

infections

UTI

Sinusitis

CBC to monitor pts response

Culture treatment to ensure

bacteria are sensitive to PCNs

Hepatic function, in these patients

check at regular intervals

PCN allergies

Hemodialysis pts

Severe renal

impairment

Skin: diaper rash

GI: diarrhea, loose stool,

N/V

Reproductive: Mycosis

vaginitis

Other: Candidiasis


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Medication


Trimethoprim-

sulfamethoxazole

Bactrim

Sulfamethoxalzole is an

antibacterial sulfonamide

that prevents the formation

of dihydrofolic acid, blocking

bacterial synthesis. It

interferes with the

production of folic acid.

Acute infective

exacerbation of COPD

HIV Pneumocystis

pneumonia

Travelers diarrhea

UTI

Shigellosis

Watch for fever and check the CBC

counts.

Monitor Renal function

Serum K, especially in elderly, HIV

pts, and is also known to cause

hyperkalemia

Allergies to

sulfonamides

Infants less than 2

months

Hepatic damage

Pregnant or nursing

mothers

Renal dysfunction

Skin: Rash, Uticaria.

GI:N/V

Dermatologic: Erythema

multiforme (SStevens-

Johnson syndrome

Hepatic: Hepatic necrosis

Flonase/Fluticasone

Propionate

Acts as an anti-inflammatory

as a human glucocorticoid

receptor agonist

Allergic rhinitis,

Asthma, Atopic

dermatitis, Disorder of

skin, corticosteroid-

responsive dermatoses,

and non-allergic rhinitis

(off label nasal polyp

and vitiligo)

-Resp: Lung sounds, pulmonary

function tests during and several

months after change from systemic

to inhalation corticosteroids

-Withdrawal symptoms from oral

corticosteroids: depression, pain in

joints, fatigue

-Safety Alert! Adrenal Insufficiency:

nausea, weakness, fatigue,hypotension, hypoglycemia,

anorexia; may occur when

changing from systemic to

inhalation; may be life threatening;

adrenal function tests periodically:

hypothalamic-pituitary-adrenal axis

suppression in long-term treatment

-growth rate in children

Hypersensitivity to

the drug or to milk

proteins, and

primary treatment

of status

asthmaticus or

other forms of

asthma requiring

and inhaler.

Candidiasis of mouth and

esophagus, headache,

bronchitis, cough,

epistaxis, inflammatory

disorder of upper

respiratory tract, sinusitis,

throat irritation, and upper

respiratory infection are

the most common. Seriousside effects include

secondary hypocortisolism,

anaphylaxis, immune

hypersensitivity reaction,

glaucoma, and pneumonia

Allegra/ Fexofenadine

Hydrochloride

Inhibits release of histamine

from mast cells and

selectively antagonizes

peripheral histamine-

receptor activity.

Chronic idiopathic

urticarial and seasonal

allergic rhinitis. (Off-

label: hymenoptera

immunotherapy

pretreatment and

perennial allergic

rhinitis)

-Allergy: itchy, runny, watery eyes;

congested nose; before and during

treatment

-I&O: be alert for urinary retention,

frequency, dysuria, esp. geriatric

pts; product should be

discontinued if these occur, serum

creatinine/BUN baseline and

periodically during treatment

-Resp: rate, rhythm, increase in

bronchial secretions, wheezing,

chest tightness

Hypersensitivity Indigestion, dizziness,

headache, somnolence,

otitis media,

dysmenorrhea, upper

respiratory infection,

fatigue, viral disease, cold,

and flu


3/34

Medication


Zyrtec/ Cetirizine

Hydrochloride

An antihistamine that

selectively inhibits the effect

of peripheral H1-receptors; a

human metabolite of

hydroxyzine

Perennial and seasonal

allergic rhinitis, and

chronic urticaria (off-

label: adjunct asthma,

atopic dermatitis, and

acute urticaria)

-Allergy symptoms: pruritus,

urticaria, watering eyes, baseline

and during treatment



chest tightness

-Blood studies: LFTs, BUN,

creatinine baseline, periodically

Hypersensitivity to

cetirizine,

levocetirizine, or

hydroxyzine

Xerostomia, headache,

somnolence, and fatigue.

Benadryl/

Diphenhydramine

Hydrochloride

Acts as an antihistamine by

competing with histamine

for receptor cites on effector

cells

Allergic rhinitis,

anaphylaxis, common

cold, insomnia, motion

sickness, Parkinsons,

and pruritus of skin

(off-label:

chemotherapy,

extrapyramidal disease,

hyperemesis

gravidarum, local

anesthesia)

-Be alert for urinary retention,

frequency, dysuria; product should

be discontinued

-CBC during long-term therapy;

blood dyscrasias may occur



chest tightness

Hypersensitivity,

newborn/premature

infants, and nursing

mothers

Xerostomia, dizziness,

dyskinesia, sedative

effects, somnolence, dry

nasal mucosa, pharyngeal

dryness, thick sputum, and

anaphylaxis

Fentanyl Systemically produces effects

via agonist actions at the mu

receptor. May cause

respiratory depression.

Increases tone and decreases

contractions of smooth

muscle of GI tract.

Transdermally acts with

opiod mu-receptors in CNS

causing analgesia, mood

alterations, euphoria,

dysphoria, and drowsiness.

Constricts the pupils. Alters

perception of and emotional

response to pain.

Moderate to severe

chronic pain that

cannot be managed by

other means in a

patient who is opioid

tolerant. (Off-label:

moderate to severe

osteoarthritis with an

inadequate response

with a weak opioid

analgesic therapy)

-VS after parenteral route; note

muscle rigidity, drug history,

hepatic and renal function tests

-CNS: dizziness, drowsiness,

hallucinations, euphoria, LOC, pupil

reaction

-Allergic reaction: rash, urticaria

-Resp: respiratory depression,

character, rate, rhythm; notify

prescriber if respirations < 10/min

MAY CAUSE

RESPIRATORY

DEPRESSION.

Acute or

postoperative pain,

risk of life-

threatening

hypoventilation,

acute or severe

bronchial asthma.

Hypersensitivity.

Mild or intermittent

pain management.

Opioid non-tolerant

patients. Suspected

or known paralytic

ileus. Should not be

used on children.

Potential for abuse due to

opioid-like effects.

Application site reactions,

pruritus, sweating,

abdominal pain,

constipation, diarrhea,

indigestion, nausea,

vomiting, xerostomia,

asthenia, confusion,

dizziness, nervousness,

headache, insomnia,

somnolence, anxiety,

depression, euphoria,

hallucinations, urinary

retention, upper

respiratory infection, and

fatigue. Serious side effects

include bradyarrhythmia,

cardiac dysrhythmia, chest

pain, apnea, dyspnea,

respiratory depression.


