Generic Name: Acetaminophen Classification: Central analgesic/Non-narcotic analgesic/antipyretic Adult Dosage: 325-650 mg q4-6h, max 4 g per day Geriatric

Dosage: Same as above Side Effects Drug/Food Interactions Rare- hypersensitivity Drug:Alcohol(chronic reaction use), liver enzymes inducers(e.g., cimetidine), hepatotoxic medications (e.g., phenytoin), warfarin Food: None Known Generic Name:

Trade Name: Tylenol Action: Appears to inhibit prostaglandin synthesis in the CNS and , to a lesser
extent, block pain impulses through peripheral action. Acts centrally on hypothalamic heat-regulating center, producing peripheral vasodilation (heat loss, skin erythema, diaphoresis).

Reason Receiving: Pain relief Pregnancy Category: B NI R/T Adm, SE, Interactions Assess onset, duration, location and intensity of pain. Assess for clinical improvement and relief of pain, fever.

Evaluation

acetaminophen and Opioid agonist

Trade Name: Vicodin Action:

hydrocodone
Classification:

Binds with opioid receptors; also antipyretic

(schedule III)
Adult Dosage: 500 mg/5 mg one to two tablets q.4-6h as needed for pain Newborn Dosage: Safety and effectiveness has not been established Side Effects Lightheadedness/dizziness Sedation Nausea and vomiting Constipation Respiratory depression Skin rash and pruritus Reason Receiving: moderate to moderately severe pain Pregnancy Category: C Nursing Implications R/T Adm. & S. E Evaluation

Give without regard to meals. Tablets may be crushed. Obtain VS before giving medication; respirations 12 or less (20 or less in kids) hold medication and call physician. Assess onset, type, location, duration of pain. Evaluate for urinary retention. Monitor daily bowel pattern and stool consistency. Start deep breathing and coughing exercises. Assess for clinical improvement; record onset of relief of pain, cough. Caution with breastfeeding mothers

Generic Name: acetaminophen 500 mg and oxycodone 5 mg Classification: opioid analgesic; nonnarcotic analgesic, antipyretic Adult Dosage: one capsule q6h as needed for pain Newborn Dosage: safety and effectiveness has not been established Side Effects

Trade Name: Tylox Action: semisynthetic narcotic analgesia involving the CNS, and blocks pain impulses; also, results in antipyresis Reason Receiving: moderate to moderately severe pain or antiemesis Pregnancy Category: C Nursing Implications R/T Adm. & S. E Evaluation

Dizziness/lightheadedness Sedation Nausea, vomiting Skin rash and pruritus Constipation May be habit forming

Caution if breasting feeding mother Assess onset, type, location and duration of pain. Assess for clinical improvement and relief of pain/fever. Assess mental and/or physical abilities
Trade Name: Aspirin Action: Inhibits prostaglandin synthesis, acts on the hypothalamus heatregulating center,interfers with production of thromboxane A, a substance that stimulates platelet aggregation. Reason Receiving: Reduces inflammation due to osteoarthritis Pregnancy Category: C (D if full dose used in 3rd trimester of pregnancy)

Generic Name: Acetylsalicylic Acid Classification: Nonsteroidal salicylate/Antiinflammatory Adult Dosage: 80-325mg/day Geriatric Dosage: Same as above Side Effects GI distress(including abdominal distention, cramping, heartburn, mild nausea); allergic reaction (including bronchospasm, pruritis, urticaria) Drug/Food Interactions Drug: ETOH, NSAIDs,
Antiacids, urinary alkalinizers, Anitcoagulants, heparin, thrombolytics, Platelet aggregation inhibitors, valproic acid, methotrexate, zidovudine, ototoxic meds, vancomysin, probenecid, sulfinpyrazone. Food: None Known

NI R/T Adm, SE, Interactions Assess type, location, duration of pain, inflammation Monitor urinary pH Assess skin for ecchymosis Report tinnitus or persistent abdominal GI pain

Evaluation

Generic Name: Acyclovir Classification:Synthetic Nucleoside/Antiviral Adult Dosage: 200mg Q4H, 5 times per day Newborn Dosage: N/A Side Effects
Rare; vomiting, diarrhea, rash, HA

Trade Name: Zovirax Action: Converts to acyclovir triphosphate, becoming part of DNA
chain.

Reason Receiving: Prevent infection Pregnancy Category: B Nursing Implications R/T Administration & Side Effects Evaluation

History of allergies Assess herpes simplex lesions bf treatment to assess therapeutic effect Provide comfort measures

Generic Name: Albuterol Classification: Sympathomimetic/Bronchodilator Adult Dosage:2.5mg 3-4 times/day over 5-15 mins Geriatric Dosage: Same as above Side Effects Drug/Food Interactions Drug: Beta-blockers, HA, nausea, restlessness, digoxin, MAOIs, tricyclic nervousness, tremors, antidepressants, Thyroid hormone. dizziness, throat dryness and irritation, pharyngitis, Food: None Known B/P changes, heartburn, transient wheezing. Generic Name: Allopurinol Classification: Antigout/Xanthine oxidase inhibitor Adult Dosage:600-800mg/day Newborn Dosage: N/A Side Effects Somnolence; Unusual hair loss; diarrhea; HA

Trade Name: Albuterol Sulfate Action: Stimulates beta-adrenergic receptors in lungs, resulting in
relaxation of bronchial smooth muscle.

Reason Receiving: Relief of bronchospasm Pregnancy Category: C NI R/T Adm, SE, Interactions Evaluation Monitor rate, depth, rhythm, type of respirations and pulse. Assess lung sounds.Increase fluids. Rinse mouth with water after inhalation.

Trade Name: Zyloprim Action: Decreases uric acid production by inhibiting xanthine
oxidase, an enzyme

Reason Receiving: Decrease uric acid due to chemotherapy Pregnancy Category: C Nursing Implications R/T Administration & Side Effects Evaluation
Tell patient to drink 10 to 12 glasses of water daily. Monitor I&O, assess cbc, uric acid hepatic function tests Assess urine for color, clarity, odor, assess for therapeutic response

Generic Name: Alprazolam Classification: benzodiazepine(schedule IV)/Antianxiety Adult Dosage: 0.25-0.5mg 3 times per day Geriatric Dosage: 0.25mg 2-3 times a day Side Effects Drug/Food Interactions Ataxia, light headedness, Drug: Potentiated effects
mild somnolence, slurred speech, confusion, constipation
when used with other CNS depressants (including alcohol). Ketoconazole, nefazodone, fluvoxamine may inhibit hepatic metabolism, increase serum concentration. Food: None known

Trade Name: Xanax Action: Enhances the action of the neurotransmitter gammaaminobutyric acid(GABA) in the brain

Reason Receiving: Treatment for Anxiety Pregnancy Category: D NI R/T Adm, SE, Interactions Evaluation
Offer emotional support assess motor responses, perform hepatic/renal function test, blood counts periodically. Evaluate for therapeutic response

Generic Name: Amitriptyline HCL Classification: Antineuralgia/Antidepressant Adult Dosage: 25-100mg at bedtime Geriatric Dosage: Same as above Side Effects Drug/Food Interactions Drug: CNS depressants, Dizziness, somnolence, dry mouth, orthostatic Antithyroid agents, hypotension, HA, Phenothiazine, increased appetite, Cimetidine, valporic acid, weight gain, nausea, clonidine, sympathomimetics. fatigue, unpleasant taste Food: None Known

Trade Name: Elavil Action: Blocks reuptake of neurotransmitters, at presynaptic membranes,

increase availability of receptor sites.

Reason Receiving: Relief of neuropathic pain Pregnancy Category: C NI R/T Adm, SE, Interactions Evaluation Assess location, type, frequency, duration of pain. Monitor B/P & Pulse. Assess pain relief.

Generic Name: Amlodipiine Besylate Classification: Calcium Channel Blocker/Antihypertensive Adult Dosage: Initially 5mg/day as a single dose. Increase by
2.5mg/day for 7-14 days

Trade Name:Norvasc Action: Inhibits Ca movement across cardiac and vascular

smooth muscle cell membranes.

Reason Receiving: Hypertension

Newborn Dosage: N/A Side Effects Peripheral edema, HA, flushing, dizziness, palpitations, nausea, unusual fatigue or weakness

Pregnancy Category: C Nursing Implications R/T Administration & Side Effects Assess b/p, apical pulse Assess for peripheral edema. Assess skin for flushing.

Evaluation

Generic Name: Amphotericin B Lipid Classification: Antifungal/Antiprotozoal

Trade Name: Abelcet Action:Generally fungistatic but may become fungicidal with high
dosages or very susceptible microorganisms. Binds to stero;s om fungal cell membrane.

Adult Dosage: 2.5-5mg/kg/day at a rate of Reason Receiving: Prevents fungal infection 2.5mg/kg/hr Newborn Dosage: N/A Pregnancy Category:B Nursing Implications R/T Side Effects Administration & Side Effects Evaluation Chills, fever, increased serum Hx fo allergies to amphotericin B, creatinine, multiple organ failure sulfite. Monitor b/p, temp, pulse, resp. Evaluate IV site for phlebitis(heat, pain, red streaking over vein). Monitor I&O. Generic Name: Aripiprazole Classification: Dopamine agonist/Antipsychoitic agent Adult Dosage: 2-5mg/day Newborn Dosage: N/A Side Effects Weight gain, HA, insomnia, vomiting Trade Name: Abilify Action: Provides partial agonist activity at dopamine and
serotonin (5-HT1A) receptors and antagonist activity at serotonin (5HT2A) receptors.

Reason Receiving: Depression Pregnancy Category: C Nursing Implications R/T Administration & Side Effects Evaluation
Periodically monitor weight. Monitor for extrapyramidal symptoms (abnormal movement), tardive dyskinesia(protruding tongue, puffing of cheeks, chewing/puckering of mouth). Monitor B/P, pulse. Assess for therapeutic response.

Generic Name: Ascorbic Acid Classification: Vitamin Adult Dosage: 50-200 mg per day Newborn Dosage: na Side Effects
Abdominal cramps, NV, diarrhea, increased urination.

Trade Name: Vitamin C Action: assist in tissue repair, involved in oxidation reaction Reason Receiving: supplement Pregnancy Category: A Nursing Implications R/T Administration & Side Effects Evaluation
Monitor for Abdominal cramps, NV, diarrhea, increased urination. No complaints of abdominal cramp, NV.

Generic Name: aspirin Classification: nonsteroidal salicylate

Adult Dosage: 325-650 mg Geriatric Dosage: same Side Effects Drug/Food Interactions GI distress Alcohol, NSAIDs, Allergic reaction antacids, heparin, platelet aggregation inhibitors, valproic acid

Trade Name: Ecotrin Action: inhibits prostaglandin synthesis, acts on the hypothalamus regulating center and inhibits platelet aggregation Reason Receiving: prophylactic for MI Pregnancy Category: C NI R/T Adm, SE, Interactions Evaluation Assess skin for ecchymosis Assess pain level Assess PLT

Generic Name: Atenolol Classification: Beta-Adrenergic Blocker/Antihypertensive Adult Dosage: 25-50mg daily Newborn Dosage: N/A Side Effects Hypotension manifested as cold extremities, constipation or diarrhea, diaphoresis, dizziness, fatigue, HA, nausea

Trade Name: Tenormin Action: Blocks beta1-adrenergice receptors in cardiac tissue. Reason Receiving: hypertension Pregnancy Category: D Nursing Implications R/T Administration & Side Effects Evaluation Assess B/P, apical pulse before admin med. Respiration for difficulty in breathing. Monitor I&O. Monitor bowel activity. Assess extremities for coldness. Trade Name: Lipitor
Action: inhibits the enzyme that catalyzes the early step in cholesterol synthesis; decreased LDL and VLDL, and increases HDL

Generic Name: atorvastatin calcium

Classification: HMG-CoA reductase inhibitor; antihyperlipidemic

Adult Dosage: 10-20 mg (80 max)

Newborn Dosage: Safety not established

Side Effects Generally well tolerated; if any, mild and transient. Headache Myalgia, rash, pruritis, allergy

Reason Receiving: Pregnancy Category: X Nursing Implications R/T Adm. & S. E Monitor for headache Assess for rash, pruritus, malaise Monitor cholesterol, triglyceride labs for therapeutic response

Evaluation

Generic Name: azithromycin Classification: macrolide; antibiotic Adult Dosage: 1200 mg once weekly
Newborn Dosage: safety not established

Trade Name: Zithromax

Action: binds to ribosomal receptor sites of susceptible organisms, inhibiting RNA-dependent protein synthesis; bacterostatic/bactericidal

Side Effects Nausea, vomiting, diarrhea, abdominal pain

Reason Receiving: Pregnancy Category: B Nursing Implications R/T Adm. & S. E Check for GI discomfort, nausea, vomiting Monitor daily pattern of bowels and stool consistency Monitor hepatic function tests, assess for hepatotoxicity (malaise, fever, abdominal pain, GI disturbances Be alert for superinfection (fever, vomiting, diarrhea, anal/genital pruritus, oral mucosal changes

Evaluation

Generic Name: Baclofen Trade Name: Lioresal Classification: skeletal muscle relaxant, antispastic Action: inhibits transmission of reflexes at spinal cord level Adult Dosage: 40-80mg/day Reason Receiving: spasms due to spinal injury Newborn Dosage: na Pregnancy Category:C Nursing Implications R/T Side Effects Administration & Side Effects Evaluation
Transient somnolence, asthenia, dizziness, light headedness, NV. Hypotension, confusion, Assess for paradoxical reaction. For long term therapy, hepatic/renal function test, Evaluate for therapeutic response.

K-3.6 NA- 141 CL- 105 BP 151/84-132-78 No pt complains of somnolence, dizziness, lightheadedness, nausea

Generic Name: betamethasone Classification: adrenocorticosteroid; anti-inflammatory, immunosuppressant Adult Dosage: 0.6-7.2 mg/day po Newborn Dosage: 0.0175-0.25 mg/kg/day in 3-4 divided doses po Side Effects Increased appetite Abdominal distention Nervousness Insomnia False sense of well being Topical: burning, stinging, pruritus

Trade Name: Diprolene Action: controls rate of protein synthesis, prevents or controls inflammation; decreases tissue response to inflammatory process Reason Receiving: Pregnancy Category: C (D if in first trimester) Nursing Implications R/T Adm. & S. E Question for hypersensitivity to any of the corticosteroids Obtain baselines for height, weight, BP, glucose, electrolytes Monitor BP, blood glucose, electrolytes Apply topical preparation sparingly and not on broken skin or areas of infection Do not apply to wet skin, face or inguinal areas IM inject slowly, deep IM into large muscle Trade Name: Dulcolax
Action: stimulates intramural nerve plexi of colonic smooth muscle

Evaluation

Generic Name: bisacodyl Classification: GI stimulant Adult Dosage: 10 mg rectally Geriatric Dosage: same Side Effects Drug/Food Interactions Some degree of abdominal Antacids discomfort Cimetidine Nausea Famotidine Mild cramps Ranitidine Faintness Milk
With rectal, mild burning of rectal mucosa

Reason Receiving: induce bowel movement Pregnancy Category: C NI R/T Adm, SE, Interactions Evaluation Chill for 30 min in frig if too soft Moisten suppository with cold water before insertion Encourage adequate fluid intake Assess BS for peristalsis Monitor bowel activity and stool consistency Monitor electrolytes

Generic Name: budesonide

Classification: anti-inflammatory, antiallergy Adult Dosage: 1 spray each nostril per day

Newborn Dosage: nebulizer 0.5 mg/day Side Effects Flu-like symptoms, headache, pharyngitis Back pain, vomiting, altered taste, voice changes, abdominal pain, nausea, dyspepsia

Trade Name: Symbicort/Formoterol Action: relieves symptoms of allergic rhinitis Reason Receiving: Pregnancy Category: B Nursing Implications R/T Administration & Side Effects Monitor relief of symptoms

Evaluation

Generic Name:Bupropion HCL Classification: Aminoketone/Antidepressant

Trade Name:Wellbutrin XL Action: Blocks reuptakeof neurotransmitters,(serotonin,

norepinephrine) at CNS presynaptic membranes, increasing availability at postsynapticeceptor sites.Reduces firing rate of noradrenergic neurons.

Adult Dosage:150mg daily Newborn Dosage: N/A Side Effects Constipation, weight gain or loss, nausea, vomiting, anorexia, dry mouth, HA, diaphoresis, tremor, sedation, insomnia, dizziness, agitation.

Reason Receiving: Major depression Pregnancy Category:B Nursing Implications R/T Administration & Side Effects Evaluation Hepatic/renal function tests. Assess appearance, behavior, speech pattern, level of interest, mood.

