Medication

-dose Classification Indication/Intended Nursing

-route Mechanism of action Purpose for this patient Implications
-frequency Relevant
Assessment

Acetaminophen CNS agent, Non-narcotic analgesic, Used to mediate mild Monitor for S&S of
hepatotoxicity especially in
325-650mg q4-6h or antipyretic pain or fever. pts with poor nutrition.
1g 3-4 times daily or Assess amount,
1300mg q8h (not to frequency, and
exceed 4g) MoA: Produces analgesia by Contraindicated with use of alcohol. type of drugs
Toxicity leads to liver damage.
Oral unknown mechanism, perhaps by taken by pts who
action on peripheral nervous A/e: nausea, stomach pain, loss of
appetite, itching, rash, headache, dark
are self-
system. Reduces fever by urine, clay-colored stools, jaundice, medicating. Assess
lethargy, diaphoresis.
direct action on pain type, location,
hypothalamus heat- and intensity
regulating center with before and 30-
consequent peripheral 60min after
vasodilation, sweating, and administration.
dissipation of heat. Unlike For fever: assess
aspirin, acetaminophen has fever, note
little effect on platelet presence of
aggregation, does not affect associated signs
bleeding time, and generally (diaphoresis,
produces no gastric bleeding tachycardia, and
malaise)
Pharm:

Acetylsalicylic Acid EC CNS agent, Analgesic, salicylate; To relieve pain of low to moderate Pain: Assess pain and
antipyretic, antiplatelet intensity. For various limitation of movement;
inflammatory conditions such as note type, location, and
Antiplatelet action: Aspirin (but not rheumatic fever/arthritis, intensity before and at
other salicylates) powerfully inhibits osteoarthritis and to reduce fever the peak (1-3hr)
platelet aggregation. Inhibits formation in selected febrile conditions. To
of prostaglandins involved in prevent recurrence of MI. Can be
production of inflammation, pain, and used as a blood thinner. Monitor PTT and INR
fever.
A/e: dizziness, confusion, tinnitus,
hearing loss, nausea, vomiting,
diarrhea, occult bleeding, GI
bleeding, anemia, bruising, rash,
impaired renal function.
Alendronate Biphosphonate; regulator, bone Prevention and treatment Monitor albumin-
metabolism of osteoporosis in adjusted serum
postmenopausal women, calcium,
MoA: Inhibits osteo-clast mediated Paget’s disease. phosphate,
bone resorption. Treatment of alkaline
 glucocorticoid-induced phosphatase.
osteoporosis. Periodically
monitor renal and
liver functions.
Alprazolam CNS agent, anxiolytic, sedative- Management of anxiety Monitor S&S of
hypnotic, benzodiazepine disorders or for short- drowsiness and
term relief of anxiety sedation,
symptoms. Also used as especially in older
adjunct in management of adults. May
anxiety associated with require supervised
depression and agitation, ambulation and/or
and for panic disorders side rails.
such as agoraphobia.
Amiodarone tablet Cardiovascular agent; antiarrhythmic Prophylaxis treatment of Monitor S&S of
100mg life-threatening adverse effects,
PO ventricular arrhythmias particularly
OD and supraventricular conduction
arrhythmias, particularly disturbances and
with atrial fibrillation exacerbation of
arrhythmias.
Auscultate chest
periodically if
patient complains
of respiratory
symptoms.
Amlodipine Cardiovascular agent; calcium Management of mild to Monitor BP for
5-10mg channel blocker; antihypertensive moderate hypertension therapeutic
PO agent and angina effectiveness.
Monitor for S&S of
OD dose related
MoA: Calcium channel A/e: palpitations, peripheral or facial
Calcium channel blocking agent that tachycardia, peripheral or edema that may not
blocker selectively blocks calcium ion facial edema, be accompanied by
reflux across cell membranes bradycardia, chest pain, weight gain. Monitor
of cardiac and vascular light headedness, fatigue, BP with postural
abdominal pain, nausea, changes. Report
smooth muscle without
postural hypotension.
changing serum calcium myalgia Monitor HR.
concentrations. It
predominantly acts on the
peripheral circulation,
decreasing peripheral
vascular resistance, and
increases cardiac output

Amoxicillin Antibiotic Used to treat infections. Monitor renal,

250mg – 500mg Mild to moderate ear, hepatic,
Oral nose, throat, and skin. hematologic
Q8h/Q12h Pharyngitis, tonsillitis, function. Assess at
acute otitis media, GU the beginning and
tract throughout for
 infection.
Aripiprazole CNS agent; Psychotherapeutic,
antipsychotic; Atypical

MoA: Functions as a partial

agonist at the dopamine
D2 and the serotonin 5-
H1A receptors, and as an
antagonist at serotonin 5-
HT2A receptors

Atorvastatin Tablet Cardiovascular agent, antilipemic Adjunct to diet for the Monitor for
10mg-80mg agent, reductase inhibitor (statin) reduction of LDL therapeutic
PO cholesterol and effectiveness
MoA: inhibitor of reductase 3- triglycerides in patients which is indicated
hydroxy-3-methyl-glutaryl with primary by reduction of
coenzyme A (HMG-CoA), hypercholesterolemia and LDL-C. Assess for
which is essential to hepatic dyslipidemia muscle pain,
production of cholesterol. tenderness or
Contraindicated in active liver disease, weakness and if
Lipitor increases the number caution use in patients who consume
of hepatic low-density-lipid substantial quantities of alcohol. present monitor
Adverse effects: Back pain, CPK level.
(LDL) receptors, thus hypersensitivity reaction,
increasing LDL uptake and rhabdomyolysis, headache, abdominal Monitor liver
pain, constipation, diarrhea, dyspepsia, function test
catabolism of LDL flatulence, increased liver function
tests, sinusitis, pharyngitis, rash.
Atrovent ANS agent; Anticholinergic; Maintenance therapy in Monitor
Bronchodilator COPD including chronic respiratory status.
bronchitis and Auscultate lungs
MoA: Does not cross BBB, site emphysema. Nasal spray before and after
specific effects on larger central for perennial rhinitis and inhalation. Report
airways including bronchioles symptomatic relief of treatment failure to
prevention of bronchospasms rhinorrhea assoc. with MD.
common cold. (Exacerbation of
respiratory
A/e: Blurred vision, eye symptoms)
pain, worsening of
narrow angle glaucoma,
bitter taste, nausea,
constipation, cough,
hoarseness, rash, hives,
urinary retention,
headache.
Bacitracin Anti-infective, anti-biotic Used topically for Clean affected
superficial infections of area prior to
MoA: Appears to interfere skin application.
with function of bacterial cell
membrane by inhibiting cell A/E: Anorexia, nausea,
wall synthesis. Similar to vomiting, diarrhea, rectal
penicillin. Bactericidal or itching and burning
 bacteriostatic depending on
concentration and
susceptibility of organism

Pharm: poorly absorved from

intact or denuded skin or
mucous membranes.

Betamethasone Hormone and synthetic substitute; Topical use provides Assess therapeutic
Valerate adrenal Corticosteroid; relief of effectiveness.
Glucocorticoid; Anti-inflammatory inflammatory Response
manifestations of following
MoA: Synthetic, long-acting corticosteroid- intraarticular,
glucocorticoid with minor responsive intralesional,
mineralocorticoid properties dermatoses. or
but strong intrasynovial
immunosuppressive, administration
antiinflammatory, and occurs within a
metabolic actions few hours and
persists for 1–4
wk

Bisacodyl EC Gastrointestinal agent; stimulant laxative Treatment of Assess patient for

tablet constipation, particularly abdominal
5-15mg MoA: Expands intestinal fluid when associated with distention,
PO volume by increasing epithelial prolonged bed rest. presence of bowel
permeability. sounds, and usual
A/e: Systemic effects pattern of bowel
not reported. Mild function. Assess
cramping, nausea, color, consistency,
diarrhea, fluid and and amount of
electrolyte stool produced.
disturbances
(especially
potassium and
calcium

Bisoprolol ANS agent; Beta adrenergic antagonist; Hypertention Monitor BP and

antihypertensice HR, monitor for
MoA: Decreased HR, BP, reduces
bronchospasm or
myocardial oxygen consumption and A/e: Dizziness, fatigue, diabetics for loss
increases flow to myocardium vertigo, headache, of glycemic
bradycardia, orthostatic control
hypotension, rebound
HTN d/c, abdominal pain,
nausea, vomiting, rash.
Budesonide/ Hormone and synthetic substitute, Treatment of allergic and Monitor closely
formoterol Dose adrenal corticosteroid; perennial rhinitis, for S&S of
1 puff patient to glucocorticoid. maintain remission in hypercorticism
use own med. mild to moderate Crohn’s especially in
disease; prophylaxis for patients with
asthma moderate to severe
liver disease.
Bupropion CNS agent; antidepressant Mental depression; May take 4 weeks
adjunct for smoking to see
MoA: Unknown, does not inhibit cessation effectiveness,
monoamine. Weak blocker of uptake monitor close for
of serotonin and norepinephrine A/e: weight loss or gain, worsening of
Pharm: Absorbed in GI tract, onset 3- seizures highly dependent depression or
4 weeks, metabolized in liver via first on dose especially suicidal
pass. Excreted in urine. >450mg/day or hx of tendencies, report
seizures, tachycardia, restlessness,
rash. agitation, anxiety,
insomnia.

