Summary of drug Adult 1/Clinical

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Summary of drug Adult 1/Clinical

Drug Classification Indication to use side effect

AMLODIPINE calcium channel 1-Management of 1-Peripheral edema
blocker hypertension,chronic 2Arrhythmias
stable angina, 3-hypotension
Antihypertensive vasospastic 4-Dizziness
(Prinzmetal’s or 5-fatigue
Antianginal variant) angina. 6-nausea
2-May be used alone 7- Dry mouth
or with other 8-constipatin
antihypertensives or 9-Abdominal pain
antianginals. 10-headche
11-Diarrhea
12- vomiting
#NURSING CONSIDERATIONS:

1-BASELINE ASSESSMENT

Assess baseline renal/hepatic function tests, B/P, apical pulse.

2-INTERVENTION/EVALUATION

a-Assess B/P (if systolic B/P is less than 90 mm Hg, withhold medication,
contact physician).

b-Assess for peripheral edema behind medial malleolus (sacral area in

bedridden pts).

c- Assess skin for flushing.

d-Question for headache, asthenia.

3- PATIENT/FAMILY TEACHING

a-Do not abruptly discontinue medication.

b- Compliance with therapy regimen is essential to control hypertension.

c-Avoid tasks that require alertness, motor skills until response to drug is
established.

d- Do not ingest grapefruit produc

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 Summary of drug Adult 1/Clinical

Drug Classification Indication to use Side effect

-ASPIRIN -Non opioid 1-Coronary artery bypass 1-Occult blood
-ANOTHER -Analgesic surgery loss
NAME -Antiplatelet 2- Acute rheumatic fever 2-leukopnia
-Acetylsalicylic -Antipyretic 3-Post cardiac stenting 3- Difficulty
-ASA -NSAIDS 4-rheumatic condition hearing,
5-Myocardial infraction 4-Tinnitus
6-Arthritis 5-Decrease blood
7-Angina iron level
8- Ischemic stroke 6- prolonged
9-Osteoarthritis bleeding time
10-treatment of mild to 7- GI bleeding
moderate pain 8-Heart burn
11-fever. 9-Epigastric
12-reduces inflammation discomfort
related to rheumatoid 10-Acute aspirin
arthritis (ra), juvenile toxicity
arthritis, osteoarthritis, 11-Dizziness,
rheumatic fever. 12- Dyspepsia
13- used as platelet 13-Nausea
aggregation inhibitor in
the prevention of
transient ischemic
attacks

#NURSING IMPLICATIONS

1-Give drug with full glass of water to reduce risk of tablet or capsule lodging
in the esophagus

2-Give drug with food or after meals if Gl upset occurs

3- Do not crush, and ensure that patient does not chew SR preparations
instruct patient to stop aspirin

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Summary of drug Adult 1/Clinical
4- If any symptoms of stomach bleeding occur monitor CBC especially platelets
monitor signs of bleeding

5-Do not give to children or teenagers who have or recently had viral infections
(increases risk of reye’s syndrome).

6-Do not use if vinegar-like odor is noted (indicates chemical breakdown).

7- Assess type, location, duration of pain, inflammation.

8-Inspect appearance of affected joints for immobility, deformities, skin

condition.

#Therapeutic serum level for antiarthritic effect:

20–30 mg/dl (toxicity occurs if level is greater than 30 mg/dl).

#Intervention/evaluation

a-Monitor urinary ph (sudden acidification, ph from 6.5 to 5.5, may result in

toxicity).

b-Assess skin for evidence of ecchymosis.

c-If given as antipyretic, assess temperature directly before and 1 hr after

giving medication.

d-Evaluate for therapeutic response: relief of pain, stiffness, swelling;

increased joint mobility; reduced joint tenderness; improved grip strength.

#Patient/family teaching

a-Do not, chew, crush, dissolve, or divide enteric-coated tablets.

b-Avoid alcohol report tinnitus or persistent abdominal gi pain, bleeding.

c-Therapeutic anti-inflammatory effect noted in 1–3 wks.

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Summary of drug Adult 1/Clinical
Drug Classification Indication to use Side effect
CLEXANE OR Low molecular 1-To prevent 1-Thrombocytopenia
Enoxaparin sodium weight heparin deep vein 2-Epistaxis
thrombosis Bleeding & bruising
Antithrombotic 2-To prevent 3-Anemia
ischemic 4-Hyperkalemia
complications of 5-Hematoma
unstable angina 6-Ecchymosis
3-To treat acute 7-Alopecia Melena
STEMI Arterial 8-GI bleeding
fibliration
Prosthetic heart
valves

#NURSING IMPLICATIONS

1-Assess location of injection for bruising or bleeding

2-Monitor patient lab value&factor Xa

3-Test stool for blood and keep potassium sulfate nearby

4-Teach patient how to give subq injection at home& not to expel air bubble
from syringe

5-Teach patient signs of bleeding & assess neurological status0

#Baseline assessment

a-Obtain baseline cbc. note platelet count.

b-Assess potential risk of bleeding.

#Intervention/evaluation

a-Periodically monitor cbc, platelet count,stool for occult blood (no need for
daily monitoring in pts with normal presurgical coagulation parameters).

b-Assess for any sign of bleeding (bleeding at surgical site, hematuria, blood in
stool, bleeding from gums, petechiae, bruising, bleeding from injection sites).

#Patient/family teaching
Page | 5
Summary of drug Adult 1/Clinical
a- Usual length of therapy is 7–10 days.

b- Do not take any otc medication (esp. aspirin) without consulting physician.