Generic Name: busPIRone Classification: nonbarbiturate Adult Dosage: 5 mg 2-3 times a day Geriatric Dosage: 5 mg bid Side Effects Drug/Food Interactions Dizziness, somnolence, Alcohol, other CNS nausea, headache depressants Nervousness, fatigue, Erythromycin, MAOIs insomnia, dry mouth, St. Johns wort lightheadedness, mood Grapefruit and grapefruit swings, blurred vision, juice poor concentration, diarrhea, paresthesia

Trade Name: BuSpar

Action: binds to serotonin, dopamine at presynaptic neurotransmitter receptors in CNS; anxiolytic

Reason Receiving: augment depression meds Pregnancy Category: B NI R/T Adm, SE, Interactions Evaluation Offer emotional support if anxious Assess motor responses (agitation, trembling, tension), autonomic responses (cold, clammy hands; diaphoresis) Monitor LFTs, renal function, blood counts for long-term use Assist with ambulation if dizzy

Generic Name: Calcium Carbonate- Vit D Classification: electrolyte replenisher

Trade Name: Alpo-Cal, Caltrate Action: Assists in regulating release/storage of hormones.

Neutralizes/reduces gastric acid(increases ph)

Adult Dosage: 1-2 g a day in divided doses Reason Receiving: prevention of calcium deficiency Newborn Dosage: na Pregnancy Category: na Nursing Implications R/T Side Effects Administration & Side Effects Evaluation Milk alkali syndrome(HA, Assess BP, EKG, and cardiac decreased appetite, NV, unusual rhythm renal function, serum fatigue) Chalky taste magnesium phosphate, potassium concentrations.

Generic Name: Calcium Polycarbophil Classification: Bulk-forming laxative/antidiarrheal

Trade Name: Fiber-Lax Action: Retains water in intestines, opposes dehydrating forces of bowel. Adult Dosage: 2 tab- 625 mg orally Reason Receiving: Prevents Constipation Newborn Dosage: N/A Pregnancy Category: C Nursing Implications R/T Side Effects Administration & Side Effects Evaluation Abdominal pain, Nausea, vomiting Take with adequate amount of water(8 ounces)

Generic Name: carbamazepine Classification: iminostilbene derivative; anticonvulsant, antipsychotic Adult Dosage: 200 mg bid Geriatric Dosage: 100 mg 1-2 times a day Side Effects Drug/Food Interactions Drowsiness, dizziness, Anticoagulants, nausea, vomiting clarithromycin, diltiazem, Visual abnormalities erythromycin, estrogens, (spots, difficult focusing, propoxyphene, blurred), dry quinindine, steroids mouth/pharynx, tongue Antipsychotics, irritation, headache, fluid haloperidol, tricyclics retention, diaphoresis, Other anticonvulsants, constipation, diarrhea barbiturates, benzodiazepine, valproic acid, MAOIs St. Johns wort, grapefruit, grapefruit juice

Trade Name: Tegretol

Action: decreases sodium, calcium ion influx into neural membranes, reducing post-tetanic potentiation at synapses; anticonvulant effect

Reason Receiving: withdrawal Pregnancy Category: D NI R/T Adm, SE, Interactions Monitor CBC, iron, UA, BUN Assess for early signs of toxicity (fever, sore throat, mouth ulcerations, unusual bruising/bleeding, joint pain)

Evaluation

Generic Name: carvedilol

Classification: beta-adrenergic blocker; antihypertensive

Trade Name: Coreg

Action: has nonselective beta-blocking and alpha-adrenergic blocking activity; causes vasodilation; reduces cardiac output and tachycardia; reduces peripheral vascular resistance

Adult Dosage: 6.25 mg/day (50 max)

Newborn Dosage: safety not established

Side Effects Generally well tolerated with mild transient side effects Fatigue, dizziness Diarrhea, bradycardia, rhinitis, back pain

Reason Receiving: Hypertension Pregnancy Category: C Nursing Implications R/T Adm. & S. E Monitor BP for hypotension and resp for dyspnea Assess pulse for quality, irregular rate, bradycardia Monitor EKG for arrhythmias Assist with ambulation if dizziness occurs Assess for CHF (dyspnea, night cough, peripheral edema, distended neck veins) Monitor I&O

Evaluation

Generic Name: cefazolin Classification: first-gen cephalosporin Adult Dosage: 0.5-1 g q.6-8 h postop Geriatric Dosage: same Side Effects Drug/Food Interactions Oral candidiasis Aminoglycosides Mild diarrhea Furosemide Mild abdo cramping Probenecid Vaginal candidiasis Warfarin = bleeding Nausea No herbs or food

Trade Name: cefazolin Action: Inhibits cell wall synthesis of bacterial cell membranes; bactericidal Reason Receiving: Prophylaxis postoperatively Pregnancy Category: B NI R/T Adm, SE, Interactions Evaluation Assess oral cavity Monitor daily bowel activity and stool consistency Monitor I&O, renal function tests Be alert for superinfection (fever, vomiting, diarrhea)

Generic Name: Cefepime HCL/ th Classification: 4 generation cephalosporin Adult Dosage:1-2 grams q12h over 7-10days Newborn Dosage: Side Effects Oral candidiasis, mild diarrhea, mild abdominal cramping

Trade Name: Maxipime Action: binds to bacterial cell membranes Reason Receiving: pneumonia Pregnancy Category:B Nursing Implications R/T Administration & Side Effects Evaluation Question for allergies to cephalosporins and penicillins Assess oral cavity for white patches. Monitor bowel activity, I&O, renal function test

Generic Name: Ceftriaxone rd Classification: 3 generation cephalosporin/Antibiotic Adult Dosage: 1-2g as a single dose or in 2 divided doses Geriatric Dosage: Same as above Side Effects Drug/Food Interactions Drug: Probenecid Oral candidiasis, mild Food: None Known diarrhea, mild abdominal

Trade Name: Rocephin Action: Binds to bacterial cell membranes, inhibits cell wall synthesis. Bactericide. Reason Receiving: Treatment of gram(-) infections Pregnancy Category: B NI R/T Adm, SE, Interactions Assess hx of sensitivity. Assess oral cavity. Monitor bowel

Evaluation

cramping, vaginal candidiasis

pattern and activity. Asses for superinfection: fever, vomiting, diarrhea, anal/genital pruritis, oral mucosal changes.

Generic Name: Cetirizine HCl Classification: 2nd Generation Piperazine/Antihistamine Adult Dosage: Initially 5-10mg/day as a single or in 2 divided
doses

Trade Name: Zyrtec Action: Competes with histamine for H1-receptor sites on
effector cells in GI tract, blood vessels, respiratory tract.

Reason Receiving: Seasonal Allergies

Newborn Dosage: N/A Side Effects Pharyngitis; dry mucous membranes, nose, throat; N/V; abdominal pain; HA; dizziness; fatigue; thickening of mucus; somnolence; photosensitivity; urinary retention

Pregnancy Category: B Nursing Implications R/T Administration & Side Effects Assess lung sounds. Increase fluids to maintain thin secretions and offset thrist. Monitor symptoms for therapeutic response.

Evaluation

Generic Name: Chemo-Cytarabine Classification: Antimetabolite/Antineoplastic

Trade Name: Cytarabine Action: Converted intracellularly to nucleotide. Cell cycle-specific

for S phase of cell division.

Adult Dosage: 75-200mg/m2/day for 5-10 days Reason Receiving: Prevents cell growth Newborn Dosage: N/A Pregnancy Category: D Nursing Implications R/T Side Effects Administration & Side Effects Evaluation Asthenia, fever, pain, altered Monitor CBC for evidence of taste/smell, nausea, vomiting myelosuppression. Monitor for blood dyscrasias(fever, sore throat, signs of local infection, unusual bruising/bleeding). Increase fluid intake
Generic Name: Chemo-cyclophosphamide Trade Name: Cytoxam (sye-cloe-FOSS-fa-mide Classification: alkylating agent Action: Inhibits DNA,RNA protein synthesis Adult Dosage:400-1800mg/m2 per treatment course (1-5 Reason Receiving: ACL days) Newborn Dosage: na Pregnancy Category: na Nursing Implications R/T Side Effects Administration & Side Effects Evaluation Marked leucopenia 8-15 days after Obtain WBC count weekly during No complaints of NV initial therapy. Nausea vomiting therapy or until maintenance dose is WBC-4.0L RBC- 2.78L established than at 2-3 wk intervals. PLT- 152L Seg. Neu-2.6 Monitor CBC, Monitor for hematologic Lymph-0.5L Mono-0.8 toxicity. Baso- 0.0 EOSN-0.0

Generic Name: Chemo- Decitabine DACOG Trade Name: Classification: antineoplastic Action: exerts cytotoxic effect on rapidly dividing cells Adult Dosage: 15 mg given over 3hrs q8h Reason Receiving: treatment of AML Newborn Dosage: Pregnancy Category: D Nursing Implications R/T Side Effects Administration & Side Effects Evaluation
Fever, nausea, cough, constipation, Monitor for fever, sore throat, signs of Did not administer. No c/o of NV,

diarrhea, peripheral edema, echhymosis, arthralgia.

local infection. Monitor and report N/V, diarrhea, If pt has active or uncontrolled infection, treatment should be stopped and not restarted until toxicity if resolved.

diarrhea, peripheral edema, echymosis, arthralgia. Pt being treated for pneumonia. Temp-96.5 Pt c/o unproductive cough

Generic Name: Chemo-etoposide (eh-TOE-poe-side) Trade Name: Toposar, VePesid Classification: Epipodophyllotoxin Action: Inhibits single and double stranded breaks in DNA. Adult Dosage: 150 mg/m2/day for 2-3 days, 2-3 cycles Reason Receiving: ACL Newborn Dosage: na Pregnancy Category: na Nursing Implications R/T Side Effects Administration & Side Effects Evaluation Mild to moderate nausea/vomiting, Obtain hematologic test before No complaints of NV alopecia. administration at frequent intervals HGB-9.9L HCT-25.9L during therapy. Use anti-emetics to WBCRBCcontrol nausea and vomiting. PLTSeg. Neu-2.6 Lymph-0.5L Mono-0.8 Baso- 0.0 EOSN-0.0

Generic Name: Chemo-Midostaurin Classification: Kinases inhibitor Adult Dosage: Newborn Dosage: Side Effects

Trade Name:Chemo-Midostaurin Action: blocks a key class of enzymes kinases that often spur cancer
cell growth. It works by targeting the FLT3 cell receptor, which is overactive in the white blood cells

Reason Receiving: reduces the number of circulating leukemia cells Pregnancy Category: Nursing Implications R/T Administration & Side Effects Evaluation

Generic Name: cholecalciferol Classification: Fat-soluble vitamin/Nutritional

Trade Name: Vitamin D3 Action: Stimulates calcium/phosphate absorption from small

intestine, promotes secretion of calcium from bone to blood, promotes reabsorption of phosphate in renal tubules; acts on bone cells to stimulate skeletal growth and on parathyroid gland to suppress hormone synthesis and secretion

Supplement

Adult Dosage: 400 units per day Newborn Dosage: Side Effects None Known

Reason Receiving: Vitamin deficiency Pregnancy Category: A(C if used in doses above RDA) Nursing Implications R/T Administration & Side Effects Evaluation

Begin therapy at lowest possible dosage. Encourage adequate fluid intake. Monitor Ca+, P+, Mg+, BUN levels Trade Name: Cipro Action: Inhibits enzyme, DNA gyrase, in susceptible bacteria,
interfering with bacterial cell replication.

Generic Name: Ciprofloxacin HCl Classification: Fluoroquinolone/Anti-infective Adult Dosage: 500-750 mg q8-12h Newborn Dosage: N/A Side Effects
Nausea, diarrhea, dyspepsia,

Reason Receiving: Prevent infection Pregnancy Category: C Nursing Implications R/T Administration & Side Effects Evaluation
Question for history of sensitivity to

Vomiting, constipation, flatulence Confusion, crystalluria, abdominal pain

Ciprofloxacin, quinolones. Eval for food tolerance, bowel activity, dizziness, HA, visual changes, chest, joint pain

Generic Name: citalopram hydrobromide Classification: antidepressant (serotonin inhibitor) Adult Dosage: 20 mg Newborn Dosage: not indicated Side Effects Nausea, dry mouth, somnolence, insomnia, diaphoresis. Tremor, diarrhea, fatigue, anxiety, vomiting, anorexia

Trade Name: Celexa Action: relieves depression Reason Receiving: Depression Pregnancy Category: C Nursing Implications R/T Adm. & S.E. Observe, record behavior Assess psychological status, thought content, sleep pattern, appearance, interest in environment, mood

Evaluation

Generic Name: Clindamycin Classification: Lincosamide/Antibiotic Adult Dosage: 1.2-1.8g/day in 2-4 divided doses Geriatric Dosage: Same as above Side Effects Drug/Food Interactions Drug: Adsorbent Abdominal pain, nausea, vomiting, diarrhea antidiarrheals, Erythromycin, Neuromuscular blockers. Food: None Known

Trade Name: Cleocin Action: Inhibits protein synthesis of bacterial cell wall by binding to bacterial
ribosomal receptor sites. Topically, decrease fatty acid concentration on skin.

Reason Receiving: Treatment of infection Pregnancy Category: B NI R/T Adm, SE, Interactions Evaluation Monitor bowel activity/pattern. Assess hx of sensitivity. Monitor for superinfection: fever, vomiting, diarrhea, anal/genital pruritis, oral mucosal changes(ulceration, pain, erythema)

Generic Name: Clopidogrel Classification: Thienopyridine derivative/Antiplatelet Adult Dosage: 300mg loading dose then 75mg/day Geriatric Dosage: Same as above Side Effects Drug/Food Interactions Drug: Aspirin, NSAIDs, Skin disorders, URI, chest pain, flu-like Fluvastatin, phenytoin, symptoms, HA, dizziness, tamoxifen, tolbutamide, arthralgia torsemide, warfarin. Food: None Known Generic Name: Clonidine HCL

Trade Name: Plavix Action: Inhibits binding of enzyme adenosine phosphate (ADP) to its
platelet receptor and subsequent ADP-mediated activation of a glycoprotein complex.

Reason Receiving: Graft patency(Saphenous vein) Pregnancy Category: B NI R/T Adm, SE, Interactions Evaluation Monitor platelet count. Assess BUN, creat, bilirubin, AST, ALT, WBC, Hgb

Trade Name: Clonidine

Classification: Antiadrenergic, sympatholytic/Antihypertensive Adult Dosage: 0.1mg twice/day Geriatric Dosage: 0.1mg at bedtime Side Effects Drug/Food Interactions Drug: beta-blocker, Dry mouth, somnolence, dizziness, sedation, Tricyclic antidepressants. Food: None Known constipation

Action: Prevents pain signal transmission to brain and produce analgesia

at pre- and post-alpha-adrenergic receptors in spinal cord

Reason Receiving: HTN Pregnancy Category: C NI R/T Adm, SE, Interactions Obtain B/P before admin. Monitor bowel activity. Side effects diminish with therapy.

Evaluation

Generic Name: Clonozepam Classification: benzodiazepine (Sche II)/anticonvulsant

Trade Name: Klonopin Action: Depresses all levels of CNS; depresses nerve impulse
transmission in motor cortex. Suppresses abnormal discharge in petit mal seizures.

Adult Dosage:1.5mg/day in 3 divided doses Reason Receiving: Bipolar Disorder Newborn Dosage: N/A Pregnancy Category: D Nursing Implications R/T Side Effects Administration & Side Effects Evaluation Mild, transient drowsiness; ataxia; Hx of seizure disorder.Implement behavior disturbances(aggression, safety measures. Perform irritability, agitation) renal/hepatic function test. Evaluate for therapeutic response.

Generic Name: Clotrimazole Cream Classification: Antifungal Adult Dosage: 1% Geriatric Dosage: apply twice a day up to 8weeks Side Effects Drug/Food Interactions Pruritis, burning, stinging, Drug: None Known Food: None Known erythema, urticaria

Trade Name: Lotrimin Action: binds with phospholipids in fungal cell membrane. Reason Receiving: treat fungal infection Pregnancy Category:C NI R/T Adm, SE, Interactions Evaluation Check skin for erythema, urticaria, blistering, pruritis, stinging, burning

Generic Name: Colchicine Classification: Alkaloid/Antigout Adult Dosage: 0.6-1.2mg up to 6mg Geriatric Dosage: Same as above Side Effects Drug/Food Interactions Drug: Bone marrow N/V, abdominal discomfort depressants, clarithromycin, erythromycin, NSAIDs. Food: None Known

Trade Name: Colchicine Action: Decrease leukocyte motility, phagocytosis, lactic acid production Reason Receiving: Gouty Arthritis Pregnancy Category: D(parental)/C(oral) NI R/T Adm, SE, Interactions Evaluation Increase fluid intake. Monitor I&O. Assess therapeutic relief.

