MEDICATION          INDICATION             MECHANISM OF                SIDE EFFECTS                  NURSING RESPONSIBILITY
ACTION
Generic name:     To reduce the risk       Atorvastatin           Headache, flatulence,             -Stress that atorvastatin is an
Atorvastatin      of       myocardial      competitively          diarrhea, nausea, vomiting,       adjunct to not a substitute for
                  infarction, stroke,      inhibits HMG-COA       anorexia, xerostomia,             low-cholesterol diet.
Brand name:       angina,            or    reductase, the         angioedema, myalgia,              -Tell patient to take drug at the
Lipitor           revascularization        enzyme that            rash/pruritus, alopecia,          same time each day to maintain
                  procedures         in    catalyses the          allergy, infection, chest         its effect.
Dosage and        patients        with     conversion of HMG-     pain.                             -Instruct patient to take a
Route:            multiple        risks    COA to mevalonic       Potentially Fatal:                missed dose as soon as possible.
IV                factors of CAD.          acid. This result in    Thrombocytopenia.                I is almost time for his next
                                           the induction of the   Rhabdomyolysis with acute         dose, he should skip the missed
Classification:                            LDL receptors.         renal failure.                    dose.
HMG CoA                                    Leading to lowered                                       - Advise patient to notify
reductase                                  LDL-cholesterol                                          prescriber immediately if the
inhibitors                                 concentration.                                           develops unexplained muscle
                                                                                                    pain, tenderness, or weakness
                                                                                                    especially if accompanied by
                                                                                                    fatigue or fever.
 MEDICATION       CONTRAINDICATION           MECHANISM OF ACTION             SIDE EFFECTS             NURSING RESPONSIBILITY
Generic Name:     Patients with            Angiotensin-converting        –    dizziness         –    Monitor BUN, creatinine, and
                  hypersensitivity and     enzyme (ACE) inhibitors       –    cough                  electrolyte levels periodically.
Enalapril         history of               block the conversion of       –    hypotension       –     Serum potassium may be
                  angioedema with                                        –    rashes                 increased and BUN and
Brand Name:                                angiotensin I to the
                  previous use of ACE                                    –    hyperkalemia           creatinine concentrations
                  inhibitors. Use          vasoconstrictor angiotensin   –    angioedema             occur, dosage reduction or
Vasotec           cautiously in patients   II. ACE inhibitors also                                   withdrawal may be required.
                  with renal               prevent the degradation of                           –    Monitor CBC periodically
Dosage and
                  impairment,              bradykinin and other                                      during therapy in patient with
Route:            hypovolemia,                                                                       collagen vascular disease
                                           vasodilatory
                  hyponatremia,            prostaglandins. ACE                                       and/or renal disease.
                  concurrent diuretic                                                           –    May rarely cause slight
                                           inhibitors also increase
                  therapy (initial                                                                   decrease in hemoglobin and
Classification:                            plasma renin levels and
                  dosage reduction                                                                   hematocrit and
ACE Inhibitors                             reduce aldosterone levels.
                  recommended). Use                                                                  agranulocytosis.
                  extreme caution in       Net result is systemic                               –    May cause elevated AST, ALT,
                  patients with a          vasodilation. Indicated for                               alkaline phosphatase and
                  family history of        the treatment of                                          serum bilirubin.
                  angioedema.              hypertension.
  MEDICATION             INDICATION            MECHANISM OF                       SIDE EFFECTS              NURSING RESPONSIBILITY
                                                   ACTION
Generic Name:        Treatment of           Inhibits the second      Common side effects;                  Be sure to teach the patient
Vancomycin           potentially life-      stage of cell wall       ototoxicity, hypotension,             the following about this
                     threatening            synthesis of             nausea, vomiting,                     medication;
Brand Name:          infections when        susceptible bacteria.    nephrotoxicity, rashes,                   - Report signs of
Vancocin             less toxic anti-       There is also            eosinophilia, leukopenia,                      hypersensitivity,
                     infective are          evidence that            phlebitis, back and neck pain,                 tinnitus, vertigo or
Dosage and           contraindicated.       vancomycin alters        hypersensitivity reactions                     hearing loss.
Route:               Particularly useful    the permeability of      including anaphylaxis, chills,            - Report If there is no
                     in staphylococcal      the cell membrane        fever, red-man syndrome                        improvement in a
Classification:      infections,            and selectively          (with rapid infusion),                         few days.
Anti-infective       including              inhibits ribonucleic     superinfection.                           - Heart patients need
                     Endocarditis,          acid synthesis.                                                         to be taught
                     Meningitis,                                                                                    importance of using
                     Osteomyelitis,                                                                                 antimicrobial
                     pneumonia,                                                                                     prophylaxis prior to
                     septicicemia, soft                                                                             invasive dental or
                     tissue infections in                                                                           medical procedures.
                     patients who have
                     allergies to
                     penicillin or its
                     derivatives.