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Medication


Solu Medrol/

Methylprednisolone

Anti-Inflammatory Rheumatoid Arhritis

Psoriatic Arthritis

Ulcerative Colitis

Crohns Disease

Serum Sickness

Transfusion Rxn

Stevens-Johnson

syndrome

Acute Asthma

Monitor:

Electrolyte Balance

BP

Weight

Urinalysis

Chest X-rays needed if treatment >

6wks

Give at smallest dose possible

Osteoporosis or risk

of

Systemic fungal

infection

Fluid retention

Wight Gain

High BP

Hirutism

Headache

Weakness

Photosensitivity

Ulcers

Convulsions

Euphoria

Insomnia

Albuterol Bronchodilator Asthma

Exercise induced

asthma

Chronic Bronchitis

Emphysema

None Recommended PT Hypersensitive to

drug class

Ischemic Heart

Disease

Hypertension

ArrhythmiasHyperthyroidism

Epilepsy

Nervousness

Tremors

Headache

Palpitations

High BP

DizzinessNausea

Xopenex/ Levalbuterol Bronchodilator Asthma

Exercise induced

asthma

COPD


drug class

PT on Monoamine

oxidase inhibitor

medication

Nervousness

Tremors

Headache

Palpitations

High BP

Dizziness

Nausea

Advair/ Combination of

Flucticasone and Salmerol

Bronchodilator Asthma Maintenance

COPD

Bone Density if Osteoporotic

Oral Cavity Inspection

Monitor for Vision Changes, child

development

PT Hypersensitive to

Atropine

Narrow Angle

Glaucoma

Prostatic

Hypertrophy

Allergies to Milk

Proteins

Headache

Sore Throat

Sinus Inflammation

N/V

Bronchitis

Dizziness


5/34

Medication


Atrovent/ Ipratropium Bronchodilator

Prophylactic

COPD

Chronic Bronchitis

Emphysema


Atropine

Narrow Angle

Glaucoma

Prostatic

Hypertrophy

Urinary system

obstruction

Dizziness

Nausea

Heartburn

Constipation

Dry mouth

Back pain

Difficulty urinating

Pain when urinating

frequency

Aspirin

Blocks pain impulses in CNS,

reduces inflammation by

inhibition of prostaglandin

synthesis; antipyretic action

results from vasodilation of

peripheral vessels; decreases

platelet aggregation

Mild to moderate pain

or fever including RA,

osteoarthritis, TIA,

thromboembolic

disorders, rheumatic

fever, post MI,

prophylaxis of MI,

ischemic stroke,

angina, acute MI,

Pain: character, location, intensity;

ROM-before and 1 hr after

administration.

Fever: temperature before and 1 hr

after administration.

Hepatic studies: AST, ALT, bilirubin,

creatinine if pt is on long-term

therapy.

Renal Studies: BUN, urine

creatinine; I&O ratio; decreasing

output may indicate renal failure.

Blood studies: CBC, Hct, Hgb, PT if

patient is on long-term therapy.

Allergic RXN: rash, urticaria,.

Ototoxicity: tinnitus, ringing,

roaring in ears.

Edema in feet, ankles, legs.

Pregnancy (D) 3rd

trimester,

breastfeeding,

children


6/34


7/34

Medication


Lovenox

Prevents conversion of

prothrombin to thrombin

and prevents fibrin from

further converting to

thrombin.

Prevention of DVT, PE

(inpatient) in hip and

knee replacement,

abdominal surgery at

risk for thrombosis;

unstable angina/non Q

wave MI.

Blood studies: Hct, Hgb, CBC,

coagulation, platelets, occult blood

ins tools, anti-factor Xa.

Renal studies: BUN/creatinine

baseline and periodically.

Bleeding: gums, petechiae,

ecchymosis, black tarry stools,

hematuria

Neuro symptoms in patients who

have received spinal anesthesia.

Active major

bleeding;

thrombocytopenia

with a positive in

vitro test for anti-

platelet antibody in

the presence of

enoxaparin sodium;

known

hypersensitivity to

enoxaparin sodium,

heparin, pork

products, or benzyl

alcohol (multi-dose

formulation only)

Hemorrhage, hypochromic

anemia,

thrombocytopenia,

bleeding. Fever confusion,

nausea, ecchymosis,

hyperkalemia in renal

failure, edema, peripheral

edema; allergic reaction:

hives; difficulty breathing;

swelling of face, lips,

tongue, or throat. Bleeding

that wont stop;

pale skin, easy bruising,

unusual weakness;

swelling, bruising or

swelling in one or both

legs.

Prilosec

Gastric acid pump inhibitor-

Suppresses gastric acid (H+

ion) secretion by blocking

the hydrogen/potassium ATP

ase pump (proton pump) of

the gastric parietal cells

which secrete H+ directly

into the gastric lumen.

Duodenal ulcer, gastric

ulcer, gastro-

esophageal reflux

disease (GERD);

maintain healing of

erosive esophagitis;

long-term treatment of

pathological

hypersecretory

conditions in adults.

GI system: bowel sounds q8hr,

abdomen for pain, swelling,

anorexia, blood in stools.

Hepatic enzymes: AST, ALT, alkaline

phosphatase during treatment;

blood studies: CBC, differential

during treatment, blood dyscrasias

may occur.

Seious skin rxns: toxic epidermal

necrolysis, Stevens-Johnson

syndrome, angioedema, exfoliativedermatitis; fever, sore throat,

fatigue, thin ulcers, lesions in

mouth, lips.

Known

hypersensitivity.

Pregnancy (C),

breastfeeding,

children.

Heart Failure, hepatic

failure, proteinuria,

hematuria, pancytopenia,

leukocytosis, pneumonia,

angioedema, exfoliative

dermatitis, Stevens-

Johnsons Syndrome, toxic

epidermal necrolysis.

Headache, dizziness,

asthenia, diarrhea,

abdominal pain, vomiting,nausea, constipation,

flatulence, acid

regurgitation, rash, back

apin, upper respiratory

infections, cough. Tinnitus,

taste perversion, chest

pain, palpitations,

tachycardia, bradycardia,

peripheral edema,

abdominal swelling,

anorexia, irritable colon,

dry mouth, UTI, urinary


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Medication


Prilosec cont.

frequency, dry skin,

urticaria, pruitis, alopecia,

hypoglycemia, weight gain,

fever, fatigue, malaise.

Synthroid/Levothyroxine

Sodium

Thyroid replacement

hormone; mechanism not

established. Suspected that

principal effects are exerted

through control of DNA

transcription and protein

synthesis.

