nursing medication list 2

8/12/2019 Nursing Medication List 2

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Medications: only need the meds YOU give during your shift.

Include PRNs and designate as such.

Drug: astreonam: Azactam Classification: Antibiotic monobactams

Mechanism of action:!inds to bacterial cell "all membrane causing cell death# bactericidal action.

Why is THIS pt taking?: U$I infection lo"er res%iratory infection se%ticemia s&in structure infections cause by '(

bacteria )*.coli +. %neumoniae,

Monitoring parameters: -onitor for ss of ana%hyla/is monitor bo"el function assess res%iratory status obtain

s%ecimen for culture 0 sensitivity assess for infection )vital signs urine a%%earance,

Pt teachingside effects: may cause 1N2 seizures N3 rash diarrhea dizziness headache blurred vision and

rednessdiscomfort%ains"elling at in4ection site.

Drug: clindamycin: 1leocin Classification: antibiotic

Mechanism of action: !actericidal or bacteriostatic

Why is THIS pt taking?: !acterial '( infection

Monitoring parameters: -onitor bo"el elimination diarrhea fever abdominal cram%ing and bloody stools monitor

1!1.

Pt teachingside effects: Instruct %atient to ta&e medication around the cloc& at evenly s%aced times and to

finish the drug com%letely as directed even if feeling better. Notify 51P immediately if 'I issues occur.6izziness headache vertigo arrhythmias hy%otension NI3# %hlebitis at I3 site Pseudomembranous colitis resulting

in diarrhea and bacterial gro"th of 1. difficile during treatment or "ee&s to months after treatment has sto%%ed,.

Drug: 5e%arin )5e%(7oc&, Classification: anticoagulants antithrombotic

Mechanism of action: Prevention of thrombus formation and e/tension of e/isting thrombi

Why is THIS pt taking?: Pro%hyla/is and treatment of venous and %eri%heral arterial thromboembolism

Monitoring parameters: Assess for signs of bleeding and hemorrhage )bleeding gums# nosebleed# unusual bruising#

blac& tatty stools# hematuria# fall in hematocrit or !P# guaiac %ositive stools,. -onitor for %atient for hy%ersensitivity

reactions )chills fever urticarial,. -ay cause hy%er&alemia and 8 A2$ and A7$ levels# monitor for Platelet

count.

Pt teachingside effects: Advise %atient to re%ort any sym%toms of unusual bleeding or bruising to health

care A2AP. Instruct %atient not to ta&e medications containing as%irin or N2AI6s "hile on he%arin

thera%y. *ffect: !leeding he%arin(induced thrombocyto%enia )5I$, )"ith or "ithout thrombosis, anemia %ain in

in4ection site osteo%orosis )long term, and fever hy%ersensitivity.

Drug: acetamino%hen9$ylenol Classification: Non(o%ioid analgesic anti%yretics

Mechanism of action: Inhibits the synthesis of %rostaglandins that may serve as mediators of %ain and fever

%rimary in the 1N2. It has no significant anti(inflammatory %ro%erties or 'I to/icity.

Why is THIS pt taking?: Pain and fever

Monitoring parameters: Assess liver function# assess %ain ty%e location and intensity %rior to and after ;(


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Pt teachingside effects: Advise %atient to ta&e medication as directed and to avoid alcohol or avoid ta&ing it

concurrently "ith salicylates or other N2AI62 for more than a fe" days. 2ide effects: an/iety headache fatigue

insomnia s&in rash anemia %ancyto%enia ne%hroto/ic he%ato/icity )if overdose# antidote is acetyl cysteine

)Acetadote,. Patients "ith diabetes that acetamino%hen may alter results of blood glucose

monitoringagitation an/iety headache fatigue insomnia atelectasis dys%nea hy%erhy%otension

he%atoto/icity consti%ation.

Drug: meto%rolol9 7o%ressor Classification: antianginals antihy%ertensive beta bloc&ers

Mechanism of action: !loc&s stimulation of beta= )myocardial,(adrenergic rece%tors. It decreased !P and heart

rate# decreased fre>uency of attac&s of angina %ectoris.

Why is THIS pt taking?: to decrease his cardiac "or&load )!P5R, and%revention of -I.

Monitoring parameters: : Instruct %atientto ta&e medication as directed# Assess and monitor !P# *1' and

%ulse fre>uency during dose ad4ustment and %eriodically during thera%y. -onitor 3ital signs and *1' every ?(=? min

during and for several hours after %arenteral administration. 5old if heart rate is less than


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Drug: %olyethylene glycol ) 'lycola/ -irala/, Classification: osmotic la/ative

Mechanism of action: Polyethylene glycol )P*', in solution. Acts as an osmotic agent dra"ing "ater into the lumen

of the 'I tract# evacuation of the 'I tract "ithout "ater or electrolyte imbalance.

Why is THIS pt taking?: $reatment of occasional consti%ation

Monitoring parameters: Assess %atient for abdominal distention %resence of bo"el sounds and usual %attern of

bo"el function# assess color consistency and amount of stool %roduced.5old if diarrhea!

Pt teachingside effects: Notify healthcare %rovider for the follo"ing adverse effects: urticarial abdominal

bloating cram%ing flatulence and nausea.

Drug:docusate sodium )1olace 1orrectol 2ilace, Classification:la/atives stool softeners

Mechanism of action:2oftening and %assage of stool.

Why is THIS pt taking?:1onsti%ation

Monitoring parameters:Inform %atient that @(D days may be re>uired to %roduce a bo"el movement#

Assess for abdominal distention %resence of bo"el sounds and usual %attern of bo"el function. Assess

color consistency and amount of stool %roduced.

Pt teachingside effects:Advise %atients that la/atives should be used only for short(term thera%y.

*ncourage %atients to use other forms of bo"el regulation such as increasing bul& in diet. Advise %atient

not to use la/atives "hen abdominal %ain nausea vomiting or fever is %resent. Advise %atient not to ta&e

medication "ithin @hrsofother la/atives. Notify healthcare %rovider of the follo"ing adverse effects: throat

irritation mild cram%s diarrhea and rashes.

Drug: Bol%idem9 Ambien Classification: sedativehy%notics

Mechanism of action: Produces 1N2 de%ression by binding to 'A!A rece%tors# sedation and induction of slee%.

Why is THIS pt taking?: Insomnia

Monitoring parameters: Assess mental status slee% %atterns and %otential for abuse %rior to administration.

Assess %atient for %ain alertness at time of %ea& effect notify %rovider if desired sedation does not occur.

Pt teachingside effects:6aytime dro"siness dizziness abnormal thin&ing amnesia behavior changes EdruggedF

feeling hallucinations N3 ana%hylactic reactions hy%ersensitivity reactions and tolerance.

Drug: 5ydrocortisone91ortef Classification: antiasthmatics# corticosteroids )systemic,

Mechanism of action: 2u%%ress inflammation and the normal immune res%onse# su%%ress adrenal function at

chronic doses.

Why is THIS pt taking?: -anagement of adrenocortical insufficiencysu%%ression of inflammation and modificationof the normal immune res%onse.

Monitoring parameters: Assess for signs of adrenal insufficiency )hy%otension "eight loss "ea&ness nv

anore/ia lethargy confusion restlessness, before and %eriodically during thera%y. -onitor IO ratios and daily "t.

Observe %atient for %eri%heral edema ralescrac&les or dys%nea. Assess sym%toms of ulcerative colitis guaiac(test

stools# su%%ress reactions to allergy s&in test.

Pt teachingside effects: 6e%ression eu%horia headache %ersonality changes restlessness cataracts %e%tic


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ulceration anore/ia nv decrease "ound healing ecchymosis fragility adrenal su%%ression fluid retention

hy%o&alemia hy%o&alemic al&alosis thromboembolism increase susce%tibility to infection.

Drug: "spirin other: #cotrin Classification: $hera%eutic: anti%yretics non(o%ioid

analgesics Pharmacologic: salicylates

Mechanism of action: Irreversibly inhibits cycloo/ygenase(= and @ )1OG(= and @, enzymes viaacetylation "hich results in decreased formation of %rostaglandin %recursors# irreversibly inhibits

formation of %rostaglandin derivative thrombo/ane A@ via acetylation of %latelet cycloo/ygenase thus

inhibiting %latelet aggregation.

