Med Cards

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viggianojb
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77547
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Med Cards
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2011-04-05 10:43:49
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aspirin
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Common medication info for nurses
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  1. Amiodarone(Cordarone)
    • Class:
    • Antiarrythmics (class III), used to prevent sudden cardiac death (VF)

    • Prolongs action potential & refractory period,
    • Inhibits adrenergic stimulation, Slows sinus rate, increases PR & QT
    • intervals & decreases PVR, vasodilates

    PO 100-400mg/day for maintenance

    • SE: hypotension,
    • bradycardia, pulmonary fibrosis, CHF, worsening of arrhythmia, dizziness,
    • fatigue, malaise, corneal micro deposits, blue discolartion of skin,
    • hypothyroidism, ataxia, involuntary movement, paresthesia, peripheral
    • neuropathy, tremor

    Teach: Avoid grapefruit juice,

    BP HR
  2. Carvedilol(Coreg)
    • Class:
    • Antihypertensive/Beta Blocker; Used in HTN, or HF, irreg heart rhythms

    • Blocks Beta1 and 2 adrenergic receptor sites
    • improving CO, decreasing BP and HR. Blocks some alpha 1 activity which can
    • result in OH

    PO: 6.25-25 mg bid

    • Dizziness, bradycardia
    • fatigue, weakness, , CHF, Pulmonary edema, diarrhea, dont Abrupt w/d masks
    • hyper/hypoglycemia, bronchospasm

    • Teach:
    • Change position slowly to avoid OH, Monitor BG in DM



    • BP ___________
    • P__________ BG _________if DM
  3. Digoxin (Lanoxin)
    • Class:Antiarrhythmics/inotropes/digitalis
    • glycoside; used in HF, & irreg heart rhythms

    • Increases force of myocardial contraction. Prolongs
    • refractory period of the AV node. Decreases conduction through the SA and AV
    • nodes

    PO: 0.125-0.25mg/day

    • SE & toxicity signs: bradycardia, Fatigue, headache, weakness, blurred vision, yellow or green
    • vision, arrhythmias, ECG changes, A-V block, S-A block, anorexia, N&V,
    • diarrhea, gynecosmastia, thrombocytopenia, e-lyte imbalances, acute digoxin
    • toxicity

    • Teach:
    • Review s/s of toxicity and advise to report immediately, Do not mix in
    • container with other meds

    HR
  4. Enalapril (Vasotec)
    • Class:
    • Antihypertensives/ACE inhibitors; used in htn, hf

    • Blocks the conversion of angiotenson I to
    • angiotenson II causing vasodialation.
    • Prevents degradation of bradykinin and other vasodilatory prostoglandins


    PO: 2.5-5mg/day

    • SE: hypotension,
    • Dizziness, fatigue, headache, weakness, vertigo, chronic cough, chest pain,
    • abd pain, diarrhea, N&V, proteinuria, impaired renal func, rash,
    • hyperkalemia, dyspnea, angioedema

    • Teach:
    • Do not d/c unless directed by DR, Avoid salt sub containing K+ and foods high
    • in K+.

    • Change position slowly to avoid OH, Notify Dr
    • immediately of swelling of face or tongue

    BP HR K
  5. Furosemide (Lasix)
    • Class:
    • Diuretics/loop diuretics; used to tx edema & CHF

    Inhibits reabsorb of Na and Cl- in kidney

    • Increases renal excretion of H2O, Na, Cl-, Mg, K+
    • and Ca++

    PO: 20-80mg/day

    • Side effects: Dehydration, hypokalemia,
    • hypomagnesemia, hyponatremia, hypov olemia,
    • dizziness, vertigo, headache, hypotension, polyuria, hyperglycemia

    • Teach:
    • Daily wts, notify Dr of cramping, tachycardia, dizziness, increased fall risk,
    • rise slowly



    • Wt trending BP
    • HR K
  6. Heparin
    • Class:
    • Anticoagulants/antithrombotics---prevent DVTs

    • Potentiates the inhibitory effect of antithrombin
    • on factor X and thrombin