Replacement or

supplemental therapy

in congenital or

acquired

hypothyroidism during

recovery phase of

subacute thyroiditis.

Treatment or

prevention of various

types of euthyroid

goiters, including

thyroid nodules,

subacute or chroniclymphocytic thyroiditis,

multinodular goiter and

as an adjunct to

surgery and radioiodine

therapy for

thyrotropin-dependent

well-differentiated

thyroid cancer.

Assess for untreated subclinical or

overt thyrotoxicosis, acute MI,

uncorrected adrenal insufficiency,

age, CAD, CV disorders, nontoxic

diffuse goiter, nodular thyroid

disease, DM, hypersensitivity,

pregnancy/nursing status, and for

possible drug interactions. In

patients w/ secondary or tertiary

hypothyroidism, assess for

additional hypothalamic/pituitary

hormone deficiencies. Assess for

weight and TSH levels. In infantswith congenital hypothyroidism,

assess for congenital anomalies.

Untreated

subclinical

(suppressed serum

TSH level with

normal T3 level and

T4 levels) or overt

thyrotoxicosis of any

etiology, acute MI,

and uncorrected

adrenal

insufficiency.

Fatigue, increase appetite,

weight loss, heat

intolerance, headache,

hyperactivity, irritability,

insomnia, palpitations,

arrhythmias, dyspnea, hair

loss, menstrual

irregularities,

pseudotumor cerebri

(children), slipped capital

femoral epiphysis

(children).

Plavix/Clopidogrel

Bisulfate

Platelet activation and

aggregation inhibitor;

irreversibly and selectivelyinhibits the binding of ADP to

its platelet P2Y12 receptor

and subsequent ADP-

mediated activation of the

glycoprotein GPIIb/IIIa

complex.

To decrease the rate of

combined endpoint of

CV death, MI, stroke, orrefractory ischemia in

pts w/ non-ST-segment

elevation ACS,

including those who

are managed medically

and those w/ coronary

revascularization. To

reduce rate of death

from any cause and the

rate of combined

endpoint of death, re-

infarction, or stroke in

Assess for presence of active

pathological bleeding, previous

hypersensitivity to the drug,reduced CYP2C19 function,

pregnancy/nursing status, and

possible drug interactions. Assess

use in pts at risk for increase

bleeding (eg, undergoing surgery).

Active pathological

bleeding (eg, peptic

ulcer, intracranialhemorrhage).

TTP, bleeding, epistaxis,

hematuria, bruising,

hematoma, pruritus.


9/34

Medication


Plavix/Clopidogrel

Bisulfate

Cont.

patients with

ST_elevation MI. To

reduce rate of

combined endpoint of

new ischemic stroke or

MI, and other vascular

deaths in pts with hx of

recent MI or stroke, or

established PAD.

Vancomycin/Vancomycin

HCl

Tricyclic glycopeptide

antibiotic; inhibits cell-wall

biosynthesis, alters bacterial

cell membrane permeability

and RNA synthesis.

Treatment of serious or

severe infections

caused by susceptible

strains of methicillin-

resistant staphylococci.

Indicated for PCN-

allergic pts who cannot

receive or have failed

to respond to other

drugs, and for

infections caused by

vancomycin-susceptible

organisms that are

resistant to other

antimicrobials.

Assess for renal function,

underlying hearing loss,

pregnancy/nursing status and

possible drug interactions. Perform

culture and susceptibility testing.

Contraindicated for

pts with known

hypersensitivity to

this product, renal,

and auditory

susceptibility/insuffi

ciency.

Infusion-related events,

hypotension, wheezing,

pruritus, chest and back

muscle spasm or pain,

dyspnea, urticaria,

nephrotoxicity,

pseudomembranous

colitis, ototoxicity,

neutropenia, phlebitis.

Maxipime/Cefepime HCl 4th generation

cephalosporin; bactericidal

agent that acts by inhibiting

cell wall synthesis.

Treatment of

uncomplicated/complic

ated UTI including

pyelonephritis,

uncomplicated skin and

skin structure,

complicated intra-

abdominal infections,

and pneumonia caused

by susceptible strains

of microorganisms.

Empiric therapy for

febrile neutropenia.

Assess for PCN allergy,

pregnancy/nursing status, history

of GI disease, renal/hepatic

impairment, nutritional status, and

possible drug interactions.

Document indications for therapy

with culture and susceptibility

testing. (Generic): Assess for allergy

to corn or corn products.

Hypersensitivity to

penicillins or other

beta-lactam

antibiotics.

Local reactions (eg,

phlebitis), rash, diarrhea,

(+) Coombs test (without

hemolysis).


10/34

Medication


Zyvox/Linezolid Oxazolidinone antibacterial;

inhibits bacterial protein

synthesis; bids to a site on

the bacteria 23S ribosomal

RNA of the 50S subunit and

prevents formation of

functional 70S initiation

complex, which is an

essential component of the

bacterial translation process.

Treatment of

vancomycin-resistant

Enterococcus faecium

(VRE) infections

including cases with

concurrent bacteremia,

nosocomial

pneumonia,

complicated skin and

skin structure

infections (SSSI)

including diabetic food

infections without

concomitant

osteomyelitis,

uncomplicated SSSI,

community-acquired

pneumonia (CAP)including concurrent

bacteremia caused by

susceptible strains of

designated

microorganisms.

Assess for pre-existing

myelosuppression (including

anemia, leukopenia, pancytopenia,

thrombocytopenia), concomitant

drugs that produce

myelosuppression, presence of

chronic infections, previous or

concomitant antibiotic therapy,

catheter-related bloodstream

infections or catheter-site

infections, pregnancy/nursing

status, uncontrolled HTN, carcinoid

syndrome, pheochromocytoma,

untreated hyperthyroidism,

phenylketonuria, renal/hepatic

impairment, and possible drug

interactions.

MAOIs A or B (eg

phenelzine,

isocarboxazid) or

within two weeks

after taking such

drugs; uncontrolled

HTN,

pheochromocytoma

, thyrotoxicosis,

and/or taking

directly and

indirectly acting

sympathomimetic

agents, vasopressive

agents,

dopaminergic

agents; carcinoid

syndrome and/ortaking SSRIs, TCAs,

serotonin 5-HT1

receptor agonists,

meperidine or

buspirone.

Diarrhea, headache, N/V,

fever, sepsis, anemia,

thrombocytopenia, upper

respiratory infection,

trauma.

Lisinopril

Angiotensin-converting

enzyme (ACE) inhibitor.