Why is THIS pt taking?: Pro%hyla/is to %revent recurrence of his myocardial infarction also reduces his

blood clotting )thrombi formation,.

Monitoring parameters: -onitor for ss of 'I u%set and bleedingbruising liver /.

Pt teachingside effects: Instruct %atient to ta&e "ith a full glass of "ater and in u%right %osition )if

%ossible, for =?(; minutes after administration. 7imit alcohol use to decrease gastric irritation. Advise

health care %rofessionals of medication use %rior to surgery. 2ide *ffects: hearing loss tinnitus 'I

bleeding dys%e%sia e%igastric distress heartburn nausea increased bleeding time.

Drug: 7asi/ )furosemide, Classification: thera%eutic: diuretics %harmacologic: loo% diuretics

Mechanism of action: Inhibits the reabsor%tion of sodium and chloride from the loo% of 5enle and distal

renal tubule. Increases renal e/cretion of "ater sodium chloride magnesium %otassium and calcium.

Why is THIS pt taking?: Increase urine out%ut )diuresis, "hile ridding the body of e/cess fluid to

decrease his cardiac "or&load.

Monitoring parameters: Assess fluid status during thera%y )daily "eight IO amount and location of

edema lung sounds s&in turgor mucous membranes. Assess elderly for fall ris&. Assess for tinnitus and

hearing loss. -onitor electrolytes renal and he%atic function serum glucose and uric acid. -onitor serum%otassium calcium magnesium !UN serum glucose creatinine and uric acid levels.

Pt teachingside effects: Instruct %atient to ta&e as directed. 1onsult health care %rofessional regarding

a diet high in %otassium. 1hange %ositions slo"ly to minimize orthostatic hy%otension may cause

dizziness. 2ide *ffects ( fluid and electrolytes: dehydration hy%ochloremia hy%o&alemia

hy%omagnesemia hy%onatremia hy%ovolemia metabolic al&alosis# life threatening: 2tevens(Hohnson

syndrome to/ic e%idermal necrolysis a%lastic anemia agranulocytosis.

Drug: lisino%ril )Bestril, Classification: thera%eutic: antihy%ertensive %harmacologic: A1*(Inhibitor

Mechanism of action: !loc&s the formation of angiotensin II and inhibits the brea&do"n of brady&inin

)vasodilator,. $he anti(hy%ertensive action of A1* inhibitors is %rimarily caused by a reduction in

%ulmonary vascular resistance )P3R, decreasing both arterial and venous %ressure. !y reducing

angiotensin(stimulated aldosterone secretion A1* inhibitors %revent the com%ensatory increase in Na

retention and %lasma volume seen "ith other agents. In %atients treated "ith A1* inhibitors renal Na

retention is decreased "hereas renal + retention is increased.

Why is THIS pt taking?: A1*(I vasodilation decreases his cardiac "or&load# lo"ers !P and treats 15

Monitoring parameters: -onitor !P %ulse "eight edema lung sounds )rales crac&les, dys%nea


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A2$A7$ increases H36. -onitor !UN and creatinine for renal function and electrolyte levels %eriodically.

2erum %otassium !UN and creatinine may be 8 "hereas sodium levels may be J.

Pt teachingside effects: 1hange %osition slo"ly avoid O$1 cough meds that can raise blood %ressure

additional interventions for hy%ertension )lo" salt e/ercise"eight loss no smo&ing lo" stress, monitor

!P %eriodically. 2ide effects: the most common side effect of A1* inhibitors is a dry non%roductive cough

)@;K of %atients, caused by increased brady&inin levels. 1ause fetal and neonatal morbidity and mortality"hen administered to %regnant "omen. Rash first dose hy%otension cough hy%er&alemia renal failure

dizzy fatigue headache.

Drug: magnesium chloride )-A' delay, Classification: mineral and electrolyte

re%lacementssu%%lements

Mechanism of action: *ssential for the activity of many enzymes# im%ortant role in neurotransmission

and muscular e/citability.

Why is THIS pt taking?: $o treat or %revent hy%omagnesemia# treats hy%otension and consti%ation.

Monitoring parameters: 3ital signs and labs

Pt teachingside effects: 6o not crush %ill it is time released. 1onsult %rescriber before using

magnesium if heLs ta&ing other drugs. -agnesium may delay or enhance absor%tion of other drugs. 2ide

effects: Abru%t elevation of %lasma -g can remove the stimulus for -g retention and lead to increased

e/cretion# 6iarrhea# 6rug interactions# -agnesium into/ication Aluminum into/ication.

Drug: %i%eracillintazobactam )Bosyn, Classification: anti(infectives 0 e/tended s%ectrum %enicillins

Mechanism of action:Pi%eracillin: !inds to bacterial cell "all membrane causing cell death. 2%ectrum is

e/tended com%ared "ith other %enicillins. $azobactam: Inhibits beta(lactamase an enzyme that can

destroy %enicillins.

Why is THIS pt taking?: -anagement of sus%ected %neumonia.

Monitoring parameters:Assess %atient for infection at beginning of and during thera%y )vital signs,.

Obtain a history before initiating thera%y to determine %revious use of and reactions to %enicillins or

ce%halos%orins. Observe %atient for signs and sym%toms of ana%hyla/is )rash %ruritus laryngeal edema

"heezing,. *valuate renal and he%atic function 1!1 serum %otassium and bleeding times %rior to and

routinely during thera%y.

Pt teachingside effects:Advise %atient to re%ort signs of su%erinfection )blac& furry overgro"th on

tongue vaginal itching or discharge loose or foul(smelling stools, and allergy. 1aution %atient to notify

health care %rofessional if fever and diarrhea occur es%ecially if stool contains blood %us or mucus.

Advise %atient not to treat diarrhea "ithout consulting health care %rofessional. -ay occur u% to several

"ee&s after discontinuation of medication. 2ide effects: diarrhea rashes %ain and %hlebitis at I3 site M lifethreatening: %seudomembranous colitis seizures ana%hyla/is and serum sic&ness.

Drug:%regabalin )7yrica, Classification:thera%eutic: analgestic anticonvulsant mood

stabilizer

Pharmacologic: 'A!A analogues non(o%ioid analgesic

Mechanism of action:!inds to calcium channels in 1N2 tissues "hich regulate neurotransmitter

release. 6oes not bind to o%ioid rece%tors. $hera%eutic *ffects: 6ecreased neuro%athic or %ost(her%etic


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%ain. 6ecreased %artial(onset seizures.

Why is THIS pt taking?: 5e is ta&ing this for %ain management.

Monitoring parameters:-onitor for and %rom%tly re%ort mental status or behavior changes. -onitor for

"eight gain %er%heral edema and 22 of heart failure es%ecially " concurrent thiazolidinedione thera%y.

-onitor baseline and %eriodic &idney f/n tests# %eriodic %latelet counts. -onitor diabetics for increasedincidences of hy%oglycemia. 2u%ervise ambulation es%ecially "hen other 1N2 drugs are used

concurrently.

Pt teachingside effects:6o not discontinue abru%tly# may cause insomnia nausea headache or

diarrhea. -ay cause dizziness dro"siness and blurred vision. Avoid driving or activities re>uiring

alertness until res%onse to medication is &no"n. Notify health care %rofessional if changes in vision occur.

Prom%tly re%ort une/%lained muscle %ain tenderness or "ea&ness es%ecially if accom%anied by malaise

or fever. Notify health care %rofessional if thoughts about suicide or other unusual changes in behavior or

mood occur. -ay cause edema and "eight gain. Avoid alcohol or other 1N2 de%ressants. Notify health

care %rofessional of medication regimen before treatment or surgery. 1arry identification describing

disease %rocess and medication regimen at all times. 2ide effects: 2UI1I6A7 $5OU'5$2 dizziness

dro"siness im%aired attentionconcentrationthin&ing# edema# blurred vision# dry mouth abdominal %ainconsti%ation 8 a%%etite vomiting# thrombocyto%enia# "eight gain# allergic reactions fever.

