Medication Assignment.

1. Anti-Hypertensives
a. ACE Inhibitors (e.g., Enalapril):
Definition: ACE inhibitors block the conversion of angiotensin I to angiotensin II, leading to
vasodilation and reduced aldosterone secretion.
Reasons for Use: Hypertension, heart failure, diabetic nephropathy.
Actions: Vasodilation, decreased blood pressure, decreased aldosterone secretion.

Side Effects:
 Common: Cough, hypotension.
 Serious: Hyperkalemia, renal impairment.
Nursing Responsibilities:
 Monitor blood pressure regularly.
 Assess for signs of hyperkalemia.
 Advise patients about the potential for a persistent dry cough.
Health Teaching:
 Emphasize the importance of medication adherence.
 Encourage regular follow-up for blood pressure monitoring.

2. Angiotensin Receptor Blockers (ARBs)

Examples: Losartan, Valsartan

Definition: ARBs are a class of antihypertensive medications that block the action of
angiotensin II at the angiotensin II type 1 (AT1) receptor, leading to vasodilation and decreased
aldosterone secretion. used to treat high blood pressure and heart failure
Reasons for Use:
1. Hypertension: ARBs are commonly prescribed to lower blood pressure.
2. Heart Failure: Used in heart failure patients who cannot tolerate ACE inhibitors.
3. Diabetic Nephropathy: ARBs help to delay the progression of kidney disease in diabetic
patients.
Actions: Vasodilation: Blocks angiotensin II, leading to relaxation of blood vessels.
Reduced Aldosterone Secretion: Results in decreased sodium and water retention.

Side Effects:
 Common: Dizziness, hypotension, hyperkalemia.
 Serious: Renal impairment (especially in patients with renal artery stenosis),
angioedema (rare).

Nursing Responsibilities:

Monitor Blood Pressure: To ensure the desired therapeutic effect.

Potassium Levels: Regularly check serum potassium levels, especially in patients at risk of
hyperkalemia.
Renal Function: Assess renal function, especially in patients with pre-existing renal conditions.
Symptoms of Angioedema: Educate patients about signs of angioedema, such as swelling of the
face and lips.

Health Teaching:

Advise patients to rise slowly from a sitting or lying position to minimize the risk of dizziness.
Encourage a diet with consistent potassium intake and educate patients about foods high in
potassium.
Reporting Side Effects: Instruct patients to report any signs of renal impairment, such as
decreased urine output or swelling.

3. Beta-Blockers
Examples:
 Non-selective: Propranolol
 Selective (Beta-1): Metoprolol, Atenolol
Definition: Beta-blockers are a class of medications that block the effects of adrenaline and
other stress hormones on the beta receptors in the body. They primarily act on the heart,
reducing heart rate and contractility.
Reasons for Use:
1. Hypertension: Beta-blockers lower blood pressure by reducing the heart's workload.
2. Angina: Used to decrease the workload on the heart and prevent angina attacks.
3. Arrhythmias: Effective in controlling abnormal heart rhythms.
4. Heart Failure: Can improve symptoms and decrease hospitalizations.
5. Migraine Prevention: Propranolol is sometimes used to prevent migraines.
6. Anxiety: Propranolol may be used to manage symptoms of performance anxiety.
Actions:
1. Reduced Heart Rate: Beta-blockers slow down the heart rate.
2. Decreased Contractility: The force of heart contractions is reduced, decreasing
workload.
3. Vasodilation: Some beta-blockers cause blood vessel relaxation, reducing blood
pressure.
Side Effects:
 Common: Fatigue, dizziness, bradycardia (slow heart rate).
 Serious: Bronchospasm (especially in patients with asthma), heart block, hypotension.
Nursing Responsibilities:
1. Vital Signs Monitoring.
2. Respiratory Status: Monitor for signs of bronchospasm in patients with respiratory
conditions.
3. Blood Glucose Levels: Beta-blockers can mask symptoms of hypoglycemia; monitor
glucose levels in diabetic patients.
4. Heart Failure Patients: Monitor for signs of worsening heart failure symptoms.
Health Teaching:
1. Orthostatic Hypotension: Advise patients to rise slowly from sitting or lying positions.
2. Medication Adherence: Stress the importance of taking medication regularly and not
discontinuing abruptly.
3. Avoidance in Asthma
4. Symptoms of Worsening Heart Failure: Educate heart failure patients about signs of
worsening symptoms (e.g., increased swelling, shortness of breath).