Drug Classification Indication to use Side effect

HEPARIN Anticoagulant 1-Prevention and 1-Change in liver
treatment of venous enzyme
thrombosis and 2-Injection site
pulmonary embolism reaction
2-To prevent thrombosis 3-Hemorrhage &
with atrial fibrillation bruising Bleeding,
3-Diagnosis and 4-Fever& chills
treatment of DIC White clot
4-Prevention of clotting syndrome
in blood samples and 5-Melena
heparin lock sets and 6-Hematuria
during dialysis 7-
procedures to prevent Thrombocytopenia
clots in PT undergoing
open -heart and vascular
surgery
5-Adjunct in therapy of
coronary occlusion with
acute MI
6-prevention of left
ventricular thrombi and
CVA post
7-MI prevention of
cerebral thrombosis in
the evolving CVA

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Summary of drug Adult 1/Clinical
#NURSING IMPLICATIONS

1-Report nose bleeding, bleeding of the gums, unusual bruising, black or tarry
stools, cloudy or dark urine, abdominal or lower back pain, severe headache

2-Monitor for PTT,PLATELETS

3 -Check compatibilities with other IV solutions

4-Use heparin lock needle to avoid repeated injections

5-Give deep subcutaneous injections; do not give heparin by IM injection

6-Apply pressure to all injection sites after needle is withdrawn, don't massage

7-Check for signs of bleeding monitor blood tests explain that heparin can't be
take orally

Drug Classification Indication to use Side effect

WARFARIN Anticoagulant 1-Venous 1-Alopecia
OR Coumadin Jantoven thrombosis and 2- Calciphylaxis,
its extension, 3-Dermatitis
treatment, and Hemorrhage
prophylaxis 4-Priapism
2-Treatment of 5-Red-orange
thromboembolic urnie
complications of
atrial fibrillation
with embolization,
and cardiac valve
replacement
3-Pulmonary
embolism,
treatment, and
prophylaxis
4-Prophylaxis of
systemic
embolization
after acute M
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Summary of drug Adult 1/Clinical
#NURSING IMPLICATIONS

1-Monitor PT ratio or INR regularly to adjust dosage

2-Evaluate patient regularly for signs of blood loss

3-Do not give patient any IM injections

4 -Maintain INR ratio

Drug Classification Indication to use Side effect

LASIX Loop Diuretic 1-To manage mild 1-Orthostatic
OR furosemide Antihypertensive to moderate hypotension
hypertension 2-Anemia & anorexia
2-Edema 3-Hyperglycemia
associated with 4-Dizziness
heart failure 5-Hypokalemia
acute pulmonary 6-Hypotension
edema 7-Tachycardia,
renal impairment 8-Azotemia
9-Dehydration
10-Dlurred vision
11-Hypo&hypernatremia
12-Transient hearing
loss

#NURSING IMPLICATIONS

1-Measure &record weight to monitor fluid change

2 -Monitor serum electrolytes,BP hydration, liver and renal function

3 -Arrange for potassium-rich diet or supplemental potassium

4- Give dose at morning

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Summary of drug Adult 1/Clinical
Drug Classification Indication to use Side effect
ATENOLOL -Antianginal -Angina pectoris 1-Bradycardia
OR -Antihypertensive -Hypertension 2-Bronchospasm
-Tenormin -Beta adrenergic -Acute MI 3-Hypotension
-Tenopress blocker 4-Arrhythmias
5-Dizziness
6-Drowsiness
7-Fatigue
8-Renal failure

#NURSING IMPLICATIONS

1-Do not discontinue drug abruptly after long-term therapy

2-Teach PT to take drug with meals if Gl upset occurs -Instruct patient no to

stop taking

3-Monitor for hypoglycemia

4 -Monitor vital signs

5-Monitor cardiac rhythm

Drug Classification Indication to Side effect

use
INSULIN OR Hormone 1-Type 1&2 DM 1-Anaphylaxis or
#Rapid acting diabetic angioedema
-Lispro (Humalog) - 2-coma 2-Injectionsite
Aspart (novolog) - Ketoacidosis reactions
Glulisine (apidra) 3-Rash
#Short acting 4-Renal impairment
-Regular (Humalog 5- Acute
R,novoline R) bronchospasm
#Intermediate 6-Ketoacidosis
acting -NPH 7-Pulmonary
#Very long acting function
-Glargine (lantus) - 8-Decline HR
Detemin (Levemir 9-Hypoglycemia

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Summary of drug Adult 1/Clinical
#NURSING IMPLICATIONS

1-Monitor urine or serum glucose levels frequently to determine effectiveness

of drug and dosage

2-Store insulin in a cool place away from direct sunlight

3-Check glucose level before administration

4-Teach patient how to give subq injection at home

Drug Classification Indication to use Side effect

Aldacton OR Antagonists 1-Hypertension 1-GI upset and
Water pill" 2–Edema bleeding
(potassium- 3-Diagnosis of 2-Fluid and
sparing diuretic hyperaldosteronism electrolyte
imbalance.
3-Hypotension.

#NURSING IMPLICATIONS

1-Mark calendars of edema outpatients as reminders of alternate day or 3- to

5-day/wk therapy.

2-Give daily doses early so that increased urination does not interfere with
sleep

Drug Classification Indication to use Side effect

Silverin Antibiotics 1-kills bacteria. 1-Mild burning,
2 -Treating and 2-Itching
preventing 3-Pain.
bacterial 4 -Skin discoloration
infection in the
second and
3-Third

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 Summary of drug Adult 1/Clinical
#NURSING IMPLICATIONS

1-Avoid administering with Methenamine.

2-Avoid giving medication to patients with kidney or liver failure or Blood

problems (anemia, low white blood cell levels

Drug Classification Indication to use Side effect

Zinacef OR Antibiotics 1-Respiratory 1-Seizures.
Cefuroxime, sold tract infections 2-Diarrhea.
under the brand 2-Skin infections 3-Vomiting.
3-Bone and joint 4-Rashes.
infections 5–Bleeding
4-UTI infection 6-Pain at site of
5-Septicemia injection

#NURSING IMPLICATIONS

1-Assess for infection.