Drug: sertraline $%oloft& Classification:antide%ressants# selective serotonin reu%ta&e inhibitors

)22RIs,

Mechanism of action:Inhibits neuronal u%ta&e of serotonin in the 1N2 thus %otentiating the activity of

serotonin. 5as little effect on nore%ine%hrine or do%amine. $hera%eutic *ffects: Antide%ressant action.

6ecreased incidence of %anic attac&s. 6ecreased obsessive and com%ulsive behavior. 6ecreased

feelings of intense fear hel%lessness or horror. 6ecreased social an/iety. 6ecrease in %remenstrual

dys%horia.

Why is THIS pt taking?: 6e%ression

Monitoring parameters:-onitor mood suicidal tendencies a%%etite nutritional inta&e "ee&ly "eights

fre> of O16 behaviors fre> of %anic attac&s sym%toms of fear hel%lessness 0 horror blushing

s"eating trembling tachycardia during social interactions feeling angry tense tired crying easily sad or

ho%eless arguing for no reason.

Pt teachingside effects:$he drug "ill achieve ma/imum effectiveness after several "ee&s of thera%y.

6o not abru%tly sto% medication. Notify health care %rofessional immediately if you have thoughts about

suicide. 2ide effects: dizziness dro"siness fatigue headache insomnia diarrhea dry mouth nausea

se/ual dysfunction increased s"eating tremor# life threatening: N*URO7*P$I1 -A7I'NAN$

2YN6RO-* 2UI1I6A7 $5OU'5$2 2*RO$ONIN 2YN6RO-*.

Drug:%otassium chloride )+lor(1on, Classification:$hera%eutic: mineral and electrolyte

re%lacementsu%%lement

Mechanism of action:-aintain acid(base balance isotonicity and electro%hysiologic balance of the cell.

*ssential to transmission of nerve im%ulses# contraction of cardiac s&eletal and smooth muscle# gastric

secretion# renal function# tissue synthesis# and carb metabolism.

Why is THIS pt taking?: 5e is ta&ing this because his %otassium lab results "ere lo".


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Monitoring parameters:-onitor for 22 of hy%o&alemia )"ea&ness fatigue arrhythmias %olyuria

%olydi%sia, and hy%er&alemia. -onitor %ulse !P and *1'. 7abs: %otassium before and during. Renal

function bicarbonate and %5. -agnesium levels and chloride levels. -onitor for to/icity and overdose

)slo" irregular heart rate fatigue muscle "ea&ness,.

Pt teachingside effects:$a&e as directed es%ecially "hen concurrent digo/in or diuretics are ta&en. A

missed dose should be ta&en as soon as remembered "ithin @ hr# if not return to regular dose schedule.6o not double dose. 'I irritation or ulceration may result from che"ing enteric(coated tablets or

insufficient dilution of li>uid or %o"der forms. Avoid salt substitutes or lo"(salt mil& or food unless

a%%roved by health care %rofessional. Read all labels to %revent e/cess %otassium inta&e. $each

%otassium food sources. 1om%ly "ith recommended diet. Re%ort dar& tarry or bloody stools# "ea&ness#

unusual fatigue# or tingling of e/tremities. Notify health care %rofessional if nausea vomiting diarrhea or

stomach discomfort %ersists. Regular follo"(u% e/ams are im%ortant to monitor serum levels and

%rogress. 2ide effects: confusion restlessness "ea&ness ab %ain diarrhea gas nv# life threatening:

ARR5Y$5-IA2.

6rug: Albuterol 2ulfate: Proventil 5A inhaler 1lassification: !ronchodilator adrenergic

-echanism of action: !inds to beta@(adrenergic rece%tors# bronchodilator that rela/es musclesin the air"ays and increases air flo" to the lungs.

hy is $5I2 %t ta&ing: heezing

-onitoring %arameters: Assess lung sounds %ulse and !P before administering and during

%ea& of medication. Note amount color and character of s%utum %roduced# monitor %ulmonary

function tests before initiating thera%y and %eriodically# observe for %arado/ical bronchos%asm

)"heezing,

Pt teachingside effects: Instruct %atient to ta&e albuterol doses as directed not double doses or

increase fre>uency of doses. Advise %atient to rinse mouth "ith "ater after each use tominimize dry mouth and clean mouth%iece "ith "ater at least once a "ee&. 2ide effects:

Nervousness restlessness headache insomnia heezing chest %ain %al%itations angina

arrhythmias hy%ertension nv hy%erglycemia hy%o&alemia and tremors.

Drug: diltia'em Cardi'em $other Dilacor( Tia'ac& Classification: antianginals(anti(arrhythmic

antihy%ertensive Pharmacologic: calcium channel bloc&ers

Mechanism of action: systemic vasodilation resulting in decreased !P. 1oronary vasodilation resulting in

decreased fre>uency and severity of attac&s of angina# Reduction of ventricular rate in atrial fibrillation or

flutter.

Why is THIS pt taking? 5y%ertension Angina and A(ib

Monitoring parameters: -onitor !P and %ulse %rior to thera%y and %eriodically# -onitor *1'

%eriodically# may cause %rolonged PR interval. -onitor IO ratios and daily "eight. Assess for signs of 5

)%eri%heral edema ralescrac&les dys%nea "t. gain 4ugular venous distention,. Assess for rash

%eriodically during thera%y# 6iscontinue if severe or accom%anied "ith fever general malaise fatigue

oral lesions blisters he%atitis andor eosino%hilia.

Pt teachingside effects: Advise %atient to ta&e medication as directed at same time each day even if


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feeling "ell do not double doses discontinued gradually avoid large amounts of gra%efruit 4uiceday

during thera%y and monitor %ulse change %ositions slo"ly to minimize orthostatic hy%otension avoid

alcohol O$1 med vitamins or herbal %roducts.Side #ffects: %eri%heral edema bradycardia chest %ain

hy%otension %al%itations synco%e tachycardia increase liver enzymes anore/ia consti%ation diarrhea

dry mouth dys%e%sia N3 dysuria nocturia %olyuria 2tevens(Hohnsons syndrome dermatitis flushing

s"eating rash hy%erglycemia "eight gain muscle cram%s %aresthesia tremor gingival hy%er%lasia.

6rug: 5ydrocodoneAcetamino%hen )Norco 7ortab Bydone., 1lassification: O%ioid

analgesics

-echanism of action: 6ecrease in severity of moderate %ain 0 su%%ression of the cough refle/

hy is $5I2 %t ta&ing Pain management

-onitoring %arameters: Assess ty%e location and intensity of %ain %rior to and = hr. after

administration.

Assess !P %ulse and res%irations before and %eriodically during administration. Assess level

of sedation.

-onitor for he%atic to/icity liver function.

Pt teachingside effects: Advise %atient to ta&e medications as directed and not to ta&e more

than the recommended amount. 2evere and %ermanent liver damage may result from %rolonged

use or high doses of acetamino%hen or ibu%rofen. Advise %atient to change %ositions slo"ly to

minimize orthostatic hy%otension. -ay cause dro"siness or dizziness call for assistance "hen

ambulating 0 &ee% good oral hygiene. 2ide *ffects: confusion dizziness sedation eu%horia

hallucinations headache res%iratory de%ression hy%otension bradycardia consti%ation

dys%e%sia nausea vomiting 0 tolerance.

Drug: losartan )1ozaar, Classification: Antihy%ertensive) angiotensin rece%tor bloc&ers

)AR!s,

Mechanism of action: !loc&s vasoconstrictor and aldosterone(%roducing effects of angiotensin II at

rece%tor sites including vascular smooth muscle and adrenal glands. $hera%eutic: 7o"ers !P. 2lo"ed

%rogression of diabetic ne%hro%athy. 6ecreased ris& of stro&e in %atients "ith hy%ertension and left

ventricular hy%ertro%hy.

Why is THIS pt taking? or hy%ertension to %revent stro&e and left ventricular hy%ertro%hy

Monitoring parameters: -onitor %otassium )hy%er&alemia, !UN and serum creatinine may be

elevated. assess for signs of angioedema )dys%nea facial s"elling, rarely though monitor daily "eightand resolution of fluid overload )crac&les dys%nea 4ugular venous distention,# may cause increase uric

acid slight decrease in hemoglobin and hematocrit neutro%enia and thrombocyto%enia. -onitor renal

function and electrolyte levels %eriodically.

