Med cards
Content
Generic Name: Brand Name: Classification: Indication: Action: Side/Adverse Effects: Route & Dose: Drug-Drug Interactions: Assessment:
Pantoprazole Sodium Protonix Gastric proton pump inhibitor; antisecretory Short-term tx of erosive esophagitis associated w/ GERD Gastric acid pump inhibitor Diarrhea, flatulence, headache, rash PO 40 mg daily Ampicillin, iron salts, warfarin Monitor for & immediately report S&S of angioedema or a severe skin reaction. Urea breath test 4-6 wk after completion of therapy.
Implementation: Teaching:
Do not crush/ break in half. Must be swallowed whole. Contact physician if any of the following occur: Peeling, blistering, loosening of skin, shin rash, hives, itching, swelling of face, tongue lips; difficulty breathing
Generic Name: Brand Name: Classification: Indication: Action: Side/Adverse Effects: Route & Dose: Drug-Drug Interactions: Assessment: Implementation:
Teaching:
Ondansetron hydrochloride Zofran 5-HT3; Antagonist; Antiemetic Prevention of N&V associated w/ initial & repeated courses of cancer chemotherapy; postop nausea & vomiting. Selective serotonin receptor antagonist. Headache, sedation, diarrhea PO 8-16 mg Rifampin Monitor F&E & cardiovascular status. Do not push orally disintegrating tab through blister foil. Peel foil back & remove tab. Tabs will disintegrate w/ or w/out liquid. Be aware that headache requiring an analgesic for relief is a common adverse effect.
Generic Name: Brand Name: Classification: Indication: Action: Side/Adverse Effects: Route & Dose:
Drug-Drug Interactions: Assessment:
Implementation:
Generic Name: Brand Name: Classification: Indication:
Action: Side/Adverse Effects: Route & Dose: Drug-Drug Interactions: Nursing Implications:
Aspirin (Acetylsalicylic acid) Alka-Seltzer, A.S.A, Bayer, Cosprin Nonnarcotic analgesic, salicytate; antipyretic; antiplatelet Pain reliever of low-moderate intensity. Fever reducer. Inhibiting formation of prostaglandins involved in production of inflammation, pain & fever. Bronchospasm, anaphylactic shock (laryngeal edema), hemolytic anemia Pain/Fever: PO/PR 350-650 mg q4h Thromboembolic disorder: PO 81-325 mg daily MI Prophylaxis: PO 80-325 mg/day Aminosalicylic acid, ammonium chloride Monitor for loss of tolerance to aspirin. Symptoms usually occur 15 min-3 h after ingestion: profuse rinorrhea, erythema, nausea, vomiting, intestinal cramps, diarrhea. Monitor for salicylate toxicity (fullness in ears, tinnitus, decreased muffled hearing). Give w/ full glass of water, milk, food, or antacid to minimize gastric irritation. Enteric-coated tabs dissolve too quickly if administered w/ milk & should not be crushed or chewed. Fentanyl Sublimaze, Onsolis, Duragesic Analgesic; Narcotic Short-acting analgesic during operative & perioperative periods, as a narcotic analgesic supplement in general & regional anesthesia, & w/ droperidol or w/ diazepam to produce neuroleptanalgesia. Synthetic, potent narcotic agonist analgesia that causes analgesia & sedation. Sedation, circulatory depression, cardiac arrest, N&V, respiratory depression or arrest General anesthesia: IV 2-20 mcg/kg PostOp Pain: IM/IV 50-100 mcg q1-2h prn Alcohol, CNS depressants Monitor VS & observe for signs of skeletal & thoracic muscle (depressed respirations) rigidity & weakness. Have immediately available: Naloxone (Narcan), O2, resuscitative & intubation equipment
Generic Name: Brand Name: Classification: Indication:
Action: Side/Adverse Effects: Route & Dose:
Drug-Drug Interactions: Nursing Implications:
Generic Name: Brand Name: Classification: Indication: Action:
Side/Adverse Effects: Route & Dose:
Drug-Drug Interactions: Nursing Implications:
Midazolam Versed Anesthetic; benzodiazepine; anxiolytic; sedative Sedation before general anesthesia, induction of general anesthesia; to impair memory of perioperative events(anterograde amnesia); conscious sedation prior to short diagnostic and endoscopic procedures; hypnotic supplement to nitrousoxide and oxygen (balances anesthesia) for short surgical procedures. CNS depressant with muscle relaxant, sedative-hypnotic, anticonvulsant, and amnestic properties Retrograde amnesia, laryngospasm, respiratory arrest, excessive sedation Conscious sedation: IM 0.07-0.08 mg/kg 30-60 min before procedure. IV 1-2.5 mg, may be repeated in 2 min prn. Intubated pts: 0.05-0.2 mg/kg/hr continuous infusion Alcohol, CNS depressants, anticonvulsants, levodopa Inspect insertion sight for redness, pain, swelling, & other signs of extravasion during IV infusion. Monitor for indications of impending respiratory arrest. Resuscitative drugs & equipment should be immediately available. Monitor for hypotension. Monitor VS. Overdose S&S: somnolence, confusion, sedation, diminished reflexes, coma.