2-Observe patient for signs symptoms of anaphylaxis

3-Discontinue the drug and notify care professional immediately if anaphylaxis

symptoms occur

4-Monitor bowel function, should be reported to health care professional

promptly as sign of

Drug Classification Indication to use Side effect

Plasil OR Antiemetic 1-Prevent nausea 1-Dizziness.
Metoclopramide and vomiting 2-Extrapyramidal
induced from symptoms(dystonia
chemotherapy. akathisia
2-Diabetic 3–Hypertention
gastroparesis 4-Depression.
works by increasing 5-Neuroleptic
the movement or malignant syndrome
contraction the (cardiac conduction
stomach and disorders may occur
intestines with IV dosage form)
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Summary of drug Adult 1/Clinical
#NURSING IMPLICATIONS

1-Assess for nausea, neuroleptic malignant vomiting, abdominal distention, and

bowel sounds before and after administration.

2-Monitor for syndrome (hyperthermia, muscle rigidity, altered consciousness

irregular pulse or BP and tachycardia)

3-Assess for extrapyramidal side effects

Drug Classification Indication to use Side effect

Zofran OR Antiemetic 1-Prevent nausea 1-Headache
Zofran ODT, and and vomiting 2–Fatigue
Zuplenz induced from 3-Constipation.
chemotherapy 4-Extrapyramidal
2-Prevention and reactions
treatment post
3-Operative and
vomiting
4-Block the
effects of
serotonin

#NURSING IMPLICATIONS

1-Monitor BP carefully during IV administration.

2-Monitor for extrapyramidal reactions, and consult physician if they occur

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 Summary of drug Adult 1/Clinical

Drug Classification Indication to use Side effect

Candesartan Antihypertensive 1-Treat 1-Peripheral edema
OR drugs hypertension(By 2-Dizziness.
Blopress, preventing the 3-Hypertriglyceridemia.
Atacand, Amias, production of 4-Renal failure
and Ratacand angiotensin II)
2-Helps prevent
strokes heart
attacks, and
kidney problems.
3-Aprovied
treatment of
diabetic
nephropathy

#NURSING IMPLICATIONS

1-Administer drug empty stomach one hour before or two hours after meal to
ensure optimum drug absorption.

2-Monitor renal and hepatic function

3-Educate the patient on importance of health lifestyle choices to maximize

the effect of antihypertensive therapy

Drug Classification Indication to use Side effect

OMPERAZOL Proton pump inhibitor 1-Reduction of risk 1-Acute interstitial
of GI bleeding nephritis
2-Duodenal ulcers 2-Bone fracture
3-Dizziness
4-Headache
5-Pneumonia
6-Rash
7-B12 deficiency

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Summary of drug Adult 1/Clinical
#NURSING IMPLICATIONS:

1-Advise patient to avoid alcohol and foods that may cause an increase in GI
irritation

2-Instruct patient to report side effects, including skin problems (itching,

rash) or Gl effects (nausea, diarrhea, vomiting, constipation, heartburn,
flatulence, abdominal pain

Drug Classification Indication to use Side effect

Vancomycin Antibiotic 1-Risk for injury 1-Red man
related to syndrome
histamine release 2-Nephrotoxicity,
if administered 3-Rash
too rapidly- 4-Super infection
2-Sensory 5-Fever
perceptual 6-Paresthesia
disturbance
related to
ototoxicity-
3-Fluid volume
deficit related to
nausea and
vomiting
4-Impaired
tissue integrity

#NURSING IMPLICATIONS:

1-Monitor BP and heart rate continuously through period of drug

administration

2-Monitor urinalysis, kidney & liver functions, and hematologic studies

periodically

3-Report changes in 1&O ratio and pattern.

4-Oliguria or cloudy or pink urine may be a sign of nephrotoxicity

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Summary of drug Adult 1/Clinical

Drug Classification Indication to use Side effect

ROCEPHIN Cephalosporin 1-Bacterial 1-Bone marrow
septicemia depression
meningitis. 2-Colitis
2-Acute bacterial 3-Pain,
otitis media 4-Anorexia
3-Pelvic 5-Super
inflammatory infection
disease 6-Hepatotoxicity
4-Skin infection
5-Lower respiratory 7-Anaphylaxis
tract infection

#NURSING IMPLICATIONS :

1-IV administration: Infusion by syringe pump over 30 minutes.

2-Observe for signs of adverse reactions.

3-Monitor renal, hepatic, hematopoietic functions

Drug Classification Indication to use Side effect

Perfelgan Analgesic 1-Minor pain 1-Myocardial
2-Reduction of fever infraction
2-Hepatic failure
3-Hepatotoxicity
4-Skin reaction

#NURSING IMPLICATIONS:

1-Monitor signs of allergic reaction.

2-Assess PT pain (OLD CAR.

3-Reassess pain after minutes.