Pt teachingside effects: instruct %atient to notify %rovider if s"elling of face eyes li%s or tongue

occurs or difficulty s"allo"ing or breathing. Instruct %atient and family on %ro%er techni>ue for monitoring

!P. Advise them to chec& !P at least "ee&ly and to re%ort significant changes. 1aution %atient to avoid

sudden changes in %osition to decrease orthostatic hy%otension# may cause dizziness no driving avoid


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salt substitutes containing %otassium or sodium in high >uantities unless directed by %hysician. arn

%atient not to discontinue thera%y unless directed encourage %atient to com%ly "ith additional

interventions for hy%ertension )"t. reduction lo" sodium diet 61 smo&ing or alcohol use regular

e/ercise stress management,. Re%ort any O$1 %roducts being ta&en es%ecially cough cold or allergy

remedies.

Drug: montelukast $Singulair& P*+ Classification:Allergy cold 0 cough remediesbronchodilators

7eu&otriene antagonist

Mechanism of action: It bloc&s the binding of some leu&otrienes to cells that cause inflammation#

6ecrease severity of acute asthma and allergic rhinitis.

Why is THIS pt taking? Patient ta&ing it for asthma and allergic rhinitis

Monitoring parameters: assess lung sounds and res%iratory function %rior to and %eriodically duringthera%y# assess allergy sym%toms )rhinitis con4unctivitis hives, before and %eriodically monitor closely

for changes in behavior that could indicate the emergence or "orsening of de%ression or suicidal

thoughts.

Pt teachingside effects: instruct %atient to ta&e medication daily in the evening even if not e/%eriencing

sym%toms of asthma. 6o not double doses discontinue thera%y "ithout consulting %rovider it is not used

to treat acute asthma attac&s but may be continued during an acute e/acerbation. Patient should carry

ra%id(acting thera%y for bronchos%asm at all times. Side #ffects: suicidal thoughts agitation aggression

an/iety de%ression disorientation headache fatigue insomnia irritability "ea&ness rash eosino%hilic

conditions including 1hurg(2trauss syndrome fever.

Drug: modafinil9Provigil Classification: central nervous system stimulants

Mechanism of action: %roduces 1N2 stimulation# Im%roves "a&efulness in %atients "ith e/cessive

daytime dro"siness due to narcole%sy 0 obstructive slee% a%nea.

Why is THIS pt taking? Pt is slee%y and needs to be stimulated to stay a"a&e during the day

Monitoring parameters: observe and document fre>uency of narcole%tic e%isodes )brain disorder

involving %oor control of slee%("a&e(cycles, monitor for ss of angioedema or ana%hyla/is )s"elling on

face, elevated liver enzymes and changes in behavior that "ould indicate the emergence or "orsening

of suicidal thoughts or de%ression assess for rash %eriodically during thera%y and discontinue if severe or

accom%anied "ith fever general malaise fatigue muscle or 4oint aches oral lesions blisters

con4unctivitis he%atitis and or eosino%hilia occurs.

Pt teachingside effects: Instruct %atient to ta&e medication as directed# medication may im%air

4udgment encourage %atient and family to be alert for emergence of an/iety agitation %anic attac&s

insomnia irritability hostility im%ulsivity hy%omania mania "orsening of de%ression and suicidal

ideation# assess ss on a day to day basis as changes may be abru%t and notify %rovider if rash or

sym%toms of ana%hyla/is occur.Side #ffects: suicidal ideation headache aggression amnesia

an/iety cata%le/y confusion delusion de%ression dizziness hallucinations insomnia seizures rhinitis

e%ista/is %haryngitis dys%nea lung disorder arrhythmias chest %ain hy%ertension hy%otension


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synco%e vasodilation increase liver enzymes nausea anore/ia mouth ulcers thirst vomiting urinary

retention hy%erglycemia nec& %ain tremor and infection.

Drug: pento'ifylline $Trental& Classification: anti%latelet

Mechanism of action: !ound to erythrocyte membrane# it inhibits %hos%hodiesterase resultanting in the

increase in cyclic A-P in red blood cells reduces blood viscosity due to decreased %lasma fibrinogenconcentrations and inhibition of red blood cell and %latelet aggregation.

Why is THIS pt taking? or treatment of intermittent claudication caused by %eri%heral artery disease0

%romoting healing of stasis ulcers associated "ith venous insufficiency

Monitoring parameters: monitor 5eart beat if fast heartbeat and co chest %ain call %rovider

immediately.

Pt teachingside effects: 6o not ta&e double dose# ta&e %ento/ifylline "ith meals to %revent u%set

stomach. 1ommon adverse effects include nausea vomiting dizziness headache diarrhea blurred

vision agitation insomnia and dro"siness. Rarely %atients may e/%erience abnormal heartbeats

elevation of liver function test 4aundice and he%atitis.

Drug: ampicillin $Sul,actam& Classification: anti(infectives# amino%enicillinbeta lactamase

inhibitors

Mechanism of action: binds to bacterial cell "all resulting in cell death# bactericidal action.

Why is THIS pt taking? Patient is ta&ing it for %ro%hyla/is for s&in structure infection rt surgery# soft

tissues intra(abdominal res%iratory 0 'I infection.

Monitoring parameters: Assess %atient for infection )vital signs "ound a%%earance s%utum urine

stool and !1s, at beginning and throughout thera%y# -onitor A2$ A7$ 765 bilirubin al&aline

%hos%hatase !UN and creatinine.

Pt teachingside effects:Advice %atient to re%ort signs of su%er infection )furry overgro"th on the

tongue foul smelling stools and allergy.Side #ffects: seizures %seudomembranous colitis diarrhea nv

rashes urticarial blood dyscrasias %ain at I- site %ain at I3 site allergic reactions including ana%hyla/is

and serum sic&ness su%er(infection elevated liver enzymes.

Drug: hydromorphone $Dilaudid& Classification: opioid analgesics )antitussives, o%ioid

agonist

Mechanism of action: binds to o%iate rece%tors in the 1N2. Alters the %erce%tion of and res%onse to

%ainful stimuli "hile %roducing generalized 1N2 de%ression# su%%resses the cough refle/ via a direct

central action.

Why is THIS pt taking?$he decrease in moderate to severe %ain 0 su%%ression of cough

Monitoring parameters: Assess !P Pulse 0 res%irations before and %eriodically during administration#

assess ty%e location and intensity of %ain %rior to and = hr. after PO or ? mins after I3

administration.

Pt teachingside effects: Instruct %atient on ho" and "hen to as& for %ain medication# change %ositions

slo"ly to minimize orthostatic hy%otension encourage %atient to turn cough and breathe dee%ly every
http://www.medicinenet.com/heart_rhythm_disorders/article.htmhttp://www.medicinenet.com/heart_rhythm_disorders/article.htmhttp://www.medicinenet.com/heart_rhythm_disorders/article.htmhttp://www.medicinenet.com/heart_rhythm_disorders/article.htm


11/22

t"o hours to %revent atelectasis. 2ide effects: confusion sedation dizziness dys%horia eu%horia

floating feeling hallucinations headache blurred vision res%iration de%ression hy%otension and

consti%ation.

Drug: le-oflo.acin $/e-a0uin& Classification: anti(infectives# fluoro>uinolones

Mechanism of action: Inhibits bacterial 6NA synthesis by inhibiting 6NA gyrase: 6eath of susce%tiblebacteria broad activity includes many gram %athogens.

Why is THIS pt taking? or s&in and s&in structure infection rt surgery other: res%. tract bone and 4oint

infection.

Monitoring parameters: assess for infection )vital signs a%%earance of "ound s%utum urine and stool#

!1 urinalysis fre>uency and urgency of urination cloudy or foul smelling urine and %rior and during

thera%y. Obtain s%ecimens for culture and sensitivity before initiating thera%y.-onitor !o"el function

diarrhea abdominal cram%ing fever bloody stools should be re%orted to %hysician %rom%tly as a sign of

1. diff. ss of ana%hyla/is )rash "heezing laryngeal edema, &ee% e%ine%hrine and antihistamine close

by in case of ana%hylactic e%isode.