    SC: 5000 units/tid

    • SE: Drug-induced hepatitis, alopecia, bleeding,
    • anemia, thrombocytopenia, osteoporosis, fever, hypersensitivity, pain at
    • injection site, rash, urticaria

    • Teach:
    • Report s/s of unusual bleeding/bruising, No asa or NSAIDS, Avoid IM
    • injections(IV Route), Use soft toothbrush and electric razor



    • PTT (IV route)
    • platelets:
  7. Hydralazine (Apresoline)
    • Class:
    • Antihypertensive/vasodilator, used in htn & HF

    Direct-acting peripheral arteriolar vasodilator

    PO: 10-50mg

    • SE: Dizziness, drowsiness, headache,
    • tachycardia, angina, arrhythmia, edema, OH, diarrhea, N&V, rashes, Na
    • retention, arthritis, peripheral
    • neuropathy,

    • Teach:
    • Take even if feeling well, Take at same time daily, Don’t abruptly stop taking,
    • Compliance with Htn interventions, Change position slowly to avoid OH, Report
    • generalized tiredness, fever, muscle/joint pain, rash, chest pain



    • BP ____________
    • P _____________
  8. Hydrochlorothiazide (HCTZ)
    • Class:
    • Antihypertensive/Diuretics: used in htn

    • Increases excretion of Na and H2O by inhibiting Na
    • reabsorption in distal tubule. Promotes
    • excretion of K+, H+, Mg, Ph, Ca++ and Bicarb.
    • May produce arteriolar dilation

    PO: 12.5-100mg/day

    • SE: Dizziness, drowsiness, lethargy,
    • weakness, hypotension, anorexia, N&V, photosensitivity, dehydration,
    • hypercalcemia, hypokalemia, hypomagnesemia, hyponatremia, hypovolemia,
    • hypophosphatnemia

    • Teach:Take
    • same time every day, Monitor wt biweekly, Change position slowly to avoid OH



    Wt trending BP HR K
  9. Isosorbide Mononitrate (IMDUR) (Nitrate)
    • Class:
    • Venodialators/antianginals/nitrates: used in CAD

    • Vasodilation, Decreases LVED pressure and preload,
    • Increases coronary blood flow, reduces myocardial O2 use

    • Usual dose
    • range 30-60mg/day can not be crushed

    • Side effects: Dizziness, headache, hypotension,
    • tachycardia, paradoxic bradycardia, syncope, N&V, flushing, tolerance

    • Teach:
    • Take even if feel better, Take daily doses 7hr apart, Avoid alcohol, Inform Dr
    • of dry mouth or blurred vision

    Change position slowly to avoid OH



    • BP ____________
    • P _____________
  10. Lisinopril (Prinivil)
    • Class:
    • antihypertensive/ACE Inhibitor; used htn, HF

    • Blocks the conversion of angiotenson I to
    • angiotenson II causing vasodialation.
    • Prevents degradation of bradykinin and other vasodilatory prostoglandins
    • ****decreases remodeling

    PO 5-10mg/day may be titrated to 40mg/day

    • SE: Dizziness, fatigue, headache, weakness,
    • chronic cough, hypotension, chest pain, abd pain, diarrhea, nausea, vomiting,
    • ED, impired renal func, rashes, hyperkalemia, angioedema

    • Teach:
    • Do not d/c unless directed by DR, Avoid salt sub containing K+ and foods high
    • in K+

    • Change position slowly to avoid OH, Notify Dr
    • immediately of swelling of face or tongue

    BP HR K
  11. Losartan (Cozaar)
    • Class:
    • Antihypertensive/ Angiotension
    • receptor blocker (ARB) (lowers BP
    • & used in HF)

    • Blocks vasoconstriction and aldosterone secreting
    • effects of angiotensin ii at various receptor sites; used in htn & heart
    • failure

    Usual dose range: 25-100 mg/day

    • Side effects: Dizziness, fatigue, headache, insomnia,
    • weakness, chest pain, edema, hypotension, diarrhea, angioedema, hyperkalemia,
    • impaired renal function

    • Teach: Change
    • position slowly to avoid OH



    • BP ____________
    • P _____________ K+
    • ___________
  12. Metolazone (Zaroxolyn)
    • Class:
    • Antihypertensive/thiazide like diuretic, used to tx edema & CHF

    • Increase excretion of Na by preventing reabsorbtion
    • in distal tubule. Promotes excretion of Cl-, K+, Mg and bicarb. May arteriolar dialate.