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Summary of drug Adult 1/Clinical

Drug Classification Indication to use Side effect

PETHIDINE Opioid agonist 1-Relief of 1-Apnea
OR Meperidine analgesic severe acute pain 2- Cardiac arrest
2-Preoperative 3-Shock
medication 4- Constipation
3-Obstetric 5- Dizziness,
analgesia 6- Depression
7- Sweating
8-Circulatory depression
9-Respiratory arrest
10-Light headedness

#NURSING IMPLICATIONS

1-Report severe nausea, vomiting, constipation, shortness of breath, or

difficulty breathing

2-Avoid alcohol, antihistamines sedatives, tranquilizers, over-the-counter drugs

3-Keep opioid antagonist and facilities for assisted or controlled respiration

readily available during parenteral administration

Drug Classification Indication to use Side effect

MORPHINE Opioid agonist 1-Preoperative medication 1-Circulatory
analgesic to sedate and allay depression
apprehension, facilitate 2-Respiratory
induction of anesthesia, and depression
reduce anesthetic dosage 3-Injection
2-Relief of moderate to side irritation
severe acute and chronic 4-Sweating
pain 5-Apnea
3-Treatment of pain 6-Laryngo
following major surgery spasm
4-Analgesic adjunct during 7-Hypotension
anesthesia
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Summary of drug Adult 1/Clinical
#NURSING IMPLICATIONS

1-Dilute &administer slowly IV to minimize adverse effect

2-Assess site of injection from any signs of infection

3-Tell PT to lie down during IV administration

Drug Classification Indication to use Side effect

GLUCOPHAGE Antidiabetic To reduce blood 1-Heart burn
OR glucose level in 2-Hypoglycemia
Metformin type 2 DM as 3-Allergic
hydrochloride adjunct to insulin 4-Skin reaction
therapy in type 2 5- Lactic acidosis
DM

#NURSING IMPLICATIONS

1-Monitor serum glucose frequently to determine drug effectiveness

2-Arrange for transfer to insulin during high stress periods

3-Teach Pt to Avoid alcohol; continue diet/exercise program

4-Give tablets with food

5-Monitor BUN & CREATININE

6-Monitor for dehydration

7-Instruct PT to take tablets with breakfast and dinner

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Summary of drug Adult 1/Clinical

Drug Classification Indication to use Side effect

Tienam:imipenem/cilastatin Antibiotic 1-Treatment of 1-Diarrhea
susceptible infections 2-Nausea
due to gram-negative, 3-Vomiting.
gram 4-Rare Rash
positive,anaerobic
organisms including:
respiratory tract,
skin/skin structure,
gynecologic,bone,
joint, intra-abdominal
complicated or
uncomplicated UTIs
2-
Endocarditis(caused
by S. aureus);
3-polymicrobic
infections; septicemia

#Nursing considerations
1-Question for history of allergies, particularlyto beta-lactams, penicillins,
cephalosporins.

2-Inquire about history of seizures.

3-Monitor renal, hepatic, hematologicfunction tests.

4-Evaluate for phlebitis(heat, pain, red streaking over vein),pain at IV injection

site.

5-Assess for GIdiscomfort, nausea, vomiting.

6-Monitordaily pattern of bowel activity, stool consistency.

7-Assess skin for rash.

8-Be alert to tremors, possible seizures

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Summary of drug Adult 1/Clinical

Drug Classification Indication to use Side effect

Flagyl / Antibacterial 1-Treatment of 1-Frequent:
Metronidazole Antiprotozoal anaerobic infections -systemic: anorexia,
(skin/skin structure, nausea, dry mouth,
cns, lower respiratory metallic taste.
tract, bone/joints, -vaginal:
intra-abdominal, symptomatic
gynecologic, cervicitis/vaginitis,
endocarditis, abdominal cramps,
septicemia). uterine pain.
2-Treatment of h. 2-Occasional:
pylori (part of -systemic: diarrhea,
multidrug regimen); constipation,
surgical prophylaxis vomiting, dizziness,
(colorectal), erythematous rash,
trichomoniasis, urticaria, reddish-
amebiasis, antibiotic- brown urine.
associated topical: transient
pseudomembranous erythema, mild
colitis (aapc). dryness, burning,
3-Topical treatment of irritation, stinging,
acne rosa cea or tearing when applied
inflammatory lesions. too close to eyes.
4-Vaginal gel: 3-Vaginal:
treatment of bacterial -vaginal, perineal,
vaginosis. vulvar itching;
vulvar swelling.
-rare: mild,
transient
leukopenia;
thrombophlebitis
with iv therapy.

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Summary of drug Adult 1/Clinical
#Nursing considerations

1-baseline assessment:

a-question for history of hypersensitivity to metronidazole, other

nitroimidazole derivatives (and parabens with topical).

b-obtain specimens for diagnostic tests, cultures before giving first dose
(therapy may begin before results are known).

2-intervention/evaluation

a-monitor daily pattern of bowel activity, stool consistency.

b- monitor i&o, assess for urinary problems.

c-be alert to neuro logic symptoms (dizziness, paresthesia of extremities).

d-assess for rash, urticaria.

e-monitor for onset of superinfection (ulceration/change of oral mucosa, furry

tongue, vaginal discharge, genital/anal pruritus).

3- patient/family teaching

a- urine may be red-brown or dark.

b- avoid alcohol, alcohol-containing preparations (cough syrups, elixirs) for at

least 48 hrs after last dose.

c- Avoid tasks that require alertness, motor skills until response to drug is
established.

d- If taking metronidazole for trichomoniasis, refrain from sexual in tercourse

until full treatment is completed.

e-For amebiasis, frequent stool specimen checks will be necessary.

f-Topical: Avoid contact with eyes.

j-May apply cosmetics after application.

h- Metronidazole acts on ery thema, papules, pustules but has no ef fect on

rhinophyma (hypertrophy of nose), telangiectasia, ocular problems
(conjunctivitis, keratitis, blepharitis).

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Summary of drug Adult 1/Clinical

Drug Classification Indication to use Side effect

Hydrocortisone glucocorticoid. 1-systemic: 1-Frequent:
management of insomnia,
adrenocortical heartburn,
insufficiency, anxiety, abdominal
antiinflammatory, distention,
immunosuppressive. diaphoresis, acne,
2-Topical: mood swings,
inflammatory increased
dermatoses, appetite, facial
adjunctive treatment flushing, delayed
of ulcerative colitis, wound healing,
atopic dermatitis, increased
inflamed hemorrhoids susceptibility to
infection,
diarrhea
or constipation
2-Occasional:
headache, edema,
change in skin
color, frequent
urination.
3-Topical:
pruritus, redness,
irritation.