Pt teachingside effects: Instruct the %atient to ta&e medications as directed at evenly s%aced times and

to finish drug com%letely even "hen feeling better do not double dose notify %rovider if ta&ing

theo%hylline advise %t. that antacids or med containing iron or zinc "ill decrease absor%tion. Notify

%rovidr if C$ %rolongation or %roarrhythmic conditions such as recent hy%o&alemia significant

bradycardia or recent -I or fainting s%ells or %al%itations occur. Notify %rovider if su%er infection )furry

overgro"th on tongue foul smelling stool occurs. As "ell as rashes 4aundice %ain s"elling occurs. Side

effects:elevated intracranial %ressure seizure dizziness headache insomnia acute %sychoses

agitation confusion de%ression dro"siness tremor C$ %rologation vasodilation he%atoto/ity diarrhea

nausea abdominal %ain increase liver enzymes hy%oglycemia %hlebitis at I3 site tendinitis

hy%ersensitivity reactions.

Drug: Clopidogrel Pla-i. Classification: anti%latelet agent %latelet aggregationinhibitor

Mechanism of action:inhibits %latelet aggregation by irreversibly inhibiting the binding of A$P to %latelet

rece%tors.

Why is THIS pt taking? Reduction of atherosclerotic events rt -I acute coronary syndrome unstable

angina stro&e and P36

Monitoring parameters: assess %atient for sym%toms of stro&e P36 -I %eriodically during thera%y.

-onitor for signs of thrombocyto%enia neurologic findings fever etc. 7ab test: bleeding time during

thera%y# 1!1 "ith differential and %latelet count %eriodically# -ay cause increase of bilirubin he%atic

enzymes total cholesterol non%rotein nitrogen and uric acid concentrations.

Pt teachingside effects: advise %atient to notify %rovider %rom%tly if fever chills sore throat or unusual

bleeding or bruising occurs also any R/ or O$1 medications herbal vitamins %roducts ta&en! Side

effects: de%ression dizziness fatigue headache e%ista/is cough dys%nea chest %ain edema

hy%ertension bleeding abdominal %ain diarrhea dys%e%sia gastritis %ruritis %ur%ura rash

neutro%enia thrombotic thrombocyto%enic %ur%ura hy%ercholesterolemia arthralgia bac& %ain fever

hy%ersensitivity reaction.


12/22

Drug: Bylo%rimallo%urinol Classification: Anti(gout agents antihy%er(uricemics

Mechanism of action: Inhibits %roduction of uric acid by inhibiting the action of /anthine o/idase.

Why is THIS pt taking?: Prevention of attac& of gouty arthritis# to %revent ne%hro%athy.

Monitoring parameters: IO(+idney failure monitor 4oint for %ain and s"elling !2

Pt teachingside effects: 6rin& lots of fluid "ith %ill ta&e "ith a meal may be crushed if cannot s"allo"

"hole rash hy%otension bradycardia diarrhea flushing and dro"siness.

-ore meds-egan

Drug: 7i%itoratorvastatin Classification: li%id(lo"ering agents

Mechanism of action: Inhibit the enzyme 5-'(1oA reductase that is res%onsible for catalyzing an early

ste% in the synthesis of cholesterol.

Why is THIS pt taking?: 5as multi%le ris& factors for coronary heart disease.

Monitoring parameters: *valuate cholesterol and triglyceride levels monitor liver function test muscle

tenderness and 1+ levels.

Pt teachingside effects: Notify us if une/%lained muscle %ain tenderness or "ea&ness occurs

es%ecially "ith feverabdominal cram%s consti%ation diarrhea flatus heartburn rashes.

Drug: Rocaltrolcalcitriol Classification: fat(souble vitamins

Mechanism of action: Promotes the absor%tion of 1a 0 decreased %arathyroid hormone

concentrations

Why is THIS pt taking?: Prevention or treatment of secondary hy%er%arathyroidism for 1+6.

Monitoring parameters: Assess for bone %ain 0 "ea&ness hy%ercalcemia hy%er%hos%hatemia.

Pt teachingside effects: 6o not e/ceed R6A avoid concurrent use for antacids containing magnesium

6izziness malaise dys%nea.

Drug: car-edilol)Coreg& Classification: antihy%ertensivesbeta bloc&er

Mechanism of action: !loc&s stimulation of beta= and beta @ rece%tor sites. It decreases heart rate and

!P. Im%roved cardiac out%ut slo"s the %rogression of 5 and decreased ris& of death.

Why is THIS pt taking? Patient has 15 and hy%ertension.

Monitoring parameters: -onitor !P 5R IOs 0 daily "eights along "ith !2. . 1hec& %ulse and !P

before ta&ing the medication hold meds if 5R


13/22

Drug: Neurotingaba%entin Classification: analgesic ad4uncts mood stabilizer thera%eutic

anti(convulsant

Mechanism of action: not &no"n may affect trans%ort of amino acid across and stabilze neuronal

membranes

Drug: Ativanloraze%am Classification: anesthetic ad4uncts anti(an/iety agents sedative hy%notic

Mechanism of action: 6e%resses the 1N2 %otentiating 'A!A

Why is THIS pt taking?: Restlessness and to hel% him slee%.

Monitoring parameters: 1N2 reactions an/iety and s

Why is THIS pt taking?: Used to relieve neuro%athic %ain

Monitoring parameters: 1hanges in behavior seizures %ain )location intensity ty%e,

Pt teachingside effects: 6o not ta&e med "ithin @ hours of ta&ing antacid. Notify 51P if thoughts of

suicide or an/iety "orsen 1onfusion ata/ia de%ression 0 dro"siness.

Pt teachingside effects: $a%er off of the med to decrease "ithdra"al sym%toms avoid *$O5 "hile

ta&ing the med 6izziness dro"siness and lethargy.

Drug:citalo%ram )1ele/a, Classification:antide%ressants selective serotonin reu%ta&e

inhibitors )22RIs,

Mechanism of action:Antide%ressant action.

Why is THIS pt taking?:6e%ression

Monitoring parameters:Assess for suicidal tendencies es%ecially during early thera%y and dose

changes. Assess for serotonin syndrome. -onitor mood changes during thera%y.

Pt teachingside effects:Instruct %atient to ta&e medication as directed. 1aution %atient to change

%ositions slo"ly to minimize dizziness. Advise %atient family and caregivers to loo& for suicidality

es%ecially during early thera%y or dose changes. Notify the healthcare %rovider for the follo"ing adverse

effects: neurole%tic malignant syndrome suicidal thoughts a%athy confusion dro"siness insomnia

"ea&ness abdominal %ain anore/ia diarrhea dry mouth dys%e%sia flatulence increased saliva

nausea s"eating and tremor.

Drug: 1ytotecmiso%rostol Classification: antiulcer agents

Mechanism of action: Acts as %rostaglandin analogue decreasing gastric acid secretion and increase

%roduction of %rotective mucus.

Why is THIS pt taking?: Patient is diagnosed "ith '*R6

Monitoring parameters: Assess for e%igastric or abdominal %ain and for fran& or occult blood in stool

emesis or gastric as%irate.


14/22

Pt teachingside effects: 6o not share may cause diarrhea avoid alcohol and foods that may increase

'I irritation "hile ta&ing the medabdominal %ain and diarrhea.

Drug: Protoni/%anto%razole Classification: anti(ulcer agents

Mechanism of action: !inds to enzyme in the %resence of acidic gastric %5 %reventing the final

trans%ort of 5 into gastric lumen# Proton(%um% inhibitor.

Why is THIS pt taking?: $o treat his '*R6.

Monitoring parameters: -onitor for e%igastric and abdominal %ain fran& or occult blood and ss of

hy%omagnesemia

Pt teachingside effects: $a&e medication as directed for the full course of thera%y even if feeling

better. Advise to avoid alcohol %roducts containing as%irin or N2AI6s 0 foods that may cause an

increase in 'I irritation. Re%ort onset of blac& tarry stools diarrhea or abdominal %ainheadache

abdominal %ain diarrhea flatulence.

