Medication Card Main (Common) Side Effects:
Generic Name: Ondansetron
Trade Name: Zofran, Zofran ODT, Zuplenz
Drug Classification: oral and parenteral serotonin (5-
HT3) receptor antagonist.
Therapeutic Uses: For the prevention of nausea and
vomiting associated with emetogenic cancer
chemotherapy, post operation, and radiation. Also
used for the treatment of postoperative nausea and
vomiting.
Mechanism of Action:
Blocks the effects of serotonin at 5-HT3 receptor
sites (selective antagonist) located in bagal nerve
terminals and the chemoreceptor trigger zone in the
CNS.
Safe Dose Range and Administration Info:
PO: 4 mg/5 mL; 32 mg/50 mL-D5%; 2 mg/mL; 4
mg; 8 mg; 24 mg; 32 mg/50 mL-NaCl 0.9%
Contraindications:
Hepatic disease; Ondansetron is extensively
metabolized in the liver and should be used with
caution in patients with hepatic disease, hepatitis, or
elevated hepatic enzymes because of possible
increased plasma levels, reduced clearance, and
subsequent toxicity.
Phenylketonuria; Patients with phenylketonuria
should be informed that ondansetron orally
disintegrating tablets (ODT) contain phenylalanine (a
component of aspartame). Each 4 mg and 8 mg ODT
contains < 0.03 mg phenylalanine.
GI obstruction, ileus; The use of ondansetron may
mask the symptoms of adynamic ileus, GI
obstruction, or gastric distention after abdominal
surgery or during use to prevent chemotherapy-
induced nausea and vomiting. Ondansetron is not a
drug that stimulates gastric or intestinal peristalsis; it
should not be used instead of nasogastric suction.
Interactions: (Medication or Food)
Rifampin may decrease ondansetron levels.
Acetaminophen; Oxycodone: (Major) Serotonin
syndrome can occur during concomitant use of opiate
agonists with serotonergic drugs, such as serotonin-
receptor antagonists. Symptoms may occur hours to
days after concomitant use, particularly after dose
increases.
Drowsiness, fatigue, weakness, dry mouth, diarrhea,
constipation
Adverse Effects:
Headache, dizziness, QT interval prolongation,
extrapyramidal reaction
Nursing Implications:
assess paitent for nausea, vomiting, abdominal
distention, and bowel sounds.
hold or not give If paitent is experiencing
extrapyramidal effects (involuntary movements, facial
grimacing rigidity, shuffling walk, trembling of hands)
Monitor fluid and electrolyte status. Diarrhea, which
may cause fluid and electrolyte imbalance, is a
potential adverse effect of the drug.
Monitor cardiovascular status, especially in patients
with a history of coronary artery disease. Rare cases of
tachycardia and angina have been reported.
Evaluation of Effectiveness:
Prevention of Nausea and vomiting associated with
emetogenic cancer chemotherapy. Prevention of
postoperative nausea and vomiting. Prevention of
nausea and vomiting due to radiation therapy
Client Teaching:
- Report headache, onset or black tarry stool,
diarrhea, abdominal pain (signs of side effects)
- Avoid alcohol. (increases risk of liver disease
and work load)
- Swallow capsule whole, do not chew, crush
dissolve or divide.
- Take this pill before eating.
 Medication Card
Generic Name: Ranitidine
Trade Name: Zantac
Drug Classification: Antiulcer Agent
short-term treatment of active duodenal ulcers and
benign gastric ulcers. Maintenances therapy for
duodenal and gastric ulcers after healing of active
ulcer
Therapeutic Uses:
Healing and prevention of ulcers. Decreased
symptoms of gastroesophageal reflux. Decreased
secretion of gastric acid.
Mechanism of Action:
Inhibits gastric acid secretion by inhibiting histamine q24h with cautious and gradual reduction of the
at histamine2 receptors in parietal cells
Safe Dose Range and Administration Info:
Adult: PO 150 mg b.i.d. or 300 mg h.s. IV 50 mg q6– jaundice (dark urine, pruritus, yellow sclera and skin),
8h; 150–300 mg/24 h by continuous infusion
Contraindications:
H2-blocker hypersensitivity
Ranitidine is contraindicated in any patient
hypersensitive to the drug or its components. Cross-
sensitivity in this class of compounds has been
observed, so ranitidine should be administered with
caution to patients with a history of H2-blocker
hypersensitivity. An incidence of cross-reactivity
among this class of agents is not currently available. Decreased symptoms of esophageal reflux.
Gastric cancer Symptomatic response to therapy with Client Teaching:
ranitidine does not preclude the presence of gastric
cancer. In the patient who is self-medicating with
OTC ranitidine formulations, the continuation of
heartburn, acid indigestion, or dyspepsia beyond 2
weeks signals the need to consult a health-care
professional for evaluation.
Interactions: (Medication or Food)
Acalabrutinib: (Moderate) Separate the
administration of acalabrutinib and H2-blockers if
these agents are used together.
Acetohexamide: (Moderate) Ranitidine has been
shown to affect the pharmacokinetics of some oral
sulfonylureas.
Main (Common) Side Effects:
Headache, dizziness, drowsiness, confusion, nausea,
vomiting
Adverse Effects:
cardiac dysrhythmias, bradycardia, blood dyscrasias
Nursing Implications:
Potential toxicity results from decreased clearance
(elimination) and therefore prolonged action; greatest
in the older adult patients or those with hepatic or
renal dysfunction.
Lab tests: Periodic liver functions. Monitor creatinine
clearance if renal dysfunction is present or suspected.
When clearance is <50 mL/min, manufacturer
recommends reduction of the dose to 150 mg once
interval to q12h or less, if necessary.
Be alert for early signs of hepatotoxicity (though low
and thought to be a hypersensitivity reaction):
elevated transaminases (especially ALT) and LDH.
Long-term therapy may lead to vitamin B12
deficiency.
Evaluation of Effectiveness:
Decrease in abdominal pain.
Prevention of gastric irritation and bleeding. Healing
of duodenal ulcers can be
seen by x-rays or endoscopy. Therapy is continued for
at least 6 wk in treatment of
ulcers but not usually longer than 8 wk.
- Teach patient that Long duration of action