4. Calcium Channel Blockers (CCBs)

Examples:
 Dihydropyridines: Amlodipine, Nifedipine
 Non-dihydropyridines: Diltiazem, Verapamil
Definition: Calcium Channel Blockers are a class of medications that prevent the entry of calcium
ions into cardiac and smooth muscle cells, leading to vasodilation and decreased cardiac
contractility.
Reasons for Use:
1. Hypertension: CCBs relax blood vessels, reducing blood pressure.
2. Angina: Decrease cardiac workload and oxygen demand.
3. Arrhythmias: Non-dihydropyridines help control certain abnormal heart rhythms.
4. Raynaud's Disease: Amlodipine may be used to improve blood flow to extremities.
5. Migraine Prevention: Verapamil may be used for migraine prophylaxis.
Actions:
1. Vasodilation: Relaxation of arterial smooth muscle, leading to decreased peripheral
resistance.
2. Reduced Cardiac Contractility: Non-dihydropyridines reduce the force of cardiac
contractions.
Side Effects:
 Common: Peripheral edema, headache, flushing.
 Serious: Bradycardia (especially with non-dihydropyridines), heart block.
Nursing Responsibilities:
1. Blood Pressure Monitoring: Regularly assess blood pressure.
2. Heart Rate Monitoring: Especially with non-dihydropyridines; monitor for bradycardia.
3. Peripheral Edema: Monitor for signs of peripheral edema and adjust therapy as needed.
4. Liver and Renal Function: Assess liver and renal function, especially with verapamil.
Health Teaching:
1. Orthostatic Hypotension: Advise patients to rise slowly from sitting or lying positions.
2. Peripheral Edema: Inform patients about the possibility of swelling in the ankles and
legs.
3. Avoid Grapefruit Juice: Grapefruit juice can interact with some CCBs; advise patients to
avoid it.
4. Medication Adherence: Stress the importance of taking the medication regularly and
not discontinuing abruptly.
5. Anti-platelets
Example: Clopidogrel (Plavix)
Definition: Anti-platelets are medications that prevent platelet aggregation, reducing the risk of
blood clot formation.
Reasons for Use:
1. Acute Coronary Syndrome (ACS): Reduces the risk of myocardial infarction (heart
attack) or stroke.
2. Stroke Prevention: Used to prevent strokes, especially in individuals with a history of
cerebrovascular events.
3. Peripheral Artery Disease (PAD): Decreases the risk of cardiovascular events in patients
with PAD.
Actions:
1. Inhibition of Platelet Aggregation: Clopidogrel selectively inhibits adenosine
diphosphate (ADP)-induced platelet aggregation.
Side Effects:
 Common: GI upset, abdominal pain, bruising, bleeding.
 Serious: Risk of bleeding, especially gastrointestinal bleeding.
Nursing Responsibilities:
1. Assess Bleeding Risk: Evaluate the patient's risk for bleeding before initiating therapy.
2. Monitor Platelet Counts: Regularly monitor platelet counts to ensure therapeutic
effects.
3. Signs of Bleeding: Educate patients about signs of bleeding and when to seek medical
attention.
4. Compliance and Follow-up: Ensure adherence to the prescribed regimen and schedule
regular follow-up appointments.
Health Teaching:
1. Bleeding Precautions: Advise patients to avoid activities that may increase the risk of
bleeding (e.g., contact sports).
2. Medication Adherence: Stress the importance of taking the medication consistently and
not skipping doses.
3. Reporting Side Effects: Instruct patients to promptly report any signs of bleeding or
unusual bruising.
4. Avoiding NSAIDs: Caution patients about the increased risk of bleeding when taking
nonsteroidal anti-inflammatory drugs (NSAIDs).
6. Anticoagulants
Example: Warfarin
Definition: Anticoagulants are medications that inhibit blood clotting by interfering with the
synthesis of clotting factors.
Reasons for Use:
1. Deep Vein Thrombosis (DVT) and Pulmonary Embolism (PE): Used for prevention and
treatment.
2. Atrial Fibrillation: To reduce the risk of stroke.
3. Prosthetic Heart Valves: Prevent thrombus formation on artificial heart valves.
4. Thromboembolic Disorders: Used in various conditions to prevent blood clots.
Actions:
1. Inhibition of Vitamin K-Dependent Clotting Factors: Warfarin inhibits the synthesis of
clotting factors II, VII, IX, and X.
Side Effects:
 Common: Bleeding (bruising, nosebleeds, gastrointestinal bleeding).
 Serious: Risk of major bleeding, skin necrosis (rare), purple toe syndrome (rare).
Nursing Responsibilities:
1. Regular Monitoring of INR: Monitor the International Normalized Ratio (INR) regularly
to maintain therapeutic levels.
2. Assess for Signs of Bleeding: Keep a keen eye on signs of bleeding and promptly report
them.
3. Medication Reconciliation: Ensure an accurate list of medications to avoid interactions
that may affect anticoagulation.
4. Patient Education on Dietary Vitamin K Intake: Educate patients about maintaining
consistent vitamin K intake through their diet.
Health Teaching:
1. Consistent Vitamin K Intake: Emphasize the importance of maintaining a consistent
intake of foods rich in vitamin K.
2. Avoiding Alcohol and NSAIDs: Instruct patients to limit alcohol intake and avoid
nonsteroidal anti-inflammatory drugs (NSAIDs) due to increased bleeding risk.
3. Regular INR Monitoring: Stress the importance of regular blood tests to monitor the
INR and adjust the dosage accordingly.
4. Emergency Procedures: Educate patients on when to seek immediate medical attention
for signs of bleeding or unusual symptoms.

7. Stool Softeners
Example: Docusate
Definition: Stool softeners are medications that promote the incorporation of water into the
stool, making it softer and easier to pass.
Reasons for Use:
1. Constipation: Used to alleviate constipation by facilitating easier bowel movements.
 2. Post-Surgery or Postpartum: Provides relief from constipation associated with reduced
mobility or recovery.
Actions:
1. Surfactant Action: Docusate acts as a surfactant, allowing water to penetrate and soften
the stool.
Side Effects:
 Common: Mild abdominal cramps, diarrhea.
 Serious: Allergic reactions (rare).
Nursing Responsibilities:
1. Assessment of Bowel Function: Evaluate the patient's bowel patterns, consistency, and
frequency.
2. Monitoring for Side Effects: Observe for signs of diarrhea or abdominal discomfort.
3. Patient Hydration: Encourage adequate fluid intake to enhance the stool-softening
effect.
4. Assessing for Allergies: Determine any history of allergies, especially to docusate or
related substances.
Health Teaching:
1. Consistent Use: Emphasize the importance of taking the medication regularly for
maximum effectiveness.
2. Hydration: Encourage increased fluid intake to help soften stool and prevent
dehydration.
3. Dietary Fiber: Advocate for a diet rich in fiber to complement the stool-softening effect.
4. Avoiding Prolonged Use: Advise against prolonged use without consulting a healthcare
provider.

8. Laxatives
Example: Lactulose
Definition: Laxatives are medications that promote bowel movements by softening the stool or
stimulating bowel activity.
Reasons for Use:
1. Constipation: Lactulose is used to treat constipation by increasing water content and
softening the stool.
2. Hepatic Encephalopathy: Lactulose is also used to reduce ammonia levels in patients
with hepatic encephalopathy.
Actions:
1. Osmotic Effect: Lactulose draws water into the colon, softening the stool and promoting
bowel movements.
2. Reduction of Ammonia Absorption: In hepatic encephalopathy, lactulose acidifies the
colon, trapping ammonia for excretion.
Side Effects:
 Common: Abdominal cramps, diarrhea, flatulence.
 Serious: Electrolyte imbalances with prolonged use.
Nursing Responsibilities:
 1. Assessment of Bowel Function: Evaluate the patient's bowel patterns, consistency, and
frequency.
2. Monitoring for Electrolyte Imbalances: Watch for signs of dehydration or electrolyte
disturbances, especially with chronic use.
3. Assessing for Hepatic Encephalopathy: In patients with liver disease, monitor for signs
of hepatic encephalopathy improvement.
4. Patient Hydration: Encourage adequate fluid intake to prevent dehydration.
Health Teaching:
1. Consistent Use: Emphasize the importance of taking the medication regularly for
optimal results.
2. Hydration: Advocate for increased fluid intake to support the osmotic effect and
prevent dehydration.
3. Dietary Fiber: Encourage a diet rich in fiber to complement the laxative effect.
4. Monitoring Ammonia Levels: In patients with hepatic encephalopathy, stress the
importance of regular monitoring of ammonia levels.