Calcitriol Hormones & synthetic substtutes; Management of Monitor for S&S

vitamin D analog hypocalcemia in of hypercalcemia
patients undergoing
MoA: Calcifediol is chronic renal
biodegraded in the kidney to dialysis and in
calcitriol, the most potent patients with
form of vitamin D3. Pt with hypoparathyroidism
nonfunctioning kidneys are or
unable to synthesize pseudohypoparathyr
sufficient calcitriol and oidism.
therefore must receive it
pharmacologically.
A/e: Muscle or bone pain,
Pharm: absorbed in GI tract, palpitation, anorexia,
metabolized in liver, excreted in N&V, dry mouth, thirst,
feces. cramps, hypercalemia,
blurred vision.
Calcium Carbonate Mineral and Electrolyte Prevention of Observe patient
1-2g/day replacement/supplement Hypocalcemia, treatment closely for
Antacid 0.5-1.5g of depletion, symptoms of
PRN MoA: Rapid-acting antacid osteoporosis. Hypocalcemia
with high neutralizing (paresthesia,
capacity and relatively muscle twitching,
prolonged duration of action. laryngospasm,
Decreases gastric acidity, colic, cardiac
thereby inhibiting proteolytic arrhythmias,
Antacid: when used as Chvostek or
 action of pepsin on gastric antacid assess for Trousseau’s sign)
mucosa. Also increases lower heartburn, indigestion, Notify physician
esophageal sphincter tone and abdominal pain. or other health
care professional if
A/e: constipation or occurs.
laxative effect, acid Monitor VS, and
rebound, nausea, ECG frequently
flatulence, vomiting, throughout
hypomagenesia, parenteral therapy.
hypophosphatemia, mood May cause
and mental changes, vasodilation
polyuria. resulting in
hypotension,
bradycardia,
arrhythmias, and
cardiac arrest.
Carbamazepine CNS agent; Anticonvulsant; In treatment of temporal Monitor for
Tricyclic lobe epilepsy and mixed drowsiness,dizzine
seizures in patients who ss, light-
MoA: provides relief in trigeminal have not responded headedness,
neuralgia by reducing synaptic satisfactorily to other gastric upset.
transmission within trigeminal agents. Also used to treat Withhold drug and
nucleus. Also has sedative, pain symptoms for other notify MD if RBC
anticholingergic, antidepressant, and neurologic disorders. <4million, Hct
muscle relaxation effects and slight <32%, Hgb
analgesic actions. <11 g/dL, WBC
<4000/mm3,
platelet count
<100,000/mm3
, reticulocyte
count
<20,000/mm3,
serum iron
>150 mg/dL.
Monitor for
toxicity, I&O
during dosage
adjustment.
Confusion and
agitation may be
aggravated in the
older adult.
Cefazolin Anti-infective; antibiotic; first Severe infections of Determine hx of
generation cephalosporin urinary and biliary sensitivity to
tracts, skin, soft cephalosporins or
MoA: Bactericidal action: tissue, and bone, penicillins before
preferentially binds to one or and for bacteremia therapy is
more of the penicillin-binding and endocarditis initiated. Perform
proteins (PBP) located on cell caused by C&S testing prior
 walls of susceptible susceptible to and during
organisms. This inhibits third organisms; also therapy. Monitor
and final stage of bacterial perioperative I&O rates and
cell wall synthesis, thus prophylaxis in pattern. Promptly
killing the bacterium patients undergoing report onset of
procedures diarrhea.
associated with high
risk of infection

A/e: anaphylaxis, fever,

superinfections, seizure,
diarrhea, anorexia,
abdominal cramps,
urticaria

Ceftazidime Anti-infective, antibiotic, third- To treat infections of Determine hx of

1g INJ IV generation cephalosporin lower respiratory tract, hypersensitivity to
skin and skin structures, cephalosporins
urinary tract, bones and and penicillin and
joints; also used to treat other drug
Peak: 1h after IV bacteremia, allergies before
Half-life: 25-60min gynecological, intra- therapy begins. Be
abdominal and CNS alert to onset of
infections. rash, itching and
dyspnea/ Check
temp. if elevated
suspect
hypersensitivity. If
diarrhea occurs
and is severe,
suspect
pseudomembranou
s colitis.
Ceftriaxone Anti-infective, Antibiotic; 3rd Used to treat infections D etermine hx of
generation Cephalosporin sensitive to
s/e Pruritus, fever, chills, cephalosporins
MoA: binds to one or more of the abdominal cramps, and penicillins.
penicillin-binding proteins (PBP) phlebitis, diarrhea Report signs of
located on cell walls of susceptible petechiae,
organisms. echymotic areas
Celecoxib CNS agent, analgesic, NSAID, Relief S&S of Therapeutic
antipyretic osteoarthritis and effectiveness is
rheumatoid arthritis. indicated by relief
Treatment of acute pain of joint pain,
and primary monitor for fluid
dysmenorrhea. retention and
edema especially
in those with hx of
HTN or CHF
Chlorthalidone Electrolyte & water balance agent; Edema associated with Establish baseline
25mg / 0.5 tab thiazide diuretic CHF, renal BP and check at
decompensation, hepatic regular intervals
cirrhosis, corticosteroid during dosage
and estrogen therapy; as adjustment. Be
sole agent or with other alert to signs of
antihypertensives to treat hypokalemia.
hypertension Older adults more
sensitive to
adverse effects.
Cholecalciferol Vitamin D3 analog Vitamin D dietary Assess patients
(Vitamin D3) supplement Calcium and
PO Binds to vitamin D receptors to Vitamin D levels
maintain calcium balance, regulation prior to
of parathyroid hormone, promotion administration.
of renal reabsorption of calcium. Monitor vitamin
toxicity for
hypercalcemia,
hypercalciuria,
confusion, N/V,
tremor, and
weakness
Ciprofloxacin Anti-infective; Quinolone Antibiotic Used to treat UTI, lower Report tendon
respiratory tract inflammation,
MoA: Bacterial agent, inhibits DNA- infections, skin culture&sensitivity
gyrase necessary for bacteria DNA /bone/joint infections, test should be
replication GI/diarrhea infectious. done prior to dose.
Monitor I&O
Pharm: Excreted in the urine with A/e:N&V, diarrhea, ratio. Assess GI
some biliary excretion cramps, headache, irritation/super
vertigo, malaise, infections
peripheral neuropathy,
seizures, rash, pruritus
Citalopram CNS agent, psychotherapeutic agent, Used to treat depression Watch closely for
20mg selective serotonin-reuptake inhibitor worsening of
PO (SSRI) depression or
OD suicidal ideations.
Monitor for
MoA: SSRI in the CNS. therapeutic
Antidepressant effect is effectiveness.
presumed to be linked to its Monitor
inhibition of CNS presynaptic periodically HR
neuronal uptake of serotonin and BP. Monitory
which results in older adults
antidepressant activity. Does closely for adverse
not produce any effects especially
sympathomimetic response with doses
or anticholinergic activity >20mg/d
Clopidogrel Antiplatelet agent Reduction of Assess patient for
Recent atherosclerotic events symptoms of
MI/stroke/PVD (MI, stroke, vascular stroke, peripheral
75mg death) in patients at risk vascular disease,
PO for such events including or MI periodically
OD recent MI, acute coronary during therapy.
Acute coronary syndrome, stroke, or
Syndrome peripheral vascular
300mg initially, then disease.
75mg once daily
PO
OD

Cloxacillin Anti-infective;anti-biotic, natural Used to treat infections Determine

penicillin, beta-lactam caused by sensitivity or
penicillinase- allergy to
MoA: Effective against most producing penicillins and
gram-positive bacteria staphylococci and cephalosporins.
penicillin-resistant Monitor for S&S
Pharm: Absorbed in GI tract, staphylococci of anaphylactoid
metabolized in liver, excreted reaction.
primarily in urine. A/e: wheezing,
sneezing, chills,
drug fever,
anaphylaxis,
superinfections;
nausea, vomiting.

Codeine CNS Agent; Narcotic agonist Symptomatic relief Record relief of

analgesic; Antitussive of mild to pain and duration
moderately severe of analgesia.
MoA: Opium derivative similar pain when control Evaluate
to morphine. In equianalgesic cannot be obtained effectiveness as
doses, parenteral codeine by nonnarcotic cough suppressant.
produces degree of analgesics and to Supervision of
respiratory depression similar suppress ambulation and
to that of morphine. In hyperactive or use other safety
contrast to morphine, orally nonproductive precautions as may
administered codeine is cough cause dizziness
about 60% as potent as the and light
parenteral form. Histamine- headedness.
releasing action appears to Monitor for
be more potent than that of nausea, a common
morphine and may result in side effect.
hypotension, flushing, and
rarely bronchoconstriction
Cotrimoxazole

Coumadin(Warfarin) Anticoagulant, Coumadin derivative Prophylaxis and treatment Monitor INR

HOLD ( on of the thromboembolic Monitor for
dalteparin for complications associated bleeding
surgery) with atrial fibrillation Monitor closely
2 mg older adult,
Oral psychotic, or
OD alcoholic patients
because they
present serious
noncompliance
problems.
Dalteparin Blood former, coagulators, Prevention and treatment Monitor for
5000 iu anticoagulant, low molecular weight of DVT following hip or bruising and
Subcut heparin knee replacement, bleeding.
OD abdominal surgery, Pt to use electric
MoA: Enhances inhibition of factor unstable angina and razor and soft
Xa and thrombin by antithrombin coronary syndromes. toothbrush to
Prevention of prevent tissue
thromboembolic events. trauma. Alternate
injection sites using the
abdomen, anterior thigh or
Contraindicated in severe and
outer aspect of upper arms.
uncontrolled HTN, hypersensitivity to
Monitor CBC with platelet
heparin, history of HIT, bleeding
count, urinalysis, stool for
disorders, recent GI bleeding, platelet
occult. Monitor S&S of
disorders, severe liver or renal disease.
excessive bleeding at
Adverse effects: rash, urticaria, pain
surgical sites or
and inflammation at injection site,
hemorrhage.
peripheral edema, fever, dizziness,
headache, insomnia, nausea, vomiting,
pruritis.

Dexamethasone Hormones and synthetic substitutes, Inflammatory conditions, Monitor for S&S
adrenal corticosteroid, allergic states, collagen of Cushing’s
glucocorticosteroid, steroid disease, hematologic syndrome or other
disorders, cerebral edema. systemic adverse
MoA: Antiinflammatory effects, monitor
action: Prevents for
accumulation of inflammatory hypersensitivity
cells at sites of infection; reaction.
inhibits phagocytosis,
lysosomal enzyme release,
and synthesis of selected
chemical mediators of
inflammation; reduces
capillary dilation and
 permeability. Immunosuppr
ession: Not clearly
understood, but may be due
to prevention or suppression
of delayed hypersensitivity
immune reaction.