    PO: 2.5-5 mg/day

    • SE: Chest pain, hypotension,
    • palpitations, anorexia, dehydration, hypochloremia, hypokalemia,
    • hypomagnesemia, hyponatremia, hypovolemia, muscle cramps

    • Teach:
    • Take same time everyday, Monitor wt daily, Change position slowly to avoid OH,
    • Wear sunscreen(d/t poss photosensitivity)



    • Wt trending BP
    • HR K
  13. Metoprolol (Lopressor)
    • Class:Antihypertensive/Beta
    • Blockers Used in HTN, or HF, irreg heart rhythms

    • Blocks stimulation of beta1(myocardial)-adrenergic
    • receptors. Does not usually affect beta2(pulmonary, vascular, uterine )
    • adrenergic receptor sites.

    PO: 25-450mg/day

    • Side effects: bradycardia, Fatigue,
    • weakness, CHF, pulmonary edema, ED, hypo/hyperglycemia, bronchospasm, wheezing,
    • hypotension, peripheral vasoconstriction, constipation, diarrhea, joint pain,
    • nightmares

    • Teach:
    • Do not abruptly withdrawl, Change
    • position slowly to avoid OH, Notify Dr of slow HR, wheezing & dyspnea

    • BP ___________
    • P__________ BG _________ if DM
  14. Spironolactone (Aldactone)
    • Class:
    • K+ sparing diuretics

    • Causes loss of Na Bicarb and Ca++ while saving K+
    • and H+ ions by antagonizing aldosterone; used to tx edema & CHF

    PO: 25-400 mg/day /CHF use 12.5-25 mg/day

    • SE: Dizziness,
    • hyperkalemia, hyponatremia, gynecomastia, ED, dysuria, arrythmias, headache, GI
    • irritation, muscle cramps

    • Teach:
    • Avoid salt substitutes and high levels of K+ unless prescribed



    Wt trending BP HR K
  15. Amlodipine (Norvasc)
    • Class:
    • Antihypertensives/Calcium channel blockers

    • Inhibits transfer of ca++ into myocardial &
    • vascular smooth muscle cells resulting in inhibition of excitation contraction
    • coupling & subsequent contraction.
    • Systemic vasodilation resulting in i
    • BP.

    • PO Adults: 5-10mg once daily;
    • antihypertensive in fragile or smaller patients or patients already receiving
    • other antihypertensives – initiate at 2.5mg/day - h as required/tolerated (up to 10mg/day).

    • PO Geriatric: Initiate at 2.5mg/day - h as reqd/tolerated (up to 10mg/day). Anti-anginal – initiate at
    • 5mg/day - h as reqd/tolerated (up to 10mg/day).

    • SE:
    • Headache, dizziness, fatigue; peripheral edema, angina,
    • bradycardia, hypotension, palpitations;
    • gingival hyperplasia, nausea, flushing.

    • Teach:
    • Take as directed; take missed dose ASAP but DO NOT double dose. Avoid large amounts of grapefruit juice (6-8
    • glasses/day) during therapy.

    BP________P_________
  16. Labetalol (Trandate)
    • Class:
    • Antianginals, antihypertensives/beta blockers

    • i BP. Blocks
    • stimulation of beta1 (myocardial)-
    • and beta2 (pulmonary, vascular, and
    • uterine)-adrenergic receptor sites. Also
    • has alpha1-adrenergic blocking
    • activity, which may result in more orthostatic hypotension.

    • PO: 100 mg bid initially, may be h by 100 mg bid q 2-3 days as needed (usual range 400-800 mg/day in
    • 2-3 divided doses; doses up to 1.2-2.4g/day have been used.)

    • SE:
    • Fatigue, weakness, anxiety, depression dizziness, drowsiness, insomnia;
    • OH, arrhythmias, bradycardia, CHF, pulmonary edema; constipation, diarrhea,
    • nausea.