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Summary of drug Adult 1/Clinical
#Nursing considerations

1-baseline assessment:

a-obtain baseline weight, b/p, serum glucose, cholesterol, electrolytes.

b- review results of initial tests (tuberculosis [tb] skin test, x-rays, ekg).

2-intervention/evaluation

a-assess for edema. be alert to infection (reduced immune response): sore

throat, fever, vague symptoms.

c-monitor daily pattern of bowel activity, stool consistency.

d-monitor electrolytes, b/p, weight, serum glucose. watch for hypocalcemia

(muscle twitching, cramps), hypokalemia (weakness, paresthesia,
nausea/vomiting, irritability, ekg changes).

e- assess emotional status, ability to sleep.

3-patient/family teaching

a- report fever, sore throat, muscle aches, sudden weight gain, swelling, visual
disturbances, behavioral changes

b-do not take aspirin or any other medication without consulting physician

c- limit caffeine, avoid alcohol.

d- inform dentist, other physicians of cortisone therapy now or within past 12

moths

e-caution against overusing joints injected for symptomatic relief.

f- topical: apply after shower or bath for best absorption.

g-do not cover or use occlusive dressings unless ordered by physician

h-do not use tight diapers, plastic pants, coverings.

i- avoid contact with eyes.

Page | 22
Summary of drug Adult 1/Clinical

Drug Classification Indication to Side effect

use
Inohep Antithrombotic Treatment of 1-Bleeding
drug acute 2-Thrombocytopenia
symptomatic 3- Elevations of
deep vein Serum
thrombosis Aminotransferases
with or without 4- Local Reactions
pulmonary 5- Hypersensitivity
embolism when
administered in
conjunction
with warfarin
sodium

#Nursing considerations

1-Monitor symptoms of DVT (pain, swelling, warmth, redness) to determine if

drug therapy is effective in preventing or reducing venous thrombosis.

2-Request or administer objective tests (Doppler ultrasound) if symptoms

increase.

Drug Classification Indication Side effect

to use
Digoxin -Inotropic Atrial 1-Headache, drowsiness,
(lanoxin) antidysrhythmic, fibrillation apathy, confusion,
-Cardiac disorientation, fatigue,
glycoside depression, hallucinations, 2-
Dysrhythmias, hypotension,
bradycardia, AV block,
3-Blurred vision, yellow-green
halos, photophobia, diplopia,
Nausea, vomiting, anorexia,
abdominal pain,
diarrhea.
Page | 23
Summary of drug Adult 1/Clinical
#NURSING CONSIDERATIONS :

1-Assess and document apical pulse for 1 min before giving product; if pulse <
60 in adult or < 90 in an infant or is significantly different, take again in 1 hr; if
< 60 in adult, call prescriber; note rate, rhythm, character, monitor I&O, daily
weight, check for edema.

2-Monitor electrolytes: potassium, sodium, chloride, magnesium,calcium; renal

function studies: BUN,creatinine; other blood studies: ALT, AST, bilirubin, Hct,
Hgb, product levels(therapeutic level 0.5-2 ng/ml) before initiating treatment
and periodically thereafter, draw >= 6-8 hr after last dose, optimally 12-24
hraftera dose, monitor for decreased potassium, or increased potassium.

3-Monitor resolution of atrial dysrhythmias by ECG; if tachydysrhythmia

develops, hold product; delay cardioversion while product levels are determined.

4-Monitor ECG continuously during parenteral loading doses and for patients
with suspected toxicity; provide hemodynamic monitoring for patients with
heart failure or administer multiple cardiac products.

5-Beers : Avoid dosage > 0.125 mg/dl in atrial fibrillation, heart failure in older
adults; decreased renal clearance may lead to toxicity.

6-Pregnancy/breastfeeding : No well-controlled studies, use only if clearly

needed, excreted in breast milk (small amounts), may breastfeed.

7-Advise patient not to stop abruptly; teach all aspects of product.

8-Caution patient to avoid OTC medications including cough, cold, allergy

preparations, antacids, since many adverse product interactions may occur; do
not take antacid at same time or within 2 hr of this product.

9-Instruct patient to notify prescriber of any loss of appetite, lower stomach

pain, diarrhea, weakness, drowsiness, headache, blurred or yellow-green vision,
rash, depression; teach toxic symptoms of this product and when to notify
prescriber.

10-Advise patient to maintain a sodium-restricted diet as ordered; to take

potassium supplements as ordered to prevent toxicity.

Page | 24
Summary of drug Adult 1/Clinical
11-Instruct patient to report shortness of breath, difficulty breathing, weight
gain, edema, persistent cough.

Drug Classification Indication to use Side effect

Ferrous Iron preparation Prevention, 1-Occasional:
Gluconate treatment of iron Mild, transient
deficiency anemia nausea.
due to inadequate 2-Rare:
diet, malabsorption, Heartburn,
pregnancy, blood anorexia,
loss constipation,
diarrhea

#NURSING CONSIDERATIONS

1-BASELINE ASSESSMENT

→Assess nutritional status, dietary history.

→To prevent mucous membrane and teeth staining with liquid preparation, use
dropper or straw and allow solution to drop on back of tongue.

2-INTERVENTION/EVALUATION

→Monitor serum iron, total iron-binding capacity, reticulocyte count, Hgb,

ferritin.