Generic Name: collagenose top oint Trade Name: Santyl Classification: enzumatic debriding agent Action: debrides dead skin Adult Dosage: small amount applied daily Reason Receiving: treatment of pressure ulcer Newborn Dosage: Pregnancy Category: Nursing Implications R/T Side Effects Administration & Side Effects Evaluation
Adverse reactions, burning sensation, erythema, Contradictions- patients who have shown local or systemic hypersentivity to collogenose. Avoid products with silver or mercury. No complains of pain or erythema observed

Generic Name: conjugated estrogen Classification: estrogen; hormone Adult Dosage: 0.3-0.625 mg/day Newborn Dosage: not indicated Side Effects Vaginal bleeding; breast pain/tenderness, gynecomastia Headache, hypertension, intolerance to contact lenses

Trade Name: Premarin

Action: increases synthesis of DNA, RNA, various proteins in target tissues; reduces release of gonadotropin-releasing hormone (FSH) and LH release; promotes normal growth, development of female sex organs, prevents bone loss

Reason Receiving: Pregnancy Category: X Nursing Implications R/T Adm. & S. E Assess BP periodically Check for edema, weigh daily Report S/S of thromboembolic disorders (sudden severe headache, SOB, vision/speech disturbance, weakness/numbness of extremity, loss of coordination, pain in chest, groin or leg)

Evaluation

Generic Name: Cyclobenzaprine Classification: skeletal muscle relaxant

Trade Name: Flexeril Action: reduces tonic somatic muscle activity at the brainstem. Adult Dosage: Initially 5 mg 3 times per day Reason Receiving: muscle spasms- fibromyalgia Newborn Dosage: na Pregnancy Category: na Nursing Implications R/T Side Effects Administration & Side Effects Evaluation Somnolence, dry mouth, dizziness Record onset, type, location, duration of muscular spasm. Check for immobility, stiffness, swelling. Assess for therapeutic response. Generic Name: cyclophosphamide
Classification: alkylating agent; antineoplastic

Trade Name: Cytoxan

Action: inhibits DNA, RNA protein synthesis; prevent cell growth, potent immunosuppressant

Adult Dosage: 400-1800 mg IV Newborn Dosage: 2-3 mg/kg/day po Side Effects Marked leucopenia 8-15 days after initial therapy Nausea, vomiting, alopecia Diarrhea, darkening of skin/fingernails, stomatitis, headache, diaphoreis

Reason Receiving: diffuse large B-cell lymphoma Pregnancy Category: D Nursing Implications R/T Adm. & S. E Evaluation Monitor cbc, serum uric acid, electrolytes Monitor WBC Monitor for hematologic toxicity (fever, sore throat, signs of local infection, unusual bruising/bleeding)

Generic Name: dantrolene sodium

Trade Name: Dantrium

Classification: skeletal muscle relaxant Action: interferes with release of calcium ion Adult Dosage: up to 100mg 2-4 times per day Reason Receiving: relief of spasticity due to spinal injuries Newborn Dosage: na Pregnancy Category: C Nursing Implications R/T Side Effects Administration & Side Effects Evaluation
Drowsiness, dizziness, weakness genera l malaise, diarrhea. HA, confusion constipation, Urinary frequency Baseline Hepatic function test ( AST,ALT alkaline phosphatase, total bilirubin) Record onset, type location, duration of muscular spasms. Assess for therapeutic response, relief of pain. No hepatic test data available Propphylactic use due to spinal injury LBM-9/29/2010 No confusion , dizziness, weakness, reported Urostomy

Generic Name: Dexamethasone Classification:Long-acting glucocorticoid/Corticosteroid

Trade Name: Decadron Action: inhibits accumulation of inflammatory cells at

inflammation site and release of mediators of inflammation

Adult Dosage: 8-20mg once, then 4mg Q4-6 Reason Receiving: Antiemetic st Newborn Dosage: N/A Pregnancy Category:C(D if used in 1 trimester) Nursing Implications R/T Side Effects Administration & Side Effects Evaluation Insomnia, facial edema Question for hypersensitivity to any (moonface), moderate abdominal corticosteroids. Height, weight, BP, distension, indigestion, increased serum glucose, electrolytes. appetite, nervousness. Assess for edema. Bowel activity Generic Name: Digoxin Classification: Cardiac Glycosides/Antiarrhythmic Adult Dosage: 0.5-0.75mg additional doses of 0.125-0.375mg
at 6-8 hr intevals

Trade Name: Lanoxin Action: Increase influx of calcium from extracellular to intracellular
cytoplasm

Reason Receiving: Treatment of CHF Pregnancy Category: C NI R/T Adm, SE, Interactions Assess AP for 60secs. Monitor pulse for bradycardia. Assess for GI disturbances, neurologic abnormalities. Monitor K, Mg. Evaluation

Geriatric Dosage: Same as above Side Effects Drug/Food Interactions Drug:Amidarone, betaNone Known blockers, Ca channel blockers, K-depleting diuretics, symoathomimetics. Food: Fiber(bran), Pectin. Generic Name: diltiazem Classification: Ca channel blocker, antihypertensive Adult Dosage: 60-120 twice a day Geriatric Dosage: 60-120 twice a day Side Effects Drug/Food Interactions Peripheral edema, Beta blockers, dizziness, lightcarbamazepine, headedness, H/A, theophylline, digoxin bradycardia, asthenia, effects nausea, constipation, flushing

Trade Name: Cardizem Action: Inhibits Ca movement across cardiac, vascular smooth-muscle cell membranes. Causing dilation Reason Receiving: Hypertension Pregnancy Category: C NI R/T Adm, SE, Interactions Evaluation Assess B/P and Pulse Assess renal and hepatic function. Assist with ambulation. Dont abruptly d/c medication May be crushed

Generic Name: Diphenhydramine HCL Classification: Ethanolamine/Antihistamine/Anticholinergic Adult Dosage:25-50 mg Q4H Newborn Dosage: N/A Side Effects Drowsiness, dizziness, muscle weakness, hypotension, urinary retention, thickening of bronchial secretions, dry mouth

Trade Name: Benadryl Action: Competitively blocks effects of histamine at peripheral H1 receptor sites Reason Receiving: pre med for blood Pregnancy Category: B Nursing Implications R/T Administration & Side Effects Evaluation Monitor BP R- rate, depth, rhythm. Assess lung sounds for rhonchi, wheezing, rales.

Generic Name: diphenoxylate HCL Classification: antidiarrheal Adult Dosage: 5-15 mg/day Newborn Dosage: Not recommended Side Effects Drowsiness, light-headedness, dizziness, nausea, headache, dry mouth

Trade Name: Lomotil Action: reduces intestinal motility of gastric mucosa Reason Receiving: Pregnancy Category: C Nursing Implications R/T Administration & Side Effects Evaluation Encourage adequate fluid intake; and, assess hydration status (skin turgor, mucous membranes for dryness and output) Assess bowel sounds Monitor bowel activity and stool Assess for abdominal distention

Generic Name: Docosahexanoic Acid Classification: Dietary supplement Adult Dosage: 1000mg capsule Geriatric Dosage: Same as above Side Effects Drug/Food Interactions Drug: None Known GI upset, diarrhea, Food: None Known increased burping, acid reflux/heartburn/indigestion, abdominal bloating, abdominal pain, fishy aftertaste. Generic Name: Docusate Na Classification: Bulk-producing laxative/Stool softener Adult Dosage: 50-500mg/day in 1-4 divided doses Geriatric Dosage: Same as above Side Effects Drug/Food Interactions Mild GI cramping Drug: None significant Food: None Known

Trade Name: Fish Oil Action: Unknown Reason Receiving: CAD/HTN Pregnancy Category: Unknown NI R/T Adm, SE, Interactions Take with meals to avoid GI upset.

Evaluation

Trade Name: Colace Action: Decreases surface film tension by mixing liquid with bowel contents Reason Receiving: Stool Softner Pregnancy Category: C NI R/T Adm, SE, Interactions Evaluation
Encourage adequate fluid intake. Assess bowel sounds. Monitor bowel activity. Record time of evacuation

Generic Name: Doripenem Classification: Carbapenem/antibiotic Adult Dosage: 500mg q8h for 10-14 days

Trade Name: Doribax Action: inactivates penicillin-binding proteins, resulting in inhibition of cell
wall synthesis

Reason Receiving: Treatment of complicated UTIs due to susceptible

gram(+), gram(-) and anaerobic bacteria

Geriatric Dosage: Same as above Side Effects Drug/Food Interactions Drug: Probenecid Diarrhea, nausea, HA, Food: None Known altered mental status

Pregnancy Category: B NI R/T Adm, SE, Interactions Hx of allergies. Monitor bowel pattern/activity. Monitor for nausea/vomiting

Evaluation

Generic Name: Doxepin HCL Classification: Tricyclic/Antidepressant Adult Dosage: 25-150mg/day at bedtime Geriatric Dosage: 10-25mg/day at bedtime Side Effects Drug/Food Interactions Drug: Alcohol, other CNS Orthostatic hypotension, depressants may increase CNS, somnolence, dry mouth, respiratory depression, HA, increased appetite, hypotensive effects. Antithyroid weight gain, nausea, agents may increase risk of unusual fatigue, agranulocytosis. Cimetidine may increase concentration risk of unpleasant taste
toxicity. May decrease effects of clonidine. MAOIs may increase risk of seizures, hyperpyrexia, hypertensive crisis. Phenothiazines may increase anticholinergic, sedative effects. Sympathomimetics may increase cardiac effects. Food: grapefruit, grapefruit juice may increase concentration/toxicity

Trade Name: Sinequan Action: Increases synaptic concentrations of norepinephine, serotonin. Reason Receiving: Treatment of depression Pregnancy Category: C(B for topical form) NI R/T Adm, SE, Interactions Evaluation Monitor B/P, pulse, weight. Supervise suicidal-risk pt closely during early therapy.Therapeutic level: 110250 ng/ml

Generic Name: DOXOrubicin

Classification: anthracycline antibiotic; antineoplastic

Trade Name: adriamycin

Action: inhibits DNA, DNA-dependent RNA synthesis by binding the DNA strands; prevents cell division

Adult Dosage: 30 mg/m

Newborn Dosage: safety not established

Side Effects Complete alopecia, nausea, vomiting, stomatitis, esophagitis Reddish urine Anorexia, diarrhea

Reason Receiving: Pregnancy Category: D Nursing Implications R/T Adm. & S. E Monitor for stomatitis; assess mucous membranes Monitor daily bowel pattern and stool consistency. Monitor for hematologic toxicity (fever, sore throat, signs of local infection, unusual bruising/bleeding) Monitor for symptoms of anemia

Evaluation

Generic Name: Enoxaparin Na Classification: Low Molecular Weight Heparin Adult Dosage: 1mg/kg q.12hr Geriatric Dosage: Same as Above Side Effects Drug/Food Interactions Drug: antiplatelet agents, Injection site hematoma, Nausea, peripheral aspirin, NSAIDs, edema thrombolytics may increase risk of bleeding. Food: None known

Trade Name: Lovenox Action: Potentiates action of antithrombin III, inactivates coagulation factor
Xa

Reason Receiving: Prevent DVT Pregnancy Category: B NI R/T Adm, SE, Interactions Monitor CBC, platelet count. Assess any sign of unusual bleeding(bruising, bleeding from gums, blood in stool).

Evaluation

Generic Name: erythromycin ophthalmic ointment Classification: Macrolide; antibiotic Adult Dosage: thin layer to affected area bid Newborn Dosage: 0.5-2 cm no later than 1 hour after deliver Side Effects Sensitivity reaction with increased irritation, burning, itching, inflammation Urticaria

Trade Name: Action: penetrates bacterial cell membranes, reversibly binds to bacterial ribosomes inhibiting protein synthesis Reason Receiving: prevention of gonococcal ophthalmia neonatorum, superficial ocular infections Pregnancy Category: B Nursing Implications R/T Adm. & S.E. Place gloved finger on lower eyelid and pull out; place to inch of ointment in; close eye gently for 1-2 minutes Monitor daily pattern of bowel activity Assess skin for rash Assess for hepatotoxicity (malaise, fever, abdominal pain, GI disturbances) Be alert for superinfection (fever, vomiting, diarrhea, oral mucosal changes) Monitor for high-dose hearing loss Evaluation

Generic Name: Escitalopram Oxalate Classification: Serotonin reuptake inhibitor/antidepressant Adult Dosage: Initially 10mg/day, increase to 20mg after a min
of 1 wk.

Trade Name: Lexapro Action: Blocks uptake of neurotransmitter serotonin at neuronal

prsynaptic membranes, increasing its availability at postsynaptic receptor sites

Reason Receiving: depression

Newborn Dosage: N/A Side Effects Nausea, dry mouth, somnolence, insomnia, diaphoresis

Pregnancy Category: C Nursing Implications R/T Administration & Side Effects Assess appearance, behavior, speech pattern, level of interest, mood.

Evaluation

Generic Name: etoposide

Classification: epipodophyllotoxin; antineoplastic

Trade Name: Etopophos

Action: induces single- and double-stranded breask in DNA; inhibits, alters DNA synthesis

Adult Dosage: 100 mg

Newborn Dosage: safety not established

Side Effects Mild to moderate nausea/vomiting, alopecia, diarrhea, anorexia, stomatitis

Reason Receiving: Pregnancy Category: D Nursing Implications R/T Adm. & S. E Monitor Hgb, Hct, WBC, PLT Monitor bowel pattern and stool consistency Monitor for hematologic toxicity (fever, sore throat, signs of local infection,

Evaluation

unusual bruising/bleeding) Monitor for symptoms of anemia Assess for paresthesias (peripheral neuropathy)

Generic Name: FeFum/Vit C/B12/stomc Classification: multivitamin with iron Adult Dosage: 1 tablet per day Geriatric Dosage: same Side Effects Drug/Food Interactions Constipation Antacids Diarrhea Cefdinir Stomach upset Cefditoren Etidronate Fluoroquinolones Levodopa Tetracyclines Thyroid hormones Warfarin Dairy products, tea or coffee within 2 hours

Trade Name: Chromagen Action: replace iron and vitamins Reason Receiving: Pregnancy Category: NI R/T Adm, SE, Interactions Take with glass of water May take with food, but best on empty stomach Do not lie down for 30 minutes after taking

Evaluation

Generic Name: fentanyl Classification: narcotic agonist(schedule II) Adult Dosage:50-100mcg/dose q1-2h Newborn Dosage: Side Effects
Post-op confusion, blurred vision, chills, orthostatic hypotension, nausea, vomiting, diaphoreses, Dyspnea, confusion, constipation

Trade Name: (sublimaze) Action: binds to opioid receptors in CNS reducing stimuli from
sensory nerve endings, inhibits ascending pain pathways; alters pain reception

Reason Receiving: abdominal pain Pregnancy Category: C Nursing Implications R/T Administration & Side Effects Evaluation
Have nalozone available. Establish baseline, BP, R. Assess type, location, intensity, duration of pain. Not given in last 24 hours.

Generic Name: Fentanyl Patch Classification: Opioid, narcotic agonist (sch. II) Adult Dosage: 12mcg/hr-100mcg/hr Newborn Dosage: Side Effects Headache, pruritus, NV, diaphoresis, Dyspnea, confusion, dizziness, diarrhea, constipation, difficulty urinating.

Trade Name: Action: Binds to opioid receptors in CNS Reason Receiving: analgesic for pain Pregnancy Category: C Nursing Implications R/T Administration & Side Effects Evaluation Assist with ambulation. Opiate Patch assessedantagonist(narcan) must be available. BP Assess BP, HR, Respirations, O2 HR stats. type, location, intensity, duration O2 of pain. Encourage to deep breathe and turn q2h.

Generic Name: Na Ferric Gluconate Classification: Trace element/Hematinic Adult Dosage: 125mg in 100mL 0.9% NaCl infused over 1 hr Geriatric Dosage: Same as above Side Effects Drug/Food Interactions Drug: Oral Iron Flushing, hypotension, Food: None Known hypersensitivity reaction

Trade Name: Ferrex Action: Repletes total iron content in body. Replaces iron found in Hgb,
myoglobin. Specific enzymes; allows oxygen transport via Hgb.

Reason Receiving: Treatment of iron deficiency anemia Pregnancy Category: B NI R/T Adm, SE, Interactions Evaluation Monitor vital signs, labs (i.e. CBC, serum iron). Do not give with oral iron. Assess pt for RA, may exacerbate joint pain, swelling.

Generic Name:Fexofenadine HCL Classification: Antihistamine Adult Dosage: 60 mg twice a day Newborn Dosage: Side Effects Rare: drowsiness, HA, fatigue, nausea, abdominal distress.