Dextrose Carbohydrate Treatment of Does not contain

injection hypoglycemia enough calories to
Provides calories, prevention and sustain an
treatment of hypoglycemia ONSET: RAPID individual for a
PEAK: RAPID prolonged period
DURATION: BRIEF of time. Assess
BG prior to
administration.
Notify MD if BG
is less than
4.0mmol/L.
Assess patient for
dehydration,
nutritional status.
Diazepam Tablet Antianxiety agent, anticonvulsants, Adjunct management of Patient should be
5mg sedative/hypnotics, skeletal muscle anxiety, preoperative kept on bedrest
PO relaxant sedation, conscious and observed for
sedation, skeletal muscle at least 3hr
relaxant, management of following
symptoms with alcohol administration,
withdrawal. tablets may be
crushed and taken
with food or water
if patient has
difficulty
swallowing
Diclofenac 1.6% CENTRAL NERVOUS SYSTEM Analgesic and antipyretic Apply to clean dry
Topical Gel AGENT; ANALGESIC, effects in symptomatic skin. Do not apply
ANTIPYRETIC; NSAID treatment of rheumatoid to open wounds or
arthritis, osteoarthritis, broken skin.
MoA: Exact mechanism of acute gout, tissue injuries Avoid contact with
action has not been fully included sprains and eyes. Inform
elucidated, it appears to be a strains. Treatment of patient about risk
potent inhibitor of actinic keratosis. of skin reactions at
cyclooxygenase, thereby application site.
decreasing the synthesis of
prostaglandin

Digoxin Cardiovascular agent; cardiac Used to treat cardiac Check apical pulse
0.125 mg glycoside; antiarrhythmic arrhythmias (atrial for 1 minute
Oral fibrillation) and rapid Hold if HR < 60
OD (once a day) MoA: Increases force and velocity of digitalization and bpm. Give without
 myocardial systolic contraction. maintenance therapy of regard to food.
Decreased conduction velocity CHF. Administering
through AV node. after food will
Contraindicated in delay rate of
ventricular fibrillation absorption. Can be
and ventricular crushed with fluid
tachycardia unless due to or food if pt
CHF. Caution use in renal cannot swallow
insufficiency, whole.
hypokalemia, advanced
heart disease, acute MI,
hypothyroidism, ling
disease.
Diltiazem Cardiovascular agent; Calcium Vasospastic angina, Withhold is
180mg channel blocking agent; chronic stable angina, systolic BP is <90
PO Antihypertensive essential hypertension. IV mm Hg or
OD form: Afib, atrial flutter, diastolic is <60
supraventricular mm Hg. Give
tachycardia. Prevention before meals and
of infarction in non-Q- at bed time. Check
wave MI. BP and ECG
before initiation.
Lab test: Do
baseline and
periodic liver and
renal function
tests. Monitor for
S&S of CHF.
Monitor for
headache.
Supervise
ambulation as
indicated.
Dimenhydrinate Antihistamine; Antiemetic; To prevent and treat Use side rails and
Tablet (Gravol) tab Antivertigo agent motion sickness. Used in supervise
15mg, 25mg, 50mg management of vertigo, ambulation; drug
PO MoA: H1-receptor antagonist nausea, and vomiting produces high
Q4-6h PRN and salt of diphenhydramine, associated with radiation incidence of
with which it shares similar sickness, labyrinthitis. drowsiness.
Injection properties Monitor for
a/e: dizziness, nausea,
Drowsiness, headac vomiting; may
he, incoordination, indicate drug
dizziness, blurred toxicity.
vision, nervousness,
restlessness

Diphenhydramine Antihistamine; H1 Receptor Temporary Monitor for

25mg antagonist symptomatic relief of adverse effects.
PO various allergic Supervise
OD MoA: H1-receptor antagonist conditions and to treat ambulation and
and antihistamine with or prevent motion use side-rails as
significant anticholinergic sickness, vertigo, and necessary. Older
activity. High incidence of reactions to blood or adults most likely
drowsiness, but GI side plasma in susceptible to manifest
effects are minor. Effects in patients. Also used in dizziness,
parkinsonism and drug- anaphylaxis as adjunct sedation, and
induced extrapyramidal to epinephrine and hypotension.
symptoms are apparently other standard
related to its ability to measures after acute
suppress central cholinergic symptoms have been
activity and to prolong action controlled; in treatment
of dopamine by inhibiting its of parkinsonism and
reuptake and storage drug-induced
extrapyramidal
reactions; as a
nonnarcotic cough
suppressant; as a
sedative-hypnotic; and
for treatment of
intractable insomnia
Docusate Sodium GI agent; stool softener Prevention of Assess patient for
240mg constipation in patients abdominal
PO MoA: Anionic surface-active who avoid straining, such distention,
OD agent with emulsifying and as after MI (myocardial presence of bowel
wetting properties infarction) or rectal sounds, and usual
surgery. Promotes pattern of bowel
incorporation of water function. Assess
into stool resulting in color, consistency,
softer fecal mass. and amount of
stool produced.
Contraindicated in atonic constipation, Administer with
nausea, vomiting, abdominal pain,
fecal impaction. Adverse effects: mild full glass of water
abdominal cramps, diarrhea, nausea, or juice, for more
bitter taste, throat irritation, rash.
rapid results admin
on empty stomach.
Donezipil ANS agent; cholinergic agent; Mild to moderate Monitor
cholinesterase inhibitor dementia of Alzheimer’s therapeutic
type. effectiveness,
MoA: In early stages of Alzheimer’s monitor closely for
disease, pathologic changes in S&S of GI
neurons result in deficiency of ulceration and
acetylcholine. bleeding
especially with
concurrent use of
NSAIDS. Monitor
closely patients
with history of
asthma or
obstructive
 pulmonary
disease.
Doxycycline Hyclate Anti-infective; antibiotic; Chlamydial and Report sudden
tetracycline mycoplasmal infections; onset of painful or
gonorrhea, syphilis in difficult
penicillin-allergic swallowing
patients; diseases; acute promptly to
exacerbations physician.
Doxycycline is
associated with
high incidence of
esophagitis.
Report evidence of
superinfections.
EC ASA CNS agent; Analgesic, salicylate; To relieve pain of low to Pts with asthma,
(Acetylsalicylic acid) Antipyretic; Antiplatelet moderate intensity. For allergies, and nasal
various inflammatory polyps or who are
MoA:Anti-inflammatory conditions such as allergic to
action: Inhibits prostaglandin rheumatic fever/arthritis, tartrazine are at an
synthesis. As an anti- osteoarthritis and to increased risk for
Salicylates inflammatory agent, aspirin reduce fever in selected developing
appears to be involved in febrile conditions. To hypersensitivity
enhancing antigen removal prevent recurrence of MI. reactions
and in reducing the spread of Can be used as a blood Pain: Assess pain
inflammation in ground thinner. and limitation of
substances. These anti- movement; note
Contraindicated in sensitivity to other type, location, and
inflammatory actions also NSAIDS, chronic rhinitis, chronic
contribute to analgesic urticaria, history of GI ulceration, intensity before
bleeding, vitamin K deficiency, and at the peak (1-
effects. Analgesic hemophilia. Adverse effects: urticaria,
action: Principally peripheral bronchospasm, anaphylactic shock, 3hr)
dizziness, confusion, drowsiness, Fever: Assess
with limited action in the tinnitus, nausea, vomiting, diarrhea,
CNS, possibly on the anorexia, heart burn, stomach pain, fever and note
ulceration, occult bleeding, GI bleeds, associated signs
hypothalamus; results in easy bruising, rash, impaired renal
relief of mild to moderate function. (diaphoresis,
pain. Antipyretic action: In tachycardia,
addition to inhibiting malaise, chills)
prostaglandin synthesis,
aspirin lowers body
temperature in fever by
indirectly causing centrally
mediated peripheral
vasodilation and
sweating. Antiplatelet
action: Aspirin (but not other
salicylates) powerfully
inhibits platelet aggregation
Epoeitin Alfa erythropoiesis-stimulating agents Used to treat anemia. Monitor BP and
(ESAs) Elevates the thrombotic events.
hematocrit of
 MoA: Glycoprotein that patients with
stimulates RBC production. anemia secondary
Hypoxia and anemia to chronic kidney
generally increase the failure.
production of erythropoietin

S/e: headache, body

aches, cough, can worsen
BP,.
Escitalopram Tablet CNS agent, psychotherapeutic agent, Used for depression, Monitor for
5mg Selective serotonin-reuptake generalized anxiety therapeutic
PO inhibitor (SSRI) disorder. effectiveness.
OD Observe for
MoA: SSRI in the CNS, inhibits A/e: Fatigue, athralgia, worsening of
presynaptic neuronal uptake of myalgia, palpitation, depression or
serotonin. HTN, nausea, diarrhea, emergence of
abdominal pain, suicidality. Lab
Pharm: Onset 1 week, peak 3h. vomiting, flatulence, tests: monitor
Metabolized in liver, protein bound. increased sweating. periodically
½ life 25h hepatic functions,
CBC, serum
sodium, and
lithium levels.
Monitor
periodically HR
and BP. Carefully
monitor complete
cardiac status in
person with known
or suspected
cardiac disease.
Monito closely
older adult patients
for adverse effects
especially if dose
>20mg/d
Ezetimibe CVS agent, antilipemic Treatment of Monitor lipid
primary profile. Assess and
Moa: Works at the lining of the hypercholesterolemi report unexplained
small intestine inhibiting the a alone or with an muscle pain.
absorption of cholesterol, but HMG-CoA reductase
does not inhibit cholesterol inhibitor (statin);
synthesis in the liver or treatment of
increases bile acid excretion. homozygous
Thus it decreases the amount sitosterolemia as an
of intestinal cholesterol adjunct to diet.
available to the liver.

Pharm: Absorbed in small

 intestine, metabolized in liver
and small intestine, excreted
in feces.