    • Teach:
    • Take as directed at the same time each day, even if feeling well; take
    • missed dose ASAP up to 8 hr. before next dose – DO NOT double dose. Abrupt withdrawal may precipitate life
    • threatening arrhythmias, hypertension, or myocardial ischemia. May cause
    • dizziness – do not drive/operate heavy machinery until response to medicine is
    • known. Change positions slowly to avoid
    • OH. Notify healthcare professional if
    • slow pulse, difficulty breathing, wheezing, cold hands and feet, dizziness,
    • light-headedness, confusion, depression, rash, fever, sore throat, unusual
    • bleeding or bruising occurs.

    • HR ______ BP
    • _____
  17. Folic acid (Apo-Folic, folate, Folvite, Novofolacid, vitamin B)
    • Class:
    • Antianemics, vitamins/water soluble vitamins

    • Required for protein synthesis and red blood cell
    • function. Stimulates the production of RBCs, WBCs, and platelets. Necessary for
    • normal fetus development. Restoration
    • and maintenance of normal hematopoiesis

    • PO, IM, IV, SubQ: 1 mg/day initial dose,
    • then 0.5 mg/day maintenance dose.

    • SE:
    • Rash, irritability, difficulty sleeping, malaise, confusion, fever.

    • Teach:
    • folic acid in early pregnancy is necessary to prevent neural tube defects; high
    • folic acid foods include vegetables, fruits, and organ meats; heat destroys
    • folic acid in foods; instruct patient to notify health care profession if rash
    • occurs, which may indicate hypersensitivity.



    Hbg Hct
  18. Metronidazole (Flagyl)
    • Class:
    • Anti-infectives, antiprotozoals, antiulcer agents.

    • Disrupts DNA and protein synthesis in susceptible
    • organisms. Most notable for activity
    • against anaerobic bacteria, including Bacteroides,
    • Clostridium. In addition is active
    • against Trichomonas vaginalis, Entamoeba
    • hystolytica, Giardia lamblia, H. pylori, Clostridium difficile.

    • PO: Anaerobic infections 7.5 mg/kg q 6 hr
    • (not to exceed 4g/day) initial dose, then 0.5 mg/day maintenance dose.

    • SE:
    • Seizures, dizziness, headache, aseptic meningitis (IV), encephalopathy
    • (IV), abdominal pain, anorexia, nausea, diarrhea, Stevens-Johnson Syndrome,
    • rash, urticaria.

    • Teach:
    • Take medication as directed with evenly spaced time between doses, even if
    • feeling better. Do not skip doses or
    • double up. May cause dizziness or
    • lightheadedness. May cause unpleasant metallic taste.
  19. Minoxidil
    • Class:
    • Antihypertensives/vasodilators

    • Directly relaxes vascular smooth muscle, probably
    • by inhibiting the enzyme phosphodi-esterase. Results in vasodilation, which is
    • more pronounced in arterioles than veins. i
    • BP.

    • Used in severe symptomatic hypertension or hypertension
    • with end-organ damage that has failed to respond to combinations of more
    • conventional therapy.

    • PO: 5 mg once daily or in 2 divided
    • doses; may double at 3-day intervalsl usual range 10-40 mg/day (for rapid
    • control with careful montoring, doses may be adjusted q 6 hrl up to 100 mg/day
    • have been used).

    • SE:
    • HA; pulmonary edema; CHF, ECG changes, tachycardia, angina, pericardial
    • effusion; nausea; hypertrichosis, rashes; sodium and water retention;
    • intermittent claudication.

    • Teach:
    • Continue this medication even if feeling well; take missed doses as soon
    • as re-membered if within a few hours; otherwise omit dose, DO NOT double dose;
    • do not D/C without physician approval; encourage proper diet and regular
    • exercise; change positions slowly to avoid OH; NSAISs may i
    • the AH effectiveness. BP P
  20. Diltiazem Hydrochloride
    (Cardizem)
    • Inhibits
    • influx of calcium through the cell membranes, resulting in a depression of
    • automaticity and conduction velocity in cardiac muscle. Decreases SA and AV
    • conduction and prolongs AV node effective and functional refractory periods.