Drug: 3ancocinvancomycin Classification: Anti infective

Mechanism of action: !inds to bacterial cell "all destroying the "all resulting in cell death.

Why is THIS pt taking?: $a&ing to treat 1lostridium difficile

Monitoring parameters: Assess %atient for infection !P es%ecially stool IOs "eight and ss of su%er(

infection.

Pt teachingside effects: $a&e as directed ta&e missed dose as soon as remembered unless close to

lossne%hroto/icity ototo/icity hy%otension nausea vomiting and %hlebitis.

Drug: 1oumadin"arfarin Classification: anticoagulant

Mechanism of action: Interferes "ith he%atic synthesis of vitamin + de%endent clotting factors.

Why is THIS pt taking?: $he %atient has atrial fibrillation "hich %uts him at ris& for blood clots so this

hel%s thin the blood and %revent clots.

Monitoring parameters: -onitor P$INR: If above .; hold. Assess for signs of bleeding and

hemorrhage. Assess for evidence of additional or increased thrombosis.

Pt teachingside effects: Instruct %atient to ta&e medication as directed. 6o not double dose. Revie"

foods high in vitamin +. *ducate that they should have consistent limited inta&e of these foods as vitamin

+ is the antidote for "arfarin. Re%ort any sym%toms of unusual bleeding or bruising. Instruct %atient notto drin& alcohol or ta&e other RG O$1 or herbal %roducts es%ecially those containing as%irin or N2AI6s

or to start or sto% any ne" medication during "arfarin thera%y "ithout advice of 51P. *m%hasize the

im%ortance of fre>uent lab test to monitor coagulation factorscram%s nausea dermal necrosis bleeding

and fever.

Drug: allo%urinol )Alo%rim, Classification: $hera%eutic: antigout agents antihy%eruricemics

Pharmacologic: /anthine o/idase inhibitors


15/22

Mechanism of action: Inhibits the %roduction of uric acid by inhibiting the action of /anthine o/idase.

$hera%eutic *ffects: 7o"ering of serum uric acid levels.

Why is THIS pt taking?: Prevention of attac& of gouty arthritis and ne%hro%athy )&idney disease,. PO I3:

$reatment of secondary hy%eruricemia )high level of uric acid in the blood, "hich may occur during

treatment of tumors or leu&emias.

Monitoring parameters: -onitor IO ratios. 6ecreased &idney function can cause drug accumulation and

to/ic effects. Assess %atient for rash or more severe hy%ersensitivity reactions. -onitor for 4oint %ain and

s"elling from gout. 7abs: 2erum and urine uric acid levels usually begin decrease @M days after PO

thera%y. -onitor blood glucose in %atients receiving oral hy%oglycemic agents. -ay cause hy%oglycemia.

-onitor hematologic renal and liver function tests before and %eriodically during thera%y. -ay cause

serum al&aline %hos%hatase bilirubin A2$ and A7$ levels. 1!1 and %latelets may indicate bone marro"

de%ression. !UN serum creatinine may indicate ne%hroto/icity.

Pt teachingside effects: Instruct %atient to ta&e as instructed increase fluids be a"are of side effects

and follo" u% on e/ams. 2ide *ffects: dro"siness diarrhea nausea vomiting and rash.

Drug:e%oetin *%ogen Classification: antianemics hormones

Mechanism of action: 2timulates erythro%oiesis.

Why is THIS pt taking?: 5as anemia related to her end stage renal failure her &idneys are not e/creting

erythro%oietin.

Monitoring parameters: -onitor !P during and after thera%y monitor for ss of anemia )fatigue

dys%nea %allor., -onitor dialysis shunts )thrill and bruit,. -onitor hemoglobin and hematocrit before and

t"ice "ee&ly during intial thera%y. -onitor 1!1 "ith differential and %latelet count, If hemoglobin

increase above ==gd7 reduce dose by @?K and if continued increase hold. -onitor 'R and

electrolytes.

Pt teachingside effects: Advise %t. to read the -edication 'uide %rior to initiation thera%y and "ith

each R/ refill in case of changes. */%lain rationale for concurrent iron thera%y. 6iscuss "ays of

%reventing self(in4ury in %atients at ris& for seizures. 6riving and activities re>uiring continuous alertness

should be avoided. Advise %atient to notify 51P immediately if signs of blood clots )chest %ain trouble

breathing or shortness of breath %ain in the legs etc.., occurs. 2tress im%ortance of com%liance "ith

dietary restrictions medications and dialysis. oods high in iron and lo" in %otassium should be

discussed. 2hould be taught %ro%er dosage administration techni>ue and di%osal of e>ui%ment

hy%ertension increased mortality and increased tumor gro"th seizures headache 15 -I 2tro&e

thromboembolic events.

Drug: letrozoleemara Classification: antineo%lastics aromatase inhibitors

Mechanism of action: Inhibits the enzyme aromatase "hich is %artially res%onsible for conversion of

%recursors to estrogen.

Why is THIS pt taking?: as diagnosed "ith !reast cancer in @;;Q trying to &ee% estrogen levels

do"n.

Monitoring parameters: Assess %atient for %ain and other side effects %eriodically throughout thera%y.


16/22

-onitor A2$ A7$ al&aline %hos%hatase bilirubin''$ and cholesterol levels.

Pt teachingside effects: Instruct %atient to ta&e medication as directed. 1aution %t to avoid driving and

other activities re>uiring a"areness until res%onse to mediation is &no"n. Inform %atient of %otential for

adverse reactions and advise her to notify health care %rofessional if side effects are %roblematic.An/iety

de%ression dizziness dro"siness nausea musculos&eletal %ain.

Drug: levothyro/ine2ynthroid Classification: hormones thyroid %re%arations

Mechanism of action: Re%lacement of or su%%lementation to endogenous thyroid hormones. Princi%le

effect is increasing metabolic rate of body tissues.

Why is THIS pt taking?: Patient has hy%othyroidism

Monitoring parameters: Assess a%ical %ulse and !P %rior to and %eriodically during thera%y. Assess

for tachyarrhythmias and chest %ain. -onitor thyroid function $25 serum levels monitor blood and urine

glucose in diabetics.

Pt teachingside effects: Instruct %atient to ta&e medication as directed at the same time each day.

*/%lain to %atient that mediation does not cure hy%othyroidism %rovides thyroid hormone su%%lement.

Notify 51P if headache nervousness diarrhea e/cessive s"eating heat intolerance chest %ain

tachycardia %al%itations or "eight loss occur.headache insomnia irritability s"eating arrhythmias

diarrhea vomiting angina %ectoris.

Drug: ome%razole )Prilosec( %egerid& Classification: antiulcer agents %roton(%um% inhibitors

Mechanism of action: !inds to an enzyme on gastric %arietal cells in the %resence of acidic gastric %5

%reventing the final trans%ort of hydrogen ions into the gastric lumen.

Why is THIS pt taking?: Acid reflu/ 0 relief '*R6

Monitoring parameters: Administer does before meals %referably in the morning must be s"allo"ed"hole. . -onitor 1!1 "ith differential %eriodically during thera%y. -onitor INR and %rothrombin time in

%tLs ta&ing "arfarin. -onitor serum magnesium %rior to and %eriodically during thera%y. Assess for

e%igastric or abd. Pain# and fran& blood in stools emesis or gastric as%irate.

Pt teachingside effects: $a&e in the morning before brea&fast do not crush s"allo" "hole. $a&e for

the full course thera%y even if feeling better. Advise to avoid alcohol %roducts containing as%irin or

N2AI6s and food that may cause increase in 'I irritation. Re%ort onset of blac& tarry stools# diarrhea#

abdominal %ain# or or %ersistent headache to 51P.dizziness dro"siness fatigue headache "ea&ness

chest %ain abdominal %ain consti%ation diarrhea flatulence nausea vomiting.

Drug: sevelamer )Renvela Renegel, Classification: electrolyte modifiers %hos%hate binders

Mechanism of action: A %olymer that binds %hos%hate in the 'I tract %reventing its absor%tion.