Fentanyl CNS agent; analgesic; Narcotic Short-acting Monitor VS,

agonist analgesic during observe for
operative and skeletal and
MoA: potent analgesia and sedation, perioperative thoracic muscle
drug induced alterations in RR and periods, as a rigidity and
alveolar ventilation narcotic analgesic weakness.
supplement in
Pharm: metabolized in the liver general and regional
excreted in the urine anesthesia, and with
droperidol or with
diazepam to
produce
neuroleptoanalgesia

A/e: Sedation,
dizziness, delirium,
hypotension,
bradycardia, cardiac
arrest, miosis
blurred vision, N&V,
muscle rigidity

Ferrous Iron supplement Prevention and treatment Monitor patients

Fumarate/Gluconate of iron-deficiency iron serum levels.
29mg-325mg anemias Admin with water
PO or juice on empty
1-2 Tab b/w meals stomach.
Ferrous Sulfate Blood former; coagulators; To correct and treat iron Monitor hgb and
anticoagulants; iron preparation deficiency anemias bowel movements,
MoA: Corrects erythropoietic constipation is
abnormalities induced by iron A/e: Nausea, heartburn, common.
deficiency but does not constipation, abdominal
stimulate erythropoiesis distress, black stools,
Pharm: food decreases lethargy, drowsiness,
absorption, transferred to N&V
bone marrow incorporated
into hgb.

Fexofenadine Antihistamine; H1 receptor Relief of symptoms Monitor

antagonist; Non-sedating associated with seasonal therapeutic
allergic rhinitis, and effectiveness
MoA: An antihistamine competively chronic urticaria. which is indicated
antagonizes histamine at the H1 by decreases nasal
receptor site; does not bind with congestion,
histamine to inactivate it. Not sneezing, watery
 associated with anticholinergic or or red eyes and
sedative properties. itching nose,
palate or eyes.
Fluticasone Skin and mucous membrane agent; Seasonal allergic rhinitis 1. Shake
anti-inflammatory; corticosteroid inhaler
A/e: candida infection, well
MoA: hoarseness, sneezing, before. 2.
crusting, headache, Inhale
nausea, vomiting. slowly
3. Hold
breath 5-10
sec if
possible
then exhale
slowly
Folic Acid Vitamin B9 Folate deficiency, Obtain a careful
0.4mg 0.8mg 1mg tab macrocytic anemia, and history of dietary
5mg/ml injection MoA: Essential for synthesis and megaloblastic anemias intake and drug
maintenance of normal EPO. Acts associated with and alcohol usage
against acid deficiency that impairs malabsorption prior to start of
synthesis. syndromes, alcoholism, therapy. Keep MD
primary liver disease, informed of pt
inadequate dietary intake, response of
pregnancy, infancy, and therapy, monitor
childhood. patient on
phenytoin for
A/E: Usually non-toxic, subtherapeutic
slight flushing and feeling levels
of warmth can occur
following IV
administration
Fosinopril Cardiovascular agent; ACE inhibitor; Mild to moderate Monitor BP and
antihypertensive agent hypertension, CHF first dose
hypotension
MoA: Lowers BP by especially in salt
interrupting conversion or volume
sequences initiated by renin depleted patients.
that lead to formation of Observe for S&S
angiotensin II, a potent of hyperkalemia.
vasoconstrictor. Inhibition of
ACE also leads to decreased
circulating aldosterone, a
secretory response to
angiotensin II stimulation.
Furosemide Loop Diuretic Used to treat edema due Closely monitor
40 mg to renal dysfunction. BP and VS,
Oral Treatment of monitor for signs
OD MoA: decreases renal vascular resistance and may hypertensions in of hypokalemia.
increase renal blood flow.
combination with other Sudden alteration
Pharmacokinetic: Absorbed from GI tract, rapidly
 excreted in urine. Half-life 30mins antihypertensives. in fluid and
Adjunct in treating edema electrolyte balance
due to CHF, hepatic may cause
cirrhosis, acute significant adverse
pulmonary edema. reactions. Report
symptoms to MD.
Contraindicated in hx of sensitivity to Monitor I&O ratio
furosemide or sulfonamides,
increasing oliguria, anuria, fluid and pattern.
electrolyte depletion states, hepatic
coma. Adverse effects: postural
hypotension, dizziness with excessive
diuresis, hypovolemia, dehydration,
hyperglycemia, vomiting, oral and
gastric burning, anorexia, diarrhea,
constipation, abdominal cramping,
acute pancreatitis, jaundice, vertigo.
Gabapentin Anticonvulsant Adjunctive therapy for Monitor for
100, 300, 400 mg Central NS agent partial seizures with or therapeutic
Caps GABA analog without secondary effectiveness; may
250/ml solution generalization in adults, not occur until
Oral MoA: unknown, does not interact post-herpetic neuralgia. several weeks
with GABA receptors or inhibit Un-labelled use of following
reuptake or degradation of GABA peripheral neuropathy and initiation of
migraine prophylaxis therapy, assess
frequency of
*Can be used to help with seizures. Assess
nerve pain due to surgery safety; vision,
concentration, and
A/e: drowsiness, fatigue, coordination.
tremor, slurred speech,
impaired concentration,
headache, weight gain,
nausea, gastric upset,
vomiting.
Gliclazide Anti-hyperglycemic agent Treatment of non-insulin Observe for S&S
dependent diabetes of hypoglycemia
MoA: stimulates beta cells of the mellitus in conjunction (hunger,
pancreas to release insulin. Enhances with diet and exercise weakness,
peripheral insulin sensitivity. Bind to diaphoretic,
beta receptor to block ATP sensitive dizziness,
potassium channels. tachycardia,
Lowers blood glucose level by anxiety).
stimulating release of insulin from
the pancreas and increasing
sensitivity to insulin at receptor sites.

Onset unknown
Peak 4-6hr duration 12-24hr

Glucosamine/ Cartilage supplement Used to slow joint Do not take if

Chondroitin Natural supplement destruction of allergic to shellfish
osteoarthritis and relieve
 mild pain.
Glycerin Rectal Fluid and electrolyte agent; Rectally to relieve Assess patient for
Suppository Hyperosmotic laxative; constipation constipation.
1 suppository rectally Antiglaucoma Consult physician
OD regarding fluid
PRN Constipation if MoA: raises osmotic pressure by intake in patients
ordered with Biscodyl withdrawing fluid from extravascular receiving drug for
suppository, insert space. Causes dehydration of elevated IOP.
glycerine first. exposed tissue which produces Monitor glycemic
irritant effect by absorbing water control in
from tissues and stimulating diabetics.
peristalsis in the tissues
Glyburide Hormones and synthetic substitutes, antidiabetic agent; Adjunction to diet to lower blood Monitor BG levels
sulfonylurea glucose in patients with type 2 DM; carefully, older adults
after dietary control alone has failed. vulnerable to glyburide
induces hypoglycemia
MoA: Most potent sulfonylurea hypoglycemic agents,
because the antidiabetic
enhanced as much as 200-fold over first-generation Contraindicated in diabetic
agent is long acting.
agents. ketoacidosis. Caution use in patients
Monitor blood and urine
with cardiovascular disease, renal or
glucose lab test and liver
hepatic insufficiency, older adults,
function test.
malnourished patients. Adverse
effects: hypoglycemia, epigastric
fullness, heartburn, nausea, vomiting,
pruritus, erythema, blurred vision.

Haloperidol CNS agent; psychotherapeutic; Management of Monitor for

antipsychotic. manifestations of therapeutic
psychotic disorders effectiveness due
MoA: Potent, long-acting and for control of to long half-life.
butyrophenone derivative tics and vocal Monitor patients
with pharmacologic actions utterances of Gilles mental status
similar to those of piperazine de la Tourette's daily.
phenothiazines but with syndrome; for
higher incidence of treatment of
extrapyramidal effects and agitated states in
less hypotensive and acute and chronic
relatively low sedative psychoses
activity
Heparin Injection Anticoagulant, blood formers, Prophylaxis and treatment Monitor for
5000 units IV coagulator. of various bleeding, melena,
Followed by initial thromboembolic bruising.
subcut dose of MoA: exerts direct effect on cascade disorders including Venipunctures and
10,000-20,000 units, of blood coagulation by enhancing Venous injection sites
then 8000-10,000 inhibitory actions of antithrombin thromboembolism, require application
units q8h or 15,000- III (heparin cofactor) on pulmonary emboli, atrial of pressure to
20,000 q12h several factors essential to fibrillation with prevent bleeding
Subcutaneous normal blood clotting, embolization, acute and or hematoma
Q8h/q12h thereby blocking the chronic consumptive formation. IM
conversion of prothrombin to coagulopathies, injections of other
thrombin and fibrinogen to peripheral arterial medications
fibrin thromboembolism, used should be avoided.
in very low doses (10-100 Dose of heparin
Pharm: Onset 2-60min. Peak units) to maintain patency should be checked
 within mins. Excreted in of IV catheters (heparin with a second
urine. flush) licensed
professional prior
A/e: Spontaneous to administration.
bleeding, fever, chills,
urticaria, pruritus, skin
rashes, itching and
burning sensation on feet.
Hydrochlorothiazide Electrolytic and water balance agent; Adjunct in treatment Monitor for
Diuretic; Thiazide of edema associated therapeutic
with CHF, hepatic effectiveness.
MoA: Similar to cirrhosis, renal Check BP before
chlorothiazide. Diuretic action failure, and in the initiation of
is associated with drug stepped-care therapy and at
interference with absorption management of regular intervals.
of sodium ions across the hypertension (step 1 Monitor closely
distal renal tubular segment and 2 agent). for hypokalemia.
of the nephron. This Monitor I&O and
enhances excretion of A/e: mood changes, check for edema.
sodium, chloride, potassium, tiredness, weakness,
bicarbonates, and water. dizziness, weak
pulse, orthostatic
hypotension, dry
mouth, increased
thirs,
hyperglycemia,
thrombocytopenia