9. Diuretics

Drug Class: Thiazide Diuretics

Examples: Hydrochlorothiazide
Definition: Thiazide diuretics are medications that promote diuresis by inhibiting sodium
reabsorption in the distal convoluted tubule of the nephron.
Reasons for Use:
1. Hypertension: Thiazides decrease blood volume, leading to reduced blood pressure.
2. Edema: Used in conditions such as heart failure and renal dysfunction to reduce fluid
retention.
Actions:
1. Inhibition of Sodium Reabsorption: Thiazides decrease sodium reabsorption, promoting
water excretion.
Side Effects:
 Common: Hypokalemia, hypotension, electrolyte imbalances.
 Serious: Photosensitivity, hyperglycemia.
Nursing Responsibilities:
1. Electrolyte Monitoring: Regularly assess potassium levels and watch for signs of
electrolyte imbalances.
2. Blood Pressure Monitoring: Monitor blood pressure regularly.
3. Renal Function: Assess renal function, especially in patients with pre-existing renal
conditions.
4. Photosensitivity: Advise patients to use sunscreen and protective clothing.
Health Teaching:
1. Potassium-Rich Foods: Encourage a diet with potassium-rich foods.
2. Medication Timing: Recommend taking thiazides in the morning to avoid nocturia.
3. Fluid Intake: Emphasize the importance of staying adequately hydrated.
Drug Class: Loop Diuretics
Examples: Furosemide
Definition: Loop diuretics are medications that inhibit sodium reabsorption in the ascending
loop of Henle, leading to significant diuresis.
Reasons for Use:
1. Edema: Especially in heart failure, renal impairment, and hepatic cirrhosis.
2. Hypertension: For acute blood pressure reduction.
Actions:
1. Inhibition of Sodium and Water Reabsorption: Loop diuretics act on the loop of Henle,
leading to profound diuresis.
Side Effects:
 Common: Hypokalemia, hypotension, electrolyte imbalances.
 Serious: Ototoxicity, dehydration.
Nursing Responsibilities:
1. Electrolyte Monitoring: Regularly assess potassium levels and watch for signs of
electrolyte imbalances.
2. Blood Pressure Monitoring: Monitor blood pressure regularly.
3. Renal Function: Assess renal function, especially in patients with pre-existing renal
conditions.
4. Ototoxicity Monitoring: Watch for signs of hearing loss or tinnitus.
Health Teaching:
1. Potassium-Rich Foods: Encourage a diet with potassium-rich foods.
2. Fluid Intake: Emphasize the importance of staying adequately hydrated.
3. Medication Timing: Recommend taking loop diuretics in the morning to avoid nocturia.

Drug Class: Potassium-Sparing Diuretics

Examples: Spironolactone
Definition: Potassium-sparing diuretics are medications that reduce sodium reabsorption in the
distal tubules while conserving potassium.
Reasons for Use:
1. Hypertension: Used as part of antihypertensive therapy.
2. Heart Failure: May be used in combination with other diuretics to manage fluid
retention.
Actions:
1. Inhibition of Aldosterone: Potassium-sparing diuretics block the effects of aldosterone,
leading to sodium and water excretion while conserving potassium.
Side Effects:
 Common: Hyperkalemia, gynecomastia (in males), menstrual irregularities.
 Serious: Renal impairment, electrolyte imbalances.
Nursing Responsibilities:
1. Potassium Monitoring: Regularly assess potassium levels and watch for signs of
hyperkalemia.
 2. Blood Pressure Monitoring: Monitor blood pressure regularly.
3. Renal Function: Assess renal function, especially in patients with pre-existing renal
conditions.
Health Teaching:
1. Potassium-Rich Foods: Advise caution with potassium-rich foods to avoid hyperkalemia.
2. Regular Follow-Up: Stress the importance of regular follow-up appointments for
monitoring.

10. Analgesics

a. Acetaminophen
Definition: Acetaminophen is a non-opioid analgesic and antipyretic medication commonly
used to relieve pain and reduce fever.
Reasons for Use:
1. Mild to Moderate Pain: Used for pain relief in conditions like headaches,
musculoskeletal pain, and osteoarthritis.
2. Fever Reduction: Effective in reducing fever associated with various illnesses.
Actions:
1. Central Nervous System: Believed to work centrally in the brain to reduce pain
perception.
2. Antipyretic Effect: Lowers fever by acting on the hypothalamus.
Side Effects:
 Common: Generally well-tolerated at recommended doses.
 Serious: Liver toxicity with high doses or prolonged use.
Nursing Responsibilities:
1. Liver Function Tests: Monitor liver function in patients taking high doses or with pre-
existing liver conditions.
2. Dose Adjustment: Adjust doses carefully, especially in patients with liver impairment.
3. Patient Education on Maximum Daily Dose: Emphasize the importance of not
exceeding the recommended maximum daily dose.
Health Teaching:
1. Avoid Alcohol: Warn against excessive alcohol consumption, which can increase the risk
of liver toxicity.
2. Monitoring for Signs of Liver Toxicity: Educate patients about signs of liver toxicity, such
as jaundice or abdominal pain.