Blocks conversion of

angiotensin I tovasoconstrictor angiotensin

II. Prevents degradation of

bradykinin and other

vasodilatory prostaglandins.

Incr plasma renin levels and

decr aldosterone levels. Net

result = systemic

vasodilation.

Hypertension, heart

failure, reduce risk of

dealth or heart failure

after MI. Lowers BP.

Monitor BP and pulse frequently,

esp during initial dose adjustment.

Monitor freq of Rx refills to

determine compliance. Assess for

signs of angioedema (dyspnea,

facial swelling). To prevent heart

failure, monitor weight and assess

pt routinely for resolution of fluid

overload (peripheral edema,

rales/crackles, dyspnea, wt gain,

jugular venous distention). Monitor

renal function. May cause incr in

BUN & serum creatinine. May

cause hyperkalemia. Monitor CBC

for pts w/ collagen vascular dx &/or

renal dx. May cause elevated AST,

Family hx of

angioedema. Pt hx

of angioedema w/

previous ACE

inhibitors.

Hypersensitivity.

Pregnancy Category

C (1st trimester),

Category D (2nd/3rd

trimesters).

Breastfeeding

(appears in breast

milk). Use caution:

Pts w/ renal

impairment,

hypovolemia,

Angioedema. CNS:

dizziness, fatigue, HA,

weakness. Resp: cough.

CV: hypotension, chest

pain. GI: abdominal pain,

N/V, diarrhea. GU: erectile

dysfunction, impaired

renal function. Derm:

rashes. F&E hyperkalemia.


11/34

Medication


Lisinopril cont.

ALT, alkaline phosphatase & serum

bilirubin.

hyponatremia,

concurrent diuretic

therapy. Incr risk of

angioedema in black

pts & monotherapy

less effective in

black pts (may

require addl

therapy).

Surgery/anesthesia

(hypotension may

be exaggerated).

Safety not

established-children

< 6yr. Geriatric:

initial dosage

reduction

recommended.

Metoprolol

(Lopressor)

Beta-Blocker

Beta-adrenergic antagonist-

block SNS

catecholamines..reduced

renin & aldosterone release

& fluid balance..vasodilation

of arterioles to decr

pulmonary vascular

resistance and blood

pressure.

Antihypertensive ACE

inhibitor. Hypertension,

antianginal in long term

tx of angina.

Dysrhythmias (to

suppress sinus and

atrial tachy-dysrhythmias) Beta1

(cardioselective)

metopropol (Lopressor,

Toprol XL) used for

angina and

hypertension

VS assess BP before & after initial

dose. Monitor closely if given w/ a

Calcium channel blocker.

Report any weakness, dizziness,

fainting, edema or difficultybreathing. If SBP is below

90mm/Hg or for bradycardia, notify

HC provider.

Pts w/ DM: tachycardia (a symp of

hypoglycemia) is often masked due

to beta1 blockade.

Atrioventricula (AV)

block,

bradydysrhythmias.

Bradycardia,hypotension. May

interact w/

hypoglycemic

agents- use caution

in pt w/ DM.

Orthostatic hypotension,

bradycardia, drowsiness,

decreased libido.


12/34

Medication


Metoclopramide

Hydrochloride (Reglan)

Suppresses emesis by

blocking dopamine receptors

in the chemoreceptor trigger

aone. Increases tone and

accelerates intestinal transit

& gastric emptying by

enhancing action of ACh.

Peristaltic stimulant,

antiemetic

Monitor renal function, BP and

heart rate. Assess hydration.

Monitor for anxiety restlessness,

extrapyramidal symptoms. Monitor

bowel response and therapeutic

response. To prevent nausea,

admin 30 pre chemotherapy. Also

30 min before meals and at

bedtime for gastroparesis.

GI obstruction or

perforation, GI

hemorrhage. Dont

use concurrently w/

meds that cause

extrapyramidal

reactions (motor

deficits, loss of

postural reflexes,

bradykinesia,

tremor, rigidity,

various involuntary

movements.

Drowsiness, restlessness,

fatigue, lethargy, dizziness,

HA, insomnia, dry mouth,

extrapyramidal symptoms

(toxic).

Promethazine

(Phenergan)

Blocks histamine receptors in

neuronal pathway, from

vestibular apparatus to

vomiting center in the

medulla.

Antiemetic,

antihistamine.

Evaluate pt respiratory status,

teach pt to avoid tasks requiring

mental alertness and to report

tremors or abnormal body

movements. Long-term therapy-

check CBC. Watch for drowsiness,

restlessness, hypotension,

confusion, urinary retention.

Severe CNS

depression, acute

asthma, glaucoma,

GI or GU

obstruction,

pregnancy, seizures.

Sedation, drowsiness,disorientation, syncope in

geriatrics, hypotension, dry

mouth, urinary retention,

flushing, epigastric

distress, visual and hearing

disturbances.


13/34

Medication


Ondansetron

(Zofran)

(do not confuse with

Zosyn!)

Blocks effects of serotonin at

5-HT3 receptor sites

(selective antagonist) located

in vagal nerve terminals &

the chemoreceptor trigger

zone in the CNS.

Antiemetic. Prevent

N/V associated w

emetogenic

chemotherapy or

radiation therapy.

Prevent and treat

postoperative N/V.

Assess for N/V, abdominal

distention & bowel sounds prior to

and following administration.

Assess for extrapyramidal effects

(involuntary movements, facial

grimacing, rigidity, shuffling walk,

trembling hands). Lab tests: may

cause incr in serum bilirubin, AST &

ALT levels.

Orally disintegrating

tablets contain

aspartame and

should not be given

to pts w

phenylketonuria.

Concurrent use of

apomorphine.

Hypersensitivity.

Use cautiously in:

hepatic impairment

(daily dose must be

< 8mg), abdominal

surgery (may mask

ileus), Pregnancy

(category B),

lactation, or children

3 or younger (PO) or

< 1 mo (parenternal)

(safety not

established).

CNS: HA, dizziness,

drowsiness, fatigue,

weakness. GI: constipation,

diarrhea, abdominal pain,

dry mouth, incr liver

enzymes. Neuro:

extrapyramidal reactions.