Hydromorphone CNS agent; analgesic Narcotic Relief of moderate to Assess BP, pulse,
Adults >50kg agonist severe pain and control of respirations before
4-8mg persistent non-productive and periodically
PO MoA: Semisynthetic derivative cough. during
Q3-4h initially structurally similar to administration. If
Adults <50kg morphine but with 8–10 times resp. rate <10/min,
0.06mg/kg more potent analgesic effect. A/E: N&V, constipation, assess level of
PO Has more rapid onset and euphoria, dizziness, sedation. Assess
Q3-4h initially shorter duration of action sedation, drowsiness, bowel function
Antitussive: than morphine and is hypotension, tachycardia, routinely.
1mg reported to have less respiratory depression. Pain: Assess type,
PO hypnotic action and less location, and
Q3-4h Onset: 15 min IV/30 min intensity of pain
tendency to produce nausea PO/rectal
and vomiting prior to and 1hr
Peak: 30-90min following IM and
5min (peak)
Duration: 3-4 hours
following IV
admin
Hyoscine Autonomic nervous system agent; prophylactic agent Observe patient
anticholinergic; antimuscarinic; for motion sickness closely; some
antispasmodic and as mydriatic patients manifest
 and cycloplegic in excitement,
ophthalmology. delirium, and
Therapeutic system disorientation
is used to prevent shortly after drug
nausea and is administered
vomiting associated until sedation
with motion effect takes hold.
sickness.
Insulin Glargine Bedtime dosing of Monitor for S&S
(Lantus) adults and children of hypoglycemia,
Long acting MoA: recombinant human insulin with Type 1 diabetes monitor fasting
Duration: 10.4-24h analog with long duration of action. or adults with type 2 BG and HbA1c.
Enhances transmembrane passage of diabetes Withhold and
glucose across cell membranes notify MD if pt is
Contraindicated in hypokalemic.
Pharmacokinetic: slowly absorbed hypoglycemia.
from SC injection site. Metabolized Caution use in renal
in liver to active metabolites. and hepatic
impairment.
Adverse effects:
Hypoglycemia,
hypokalemia.
Insulin Humulin R HORMONE AND SYNTHETIC To initiate therapy in Should not be
(regular, clear) SUBSTITUTE; ANTIDIABETIC AGENT; patient with insulin mixed unless
INSULIN dependent DM. prescribed. If
Emergency mixing, draw up
30/70 = isophane MoA: short acting, clear, exogenous treatment of clear first. Give
&reg unmodified insulin extracted from diabetic 30min before meal
beta cells in pork pancreas or ketoacidosis or Monitor BG and
synthesized by recombinant DNA coma and given in HbA1C. Monitor
technology. Enhances combination with for hypoglycemia
transmembrane passage of glucose intermediate or at peak of insulin.
across cell membranes of most body long-acting insulin
cells. Promotes conversion of to provide better
glucose to glycogen. control of BG
concentrations.

Insulin Lispro HORMONE AND SYNTHETIC Treatment of DM. Assess blood

Rapid-acting SUBSTITUTE; ANTIDIABETIC AGENT glucose level
MOA: RAPID-ACTING, GLUCOSE- before
LOWERING AGENT. administration.
Give 10-15min
Pharmacokinetic: rapidly before meals. Can
absorbed from IM and SC be given in the
injection sites. Onset same syringe as
<15min Peak 0.5-1h long-acting insulin
Duration 3-4h, but absorption
metabolized in the liver may be delayed.
 and kidney Assess for
hypoglycemia 1-3
hours after
injection.
Insulin Isophane HORMONE AND SYNTHETIC Used to control Give 30mins
(NPH) SUBSTITUTE; ANTIDIABETIC hyperglycemia in a before first meal
Intermediate acting AGENT; INTERMEDIATE ACTING diabetic patient. of the day,
INSULIN Mixtard and Novolin isophane may be
70/30 are fixed mixed with other
MoA: Cloudy suspension of zinc combinations of insulins, draw up
insulin crystals modified by purified insulin 30% regular first.
protamine in a neutral buffer, less and NPH 70% Assess for
likely to cause allergic reactions than hypoglycemia
non-purified preparations (Fatigue,
weakness,
Pharm: Onset: 1-2h Peak: 4-12h sweating, tremor,
Duration 18-24h. Metabolized in nervousness)
kidney and liver. 13h half life
Ipratropium inhaler Bronchodilator Maintenance Monitor
(ATROVENT) therapy in COPD respiratory
MoA: Produces local, site- including chronic status;
specific effects on the larger bronchitis and auscultate
central airways including emphysema; nasal lungs before
bronchodilation and spray for perennial and after
prevention of rhinitis and inhalation
bronchospasms. symptomatic relief Shake canister
of rhinorrhea before use. If 1 or
associated with the more inhalation is
common cold ordered wait at
least 2 minutes.
A/e: Blurred vision, acute Use spacer to
eye pain, bitter taste, improve drug
cough, rash, urinary delivery if
retention, headache. appropriate
Irbesartan Cardiovascular Agent; angio II HTN, treatment of Monitor Bp,
receptor antagonist diabetic neuropathy in BUN, CR.
patients with HTN and
MoA: angiotensin II receptor DM2
antagonist blocking the binding to
the receptor sites that is used to
increase BP, body water and sodium
content.
Isosorbide Dinitrate Antianginal Acute treatment of Assess location,
10-40mg anginal attacks, duration, intensity,
PO prophylactic management and precipitation
Q6h of angina pectoris, Tx of factors of anginal
chronic congestive heart pain. Monitor BP
failure and pulse routinely
during period of
 dosage adjustment.
Lactulose Liquid Gastrointestinal Agent; Prevention and treatment Promote fluid
10g/15ml Solution Hyperosmotic Laxative of portal-systemic intake during drug
Oral encephalopathy includin therapy for
MoA: Reduces blood g stages of hepatic constipation.
ammonia; appears to involve precoma and coma, Lactulose-induced
metabolism of lactose to and by prescription osmotic changes in
organic acids by resident for relief of chronic the bowel support
intestinal bacteria. constipation intestinal water
loss and potential
A/e: Flatulence, hyponatremia
belching, abdominal
cramps, pain,
distention, diarrhea,
nausea, vomiting,
hypernatremia.

Levodopa/Carbidopa Antiparkinsonians Levodopa relieves Observe patient

200mg/50mg parkinsonian symptoms and monitor VS,
PO by being converted to especially changes
TID dopamine in the brain. in BP, when
Carbidopa inhibits the changing positions
decarboxylation of and while
peripheral levodopa. adjusting dosage.
Report significant
changes.
Levothyroxine Thyroid hormone replacement Used to treat Check pulse
13mcg-125mcg Hypothyroidism. before dose and
MoA: Synthetically prepared Replacement therapy for during dose
monosodium salt and levo-isomer of diminished or absent adjustment – if >
thyroxine, with similar actions and thyroid function. 100bpm, consult
uses. Promotion of normal physician. Give
metabolism. before meals

A/e: irritability,
nervousness, insomnia,
headache, tremors,
diarrhea, change in
appetite. Palpitations,
tachycardia, arrhythmias,
HTN, sweating, leg
cramps.
Lidocaine/Prilocaine Anesthetics-topical/local Anesthetic action Assess application
Topical Cream localized to the area of site for open
application. wounds. Apply
only on to intact
skin. Assess
application site for
anesthesia
 following removal
of system and
before procedure.
Lorazepam CNS agent, anxiolytic, sedative- Management of anxiety Supervise
2-6mg/day hypnotic disorders and for short ambulation of
PO term relief of symptoms older adult patients
MoA: Most potent available benzodiazepines. of anxiety. Used for for at least 8h after
Effects are mediated by the neurotransmitter
GABA. Action sites: thalamic, hypothalamic, and preanesthetic medication to prevent falling
limbic levels of CNS. to produce sedation and and injury,
reduce anxiety and recall supervise patient
of events related to day of who exhibits
surgery; management of depression with
status epilepticus anxiety closely.
A/E:
Magnesium elemental Gastrointestinal agent; Saline To evacuate bowel prior Monitor for
(As citrate) cathartic to certain surgeries and dehydration,
procedures and to help hypokalemia, and
MoA: Promotes bowel evacuation by eliminate parasites and hyponatremia
causing osmotic retention of fluid, toxic materials after since drug may
which distends colon and stimulates treatment with a cause bowel
peristaltic activity. vermifuge. evacuation.
Magnesium Laxatives Used for short time to Assess patient for
Hydroxide 8% treat occasional abdominal
Suspension MoA: Essential for the action of constipation; symptoms distention or
many enzymes. Important role in caused by too much unusual pattern of
neurotransmission and muscular stomach acid such as bowel function.
excitability. Osmotically active in the heartburn, upset stomach Assess colour,
GI tract drawing water into the or indigestion. consistency and
lumen and causing peristalsis. amount of stool.