    PO 120 mg or 180 mg

    • S/E AV block, bradycardia, edema, dizziness/lightheadedness, HA,
    • pain, dyspnea, rhinitis, infection.

    • Teach:
    • Take at same time each day, Rise slowly from a lying to a sitting and standing
    • position; may cause decreased BP.



    BP P
  21. Pentoxifylline (Pentoxil, Trental)
    • Class: Blood viscosity reducing agent;
    • used in management of symptomatic PVD (intermittent claudication)

    • Increases the flexibility of RBC’s by increasing
    • levels of cyclic adenosine monophosphate (cAMP). Decreases blood viscosity by inhibiting
    • platelet aggregation and decreasing fibrinogen.

    • PO: (Adults)
    • 400 mg tid. If GI or CNS S/E occur, i dose to 400 mg bid.

    • SE:
    • Agitation, dizziness, drowsiness, headache, insomnia, nervousness, blurred
    • vision, dyspnea, angina, arrhythmias, edema, flushing, hypotension, abdominal
    • discomfort, belching, bloating, diarrhea, dyspepsia, flatus, nausea, vomiting,
    • tremors.

    • Teach: Instruct pt. to
    • take medication as directed, consult healthcare provider before d/c or if
    • nausea, vomiting, GI upset, drowsiness, or headache persists; to avoid driving
    • as dizziness & blurred vision may occur; avoid smoking, as nicotine
    • constricts blood vessels.

    BP
  22. Ranolazine (Ranexa)
    • Class: Antianginals, used
    • for chronic angina to decrease frequency

    PO: 500mg BID, may be á to 1000mg BID, do not break, crush, or chew

    • SE: dizziness, headache, tinnitus, palpitations, abdominal pain,
    • constipation, dry mouth, N&V

    • Teach: If miss a dose, take next
    • dose at usual time, do not double doses, Avoid grapefruit juice and grapefruit
    • products, Avoid driving and activities until side effects are known, Consult
    • provider before taking other Rx, OTC, or herbal products

    • Assess: location, duration,
    • intensity, and precipitating factors of angina pain



    • BP__________
    • HR _________
  23. Nitroglycerine (Nitrostat)
    • Class:
    • Antianginals/nitrates

    • Vasodilation; i
    • LVED pressure and preload; h coronary blood flow;
    • reduces myocardial O2 use.

    • SL: 0.3-0.6 mg - may repeat q5 min 2
    • additional doses for acute attack

    PO: 2.5-9 mg q8-12 hours

    • SE: Dizziness, headache, hypotension, tachycardia, syncope, blurred
    • vision, weakness, apprehension, restlessness.

    • Teach:
    • Do not abruptly d/c; Change position slowly to avoid OH; Call 911 or go to ER
    • if 3SL/15 min not effective (home use instruction); Avoid alcohol consumption.



    BP HR P ECG
  24. Warfarin (Coumadin)
    • Class:
    • Anticoagulant/coumarin

    • Interferes with hepatic synthesis of vitamin
    • K-dependent clotting factors.

    • PO, IV: 2.5-10 mg/day – Adjusted based on
    • PT INR

    SE: Cramps, N & V, dermal necrosis, bleeding, fever.

    • Teach:
    • Avoid alcohol, NSAIDs, ASA. Review foods
    • high in vitamin K and keep amount consistent.
    • Avoid IM injection. Frequent lab
    • monitoring. Bleeding precautions.



    PT INR

    • Plt Hgb Hct Stool
    • OB
  25. Levothyroxine (Synthroid)
    • Class:
    • Hormones/thyroid preparations

    • Replaces or supplements endogenous thyroid
    • hormones. h
    • metabolic rate of body tissues.

    PO: 75-125 mcg/day (1.5mcg/kg/day)

    IM, IV: 50-100mcg/day as single

    • SE:
    • Insomnia, irritability, headache, arrhythmias, tachycardia, angina
    • pectoris, abd. cramps, diarrhea, vomiting, hyperhydrosis, hyperthyroidism,
    • menstrual irregularities, wt. loss, heat intolerance.