b. Morphine
Definition: Morphine is an opioid analgesic used to manage moderate to severe pain.
Reasons for Use:
1. Post-Surgical Pain: Used for pain control following surgical procedures.
2. Cancer Pain: Effective in managing pain associated with advanced cancer.
3. Acute Trauma: Administered for severe pain resulting from trauma.
Actions:
 1. Central Nervous System: Binds to opioid receptors in the central nervous system,
altering pain perception.
Side Effects:
 Common: Constipation, nausea, sedation.
 Serious: Respiratory depression, hypotension.
Nursing Responsibilities:
1. Respiratory Monitoring: Regularly assess respiratory rate and depth.
2. Pain Assessment: Continuously assess pain levels and response to medication.
3. Bowel Function: Monitor for constipation and implement measures to prevent
constipation.
Health Teaching:
1. Constipation Management: Educate patients on the importance of maintaining bowel
regularity and provide guidance on laxative use.
2. Avoiding Alcohol and CNS Depressants: Caution against the concurrent use of alcohol
or other central nervous system (CNS) depressants.

c. Hydromorphone
Definition: Hydromorphone is a potent opioid analgesic used for the management of moderate
to severe pain.
Reasons for Use:
1. Post-Operative Pain: Administered for pain control following surgical procedures.
2. Chronic Pain: Used in patients with chronic pain conditions, such as cancer-related pain.
Actions:
1. Central Nervous System: Binds to opioid receptors in the central nervous system,
altering pain perception.
Side Effects:
 Common: Constipation, nausea, sedation.
 Serious: Respiratory depression, hypotension.
Nursing Responsibilities:
1. Respiratory Monitoring: Regularly assess respiratory rate and depth.
2. Pain Assessment: Continuously assess pain levels and response to medication.
3. Bowel Function: Monitor for constipation and implement measures to prevent
constipation.
Health Teaching:
1. Constipation Management: Educate patients on the importance of maintaining bowel
regularity and provide guidance on laxative use.
2. Avoiding Alcohol and CNS Depressants: Caution against the concurrent use of alcohol
or other central nervous system (CNS) depressants
11. Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)
Examples: Ibuprofen, Naproxen, Celecoxib
Definition: NSAIDs are a class of medications that possess analgesic (pain-relieving), anti-
inflammatory, and antipyretic (fever-reducing) properties. They work by inhibiting the activity
of enzymes called cyclooxygenases (COX), which are involved in the synthesis of prostaglandins.
Reasons for Use:
1. Pain Relief: Used to alleviate mild to moderate pain, such as headaches,
musculoskeletal pain, and dental pain.
2. Inflammation Control: Effective in reducing inflammation associated with conditions
like arthritis.
3. Fever Reduction: Used to lower fever in various illnesses.
Actions:
1. Inhibition of Cyclooxygenase (COX): NSAIDs block the activity of COX enzymes, reducing
the synthesis of prostaglandins responsible for pain, inflammation, and fever.
Side Effects:
 Common: Gastrointestinal upset, ulcer formation, renal impairment.
 Serious: Cardiovascular events, gastrointestinal bleeding, renal failure.
Nursing Responsibilities:
1. Gastrointestinal Assessment: Monitor for signs of gastrointestinal bleeding or ulcer
formation.
2. Renal Function: Assess renal function, especially in patients with pre-existing renal
conditions.
3. Blood Pressure Monitoring: NSAIDs can affect blood pressure; monitor regularly.
4. Patient Allergies: Assess for any history of allergies, especially to NSAIDs.
Health Teaching:
1. Take with Food or Milk: Advise patients to take NSAIDs with food or milk to minimize
gastrointestinal upset.
2. Avoid Alcohol and Smoking: Alcohol and smoking can increase the risk of
gastrointestinal bleeding; instruct patients to avoid these.
3. Stay Hydrated: Emphasize the importance of staying well-hydrated to maintain renal
function.
4. Report Signs of Bleeding: Educate patients on signs of gastrointestinal bleeding (e.g.,
dark stools) and the need to report them promptly.

12. Oral Glycemic Agents

a. Glyburide
Definition: Glyburide is an oral sulfonylurea antidiabetic medication that stimulates insulin
release from the pancreatic beta cells.
Reasons for Use:
1. Type 2 Diabetes: Glyburide is used to control blood sugar levels in patients with type 2
diabetes.
Actions:
 1. Stimulation of Insulin Release: Glyburide acts on pancreatic beta cells to enhance
insulin secretion.
Side Effects:
 Common: Hypoglycemia, weight gain.
 Serious: Allergic reactions, prolonged hypoglycemia.
Nursing Responsibilities:
1. Blood Glucose Monitoring: Regularly monitor blood glucose levels to adjust the dosage
as needed.
2. Hypoglycemia Assessment: Assess for signs of hypoglycemia, especially in elderly
patients.
3. Renal and Hepatic Function: Assess renal and hepatic function regularly.
Health Teaching:
1. Dietary Consistency: Stress the importance of maintaining consistent carbohydrate
intake.
2. Signs of Hypoglycemia: Educate patients on the signs of hypoglycemia and appropriate
interventions.
3. Avoiding Alcohol: Caution against excessive alcohol intake, which can increase the risk
of hypoglycemia.

b. Metformin
Definition: Metformin is an oral biguanide antidiabetic medication that reduces hepatic glucose
production and enhances peripheral insulin sensitivity.
Reasons for Use:
1. Type 2 Diabetes: Metformin is used as a first-line therapy to improve glycemic control in
type 2 diabetes.
Actions:
1. Decreased Hepatic Glucose Production: Metformin reduces glucose production by the
liver.
2. Enhanced Peripheral Insulin Sensitivity: Improves the body's response to insulin in
peripheral tissues.
Side Effects:
 Common: Gastrointestinal upset, diarrhea, metallic taste.
 Serious: Lactic acidosis (rare but potentially life-threatening).
Nursing Responsibilities:
1. Renal Function: Assess renal function before starting metformin and regularly
thereafter.
2. Lactic Acidosis Monitoring: Watch for signs of lactic acidosis, especially in patients with
renal impairment or other risk factors.
3. Hold Before Contrast Studies: Discontinue metformin before contrast studies to reduce
the risk of lactic acidosis.
Health Teaching:
1. Dietary Recommendations: Educate patients on the importance of a healthy diet and
regular meals.
 2. Hydration: Encourage adequate fluid intake to prevent dehydration and minimize the
risk of lactic acidosis.
3. Recognizing Lactic Acidosis Symptoms: Instruct patients to seek medical attention if
they experience symptoms of lactic acidosis (e.g., muscle pain, weakness).