Melatonin Tablet Sedative/hypnotics Promotes sleep and Assess sleep

0.3mg-10mg physiologic roles of patterns before and
PO melatonin including periodically
regulation of GH and throughout
gonadotropic hormones. therapy.
Possesses antioxidant
activity.
Metformin Hormones & synthetic substitutes; Treatment of DM2 in Monitor blood
Antidiabetic agent; Biguanides patients not controlled glucose and
with diet alone. May be HbA1C, and lipid
MoA: Biguanide oral hypoglycemia agent, unlike used with an oral profile
sulfonylureas it does not stimulate release of insulin
from beta cells of the pancreas. Increases binding of sulfonylurea periodically.
insulin to receptor and potentiation insulin action Monitor
Contraindicated in hypersensitivity, cardiopulmonary
alcoholism, concurrent infection, acute
MI, ketoacidosis, hypoxemia, lactic status throughout
acidosis, renal course of therapy.
disease/failure/impairment, sepsis,
surgery. Adverse effects: Headache, Report to MD
 dizziness, agitation, fatigue, lactic immediately if
acidosis, nausea, vomiting, abdominal
pain, bitter or metallic taste, diarrhea, S&S of infection,
bloating, anorexia. which increases
the risk of lactic
acidosis (e.g.
abdominal pains,
nausea, vomiting)
Methylprednisone IV Hormone/synthetic sub.; Adrenal Antinflammatory agent Monitor kidney
corticosteroid; glucocorticoid; anti- for acute/chronic and liver function
inflammatory inflammatory diseases; & diabetics for
palliative management of loss of glycemic
MoA: intermediate acting synthetic neoplastic diseases and control. Monitor
adrenal corticosteroid with similar control of severe acute S7S of
glucocorticoid activity, fewer sodium and chronic allergic hypokalemia and
and water retention s/e than responses. cushing's
hydrocortisone syndrome
Cautious use in GI
ulceration, HTN,
varicella, DM.
A/e: Headache, insomnia,
confusion, psychosis,
CHF, edema, N&V,
peptic ulcer. Muscle
weakness delayed wound
healing. Hypokalemia.
Metoclopramide Gastrointestinal agent; Prokinetic Management of diabetic Report
tab/inj. 10-20mg Agent (GI stimulant) gastric stasis, to prevent immediately the
Intravenous nausea and vomiting onset of
IM MoA: Potent central dopamine associated with restlessness,
Q4h receptor antagonist. emetogenic cancer involuntary
Structurally related to chemotherapy; to movements, facial
procainamide but has little facilitate intubation of grimacing,
antiarrhythmic or anesthetic small bowel; rigidity, or
activity. Exact mechanism of symptomatic treatment of tremors. Monitor
action not clear but appears gastroesophageal reflux. possible
to sensitize GI smooth muscle hypernatremia and
to effects of acetylcholine by A/e: mild sedation, hypokalemia
direct action fatigue, restlessness, especially if
agitation, headache, patient has CHF or
insomnia, disorientation, cirrhosis.
neurologic malignant
syndrome, constipation
Metolazone Electrolyte and water balance agentl; Management of HTN or Geriatric patients
thiazide-like diuretic; anti- edema associated with more sensitive to
hypertensive CHF and kidney disease. overdose and
adverse reactions.
MoA: Transport sodium ions across A/e: Cholestatic jaundice,
renal tubular epithelium enhancing vertigo, orthostatic
secretion of NA, Chl, K, bicarb, and hypotension, venous
water. thrombosis, leukopenia,
 dehydration,
hypokalemia,
hyperuricemia,
hyperglycemia.
Metoprolol ANS Agent, Management of mild to Check BP and
50mg Antihypertensive, antianginal, beta- severe hypertension. apical pulse for 1
Oral adrenergic antagonist Long-term treatment of min. Hold if HR
BID angina pectoris and <50bpm. Monitor
prophylactic management BP, ECG, and
MoA: Beta-adrenergic blocking agent with of stable angina pectoris pulse frequently
preferential effect on beta1 adrenoreceptors
located primarily on cardiac muscle. At higher reduces the risk of during dose
doses, metoprolol also inhibits beta2 receptors mortality after an MI. adjustment.
located chiefly on bronchial and vascular
musculature. Monitor vital
Contraindicated in cardiogenic shock, signs, intake and
Pharm: Absorbed in GI tract, extensively sinus bradycardia, heart block greater
metabolized in liver, excreted in urine. than first degree, overt cardiac failure, output ratios and
right ventricular failure secondary to daily weights.
pulmonary HTN. Adverse effects:
Rash, fever, headache, muscle aches,
sore throat, respiratory distress,
dizziness, fatigue, insomnia, mental
depression, bradycardia, palpitation,
cold extremities, dry
skin/mouth/mucous. Hypoglycemia,
bronchospasm
Metronidazole Anti-infective;Antitrichomonal, Asymptomatic and Discontinue
250mg 500mg tab Amebicide, Antibiotic symptomatic immediately if
500mg vials trichomoniasis, acute symptoms of CNS
PO/INJ. MoA: Synthetic compound intestinal amebiasis and toxicity. Monitory
with direct trichomonacidal amebic liver abscess; especially for
and amebicidal activity as preoperative prophylaxis seizures and
well as antibacterial activity in colorectal surgery, peripheral
against anaerobic bacteria elective hysterectomy or neuropathy, obtain
and some gram-negative vaginal repair. IC used total and
bacteria for treatment of serious differential WBC
infections caused by count before,
susceptible anaerobic during, and after
bacteria in intraabdominal therapy. Monitor
, skin. S&S of NA
retention
A/e: rash, urticaria, especially in pt on
flushing, vertigo, corticosteroid
headache, ataxia, therapy of history
depression, weakness, of CHF
fatigue, drowsiness,
insomnia, N&V, diarrhea,
dry mouth

Mometasone Furoate Corticosteroid, Anti-inflammatory

Intranasal 2 sprays in
each nostril OD MoA:
Morphine CNS agent; Analgesic; Narcotic agonist Obtain respiratory rate,
Symptomatic relief of severe acute depth, rhythm and size of
MoA: Natural opium alkaloid with agonist activity and chronic pain after nonnarcotic pupils before administering.
by binding with the same receptors as endogenous analgesics have failed and as Respirations of 12/min or
opioid peptides preanesthetic medication; also below and miosis are signs
used to relieve dyspnea of acute of toxicity. Observe patient
left ventricular failure and closely for pain relief,
pulmonary edema and pain of MI monitor for respiratory
depression. Be alert for
orthostatic hypotension,
Contraindicated in increased
monitor
intercranial pressure, convulsive
disorders, acute alcoholism, acute
bronchial asthma, chronic pulmonary
diseases, severe respiratory depression.
Cautious use in cardiac arrhythmias,
emphysema, kyphoscoliosis, severe
obesity, very old, very young or
debilitated patients. Adverse effects:
Sweating, edema, rash, urticaria,
cold/clammy skin, hypothermia,
euphoria, insomnia, disorientation,
visual disturbances, decreased cough
reflex, bradycardia, palpitations,
dysuria, dry mouth.

Multivitamin Vitamin Prevention and treatment Administer

1 Tablet of vitamin and mineral vitamin with food
PO Provides vitamins that are not taken deficiencies; used as to decrease
Daily in through diet dietary supplement stomach ulcer.
Mycophenolate Immunosuppressant Prophylaxis of organ Monitor CBC
Mofetil rejection in patients weekly for first
MoA: prodrug inhibits T and B receiving kidney month. If
lymphocyte perforation responses transplants or heart neutropenia
inhibiting antibody formation and transplants develops withhold
blocks generation of cytotoxic T dose and notify
cells. A/e: Headache, tremor, physician. Monitor
insomnia, dizziness, and report S&S of
weakness, infection or sepsis.
hyperglycemia, low
phosphate, low
potassium, edema,
diarrhea, constipation,
nausea, anorexia,
vomiting, sepsis.
Naloxone CNS agent; Narcotic antagonist Narcotic overdosage; Observe patient
0.1mg/0.25ml IV complete or partial closely; keep
Unscheduled MoA: Analog of oxymorphone. reversal of narcotic physician
A "pure" narcotic antagonist, depression. Drug of informed; repeat
essentially free of agonistic choice when nature of dose if necessary.
(morphine-like) properties. depressant drug is not Monitor VS and
Produces no significant known and for diagnosis surgical patients
analgesia, respiratory suspected acute opiod closely for
depression, psychotomimetic overdosage. bleeding.
effects, or miosis when
administered in the absence A/e: reversal of analgesia,
of narcotics and possesses tremors, hyperventilation,
more potent narcotic sweating, increased BP,
 antagonist action. tachycardia, N&V.

Nalbuphine Hcl CNS agent; analgesic; Narcotic Relieves moderate to Assess RR before
agonist severe pain. administration and
VS. Withhold and
MoA: synthetic analgesic with notify MD if RR
agonist and weak antagonist A/e: HTN, hypotension, below 12. Watch
properties. Produces respiratory brady/tachycardia, for sensitivity with
depression about equal to that of abdominal cramps, bitter sulfite. Monitor
morphine doses >30mg produce no taste, N&V, dry mouth. ambulatory
further respiratory depression. patients.
Onset: 2-3min IV; 15min
IM
Peak 30min.
Duration 3-6h
Nicotine CNS and ANS agent; smoking To withdrawal symptoms Remove old patch
Transdermal detterent; Cholinergic accompanying cessation before applying
System of smoking, temporary new patch. Apply
Stimulant and depressant effects on and alternate source of to non hairy,
the PNS and CNS, respiratory nicotine. clean, dry skin.
stimulation, peripheral Erythema,
vasoconstriction, increased HR, pruritus, or
increased tone and motor activity of burning is
GI smooth muscles. Heavy smokers common with
are tolerant of these effects. transdermal patch
and usually
disappears 24h
after patch
removal
Nitroglycerin Antianginal Acute and long term Assess Hx of
spray 0.4mg prophylactic management nitrate/nitrite
sublingual of angina pectoris, control hypersensitivity,
Q5m PRN chest of BP during surgery, monitor BP.
pain. Call house adjunct treatment of CHF Hold canister
staff if not associated with acute MI. vertically and
resolved after 3 spray on tongue,
Side effects: headache, dizziness, have pt close
doses. Keep lightheadedness, nausea, flushing.
nitroglycerin at mouth
bedside when immediately, not
appropriate inhale spray.
Olanzapine Wafer CNS agent; psychotherapeutic agent; Management of psychotic Monitor diabetics
antipsychotic agent; atypical; SSRI; disorders, treatment of for loss of
Pharmacokinetic: Dopamine-reuptake inhibitor bipolar disorder, acute glycemic control.
Rapidly absorbed agitation. Monitor BP and
from GI tract, MoA: May inhibit the presynaptic HR periodically.
metabolized in neuronal reuptake of serotonin and Unlabelled uses: Monitor for
liver from P450, dopamine. Antagonism of alfa- Alzheimer’s dementia seizures especially
excreted in urine adrenergic receptor results in adverse in older adults and
effects of hypotension. cognitively
 impaired persons.
Ondansetron HCL Inj. Gastrointestinal agent; Anti-emetic Prevention of nausea and Monitor fluid and
8mg 5-HT3 Antagonist vomiting associated with electrolyte status.
Intravenous initial and repeated Diarrhea, which
Q8H MoA: Selective serotonin courses of cancer may cause fluid
PRN receptor antagonist. chemotherapy, including and electrolyte
Nausea/Vomiting Serotonin receptors are high-dose cisplatin; imbalance,
located centrally in the postoperative nausea and potential adverse
chemoreceptor trigger zone vomiting effect of the drug.
(CTZ) and peripherally on the Monitor CV status
vagal nerve terminals. A/e: dizziness, light- especially in
Serotonin is released from headedness, sedation, patients with Hx
the wall of the small intestine diarrhea, constipation, dry of CAD. Rare
and stimulates the vagal mouth. cases of
efferents through the tachycardia and
serotonin receptors and angina have been
initiates the vomiting reflex. reported.