Heparin Hep-Lock Anticoagulant Prophylaxis & tx of venous thrombosis & pulmonary embolism & to prevent thromboembolic complications Exerts direct effect on cascade of blood coagulation by enhancing inhibitory of antithrombin III. Inhibits formation of new clots. Spontaneous bleeding, transient thrombocytopenia, bronchospams, anaphylactoid rxns, fever, chills Prophylaxis of embolism: SQ 5000 U q8-12h until pt is ambulatory Tx of Thromboembolism: IV 5000 U bolus dose, then 20,000-40,000 U infused over 24 hrs Oral anticoagulants, aspirin, NSAIDs (risk for bleeding) Lab: blood coagulation tests: Hct, Hgb, RBC, & platelet counts. Monitor APTT levels closely. Draw blood for coagulation test 30 min before each scheduled SQ or intermittent IV dose & q4h for pts receiving continuous IV heparin. Report fever, drop in BP, rapid pulse, & other S&S of hemorrhage. Observe needle sited daily for hematoma & signs of inflammation. Antidote: protamine sulfate (1% solution)
Generic Name: Brand Name: Classification: Indication:
Action: Side/Adverse Effects: Route & Dose:
Drug-Drug Interactions: Nursing Implications:
Generic Name: Brand Name: Classification: Indication: Action: Side/Adverse Effects:
Route & Dose: Drug-Drug Interactions: Nursing Implications:
Generic Name: Brand Name: Classification: Indication: Action: Side/Adverse Effects:
Route & Dose: Drug-Drug Interactions:
Nursing Implications:
Meropenem Merrem Carbapenem Antibiotic Complicated appendicitis & peritonitis, bacterial meningitis caused by susceptible bacteria, complicated skin infections, intra-abdominal infections, skin/soft tissue infections Inhibits cell wall synthesis of gram-+ & gram-- bacteria Diarrhea, N&V, phlebitis, pruritis, sepsis, shock, anemia Intra-abdominal infections: IV 1 g q8h Bacterial Meningitis: IV 2 g q8h Complicated skin infections: IV 500 mg q8h Probenecid Determine hx of hypersensitivity rxns to other beta-lactams, cephalosporins, penicillins, or other drugs. Lab: C&S test prior to therapy. Monitor liver & kidney function. D/C drug & report S&S of hypersensitivity. Report S&S of superinfection or pseudomembraneous colitis. Risperidone Risperdal Atypical Antipsychotic Tx of schizophrenia; tx of bipolar disorder Interferes with binding of dopamine. Controlls symptoms of schizophrenia as well as other psychotic symptoms. Sedation, drowsiness, headache, insomnia, agitation, extrapyramidal symptoms (akathisia, dystonia, pseudoparkisonism), neuroleptic malignant syndrome (NMS) Schizophrenia: PO 1-2 mg/day Bipolar Disorder: PO 2-3 mg once daily for up to 3 wks Risperidone may enhance effects of certain hypertensives. Carbamazepine, phenytoin may decrease risperidone levels. Monitor diabetics for loss of glycemic control. Reassess pts periodically & maintain on lowest effective drug dose. Monitor cardiovascular status closely; assess for orthostatis hypotension. Lab: Monitor blood glucose, serum elctrolytes, liver function, & CBCs. Vancomycin Hydrochoride Vancocin Antibiotic; Glycopeptide Tx of schizophrenia; tx of bipolar disorder Active against many gram-positive organisms. Nephrotoxicity leading to uremia, shock-like-state, anaphylactoid rxn w/ vascular collapse, hypotension accompanied by flushing & erythematous rash on face & upper body Systemic infections: IV 500 mg q6h or 1 g q12h C.diff Colitis: PO 125-500 mg q6h Metformin (may increase risk of lactic acidosis). Aminoglycosides(adds to toxicity of ototoxic & nephrotoxic drugs Monitor BP & HR continuously. Lab: Periodic urinalysis, kidney & liver functions, & hematologic studies. Monitor serial tests of vancomycin blood levels (peak, trough). Assess hearing (may cause damage to auditory branch). Monitor for ototoxicity (60-80 mcg/mL). Monitor I&O.