Niravam, Xanax

Alprazolam

Depresses subcortical levelsof CNS, including limbic

system, reticular formation

Anxiety, panic

disorders with orwithout agoraphobia,

anxiety with depressive

symptoms

Monitor hepatic, blood studies

Monitor BP lying, standing; pulse, if

systolic pressure drops 20 mm Hg,hold product, notify prescriber

Monitor mental status: anxiety,

mood, drowsiness, dizziness,

sleeping pattern, orientation and

sensorium, especially in geriatric

patients prior to and during

treatment

Monitor physical dependency,

withdrawal symptoms, agitation,

Pregnancy

Breastfeeding

Hypersensitivity to

benzodiazepines

Closed- angle

glaucoma

Psychosis

Addiction

Skin: Rash, dermatitis,

itching

GI: Constipation, dry

mouth, nausea, vomiting

anorexia, diarrhea, weight

gain/ loss, increased

appetite

EENT: Blurred vision,

tinnitus, mydriasis

CV: Orthostatic

hypotension, ECG changes,


14/34

Medication


Niravam, Xanax

Alprazolam cont.

seizures, muscle pain, weakness,

headache, panic attacks, nausea,

vomiting

tachycardia, hypotension

CNS: Dizziness, drowsiness,

confusion, headache,

anxiety, tremors, fatigue,

depression, insomnia,hallucinations, memory

impairment, poor

coordination

Dilantin

PhenytoinInhibits spread of seizure

activity in motor cortex by

altering ion transport;

increases AV conduction

Generalized tonic-

clonic seizures; status

epilepticus;

nonepileptic seizures

associated with Reyes

syndrome or after head

trauma; Bells palsy,

complex partial

seizures

Monitor respiratory depression:

rate, depth, character

Monitor blood dyscrasias: fever,

sore throat, bruising, rash, jaundice

Monitor mental status: mood,

sensorium, memory (long, short),

suicidal thoughts/ behaviors

Monitor purple glove syndrome

with IV use

Monitor skin disorders: rash that

may lead to Stevens- Johnson

syndrome or toxic epidermal

necrolysis; phenytoin should not be

used again

Monitor temperature,

lymphadenopathy; may cause

hepatotoxicity, renal failure,

rhabdomyolysis

Pregnancy

Hypersensitivity

Psychiatric condition

Bradycardia

AV and SA block

Stokes- Adams

syndrome

Hepatic failure

CNS: Drowsiness, dizziness,

insomnia, depression,

suicidal tendencies,

paresthesias, aggression,headache, confusion,

slurred speech, peripheral

neuropathy

CV: Hypotension,

ventricular fibrillation

EENT: Nystagmus, diplopia,

blurred vision

ENDO: Diabetes insipidus

GI: Nausea, vomiting,

constipation, anorexia,

weight loss, hepatitis,

jaundice, gingival

hyperplasia

GU: Nephritis, urine

discoloration

Skin: Rash, hirsutism, toxic


15/34

Medication


Dilantin

Phenytoin cont.

Acute intermittent

porphyria

epidermal necrolysis, lupus

erythematosus, Stevens-

Johnson syndrome

SYST: Hypocalcemia,

purple glove syndrome (IV)

HEMA: Agranulocytosis,

leucopenia, aplastic

anemia, megaloblastic

anemia thrombocytopenia,

Topamax

Topiramate

May prevent seizure spread

as opposed to an elevation

of seizure threshold

Partial seizures in

adults and children 2-

16 yr old; tonic- clonic

seizures; seizures in

Lennox- Gastaut

syndrome, migraineprophylaxis

Monitor renal and hepatic studies

Monitor CBC during long- term

therapy (anemia), metabolicacidosis

Seizures- location, type, duration

Migraines- pain location, duration,

alleviating factor

Bipolar disorder: mood, behavior

Mental status: behavioral changes,

suicidal thoughts/ behaviors,

sensorium, body weight, evidence

of cognitive disorder

Hypersensitivity

Metabolic acidosis

CNS: Dizziness, fatigue,

cognitive disorder,

insomnia, anxiety,

depression, paresthesia,memory loss, tremor,

motor retardation, suicidal

ideation

EENT: Diplopia, vision

abnormality

GI: Diarrhea, anorexia,

nausea, dyspepsia,

abdominal pain,

constipation, dry mouth,

pancreatitis

Skin: Rash

GU: Breast pain,

dysmenorrheal, menstrual

disorder

RESP: Upper respiratory

tract infection, pharyngitis,


16/34

Medication


Topamax

Topiramate cont.

sinusitis

Misc: Weight loss,

leukopenia, metabolic

acidosis, increased body

temperature, unexplaineddeath (epilepsy)

Cerebyx, Prodilantin

Fosphenytoin

Inhibits spread of seizure

activity in motor cortex by

altering ion transport;increases AV conduction,

prodrug of phenytoin

Generalized tonic-

clonic seizures status

epilepticus, partial

seizures

Monitor seizure activity includingtype, location, duration; provide

seizure precaution

Monitor mental status: mood,

memory (long, short), suicidal

thoughts/ behaviors

Toxicity: bone marrow depression,

nausea, vomiting, ataxia, diplopia,

cardiovascular collapse, slurred

speech, confusion

Respiratory depression: rate,

depth, character of respirations

Blood dyscrasias: fever, sore throat,

bruising, rash, jaundice

Monitor BP and ECG

Pregnancy

Hypersensitivity

Psychiatric

conditions

Bradycardia

SA and AV block

Stokes- Adams

syndrome

CNS: Drowsiness,

dizziness, insomnia,

paresthesias, depression,

suicidal tendencies,

aggression, headache,

confusion

CV: Hypo/ hypertension,

ventricular fibrillation,

shock

EENT: Nystagmus, diplopia,

blurred vision

GI: Nausea, vomiting,

diarrhea, constipation,

anorexia, weight loss,

hepatitis, jaundice, gingival

hyperplasia

HEMA: Agranulocytosis,

leukopenia, aplastic

anemia,


17/34

Medication


Cerebyx, Prodilantin

Fosphenytoin cont.

Absence seizures

thrombocytopenia,

megaloblastic anemia

Skin: Rash, lupus

erythematosus, Stevens-

Johnson syndrome,hirsutism, hypersensitivity,

pruritus

SYST: Hyperglycemia,

hypokalemia

Nitro- Time, Nitro- Bid,

Nitro- Stat, Nitro- Mist,Minitran, Nitro-Dur

Nitroglycerine

Decreases preload, afterload,

which is responsible fordecreasing left ventricular

end diastolic pressure,

systemic vascular resistance;