Pantoprazole Gastrointestinal agent; Proton pump

Short term treatment of Monitor for and
40mg inhibitor; Antiulcer agent erosive esophagitis immediately report
PO associated with GERD. S&S of
OD MoA: Gastric acid pump *Used to prevent high angioedema or a
inhibitor; belongs to a class of acidity in GI due to meds severe skin
antisecretory compounds. reaction. Assess
Gastric acid secretion is A/e: Bradycardia, patient routinely
decreased by inhibiting the palpitation, Raynauds, for epigastric or
H , K -ATPase enzyme
+ +
CHF, dry mouth and abdominal pain
system responsible for acid mucous membranes. and for frank or
production occult blood in
stool, emesis, or
Pharm: Well absorbed 77% gastric aspirate.
bioavailability, 98% protein
bound, metabolized in the
liver, excreted in urine and
feces
Paroxetine CNS agent; psychotherapeutic agent, Depression, OCD, panic Monitor for
anti-depressant attacks, social anxiety, worsening
generalized anxiety, depression or
MoA: Antidepressant PTSD suicide ideation,
structurally unrelated to adverse effects.
other serotonin reuptake A/e: Postural Older adult for
inhibitors. Potent and highly hypotension, headache, fluid and sodium
selective inhibitor of tremor, agitation, imbalances.
serotonin reuptake by nervousness, anxiety,
neurons in CNS. dizziness, taste aversion,
dry mouth.

Perindopril Cardiovascular agent; Angiotensin- Treatment of Monitor BP and

converting enzyme inhibitor; hypertension, CHF HR. Place patient
 antihypertensive immediately in
supine position if
excess
hypotension
develops.
Monitory kidney
function in
patients with CHF.
Piperacillin/ Anti-infective; Beta-lactam Treatment of moderate to Obtain Hx of
Tazobactam Inj. antibiotic; Antipseudomonal severe appendicitis, hypersensitivity to
(TAZOCIN) penicillin uncomplicated and penicillins,
2.25g complicated skin and skin cephalpsporins, or
IV MoA: interferes with bacterial cell structure infections, other drugs prior
Q8H wall synthesis, promotes loss of endometritis, pelvic to admin. Lab
membrane integrity and leads to inflammatory disease, tests: C&S prior to
death of the organism. nosocomial or community first dose of drug;
acquire pneumonia start drug pending
caused by piperacillin- results. Monitor
resistance. hematologic status
with prolonged
therapy. Monitor
carefully during
the first 30min
after initiation of
the infusion for
signs of
hypersensitivity.
Polyethylene Electrolyte replacement Treatment of occasional Assess health,
Glycol constipation. Bowel nutritional status,
MoA: osmotic effect which causes cleaning in preparation bowel sounds, GI
water to be retained in the colon for GI examination. function. Duration
and produces a watery stool. of constipation

Prednisone Hormone & Synthetic Sub; Adrenal Used systemically and Monitor Bp, sleep
5-60mg corticosteroid; glucocorticoid locally in a wide variety patterns and
PO of chronic diseases potassium levels.
OD MoA: Immediate actin synthetic including inflammatory, Weight patient
analog of hydrocortisone, sodium allergic, hematologic, daily. Fasting BG.
retention and potassium depletion neoplastic, autoimmune
and occur disorders, asthma

May be used in adjunct in

cancer therapy, tx of
myasthenia gravis &
inflammatory conditions
as immunosuppressant

A/e: Headache, insomnia,

confusion, psychosis,
CHF, edema, N&V,
 peptic ulcer, muscle
weakness, delayed
healing, osteoporosis.

Pregabalin (LYRICA) CNS agent; analgesic anticonvulsant; Has analgesic, anti- Monitor weight
GABA-analog anxiety and gain, peripheral
anticonvulsant properties. edema, and S&S
MoA: Greater potency in pain and Management of of HF. Monitor
seizure disorders than gabapentin. neuropathic pain and diabetics with
Exact action is unknown. Increases moderate pain. increased
neuronal GABA and reduces calcium incidences of
currents in the calcium channels of hypogylcemia.
neurons which may control pain and
anxiety.
Quinine Sulfate Anti-infective; antimalarial Chloroquine- Be alert for rising
resistant falciparum S&S of rising
MoA: Exact mechanism of malaria and in plasma
antimalarial action uncertain. combination with concentration of
Inhibits protein synthesis and other antimalarials quinine marked by
depresses many enzyme for radical cure of tinnitus and
systems in malaria parasite. relapsing vivax hearing
Resembles salicylates in malaria; also relief impairment, which
analgesic and antipyretic of nocturnal usually do not
properties and exerts curare- recumbency leg occur if
like skeletal muscle relaxant cramps concentration is
effect. Also has oxytocic 10mcg/mL or
action and more.
hypoprothrombinemic effect.

Quetiapine Antipsychotic; CNS agent; Treatment of psychotic Assess VS, esp.

(Seroquel) psychotherapeutic agent disorders, management of BP, history of
25mg-40mg bipolar disorder, seizures. Monitor
PO MoA: Antagonizes histamine agitation, dementia diabetics for loss
H1 receptors resulting in of glycemic
possible somnolence, and control. HOLD if
adrenergic alpha1 and Adverse: Asthenia, fever, S&S of tardive
alpha2 receptors which may hypertonia, flu syndrome, dyskinesia or
lead to orthostatic edema, hypotension, neuroleptic
hypotension. tachycardia, palpitations, syndrome.
dry mouth
Pharmacokinetic: rapidly and
completely absorbed from GI tract,
83%protein bound, metabolized in
the liver, excreted in the urine &
feces.
Ramipril Antihypertensive, Treatment of mild to Monitor BP & HR.
10 mg ACE inhibitor; cardiovascular agent. moderate hypertension, Report complaints
oral CHF. of dizziness.
OD MoA: lowers BP. Inhibition of ACE Observe for S&S
also decreases serum aldosterone Contraindicated in hypersensitivity to of hyperkalemia.
ramipril or any other ACE inhibitor,
levels; reduces peripheral arterial Monitor BUN and serum
patients with hx of angioneurotic
creatinine.
resistance (afterload) and improves edema. Cautious use in kidney or liver
impaired function, surgery or
cardiac output as well as exercise anesthesia. Adverse effects: dizziness,
tolerance. fatigue, headache, nausea, vomiting,
diarrhea, hyperkalemia, hyponatremia,
erythema, pruritis, angioedema, cough.
Resource 2.0 High-protein medical nutritional Oral nutritional Opened product
60ml supplement supplement used for should not stay at
PO patients with room temperature
QID fluid/volume restriction for more than 2
or with elevated hours. Opened
nutritional or wound product should
healing needs. have “date
opened” label.
Document
consumption.

Rivaroxaban Xa inhibitor; Anticoagulant Used to treat DVT & PE. Monitor for signs
Also used to prevent of neurological
MoA: Selectively blocks the active strokes impairment.
site of factor Xa which is necessary Monitor carefully
for anticoagulation A/e: Snycope, fatigue, for signs of
oropharyngeal pain, bleeding. Stop
sinusitis, abdominal pain, 24hrs prior to any
UTI, bleeding events, procedure.
muscle spasm
Rosuvastatin Antilipemic; CVS agent Adjunct to diet for
Before therapy
5mg-10mg the reduction of LDL
starts assess for
PO MoA: Rosuvastatin is a potent cholesterol and underlying causes
OD inhibitor of HMG-CoA triglycerides in of
reductase, an enzyme that patients with hypercholesterole
catalyzes the conversion of primary mia, including
HMG-CoA to mevalonic acid, poorly controlled
hypercholesterolemi
an early and rate-limiting a and mixed diabetes,
step in cholesterol dyslipidemia. hypothyroidism,
biosynthesis. nephrotic
syndrome,
Pharm: Limited metabolism in A/e: Asthenia, back pain, obstructive liver
the liver, excreted in feces. flu syndrome, chest pain, disease. Interrupt
infection, peripheral statin therapy if
edema, insomnia, anxiety, patient shows
vertigo. signs or symptoms
of serious liver
injury,
hyperbilirubinemia
, or jaundice.
 Monitor and report
prompt of
myopathy (skeletal
pain), monitor
CVS status and
loss of glycemic
control.
Salbutamol Inhaler Bronchodilator Relieve bronchospasm Teach patient to
(VENTOLIN) with acute or chronic perform inhalation
1 to 2 Inhalation MoA: Acts more prominent on beta 2 asthma, bronchitis or properly.
PO receptors, inhibits histamine release reversible obstructive Wait at least 1-2
by mast cells. Produces airway disorders mins between
bronchodilation inhalations.
A/e: Hypersensitivity Instruct patient to
Pharm: Inhaled 5-15min Metabolized reaction, tremor, anxiety, report worsening
in liver. !/2 life 2.75h nervousness, restlessness, symptoms.
hallucinations,
palpitation, HTN,
hypotension, bradycardia,
reflex tachycardia,N&V,
muscle cramps
Salmeterol/fluticasone Bronchodilator Long-term maintenance Remind patient to
50/250 inhaler of asthma, prevents take at about 12
(ADVAIR 50/250) bronchospasm in patients hour intervals for
1 inhalation with nocturnal asthma or optimal effect and
PO reversible obstructive to take even when
Q12h airway disease. feeling better.
Senna (SENOSIDES) Gastrointestinal agent; stimulant Acute constipation and Reduce dose in
laxative preoperative and patients who
preradiographic bowel experience
MoA: Senna glycosides are evacuation considerable
converted in colon to active abdominal
aglycone, which stimulates A/e: abdominal cramping.
peristalsis. Concentrate is cramps, flatulence,
purified and standardized for nausea, watery
uniform action and is claimed diarrhea, excessive
to produce less colic than loss of water and
crude form. electrolytes, weight
loss, melanotic
segmentation of
colonic mucosa

Sennosides A and B Laxative Active components of Assess patient for

Sennokot senna (sennosides) alter abdominal
12-50mg water and electrolyte distention,
PO transport in the large presence of bowel
OD/BID intestine, resulting in sounds, and usual
accumulation of water pattern of bowel
and increased peristalsis. function. Assess
 Laxative action. color, consistency,
and amount of
stool produced.
Septra Anti-infective; urinary tract agent; Used for pneumonitis and Older adult more
(cotrimoxazole) sulfonamide acute episodes of at risk for adverse
bronchitis in adults reactions (N&V,
MoA: inhibition, which anorexia,
prevents bacterial synthesis A/e: mild to moderate headache,
of essential nucleic acids and rashes, N&V, diarrhea, dizziness)
proteins. abdominal pain, myaglia