Generic Name: Brand Name: Classification: Indication: Action: Side/Adverse Effects: Route & Dose: Drug-Drug Interactions: Nursing Implications:
Generic Name: Brand Name: Classification: Indication:
Action:
Side/Adverse Effects: Route & Dose:
Drug-Drug Interactions: Nursing Implications:
Generic Name: Brand Name: Classification: Indication:
Action: Side/Adverse Effects: Route & Dose: Drug-Drug Interactions: Nursing Implications:
Bisacodyl Bisacolax, Dacodyl, Fleet Bisacodyl Stimulant Laxative Temporary relief of acute constipation & for evacuation of colon before surgery Expands intestinal fluid volume by increasing epithelial permeability. Nausea, diarrhea, F&E disturbances (K+ & Ca+) PO 5-15 mg prn PR 10 mg prn Antacids (abdominal cramping) Assess periodically for use of drug (usually produces 1-2 soft formed stools daily). Monitor pts receiving concomitant anticoagulants (decreases absorption of vitamin K). Add highfiber slowly to reg. diet to avoid gas & diarrhea. Desmopressin Acetate DDAVP, Stimate Posterior pituitary hormone To control & prevent symptoms & complications of central diabetes insipidus, & to relieve temporary polyuria & polydipsia associated w/ trauma or surgery in pituitary region. Synthetic analog of natural human posterior pituitary (antidiuretic) hormone, arginine vasopressin. Can shorten or normalize bleeding time, & correct platelet adhesion abnormalities Transient headache, rhinitis, SOB, hyponatremia, heartburn Diabetes Insipidus IV/SQ 2-4 mcg in 2 divided doses. PO 0.20.4 mg/day Enuresis Intranasal 5-40 mcg at bedtime Demeclocycline,lithium, vasopressors (may decrease antidiuretic response. Monitor I&O. Fluid intake must be carefully controlled (to avoid water retention & sodium depletion). Weigh pts daily & observe for edema. Monitor BP. Lab: Monitor urine & plasma osmolality ( in urine osmolality & a in plasma osmolality indicate effectiveness of tx in diabetes insipidus. Report upper respiratory tract infection or nasal congestion. Docusate Sodium Colace Stool softener Prophylactically in pts who should avoid straining during defecation & for tx of constipation associated with hard, dry stools. Anionic surface-acting agent w/ emulsifying & wetting properties. Diarrhea, nausea, mild abdominal cramps PO 50-500 mg/day PR 50-100 mg added to enema fluid Mineral oil W/holds drug if diarrhea develops & notify physician. Therapeutic effectiveness apparent 1-3 days after first dose. Do not take w/ mineral oil.
Generic Name: Brand Name: Classification: Indication: Action: Side/Adverse Effects: Route & Dose:
Drug-Drug Interactions: Nursing Implications:
Generic Name: Brand Name: Classification: Indication:
Action: Side/Adverse Effects: Route & Dose:
Drug-Drug Interactions: Nursing Implications:
Generic Name: Brand Name: Classification: Indication: Action:
Side/Adverse Effects: Route & Dose: Drug-Drug Interactions: Nursing Implications:
Fluconazole Diflucan Azole antifungal Cryptococcal meningitis & oropharyngeal & systemic candiasis Interferes w/ formation of ergosterol, the principal sterol in fungal membrane leading to cell death. Headache, N&V, abd. pain, diarrhea, increase in AST Oropharyngeal Candidiasis PO/IV 200 mg day 1, then 100 mg /day x 14 days Esophageal Candiasis PO/IV 200 mg day 1, then 100 mg daily x 3 wk Systemic Candidemia PO/IV 40 mg day 1, then 200 mg daily x 4wk Crysptococcal Meningitis PO/IV 400 mg day 1, then 200 mg daily x 10-12 wk Warfarin, Fentanyl, Alosetron, Cyclosporine Monitor for allergic response. Lab: monitor BUN, serum creatinine & liver function. Monitor S&S of hepatotoxicity. Drug may cause elevations of ALT, AST, alkaline phosphatase, bilirubin Levoflaxacin Levaquin, Iquix, Quixin Antibiotic Tx of maxillary sinusitis, acute exacerbations of bacterial bronchitis, community-acquired pneumonia, uncomplicated skin/ skin structure infections, UTI, acute bacterial sinusitis Inhibits DNA-gyrase (an enzyme necessary for bacterial replication, transcription, repair, & recombination). Headache, insomnia, pruritis, decreased vision, foreign body sensation, photophobia, fever, pharyngitis, chest or back pain Infections PO 500 mg q24h x 10 days. IV 500 mg infused over 60 min q24h x 7 -14 days Community Acquired Pneumonia PO/IV 750mg q24h x5 days Skin & Skin Structure Infections PO 750 mg q24h x 14 days Uncomplicated UTI PO/IV 250 mg q24h x 14 days Magnesium or aluminum-containing antacids, NSAIDS Lab: Do C&S test prior to beginning therapy. W/hold therapy & notify physician for following: skin rash or signs of a hypersensitivity rxn; CNS S&S (seizures, restlessness, confusion, depression, hallucinations), joint pain, inflammation Selenium Sulfide Exsel, Selsun Antibiotic; Topical; Antifungal Itching & flaking of scalp Active against Pityrosporum ovale, a yeast like fungus found in the normal flora of the scalp. Decreases rate of growth of the epithelial cells of the scalp/ body. Skin irritation (stinging), diffuse hair loss, hair discoloration TOP Massage 5-10 mL of a 1-2.5% solution into wet scalp None Monitor effectiveness, rinse thoroughly with water if in contact with eyes. Hair loss is reversible after 2-3 wk after tx is D/C. D/C use if skin is irritated or tx fails.