    • Teach:
    • Take same time each day; Explain therapy is not cure, lifelong; Notify Dr. of
    • unusual s/s; Do not take within 4 hrs. of iron or ca++ consumption; Periodic
    • labs.

    TSH HR
  26. Thiamine (Biamine)
    • Class:
    • Vitamins/water soluble vitamins

    Required for carbohydrate metabolism.

    PO: 5-10 mg/tid / IM, IV: 5-100 mg tid.

    • SE:
    • Restlessness, weakness, tightness of throat, pulmonary edema,
    • respiratory distress, vascular collapse, hypotension, vasodilation, GI
    • bleeding, angioedema, nausea, cyanosis.

    • Teach:
    • Encourage dietary compliance; Teach about foods high in thiamine; Caution about
    • OTC vitamin supplements and teach RDA.
  27. Potassium chloride (K-Dur)
    • Class:
    • Mineral and electrolyte replacement/supplement

    Prevention of K depletion;

    • Usual dose
    • range 20-40 mEq/day in 1 – 2 divided doses. Single dose not to exceed 20 mEq

    • Side effects: Abdominal pain, diarrhea, flatulence, nausea,
    • vomiting, confusion, restlessness, weakness, arrhythmias, ECK changes.

    • Teach:
    • Take missed doses as soon as remembered within 2 hours; Do not double dose;
    • Report dark, tarry, or bloody stools; weakness, unusual fatigue, or tingling of
    • extremities; Notify Dr. of persistent nausea, vomiting, diarrhea, or stomach
    • discomfort.



    K _____________
  28. Tolterodine (Detrol)
    • Class:
    • Urinary tract antispasmodic/anticholinergic

    • PO: 2 mg as
    • tablets bid may be lowered depending on response or 2-4 mg once daily as
    • extended release capsules.

    • Side effects: Headache, dizziness, blurred vision, dry
    • eyes, dry mouth, constipation, dyspepsia.

    • Teach:
    • Instruct to take as directed; May cause dizziness and blurred vision – avoid
    • driving and other activities requiring alertness until effect is known.



    Monitor liver function. (in long term therapy
  29. Citalopram (Celexa)
    DO NOT CONFUSE WITH CELEBREX

    • Class:
    • Antidepressant/selective serotonin reuptake inhibitors (SSRI’s)

    Used for depression.

    • PO: 20 mg
    • daily initially. May be h by 20 mg at weekly intervals, up to 60
    • mg/day (usual dose is 40 mg/day).

    • Side effects: Apathy, confusion, drowsiness, insomnia,
    • weakness, abdominal pain, anorexia, diarrhea, dry mouth, dyspepsia, flatulence, h saliva, nausea, sweating, tremors; neuroleptic malignant
    • syndrome, suicidal thoughts.

    • Teach:
    • Instruct to take as directed; avoid alcohol; change positions slowly to
    • minimize dizziness; Instruct patient not to take within 14 days of MAO
    • inhibitors
  30. Pantoprazole (Protonix)
    • Class:
    • Antiulcer agent/proton-pump inhibitors

    • Prevention of stress ulcers. Diminished accumulation of acid in the
    • gastric lumen, with lessened acid reflux.

    • PO: GERD - 40 mg once daily; Gastric
    • hypersecretory conditions – 40 mg bid up to 120 mg bid.

    • SE:
    • Headache, abdominal pain, diarrhea, eructation, flatulence,
    • hyperglycemia.

    • Teach:
    • Take as directed; Take full course of therapy even if feeling better; avoid
    • alcohol; products containing NSAIDs & ASA; Report dark, tarry stools;
    • diarrhea, or abdominal pain.



    Bilirubin AST ALT Alkaline phosphatase (in long term use only)
  31. Simvastatin (Zocor)
    • Class:
    • Lipid lowering agent/Hgb CoA reductase inhibitors

    • 2° prevention of cardiovascular events (i
    • risk of MI, coronary revascu-larization, stroke, and cardiovascular mortality)
    • in patients with clinically evident CHD or those at risk for CHD (Hx of
    • diabetes, PAD, or stroke).

    PO: 5 - 80 mg once daily in the evening.