provides ulcer pain relief that is maintained
through the night as well as the day.
- Be aware that even if symptomatic relief is
provided by ranitidine, this should not be
interpreted as absence of gastric malignancy.
Follow-up examinations will be scheduled
after therapy is discontinued.
- Adhere to scheduled periodic laboratory
checkups during ranitidine treatment.
- Do not supplement therapy with OTC
remedies for gastric distress or pain without
physician's advice (e.g., Mylanta II reduces
ranitidine absorption).
- Do not smoke; research shows smoking
decreases ranitidine efficacy and adversely
affects ulcer healing.
- Do not breast feed while taking this drug
without consulting physician.
 Medication Card
Generic Name: Esomeprazole
Trade Name: Nexium
Drug Classification: Gastric anti-secretory
Therapeutic Uses:
short-term treatment of erosive esophagitis
treatment of symptomatic gastroesophageal reflux
disease (GERD)
as an adjunct in triple therapy treatment of H. pylori
infection
reduction of gastric ulcers
treatment of pathological hypersecretory conditions
(Zollinger-Ellison Syndrome)
Mechanism of Action:
it is a proton pump inhibitor that suppresses the
H+/K+ ATPase enzyme system at the secretory
surface of gastric parietal cells, inhibits the final step
of acid production
Safe Dose Range and Administration Info:
capsules, delayed-release: 20 and 40 mg
granules for oral suspension: 10, 20, 40 mg
powder for injection, freeze dried: 20, 40 mg in
single dose vials
Contraindications:
Hepatic disease, pregnancy, breastfeeding, diarrhea,
bone fractures, osteoporosis, older adults
Interactions: (Medication or Food)
Clopidogrel: Competitive inhibition of clopidogrel
metabolism to active form, reducing clopidogrel
effectiveness
CYP2C19 inhibitors: Decreased esomeprazole
metabolism increases risk of esomeprazole toxicity
CYP2C19 inducers: Increased esomeprazole
metabolism reduces esomeprazole effectiveness
CYP2C19 substrates: Decreased metabolism and
increased toxicity of substrates
pH dependent drugs: Lower gastric pH reduces
absorption
Warfarin: Increased anticoagulant effect
Main (Common) Side Effects:
headache, diarrhea, constipation, nausea, gas,
abdominal pain, dry mouth
Adverse Effects:
AST, ALT, GI bleeding, anemia, leukopenia,
thrombocytopenia, depression
Nursing Implications:
Monitor for Signs and sysmptoms of adverse CNS
effects (vertigo, agitation, depression) especially in
severely ill patients.
Monitor phenytoin levels with concurrent use.
Monitor INR/PT with concurrent warfarin use. Lab
tests: Periodic liver function tests, CBC, Hct & Hbg,
urinalysis for hematuria and proteinuria.
Evaluation of Effectiveness:
Asses for decreases pain level
Asses abdominal pain.
Client Teaching:
- take at least 1 hours prior to eating
- swallow capsules whole or sprinkle the
enteric-coated granules over applesauce and
swallow immediately without chewing
- Nexium granules should be mixed with 15 mL
of water, stirred, and let sit for 3 minutes, then
taken orally. take within 30 minutes of mixing
- antacids may be taken at the same time
- store in a cool, dry place
- if a dose is missed take it ASAP. if it is closer
to the time of your next dose, skip the missed
dose and return to your dosing schedule
- do NOT double doses
- contact physician if persistent side effects
occur, such as (headache, diarrhea,
constipation, nausea, gas, abdominal pain, dry
mouth )
 Medication Card
Generic Name: Bisacodyl
Trade Name: Laxative
Drug Classification: Dulcolax
Therapeutic Uses:
Constipation, Preparation of bowel for procedure
Mechanism of Action:
Increases peristalsis by direct effect on smooth
muscle of intestine
Safe Dose Range and Administration Info:
Adult: PO 5–15 mg prn (max: 30 mg for special
procedures) PR 10 mg prn
Child: PO 6 y, 5–10 mg prn PR 2 y, 10 mg; <2 y,
5 mg
Contraindications:
Acute surgical abdomen, nausea, vomiting,
abdominal cramps, intestinal obstruction, fecal
impaction; use of rectal suppository in presence of
anal or rectal fissures, ulcerated hemorrhoids,
proctitis.
Interactions: (Medication or Food)
Antacids: Antacids: May diminish the therapeutic
effect of Bisacodyl. Antacids may cause the delayed-
release bisacodyl tablets to release drug prior to
reaching the large intestine. Gastric irritation and/or
cramps may occur. Consider therapy modification
histamine 2 blockers, proton pump inhibitors, and
milk
Medication Card
Main (Common) Side Effects:
anorexia, nausea, vomiting, cramps, diarrhea
Adverse Effects:
dependence, hypokalemia
life threatening: tetany
Nursing Implications:
Give in the evening or before breakfast because of
action time required.
Give enteric coated tablets whole to avoid gastric
irritation; do not cut or crush. Patient should not chew
tablets. Preferably give with a full glass (240 mL) of
water or other liquid.
Do not give within 1 h of antacids or milk. These
substances may cause premature dissolution of enteric
coating; early release of drug in stomach may result in
gastric irritation and loss of cathartic action.
Store tablets in tightly closed containers at
temperatures not exceeding 30° C (86° F).
Rectal
Suppository may be inserted at time bowel movement
is desired.
Storage is same as tablets.
Evaluation of Effectiveness:
The patient having a soft formed BM when used for
constipation
Client Teaching:
- Increase fluid intake 1500-2000 mL/day during
therapy
- Do not use if experiencing cramping, diarrhea,
abdominal pain, nausea, vomiting, or if fever is
present
- expect bowel movement 15-60 min after
suppository administration.
- Report rectal bleeding or failure to have bowel
movement within 12 h after taking oral.
- Don’t take within one hour of milk. Don't take
for more than 7 days
- Educate patient about signs of a significant
reaction (eg, wheezing; chest tightness; fever;
itching; bad cough; blue skin color; seizures;
or swelling of face, lips, tongue, or throat
Main (Common) Side Effects:
 Generic Name: Finasteride
Trade Name: Procpecia Fever, itching, bad cough.