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Side/Adverse Effects: Route & Dose: Drug-Drug Interactions: Nursing Implications:
Generic Name: Brand Name: Classification: Indication: Action: Side/Adverse Effects: Route & Dose: Drug-Drug Interactions: Nursing Implications:
Generic Name: Brand Name: Classification: Indication:
Action: Side/Adverse Effects: Route & Dose: Drug-Drug Interactions: Nursing Implications:
Magnesium Hydroxide Magnesia, Milk of Magnesia Saline catharctic; Antacid Short term tx of occasional constipation, relief of GI symtoms Aqueous suspension of magnesium hydroxide w/ rapid & long-acting neutralizing action. Acts as antacid in low doses & as mild saline laxative at higher doses Diarrhea, coma, complete heart block, ECG abnormalities, respiratory depression, weakness, lethargy PO 2.4-4.8 g/ day in 1 or more divided doses Reduces effects of Digoxin, chlordiazepoxide, quinolones Evaluate for need of drug. May lead to dependence. Lab: Monitor serum Mg w/ signs of hypermagnesemia-bradycardia Piperacillin/ Tazobactam Zosyn Beta-lactam antibiotic; penicillin Moderate to severe appendicitis, uncomplicated/ complicated skin & skin structure infections, endometritis, PID 2-drug combination has antibiotic activity against extremely broad spectrum of gram-+, gram --, & anaerobic bacteria Insomnia, fever, pseudomembraneous colitis, rash, pruritis Mod- Severe Infections IV 3.375 q q6h infused over 30 min Nosocomial Pneumonia IV 4.5 g q6h infused over 30 min Anticoagulants (increases risk of bleeding) Obtain hx of hypersensitivity to penicillins (rash, itching) prior to administration. Lab: C&S prior to 1st dose. Monitor hematologic status w/ prolonged therapy (Hct, hgb, CBC, plt.count). Monitor pt during 1st 30 min after initiation. Sulfacetamide Sodium Cetamide, Ophthacet Sulfonamide antibiotic Opthlamic preparations are used for conjunctivitis, corneal ulcers, & other superficial ocular infections. Topical lotion is used for scaly dermatoses, seborrheic sicca, & other bacterial skin infections Effective against a wide range of gram-+ & gram -microorganisms Temporary stinging or burning sensation, hypersensitivity rxns (stevens-johnson’s syndrome), superinfection Ophthalmic 1-3 drops Tetracaine, local anesthetics derived from paba D/C if symptoms of hypersensitivity appear (erythema, skin, rash, pruritis, urticaria), examine eye med (discard if cloudy or dark in color), report purulent eye discharge to physician
Generic Name: Brand Name: Classification: Indication: Action: Side/Adverse Effects: Route & Dose: Drug-Drug Interactions: Assessment:
Pantoprazole Sodium Protonix Gastric proton pump inhibitor; antisecretory Short-term tx of erosive esophagitis associated w/ GERD Gastric acid pump inhibitor Diarrhea, flatulence, headache, rash PO 40 mg daily Ampicillin, iron salts, warfarin Monitor for & immediately report S&S of angioedema or a severe skin reaction. Urea breath test 4-6 wk after completion of therapy.
Implementation: Teaching:
Do not crush/ break in half. Must be swallowed whole. Contact physician if any of the following occur: Peeling, blistering, loosening of skin, shin rash, hives, itching, swelling of face, tongue lips; difficulty breathing
Generic Name: Brand Name: Classification: Indication: Action:
Side/Adverse Effects: Route & Dose:
Drug-Drug Interactions: Nursing Implications:
Heparin Hep-Lock Anticoagulant Prophylaxis & tx of venous thrombosis & pulmonary embolism & to prevent thromboembolic complications Exerts direct effect on cascade of blood coagulation by enhancing inhibitory of antithrombin III. Inhibits formation of new clots. Spontaneous bleeding, transient thrombocytopenia, bronchospams, anaphylactoid rxns, fever, chills Prophylaxis of embolism: SQ 5000 U q8-12h until pt is ambulatory Tx of Thromboembolism: IV 5000 U bolus dose, then 20,000-40,000 U infused over 24 hrs Oral anticoagulants, aspirin, NSAIDs (risk for bleeding) Lab: blood coagulation tests: Hct, Hgb, RBC, & platelet counts. Monitor APTT levels closely. Draw blood for coagulation test 30 min before each scheduled SQ or intermittent IV dose & q4h for pts receiving continuous IV heparin. Report fever, drop in BP, rapid pulse, & other S&S of hemorrhage. Observe needle sited daily for hematoma & signs of inflammation. Antidote: protamine sulfate (1% solution)
Generic Name: Brand Name: Classification: Indication: Action: Side/Adverse Effects: Route & Dose: Drug-Drug Interactions: Nursing Implications:
Generic Name: Brand Name: Classification: Indication: Action: Side/Adverse Effects: Route & Dose: Drug-Drug Interactions: Nursing Implications:
Generic Name: Brand Name: Classification: Indication: Action: Side/Adverse Effects: Route & Dose:
Drug-Drug Interactions: Nursing Implications:
Generic Name: Brand Name: Classification: Indication: Action: Side/Adverse Effects: Route & Dose: Drug-Drug Interactions: Nursing Implications:
Generic Name: Brand Name: Classification: Indication: Action: Side/Adverse Effects: Route & Dose: Drug-Drug Interactions: Nursing Implications:
Pantoprazole Sodium Protonix Gastric proton pump inhibitor; antisecretory Short-term tx of erosive esophagitis associated w/ GERD Gastric acid pump inhibitor Diarrhea, flatulence, headache, rash PO 40 mg daily Ampicillin, iron salts, warfarin Monitor for & immediately report S&S of angioedema or a severe skin reaction. Urea breath test 4-6 wk after completion of therapy.