Trade Name: Allegra Action: prevents allergic rhinitis symptoms or pruritus Reason Receiving: allergies Pregnancy Category: C Nursing Implications R/T Administration & Side Effects Evaluation Assess for therapeutic response. Pt reported a decrease in allergic rhinitis symptoms. No c/o of fatigue Nausea, GI distress

Generic Name:Filgrastin Classification: Granulocyte Colony Stimulanting factor Adult Dosage: 5mcg/kg/day Newborn Dosage: N/A Side Effects Nausea/Vomiting, Mild to severe bone pain, Diarrhea, Fever, fatigue

Trade Name: Neupogen Action: Stimulates production, maturation, activation of

neutrophils

Reason Receiving: Prevent infection Pregnancy Category: C Nursing Implications R/T Administration & Side Effects Evaluation Be alert to ARDS. Monitor b/p, temp, CBC, plts count, Hct, uric acid

Generic Name: Finasteride Classification: Androgen hormone inhibitor/Benign prostatic hyperplasia agent Adult Dosage: 5mg once a day Geriatric Dosage: Same as Above Side Effects Drug/Food Interactions Drug: None Significant Gynecomastia, sexual Food: None Known dysfunction(impotence, decreased libido, decreased vol of ejaculate).

Trade Name: Proscar Action: Inhibits 5-alpha reductase, an intracellular enzyme that converts
testosterone into dihydrotestosterone (DHT) in prostate gland, resu;ting in decreased serum DHT

Reason Receiving: BPH Pregnancy Category: X NI R/T Adm, SE, Interactions Diligent monitoring of I&O, esp in those with lg residual urinary vol, severely diminished urinary flow for obstructive uropathy

Evaluation

Generic Name: Fluconazole Classification: antifungal Adult Dosage: 400mg perday Newborn Dosage: Side Effects
Dizziness, HA, constipation, diarrhea, nausea, vomiting, abdominal pain

Trade Name: Diflucan Action: directly damages fungal membrane Reason Receiving: prevention of candidiasis Pregnancy Category: C Nursing Implications R/T Administration & Side Effects Evaluation Establish baselines for CBC serum K-3.9(normal 3.5-5) potassium No Pt complaints of dizziness, HA, Hepatic function studies Constipation, diarrhea, NV, abdominal pain

Generic Name: fluoxetine Classification: psychotherapeutic

Adult Dosage: 20 mg
Newborn Dosage: safety not established

Side Effects Headache, asthenia, insomnia, anxiety, drowsiness, nausea, diarrhea, decreased appetite Dizziness, tremors, fatigue, vomiting, constipation, dry mouth, abdominal pain, diaphoresis, rash

Trade Name: Prozac Action: selectively inhibits serotonin uptake in CNS, enhancing serotonergic function; relieves depression, obsessivecompulsive and bulimic Reason Receiving: Pregnancy Category: C Nursing Implications R/T Adm. & S. E Evaluation Assess appearance, behavior, speech pattern, level of interest, mood Monitor daily bowel pattern and stool consistency Assess skin for rash Monitor glucose, sodium and weight

Generic Name: Fluticasone Classification: Corticosteroid/Anti-inflammatory Adult Dosage: 100mcg q.12h Geriatric Dosage: Same as above Side Effects Drug/Food Interactions Drug: Ritonavir Throat irritation, Food: None Known hoarseness, dry mouth, cough, temporary wheezing, oropharyngeal candiasis (particularly if mouth is not rinsed with water after each admin.) Generic Name: Folic Acid Classification: Coenzyme/Nutritional Supplement Adult Dosage: 0.4mg/day Newborn Dosage: 0.1mg/day

Trade Name: Advair Action: Controls rate of protein synthesis, depresses migration of
polymorphonuclear leukocytes, reverses capillary permeability, stabilizes lysosomal membranes.

Reason Receiving: COPD Pregnancy Category: C NI R/T Adm, SE, Interactions Monitor rate, depth, rhythm, type of respiration. Assess lung sounds. Assess oral mucous membranes. Monitor pulse.

Evaluation

Side Effects None Known

Trade Name: Folvite Action: Stimulates production of platelets, RBCs, WBCs Reason Receiving: Anemia Pregnancy Category: Category:A(C if more than RDA) Nursing Implications R/T Administration & Side Effects Evaluation Assess for therapeutic relief from iron deficiency symptoms(fatigue,

SHOB, sore tongue, HA, pallor)

Generic Name: Furosemide Classification: Loop Diuretic Adult Dosage: 20-80mg/dose; may increase by 2040 mg/dose q.6-8h Geriatric Dosage: Same as above Side Effects Drug/Food Interactions Increase UOP, frequency, Drug: Amphotericin B, Nausea, dyspepsia, nephrotoxic, ototoxic abdominal cramps, meds, anticoagulants, diarrhea or constipation, heparin, lithium, other electrolyte imbalance med causing hypokalemia Food: None Known Generic Name: Gabapentin Classification: Anticonvulsant/Antineuralgic Adult Dosage: 200mg Geriatric Dosage: N/A Side Effects Fatigue, drowsiness, dizziness, ataxia

Trade Name: Lasix Action: Excretion of Na, Cl, K by direct action at the ascending loop of
henle

Reason Receiving: HTN Pregnancy Category: C NI R/T Adm, SE, Interactions Monitor B/P, vital signs, electrolytes, I&O, weight. Assess muscle strength, tremor, muscle cramps, altered mental status.

Evaluation

Trade Name: Neurontin Action: May increase synthesis or accumulation of gamma-aminobuytric

acid(GABA) by binding to as-yet-undefined receptor sites in brain tissue

Drug/Food Interactions Drug:Antiacids decrease

absorption. Morphine may increase CNS depression. Food: None known

Reason Receiving: Neuropathy pain Pregnancy Category: C NI R/T Adm, SE, Interactions Monitor for seizure activity. Do not abruptly stop taking

Evaluation

Generic Name: glipizide Classification: 2nd generation. Hypoglycemic Adult Dosage: 5mg daily Geriatric Dosage: 2.5 mg daily Side Effects Drug/Food Interactions Altered taste, dizziness, Beta blockers, MAOIS, somnolence, weight gain, ciprofloxacin, ranitidine, constipation, diarrhea, LG doses of salicylates heartburn, nausea, effects. vomiting, H/A Corticosteroids, lithium, thiazide diuretics effects. effects of oral anticoagulants

Trade Name: Glucotrol Action: Promotes release of insulin from beta cells of pancreases, insulin sensitivity at peripheral sites Reason Receiving: DM Type II Pregnancy Category: C NI R/T Adm, SE, Interactions Evaluation Check serum glucose level. Assess for hypoglycemia and hyperglycemia.

Generic Name: glyburide Classification: second generation sulfonylurea Adult Dosage: 2.5-5 mg; max 20 mg/day Geriatric Dosage: 1.25-2.5 mg/day Side Effects Drug/Food Interactions Altered taste, dizziness, Beta blockers, cimetidine,

Trade Name: Diabeta Action: hypoglycemic Reason Receiving: diabetes mellitus type 2 Pregnancy Category: C NI R/T Adm, SE, Interactions Evaluation Check serum glucose

somnolence, wt gain, constipation, diarrhea, heartburn, N&V, headache Photosensitivity, skin rash

ciprofloxacin, fluconazole, MAOIs, ranitidine, salicylates, corticosteroids, lithium thiazide diuretics; Garlic

Assess learning needs Assess for hypoglycemia

Generic Name: guar gum Classification: soluble fiber Adult Dosage: 2 tsp 3x qd
Newborn Dosage: ask MD before use

Trade Name: Benefiber

Action: dissolves in water for form gel-like material that passes through stomach, small intestine, colon and out of body; helps to lower blood cholesterol and glucose levels

Side Effects Generally well tolerated Bloating, diarrhea, gas and general discomfort

Reason Receiving: Pregnancy Category: Nursing Implications R/T Adm. & S. E Assess bowel pattern and stool consistency Assess abdomen for bloating

Evaluation

Generic Name: heparin Classification: blood modifier; anticoagulant Adult Dosage: 5000 units Geriatric Dosage: Side Effects Drug/Food Interactions Pruritus, burning (soles of Antithyroid; valproic acid; feet) other anticoagulants, cats claw, evening primrose, ginkgo,

Trade Name: Hep-Lock Action: Interfers with blood coagulation by blocking conversion of PT
to thrombin and fibrinogen to fibrin

Reason Receiving: Pregnancy Category: C NI R/T Adm, SE, Interactions Monitor PTT (1.5-2.5) Assess hct, plt count, ast, alt Assess for decrease in BP, increased pulse, complaint of back pain, severe headache Assess peripheral pulses Assess skin for ecchymosis, petechiae Check for excessive bleeding

Evaluation

Generic Name: Hydralazine Classification: Vasodilator/Antihypertensive Adult Dosage: 10mg 4X/day Geriatric Dosage: 10mg 2-3X/day Side Effects Drug/Food Interactions Drug: Diurectics, other HA, palpitations, tachycardia hypertensives. Food: None Known

Trade Name: Apresoline Action: Direct vasodilating effects on arterioles. Reason Receiving: HTN Pregnancy Category: C NI R/T Adm, SE, Interactions Evaluation Monitor B/P, pulse before admin. Assess for HA, palpitations, tachycardia, peripheral edema.

Generic Name: Hydrocortisone Sod Classification: adrenal corticosteroid Adult Dosage: 14-240 mg Q12H

Trade Name: Action: inhibits inflammatory cells at inflammation sites. Reason Receiving: anti-inflammatory

Newborn Dosage: na Side Effects Insomnia, Heartburn, anxiety, abdominal distention, increased appetite, increased susceptibility to infection, diarrhea or constipation. HA, edema, frequent urination.

Pregnancy Category: na Nursing Implications R/T Administration & Side Effects Baseline weight, BP, serum glucose, cholesterol electrolytes. Assess for edema. Be alert to infection. Monitor daily bowel pattern. Electrolytes. Watch for hypercalcemia (muscle twitching, cramps) Hypokalemia (weakness, paresthesias)

Evaluation

Generic Name: Hydrocortisone topical Classification: Glucocortosteroid Adult Dosage: apply sparingly Newborn Dosage: Side Effects
Pruritus, redness irritation.

Trade Name: Action: prevents tissue response to inflammatory process Reason Receiving: rash Pregnancy Category:C Nursing Implications R/T Administration & Side Effects Evaluation
Pt. stated some relief. Patient applied AM 9/23/10

Monitor for therapeutic relief.

Generic Name: hydrocodone

Classification: opiod analgesic (sch. III); narcotic analsegic

Trade Name: Vicodin

Action: binds with opioid receptors within CNS; alters pain

Adult Dosage: 5-15 mg q4-6h prn Geriatric Dosage: same Side Effects Drug/Food Interactions Sedation, dizziness, CNS depressants diaphoresis, facial MAOIs flushing, somnolence Alcohol urinary retention, blurred Kava kava, St. Johns vision, constipation, dry Wort, valerian mouth, headache, N & V, painful/difficult urination

Reason Receiving: post-op pain Pregnancy Category: C NI R/T Adm, SE, Interactions Assess pain (level, location, duration, description) Assess for therapeutic response Obtain VS before giving Assess for urinary retention Monitor bowel activity and stool consistency Initiate deep breathing/cough

Evaluation

Generic Name: Hydroxyzine Classification: Antihistamine/antipruritis Adult Dosage: 25mg 3-4X/day Geriatric Dosage: Same as above Side Effects Drug/Food Interactions Drug:Alcohol, other CNS Drowsiness, dry mouth, marked discomfort with depressants, MAOIs Food: None Known IM injection

Trade Name: Atarax Action: Competes with histamine for receptor sites in GI tract, blood
vessels, respiratory tract. Diminishes vestibular stimulation, depresses labyrinthine function.

Reason Receiving: Itching Pregnancy Category: C NI R/T Adm, SE, Interactions Monitor electrolytes, Assess motor responses, hepatic/renal function tests, lung sounds

Evaluation

Generic Name: ibuprofen Classification: nonsteroidal anti-

Trade Name: Motrin Action: produces analgesic, anti-inflammation effects,

inflammatory Adult Dosage: 200-400 q4-6h prn Newborn Dosage: safety and efficacy not established in those younger than 6 months Side Effects Nausea with or without vomiting Dyspepsia Dizziness Rash

decreases fever Reason Receiving: inflammation of the labia Pregnancy Category: B (D if in third trimester or near delivery)

Nursing Implications R/T Adm. & S. E Assess onset, type, location, duration of pain, inflammation Inspect appearance of affected joints for immobility, deformities, skin condition Assess temp Monitor for evidence of nauase, dyspepsia Monitor CBC, hepatic/renal function tests Monitor daily pattern of bowel activity Assess for skin rash Assess for therapeutic response Monitor temp for fever

Evaluation

Generic Name: Ipratropium Classification: Anticholinergic/Bronchodilator Adult Dosage: 500 mcg 3-4 times/day Geriatric Dosage: Same as above Side Effects Drug/Food Interactions Drug: Anticholinergics, Cough, dry mouth, HA, nausea meds with anticholinergic properties. Food: None Known

Trade Name: Atrovent Action: Blocks action of acetylcholine at parasympathic sites in bronchial
smooth muscle.

Reason Receiving: Treatment of bronchospasm Pregnancy Category: B NI R/T Adm, SE, Interactions Evaluation Monitor rate, depth, rhythm, type of respirations and pulse. Assess lung sounds. Increase fluids. Rinse mouth with water after inhalation.

Generic Name: Hydromorphone Classification: opioid agonist(sch II) Adult Dosage:10mg/ml Newborn Dosage: Side Effects Drowsiness, dizziness, hypotension, decreased appetite,

Trade Name: Dilaudid Action: binds to opioid receptors in CNS Reason Receiving: pain relief Pregnancy Category: C Nursing Implications R/T Administration & Side Effects Evaluation Vital signs bf giving meds. Assess for TPRpain relief, cough. Assess breath BP sounds. Monitor bowel activity. Initiate Lungs deep breathing and cough exercises. LBM Pain decreased Coughing

Generic Name: Isosorbide mononitrate Classification: Antianginal Adult Dosage: 5-20mg BID Geriatric Dosage: Same as above

Trade Name: Imdur Action: stimulates intracellular cyclic guanosine monophosphate Reason Receiving: Relief of esophageal spasm with gastroesophageal reflux Pregnancy Category: C

Side Effects HA, face/neck flushing, weakness, dizziness, orthostatic hypotension, N&V, restlessness, blurred vision, and GI upset

Drug/Food Interactions Drug: ETOH, antihypertensives, vasodilators, Sildenafil, tadalafil, vardenafil. Food: None Known

NI R/T Adm, SE, Interactions Best if taken on an empty stomach, assess for facial/neck flushing, assess pain

Evaluation

Generic Name: Insulin Aspart/Insulin Glargine Classification: Exogenous insulin Adult Dosage: 0.5- 1 unit/kg/day Geriatric Dosage: Same as above Side Effects Drug/Food Interactions Drug: Beta-blockers, Localized redness, swelling itching. Adverse Glucocorticoids, Thiazide reaction- severe diuretics. Food: None Known hypoglycemia

Trade Name: Novolog/Lantus Action: Facilitates passage of glucose, K, Mg across cellular membranes of
skeletal/cardiac muscle, adipose tissue. Controls storage, metabolism of carbs, protein, fats. Promotesconversion of glucose to glycogen in liver.

Reason Receiving: DM Pregnancy Category: B/C NI R/T Adm, SE, Interactions

Assess for hypoglycemia: cool, wet skin, tremors, dizziness, HA, anxiety, tachycardia, numbness in the mouth, hunger, diplopia. Assess for hyperglycemia: polyuria, polyphagia, polydipsia, N/V, dim vision, fatigue, Kussmaul Resp.

Evaluation

Generic Name: Labetalol HCL Classification: Alpha-, beta-adrenergic blocker/antihypertensive Adult Dosage: Initially, 100mg BID adjust in increments of 100
mg BID q2-3days

Trade Name: Trandate Action: Blocks alpha1-, beta1-, beta2-(large doses) adrenergic
receptor sites. Large doses increase airway resistance.

Reason Receiving: hypertension

Newborn Dosage: N/A Side Effects Drowsiness, difficulty sleeping, excessive fatigue, weakness, diminished sexual function, transient scalp tingling.

Pregnancy Category: C(D if used in 2nd or 3rd trimester) Nursing Implications R/T Administration & Side Effects Evaluation
Assess renal/hepatic function BP, Apical Pulse immediately bf drug administration. If pulse less than 60 or systolic less than 90 hold med. Contact physical

Generic Name: lamotrigone Classification: anticonvulsants Adult Dosage: 200 mg/day

Newborn Dosage: safety not established

Trade Name: Lamictal

Action: may block sodium channels, stabilizing neuronal membranes; produces anticonvulsant activity

Side Effects Dizziness, headache, diplopia, ataxia, nausea, blurred vision, somnolence, rhinitis Rash, pharyngitis, vomiting, cough, flulike symptoms, diarrhea, fever, insomnia

Reason Receiving: Pregnancy Category: C Nursing Implications R/T Adm. & S. E Assess for rash Assist with ambulation if dizzy Assess for clinical improvement. Assess for visual abnormalities, headache

Evaluation

Generic Name: Leucovorin Calcium Classification: folic acid antagonist

Trade Name: Wellcovorin ??? Action: competes with methotrexate for transport into cell

Adult Dosage: 5-15 mg per day Newborn Dosage: na Side Effects When combined with chemotherapeutic agents, diarrhea, stomatitis, NV lethargy Malaise fatigue.