Sertraline CNS agent; psychotherapeutic agent; Treatment of major Supervise patient

antidepressant; selective serotonin depression, OCD, panic at risk for suicide
reuptake inhibitor disorder, social anxiety, closely during
premenstrual dysphoric therapy, monitor
disorder, general anxiety, for worsening
MOA: Potent inhibitor of serotonin reuptake in post-traumatic stress depression,
the brain and does not inhibit MAO. disorder. Unlabelled use: monitor older
eating disorders adults for fluid and
sodium
imbalances.
Sodium phosphate- Mineral and electrolyte Short term treatment of Monitor for
biphosphate ENM replacement/supplements constipation adverse reactions,
have patient report
signs of fluid and
electrolyte
problems such as
confusion, muscle
pain, weakness.
Spironolactone Electrolyte and water balance agent; Used to treat conditions Admin with food to
potassium sparing diuretic associated with enhance
augmented aldosterone absorption,
MoA: Antagonist of aldosterone, acts production such as Monitor BP, serum
by competing with aldosterone for hypertension, refractory electrolytes.
cellular receptor sites in distal renal edema due to CHF, hepatic Monitor for S7S f
tubule. Promotes sodium and chloride cirrhosis, nephrotic fluid and
excretion without loss of potassium. syndrome and idiopathic electrolyte
Activity depends on exogenous or edema. Also used for imbalance (I&O),
endogenous aldosterone. treatment for primary check for edema.
aldosteronism. Report
immediately
mental changes,
lethargy in patients
with liver disease.
Monitor BUN,
cautious use if
40mg/dL or
greater.
Tacrolimus (advagraf) Immunosuppressant Rejection Monitor serum
prophylaxis for electrolytes, blood
MoA: inhibits helper t lymphocytes organ transplants glucose, uric acid,
 by inhibiting secretion of interleukin BUN, and
thus reduces transplant rejection A/e: headache, creatinine.
tremors, insomnia, Monitor kidney
nausea, abdominal, function closely,
changes in and for
electrolytes, neurotoxicity,
appetite changes, report tremors
vomiting, dyspnea, changes in LOC.
blurred vision, Report HTN
photophobia.
Terazosin ANS agent; Alpha-adrenergic To treat Monitor BP at end
antagonist hypertension alone of dosing interval.
or in combination Be aware that
MoA: Quinazoline with other drug-induced
antihypertensive and antihypertensive decrease BP
vasodilator chemically similar agents (beta- appears to be more
to prazosin. Selectively adrenergic blocking position dependant
blocks alpha1-adrenergic agents, diuretics). during the hours
receptors in vascular smooth To treat benign after dosing.
muscle producing relaxation prostatic Greatly
that leads to reduction of hypertrophy. diminished
peripheral vascular hypotensive
resistance and lowered BP. response at end of
Vasodilation is accompanied 24h indicates need
by minimal reflex increase in for change in dose.
heart rate

Thiamine (Vitamin Vitamin B To correct anorexia Keep track of

b1) r/t to thiamine dietary hx
MoA: water soluble vitamin used for deficiency, tx of essential part of
thiamine replacement therapy beriberi vitamin
replacement as
A/e: feeling warmth, well as teaching in
sweating, diet plan.
restlessness, Sources of
tightness of throat, thiamine (e.g.,
cyanosis, pulmonary yeast, pork,
edema, nausea, beef, liver,
urticaria wheat and
other whole
grains,
nutrient-added
breakfast
cereals, fresh
vegetables,
especially peas
and dried
beans)
Ticagrelor Tablet Antiplatelet drug Used for acute coronary Monitor patient for
60mg, 90mg syndrome or a history of bleeding. Monitor
PO MI to reduce rate of CV for dyspnea and
death, MI, and stroke; rule out underlying
after stent placement for conditions that
treatment of ACS to require treatment
reduce rate of thrombosis. in patients with
new, prolonged, or
worsened
breathing.
Timolol ANS Agent; Beta-adrenergic Topically to reduce Check pulse
Ophthalmic 0.5% antagonist; Eye preparation elevated IOP in before
chronic glaucoma, administering,
MoA: Demonstrates ocular hypertension. assess pulse rate
antihypertensive, and BP at regular
antiarrhythmic, and intervals and more
antianginal properties, and often in patients
suppresses plasma renin with severe heart
activity. When applied disease. Some
topically, lowers elevated and patients develop
normal intraocular pressure tolerance during
(IOP) by unknown mechanism long-term therapy.
but appears to act by
reducing formation of
aqueous humor and possibly
by increasing outflow. In
contrast to pilocarpine and
other miotics, timolol does
not constrict pupil and
therefore does not cause
night blindness, and it does
not affect accommodation or
visual acuity

Tiotropium Autonomic nervous system agent; Maintenance treatment of Withhold drug and
Bromide (Spiriva) anticholinergic; para-sympatholytic; bronchospasm associated notify MD if S&S
18mcg antimuscarinic; anti spasmodic with COPD. of angioedema
occurs. Monitor
MoA: A long-acting antispasmodic A/e: Non specific chest for anticholinergic
agent. In the bronchial airways, pain, dependent edema, effects (ex.
exhibits inhibition of muscarinic infection, cough, dry tachycardia,
receptors of the smooth muscle mouth, vomiting, reflux, urinary retention)
resulting in bronchodilation. Drug myalgia.
effect can last up to 24h.
Trazadone Tablet Antidepressant Used for major Assess emotional
50mg-300mg depression, insomnia, status, monitor
PO chronic pain syndrome, changes, CNS
and anxiety changes, suicidal
tendencies, BP,
 chest pain,
arrhythmias.
Tylenol #3 Non-narcotic/narcotic analgesic Relief of mild to Complete pain
1-2 tabs combination moderately severe pain. assessment.
Orally For constipation,
Q4-6h increase fluid and
fibre intake to
offset.
Valproic Acid CNS agent; Anticonvulsant; GABA In management of mixed Monitor for pt
inhibitor seizure; mania; migraines alertness and
therapeutic
MoA: increased bioavailability of the effectiveness.
inhibitory neurotransmitter GABA.
Inhibits secondary phase of platelet
aggregation.
Valsartan Cardiovascular agent; angiotensin II- Treatment of Monitor BP
receptor antagonist; Antihypertensive hypertension, heart periodically.
failure Monitor liver
MoA: An angiotensin II function tests,
receptor (type BUN, creatinine,
AT1 antagonist; blocks the serum potassium,
binding of angiotensin II to and CBC with
the AT1 receptors found in differential
many tissues. Angiotensin II periodically.
is a potent vasoconstrictor
and primary vasoactive
hormone of the renin–
angiotensin–aldosterone
system

Vancomycin Anti-infective; antibiotic Treatment of life- Obtain specimen

125-500mg threatening infections in for culture and
PO MoA: Acts by interfering with cell pts allergic, nonsensitive, sensitivity before
Q6h membrane synthesis in multiplying or resistant to other less giving.
organs toxic anti-microbial Assess patient for
drugs. Used orally for C infection before
Diff. and during
therapy. First does
may be given
before receiving
results.
Monitor patient’s
fluid balance and
watch for oliguria
and cloudy urine.
Monitor patient for
signs and
symptoms of
superinfection.
Venlaflaxine CNS Agent, psychotherapeutic agent, Used for depression, Monitor for
25-100mg Tablets antidepressant, serotonin generalized anxiety worsening of
norepinephrine reuptake inhibitor disorder; social anxiety depression,
(SNRI) disorder cardiovascular
status (HR and
BP). Monitor
neurologic status
and report
excessive anxiety,
nervousness, and
insomnia. Assess
safety, dizziness
and sedation
common.
Ventolin ANS agent; Beta-adrenergic agonist; Relieve bronchospasm Monitor RR and
Bronchodilator associated with acute or auscultation of
chronic asthma, lungs. Monitor
MoA: Acts on beta 2 receptors. bronchitis. effectiveness
Inhibits histamine release by mast within 60-90 min
cells. Produces bronchodilation A/e: Tremor, anxiety, after
nervousness, restlessness, administration
headache, palpitation,
HTN, hypotension, N&V,
muscle cramps.
Vitamin B12 Hormone and synthetic substitute; Vitamin B12 deficiency Monitor VS in
(Cyanocobalamin) Vitamin B12 due to malabsorption patient and be alert
1000mcg / 2ea syndrome as in pernicious to symptoms of
Oral Daily MoA: Essential for normal anemia; GI pathology; edema. Obtain a
growth, cell reproduction, dysfunction; surgery; or complete diet and
maturation of RBCs, tapeworm infestation. drug history and
nucleoprotein synthesis, Also used in B12 inquire into
maintenance of nervous deficiency caused by alcohol drinking
system. Also acts as increased physiologic patterns for all
coenzyme in various biologic requirements or patients to identify
reactions. Vitamin inadequate dietary intake. and correct poor
B12 deficiency results in habits.
megaloblastic anemia,
dysfunction of spinal cord
with paralysis, GI lesions

Warfarin Sodium Blood formers, coagulators, and Prophylaxis and treatment Monitor closely
1mg – 10mg tablets anticoagulants of deep vein thrombosis older adult,
PO and pulmonary embolism, psychotic, or
MoA: Indirectly interferes with treatment of atrial alcoholic patients
blood clotting by depressing hepatic embolism. Used as because they
synthesis of vitamin K-dependant adjunct in treatment of present serious
coagulation factors: II, VII, IX, and coronary occlusion, noncompliance
X. cerebral transient problems. Patients
ischemic attacks. Used at greater risk of
 extensively as a hemorrhage who
rodenticide have aortic valve
prosthesis who are
receiving long
term anticoagulant
therapy.
Zopiclone Sedative; Hypnotics Short-term treatment of Assess mental
insomnia characterized by status, sleep
MoA: Interacts with GABA-receptor difficulty falling asleep patterns and use of
complexes; not a benzodiazepine and frequent/early previous
awakenings. sedative/hypnotics
. Assess alertness
at time of peak
(2hr). Assess
patient for pain
and medicate as
needed, untreated
pain decreases
sedative effects