Drug Classification: Antandrogen, 5-Alpha reductase Adverse Effects:

inhibitor impotence, decreased libido, and decreased ejaculate.
Therapeutic Uses:
For the treatment of symptomatic benign prostatic
hyperplasia (BPH) in men with an enlarged prostate Nursing Implications:
to: Improve symptoms, reduce the risk of acute Evaluate carefully any sustained increase in serum SA
urinary retention, reduce the risk of the need for levels while patient is taking finasteride. It may
surgery including transurethral resection of the indicate the presence of prostate cancer or
prostate. Also used for the stimulation of regrowth of noncompliance with the therapy
hair in men with mild to moderate androgenetic
alopecia (male pattern alopecia, hereditary alopecia, Evaluation of Effectiveness:
common male baldness). Decrease in urinary symptoms of benign prostatic
Mechanism of Action: hyperplasia
Specefic inhibitor of the steroid 5- alpha reductase, Hair regrowth is showing
an enzyme necessary to convert testosterone into
potent androgen 5- alpha dihrotestosterone in the Client Teaching:
prostate gland. Decreases the production of Educate patient about signs of a significant reaction
testosterone in the prostate gland (eg, wheezing; chest tightness; fever; itching; bad
Safe Dose Range and Administration Info: cough; blue skin color; seizures; or swelling of face,
5 mg once daily (Proscar); Androgenetic lips, tongue, or throat)
alopecia: 1 mg once daily
Contraindications:
Hypersensitivity to finasteride; pregnancy (category
x) lactation, children
Women of childbearing age must not use finasteride
and should not handle crushed or broken tablets
because the active ingredient may cause
abnormalities of a male fetus’s sex organs.

Interactions: (Medication or Food)

None.

Reference
Hodgson, B. B., & Kizior, R. J. (1998). Saunders nursing drug handbook. Philadelphia: Saunders.
McCuistion, L.E., Vuljoin-DiMaggio, K., Winton, M.B., & Yeager, J.J. (2018). Pharmacology: A patient-
centered nursing process approach (9th ed.). St. Louis, MO: Elsevier.
Vallerand, A. H., Sanoski, C. A., & Deglin, J. H. (2015). Davis’s drug guide for nurses (14th ed.).
Philadelphia, PA: F.A. Davis Company.