Reason Receiving: folic acid deficiency???non

hodgkins

lymphoma
Pregnancy Category: na Nursing Implications R/T Administration & Side Effects Give as soon as possible, preferably within one hour, for treatment of overdose of folic acid antagonist. Monitor for vomiting. CBC with diff. PLT, Electrolytes, Hepatic function tests. Evaluation

Generic Name:Levetiracetam Classification:Anticonvulsant Adult Dosage:Initially 500mg q.12h Newborn Dosage: N/A Side Effects Drowsiness, asthenia(loss of energy), HA, infection.

Trade Name: Keppra Action:Inhibits burst firing without affecting normal neuronal
excitability

Reason Receiving: Pregnancy Category: C Nursing Implications R/T Administration & Side Effects Hx of seizure disorder. Monitor for hypersensitivity. Monitor renal function tests.

Evaluation

Generic Name: Levothyroxine Classification: Thyroid Hormone Adult Dosage:150 mcg Geriatric Dosage:25 mcg Side Effects Drug/Food Interactions HA, allergic rhinitis, upper Drug: Cholestryramine, respiratory infection, colestipol, estrogens, oral muscle pain, fatigue anticoagulants, sympathomimetics, H2 antagonist, proton pump inhibitors. Food: None Known Generic Name: lidocaine patch Classification: antiarhythmic anesthetic Adult Dosage: one patch Geriatric Dosage: one patch Side Effects Drug/Food Interactions Burning, stinging, Anticonvulsants, beta tenderness at application blockers, other site antiarrhythmics, St. Johns wart

Trade Name: Synthroid Action: Involved in normal metabolism, growth, development, esp. of CNS in infants. Possesses catabolic, anabolic effects. Reason Receiving:Hypothyroidism Pregnancy Category: C NI R/T Adm, SE, Interactions Evaluation Obtain weight, Monitor pulse, observe for anxiety and tremors, assess appetite and sleep pattern

Trade Name: Lidoderm Action: inhibits conduction of nerve impulses Reason Receiving: Pregnancy Category: B NI R/T Adm, SE, Interactions Evaluation Monitor VS following administration Assess BP for hypotension Assess for drowsiness (sign of high serum levels)

Generic Name: linezolid Classification: antibiotic Adult Dosage: 400 mg q12h Newborn Dosage: 10 mg/kg/dose q8-12h Side Effects Diarrhea, nausea, headache

Trade Name: Zyvox Action: protects against bacteria (enterococci, staphylococci, streptococci) Reason Receiving: Pregnancy Category: C Nursing Implications R/T Administration & Side Effects Evaluation Monitor daily bowel pattern/stool consistency; mild GI effects may be okay but more severe be alert to colitis Be alert for superinfection Monitor CBC weekly

Generic Name: Lisinopril Classification: ACE inhibitor Adult Dosage: 10-40 mg/day Geriatric Dosage: 10-40 mg/day Side Effects Drug/Food Interactions Headache, dizziness, Alcohol, diuretics, postural hypotension hypotensive agents (may Chest discomfort, fatigue, increase effect). rash, abdominal pain, Lithium, NSAIDs, Knausea, diarrhea, URI sparring diuretics. Ephedra, ginseng, yohimbe

Trade Name: Zestril Action: suppresses RAA system to help lower BP Reason Receiving: Pregnancy Category: C NI R/T Adm, SE, Interactions Evaluation Obtain BP & apical pulse prior Monitor BP regularly Watch for orthostatic HTN Monitor CBC, renal, potassium Assess for edema. Auscultate lungs for rales Monitor I&O; weigh daily Monitor bowel pattern Assist with ambulation if dizzy

Generic Name: lithium carbonate Classification: psychotherapeutic; antimanic Adult Dosage: 300 mg 3-4 times q.d. Geriatric Dosage: 900-1200 mg/day Side Effects Drug/Food Interactions Dose related and seldom Haloperidol, antithyroid occur at lithium serum meds, diuretics, NSAIDs, levels less than 1.5 molindone, mEq/L phenothiazines Occasionally, fine hand tremor, polydipsia, polyuria, mild nausea

Trade Name: Lithobid

Action: affects storage, release, reuptake of neurotransmitters; increased reuptake of norepi causing antimanic effect

Reason Receiving: manic phase of bipolar disorder Pregnancy Category: D NI R/T Adm, SE, Interactions Evaluation Monitor serum lithium levels Clinical assessment of therapeutic effect; assess behavior, appearance, emotional status, response to environment, speech pattern, thought content. Monitor for signs of lithium toxicity

Generic Name: loperamide Classification: antidiarrheal Adult Dosage: 2 mg after loose stool

Trade Name: Imodium Action: slows intestinal motility, diminishing loss of fluid/electrolytes Reason Receiving: cancer treatment-induced diarrhea

Newborn Dosage: not recommended Side Effects Rare: Dry mouth, drowsiness, abdo discomfort, allergic reaction

Pregnancy Category: C Nursing Implications R/T Administration & Side Effects Encourage adequate fluid intake Assess bowel sounds Monitor daily bowel activity/stool Withhold if abdo pain, distention, fever

Evaluation

Generic Name: Lorazepam Classification: Benzodiazepine (Sche IV)/Antianxiety

Adult Dosage: 1-10mg/day in 2-3 divided doses Geriatric Dosage: 0.5-1.0mg/day Side Effects Drug/Food Interactions Drug: Clarithromycin, HA, fatigue, drowsiness erythromycin, fluconazole, ketoconazole may increase concentration. Food: All foods delay absorption.

Trade Name: Ativan Action: Enhances action of inhibitory neurotransmitter gamma-aminobutyric acid (GABA) in CNS, affecting memory, motor, sensory, cognitive functioning Reason Receiving: Treatment of anxiety related to depressive episode Pregnancy Category: B NI R/T Adm, SE, Interactions Evaluation Monitor BP, HR, RR, CBC with diff, Hepatic function est. Evaluate for therapeutic response

Generic Name: magnesium hydroxide Classification: antacid, anticonvulsant, electrolyte, laxative Adult Dosage: 2-4 tabs or 5-15 mL prn 4 times a day Geriatric Dosage: same Side Effects Drug/Food Interactions Cramping Antacids Diarrhea Fluoroquinolones Increased thirst Ketoconazole Flatulence Tetracyclines Calcium CNS depressant meds Digoxin

Trade Name: Milk of Magnesia

Action: acts in stomach to neutralize gastric acid; osmotic effect primarily in small intestine, draws water into intestinal lumen

Reason Receiving: Pregnancy Category: B NI R/T Adm, SE, Interactions Drink full glass of water with dose Monitor daily bowel activity and stool consistency BS for peristalsis Assess for wt loss, nausea, vomiting

Evaluation

Generic Name: Magnesium Oxide Classification: Antacid/Anticonvulsant/Electrolyte/Laxative Adult Dosage: 1-2 tablets 2-3x/day Geriatric Dosage: Side Effects Drug/Food Interactions Drug: Antacids, Chalky taste, diarrhea, fluoroquinolones, ketoconazole, laxative effect, N/V, methenamine, stomach cramps, reduced tetracyclines, laxatives, digoxin, oral resp rate, decreased anticoagulants, phenothiazines, reflexes, flushing, ciprofloxacin, Na polystyrene

Trade Name: Mag-ox Action: Essential for enzyme activity, nerve conduction, muscle contraction Reason Receiving: Magnesium replacement Pregnancy Category: B NI R/T Adm, SE, Interactions Evaluation Assess renal function. Monitor Mg. Monitor for hypermagnesemia: dizziness, palpitations, altered mental status, fatigue, weakness.

hypotension, decreased heart rate

sulfonate, Calcium, CNS depressants meds.

Food: None Known Trade Name: Action: found primarily in intracellular fluids Reason Receiving: protocol for magnesium deficiency Pregnancy Category: B Nursing Implications R/T Adm. & S.E. Assess GI pain Monitor daily pattern of bowel activity and bowel sounds Assess renal function, serum magnesium Assess pt for weight loss, nausea, vomiting Monitor renal function Maintain adequate fluid intake Test patellar reflexes Respiratory rate should be over 16 Evaluation

Generic Name: magnesium sulfate

Classification: antacid, anticonvulsant, electrolyte, laxative Adult Dosage: 3 g q6h for 4 doses as needed; IV 4 g then 1-4 g/hr by cont. infusion

Newborn Dosage: not used (12yrs+) Side Effects Chalky taste Diarrhea Laxative effect Nausea and vomiting Stomach cramps Reduces respiratory rate Decreases reflexes Flushing Hypotension Decreased heart rate

medroxyprogesterone Classification: hormone

Generic Name:

Adult Dosage: 5-10 mg for 12-14 consecutive days Newborn Dosage: safety and efficacy not established Side Effects Transient menstrual abnormalities (spotting, amenorrhea) Edema Weight change Breast tenderness Anxiety Insomnia Fatigue Dizziness Depression

Trade Name: Depo-Provera Action: inhibits secretion of pituitary gonadotropins; prevents ovulation Reason Receiving: birth control Pregnancy Category: X Nursing Implications R/T Adm. & S. E Caution in nursing mothers; distributed in breast milk P.O. give without regard to meals Check weight and report gain of 5 pounds or more Assess for skin rash, urticaria Report development of chest pain, sudden SOB, decrease in vision, migraines, pain in calves, numbness of arm/leg Evaluation

Generic Name: megestrol acetate

Classification: antineoplastic/hormone

Trade Name: Megace

Action: suppresses release of LH from ant. pituitary by inhibiting pituitary function thus reducing tumor size; also increases appetite

Adult Dosage: 800 mg

Newborn Dosage: safety not established

Side Effects Weight gain secondary to increased appetite Nausea, break through bleeding, backache, headache, breast tenderness, carpal tunnel syndrome

Reason Receiving: Pregnancy Category: X Nursing Implications R/T Adm. & S. E Question possible pregnancy Provide support as med is palliative not curative Monitor for tumor response

Evaluation

Generic Name: methylergonovine maleate Classification: ergot alkaloid; uterine stimulant

Trade Name: Methergine Action: stimulates alpha-adrenergic, serotonin receptors, producing arterial vasoconstriction; acts on the smooth muscle of uterus and increases tone, rate and amplitude of rhythmic contractions; shortens third stage of labor and reduces blood loss Reason Receiving: prevention/control of postpartum hemorrhage Pregnancy Category: C Nursing Implications R/T Adm. & S. E Should not be administered IV Caution if nursing mother Assess bleeding before administration Monitor uterine tone, bleeding, BP, pulse q15 minutes until stable Assess extremities for color, warmth, movement, pain Report chest pain promptly Provide support with ambulation if dizziness occurs Evaluation

Adult Dosage: 0.2 mg 3 or 4 times daily for max of 1 week Newborn Dosage: safety and effectiveness has not been established Side Effects Uterine cramping Nausea and vomiting Diarrhea Diaphoresis Tinnitus Bradycardia Chest pain Dizziness

Generic Name:Methylphenidate HCL Classification:CNS stimulant (Sche II) Adult Dosage: Initially 0.3mg/kg/dose or 2.5-5mg before
breakfast and lunch

Trade Name: Concerta Action: Blocks reuptake of norepinephrine, dopamine into

presynaptic neurons.

Reason Receiving:ADHD

Newborn Dosage: N/A Side Effects Anxiety, insomnia, anorexia

Pregnancy Category: C Nursing Implications R/T Administration & Side Effects Avoid caffeine. Monitor CBC, Platelet count during therapy.

Evaluation

Generic Name: Metoprolol tartate Classification: Beta-adrenergic blocker/Antihypertensive Adult Dosage: : 25 mg per day , max 300 mg perday Geriatric Dosage: Side Effects Drug/Food Interactions Diminished sexual function, Drug:Diuretics, other drowsiness, insomnia, antihypertensives, insulin. unusual fatigue/weakness Oral hypoglycemic, NSAIDs, Sympathomimetics, Xanthines.

Trade Name: Lopressor Action: Selectively blocks beta-adrenergic receptors; high dosages may
block beta-adrenergic receptors. Decrease oxygen requirements. Large doses increase airway resistance.

Reason Receiving: Pregnancy Category: NI R/T Adm, SE, Interactions

Assess renal/hepatic function BP, Apical Pulse immediately bf drug administration. If pulse less than 60 or systolic less than 90 hold med. Contact physical

Evaluation

Food: None Known Generic Name: Metoclopramide Classification: Peristaltic stimulant/Antiemetic Adult Dosage: 10-20mg q.4-6h Geriatric Dosage: Side Effects Drug/Food Interactions Drug: ETOH, other CNS Drowsiness, restlessness, fatigue, depressants. Food: None Known lethargy Trade Name: Reglan Action: Stimulates motility of upper GI tract. Decreases reflux into
esophagus. Raises threshold activity in chemoreceptor trigger zone.

Reason Receiving: Pregnancy Category: NI R/T Adm, SE, Interactions Assess for dehydration. Monitor B/P & HR. Assess for peripheral edema. Assess muscle strength, mental status.

Evaluation

Generic Name: Metronidazole Trade Name: Flagyl Classification: Nitroimidzole derivative Action: Disrups DNA, inhibiting nucleic acid synthesis Adult Dosage: 500-750mg, 3 times a day Reason Receiving: antibacterial Newborn Dosage: Pregnancy Category: C Nursing Implications R/T Side Effects Administration & Side Effects Evaluation Question for history for No history of hypersentivity to Anorexia, nausea, dry mouth, metallic hypersensitivity to nitromidazole nitromidazole derivatives. Patient taste, diarrhea, constipation, reddish derivatives. I&O assess for urinary NPO. Output not being monitored. No brown urine. Erythematous rash, problems. Assess for rash. Watch for rashes or signs of infection. urticaria. signs of supervirus.

Generic Name:Micafungin Na Classification:Antifungal Adult Dosage:100mg/day Newborn Dosage: N/A Side Effects Nausea, HA, diarrhea, vomiting, fever

Trade Name: Mycamine Action:Inhibits synthesis of glucan(vital component of fungal cell

formation), damaging fungal cell membrane.

Reason Receiving: for candidiasis Pregnancy Category: C Nursing Implications R/T Administration & Side Effects Evaluation Hepatic/renal function tests

Generic Name: Minocycline HCL Classification: Tetrcycline- antibiotic Adult Dosage: 100mg Q12H Newborn Dosage: na Side Effects
Dizziness, light headedness, diarrhea, nausea, vomiting, possibly severe photosentivity, vertigo

Trade Name: Minocin Action: inhibits bacterial protein synthesis b binding to ribosomes. Reason Receiving: infection Pregnancy Category: D Nursing Implications R/T Administration & Side Effects Evaluation
No allergies to tetracycline, sulfite. LBM 9/29/2010 No reports of dizziness, lightheadness, No rash

Question for history of allergies, esp. tetracyclines, sulfite. Monitor Bowel activity. Assess skin fo rash. Observe for sign of increased intracranial pressure(altered LOC)

Generic Name: Miracle Mouthwash Classification: Antibiotic/Antifungal Adult Dosage: 5ml 3-4 times/day Geriatric Dosage: Same as above Side Effects Drug/Food Interactions Drug: None Known Problem with taste, Food: None Known burning or tingling sensation in the mouth, drowsiness, constipation, diarrhea, nausea.

Trade Name: Miracle Mouthwash Action: Kills bacteria or prevents fungal growth Reason Receiving: Treatment of mouth sores Pregnancy Category: Unknown NI R/T Adm, SE, Interactions Evaluation Swish for 1-2 mins before spitting out. Pt can not eat or drink for 30mins after admin.

Generic Name: Mirtazapine Classification: Tetracyclic/Antidepressant Adult Dosage: 15mg at bedtime Geriatric Dosage: Same as above Side Effects Drug/Food Interactions Drowsiness, dry mouth, Drug: ETOH, Other CNS increased appetite, depressants, MAIOs. constipation, weight gain. Food: None Known

Trade Name: Remeron Action: Acts as antagonist at presynaptic alpha-adrenergic receptors,

increasing norepinephrine, serotonin neurotransmission. Has low anticholinergic activity.