Implementation: Teaching:
Do not crush/ break in half. Must be swallowed whole. Contact physician if any of the following occur: Peeling, blistering, loosening of skin, shin rash, hives, itching, swelling of face, tongue lips; difficulty breathing
Generic Name: Brand Name: Classification: Indication: Action: Side/Adverse Effects: Route & Dose: Drug-Drug Interactions: Assessment: Implementation:
Teaching:
Ondansetron hydrochloride Zofran 5-HT3; Antagonist; Antiemetic Prevention of N&V associated w/ initial & repeated courses of cancer chemotherapy; postop nausea & vomiting. Selective serotonin receptor antagonist. Headache, sedation, diarrhea PO 8-16 mg Rifampin Monitor F&E & cardiovascular status. Do not push orally disintegrating tab through blister foil. Peel foil back & remove tab. Tabs will disintegrate w/ or w/out liquid. Be aware that headache requiring an analgesic for relief is a common adverse effect.
Generic Name: Brand Name: Classification: Indication: Action: Side/Adverse Effects: Route & Dose:
Drug-Drug Interactions: Assessment:
Implementation:
Generic Name: Brand Name: Classification: Indication:
Action: Side/Adverse Effects: Route & Dose: Drug-Drug Interactions: Nursing Implications:
Aspirin (Acetylsalicylic acid) Alka-Seltzer, A.S.A, Bayer, Cosprin Nonnarcotic analgesic, salicytate; antipyretic; antiplatelet Pain reliever of low-moderate intensity. Fever reducer. Inhibiting formation of prostaglandins involved in production of inflammation, pain & fever. Bronchospasm, anaphylactic shock (laryngeal edema), hemolytic anemia Pain/Fever: PO/PR 350-650 mg q4h Thromboembolic disorder: PO 81-325 mg daily MI Prophylaxis: PO 80-325 mg/day Aminosalicylic acid, ammonium chloride Monitor for loss of tolerance to aspirin. Symptoms usually occur 15 min-3 h after ingestion: profuse rinorrhea, erythema, nausea, vomiting, intestinal cramps, diarrhea. Monitor for salicylate toxicity (fullness in ears, tinnitus, decreased muffled hearing). Give w/ full glass of water, milk, food, or antacid to minimize gastric irritation. Enteric-coated tabs dissolve too quickly if administered w/ milk & should not be crushed or chewed. Fentanyl Sublimaze, Onsolis, Duragesic Analgesic; Narcotic Short-acting analgesic during operative & perioperative periods, as a narcotic analgesic supplement in general & regional anesthesia, & w/ droperidol or w/ diazepam to produce neuroleptanalgesia. Synthetic, potent narcotic agonist analgesia that causes analgesia & sedation. Sedation, circulatory depression, cardiac arrest, N&V, respiratory depression or arrest General anesthesia: IV 2-20 mcg/kg PostOp Pain: IM/IV 50-100 mcg q1-2h prn Alcohol, CNS depressants Monitor VS & observe for signs of skeletal & thoracic muscle (depressed respirations) rigidity & weakness. Have immediately available: Naloxone (Narcan), O2, resuscitative & intubation equipment
Generic Name: Brand Name: Classification: Indication:
Action: Side/Adverse Effects: Route & Dose:
Drug-Drug Interactions: Nursing Implications:
Generic Name: Brand Name: Classification: Indication: Action:
Side/Adverse Effects: Route & Dose:
Drug-Drug Interactions: Nursing Implications:
Midazolam Versed Anesthetic; benzodiazepine; anxiolytic; sedative Sedation before general anesthesia, induction of general anesthesia; to impair memory of perioperative events(anterograde amnesia); conscious sedation prior to short diagnostic and endoscopic procedures; hypnotic supplement to nitrousoxide and oxygen (balances anesthesia) for short surgical procedures. CNS depressant with muscle relaxant, sedative-hypnotic, anticonvulsant, and amnestic properties Retrograde amnesia, laryngospasm, respiratory arrest, excessive sedation Conscious sedation: IM 0.07-0.08 mg/kg 30-60 min before procedure. IV 1-2.5 mg, may be repeated in 2 min prn. Intubated pts: 0.05-0.2 mg/kg/hr continuous infusion Alcohol, CNS depressants, anticonvulsants, levodopa Inspect insertion sight for redness, pain, swelling, & other signs of extravasion during IV infusion. Monitor for indications of impending respiratory arrest. Resuscitative drugs & equipment should be immediately available. Monitor for hypotension. Monitor VS. Overdose S&S: somnolence, confusion, sedation, diminished reflexes, coma.