13. Insulin
a. Short-Acting Insulin (e.g., Regular Insulin)
Reasons for Use:
1. Mealtime Control: Administered before meals to manage postprandial glucose levels.
2. Hyperglycemia Correction: Used to rapidly lower blood glucose levels in emergency
situations.
Actions:
1. Rapid Onset: Begins working within 30 minutes of administration.
2. Peak Effect: Peaks around 2 to 4 hours after administration.
3. Duration: Typically lasts for 6 to 8 hours.
Side Effects:
 Common: Hypoglycemia, injection site reactions.
 Serious: Hypokalemia (due to increased cellular uptake of potassium).
Nursing Responsibilities:
1. Blood Glucose Monitoring: Regularly monitor blood glucose levels to adjust insulin
doses.
2. Assess Hypoglycemia: Monitor for signs of hypoglycemia, especially during peak times.
3. Patient Education on Self-Injection: Teach proper injection techniques and site rotation.
Health Teaching:
1. Mealtime Administration: Emphasize the importance of administering before meals.
2. Signs of Hypoglycemia: Educate patients on recognizing and managing hypoglycemia.
3. Storage: Instruct patients on proper insulin storage to maintain efficacy.

b. Intermediate-Acting Insulin (e.g., NPH Insulin)

Reasons for Use:
1. Basal Insulin Coverage: Used to provide a baseline insulin level throughout the day.
2. Mixed Regimens: Often used in combination with short-acting insulins.
Actions:
1. Onset: Begins working within 1 to 2 hours of administration.
2. Peak Effect: Peaks around 4 to 12 hours after administration.
3. Duration: Typically lasts for 12 to 18 hours.
Side Effects:
 Common: Hypoglycemia, injection site reactions.
 Serious: Hypokalemia (due to increased cellular uptake of potassium).
Nursing Responsibilities:
1. Blood Glucose Monitoring: Regularly monitor blood glucose levels to adjust insulin
doses.
2. Assess Hypoglycemia: Monitor for signs of hypoglycemia, especially during peak times.
 3. Patient Education on Self-Injection: Teach proper injection techniques and site rotation.
Health Teaching:
1. Consistent Timing: Emphasize the importance of consistent timing with meals.
2. Signs of Hypoglycemia: Educate patients on recognizing and managing hypoglycemia.
3. Storage: Instruct patients on proper insulin storage to maintain efficacy.

c. Long-Acting Insulin (e.g., Insulin Glargine, Insulin Detemir, Insulin Degludec)

Reasons for Use:
1. Basal Insulin Coverage: Used to provide a steady baseline insulin level throughout the
day.
2. Reducing Nighttime Hypoglycemia: Long-acting insulins with less variability are often
preferred for nighttime coverage.
Actions:
1. Onset: Begins working within 1 to 2 hours of administration.
2. No Peak Effect: These insulins are designed to have a steady, prolonged effect.
3. Duration: Lasts for 24 hours or longer, depending on the specific formulation.
Side Effects:
 Common: Hypoglycemia, injection site reactions.
 Serious: Hypokalemia (due to increased cellular uptake of potassium).
Nursing Responsibilities:
1. Blood Glucose Monitoring: Regularly monitor blood glucose levels to adjust insulin
doses.
2. Assess Hypoglycemia: Monitor for signs of hypoglycemia, especially during peak times.
3. Patient Education on Self-Injection: Teach proper injection techniques and site rotation.
Health Teaching:
1. Consistent Timing: Emphasize the importance of consistent timing with long-acting
insulins.
2. Signs of Hypoglycemia: Educate patients on recognizing and managing hypoglycemia.
3. Storage: Instruct patients on proper insulin storage to maintain efficacy.

14. Bronchodilators
Examples:
1. Beta2-Adrenergic Agonists (Short-Acting): Albuterol, Levalbuterol
2. Beta2-Adrenergic Agonists (Long-Acting): Salmeterol, Formoterol
3. Anticholinergic Agents: Ipratropium, Tiotropium
4. Methylxanthines: Theophylline
Definition: Bronchodilators are medications that relax and widen the airways in the lungs,
making it easier to breathe. They are commonly used in the management of asthma, chronic
obstructive pulmonary disease (COPD), and other respiratory conditions.
Reasons for Use:
1. Asthma: To relieve acute bronchoconstriction and prevent exercise-induced
bronchoconstriction.
2. COPD: Improve airflow in conditions like chronic bronchitis and emphysema.
Actions:
1. Beta2-Adrenergic Agonists: Stimulate beta2 receptors in the airways, leading to
bronchodilation.
2. Anticholinergic Agents: Block the action of acetylcholine, resulting in bronchodilation.
3. Methylxanthines: Relax smooth muscles in the airways and may have anti-inflammatory
effects.
Side Effects:
 Common: Tachycardia, tremors, nervousness, dry mouth.
 Serious: Cardiac arrhythmias, hypokalemia (with beta2-agonists), gastrointestinal upset
(with methylxanthines).
Nursing Responsibilities:
1. Respiratory Assessment: Regularly assess respiratory status, including breath sounds
and respiratory rate.
2. Cardiac Monitoring: Monitor heart rate and rhythm, especially with beta2-agonists.
3. Assess Electrolytes: Check potassium levels, particularly with the use of beta2-agonists.
4. Patient Education on Inhaler Use: Teach proper inhaler technique, emphasizing
coordination and breath-holding.
Health Teaching:
1. Inhaler Technique: Demonstrate and instruct patients on proper inhaler technique to
ensure effective drug delivery.
2. Recognizing Side Effects: Educate patients on common and serious side effects,
instructing them to report any unusual symptoms promptly.
3. Medication Schedule: Emphasize the importance of adhering to the prescribed
medication schedule for optimal control of symptoms.
4. Emergency Response: Instruct patients on recognizing and responding to worsening
respiratory symptoms and when to seek immediate medical attention.