Reason Receiving: Treatment of depression Pregnancy Category: C NI R/T Adm, SE, Interactions Evaluation
For long term therapy, hepatic/renal function tests, blood counts should be performed periodically

Generic Name: misoprostol Classification: prostaglandin; gastric protection Adult Dosage: 110 mcg and 200 mcg tablets Newborn Dosage: safety no established Side Effects Produces uterine contractions, uterine bleeding, expulsion of POC Abdominal pain Diarrhea Nausea Flatulence Dyspepsia Headache

Trade Name: Cytotec Action: reduces acid secretion from gastric parietal cells Reason Receiving: treatment of therapeutic second-trimester abortion, cervical ripening, induction of labor Pregnancy Category: X Nursing Implications R/T Adm. & S.E. Give with or after meals (minimizes diarrhea) Question possible pregnancy before giving Evaluation

Generic Name: modafinil Classification: alpha1 agonist; antinarcoleptic Adult Dosage: 200 mg/day Geriatric Dosage: 100 mg/day Side Effects Drug/Food Interactions Anxiety, insomnia, Cyclosporine, oral nausea contraceptives, Anorexia, diarrhea, theophylline, diazepam,

Trade Name: Provigil

Action: binds to dopamine reuptake carrier sites, increasing alpha activity, and decreasing delta, beta, theta brain wave activity; reduces sleep episodes

Reason Receiving: depression (off label) Pregnancy Category: C NI R/T Adm, SE, Interactions Evaluation Monitor sleep pattern, evidence of restlessness during sleep Assess for dizziness, anxiety;

dizziness, dry mouth/skin, muscle stiffness, polydipsia, rhinitis, paresthesia, tremor, headache, vomiting

phenytoin, propranolol, tricyclic, antidepressants, warfarin, other CNS stimulants

initiate fall precautions. Use sugarless gum and sips of water for relief of dry mouth

Generic Name: montelukast Classification: leukotriene receptor inhibitor; antiasthmatic Adult Dosage: 10 mg/day
Newborn Dosage: safety not established

Trade Name: Singulair

Action: bind to leukotriene receptors, inhibiting effects of leukotrienes on bronchial smooth muscle; decreases bronchoconstriction, vascular permeability, mucosal edema, mucus production

Side Effects Headache Influenza

Reason Receiving: Pregnancy Category: B Nursing Implications R/T Adm. & S. E Monitor rate, depth, rhythm, type of respirations Monitor quality/rate of pulse Assess lung sounds for rhonchi, wheezes, rales Observe for cyanosis

Evaluation

Generic Name:Morphine Sulfate Classification: Narcotic Agonist/Opiate Analgesic (Sche II) Adult Dosage: Use prompt-release formation guidelines Newborn Dosage:N/A

Trade Name: MS Contin Action: Binds with opioid receptors Reason Receiving: Pain Relief

within CNS

Side Effects Sedation, decreased b/p(including orthostatic hypotension), diaphoresis, facial flushing, constipation, dizziness, drowsiness, nausea, vomiting

Pregnancy Category:C(D if used for prolonged pds or at high dosages) Nursing Implications R/T Administration & Side Effects Evaluation Assess onset, type, location, duration of pain. Obtain vital signs before giving med. Monitor bowel activity. Assess for therapeutic response. Trade Name: Avelox Action: Inhibits two enzymes, topoisomerase II and IV, in
susceprible microorganisms

Generic Name: Moxifloxacin Classification: Flouroquinolone/Antibacterial Adult Dosage: 400mg q24h Newborn Dosage: N/A Side Effects Nausea, diarrhea, dizziness, HA, abdominal pain, vomiting

Reason Receiving: Pneumonia Pregnancy Category: C Nursing Implications R/T Administration & Side Effects Evaluation Hx of hypersensitivity to quinolones. Monitor WBC for infection. Assess for HA, abdominal pain, vomiting, altered taste, dyspepsia

Generic Name: nalbuphine Classification: Narcotic agonist, antagonist; Opioid analgesic Adult Dosage: 10 mg q3-6h as needed Newborn Dosage: not used for less than 1 year Side Effects Readily crosses placenta Distributed in breast milk; breast feeding not recommended May cause fetal, neonateal adverse effects during labor/delivery (fetal bradycardia) Sedation Diaphoresis Cold/clammy skin Nausea and vomiting Dizziness/vertigo Dry mouth Headache

Trade Name: Nubain Action: Binds with opioid receptors in CNS (may displace opioid agonists); alters pain perception, emotional response to pain Reason Receiving: Pain Pregnancy Category: B (D if prolonged usage or high dosages at term) Nursing Implications R/T Adm. & S. E Evaluation Rotate IM sites Raise bed rails Obtain VS before giving; if respirations 12 or less without and contact MD Assess onset, type, location, duration of pain; effect of med is reduced if full pain recurs before next dose Low abuse potential Monitor of change in RR, BP and rate/quality of pulse Monitor daily pattern of bowel activity Initiate deep breathing, coughing exercises Assess for clinical improvement, record onset of relief of pain; contact MD if pain relief not adequate Trade Name: Neomycin Action: interferes with bacterial protein synthesis Reason Receiving: Pregnancy Category: C Nursing Implications R/T Administration & Side Effects Evaluation Assess for rash, redness, pruritus Be alert for superinfection, particularly genital/anal pruritus, stomatitis, diarrhea

Generic Name: neomycin/polymix Classification: antibiotic Adult Dosage: apply 1-3 times a day Newborn Dosage: safety not established Side Effects Pruritus, redness, swelling, rash

Generic Name: Nephro-Vite

Classification: vitamin B and C complex

Adult Dosage: once daily Newborn Dosage: consult with MD Side Effects Mild upset stomach

Trade Name: Vicon-C Action: Reason Receiving: prevent vitamin deficiency Pregnancy Category: Nursing Implications R/T Adm. & S. E Evaluation

Generic Name: Nicotine Classification: Cholinergic-receptor agonist/Smoke deterrent Adult Dosage:21mg/day for 4-6 wks; 14mg/day for 2 wks;
7mg/day for 2 wks

Trade Name: Nicoderm Action:Binds to acetylcholine receptors, producing both stimulating, depressant effects on peripheral, central nervous systems . Reason Receiving: Smoking cessation Pregnancy Category: D NI R/T Adm, SE, Interactions Monitor b/p, pulse, sleep pattern, skin for erythema, pruritus, burning at application site. Rotate application sites. Evaluation

Geriatric Dosage: Same as Above Side Effects Drug/Food Interactions Drug: beta-adrenergic Hiccups, nausea, erythema, pruritus, blockers, bronchodilators, burning at application site insulin, propoxyphene. Food: None known Generic Name: nifedipine Classification: calcium channel blocker; antianginal, antihypertensive

Adult Dosage: 10 mg 3 times a day Newborn Dosage: safety and efficacy not established Side Effects Peripheral edema Headache Flushed skin Dizziness Nausea Shakiness Muscle cramps/pain Drowsiness Palpitations Nasal congestion Cough Dyspnea Wheezing

Trade Name: Procardia Action: inhibits calcium ion movement across cell membranes, depressing contraction of cardiac, vascular smooth muscle; increases heart rate, cardiac output, decreases systemic vascular resistance and BP Reason Receiving: Pregnancy Category: C Nursing Implications R/T Adm. & S. E Record onset, type, radiation, location, intensity, duration of angina pain; precipitating factors (exertional, emotional stress) Check BP for hypotension immediately before giving medication Assist with ambulation if lightheadedness, dizziness occurs Assess for peripheral edema Assess skin for flushing Monitor serum hepatic enzymes Evaluation

Generic Name: nilotinib Classification: antineoplastic Adult Dosage: 400 mg bid q.12h
Newborn Dosage: Safety not established

Side Effects Rash, nausea, headache, pruritus, fatigue, diarrhea, constipation, vomiting

Trade Name: Tasigna Action: inhibits tumor growth during 2 stages of CML Reason Receiving: CML Pregnancy Category: D Nursing Implications R/T Adm. & S.E. Evaluation Monitor electrolytes; potassium, mag, sodium Monitor weight gain Monitor for nausea/vomiting Monitor daily bowel pattern/stool consistency

Generic Name: nitroglycerin Classification: Nitrate Adult Dosage: 0.2-0.4 mg/hr Geriatric Dosage: same Side Effects Drug/Food Interactions Headache (may be Alcohol, other severe in early therapy, antihypertensives, but diminishes with vasodilators (increases continued treatment) hypotension) Transient flushing of Ephedra, ginger, ginseng, face/neck, dizziness, licorice, black cohosh weakness, orthostatic hypotension Contact dermatitis with patch

Trade Name: Nitrostat, Nitro-Dur, Nitro-Bid

Action: decreases myocardial oxygen demand; reduces LV preload, afterload

Reason Receiving: chest pain Pregnancy Category: B NI R/T Adm, SE, Interactions Monitor BP, apical pulse prior Assess for flushing EKG for IV administration Record onset/type of pain

Evaluation

Generic Name: Nystatin Classification:Antifungal Adult Dosage:Apply 2-4X/day Newborn Dosage: N/A Side Effects Skin irritation

Trade Name:Mycostatin Action:Binds to sterols in cell membrane, increasing fungal cellmembrane permeability, permitting loss of K, other cellular components.

Reason Receiving: rash Pregnancy Category: B Nursing Implications R/T Administration & Side Effects Assess skin for further irritation.

Evaluation

Generic Name: Octreotide Acetate Classification: Secretory inhibitory, growth hormone suppressant. Adult Dosage: 50-100mcg q8h Newborn Dosage: N/A Side Effects Diarrhea, nausea, abdominal discomfort, HA, injection site pain

Trade Name: Sandostatin Action: Suppresses secretion of serotonin,

gastroenteropancreatic peptides. Enhances fluid/electrolyte absorption from GI tract.

Reason Receiving: Treatment of Chemo-induced diarrhea Pregnancy Category: B Nursing Implications R/T Administration & Side Effects Evaluation Monitor B/P, glucose, pulse & respirations. Monitor bowel activity.

Generic Name: Ondansetron HCL Classification: Selective receptor Antagonist/Antiemetic Adult Dosage: 0.15mg/kg 3 times a day Geriatric Dosage: Same as above Side Effects Drug/Food Interactions Drug: Apomorphine may Anxiety, dizziness, HA, fatigue, constipation, cause profound hypoxia, urinary retention hypotension, alter LOC Food: None Known

Trade Name: Zofran Action: Blocks serotonin, both peripherally on vagal nerve terminals,
centrally in chemo-receptor trigger zone

Reason Receiving: Prevents Nausea/Vomiting Pregnancy Category: B NI R/T Adm, SE, Interactions Evaluation Assess for dehydration, assess bowel sounds. Assess mental status. Monitor bowel activity. Record bowel evacuation

Generic Name: oxybutynin Classification: Anticholinergic Adult Dosage: 5mg, 2-3 times daily Geriatric Dosage: 2.5-5 mg, 2-3 times daily Side Effects Drug/Food Interactions Constipation, dry mouth, Medications with somnolence, decreased anticholinergic effects can perspiration, urinary increase effects. retention, blurred vision, Erythromycin, nausea, vomiting, itraconazole, insomnia ketoconazole may alter pharmacokinetic parameters

Trade Name: Ditropan Action: exerts antispasmodic, antimuscarinic action on detrusor

smooth muscle of bladder. bladder capacity, delays desire to void

Reason Receiving: Neurogenic bladder Pregnancy Category: B NI R/T Adm, SE, Interactions Evaluation Asses dysuria, urgency, freq. incontinence. Monitor for symptomatic relief. Monitor I&Os Palpate bladder for retention.

Generic Name: Oxycodone Classification: Opioid analgesic (Sche II) Adult Dosage: 5mg q6h Geriatric Dosage: Same as above Side Effects Drug/Food Interactions Drug:Alcohol, other CNS Dizziness, nausea, vomiting, hypotension, depressants, MAOIs Food: None Known drowsiness, anorexia, constipation, urinary retention

Trade Name: Roxicodone Action: Binds to opioid receptors within CNS Reason Receiving: Pain relief Pregnancy Category:B(D if used for prolong pds or at high doses) NI R/T Adm, SE, Interactions Evaluation Monitor bowel activity, initiate deep breathing. Monitor pain relief. Respiration, BP, Mental Status

Generic Name: Oxycodone HCL-Acetaminophen Trade Name: Percocet Classification: binds to opioid receptors in CNS Action: binds to opioid receptors in CNS Adult Dosage: Reason Receiving: pain Newborn Dosage: na Pregnancy Category: na Nursing Implications R/T Side Effects Administration & Side Effects Evaluation Dizziness, nausea, vomiting, Monitor bowel activity, initiate deep Not given in previous 24 hours hypotension, drowsiness, anorexia, breathing. Monitor pain relief. constipation, urinary retention. Respiration, BP, Mental Status

Generic Name: oxytocin Classification: Uterine smooth muscle stimulant Adult Dosage: 0.5-1 milliunit/min

Trade Name: Pitocin Action: affects uterine myofibril activity and stimulates mammary smooth muscle; contracts uterine smooth muscle and enhances lactation Reason Receiving:

Newborn Dosage: not used Side Effects Small amounts in breast milk; breast feeding not recommended Tachycardia Premature ventricular contractions Hypotension Nausea Vomiting Unexpected uterine bleeding/contractions

Pregnancy Category: X Nursing Implications R/T Adm. & S. E Give by IV infusion Assess baseline VS for BP, FHR Determine frequency, duration, strength of contractions Notify MD of contraction lasting longer than 1 min, occur more frequently than every 2 min or stop Maintain careful I&Os Check for blood loss

Evaluation

Generic Name: pancrelipase Classification: Digestive enzyme Adult Dosage:1-3 capsules per day Newborn Dosage: na Side Effects Rare: allergic reaction, mouth irritation, SOB, wheezing

Trade Name: Action: pancreatic enzyme replacer Reason Receiving: pancreas not producing enzymes Pregnancy Category: C Nursing Implications R/T Administration & Side Effects Evaluation Question for Therapeutic relief Patient NPO, no NV from GI symptoms.

Generic Name: Pantoprazole NA Classification: Proton Pump Inhibitor Adult Dosage: 40 mg twice a day, may to 240mg Geriatric Dosage: Same as above Side Effects Drug/Food Interactions Rare-diarrhea, HA,dizziness, Drug: May increase pruritus, rash effect of warfarin Food: None Known

Trade Name: Prontonix Action: Irreversibly bind to, inhibits hydrogen-potassium adenosine
triphosphate, an enzyme on surface of gastric parietal cells. Inhibits hydrogen ion transport into gastric lumen

Reason Receiving: Reduce gastric acid Pregnancy Category: B NI R/T Adm, SE, Interactions Evaluation
Assess creatinine, cholesterol, evaluate for therapeutic response, question if GI discomfort, nausea occur

Generic Name: Pentamidine Classification: Anti-infective/Antiprotozoal Adult Dosage: 300mg once q.4wks Newborn Dosage: N/A Side Effects Fatigue; metallic taste; SHOB; decreased appetite; dizziness; rash; cough; N/V; chills

Trade Name: Nebupent Action: Interferes with nuclear metabolism, incorporation of

nucleotides, inhibiting DNA, RNA, phospholipid, protein synthesis

Reason Receiving: Prevent PCP Pregnancy Category: C Nursing Implications R/T Administration & Side Effects Evaluation Establish baseline B/P. Monitor glucose for hypoglycemia or hyperglycemia.

Generic Name: phosphorus Classification: electrolyte; mineral Adult Dosage: 50-150 mmol/day Newborn Dosage: 0.5-1.5 mmol/day Side Effects Mild laxative effect (first few days) Diarrhea, nausea, abdominal pain, vomiting

Trade Name: Neutra-Phos-K, Fleet Enema Action: active in bone deposition, calcium metabolism; acts as a buffer in maintaining acid-base balance Reason Receiving: protocol for phosphorus deficiency Pregnancy Category: C Nursing Implications R/T Adm. & S. E Evaluation Routinely monitor calcium, phosphorus, potassium, sodium, AST, ALT, alkaline phosphatase, bilirubin

Generic Name: Pilocarpine Classification: Direct-acting Miotic Adult Dosage: 1-2 gtt 3-4 times/day Geriatric Dosage: Same as above Side Effects Drug/Food Interactions Drug:Avoid use with Blurred vision, eye pain, HA, eye irritation, brow carbachol and ache, stinging and echothiophate; decrease burning, N/V, diarrhea, antiglaucoma effects with increased salivation and belladonna alkaloids; perspiration, muscle decrease dilation with tremors, contact allergy phenylephrine Food: None Known Generic Name: pioglitazone Classification: antidiabetic Adult Dosage: 15-30 mg once a day Geriatric Dosage: same Side Effects Drug/Food Interactions Headache, upper resp Ketoconazole, oral tract infection contraceptives Sinusitis, myalgia, St. Johns wort, garlic pharyngitis, aggravated DM

Trade Name: Pilopine Action: Stimulation of papillary and ciliary sphincter muscles Reason Receiving: to decrease IOP in glaucoma Pregnancy Category: C NI R/T Adm, SE, Interactions Evaluation Obtain medical, herbal and drug hx. Assess vital signs. Assess pts eye pigment. Assess pts level of anxiety.