Why is THIS pt taking?: 2he has end stage renal disease the &idney has an inability to e/crete the

%hos%hate.

Monitoring parameters: Assess %atient for 'I side effects %eriodically during thera%y. -onitor serum

%hos%horous calcium bicarbonate and chloride levels %eriodically during thera%y.


17/22

Pt teachingside effects: Instruct %atient to ta&e sevelamer "ith meals as directed and to adhere to

%rescribed dies. 1aution %atient to s%ace concurrent medications at least = hr before or hr after

sevelamer. Advise %atient to notify 51P if 'I effects are sever or %rolonged.

Drug: ceftazidimeortaz Classification: anti(infectives third(gneration ce%halos%orins

Mechanism of action: !ind to the bacterial cell "all membrane causing cell death.

Why is THIS pt taking?: $a&ing to treat 1elulitis

Monitoring parameters: Assess for infection: 32 Observe for ss of ana%hyla/is monitor bo"el

function.

Pt teachingside effects: Instruct %atient to ta&e mediation arund the cloc& and to finish the medication

com%letely even if feeling better. Instruct %atients that concurrent use of alcohol "ith cefo%erazone may

cause a disulfiram li&e reaction. Notify health care %rofessional if rash fever and diarrhea develo%.

Drug: atenolol $enormin Classification: antianginals antihy%ertensives beta bloc&ers

Mechanism of action: !loc&s stimulation of beta= rece%tors.

Why is THIS pt taking?: tachycardia and hy%ertension

Monitoring parameters: 3itals es%ecially 5R and !P and *1' IOs daily "eights assess routinely for

5 angina.

Pt teachingside effects: $a&e as directed at the same time each day even if feeling "ell# do not s&% or

double u% on missed doses. $each %atient and family ho" to chec& %ulse and !P. 1hange %ositions

slo"ly to minimize orthostatic hy%otension. Notify 51P of a ll R/ or O$1 meds vitamins or herbal

%roducts being ta&en avoid alcohol. Advise %atient to notify 1P if slo" %ulse difficulty breathing

"heezing cold hands and feet dizziness lightheadedness confusion de%ression rash feer sore throat

unusual bleeding or bruising occurs.

rom 7eslie

Drug: amlodi%ine $+or-asc& Classification: antihy%ertensives calcium channel bloc&ers

Mechanism of action: 2ystemic vasodilation resulting in decreased !P. 1oronary vasodilation resulting

in decreased fre>uency and severity of attac&s of angina.

Why is THIS pt taking?: Patient has hy%ertension.

Monitoring parameters: -onitor !P and %ulse before thera%y during dose titration and %eriodically

during thera%y. -onitor *1' %eriodically. -onitor inta&e and out%ut ratios and daily "eight.

Pt teachingside effects:Advise %atient to ta&e medication as directed to change %ositions slo"ly to

minimize orthostatic hy%otension notify health %rofessional if any of the follo"ing adverse effects occur:

headache dizziness fatigue %eri%heral edema angina bradycardia hy%otension %al%itations gingival

hy%er%lasia nausea and flushing

Drug:2odium bicarbonate $anti1acid& Classification:antiulcer agents al&alinizing agents

Mechanism of action:Al&alinization. Neutralization of gastricacid.


18/22

Why is THIS pt taking?:$o &ee% the %5 from getting too acidic.

Monitoring parameters:Assess %atients for signs of acidosis )disorientation headache "ea&ness

dys%nea and hy%erventilation, and al&alosis )confusion irritability %aresthesia tetany and altered

breathing %attern,.

Pt teachingside effects:Instruct %atient to ta&e medication as directed. Advise %atient not to ta&e mil&%roducts concurrently "ith this medication. Revie" sym%toms of electrolyte imbalance "ith %atients "ith

this medication. Notify the healthcare %rovider is the follo"ing adverse effects occur: metabolic al&alosis

edema flatulence gastric distention hy%ernatremia hy%ocalcemia and hy%o&alemia.

Drug:Novolog insulin aspart Classification:antidiabetics hormones %ancreatics

Mechanism of action:1ontrol of hy%erglycemia in diabetic %atients.

Why is THIS pt taking?Patient has diabetes mellitus.

Monitoring parameters:Assess for sym%toms of hy%oglycemia. -onitor body "eight %eriodically.

Assess %atient for signs of allergic reactions during thera%y.

Pt teachingside effects:Instruct %atient on %ro%er techni>ue for administration. */%lain to %atient tha

the medication controls hy%erglycemia but does not cure diabetes. Instruct %atient in %ro%er testing of

serum glucose and &etones. Instruct %atient on sym%toms and signs of hy%oglycemia. Notify healthcare

%rovider if the follo"ing adverse effects occur: hy%oglycemia erythema li%odystro%hy %ruritis s"elling

allergic reactions including ana%hyla/is.

Drug:sodium chloride Classification: -ineral and electrolyte re%lacementsu%%lements

Mechanism of action: Re%lacement in deficiency states and maintenance of homeostasis.

Why is THIS pt taking?: 2cheduled to flush I3 line.

Monitoring parameters: Assess fluid balance )inta&es and out%ut daily "eight edema lung sounds,

throughout thera%y. Assess %atient for sym%toms of hy%onatremia )headache tachycardia lassitude dry

mucous membranes,.

Pt teachingside effects:*/%lain to %atient %ur%ose of the infusion. 1ontact healthcare %rofessional for

the follo"ing adverse effects: 5 %ulmonary edema edema hy%ernatremia hy%ervolemia

e/travasation and irritation at I3 site.

Drug:glucagon Classification:hormones %ancreatics

Mechanism of action:Increase in blood glucose. Rela/ation of 'I musculature facilitating radiogra%hic

e/amination.

Why is THIS pt taking?:$o treat hy%oglycemia.

Monitoring parameters:Assess for signs of hy%oglycemia %rior to and %eriodically during thera%y.

Assess neurologic status throughout thera%y. Assess nutritional status. Assess for nausea and vomiting

after administration of dose.

Pt teachingside effects:$each %atient and family signs and sym%toms of hy%oglycemia. Notify the

healthcare %rovider if the follo"ing adverse effects occur: hy%otension nausea vomiting hy%ersensitivity


19/22

reactions including ana%hyla/is.

Drug:o/ycodone Classification: o%ioid analgesics o%ioid agonists o%ioid

agonistsnono%ioid analgesic combinations

Mechanism of action:6ecreased %ain.

Why is THIS pt taking?: Pain.

Monitoring parameters:Assess ty%e location and intensity of %ain %rior to and = hr )%ea&, after

administration. Assess !P %ulse and res%irations before and %eriodically during administration. Assess

bo"el function routinely.

Pt teachingside effects:Instruct %atient on ho" and "hen to as& for and ta&e %ain medication. Advise

%atient that o/ycodone is a drug "ith &no"n abuse %otential. Advise %atient to ma&e %osition changes

slo"ly to minimize orthostatic hy%otension. Notify healthcare %rofessional of the follo"ing adverse effects:

confusion sedation consti%ation res%iratory de%ression.

Drug:fentanyl M transdermal )6uragesic, Classification:o%ioid analgesics anesthetic ad4uncts

o%ioid agonists

Mechanism of action:6ecrease in severity of chronic %ain.

Why is THIS pt taking?:Pain.

Monitoring parameters:Assess ty%e location and intensity of %ain before and @D hr after a%%lication

and %eriodically during thera%y. Assess !P %ulse and res%iration before and %eriodically during

administration. Prolonged use may lead to %hysical and %sychological de%endence and tolerance.

Progressively higher doses may be re>uired to relieve %ain "ith long(term thera%y. Assess bo"el function

routinely.

Pt teachingside effects: Instruct %atient in ho" and "hen to as& for and ta&e %ain medication. Instruct%atient incorrect method for a%%lication and dis%osal of transdermal system. Advise %atient to change

%ositions slo"ly to minimize dizziness. 1aution %atient to avoid concurrent use of alcohol or other 1N2

de%ressants "ith this medication. Notify healthcare %rovider of the follo"ing adverse effects: confusion

sedation "ea&ness anore/ia consti%ation dry mouth nausea vomiting and s"eating.