MEDICATION         INDICATION         MECHANISM OF           SIDE EFFECTS                        NURSING RESPONSIBILITY
                                           ACTION
Generic           Chronic stable    Inhibits calcium ion   CNS: headache,           –   Alert: Monitor patient carefully. Some patients,
Name:             angina,           influx across          somnolence,                  especially those with severe obstructive
                  vasospastic       cardiac and            fatigue, dizziness ,         coronary artery disease, have developed
Amlodipine        angina            smooth-muscle          light-headedness,            increased frequency, duration or severity of
besylate          (Prinzmetal or    cells, dilates         paresthesia                  angina or acute MI after initiation of calcium
                  variant           coronary arteries      CV: edema,                   channel blocker therapy or at time of dosage
Brand Name:       angina).          and arterioles and     flushing,                    increase.
                  Hypertension      decreases blood        palpitations             –   Monitor blood pressure frequently during
Norvasc                             pressure and           GI: nausea,                  initiation of therapy. Because drug-induced
                                    myocardial oxygen      abdominal pain               vasodilation has a gradual onset, acute
Classification:
                                    demand.                GU: sexual                   hypotension is rare.
                                                           difficulties             –   Notify prescriber if signs of heart failure occur,
Calcium
                                                           Musculoskeletal:             such as swelling of hands and feet or shortness
channel
                                                           muscle pain                  of breath.
blocker
                                                           RESPIRATORY:             –   Alert: Abrupt withdrawal of drug may increase
                                                           dyspnea                      frequency and duration of chest pain. Taper
                                                           SKIN: rash                   dose gradually under medical supervision.
                                                           pruritus                 –   Look alike-sound alike: Don’t confuse
                                                                                        amlodipine with amiloride.
   MEDICATION               INDICATION              MECHANISM OF ACTION               SIDE EFFECTS             NURSING RESPONSIBILITY
 Generic Name:         Treatment of                It is similar to that of other   CNS: headache,       –    Obtain history of
                       moderate to severe          penicillin’s. Interfere with     insomnia, fever           hypersensitivity to penicillin,
 Piperacillin/         appendicitis,               bacterial cell wall synthesis                              cephalosporin, or other drugs
 Tazovactam                                                                                                   prior to administration.
                       uncomplicated and           promotes loss of                 GI: diarrhea,
                                                                                                         –    Obtain specimen for culture
 Brand Name:           complicated skin and        membrane integrity and           nausea,                   and sensitivity prior to first
                       skin structure              leads to death of the            constipation,             dose of the drug: start drug
 Zosyn                 infections,                 organism.                        vomiting,                 pending results. Periodic CBC
                       nosocomial or                                                pseudomembran             with differential, platelet
                       community-acquired                                           ous colitis               count, Hgb and Hgt, and serum
                       pneumonia caused                                                                       electrolytes.
 Classification:                                                                                         –
                       piperacillin-resistant,                                      SKIN:
 Anti-infective;       piperacillin/                                                hypersensitivity
 Beta-lactam           tazobactam                                                   reactions, rash,
 antibiotic; anti-     susceptible, beta-                                           pruritus
 pseudomonal           lactamase-producing
 penicillin            bacteria.
MEDICATION                  INDICATION                MECHANISM OF             SIDE EFFECTS                  NURSING RESPONSIBILITY
                                                         ACTION
Generic              Infections caused by             Inhibits             CV:                    –    Obtain specimen for culture and
Name:                sensitive staphylococci,         bacterial            thrombophlebitis            sensitivity tests before giving first
                     streptococci, pneumococci,       protein              GI: nausea,                 dose. Therapy may begin pending
Clindamycin          Bacteroides,                     synthesis by         abdominal pain,             results.
Hydrochloride        Fusobacterium, Clostidium        binding to the       pseudomembranou        –    For IM administration, inject deep into
Brand Name:          perfringens and other            50S subunit of       s colitis, diarrhea,        muscle. Rotate sites. Don’t exceed 600
                     sensitive aerobic and            the ribosome.        vomiting                    mg per injection.
Cleocin HCl,         anaerobic organisms. Pelvic                           Hematologic:           –    IM injection may raise CK level in
                     inflammatory disease.                                 thrombocytopenia,           response to muscle irritation.
Classification:
                                                                           transient leukemia,    –    Don’t refrigerate reconstituted oral
                     Pneumocystic jiroveci                                 eosinophilia                solution because it will thicken. Drug is
Lincomycin
                     (carinii) pneumonia.                                  Hepatic: jaundice           stable for 2 weeks at room
derivative
                     CNS toxoplasmosis in AIDS                             SKIN:                       temperature.
                     patients, as alternative to                           maculopapular          –    Monitor renal, hepatic and
                     sulfonamides with                                     rash, urticarial            hematopoietic functions during
                     pyrimethamine.                                        Other: anaphylaxis          prolonged therapy.
                                                                                                  –    Observe patient for signs and
                                                                                                       symptoms of superinfection.