Trade Name: Actos Action: improves target cell response to insulin Reason Receiving: diabetes mellitus type 2 Pregnancy Category:C NI R/T Adm, SE, Interactions Evaluation Monitor glucose Monitor hepatic enzymes (ALT, AST), hgb Assess for hypoglycemia and hyperglycemia; Hypoglycemia = cool wet skin, tremors, dizziness, headache, anxiety, tachycardia, numbness in mouth, hunger, diplopia. Hyperglycemia = polyuria, polyphagia, polydipsia, nausea/vomiting, dim vision, fatigue, deep & rapid breathing

Generic Name: PiperacillinClassification: penicillin Adult Dosage: 2.25g q8-12H Newborn Dosage: na

Trade Name: Tazobactan Action: antibiotic- prevents bacterial overgrowth Reason Receiving: Pneumonia Pregnancy Category:B Nursing Implications R/T

Side Effects Diarrhea, HA, constipation, nausea, insomnia rash, vomiting, fever, candidiasis, pruritus,

Administration & Side Effects Infuse over 30 minutes Question for allergies to pencillins and cephalosporin. Monitor bowel activity, I&O< serum electrolytes, esp. K, renal function tests

Evaluation No allergies to pencillins or cephalosporins. LBM 10/6 I/O 2534/1225 K 4.4 Na 134L Cl 102 CA 7.7L

Generic Name: Polyethylene Glycol Classification: Laxative/Bowel Evacuant Adult Dosage: 17gm/day Newborn Dosage: N/A Side Effects
Some degree of abdominal fullness, nausea, bloating. Occasional: cramping

Trade Name: Miralax Action: osmotic effect/Induces diarrhea, cleanses bowel

without depleting electrolytes

Reason Receiving: Prevents constipation Pregnancy Category: C Nursing Implications R/T Administration & Side Effects Evaluation
Do not give oral medication within 1 hr of start of therapy. Assess bowel sounds. Bowel activity. Monitor serum electrolytes, bun glucose, urine osmolarity

Generic Name: Polyvinyl Alcohol 1.4% opth soln Classification: Ocular Lubicant Adult Dosage: 1-2 drops in each eye Newborn Dosage: N/A Side Effects
temporary blurry vision, minor burning, stinging, irritation

Trade Name: Artificial yra Action:Stabilizes/thickens precorneal tear film, lengthening tear
film breakup time.

Reason Receiving: relief dry eyes r/t chemotherapy Pregnancy Category: N/A Nursing Implications R/T Administration & Side Effects Evaluation
Monitor for complaints of blurry vision, burning, irritation

Generic Name:Posaconazole Classification: Antifungal/Azole derivative

Trade Name: Noxafil Action: Inhibits synthesis of ergosterol, a vital component of fungal cell wall formation. Adult Dosage: 200mg 3X/day with meals Reason Receiving: Prophylaxis for fungal infection Newborn Dosage: N/A Pregnancy Category: C Nursing Implications R/T Side Effects Administration & Side Effects Evaluation Diarrhea, nausea, vomiting, HA, Hepatic function test should be abdominal pain, cough monitored periodically. Monitor daily bowel activity. Monitor B/P for hyper/hypotension. Assess for lower extremity edema
Generic Name: Potassium Chloride Trade Name:

Classification: potassium replenisher Action: multiple cellular metabolic processes Adult Dosage: 20-40 mg per day divided in 2 doses Reason Receiving: treatment of potassium deficiency Newborn Dosage: na Pregnancy Category: na Nursing Implications R/T Side Effects Administration & Side Effects Evaluation N/V, Diarrhea, abdominal discomfort, PO should be given with food or after phlebitis with IV administration. meals,

Generic Name: pravastatin sodium Classification: antihyyperlipidemic Adult Dosage: 40 mg/day (10-80 mg) Newborn Dosage: Safety not established Side Effects Generally well tolerated; SE usually mild and transient Occasional N and V, diarrhea, constipation, abdo pain, headache, rhinitis, rash, pruritis

Trade Name: Pravachol Action: lowers LDL and raises HDL Reason Receiving: Pregnancy Category: X Nursing Implications R/T Administration & Side Effects Question for possible pregnancy Assess baseline labs Monitor bowel patter and stool consistency Check for headache and dizziness Assess skin Be alert for malaises, muscle cramping/weakness

Evaluation

Generic Name: Prednisolone Acetate Classification: Adrenal corticosteroid/Glucocorticoid Adult Dosage: 1-2 drops q.hr during day and q.2hr during Newborn Dosage: N/A Side Effects Rarely, stinging, or burning may occur

Trade Name: Pred Forte Action: Inhibits accumulation of inflammatory cells at

inflammation sites, phagocytosis, lysosomal enzyme release/synthesis, release of mediators of inflamation

night. After response, decrease dosage to 1 drop 3-4 times/day.

Reason Receiving: prevention of dry eyes related to chemo treatment st Pregnancy Category: C(D if used in 1 trimester) Nursing Implications R/T Administration & Side Effects Evaluation Evaluate Therapeutic response

Generic Name: Prednisone Classification: Adrenal corticosteroid/ Glucocorticoid Adult Dosage: 5-60mg/day in divided doses Geriatric Dosage: Same as above Side Effects Drug/Food Interactions Drug: Antacids, Insomnia, heartburn, nervousness, abdominal Amphotericia, Digoxin, distention, mood swings, insulin, diuretics, oral increased appetite, hypoglycemic, potassium delayed sound healing supplements, hepatic enzyme inducers, Live virus vaccines. Food: None Known

Trade Name: Deltasone Action: Inhibits accumulation of inflammatory cells at inflammation sites,
phagocytosis, lysosomal enzyme release/synthesis of mediators of inflammation

Reason Receiving: COPD st Pregnancy Category: C (D if used in 1 trimester) NI R/T Adm, SE, Interactions Evaluation Baselines for height, weight, BP, Glucose, electrolytes. Never give live virus vaccine. Be alert to infection

Generic Name: Prednisone Classification: glucocorticoid

Trade Name: Apo-Prednisone Action: Inhibits accumulation of inflammatory cells at

inflammation sites, phagocytosis, lysosomal enzyme release/synthesis of mediators of inflammation.

Adult Dosage: 5-60 mg per day in divided doses Reason Receiving: Newborn Dosage: na Pregnancy Category: na Nursing Implications R/T Side Effects Administration & Side Effects Insomnia, heartburn, nervousness, Baselines for height, weight, BP, abdominal distention, mood Glucose, electrolytes. Never give swings, increased appetite, live virus vaccine. Be alert to delayed sound healing. infection. Generic Name: Prednisone ophthalmic suspension Classification: glucocorticoid

Evaluation

Trade Name: Apo-Prednisone Action: causes inhibition of inflammatory response to

inciting agents of mechanical, chemical, or immunological nature

Adult Dosage: 5-60 mg per day in divided doses Newborn Dosage: na Side Effects Rarely, stinging, or burning may occur

Reason Receiving: prevention of dry eyes related to chemo treatment Pregnancy Category: na Nursing Implications R/T Administration & Side Effects Evaluation Evaluate Therapeutic response. Patient reported no problems with dry eyes.

Generic Name: Pregabalin Classification: Anticonvulsant, antineuralgic, analgesic Adult Dosage: 75g BID or 50 mg tid Newborn Dosage: Side Effects Dizziness, somnolence, ataxia, peripheral edema.

Trade Name: Lyrica Action: binds to calcium channel sites- decrease pain of
neuropathy

Reason Receiving: pain relief Pregnancy Category: C Nursing Implications R/T Administration & Side Effects Evaluation Throbbing pain in RUQ reported at Assess onset, type, location, consistent levels of 8-9 and duration of pain.

Generic Name: prenatal vitamin Classification: vitamin supplement Adult Dosage: one capsule daily Newborn Dosage: safety and efficacy not established Side Effects Allergic reaction Constipation Diarrhea Upset stomach

Trade Name: PrimaCare One Action: prevent vitamin deficiency Reason Receiving: improving nutritional status throughout pregnancy Pregnancy Category: A Nursing Implications R/T Adm. & S. E Best taken on an empty stomach 1-2 hours before a meal Take with full glass of water Give at same time each day Evaluation

Generic Name: Prochlorperazine Maleate Classification: Phenothiazine/Anitemetic

Trade Name: Compazine Action: Acts centrally to inhibit/block dopamine receptors in

chemoreceptor trigger zone, peripherally to block vagus nerve in GI tract.

Adult Dosage: 5-10mg 3-4X/day Newborn Dosage: N/A Side Effects Drowsiness; hypotension; dizziness; fainting(commonly st occurring after 1 dose, occasionally after subsequent doses, rarely with oral form).

Reason Receiving: PRN N/V Pregnancy Category: C Nursing Implications R/T Administration & Side Effects Evaluation Assess for dehydration(poor skin turgor, dry mucous membranes, longitudinal furrows in tongue). Monitor B/P for hypotension. Assess for therapeutic response.

Generic Name: promethazine HCl Classification: antihistamine, antiemetic, sedative-hypnotic Adult Dosage: 6.25-12.5 mg 3 times a day plus 25 mg q.h.s. Newborn Dosage: not recommended for those under 2 years Side Effects Drowsiness, disorientation Hypotension Confusion Syncope in elderly Dry mouth, nose, throat Urinary retention Thickening of bronchial secretions

Trade Name: Phenergan Action: inihibits histamine at histamine receptor sites; antiemetic: diminishes vestibular stimulation; prevents, relieves nausea/vomiting Reason Receiving: nausea Pregnancy Category: C Nursing Implications R/T Adm. & S. E Assess BP, pulse for bradycardia, tachycardia for parental form Anti-emetic assess for dehydration Evaluation

Generic Name: Quetiapine Furmarate Classification:Dibenzapine derivative/antipsychotic

Trade Name: Seroquel Action:Antagonizes dopamine, serotonin, histamine, alpha1adrenergic receptors.

Adult Dosage: Initially 50mg 2X/day. Increase in Reason Receiving: Bipolar disorder increments of 100mg Newborn Dosage: N/A Pregnancy Category: C Nursing Implications R/T Side Effects Administration & Side Effects Evaluation HA, drowsiness, dizziness, Assess b/p for hypotension. Constipation, orthostatic Assess pulse for tachycardia. hypotension, tachycardia, dry Assess bowel activity. Assess for therapeutic response. mouth

Generic Name: ranitidine HCL Classification: antiulcer Adult Dosage: 150 mg bid Newborn Dosage: 2-4 mg/kg/day Side Effects Diarrhea

Trade Name: Zantac Action: inhibits gastric acid secretion; reduces volume of gastric acid Reason Receiving: Pregnancy Category: B Nursing Implications R/T Adm. & S.E. Evaluation Assess mental status

Generic Name: Rho (D) immune globulin (human) Classification: Immune globulin Adult Dosage: 300 mcg Newborn Dosage: 50 mcg/kg Side Effects Hypotension Pallor Vasodilation Fever Headache Chills Dizziness Somnolence Lethargy Rash Pruritus Abdominal pain Diarrhea Discomfort/swelling at injection site Back pain Myalgia Arthralgia Asthenia (loss of strength)

Trade Name: RhoGAM Action: suppresses active antibody response formation of anti-Rh in Rh negative women exposed to Rh positive blood from pregnancy Reason Receiving: Rh negative mom with Rh positive fetus Pregnancy Category: C Nursing Implications R/T Adm. & S. E Evaluation Determine existence of bleeding disorder Assess pts HgB level; give drug cautiously to pts with HgB level less than 8 g/dl Monitor CBC (HgB, plt count), BUN, crt, retic count, UA results Assess for signs/symptoms of hemolysis IM administer into deltoid of arm or anterolateral aspect of upper thigh

Generic Name: Rifampim Classification: Antibiotic Adult Dosage: maximum 600 mg/day Newborn Dosage: Side Effects
Red orange or red brown discoloration of urine, feces, saliva, skin,

Trade Name: Rifadin Action: interferes with bacterial RNA Synthesis. antitubercular Reason Receiving: Pregnancy Category: C Nursing Implications R/T Administration & Side Effects Evaluation
No hypersensitivity to rifampin.

Question for hypersensitive to rifampin. Evaluate serum hepatic/renal function. CBC results

K-3.6 NA- 141 CL- 105

WBC-14.1H RBC-3.45L HGB-10.2L HCT30.9L

seg. Neutrophil-10.1H monocytes-1.7H

Generic Name: ropivacaine Classification: amino amide class of local anesthetics Adult Dosage: varies by use Geriatric Dosage: same Side Effects Drug/Food Interactions Hypotension Theophylline

Trade Name: Naropin Action: blocks the generation and conduction of nerve impulses;
anesthetic

Reason Receiving: control pain Pregnancy Category: B NI R/T Adm, SE, Interactions Get pt up slowly

Evaluation

Bradycardia Dizziness Nausea or vomiting Headache Pruritus Anxiety Tinnitus Dyspnea Seizures Syncope chills

Imipramine Fluvoxamine Verapamil Flecainide Tocainide mexiletine

Assess VS, especially BP, P Assess for GI distress

Generic Name: Sennosides A&B Classification: GI stimulant/Laxative Adult Dosage: 2 tablets at bedtime Geriatric Dosage: Same as above Side Effects Drug/Food Interactions Pink-red, red-violet, redDrug: Oral medications brown, or yellow-brown Food: None Known
discoloration of urine. Some degree of abdominal discomfort, nausea, mild cramps, griping, faintness.

Trade Name: Senokot Action: Direct effect on intestinal smooth musculature(stimulates intramural
nerve plexi).

Reason Receiving: Relief of constipation Pregnancy Category: C NI R/T Adm, SE, Interactions Evaluation
Increase fluid intake. Monitor bowel activity. Assess for GI disturbances

Generic Name: Sertraline HCL Classification: Serotonin reuptake inhibitor/Antidepressant Adult Dosage: 50mg/day up to 200mg/day Geriatric Dosage: 25mg/day up to 200mg/day Side Effects Drug/Food Interactions Drug: May increase HA, nausea, diarrhea, concentration, risk of highly insomnia, drowsiness, protein-bound medications (e.g., dizziness, fatigue, rash, digoxin, warfarin). MAOIs may dry mouth cause neuroleptic malignant
syndrome, hypertensive crisis, hyperpyrexia, seizures, serotonin syndrome (diaphoresis, diarrhea, fever, mental changes, restlessness, shivering). May increase concentration, risk of toxicity of tricyclic antidepressants. Food: None known

Trade Name: Zoloft Action: Blocks reuptake of the neurotransmitter serotonin at CNS neuronal
presynaptic membranes, increasing availability at postsynaptic receptor sites.

Reason Receiving: Treatment of Depression Pregnancy Category: C NI R/T Adm, SE, Interactions Evaluation Supervisor suicidal risk pts closely during early therapy. Monitor bowel activity and pattern. Assess for therapeutic relief

Generic Name: sevelamer carbonate

Classification: polymeric phosphate binder; antihyperphophatemia Adult Dosage: 800-1600 mg with each meal Newborn Dosage: safety not established

Trade Name: Renvela

Action: binds with dietary phosphorus allowing phosphorus to be eliminated through normal digestive process thus decreasing phosphorus level

Side Effects Infection, pain, hypotension, diarrhea, dyspepsia, nausea and vomiting Headache, constipation, hypertension, increased cough

Reason Receiving: Pregnancy Category: C Nursing Implications R/T Adm. & S. E Monitor serum phosphorus, bicarbonate, chloride and calcium

Evaluation

Generic Name: Simethicone Classification: Antiflatulent

Trade Name: Mylanta Maalox Action: changes surface tension of gas bubbles, allowing easier elimination of gas Adult Dosage: 40-125mg after meals and at bedtime Reason Receiving: anti flatulent Newborn Dosage: na Pregnancy Category: na Nursing Implications R/T Side Effects Administration & Side Effects Evaluation None known Evaluate for therapeutic response( relief of flatulence, abdominal bloating) Generic Name: Simvastatin Classification:Hydroxymethylglutaryl-CoA reductase inhibitor/Antihyperlipidemic Adult Dosage: 20-40mg/day in the evenings Geriatric Dosage: Same as above Side Effects Drug/Food Interactions HA, abdominal pain, Drug:Cyclosporine,
cramps, constipation, upper respiratory tract infection
erythromycin, gemfibrozil, immunosuppressants, niacin, digoxin, HIV protease inhibitors, Verapamil. Food: Grapefruit/grapefruit juice

Trade Name: Zocor Action:Interferes with cholesterol biosynthesis by inhibiting conversion of

the enzyme HMG-CoA to mevalonate

Reason Receiving: treatment of dyslipidemia Pregnancy Category: X NI R/T Adm, SE, Interactions Evaluation
Assess serum cholesterol, triglyceride, hepatic function tests.