Heparin Hep-Lock Anticoagulant Prophylaxis & tx of venous thrombosis & pulmonary embolism & to prevent thromboembolic complications Exerts direct effect on cascade of blood coagulation by enhancing inhibitory of antithrombin III. Inhibits formation of new clots. Spontaneous bleeding, transient thrombocytopenia, bronchospams, anaphylactoid rxns, fever, chills Prophylaxis of embolism: SQ 5000 U q8-12h until pt is ambulatory Tx of Thromboembolism: IV 5000 U bolus dose, then 20,000-40,000 U infused over 24 hrs Oral anticoagulants, aspirin, NSAIDs (risk for bleeding) Lab: blood coagulation tests: Hct, Hgb, RBC, & platelet counts. Monitor APTT levels closely. Draw blood for coagulation test 30 min before each scheduled SQ or intermittent IV dose & q4h for pts receiving continuous IV heparin. Report fever, drop in BP, rapid pulse, & other S&S of hemorrhage. Observe needle sited daily for hematoma & signs of inflammation. Antidote: protamine sulfate (1% solution)
Generic Name: Brand Name: Classification: Indication:
Action: Side/Adverse Effects: Route & Dose:
Drug-Drug Interactions: Nursing Implications:
Generic Name: Brand Name: Classification: Indication: Action: Side/Adverse Effects:
Route & Dose: Drug-Drug Interactions: Nursing Implications:
Generic Name: Brand Name: Classification: Indication: Action: Side/Adverse Effects:
Route & Dose: Drug-Drug Interactions:
Nursing Implications:
Meropenem Merrem Carbapenem Antibiotic Complicated appendicitis & peritonitis, bacterial meningitis caused by susceptible bacteria, complicated skin infections, intra-abdominal infections, skin/soft tissue infections Inhibits cell wall synthesis of gram-+ & gram-- bacteria Diarrhea, N&V, phlebitis, pruritis, sepsis, shock, anemia Intra-abdominal infections: IV 1 g q8h Bacterial Meningitis: IV 2 g q8h Complicated skin infections: IV 500 mg q8h Probenecid Determine hx of hypersensitivity rxns to other beta-lactams, cephalosporins, penicillins, or other drugs. Lab: C&S test prior to therapy. Monitor liver & kidney function. D/C drug & report S&S of hypersensitivity. Report S&S of superinfection or pseudomembraneous colitis. Risperidone Risperdal Atypical Antipsychotic Tx of schizophrenia; tx of bipolar disorder Interferes with binding of dopamine. Controlls symptoms of schizophrenia as well as other psychotic symptoms. Sedation, drowsiness, headache, insomnia, agitation, extrapyramidal symptoms (akathisia, dystonia, pseudoparkisonism), neuroleptic malignant syndrome (NMS) Schizophrenia: PO 1-2 mg/day Bipolar Disorder: PO 2-3 mg once daily for up to 3 wks Risperidone may enhance effects of certain hypertensives. Carbamazepine, phenytoin may decrease risperidone levels. Monitor diabetics for loss of glycemic control. Reassess pts periodically & maintain on lowest effective drug dose. Monitor cardiovascular status closely; assess for orthostatis hypotension. Lab: Monitor blood glucose, serum elctrolytes, liver function, & CBCs. Vancomycin Hydrochoride Vancocin Antibiotic; Glycopeptide Tx of schizophrenia; tx of bipolar disorder Active against many gram-positive organisms. Nephrotoxicity leading to uremia, shock-like-state, anaphylactoid rxn w/ vascular collapse, hypotension accompanied by flushing & erythematous rash on face & upper body Systemic infections: IV 500 mg q6h or 1 g q12h C.diff Colitis: PO 125-500 mg q6h Metformin (may increase risk of lactic acidosis). Aminoglycosides(adds to toxicity of ototoxic & nephrotoxic drugs Monitor BP & HR continuously. Lab: Periodic urinalysis, kidney & liver functions, & hematologic studies. Monitor serial tests of vancomycin blood levels (peak, trough). Assess hearing (may cause damage to auditory branch). Monitor for ototoxicity (60-80 mcg/mL). Monitor I&O.