→Monitor daily pattern of bowel activity, stool consistency. Assess for clinical
improvement, record relief of iron deficiency symptoms (fatigue, irritability,
pallor, paresthesia of extremities, headache).

3-PATIENT/FAMILY TEACHING

→Expect stool color to darken.

→Oral liquid may stain teeth.

→If GI discomfort occurs, take after meals or with food.

→Do not take within 2 hrs of other medication or eggs, milk, tea, coffee, cereal

Page | 25
Summary of drug Adult 1/Clinical

Drug Classification Indication to use Side effect

Folic acid Nutritional supplement 1-Treatment of None known.
megaloblastic and
macrocytic
anemias due to
folate deficiency
(e.g., pregnancy,
inadequate
dietary intake).
2-Supplement to
prevent fetal
neural tube
defects

#NURSING CONSIDERATIONS

1-BASELINE ASSESSMENT

→Pernicious anemia should be ruled out with Schilling test and vitamin B12
blood

→level before initiating therapy (may produce irreversible neurologic damage).

→Resistance to treatment may occur if decreased hematopoiesis, alcoholism,

antimetabolic drugs, deficiency of vitamin B6, B12, C, E is evident.

2-INTERVENTION/EVALUATION

→Assess for therapeutic improvement: improved sense of well-being, relief

from iron deficiency symptoms (fatigue, shortness of breath, sore tongue,
headache, pallor).

3-PATIENT/FAMILY TEACHING

→Eat foods rich in folic acid, including fruits, vegetables, organ meats.

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Summary of drug Adult 1/Clinical
Drug Classification Indication to use Side effect
TramalAnalgesic 1-Management of 1-Frequent Dizziness,
moderate to vertigo, nausea, constipation,
moderately severe headache, drowsiness.
pain. 2-Occasional Vomiting,
2-Extended-Release: pruritus, CNS stimulation
Around-the-clock (e.g., nervousness, anxiety,
management of agitation, tremor, euphoria,
moderate to mood swings, hallucinations),
moderately severe asthenia, diaphoresis,
pain for extended dyspepsia, dry mouth,
period. diarrhea.
#NURSING CONSIDERATIONS

1-BASELINE ASSESSMENT

→Assess onset, type, location, duration of pain. Assess drug history, esp.
carbamazepine, analgesics, CNS depressants, MAOIs. Review past medical
history, esp. epilepsy, seizures. Assess renal function, LFT.

2-INTERVENTION/EVALUATION

→Monitor pulse, B/P, renal/hepatic function. Assist with ambulation if

dizziness, vertigo occurs. Dry crackers, cola may relieve nausea. Palpate bladder
for urinary retention. Monitor daily pattern of bowel activity, stool consistency.
→Sips of water may relieve dry mouth. Assess for clinical improvement, record
onset of relief of pain.

3-PATIENT/FAMILY TEACHING

→May cause dependence.

→Avoid alcohol, OTC medications (analgesics, sedatives).

→May cause drowsiness, dizziness, blurred vision.

→Avoid tasks requiring alertness, motor skills until response to drug is

established.

→Report severe constipation, difficulty breathing, excessive sedation, seizures,

muscle weakness, tremors, chest pain, palpitations
Page | 27
Summary of drug Adult 1/Clinical

Drug Classification Indication to use Side effect

Omeprazole Proton pump 1-Short-term treatment (4– -Headache.
inhibitor 8 wks) of erosive -Diarrhea
esophagitis (diagnosed by -Abdominal pain,
endoscopy), symptomatic nausea,
gastroesophageal reflux -Dizziness,
disease (GERD) poorly asthenia (loss of
responsive to other strength, energy),
treatment. H. pylori– -Vomiting,
associated duodenal ulcer constipation,
(with amoxicillin and -upper
clarithromycin). respiratory tract
2-Long-term treatment of infection, back
pathologic hypersecretory pain, rash, cough
conditions, treatment of
active duodenal ulcer or
active benign gastric ulcer.
Maintenance healing of
erosive esophagitis

#Nursing considerations:

1- intervention/evaluation:

a- evaluate for therapeutic response (relief of gi symptoms).

b- question if gi discomfort, nausea, diarrhea occurs.

2-patient/family teaching :

a- report headache, onset of black, tarry stools, diarrhea, abdominal pain.

b- avoid alcohol.

c- swallow capsules whole; do not chew, crush, dissolve

d-take before eating

Page | 28
Summary of drug Adult 1/Clinical
Drug Classification Indication to use Side effect
Famotidine Antiulcer, gastric 1-Short-term treatment 1-Occasional
acid secretion of active duodenal ulcer. : Headache.
inhibitor Prevention, maintenance
of duodenal ulcer 2-Rare :
recurrence Confusion,
2- Treatment of active constipation,
benign gastric ulcer, diarrhea,
pathologic GI dizziness.
hypersecretory
conditions
3- Short-term
treatment of
gastroesophageal reflux
disease (GERD

#NURSING CONSIDERATIONS

1-BASELINE ASSESSMENT

→Assess epigastric/abdominal pain.

2-INTERVENTION/EVALUATION

→Monitor daily pattern of bowel activity, stool consistency. Monitor for

diarrhea, constipation, headache. Assess for confusion in elderly.

3-PATIENT/FAMILY TEACHING

→May take without regard to meals, antacids.

→Report headache.

→Avoid excessive amounts of coffee, aspirin.