Drug:ferrous sulfate )2eosol( 2erata,( 2e34& Classification:anti(anemiciron su%%lements

Mechanism of action:Preventiontreatment of iron deficiency.

Why is THIS pt taking?: Patient has anemia.

Monitoring parameters:Assess nutritional status and dietary history to determine %ossible cause of

anemia and need for %atient teaching. Assess bo"el functions for consti%ation or diarrhea. Assess %atient

for signs and sym%toms of ana%hyla/is )rash %ruritus laryngeal edema "heezing, for at least ;

minutes. -onitor hemoglobin hematocrit 0 reticulocyte values %rior to and every "&s during the first

@mo of thera%y and %eriodically thereafter.

Pt teachingside effects: */%lain %ur%ose of iron thera%y to %atient. *ncourage %atient to com%ly "ith

medication regimen. Advise %atient that stools may become dar& green or blac& and that this change is

harmless. Instruct %atient to follo" a diet high in iron. Notify healthcare %rovider of the follo"ing adverse


20/22

effects: seizures ana%hyla/is hy%otension nausea consti%ation dar& stools diarrhea and e%igastric

%ain.

Drug:fludrocortisone )lorinef, Classification:hormones corticosteroids )mineralocorticoid,

Mechanism of action: -aintenance of sodium balance and !P in %atients "ith adrenocortical

insufficiency.

Why is THIS pt taking?:Patient has &idney failure.

Monitoring parameters:-onitor !P %eriodically during thera%y. -onitor fluid retention. 1auses

decrease in serum %otassium levels.

Pt teachingside effects:Instruct %atient to ta&e medication as directed. Advise %atient to follo" dietary

modifications %rescribed by healthcare %rofessional. Notify healthcare %rovider of the follo"ing adverse

effects: dizziness headache arrhythmias edema hy%ertension anore/ia nausea "eight gain

hy%o&alemia hy%o&alemic al&alosis and hy%ersensitivity reactions.

Drug:mero%enem )-errem, Classification:anti(infectives1arba%enems are a class of (lactam

antibiotics "ith a broad s%ectrum of antibacterial activity.

Mechanism of action:!actericidal action against susce%tible bacteria.

Why is THIS pt taking?:Patient has a bacterial U$I.

Monitoring parameters:Assess infection at beginning of and throughout thera%y. Obtain a history before

initiating thera%y to determine %revious use of and reactions to %enicillins# Observe for signs and

sym%toms of ana%hyla/is. !UN A2$ A7$ 765 serum al&aline %hos%hatase bilirubin and creatinine

may be transiently increased.

Pt teachingside effects:Advise %atient to re%ort the signs of su%er infection and allergy# -ay cause

dizziness. Notify healthcare %rofessional for the follo"ing adverse effects: seizures a%nea dizzinessdiarrhea nausea vomiting and ana%hyla/is.

6rug: nystatin )-ycostatin Nysto%, Classification:antifungals )to%ical,

Mechanism of action:6ecrease in sym%toms of fungal infection.

Why is THIS pt taking?:$o be a%%lied under the %atientSs folds to hel% "ith fungal infection.

Monitoring parameters:Ins%ect involved areas of s&in and mucous membranes before and fre>uently

during thera%y. Increased s&in irritation may indicate need to discontinue medication.

Pt teachingside effects:Instruct %atient to a%%ly medication as directed for full course of thera%y even

if feeling better. Advise %atient to re%ort increased s&in irritation or lac& of res%onse to thera%y to

healthcare %rofessional. Notify healthcare %rofessional of the follo"ing adverse effects: burning itching

local hy%ersensitivity reactions redness and stinging. 2ide effects: dizziness tachycardia sodium

retention drug(induced lu%us syndrome dro"siness headache angina arrhythmias edema orthostatic

hy%otension nv %eri%heral neuro%athy.

6rug: 5ydralazine )A%resoline, classification: antihy%ertensivevasodilator


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Mechanism of action: direct acting %eri%heral arteriolar vasodilator to lo"er !P in hy%ertensive %atients

and decrease afterload in %atients "ith 5.

Why is this pt! taking?or moderate to severe 5y%ertension

Monitoring parameters: monitor !P %ulse fre>uently )ethnic ris& of to/icity ie 1aucasians !lac&

-e/ican slo" acetylators "hile Ha%anese 1hinese are ra%id acetylators at ris& for decreased levels andtreatment failure,# labs: 1!1 electrolytes 7* cell %re% and ANA titer %rior to and %eriodically during

%rolonged thera%y. Administer "ith meals consistently to enhance absor%tion.

Pt! teachingside effects:*ncourage %atient to continue ta&ing medication on same time each day and

even if feeling "ell. $o com%ly "ith additional interventions for hy%ertension )"eight reduction lo" sodium

diet smo&ing cessation and moderation of alcohol inta&e e/ercise and stress management,# notify care

%rovider of general tiredness fever muscle or numbness tingling %ain or "ea&ness of hands occurs

and em%hasize im%ortance of follo" u% e/am to evaluate effectiveness of medication.

Drug: fluo/etine )Prozac, Classification: $hera%eutic: antide%ressants

Pharmacologic: selective serotonin reu%ta&e inhibitors )22RIs,

Mechanism of action: 2electively inhibits the reu%ta&e of serotonin in the 1N2. $hera%eutic *ffects:

Antide%ressant action. 6ecreased behaviors associated "ith: %anic disorder bulimia. 6ecreased mood

alterations associated "ith %remenstrual dys%horic disorder )P-66,.

Why is THIS pt taking?: -ood enhancement.

Monitoring parameters: -onitor mood changes. Assess for suicidal tendencies es%ecially during early

thera%y. -onitor a%%etite and nutritional inta&e. Assess %atient for sensitivity reaction. Assess for se/ual

side effects. Assess %atient for fre>uency of obsessive(com%ulsive behaviors. Note degree to "hich these

thoughts and behaviors interfere "ith daily functioning. Assess fre>uency of binge eating and vomiting

during thera%y. -onitor 1!1 and differential %eriodically during thera%y.

Pt teachingside effects: It may ta&e u% to D "ee&s before the full effect occurs. $a&e in the morning. If

you feel slee%y or tired you may ta&e it at night# If you are ta&ing the once("ee&ly ca%sule mar& calendar

"ith reminders of drug day. 6o not ta&e this drug during %regnancy. If you thin& that you are %regnant or

"ish to become %regnant consult your health care %rovider. +ee% this drug and all medications out of

the reach of children. 2ide effects: 5eadache nervousness insomnia dro"siness an/iety tremor

diarrhea se/ual dysfunction s"eating and %ruritus# life threatening: N*URO7*P$I1 -A7I'NAN$

2YN6RO-* 2*IBUR*2 2UI1I6A7 $5OU'5$2 and 2*RO$ONIN 2YN6RO-*.

Drug: isosorbide mononitrate)I-6UR, Classification: $hera%eutic: antianginals

Pharmacologic: nitrates

Mechanism of action: Produce vasodilation )venous greater than arterial,. 6ecrease left ventricular end(

diastolic %ressure and left ventricular end(diastolic volume )%reload,. Net effect is reduced myocardial

o/ygen consum%tion. Increase coronary blood flo" by dilating coronary arteries and im%roving collateral

flo" to ischemic regions. $hera%eutic *ffects: Angina ( relieve and %revention. Increase cardiac out%ut.

Why is THIS pt taking?: Relief of angina.

Monitoring parameters: Assess location duration intensity and %reci%itating factors of anginal %ain.

-onitor !P and P routinely during %eriod of dosage ad4ustment.


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Pt teachingside effects: $a&e as directed. Ris& of orthostatic hy%otension# -ay cause dizziness# 6riving

caution. Avoid alcohol# O$1 herbal su%%l. revie" "ith 51P. 5eadache is a common side effect. A2A or

acetamino%hen may be ordered to treat headache. Inform 51P if dry mouth or blurred vision occurs# side

effects: dizziness headache a%%rehension restlessness "ea&ness blurred vision hy%otension

tachycardia synco%e abd %ain N3 flushing and tolerance

nursing medication list 2

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