Generic Name: Brand Name: Classification: Indication: Action: Side/Adverse Effects: Route & Dose: Drug-Drug Interactions: Nursing Implications:
Generic Name: Brand Name: Classification: Indication:
Action:
Side/Adverse Effects: Route & Dose:
Drug-Drug Interactions: Nursing Implications:
Generic Name: Brand Name: Classification: Indication:
Action: Side/Adverse Effects: Route & Dose: Drug-Drug Interactions: Nursing Implications:
Bisacodyl Bisacolax, Dacodyl, Fleet Bisacodyl Stimulant Laxative Temporary relief of acute constipation & for evacuation of colon before surgery Expands intestinal fluid volume by increasing epithelial permeability. Nausea, diarrhea, F&E disturbances (K+ & Ca+) PO 5-15 mg prn PR 10 mg prn Antacids (abdominal cramping) Assess periodically for use of drug (usually produces 1-2 soft formed stools daily). Monitor pts receiving concomitant anticoagulants (decreases absorption of vitamin K). Add highfiber slowly to reg. diet to avoid gas & diarrhea. Desmopressin Acetate DDAVP, Stimate Posterior pituitary hormone To control & prevent symptoms & complications of central diabetes insipidus, & to relieve temporary polyuria & polydipsia associated w/ trauma or surgery in pituitary region. Synthetic analog of natural human posterior pituitary (antidiuretic) hormone, arginine vasopressin. Can shorten or normalize bleeding time, & correct platelet adhesion abnormalities Transient headache, rhinitis, SOB, hyponatremia, heartburn Diabetes Insipidus IV/SQ 2-4 mcg in 2 divided doses. PO 0.20.4 mg/day Enuresis Intranasal 5-40 mcg at bedtime Demeclocycline,lithium, vasopressors (may decrease antidiuretic response. Monitor I&O. Fluid intake must be carefully controlled (to avoid water retention & sodium depletion). Weigh pts daily & observe for edema. Monitor BP. Lab: Monitor urine & plasma osmolality ( in urine osmolality & a in plasma osmolality indicate effectiveness of tx in diabetes insipidus. Report upper respiratory tract infection or nasal congestion. Docusate Sodium Colace Stool softener Prophylactically in pts who should avoid straining during defecation & for tx of constipation associated with hard, dry stools. Anionic surface-acting agent w/ emulsifying & wetting properties. Diarrhea, nausea, mild abdominal cramps PO 50-500 mg/day PR 50-100 mg added to enema fluid Mineral oil W/holds drug if diarrhea develops & notify physician. Therapeutic effectiveness apparent 1-3 days after first dose. Do not take w/ mineral oil.
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Drug-Drug Interactions: Nursing Implications:
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Action: Side/Adverse Effects: Route & Dose:
Drug-Drug Interactions: Nursing Implications:
Generic Name: Brand Name: Classification: Indication: Action:
Side/Adverse Effects: Route & Dose: Drug-Drug Interactions: Nursing Implications:
Fluconazole Diflucan Azole antifungal Cryptococcal meningitis & oropharyngeal & systemic candiasis Interferes w/ formation of ergosterol, the principal sterol in fungal membrane leading to cell death. Headache, N&V, abd. pain, diarrhea, increase in AST Oropharyngeal Candidiasis PO/IV 200 mg day 1, then 100 mg /day x 14 days Esophageal Candiasis PO/IV 200 mg day 1, then 100 mg daily x 3 wk Systemic Candidemia PO/IV 40 mg day 1, then 200 mg daily x 4wk Crysptococcal Meningitis PO/IV 400 mg day 1, then 200 mg daily x 10-12 wk Warfarin, Fentanyl, Alosetron, Cyclosporine Monitor for allergic response. Lab: monitor BUN, serum creatinine & liver function. Monitor S&S of hepatotoxicity. Drug may cause elevations of ALT, AST, alkaline phosphatase, bilirubin Levoflaxacin Levaquin, Iquix, Quixin Antibiotic Tx of maxillary sinusitis, acute exacerbations of bacterial bronchitis, community-acquired pneumonia, uncomplicated skin/ skin structure infections, UTI, acute bacterial sinusitis Inhibits DNA-gyrase (an enzyme necessary for bacterial replication, transcription, repair, & recombination). Headache, insomnia, pruritis, decreased vision, foreign body sensation, photophobia, fever, pharyngitis, chest or back pain Infections PO 500 mg q24h x 10 days. IV 500 mg infused over 60 min q24h x 7 -14 days Community Acquired Pneumonia PO/IV 750mg q24h x5 days Skin & Skin Structure Infections PO 750 mg q24h x 14 days Uncomplicated UTI PO/IV 250 mg q24h x 14 days Magnesium or aluminum-containing antacids, NSAIDS Lab: Do C&S test prior to beginning therapy. W/hold therapy & notify physician for following: skin rash or signs of a hypersensitivity rxn; CNS S&S (seizures, restlessness, confusion, depression, hallucinations), joint pain, inflammation Selenium Sulfide Exsel, Selsun Antibiotic; Topical; Antifungal Itching & flaking of scalp Active against Pityrosporum ovale, a yeast like fungus found in the normal flora of the scalp. Decreases rate of growth of the epithelial cells of the scalp/ body. Skin irritation (stinging), diffuse hair loss, hair discoloration TOP Massage 5-10 mL of a 1-2.5% solution into wet scalp None Monitor effectiveness, rinse thoroughly with water if in contact with eyes. Hair loss is reversible after 2-3 wk after tx is D/C. D/C use if skin is irritated or tx fails.