→Report persistent symptoms of heartburn, acid indigestion, sour stomach

Page | 29
Summary of drug Adult 1/Clinical

Drug Classification Indication to use Side effect

Prednisolone Glucocorticoid. 1-Systemic: 1-Frequent: Insomnia,
tablet Endocrine, rheumatic, heartburn,
hematologic nervousness, abdominal
disorders; collagen, distention, diaphoresis,
respiratory, acne, mood swings,
neoplastic, GI increased appetite,
diseases; allergic facial flushing, delayed
states;acute or wound healing,
chronic solid organ increased
rejection. susceptibility to
2-Ophthalmic: infection, diarrhea,
Treatment of constipation.
conjunctivitis, corneal 2-Occasional:
injury (from Headache, edema,
chemical/thermal change in skin color,
burns, foreign body frequent urination
#NURSING CONSIDERATIONS

1-BASELINE ASSESSMENT

→Obtain baselines for height, weight, B/P, serum glucose, electrolytes. Check
results of initial tests (tuberculosis [TB] skin test, X-rays, EKG). Never give
live virus vaccine (e.g., smallpox).

2-INTERVENTION/EVALUATION

→Monitor B/P, weight, serum electrolytes, glucose, results of bone mineral

density test, height, weight in children. Be alert to infection (sore throat,
fever, vague symptoms); assess oral cavity daily for signs of candida infection.

3-PATIENT/FAMILY TEACHING

→Report fever, sore throat, muscle aches, sudden weight gain, swelling, loss of
appetite, fatigue. /• Avoid alcohol, limit caffeine. / • Maintain fastidious oral
hygiene.

→Do not abruptly discontinue without physician’s approval. / • Avoid exposure

to chickenpox, measles.
Page | 30
Summary of drug Adult 1/Clinical
Drug Classification Indication to use Side effect
Dexamethasone Corticosteroid. Used primarily as 1-Frequent:
an anti- Inhalation: Cough, dry
inflammatory or mouth, hoarseness,
immunosuppressant throat irritation.
agent in a variety Intranasal: Burning,
of diseases (e.g., mucosal dryness.
allergic, 2-Ophthalmic: Blurred
inflammatory vision. Systemic:
autoimmune) Insomnia, facial edema
(cushingoid
appearance [“moon
face”]), moderate
abdominal distention,
indigestion, increased
appetite, nervousness,
facial flushing,
diaphoresis

#NURSING CONSIDERATIONS

1-BASELINE ASSESSMENT

→Question for hypersensitivity to any corticosteroids. Obtain baselines for

height, weight, B/P, serum glucose, electrolytes.

2-INTERVENTION/EVALUATION

→Monitor I&O, daily weight, serum glucose.

→Assess for edema.

→Evaluate food tolerance.

→Monitor daily pattern of bowel activity, stool consistency.

→Report hyperacidity promptly.

→Check vital signs at least twice a day.

→Be alert to infection (sore throat, fever, vague symptoms).

Page | 31
Summary of drug Adult 1/Clinical
→Monitor serum electrolytes, esp. for hypercalcemia (muscle twitching,
cramps), hypokalemia (weakness, muscle cramps, paresthesia [esp. lower
extremities], nausea/vomiting, irritability), Hgb, occult blood loss.

→Assess emotional status, ability to sleep.

3-PATIENT/FAMILY TEACHING

→Do not change dose/schedule or stop taking drug. • Must taper off gradually
under medical supervision.

→Report fever, sore throat, muscle aches, sudden weight gain, edema, exposure
to measles/chickenpox.

→Severe stress (serious infection, surgery, trauma) may require increased

dosage.

→Inform dentist, other physicians of dexamethasone therapy within past 12

mos.

→Avoid alcohol, limit caffeine

Page | 32
Summary of drug Adult 1/Clinical
Drug Classification Indication to use Side effect
Zufran -Antiemetics, Chemotherapy- Headache,
-Antagonist Postoperative- lightheadedness,
Radiation-Induced dizziness,
Nausea & drowsiness,
Vomiting tiredness, or
constipation

#NURSING CONSIDERATIONS

1-Patient should avoid over the counter cold medications

2-Assess lung sounds

3-Maintain adequate fluid intake

Drug Classification Indication to use Side effect

Zantak Histamine2 (H2) 1-Short-term treatment of 1-
antagonist active duodenal ulcer Headache,dizziness.
2-Maintenance therapy for 2-Rarely hepatitis,
duodenal ulcer at reduced thrombocytopaenia,
dosage leucopaenia,
3-Short-term treatment of hypersensitivity,
active, benign gastric ulcer confusion,
4-Short-term treatment of gynaecomastia,
GERD impotence,
5-Pathologic somnolence, vertigo,
hypersecretory conditions hallucinations.
(eg, Zollinger-Ellison
syndrome)

6-Treatment of erosive
esophagitis

7-Treatment of heartburn,
acid indigestion, sour
stomach
Page | 33
Summary of drug Adult 1/Clinical
#NURSING CONSIDERATIONS

1-Administer oral drug with meals and at bedtime.

2-Decrease doses in renal and liver failure.

3-Provide concurrent antacid therapy to relieve pain.

4-Administer IM dose undiluted, deep into large muscle group.

5-Arrange for regular follow-up, including blood tests, to evaluate effects.

Drug Classification Indication to use Side effect

Tegretol Antiepileptic 1-Refractory seizure 1-CNS: Dizziness,
disorders: Partial drowsiness, unsteadiness,
seizures with complex disturbance of
symptoms coordination, confusion,
(psychomotor, temporal headache, fatigue, visual
lobe epilepsy), hallucinations, depression
generalized tonic-clonic 2-CV: CHF, aggravation of
(grand mal) seizures, hypertension,
mixed seizure patterns hypotension, syncope and
or other partial or collapse, edema, primary
generalized seizures. thrombophlebitis
3-Dermatologic: Pruritic
2-Trigeminal neuralgia and erythematous rashes,
(tic douloureux): urticaria
Treatment of pain GI: Nausea, vomiting,
associated with true gastric distress,
trigeminal neuralgia; abdominal pain, diarrhea,
also beneficial in constipation, anorexia
glossopharyngeal
neuralgia

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Summary of drug Adult 1/Clinical
#Nursing considerations

1-Use only for classifications listed. ...