15. Corticosteroids
Examples:
1. Inhaled Corticosteroids (ICS): Beclomethasone, Fluticasone, Budesonide
2. Oral Corticosteroids: Prednisone, Methylprednisolone
3. Topical Corticosteroids: Hydrocortisone, Betamethasone
Definition: Corticosteroids are synthetic drugs that mimic the effects of the body's natural
hormones produced by the adrenal glands. They have potent anti-inflammatory and
immunosuppressive properties.
Reasons for Use:
1. Inhaled Corticosteroids: Control and prevent inflammation in the airways, commonly
used in asthma and chronic obstructive pulmonary disease (COPD).
2. Oral Corticosteroids: Used for a wide range of inflammatory conditions, including
asthma exacerbations, autoimmune disorders, and allergic reactions.
3. Topical Corticosteroids: Treat skin conditions such as eczema, dermatitis, and psoriasis.
Actions:
 1. Suppression of Inflammation: Corticosteroids inhibit the production and release of
inflammatory mediators, reducing inflammation.
2. Immunosuppression: Modulate the immune response, decreasing the activity of
immune cells.
Side Effects:
 Common: Increased risk of infection, adrenal suppression, osteoporosis, weight gain.
 Serious: Long-term use may lead to Cushing's syndrome, glaucoma, and adrenal
insufficiency.
Nursing Responsibilities:
1. Assessment of Infection Risk: Monitor for signs of infection due to immunosuppressive
effects.
2. Blood Glucose Monitoring: Regularly assess blood glucose levels, especially in patients
with diabetes.
3. Bone Health Assessment: Evaluate bone density and assess for signs of osteoporosis.
4. Patient Education on Tapering: Instruct patients on the importance of gradual tapering
when discontinuing long-term corticosteroid therapy.
Health Teaching:
1. Inhaler Technique: Demonstrate proper inhaler technique for patients using inhaled
corticosteroids.
2. Adherence to Medication Schedule: Emphasize the importance of consistent dosing
and not abruptly stopping medication.
3. Infection Prevention: Educate patients on strategies to minimize the risk of infections,
such as hand hygiene.
4. Bone Health: Encourage a diet rich in calcium and vitamin D, along with weight-bearing
exercises, to support bone health.

16. Antibiotics
Examples:
1. Penicillin: Amoxicillin, Ampicillin
2. Cephalosporins: Cephalexin, Ceftriaxone
3. Macrolides: Azithromycin, Clarithromycin
4. Fluoroquinolones: Ciprofloxacin, Levofloxacin
5. Tetracyclines: Doxycycline, Minocycline
6. Sulfonamides: Trimethoprim-Sulfamethoxazole
7. Aminoglycosides: Gentamicin, Tobramycin
Definition: Antibiotics are medications that kill or inhibit the growth of bacteria. They are used
to treat bacterial infections and may target specific bacterial structures or processes.
Reasons for Use:
1. Bacterial Infections: Antibiotics are used to treat a wide range of bacterial infections,
including respiratory, urinary tract, skin, and systemic infections.
Actions:
1. Inhibition of Bacterial Growth: Antibiotics interfere with bacterial cell wall synthesis,
protein synthesis, DNA replication, or other vital processes, leading to bacterial death or
growth inhibition.
Side Effects:
 Common: Gastrointestinal upset, diarrhea, rash.
 Serious: Allergic reactions, superinfections (overgrowth of non-sensitive organisms).
Nursing Responsibilities:
1. Cultural and Allergy Assessment: Assess patient allergies and cultural considerations
related to antibiotic use.
2. Monitor for Side Effects: Regularly assess for common and serious side effects,
especially during the course of treatment.
3. Complete Course of Antibiotics: Encourage patients to complete the full course of
antibiotics even if symptoms improve before the end of treatment.
4. Renal and Hepatic Function: Monitor renal and hepatic function for certain antibiotics,
especially in patients with pre-existing conditions.
Health Teaching:
1. Adherence to Medication Schedule: Emphasize the importance of taking antibiotics as
prescribed and at the scheduled times.
2. Avoiding Alcohol: Advise against alcohol consumption during antibiotic therapy, as it
may interact with certain antibiotics.
3. Probiotics: Recommend the use of probiotics to help prevent antibiotic-associated
diarrhea.
4. Reporting Side Effects: Instruct patients to report any unusual or severe side effects
promptly.
5. Preventing Spread of Infection: Educate patients on proper hygiene practices to
prevent the spread of infection.

17. Antiemetics
Examples:
1. Serotonin Receptor Antagonists: Ondansetron, Granisetron
2. Dopamine Receptor Antagonists: Metoclopramide, Prochlorperazine
3. NK1 Receptor Antagonists: Aprepitant, Fosaprepitant
4. Antihistamines: Dimenhydrinate, Meclizine
5. Corticosteroids: Dexamethasone
6. Benzodiazepines: Lorazepam
Definition: Antiemetics are medications used to prevent or treat nausea and vomiting, which
may result from various causes such as chemotherapy, surgery, or motion sickness.
Reasons for Use:
1. Chemotherapy-Induced Nausea and Vomiting (CINV): Administered to prevent nausea
and vomiting associated with chemotherapy.
2. Postoperative Nausea and Vomiting (PONV): Used to prevent or treat nausea and
vomiting after surgery.
3. Motion Sickness: Given to prevent motion sickness during travel.
4. Gastrointestinal Disorders: Used in conditions such as gastroparesis or gastroenteritis.
Actions:
1. Serotonin Receptor Antagonists: Block serotonin receptors in the brain, preventing
nausea and vomiting signals.
2. Dopamine Receptor Antagonists: Inhibit dopamine receptors in the chemoreceptor
trigger zone, reducing nausea and vomiting.
3. NK1 Receptor Antagonists: Block substance P, a neurotransmitter involved in vomiting
reflex.
4. Antihistamines: Block histamine receptors in the brain, reducing nausea and vomiting.
5. Corticosteroids: Have anti-inflammatory effects and may reduce nausea associated with
inflammation.
6. Benzodiazepines: Have a calming effect and can help control anticipatory nausea and
vomiting.
Side Effects:
 Common: Drowsiness, dizziness, constipation.
 Serious: QT prolongation (with some medications), extrapyramidal symptoms (with
dopamine antagonists).
Nursing Responsibilities:
1. Assessment of Nausea and Vomiting: Evaluate the frequency and severity of nausea
and vomiting.
2. Vital Signs Monitoring: Monitor blood pressure, heart rate, and respiratory rate,
especially with medications that may cause QT prolongation.
3. Assess Renal and Hepatic Function: Evaluate renal and hepatic function for certain
antiemetics, especially in patients with pre-existing conditions.
4. Education on Timing and Administration: Instruct patients on the importance of taking
medications as directed and timing doses appropriately.
Health Teaching:
1. Drowsiness Precautions: Caution patients about the potential for drowsiness, especially
when operating machinery or driving.
2. Hydration: Encourage adequate fluid intake to prevent dehydration, especially with
persistent vomiting.
3. Reporting Side Effects: Instruct patients to report any unusual or severe side effects
promptly.
4. Avoiding Triggers: Educate patients on identifying and avoiding triggers that may
exacerbate nausea and vomiting.