dilates coronary arteries,

improves blood flow through

coronary vasculature, dilates

arterial, venous beds

systemically

Chronic stable angina

pectoris, prophylaxis of

angina pain, CHF acute

MI, controlled

hypotension in surgical

procedures

Monitor pain: duration, time

started, activity being performed,

character

Orthostatic BP, pulse prior to and

after administration

Headache, light- headedness,

decreased BP; may indicate a need

for decreased dosage

Tolerance if taken over long period

Hypersensitivity to

this product or

nitrites, severeanemia, increased

intracranial

pressure, cerebral

hemorrhage, closed-

angle glaucoma,

cardiac temponade,

cardiomyopathy,

constrictive

pericarditis

CNS: Headache, flushing,

dizziness

CV: Postural hypotension,

tachycardia, collapse,

syncope, palpitations

GI: Nausea, vomiting

Skin: Pallor, sweating, rash


18/34

Medication


Morphine

Brands: Astramorph PF,

Avinza, Depo Dur,

Infumorph PF, Kadian,

M.O.S., MS Contin, MSIR,

Oramorph SR, PMS-

Morphine Sulfate, ratio-

Morphine, ratio-

Morphine SR

Depresses pain impulse

transmission at the spinal

cord level by interacting with

opioid receptors

Moderate to severe

pain

Pain: Location, type, character -give before too severe Bowel

function - constipation I&O - may

cause urinary retention B/P, Pulse,

Resp - character, depth, rate CNS -

dizziness, drowsiness,


rxn Allergic Rxn - rash, urticaria

Respiratory dysfunction -

depression, character, rate,

rhythm, notify prescriber if

resp


19/34

Medication


Hydromorphone

Brands: Dilaudid,

Dilaudid HP, Exalgo,

Hydromorph contin,

PMS-Hydromorphone

Inhibits ascending pain

pathways in CNS, increases

pain threshold, alters pain

perception

Moderate to severe

pain, nonproductive

cough

Respiratory dysfunction

depression, character, rate,

rhythm, notify prescriber if resp


20/34

Medication


Hydrocodone /

Acetaminophen

Brands: Anexsia, Co-

Gesic, Hycet, Liquicet,

Lorcet, Lorcet Plus,

Lortab, Margesic H,

Maxidone, Norco,

Polygesic, Stagesic,

Vanacet, Vicodin, Vicodin

ES, Vicodin HP, Xodol,

Zamicet, Zolvit, Zydone

Acts directly on cough center

in medulla to suppress

cough; binds to opiate

receptors in CNS to reduce

pain

Hyperactive and

nonproductive cough,

mild to moderate pain

Pain: intensity, type, location, and

other characteristics before and 1

hr after giving product, titrateupward by 25% until pain is

reduced by 1/2 CNS changes:



rxn B/P, Pulse, Resp:before and

periodically, if resp < 10/min, dose

may need to be reduced,

oversedation may occur Bond

Status: constipation, provide fluids,

fiber in diet, may need stimulative

laxative Allergic Rxn: rash, urticaria

Cough and Resp.

dysfunction:respiratory depression,

character, rate, rhythm Need for

pain medication, physical

dependence, opioid is more

effective before pain is severe

Ance

rosacea/vulgaris,

Cushing's, measles,

perioral dermatitis,

varicella, abrupt

discontinuation,

hypersensitivity to

this product or

benzyl

hypersensitivity

CNS: drowsiness, dizziness,

light-headedness,

confusion, H/A, sedation,

euphoria, dysphoria,

weakness, hallucinations,

disorientation, mood

changes, dependence,

seizures CV: palpitations,


change in B/P,circulatory

depression, syncope;

cardiac arrest (children)

EENT: tinnitus, blurred

vision, miosis, diplopia GI:

nausea, vomiting,

anorexia, constipation,

cramps, dry mouth, ulcersGU: Increased urinary

output, dysuria, urinary

retention INTEG: rash,

urticaria, flushing, pruritus

RESP: resp depression;

pulmonary edema,

bronchopneumonia, resp

arrest (children)


21/34

Medication


Hydrocodone Brands:

Hycodan, Tussigon

Acts directly on cough center

in medulla to suppress

cough; binds to opiate

receptors in CNS to reduce

pain

Hyperactive and

nonproductive cough,

mild to moderate pain

Pain: intensity, type, location, and

other characteristics before and 1

hr after giving product, titrate

upward by 25% until pain is

reduced by 1/2 CNS changes:



rxn B/P, Pulse, Resp:before and

periodically, if resp < 10/min, dose

may need to be reduced,

oversedation may occur Bond

Status: constipation, provide fluids,

fiber in diet, may need stimulative

laxative Allergic Rxn: rash, urticaria

Cough and Resp.dysfunction:respiratory depression,

character, rate, rhythm Need for

pain medication, physical

dependence, opioid is more

effective before pain is severe

Ance

rosacea/vulgaris,

Cushing's, measles,

perioral dermatitis,

varicella, abrupt

discontinuation,

hypersensitivity to

this product or

benzyl

hypersensitivity

CNS: drowsiness, dizziness,

light-headedness,

confusion, H/A, sedation,

euphoria, dysphoria,

weakness, hallucinations,

disorientation, moodchanges, dependence,

seizures CV: palpitations,


change in B/P,circulatory

depression, syncope;

cardiac arrest (children)

EENT: tinnitus, blurred

vision, miosis, diplopia GI:

nausea, vomiting,


cramps, dry mouth, ulcers

GU: Increased urinary

output, dysuria, urinary

retention INTEG: rash,

urticaria, flushing, pruritus

RESP: resp depression;

pulmonary edema,

bronchopneumonia, resp

arrest (children)


22/34

Medication


Hydrocortisone

Brands: Cortef

decreases inflammation by

suppression of migration of

polymorphonus clear

leukocytes, fibroblasts,

reversal of increased

capillary permeability, and

lysosomal stabilization

Severe inflammation,

septic shock, adrenal

insufficiency, ulcerative

colitis, collagen

disorders

1. Potassium, blood glucose, urine

glucose while on long-term

therapy; hypokalemia and

hyperglycemia; potassium

depletion: paresthesias, fatigue,

nausea, vomiting, depression,polyuria, dysrhythmias, weakness

2. B/P every 4hr, pulse; notify

prescriber if chest pain 3. I&O be

alert for decreasing urinary output,

increasing edema, weight daily,

notify prescriber of weekly gain >5

lbs 4.Adrenal insufficiency

(Cushingoid symptoms): nausea,

anorexia, SOB, moon face, fatigue,

dizziness, weakness, joint pain

before and during treatment 5.