Generic Name: sitagliptin Classification: DPP-4 inhibitors; antidiabetic Adult Dosage: 100 mg/day Geriatric Dosage: same Side Effects Drug/Food Interactions Headache, Slightly increases digoxin nasopharyngitis concentration

Trade Name: Januvia Action: slows inactivation of incretin hormones Reason Receiving: diabetes mellitus type 2 Pregnancy Category:B NI R/T Adm, SE, Interactions Evaluation Check glucose Assess learning needs Assess for hypoglycemia and hyperglycemia; Hypoglycemia = cool wet skin, tremors, dizziness, headache, anxiety, tachycardia, numbness in mouth, hunger, diplopia. Hyperglycemia = polyuria, polyphagia, polydipsia, nausea/vomiting, dim vision, fatigue, deep & rapid breathing

Generic Name: sodium chloride Classification: electrolyte Adult Dosage:

Trade Name: Action: controls fluid and electrolyte balance Reason Receiving: fluid replacement

Newborn Dosage: Side Effects

Facial flushing, occ. Fever, irritation, phlebitis, extravasation at injection site.

Pregnancy Category: C Nursing Implications R/T Administration & Side Effects

Monitor I&O, lung sounds, IV site, Monitor serum electrolytes. BP, Monitor for hypernatremia with edema, weight gain. Elevated BP. Monitor hyponatremia associated with muscle cramps, NV.

Evaluation

Not administered

Generic Name: Sodium Chloride Nasal Spray Trade Name: Classification: electrolyte Action: restores moisture, relieves dry, cracked Adult Dosage: 2 to 3 sprays as needed Reason Receiving: congestion Newborn Dosage: Pregnancy Category: C Nursing Implications R/T Side Effects Administration & Side Effects Evaluation
None noted Monitor for relief of symptoms Pt stated nasal spray has helped nasal dryness

Generic Name: sodium phosphate Classification: Adult Dosage: per label Geriatric Dosage: same Side Effects Drug/Food Interactions Nausea Diuretics Stomach pain Narcotics Bloating Antibiotics Dizziness Antidepressant Headache NSAIDs Antipsychotics Antinausea, anzemet or No use with renal ds zofran (on dialysis) Heart/BP meds Heart rhythm meds Migraine meds Generic Name: sotalol Classification: beta adrenergic blocking agent Adult Dosage: 80 mg bid Geriatric Dosage: 80 mg bid Side Effects Drug/Food Interactions Diminished sexual Calcium channel function, drowsiness, blockers, insulin, insomnia, asthenia sympathomimetics, Depression, cold theophylline, ephedra hands/feet, diarrhea, constipation, anxiety, nasal congestion, nausea, vomiting

Trade Name: Fleets Action: promotes peristalsis to clean out bowels Reason Receiving: postop bowel care Pregnancy Category: C NI R/T Adm, SE, Interactions Evaluation Take with 8 ounces of water Take on empty stomach/at bedtime Assess bowel activity and stool consistency Assess BS

Trade Name: Betapace Action: prolongs action potential. Produces antiarrhythmic activity Reason Receiving: Pregnancy Category: B (D if second or third trimester) NI R/T Adm, SE, Interactions Evaluation Continuous monitor on initiation Do not give if P <60 Assess creatinine clearance before dosing Monitor for arrhythmias Assess BP (hypo) and pulse (brady) Assess for CHF. Teach do not discontinue or change dose without MD

Generic Name: sucralfate Classification: antiulcer Adult Dosage: 1g 4 times a day Newborn Dosage: Side Effects Constipation. Occ. Dry mouth, backache, diarrhea, drowsiness, nausea, abdominal discomfort.

Trade Name: Carafate Action: protects by absorbing gastric acid, Reason Receiving: abdominal pain Pregnancy Category: B Nursing Implications R/T Administration & Side Effects Evaluation LBM 9/5/10 Monitor bowel activity and stool No NV complaints consistency.

Generic Name: Tamsulosin HCL Classification: Alpha-adrenergic blocker/Benign prostatic hyperplasia agent Adult Dosage: 0.4mg/day 30 min ac up to 0.8mg Geriatric Dosage: Same as above Side Effects Drug/Food Interactions Drug: Other alphaDizziness, drowsiness, HA, anxiety, insomnia, adrenergic blocking orthostatic hypotension agents (e.g.-doxazosin, prazosin, terazosin), Sildenafil, Tadafil, vardenafil, warfarin. Food: None Known Generic Name: terbutaline Classification: sympathomimetic; bronchodilator, premature labor inhibitor Adult Dosage: 2.5 mg 3-4 times a day Newborn Dosage: safety and efficacy not established in those younger than 6 years Side Effects Tremor Anxiety Drowsiness Headache Nausea Heartburn Dizziness

Trade Name: Flomax Action: Targets receptors around bladder neck, prostate capsule. Reason Receiving: BPH Pregnancy Category: B NI R/T Adm, SE, Interactions Evaluation Assess sensitivity hx. Monitor renal function, B/P.

Trade Name: Brethine Action: stimulates beta2 adrenergic receptors, resulting in relaxation of uterine, bronchial smooth muscle; inhibits uterine contractions and relieves bronchospasm, reduces airway resistance Reason Receiving: stopping/preventing preterm labor Pregnancy Category: B

Nursing Implications R/T Adm. & S. E Assess baseline maternal pulse, BP, frequency and duration of contractions, fetal heart rate Monitor for frequency, duration and strength of contractions Diligently monitor fetal heart rate

Evaluation

Generic Name: Tiotropium Classification: Anticholinergic/Bronchodilator Adult Dosage: 18mcg/day Geriatric Dosage: Same as above Side Effects Drug/Food Interactions Drug: Concurrent admin Dry mouth, sinusitis, pharyngitis, dyspepsia, with ipratropium is not recommended. UTI, rhinitis Food: None Known

Trade Name: Spiriva Action: Binds to recombinant human muscarinic receptors at smooth
muscle, resulting in long-acting bronchial smooth muscle relaxation.

Reason Receiving: Treatment of bronchospasm Pregnancy Category: C NI R/T Adm, SE, Interactions Evaluation Monitor rate, depth, rhythm, type of respirations and pulse. Assess lung sounds. Increase fluids. Rinse mouth with water after inhalation.

Generic Name: Tramadol HCL Classification: analgesic Adult Dosage: 100-300mg once per day Newborn Dosage: na Side Effects Dizziness, vertigo, nausea, constipation, headache, drowsiness. vomiting

Trade Name: Ultram Action: binds to opioid receptors, Reason Receiving: pain Pregnancy Category: na Nursing Implications R/T Administration & Side Effects Evaluation Assess pain. Assess renal/hepatic Pain at 7. PRN pain meds needed function lab values. Monitor Pulse, to move pain from 5 to 3 BP, Monitor bowel activity. LBM 10/6 CRT 1.8 H/1.7H Urea-N 7L/5L Pulse- 106 BP 104/60-106/56

Generic Name: Trazodone HCL Classification: Serotonin reuptake inhibitor Adult Dosage: 150mg/day in 3 equal doses Geriatric Dosage:25-50mg at bedtime Side Effects Drug/Food Interactions Drowsiness, dry mouth, lightDrug:Alcohol, CNSheadedness, dizziness, HA, blurred vision, nausea, vomiting. depression-promoting meds may increase CNS depression. May increase concentration of digoxin, phenytonin.May increase effects of antihypertensives. Food:None known

Trade Name: Desyrel Action: Blocks reuptake of the neurotransmitter serotonin at CNS neuronal
presynaptic membranes, increasing availability at postsynaptic receptor sites.

Reason Receiving: Treatment of depression disorder Pregnancy Category: C NI R/T Adm, SE, Interactions Evaluation Supervisor suicidal risk pts closely during early therapy.Monitor WBC, neutrophil count. Assess for therapeutic relief.

Generic Name: Triamterene hydrochlothiazide Classification: Potassium sparing diuretic Adult Dosage: 50-75 mg daily Newborn Dosage: Side Effects Abdominal Pain, NV, rash, HA dizziness, constipation, , increased K

Trade Name: Marzide Pyazide Action: prevents reabsorption of NA and potassium Reason Receiving: HTN and edema Pregnancy Category: Nursing Implications R/T Administration & Side Effects Evaluation Monitor K Level K-3.6 Monitor Glucose Glu-178-170 BP- 107/59 150/65

Generic Name: triamcinolone

Trade Name: Eucerin

Classification: topical steroid Adult Dosage: 2-3 x qd Newborn Dosage: thin film 2-3 x qd Side Effects Drying or cracking of skin Acne Itching or burning Change in skin color Thinning of skin/stretch marks

Action: reduces the actions of chemicals in the body that cause inflammation, redness and swelling

Reason Receiving: Pregnancy Category: C Nursing Implications R/T Adm. & S. E Assess skin

Evaluation

Generic Name:

Trade Name: Bactrium, Septra DS

Action: blocks bacterial biosynthesis of nucleic acids, proteins by interfering with metabolism of folinic acid; bacteriostatic

trimethoprim/sulfamethoxazole
Classification: folate antagonist; urinary tract agent, antibacterial

Adult Dosage: 100 mg q12 hours

Newborn Dosage: safety not established

Side Effects Nausea and vomiting, diarrhea, decreased appetite, abdominal cramps, headache

Reason Receiving: Pregnancy Category: C Nursing Implications R/T Adm. & S. E Assess skin for rash Evaluate food tolerance Check for hematologic toxicity (pallor, fever, sore throat, malaise, bleeding/bruising)

Evaluation

Generic Name: Trimethoprim sulfamethoxazole Classification: Folate Antagonist Adult Dosage:100mg Q12 Newborn Dosage: na Side Effects Nausea, vomiting diarrhea, decreased appetite, abdominal cramps, HA.

Trade Name: Primsol Action: Blocks biosynthesis of nucleic acids Reason Receiving: urinary tract antibacterial Pregnancy Category: na Nursing Implications R/T Administration & Side Effects Evaluation Assess hematology baseline reports, NA-146 serum renal function tests. Assess for K- 4.0 rash. Check for developing CL-112H hematologic toxicity(pallor, fever, sore CA- 8.8 throat, malaise, bleeding/bruising) Urea-N- 10 Bili-6.7 No rash, no S&S of hematologic toxicity

Generic Name: Classification: Adult Dosage: 1 pad up to six times a day with bowel movement Newborn Dosage: safety and effectiveness has not been confirmed Side Effects Stop if: rectal bleeding condition worsens or not improving in 7 days

Trade Name: Tucks pads Action: relieves irritation and burning due to hemorrhoids Reason Receiving: hemorrhoids Pregnancy Category: C Nursing Implications R/T Adm. & S. E external use only keep out of reach of children can be used up to 6 times a day or after each bowel movement clean area with soap and water Evaluation

before application

Generic Name: valproic acid Classification: anticonvulsant, antimanic Adult Dosage: 750-1500 mg/day (divided doses) Geriatric Dosage: same Side Effects Drug/Food Interactions Nausea, somnolence CNS depressants Asthenia, abdominal pain, Alcohol dyspepsia, rash Evening primrose

Trade Name: Depakote

Action: directly increases concentration of inhibitory neurotransmitter GABA

Reason Receiving: manic phase of bipolar disorder Pregnancy Category: D NI R/T Adm, SE, Interactions Evaluation Initiate safety measures Cbc/plt before and 2 weeks after initiation Assess behavior, appearance, emotional status, response to environment, speech pattern, thought content Monitor serum level; 50-100 normal Trade Name: Vancocin Action: Binds to bacterial cell walls, altering cell membrane permeability,
inhibiting RNA synthesis. Bactericidal

Generic Name: Vancomycin Classification: Tricyclic glycopeptides antibiotic Adult Dosage: 10-19mg/kg/dose or 1g q.12h Geriatric Dosage: Same as above Side Effects Drug/Food Interactions Drug: Aminoglycosides, Rare: phlebitis, amphotericin B, aspirin, thrombophlebits, pain at bumetanide, carmustine, peripheral IV site, cisplatin, cyclosporine, dizziness, rash. ehtancrynic acid, furosemide,
streptozocin, cholestyramine, colestipol. Food: None Known

Reason Receiving: Prevent Infection Pregnancy Category: C NI R/T Adm, SE, Interactions Monitor BP-give over 60 minutes or longer.Assess skin for rash. Evaluate IV site for phlebitis(heat, pain, red streaking over vein)

Evaluation

Generic Name: Venlafaxine HCL Classification: Phenethylamine derivative/Antidepressant Adult Dosage: 75mg/day in 2-3 divided doses Geriatric Dosage: Same as above Side Effects Drug/Food Interactions Nausea, drowsiness, HA, Drugs:MAOIs may cause dry mouth neuroleptic malignany syndrome, autonomic instability( including rapid fluctuations of vital signs), extreme agitation, hyperthermia, altered mental status, myoclonus, rigidity, coma. Food: None Known Generic Name: vincristine
Classification: vinca alkaloid; antineoplastic

Trade Name: Effexor Action: Potentiates CNS neurotransmitter activity by inhibiting reuptake of
serotonin, norepinephrine, and to a lesser degree, dopamine

Reason Receiving: Treatment for depression Pregnancy Category: C NI R/T Adm, SE, Interactions Evaluation Monitor signs/symptoms of depression. Take with food. Assess therapeutic relief. Supervise suicidal-risk pt closely during early therapy.

Trade Name: Vincasar

Action: binds to microtubular protein of mitotic spindle, causing metaphase arrest; inhibits cell division

Adult Dosage: 0.4-1.4 mg/week Newborn Dosage: 0.05 mg/kg/week

Reason Receiving: Pregnancy Category: D

Side Effects Peripheral neuropathy, peripheral paresthesia, alopecia, constipation/obstipation, abdominal cramps, headache, jaw pain, hoarseness, diplopia, ptosis, urinary tract distubances

Nursing Implications R/T Adm. & S. E Monitor serum uric acid levels Assess Achilles tendon reflex Monitor bowel pattern and stool consistency Monitor for ptosis, diplopia, blurred vision Question about urinary changes

Evaluation

Generic Name: vitamin K Classification: Fat-soluble vitamin; nutritional supplement Adult Dosage: 2.5-10 mg/dose; may repeat in 12-48 hours if given orally Newborn Dosage: 0.5-5 mg Side Effects Crosses placenta Distributed in breast milk PO/subcu less likely to produce SE Pain Soreness Swelling at IM injection site Pruritic erythema (with repeated injections) Facial flushing Altered taste Newborns may develop hyperbilirubinemia

Trade Name: Aquamephyton Action: promotes hepatic formation of coagulation factors, II, VII, IX, X; essential for normal clotting of blood Reason Receiving: Pregnancy Category: C Nursing Implications R/T Adm. & S.E. Scored tablets may be crushed Monitor PT, INR routinely Assess skin Assess gums for gingival bleeding and erythema Assess urine for hematuria Assess Hct, platelet count, urine/stool culture Assess for decrease in BP, increase in pulse rate, complaint of back pain, severe headache (evidence of hemorrhage) Assess peripheral pulses Check for excessive bleeding from minor cuts/scratches

Evaluation

Generic Name: Voriconazole Classification: triazole derivative Adult Dosage:200 mg Q12H Newborn Dosage: na Side Effects Abnormal Vision, fever, nausea, rash vomiting, Headache, chills, tachycardia, hypertension.

Trade Name: Vfend Action: inhibits synthesis of ergosterol (vital component of fungal cell wall formation) Reason Receiving: fungal infection Pregnancy Category: na Nursing Implications R/T Administration & Side Effects Evaluation Take at least 1 hour before or after a meal. Monitor serum hepatic/renal function test. Monitor visual function.

Generic Name: warfarin Classification: anticoagulant Adult Dosage: 2-10 mg/day Newborn Dosage: 0.05-0.2 mg/day Side Effects GI distress (nausea, anorexia, abdo. Cramps, diarrhea)

Trade Name: Coumadin Action: prevents growth of clot or development of new clot Reason Receiving: Pregnancy Category: X Nursing Implications R/T Administration & Side Effects Evaluation Monitor INR; and, assess Hct., platelet count, urine/stool for occult blood

Be alert for abdo/back pain, severe headache Watch for decrease BP or pulse Assess peripheral pulses and skin for ecchymoses Check gums Assess urine for hematuria

Generic Name: Zinc Sulfate Classification: supplement Adult Dosage: 220 mg Newborn Dosage: Side Effects Nausea

Trade Name: Orazinc Action: important for tissue development Reason Receiving: supplement Pregnancy Category: Nursing Implications R/T Administration & Side Effects Evaluation Monitor for nausea No reports of nausea.

Generic Name: Zolpidem Classification: nonbenzodiazepine Adult Dosage: 10mg QS Newborn Dosage: Side Effects HA, dizziness, nausea

Trade Name: ambien Action: Enhances action of GABA Reason Receiving: insomnia Pregnancy Category: C Nursing Implications R/T Administration & Side Effects Evaluation Assess BP, P, R, raise bed rails, provide Patient stated he had a good nights rest. call light. Evaluate therapeutic response. BP 129/68-117/63 HR-68/56 R- 18, No complaints of HA, Dizziness, nausea