18. Antihistamines
Examples:
1. First-Generation Antihistamines: Diphenhydramine, Chlorpheniramine
2. Second-Generation Antihistamines: Loratadine, Cetirizine, Fexofenadine
Definition: Antihistamines are medications that block the effects of histamine, a natural
substance released by the body during an allergic reaction. They are commonly used to relieve
symptoms of allergies, such as itching, sneezing, and runny nose.
Reasons for Use:
 1. Allergic Rhinitis: Used to alleviate symptoms of seasonal or perennial allergies, including
sneezing, itching, and nasal congestion.
2. Allergic Conjunctivitis: Relieve symptoms such as itchy and watery eyes associated with
allergies.
3. Allergic Skin Reactions: Used to reduce itching and hives caused by allergic reactions.
4. Motion Sickness: Some antihistamines have antiemetic properties and are used to
prevent motion sickness.
Actions:
1. Histamine Receptor Blockade: Antihistamines block histamine receptors, preventing the
action of histamine on target tissues.
2. Decreased Allergic Response: By inhibiting histamine, they reduce the symptoms of
allergic reactions.
Side Effects:
 Common: Drowsiness (more common with first-generation), dry mouth, constipation.
 Second-Generation Side Effects: Generally less sedating, but may cause headaches or
mild stomach upset.
Nursing Responsibilities:
1. Assessment of Allergic Symptoms: Evaluate the type and severity of allergic symptoms.
2. Medication History: Obtain a thorough medication history, including over-the-counter
antihistamines.
3. Evaluation of Sedation: Monitor for sedation, especially with first-generation
antihistamines.
4. Renal and Hepatic Function: Assess renal and hepatic function for certain
antihistamines, especially in patients with pre-existing conditions.
Health Teaching:
1. Sedation Precautions: Advise patients about the potential for drowsiness, especially
with first-generation antihistamines, and caution against activities requiring alertness.
2. Dry Mouth Management: Encourage adequate fluid intake and sugar-free lozenges or
gum to manage dry mouth.
3. Avoiding Alcohol: Instruct patients to avoid alcohol, as it can enhance the sedative
effects of antihistamines.
4. Taking with Food: Recommend taking some antihistamines with food to minimize
stomach upset.
5. Contacting Healthcare Provider: Educate patients on when to contact their healthcare
provider, especially if they experience severe side effects.

19. Anti-neoplastic Agents (Chemotherapy)

Examples:
1. Alkylating Agents: Cyclophosphamide, Cisplatin
2. Antimetabolites: Methotrexate, 5-Fluorouracil
3. Antitumor Antibiotics: Doxorubicin, Bleomycin
4. Topoisomerase Inhibitors: Etoposide, Irinotecan
5. Mitotic Inhibitors: Paclitaxel, Vinblastine
6. Targeted Therapies: Imatinib, Trastuzumab
 7. Hormonal Agents: Tamoxifen, Anastrozole

Definition: Anti-neoplastic agents, commonly known as chemotherapy, are medications used to

treat cancer by interfering with the growth and division of cancer cells. They may act on various
stages of the cell cycle or target specific molecular pathways involved in cancer progression.
Reasons for Use:
1. Cancer Treatment: Used to shrink tumors, prevent cancer spread, or eliminate cancer
cells after surgery or radiation therapy.
2. Adjuvant Therapy: Given after primary treatment to reduce the risk of cancer
recurrence.
3. Palliative Care: Used to relieve symptoms and improve the quality of life in advanced or
metastatic cancer.
Actions:
1. Cell Cycle Disruption: Act on different phases of the cell cycle to interfere with cancer
cell division.
2. DNA/RNA Synthesis Inhibition: Interfere with the synthesis of DNA or RNA, preventing
cancer cell replication.
3. Apoptosis Induction: Promote programmed cell death in cancer cells.
4. Targeted Therapies: Target specific molecular pathways or proteins involved in cancer
growth.
5. Hormonal Agents: Inhibit hormone receptors or hormone production in hormone-
sensitive cancers.
Side Effects:
 Common: Fatigue, nausea, vomiting, hair loss, bone marrow suppression.
 Serious: Immunosuppression, anemia, thrombocytopenia, neuropathy, cardiotoxicity.
Nursing Responsibilities:
1. Chemotherapy Administration: Administer chemotherapy following established
protocols, considering dose adjustments based on patient factors.
2. Monitor for Adverse Effects: Regularly assess for signs of common and serious side
effects, adjusting care as needed.
3. Blood Counts Monitoring: Monitor complete blood counts (CBC) to assess for bone
marrow suppression.
4. Supportive Care: Provide supportive care measures, such as antiemetics, growth
factors, and blood transfusions.
Health Teaching:
1. Managing Side Effects: Educate patients on strategies to manage common side effects,
such as nausea, fatigue, and hair loss.
2. Infection Prevention: Instruct patients on infection prevention measures, emphasizing
the importance of hand hygiene.
3. Follow-Up Appointments: Stress the importance of attending regular follow-up
appointments for monitoring and adjustment of treatment.
4. Emotional Support: Provide emotional support and resources for coping with the
psychological impact of cancer treatment.
 Lab Values