2-Give drug with food to prevent GI upset.

3-Do not mix suspension with other medications or elements—precipitation may

occur.

4-WARNING: Reduce dosage, discontinue, or substitute other antiepileptic

medication gradually.

Drug Classification Indication to use Side effect

Voltaren Anti-inflammatory 1-Acute or long-term GI
NSAID treatment of mild to disturbances;
moderate pain, including headache,
dysmenorrhea dizziness,
rash; GI
2-Rheumatoid arthritis bleeding,
peptic
3-Osteoarthritis ulceration;
abnormalities
4-Ankylosing spondylitis of kidney
function. Pain
5-Treatment of actinic and tissue
keratosis in conjunction with damage at Inj
sun avoidance site (IM)

6-Ophthalmic: Postoperative
inflammation from cataract
extraction

Page | 35
Summary of drug Adult 1/Clinical
#Nursing considerations

1-Evaluate therapeutic response by assessing pain, joint stiffness, joint swelling

and mobility.

2-Assess any worsening of asthma in appropriate patients.

3-Regular full dosage has both lasting analgesic and anti-inflammatory effects,
making it useful for continuous pain associated with inflammation.

4-Nurses should refer to manufacturer’s summary of product characteristics

and to appropriate local guidelines.

Drug Classification Indication to use Side effect

Concor beta-blockers 1-Treatment of 1-Nausea
Hypertension (high blood
pressure) 2-Headache

2-Treatment of Angina 3-Slow heart rate

(heart-related chest pain)
4-Fatigue
3-Treatment of Arrhythmia
5-Constipation
4-Prevention of Heart
attack 6-Diarrhea

5-Prevention of Migraine 7-Dizziness

8-Cold extremities

#Nursing considerations

1-Patients are encouraged to stick to a healthy diet, regular exercise and their
prescribed medication to control high blood pressure

2-Do not stopping Concor therapy without prior medical advice , because may
cause the patient's condition to worsen.

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Summary of drug Adult 1/Clinical

Drug Classification Indication to use Side effect

Spasmopan Anticholinergic Prevention of motion Dry mouth,
sickness, postop drowsiness, blurred
nausea/vomiting. vision.
OFF-LABEL: Rare:
Breakthrough Dizziness,
treatment of restlessness,
nausea/vomiting hallucinations,
associated with confusion,
chemotherapy. difficulty
urinating, rash.

#Nursing considerations

1-Baseline assessment

→Assess for use of other CNS depressants, drugs with anticholinergic action,
history of narrow-angle glaucoma. Question medical history as listed in
Precautions.

2-Intervention/evaluation

→Monitor for dehydration. Observe for improvement of symptoms.

3-Patient/family teaching

→Avoid tasks requiring alertness, motor skills until response to drug is

established (may cause drowsiness, disorientation, confusion).

→Use only 1 patch at a time; do not cut.

→Wash hands after administration.

Page | 37
Summary of drug Adult 1/Clinical
Drug Classification Indication to use Side effect
Ramlac syrup Laxative -Constipation 1-Occasional:
Abdominal
-Prevention of cramping,
Portal-Systemic flatulence,
Encephalopathy increased thirst,
abdominal
-Treatment of discomfort.
Portal-Systemic 2-Rare: Nausea,
Encephalopathy vomiting.

-Rectal
Administration
(as Retention
Enema)

-Renal/Hepatic
Impairment
#Nursing considerations

1-Baseline Assessment

→Question usual stool pattern, frequency, characteristics.

→Conduct neurological exam in pts with elevated serum ammonia levels,

symptoms of encephalopathy.

→Assess hydration status.

2-Intervention/evaluation

→Encourage adequate fluid intake.

→Assess bowel sounds for peristalsis.

→Monitor daily pattern of bowel activity, stool consistency; record time of

evacuation.

→Assess for abdominal disturbances.

→Monitor serum electrolytes in pts with prolonged, frequent, excessive use of

medication.
Page | 38
Summary of drug Adult 1/Clinical
Drug Classification Indication to use Side effect
Ventolin Adrenergic agonist Treatment or Headache,
Bronchodilator. prevention of restlessness,
bronchospasm due nervousness,
to reversible tremors, nausea,
obstructive dizziness, throat
airway dryness and
disease, irritation,
prevention of pharyngitis, B/P
exercise-induced changes including
bronchospasm. hypertension,
heartburn,
transient
wheezing.

#Nursing considerations

1-Baseline assessment

→Assess lung sounds, pulse, B/P, color, characteristics of sputum noted.

→Offer emotional support (high incidence of anxiety due to difficulty in

breathing and sympathomimetic response to drug).

2-Intervention/evaluation

→Monitor rate, depth, rhythm, type of respiration; quality and rate of pulse;
EKG; serum potassium, glucose; ABG determinations.

→Assess lung sounds forwheezing (bronchoconstriction), rales.

3-Patient/family teaching

→Follow guidelines for proper use of inhaler.

→A health care provider will show you know to properly prepare and use your
medication. You must demonstrate correct preparation and injection techniques
before using medication.

→Increase fluid intake (decreases lung secretion viscosity).

Page | 39
Summary of drug Adult 1/Clinical
→Do not take more than 2 inhalations at any one time (excessive use may
produce paradoxical bronchoconstriction or decreased bronchodilating effect).

→Rinsing mouth with water immediately after inhalation may prevent

mouth/throat dryness.

→Avoid excessive use of caffeine derivatives (chocolate, coffee, tea, cola,

cocoa).

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