    • SE:
    • Dizziness, headache, insomnia, weakness, chest pain, peripheral edema,
    • rhinitis, lovastatin, blurred vision, bronchitis, abdominal cramps,
    • constipation diarrhea, flatus, heartburn, nausea, rashes, hypersensitivity
    • reactions.

    • Teach:
    • Take as directed; Advise patient that this medicine should be taken in
    • conjunction with diet restriction.
    • Notify Dr. of unexplained muscle tenderness, pain, weakness, fever, or
    • malaise.



    • Serum cholesterol Triglyceride Liver
    • function-AST
  32. Aspirin (Acetylsalicylic acid, Acuprin, ASA, Aspirtab, Bayer, Ecotrin)
    • Class:
    • Antipyretics, Non-opioid analgesics/Salicylates

    • i platelet aggregation. i
    • inflammation & fever by inhibiting the production of prostaglandins.

    PO: 80-325mg once daily.

    • SE:
    • Tinnitus (ringing in ears), GI BLEEDING, dyspepsia (indigestion),
    • epi-gastric distress, nausea, abdominal pain, anorexia, hepatotoxicity,
    • vomiting, anemia, hemolysis, rash,
    • urticaria (hives), anaphylaxis &
    • laryngeal edema.

    • Teach:
    • Take w/full glass of water and remain upright for 30 min after administration. Report tinnitus, unusual bleeding of gums,
    • bruising, black tarry stool, or fever
    • > 3 days. AVOID USING ALCOHOL,
    • ACETA-MINOPHEN, OR NSAIDs W/ THIS MED.
    • Reduce sodium intake.
  33. Clopidogrel (Plavix)
    • Class:
    • Antiplatelet agents/platelet aggregation inhibitors

    • Inhibits platelet aggregation by irreversibly
    • inhibiting the binding of ATP to platelet receptors. i
    • occurrence of atherosclerotic events in patients at risk

    PO: 75mg once daily.

    • SE:
    • GI BLEEDING, NEUTROPENIA, THROMBOTIC THROMBOCYTOPENIC PUPURA, depression,
    • dizzy, fatigue, HA, epistaxis, cough, dyspnea, chest pain, edema, HTN,
    • abdominal pain, diarrhea, dyspepsia, hypercholesterolemia, back pain, fever,
    • hypersensitivity reactions.

    • Teach:
    • Take exactly as directed. Take missed
    • dose ASAP unless almost time for next dose; DO NOT double dose. Notify physician if fever, chills, sore
    • throat, unusual bleeding or bruising occurs.
    • Contact physician before taking Rx, OTC or Herbal products especially
    • those containing ASA, NSAIDs, or proton pump inhibitors.

    • Monitor renal function & Neuro. CBC
    • Platelet
  34. Clonidine
    (Catapres)
    • Class:
    • Antihypertensive/adrenergic; used in HTN, cancer pain
    • unresponsive to opioids alone

    • Stimulates alpha-adrenergic
    • receptors in CNS resulting in decreased sympa-thetic outflow (HTN); this also
    • prevents pain signal transmission to CNS.

    • PO: 0.1mg bid to start, increasing to maintenance dose of 0.2-0.6
    • mg/day

    • S/E: drowsiness,
    • depression, dizziness, nervousness, nightmares, bradycardia, hypotension,
    • palpitations, dry mouth,
    • constipation,

    • N & V, ED, rash,
    • sweating, Na+ retention, wt gain, withdrawal
    • phenomenon

    • Teach:
    • Take at same time each day, change position slowly to avoid OH, freq mouth
    • rinses, good oral hygiene and sugar-free gum can help with dry mouth

    BP________ P_________
  35. Tamsulosin (Flomax)
    • Class:
    • Peripherally acting antiadrenergic

    • i
    • symptoms of prostatic hyperplasia (urinary urgency, hesitancy, nocturia).

    • i contractions of smooth muscle of prostatic capsule
    • by preferentially binding to alpha, -adrenergic receptors.

    • PO: 0.4 mg/daily after a meal; may be h after 2-4 weeks to 0.8mg/day.
    • DO NOT open, crush, or chew.