Explanation for
Lab Test Normal Range Abnormal Values
WBC: 4,000-11,000/mm³ Elevated WBC
White Blood Cell count indicates infection or
(WBC): Measures the inflammation, while
number of white blood decreased levels may
CBC (Complete cells, indicating the body's suggest bone marrow
Blood Count) immune response. issues.
Low hemoglobin (Hgb)
Hemoglobin: 12-16 g/dL may indicate anemia,
(males), 12-15 g/dL while high levels could
(females) Measures the suggest dehydration or
oxygen-carrying protein in chronic respiratory
red blood cells. conditions.
Elevated hematocrit
Hematocrit: 38.3-48.6% (HCT) may indicate
(males), 35.5-44.9% dehydration, while
(females) Represents the decreased levels could
proportion of blood that is indicate anemia or
cellular (red blood cells). blood loss.
Red Blood Cell count: 4.5-
5.5 million/mm³ (males),
4.0-5.0 million/mm³ Abnormal red blood
(females) Measures the cell (RBC) counts may
number of red blood cells, indicate anemia or
involved in oxygen bone marrow
transport. disorders.
Sodium: 135-145 mEq/L Abnormal sodium
levels can indicate
Essential for fluid balance, dehydration, kidney
nerve function, and muscle issues, or hormonal
Electrolytes contraction. imbalances.
Elevated potassium
may suggest kidney
Potassium: 3.5-5.0 mEq/L dysfunction, while
decreased levels may
Critical for heart and result from diuretic use
muscle function. or inadequate intake.
Abnormal chloride
Chloride: 98-106 mEq/L levels may be linked to
dehydration, kidney
Maintains fluid balance issues, or metabolic
and helps in digestion. acidosis.
 Explanation for
Lab Test Normal Range Abnormal Values
BUN (Blood Urea
Nitrogen)

Measures the
amount of nitrogen in Elevated BUN may
the blood from the indicate kidney
waste product urea, dysfunction,
reflecting kidney dehydration, or heart
function. 8-20 mg/dL failure.
Creatinine

Indicates kidney High creatinine levels

function by suggest impaired
measuring the waste kidney function,
product creatinine in dehydration, or urinary
the blood. 0.6-1.2 mg/dL obstruction.
Elevated glucose may
Glucose indicate diabetes,
stress, or certain
Measures blood medications, while low
sugar levels, crucial levels can result from
for energy production insulin overdosing or
in the body. 70-110 mg/dL (fasting) adrenal insufficiency.
Abnormal calcium
Calcium: 8.5-10.5 mg/dL: levels may suggest
Essential for bone health, parathyroid issues,
nerve function, and blood kidney disease, or
Calcium Profile clotting. vitamin D imbalances.
High phosphate can
occur in kidney
Phosphate: 2.7-4.5 mg/dL disease, while low
levels may result from
Important for bone and malnutrition or
teeth formation. alcoholism.
Magnesium: 1.5-2.5
mEq/L Abnormal magnesium
levels may indicate
Involved in muscle and kidney dysfunction,
nerve function, as well as malnutrition, or
bone health. gastrointestinal issues.
Liver Function Tests ALT (Alanine Elevated ALT may
Aminotransferase): 7-56 indicate liver damage
units/L Indicates liver or disease.
 Explanation for
Lab Test Normal Range Abnormal Values
health
AST (Aspartate Elevated AST can be a
Aminotransferase): 8-48 sign of liver damage,
units/L Reflects liver and heart issues, or muscle
heart health. injury.
Albumin

A protein produced
by the liver,
important for Low albumin levels
maintaining blood may suggest liver or
volume and 3.5-5.0 g/dL kidney disease,
regulating malnutrition, or
pressure inflammation.
INR/PTT, PT

INR (International
Normalized Ratio):
Measures blood
clotting time.

PT (Prothrombin Abnormal coagulation

Time): Measures the INR: 0.9-1.2, PTT: 30-40 times may indicate
time it takes for blood seconds, PT: 11-13 bleeding disorders or
to clot. seconds clotting issues.
CRP (C-Reactive
Protein)
Elevated CRP
A marker of indicates inflammation,
inflammation in infection, or tissue
the body. <1.0 mg/dL injury.
ESR (Erythrocyte
Sedimentation Rate)

Measures
inflammation by
assessing the rate
at which red blood Elevated ESR
cells settle in a suggests inflammation
tube. 0-20 mm/hour or infection.
CK (Creatine Kinase) 38-174 units/L Elevated CK levels
may indicate muscle or
Indicates muscle heart damage.
 Explanation for
Lab Test Normal Range Abnormal Values

damage when
elevated.
CKMB (Creatine
Kinase-MB)

A specific form of CK Elevated CKMB

that indicates cardiac indicates cardiac
muscle damage. 0-25 units/L muscle damage.
Troponin A protein
released during Elevated troponin
heart muscle levels suggest
damage, indicating <0.04 ng/mL (normal myocardial infarction
a heart attack. range can vary) (heart attack).
Lactate Measures
the level of lactate
in the blood, often
used to assess Elevated lactate levels
tissue may indicate tissue
oxygenation. 0.5-2.2 mmol/L hypoxia or sepsis.
HbA1C Reflects
average blood
sugar levels over a High HbA1C levels
few months, indicate poor blood
providing insight <5.7% (normal), 5.7-6.4% sugar control over
into diabetes (pre-diabetes), ≥6.5% time, suggesting
control. (diabetes) diabetes.
TSH (Thyroid
Stimulating
Hormone)
Stimulates the
thyroid gland to Abnormal TSH levels
produce thyroid may indicate thyroid
hormones. 0.4-4.0 mIU/L dysfunction.
Lipid Assessment
HDL (High-Density
Lipoprotein): "Good"
cholesterol, helps
remove other forms
of cholesterol from
the bloodstream. Low HDL levels
HDL: >40 mg/dL (males), increase
>50 mg/dL (females) cardiovascular risk.
 Explanation for
Lab Test Normal Range Abnormal Values
LDL (Low-Density
Lipoprotein): "Bad"
cholesterol,
contributes to plaque
buildup in arteries. Elevated LDL levels
increase
LDL: <100 mg/dL cardiovascular risk.
Triglycerides: A type
of fat in the blood,
high levels may High triglyceride levels
increase the risk of may increase
heart disease. Triglycerides: <150 mg/dL cardiovascular risk.