Generic Name: Brand Name: Classification: Indication: Action:
Side/Adverse Effects: Route & Dose: Drug-Drug Interactions: Nursing Implications:
Generic Name: Brand Name: Classification: Indication: Action: Side/Adverse Effects: Route & Dose: Drug-Drug Interactions: Nursing Implications:
Generic Name: Brand Name: Classification: Indication:
Action: Side/Adverse Effects: Route & Dose: Drug-Drug Interactions: Nursing Implications:
Magnesium Hydroxide Magnesia, Milk of Magnesia Saline catharctic; Antacid Short term tx of occasional constipation, relief of GI symtoms Aqueous suspension of magnesium hydroxide w/ rapid & long-acting neutralizing action. Acts as antacid in low doses & as mild saline laxative at higher doses Diarrhea, coma, complete heart block, ECG abnormalities, respiratory depression, weakness, lethargy PO 2.4-4.8 g/ day in 1 or more divided doses Reduces effects of Digoxin, chlordiazepoxide, quinolones Evaluate for need of drug. May lead to dependence. Lab: Monitor serum Mg w/ signs of hypermagnesemia-bradycardia Piperacillin/ Tazobactam Zosyn Beta-lactam antibiotic; penicillin Moderate to severe appendicitis, uncomplicated/ complicated skin & skin structure infections, endometritis, PID 2-drug combination has antibiotic activity against extremely broad spectrum of gram-+, gram --, & anaerobic bacteria Insomnia, fever, pseudomembraneous colitis, rash, pruritis Mod- Severe Infections IV 3.375 q q6h infused over 30 min Nosocomial Pneumonia IV 4.5 g q6h infused over 30 min Anticoagulants (increases risk of bleeding) Obtain hx of hypersensitivity to penicillins (rash, itching) prior to administration. Lab: C&S prior to 1st dose. Monitor hematologic status w/ prolonged therapy (Hct, hgb, CBC, plt.count). Monitor pt during 1st 30 min after initiation. Sulfacetamide Sodium Cetamide, Ophthacet Sulfonamide antibiotic Opthlamic preparations are used for conjunctivitis, corneal ulcers, & other superficial ocular infections. Topical lotion is used for scaly dermatoses, seborrheic sicca, & other bacterial skin infections Effective against a wide range of gram-+ & gram -microorganisms Temporary stinging or burning sensation, hypersensitivity rxns (stevens-johnson’s syndrome), superinfection Ophthalmic 1-3 drops Tetracaine, local anesthetics derived from paba D/C if symptoms of hypersensitivity appear (erythema, skin, rash, pruritis, urticaria), examine eye med (discard if cloudy or dark in color), report purulent eye discharge to physician
Generic Name: Brand Name: Classification: Indication: Action: Side/Adverse Effects: Route & Dose: Drug-Drug Interactions: Assessment:
Pantoprazole Sodium Protonix Gastric proton pump inhibitor; antisecretory Short-term tx of erosive esophagitis associated w/ GERD Gastric acid pump inhibitor Diarrhea, flatulence, headache, rash PO 40 mg daily Ampicillin, iron salts, warfarin Monitor for & immediately report S&S of angioedema or a severe skin reaction. Urea breath test 4-6 wk after completion of therapy.
Implementation: Teaching:
Do not crush/ break in half. Must be swallowed whole. Contact physician if any of the following occur: Peeling, blistering, loosening of skin, shin rash, hives, itching, swelling of face, tongue lips; difficulty breathing
Generic Name: Brand Name: Classification: Indication: Action:
Side/Adverse Effects: Route & Dose:
Drug-Drug Interactions: Nursing Implications:
Heparin Hep-Lock Anticoagulant Prophylaxis & tx of venous thrombosis & pulmonary embolism & to prevent thromboembolic complications Exerts direct effect on cascade of blood coagulation by enhancing inhibitory of antithrombin III. Inhibits formation of new clots. Spontaneous bleeding, transient thrombocytopenia, bronchospams, anaphylactoid rxns, fever, chills Prophylaxis of embolism: SQ 5000 U q8-12h until pt is ambulatory Tx of Thromboembolism: IV 5000 U bolus dose, then 20,000-40,000 U infused over 24 hrs Oral anticoagulants, aspirin, NSAIDs (risk for bleeding) Lab: blood coagulation tests: Hct, Hgb, RBC, & platelet counts. Monitor APTT levels closely. Draw blood for coagulation test 30 min before each scheduled SQ or intermittent IV dose & q4h for pts receiving continuous IV heparin. Report fever, drop in BP, rapid pulse, & other S&S of hemorrhage. Observe needle sited daily for hematoma & signs of inflammation. Antidote: protamine sulfate (1% solution)
Generic Name: Brand Name: Classification: Indication: Action: Side/Adverse Effects: Route & Dose: Drug-Drug Interactions: Nursing Implications:
Generic Name: Brand Name: Classification: Indication: Action: Side/Adverse Effects: Route & Dose: Drug-Drug Interactions: Nursing Implications:
Generic Name: Brand Name: Classification: Indication: Action: Side/Adverse Effects: Route & Dose:
Drug-Drug Interactions: Nursing Implications:
Generic Name: Brand Name: Classification: Indication: Action: Side/Adverse Effects: Route & Dose: Drug-Drug Interactions: Nursing Implications:
Generic Name: Brand Name: Classification: Indication: Action: Side/Adverse Effects: Route & Dose: Drug-Drug Interactions: Nursing Implications:
