BRAND NAME/ CLASSIFICATION DOSAGE, DATE AND MODE OF ACTION INDICATION SIDE EFFECT NURSING CONSIDERATIONS

TRADE NAME TIME STARTED

Omeprazole Proton pump inhibitor Gastric acid-pump short-term treatment of CNS: Headache, >Give before meals
inhibitor: Suppresses active duodenal ulcer dizziness, asthenia, >Do not crush or chew
gastric acid secretion by vertigo, insomnia, tablets, swallow whole
specific inhibition of the apathy, anxiety, >Evaluate for therapeutic
hydrogen-potassium paresthesias, dream response like relief of
ATPase enzyme system abnormalities Gastrointestinal symptoms
at the secretory surface
of the gastric parietal Dermatologic: Rash,
cells; blocks the final inflammation, urticaria,
step of acid production. pruritus, alopecia, dry
skin

GI: Diarrhea, abdominal

pain, nausea, vomiting,
constipation, dry mouth,
tongue atrophy

Respiratory: URI
symptoms, cough,
epistaxis

Other: Cancer in
preclinical studies, back
pain, fever

Inhibits the reabsorption Edema, nephrotic F&E: Fluid and  Note indications
Furosemide Diuretics, Loop of sodium and chloride syndrome electrolyte depletion, for therapy and
in the proximal and Dehydration, other agents
Lasix distal tubules as well as Hypovolemia, trialed
the ascending loop of Thromboembolsm
Henle, this results in the IV for acute  Observe for
excretion of sodium, pulmonary OTIC: Tinnitus, hearing ototoxicity
 chloride and to a lesser impairment
degree, potassium and edema  Assess closely for
bicarbonate ions. GI: Nausea, oral and signs of vascular
gastric irritation, thrombosis
vomiting, anorexia
 PO to treat HPN  Monitor BP, weight,
in conjunction CNS: vertigo, edema, breath
with headache, dizziness, sounds, I & O
spironolactic blurred vision
 For chronic use,
Hemat: Anemia, assess for thiamine
Neutropenia deficiency

CV: Orthostatic
Hypotension

Ketorolac Nonsteroidal anti- Inhibits prostaglandin CNS:drowsiness

inflammatory agents, synthesis, producing Short term management abnormal thinking
Toradol nonopioid analagesics peripherally mediated of pain dizziness
analgesia CV: edema,pallor,  Consider
- Also has antipyretic and vasodilation supplemental
anti-inflammatory GI: GI Bleeding opioid analgesics
properties. abnormal taste, for breakthrough
diarrhea, dry mouth pain; don't increase
GU: oliguria, renal the dose or
toxicity, urinary frequency of
frequency ketorolac.
- - HEMAT:
prolonged bleeding time  Hypersensitivity
MISC: allergic reaction, reactions may occur
anaphylaxis after an I.M. or I.V.
dose; have
 epinephrine and
emergency
equipment
available.

 Assess for unusual

bleeding or
bruising, edema,
and renal
impairment.

 Test stools and

emesis for occult
blood. .

 Ketorolac is also
available in oral
form. Oral therapy
is indicated only as
a continuation of
Tramadol Analgesic, centrally Binds to mu-opioid CNS: Sedation, dizziness I.V. therapy; don't
Hydrochlooride acting receptors and inhibits Relief of moderate to or vertigo, headache, give oral ketorolac
the reuptake of moderately severe pain. confusion, dreaming, to patients who
Ultram norepinephrine and sweating, anxiety, weren't on I.V.
serotonin; causes many seizures ketorolac.
effects similar to the CV: Hypotension,
opioids—dizziness, tachycardia, bradycardia
somnolence, nausea, Dermatologic: Sweating,
constipation—but does pruritus, rash, pallor,  Assess type,
not have the respiratory urticaria location, and
depressant effects GI: Nausea, vomiting, intensity of pain
dry mouth, constipation, before and 2-3 hr
flatulence (peak) after
 Other: Potential for
abuse, anaphylactoid administration.
reactions
 Assess BP & RR
before and
periodically during
administration.
Respiratory
depression has not
occurred with
recommended
Spironolactone Potassium-sparing Competitively blocks the CNS: Dizziness, doses.
Diuretic effects of aldosterone in Adjunctive therapy in headache, drowsiness,
Aldactone the renal tubule, causing edema associated with fatigue, ataxia, confusion  Encourage patient
loss of sodium and water CHF Dermatologic: Rash, to cough and
and retention of Essential hypertension, urticaria breathe deeply
potassium. usually in combination GI: Cramping, diarrhea, every 2 hr to
with other drugs dry mouth, thirst, prevent atelactasis
vomiting. and pneumonia.
GU: Impotence, irregular
menses, amenorrhea,
postmenopausal
bleeding  Used with other
Hematologic: diuretics
Hyperkalemia,
hyponatremia,  Give with meals
agranulocytosis
Other: Carcinogenic in  Avoid salt
animals, deepening of substitutes
the voice, hirsutism, containing
gynecomastia potassium

Albuterol Sulfate Bronchodilator In low doses, acts CNS: Restlessness,  Monitor I and O
Beta2-selective relatively selectively at Relief and prevention of apprehension, anxiety,
Salbutamol adrenergic agonist beta2-adrenergic bronchospasm in fear, CNS stimulation,
receptors to cause patients with reversible hyperkinesia, insomnia,
bronchodilation and obstructive airway tremor, drowsiness,
vasodilation; at higher disease irritability, weakness,
doses, beta2 selectivity is vertigo, headache
lost, and the drug acts at   CV: Cardiac
beta2 receptors to cause arrhythmias,
typical tachycardia, palpitations,
sympathomimetic PVCs (rare), anginal pain
cardiac effects. Dermatologic: Sweating,
pallor, flushing
GI: Nausea, vomiting,
heartburn, unusual or
bad taste in mouth  Drug may decrease
GU: Increased incidence sensitivity of
of leiomyomas of uterus spirometry used for
when given in higher diagnosis of asthma
than human doses in
preclinical studies  Monitor for
Respiratory: Respiratory evidence of allergix
difficulties, pulmonary reaction
edema, coughing,
bronchospasm,
paradoxical airway
resistance with
repeated, excessive use
of inhalation
preparations

Digoxin Cardiac glycoside Increases intracellular CNS: Headache,

 calcium and allows more For the treatment and weakness, drowsiness,
Lanoxin calcium to enter the management of visual disturbances,
myocardial cell during congestive cardiac mental status change
depolarization via a insufficiency, CV: Arrhythmias
sodium–potassium arrhythmias and heart GI: GI upset, anorexia
pump mechanism; this failure.
increases force of
contraction (positive
inotropic effect),
increases renal perfusion
(seen as diuretic effect in
patients with CHF),
decreases heart rate
(negative chronotropic
effect), and decreases
AV node conduction  Take apical pulse
velocity. for 1 full minute
noting the rate,
rhythm, quality
before
administering. If
changes are noted,
withhold the
digoxin

Dobutamine Inotropic, Adrenergic Enhancing the force of CV: angina,  Withdold med if
Hydrochloride myocardial contraction Short term treatment of hypertension, pulse falls below
Increasing the H R, CO, cardiac decompensation hypotension, increased ordered
Dobutrex and SV with minor in heart parameters
effects to HR. organic heart disease of rate, nonspecific chest
Decrease elevated cardiac surgical pain,  Monitor I and O
ventricular filling pressures phlebitis, PVCs. ratio during
pressure and helps AV GI: nausea and vomiting. digitalization,
node conduction Respiratory: asthma particularly in
 attacks,
shortness of breath. patients with
Others: anaphylaxis impaired renal
function. M0nitor
for edema daily and
auscultate of
altered chest for
rales>>

 Monitor ECG and

Clopidrogel Adenosine diphosphate Inhibits platelet CNS: Headache, BP
(ADP) receptor aggregation by blocking For the reduction of dizziness, weakness, continuously during
Plavix antagonist ADP receptors on atherosclerotic events syncope, flushing drug
platelets, preventing (myocardial infarction, CV: Hypertension, administration
Antiplatelet clumping of platelets. stroke, and vascular edema
death) in patients with Dermatologic: Rash,  Record I&O>
atherosclerosis pruritus
documented by recent   GI: Nausea, GI distress,  Drug is
stroke, recent constipation, diarrhea, administered IV to
myocardial infarction, or GI bleed improve cardiac
established peripheral Other: Increased function thus
arterial disease bleeding risk increasing BP and
improving
urine output.>
Hydroxyzine Anxiolytic Mechanisms of action CNS: Drowsiness,
not understood; actions Symptomatic relief of involuntary motor  Report any chest
may be due to anxiety and tension activity, including tremor pain,
suppression of associated with and seizures increase SOB,
subcortical areas of the psychoneurosis; adjunct         GI: Dry mouth, headaches or
CNS; has clinically in organic disease states reflux, constipation IV site pain>
demonstrated in which anxiety is         GU: Urinary
antihistaminic, analgesic, manifested; alcoholism retention
 and asthma;         Hypersensitivity:
antispasmodic, Wheezing, dyspnea,
antiemetic, mild chest tightness
antisecretory, and  Advise patients that
bronchodilator activity excessive intake of
alcohol should be
avoided with this
medication>

 Ensure that
patients know they
should report any
signs of increased
bleeding and
bruising.>

 Assess patient for

profound sedation
and provide safety
precautions as
indicated (side rails
up, bed in low
position, call bell
within reach,
supervision of
ambulation and
transfer).Geri:
Older adults are
more sensitive to
CNS and
anticholinergic
effects (delirium,
 acute confusion,
dizziness, dry
mouth, blurred
vision, urinary
retention,
Ceftrazidime CNS: Headache, constipation,
Bactericidal: Inhibits Lower respiratory dizziness, lethargy, tachycardia).>
Ceptaz synthesis of bacterial cell infections caused by P. paresthesias
Antibiotic wall, causing cell death. aeruginosa, other GI: Nausea, vomiting,  Monitor for
Pseudomonas, S. diarrhea, anorexia, drowsiness,
Cephalosporin (third pneumoniae, S. aureus, abdominal pain, agitation, over
generation) Klebsiella, H. influenzae, flatulence, sedation, and other
P. mirabilis, E. coli, pseudomembranous systemic side
Enterobacter, Serratia, colitis, liver toxicity effects. Assess falls
Citrobacter GU: Nephrotoxicity risk and implement
Hematologic: Bone prevention
marrow depression— strategies>
decreased WBC,
decreased platelets,  AnxietyAssess
decreased Hct mental status
Hypersensitivity: (orientation, mood,
Ranging from rash to and behavior)>
fever to anaphylaxis,
serum sickness reaction  Nausea and
Local: Pain, abscess at VomitingAssess
injection site; phlebitis, degree of nausea
inflammation at IV site and frequency and
Other: Superinfections, amount of emesis>
disulfiram-like reaction
with alcohol  PruritusAssess
degree of itching
and character of
Tranexamic acid CV: Hypotension
Medical: epistaxis, Respiratory: respiratory involved skin
Cyklokapron hemoptysis, hematuria, tract and sinus
Antifibrinolytic Tranexamic acid peptic ulcer with congestion, sinusitis,
competitively inhibits hemorrhage and blood acute sinusitis, sinus
antihemorrhagic activation of dyscrasias with headache, and allergic  Ask patient if he is
plasminogen (via binding hemorrhage sinusitis and sinus pain. has
to the kringle domain), Musculoskeletal: allergies to
thereby reducing included back pain, penicillin
conversion of musculoskeletal pain, and cephalosporin
plasminogen to plasmin muscle cramps and
(fibrinolysin), an enzyme spasms, myalgia, and  If large doses are
that degrades fibrin arthralgia including joint given, therapy is
  clots, fibrinogen, and stiffness and swelling. prolonged or
other plasma proteins, GI: nausea, vomiting, patient is
including the and diarrhea. Abdominal at high risk,
procoagulant factors V pain has also been monitor for
and VIII. Tranexamic acid reported. sing and symptoms
also directly inhibits of
plasmin activity, but super infection.
higher doses are
required than are
needed to reduce
plasmin formation.