Plasma cortisol levels during long

term therapy (normal level:138-635

nmol/L SI units when drawn at 8

am) 6.Infection:increase temp,

WBC, even after withdrawal of

medication; product masks

infection 7. Mental status: affect

mood, behavioral changes,

aggression

Children < 2yrs,

psychosis,

hypersensitivity,

idiopathic

thrombocytopenia(I

M), acute

glomerulonephritis,

amebiasis, fungal

infections, non-

asthmatic bronchial

disease, AIDS, TB,

recent MI

(associated with left

ventricular rupture)

CNS: depression, flushing,

sweating, H/A, mood

changes CV: hypertension,

circulatory collapse,

thrombophlebitis,

embolism,tachycardia,

edema EENT: fungal

infections, increased

intraocular pressure,

blurred vision GI: diarrhea,

nausea, abdominal

distention, GI hemorrhage,

increased appetite,

pancreatitisHEMA:thrombocytopenia INTEG:

acne, poor wound healing,

ecchymosis, petechiae MS:

fractures, osteoporosis,

weakness


23/34

Medication


Tamoxifen

Citrate/Nolvadex

Competes with estrogen for

binding sites in breast and

other tissues

Reduces DNA synthesis and

estrogen response

Breast Caner in

postmenoposal

women, adjunctively

with surgery in the

treatment of breast

carcinoma with positivelymph nodes

Assess for an increase in bone or

tumor pain. Confer with health

care professional regarding

analgesics. This transient pain

usually resolves despite continued

therapyLab Test Considerations

Monitor CBC, platelets, and

calcium levels before and during

therapy. May cause transient

hypercalcemia in patients with

metastases to the bone. An

estrogen receptor assay should be

assessed before initiation of

therapy

Monitor serum cholesterol and

triglyceride concentrations in

patients with pre-existinghyperlipidemia. May cause

concentrations

Monitor hepatic function tests

and thyroxine (T4) periodically

during therapy. May cause

serum hepatic enzyme and

thyroxine concentrations

Gynecologic examinations

should be performed regularly;

may cause variations in

Papanicolaou and vaginal smearsTop

Anticoagulant

therapy including

coumadin;

preexisting

endometrial

hyperplasia; IM if

platelets 100

mg/m2/cycle once every 34 wk

are rarely used. Differentiate daily

doses from total dose/cycle.

Symptoms of high cumulativedoses include muscle cramps

(localized, painful involuntary

skeletal muscle contractions of

sudden onset and short duration)

and are usually associated with

advanced stages of peripheral

neuropathy

Lab Test Considerations

Monitor CBC with differential

and platelet count before and

routinely throughout therapy. Thenadir of leukopenia,

thrombocytopenia, and anemia

occurs within 1823 days and

recovery 39 days after a dose.

Withhold further doses until WBC

is >4000/mm3 and platelet count

is >100,000/mm3

Monitor BUN, serum creatinine,

and CCr before initiation of

therapy and before each course of

cisplatin to detect nephrotoxicity.

May cause BUN and creatinine

and calcium, magnesium,

phosphate, sodium, and potassium

levels that usually occur the 2nd

wk after a dose. Do not administer

additional doses until BUN is


28/34

Medication


Platinol/Cisplatin cont.

May cause positive Coombs' test

result

Methotrexate/MTX

Interferes with folic acid

metabolism. Result is

inhibition of DNA synthesis

and cell reproduction (cell-

cycle S-phasespecific Also

has immunosuppressive

activity

Severe psoriasis, severe

active rheumatoid

arthritis, breast cancer,

lung cancer, certain

cancers of the headand neck, certain types

of lymphoma, and

leukemia

Monitor CBC and differential priorto and frequently during therapy.

The nadir of leukopenia and

thrombocytopenia occurs in 714

days. Leukocyte and thrombocyte

counts usually recover 7 days after

the nadirs. Notify health care

professional of any sudden drop in

values

Monitor renal (BUN and

creatinine) and hepatic function

(AST, ALT, bilirubin, and LDH) prior

to and routinely during therapy.

Urine pH should be monitored

prior to high-dose methotrexate

therapy and every 6 hr during

leucovorin rescue. Urine pH should

be kept above 7.0 to prevent renal

damage

May cause serum uric acid

concentrations, especially during

initial treatment of leukemia and

lymphoma

Hypersensitivity

OB: Lactation:

Pregnancy or

lactation

Pedi: Products

containing benzyl

alcohol should not

be used in neonates

Use Cautiously in:

Renal impairment

(CCr must be B60

mL/min prior totherapy)

Patients with

childbearing

potential

Active infections

bone marrow

reserve

Geri: May be more

sensitive to toxicity

and adverse events

CNS: arachnoiditis (IT use

only), dizziness,

drowsiness, headache,

malaise.

EENT: blurred vision,

dysarthria transient

blindness.

Resp: PULMONARY

FIBROSIS, intestinal

pneumonitis.

GI: anorexia,

hepatotoxicity, nausea,

stomatitis, vomiting.

GU: infertility.

Derm: alopecia, painfulplaque erosions (during

psoriasis treatment),

photosensitivity, pruritus,

rashes, skin ulceration,

urticaria.

Hemat: APLASTIC ANEMIA,

anemia, leukopenia,

thrombocytopenia.

Metabolic: hyperuricemia.

MS: osteonecrosis, stress

fracture.Misc: nephropathy, chills,

fever, soft tissue necrosis.


29/34

Medication


Vincristine

Binds to proteins of mitotic

spindle, causing metaphase

arrest

Cell replication is stopped as

a result (cell cyclespecific

for M phase)

Has little or no effect on

bone marrow

Hodgkin's disease,Leukemias,

Neuroblastoma,

Malignant lymphomas,

Rhabdomyosarcoma,Wi

lms' tumor, Other

tumors

Monitor blood pressure, pulse,

and respiratory rate during

therapy. Report significant

changes

Monitor neurologic status. Assess

for paresthesia (numbness,

tingling, pain), loss of deep tendonreflexes (Achilles reflex is usually

first involved), weakness (wrist

drop or footdrop, gait

disturbances), cranial nerve palsies

(jaw pain, hoarseness, ptosis,

visual changes), autonomic

dysfunction (ileus, difficulty

voiding, orthostatic hypotension,

impaired sweating), and CNS

dysfunction (decreased level of

consciousness, agitation,hallucinations). Notify physician if

these symptoms develop, as they

may persist for months

Monitor intake and output ratios

and daily weight; report significant

discrepancies. Decreased urine

output with concurrent

hyponatremia may indicate SIADH,

which usually responds to fluid

restriction

Assess infusion site frequently

for redness, irritation, or

inflammation. If extravasation

occurs, infusion must be stopped

and restarted elsewhere to avoid

damage to subcut tissue. Cellulitis

and discomfort may be minimized

by infiltration with hyaluronidase

and application of moderate heat

or by application of cold

compresses

Assess nutritional status. An

antiemetic may be used to

Hypersensitivity

OB: Lactation:

Pregnancy or

lactation

Use Cautiously in:

Infection

bone marrow

reserve

Hepatic

impairment (50%

dose

recommended if

serum bilirubin >3

mg/dL)

OB: Instruct

women of

childbearing

potential to avoid

pregnancy duringtreatment

CNS: agitation, insomnia,

mental depression, mental

status changes.