    • SE:
    • Headache, dizziness; rhinitis; OH.

    • Teach:
    • Take as directed; Take full course of therapy even if feeling better; take at
    • same time each day. May cause dizziness
    • – do not drive/operate heavy machinery until response to medicine is
    • known. Change positions slowly to avoid
    • OH.

    I/O BP
  36. Hydrocodone/acetaminophen
    (Vicodin)
    • Class:
    • Opioid analgesic/opioid agonists; non-opioid analgesic combinations

    • Binds to receptors in the CNS. Alters perception of, and response to,
    • painful stimuli while producing generalized CNS depression.

    • i
    • in severity of moderate pain, suppression of cough reflex

    • PO: 2.5-10mg q3-6h as
    • needed. Acetaminophen dosage should not
    • exceed 4g/day. (Ibuprofen products
    • should not exceed 5 tablets/day.)

    • S/E: Confusion, dizziness,
    • sedation; hypotension; constipation, dyspepsia, nausea, vomiting, urinary
    • retention, sweating.

    • Teach:
    • Take as directed, do not take more than recommended amount. Teach patient to turn, cough, and deep breath
    • q2hr to prevent atelectasis.



    • May cause h
    • plasma amylase and lipase concentrations in long term use
  37. Famotidine (Pepcid)
    • Class:
    • Anti-ulcer agent/Histamine H2 antagonist.

    • Inhibits the action of histamine at the H2 receptor
    • site located primarily in gastric parietal cells, resulting in inhibition of
    • gastric acid secretion. Healing and
    • prevention of ulcers.

    • PO: 40 mg/day HS or 20mg bid for up to 8
    • weeks.

    • SE:
    • Confusion, dizziness; drowsiness, hallucination, headache; arrhythmias;
    • constipation diarrhea, nausea; agranulocytosis; aplastic anemia.

    • Teach:
    • Take as directed; Take full course of therapy even if feeling better; take
    • missed dose ASAP but DO NOT double dose.
    • Report to physician onset of black, tarry stools, fever, sore throat,
    • diarrhea, dizziness, rash, confusion, or hallucinations.



    CBC w/differential in long term use
  38. Docusate (Colace, Dulcolax, Correctol)
    • Class:
    • Laxatives/Stool softeners

    • Promotes incorporation of water into stool,
    • resulting in softer stool mass.

    PO: 50-400mg in 1-4 divided doses.

    • Rectum: 50-100mg or 1 unit containing
    • 283mg docusate sodium, soft soap, and glycerin.

    • SE:
    • Throat irritation; mild cramps, rashes.

    • Teach:
    • Laxatives should be used only for short term therapy. Encourage patient to use other forms of
    • therapy such as h bulk in diet, h
    • fluid intake (6-8 glasses of water daily), h
    • mobility. Instruct patients with cardiac
    • disease to avoid straining during a BM (Valsalva maneuver). Do not take within 2 hours of other
    • laxatives.



    Please hold if not needed
  39. Amlopidine (Norvasc)
    • Class:
    • Antihypertensives/Calcium channel blockers

    • Inhibits transfer of ca++ into myocardial &
    • vascular smooth muscle cells resulting in inhibition of excitation contraction
    • coupling & subsequent contraction.
    • Systemic vasodilation resulting in i
    • BP.

    • PO Adults: 5-10mg once daily;
    • antihypertensive in fragile or smaller patients or patients already receiving
    • other antihypertensives – initiate at 2.5mg/day - h as required/tolerated (up to 10mg/day).

    • PO Geriatric: Initiate at 2.5mg/day - h as reqd/tolerated (up to 10mg/day). Anti-anginal – initiate at
    • 5mg/day - h as reqd/tolerated (up to 10mg/day).

    • SE:
    • Headache, dizziness, fatigue; peripheral edema, angina,
    • bradycardia, hypotension, palpitations;
    • gingival hyperplasia, nausea, flushing.

    • Teach:
    • Take as directed; take missed dose ASAP but DO NOT double dose. Avoid large amounts of grapefruit juice (6-8
    • glasses/day) during therapy.

    • BP________P_________
    • ECG_________

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