EENT: cortical blindness,

diplopia.

Resp: bronchospasm.

GI: nausea, vomiting,

abdominal cramps,


ileus, stomatitis.

GU: gonadal suppression,nocturia, oliguria, urinary

retention.

Derm: alopecia.

Endo: syndrome of

inappropriate antidiuretic

hormone (SIADH).

Hemat: anemia,

leukopenia,

thrombocytopenia (mild

and brief).

Local: phlebitis at IV site,

tissue necrosis (from

extravasation).

Metabolic: hyperuricemia.

Neuro: ascending

peripheral neuropathy.


30/34

Medication


Vincristine cont.

minimize nausea and vomiting

Monitor for symptoms of gout

(increased uric acid, joint pain,

edema). Encourage patient to

drink at least 2 liters of fluid per

day. Allopurinol or alkalinization

of urine may be used to decreaseuric acid levels

Lab Test Considerations

Monitor CBC prior to and

periodically throughout therapy.

May cause slight leukopenia 4

days after therapy, which resolves

within 7 days. Platelet count may

or

Monitor liver function studies

(AST, ALT, LDH, bilirubin) and renal

function studies (BUN, creatinine)prior to and periodically

throughout therapy

May cause uric acid. Monitor

periodically during therapy


31/34

Medication


Robaxin

(Methocarbamol)

Depresses multisynaptic

pathways in the spinal cord,

causing skeletal muscle

relaxation.

Adjunct for relief of

spasm and pain in

musculoskeletal

conditions, tetanus.

Pain, spasm: ROM; Blooddyscrasias: CBC, WBC, differential;

EEG in epileptic patients;

Allergic rxns: rash, fever,

respiratory distress; Severe

weakness, numbness in

extremities; Tolerance: increased

need for medication; CNS

depression: dizziness, drowsiness.

Hypersensitivity to

this product;

hypersensitivity to

PEG 300 (inj);

children


32/34

Medication


Decadron

(Dexamethasone)

Decreases inflammation by

suppression of migration of

polymorphonuclear

leukocytes, fibroblasts,

reversal of increased

capillary permeability and

lysosomal stabilization.

Inflammation, allergies,

neoplasms, cerebral

edema, septic shock,

collagen disorders.

Potassium, blood, urine glucosewhile on long-term therapy;

hypokalemia and hyperglycemia;

weight daily: notify MD if weekly

gain>5lb; B/P q4hr, pulse; notify

MD of chest pain; I&O ratio: be

alert for decreasing urinary

output, increasing edema; plasma

cortisol levels during long-term

therapy; infection: fever, WBC

after withdrawal of medicine;

potassium depletion; edema,

hypertension, cardiac symptoms;

mental status.

Children


33/34

Medication


Valium (Diazepam)

Potentiates the actions of

GABA, especially in limbicsystem, reticular formation;

enhances presympathetic

inhibition, inhibits spinal

polysynaptic afferent paths.

Anxiety, acute alcohol

withdrawal, adjunct in

seizure disorders;preoperatively as a

relaxant, skeletal

muscle relaxation;

rectally for acute

repetitive seizures.

B/P (lying+standing): if systolic

drops 20mmHg hold product;

Pulse; Respiratory rate:

respirations q5-15min if given IV;

Blood studies: CBC during long-

term therapy, blood dyscrasias;

Hepatic studies: AST, ALT,

bilirubin, creatinine, LDH, alk phos;

Degree of anxiety; Pain relief; IV

site for thrombosis or phlebitis;

Mental status: mood, sensorium,

affect, suicidal tendencies;

Physical dependency; Withdrawal

symptoms: headache, nausea,

vomiting, muscle pain.

Pregnancy (D),

hypersensitivity to

benzodiazepines,

closed-angle

glaucoma, coma,

myasthenia gravis,

ethanol intoxication,

hepatic disease,

sleep apnea.

Dizziness, drowsiness,

confusion, headache,

anxiety, tremors,

depression, insomnia,

hallucinations, fatigue;

Orthostatic hypotension,

ECG changes, tachycardia,

hypotension; Blurred

vision, tinnitus, mydriasis;

constipation, dry mouth,

NV, diarrhea; Neutropenia;

Rash, dermatitis, itching;

Respiratory depression.

Ancef (Cefazolin)

Inhibits bacterial cell wall

synthesis, rendering cell wall

osmotically unstable, leading

to cell death; lysis mediated

by cell wall autolytic

enzymes.

Gram-negative bacilli:

Haemophilus

influenzae, Escherichia

coli, Proteus mirabilis,

Klebsiella; Gram-

positive organisms:

Staphylococcus aureus;

Upper and lower

respiratory tract,

urinary tract, skin

infections, bone, joint,biliary, genital

infections,

endocarditis, surgical

prophylaxis,

septicemia.

Sensitivity to penicillin and other

cephalosporins; Nephrotoxicity:

increased BUN, creatinine; I&O

daily; Blood studues:AST, ALT,

CBC, Hct, bilirubin, LDH, alk phos;

Electrolytes: K, Na, Cl; Bowel

pattern daily: Urine output;

Anaphylaxis; Bleeding:

ecchymosis, bleeding gums,

hematuria, stool guaiac daily;Overgrowth of infection:perineal

itching, malaise, redness, pain,

swelling, diarrhea, change in

cough, sputum.

Hypersensitivity to

cephalosporins;

infants


34/34

N3515 Medications

Bold and Red life-threatening

Italics - common

ATC Anatomical Therapeutic Chemical (ATC) Classification System

B/P blood pressure

H/A headache

LOC loss of consciousness

N/V nausea & vomiting

Rxn - reactionResp respiratory/respirations

SOB- Shortness of Breath

Abbreviations: N/V: nausea/vomiting. HA: headache. Pt: patient. Mo: month. Incr: increase. Decr: decrease. MI: myocardial infarction. Hx: history. Dx: disease. w/ : with. Wt:

weight. F&E: fluid & electrolytes.

aPTT=activated partial thromboplastin time

AST=aspartate aminotransferase

ALT=alanine aminotransferase

BUN=Blood Urea Nitrogen

CBC=Complete Blood Count

Hct=Hematocrit

Hgb=Hemoglobin

PT=Prothrombin Time

RA=Rheumatoid Arthritis

TIA=transient ischemic attack

MI=Myocardial Infarction

LFT = Liver Function Test

HYPERSENSITIVITY REACTIONS, chills, fever, infection, pain, allergic reactions, flu-like syndrome.

common medication list - moser

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