DRUG NAME DRUG ACTION INDICATION and DOSE and ROUTE
CONTRAINDICATION And SIDE EFFECT RESPONSIBILITIES
Generic Name: Exact mechanism is not Indications:
Metformin understood; possibly Adjunct to diet to lower
Hydrochloride increases peripheral blood glucose with type 2
utilization of glucose, (non-insulin dependent)
decreases hepatic diabetes mellitus in
Brand Name: glucose production and patients > 10 yr; extended-
Fortamet, Glucophage, alters intestinal release in patients > 17 yr.
Glucophage XR, absorption of glucose. As part of combination
Glumetza, Metformin therapy with a
HCl ER, Riomet sulfonylurea or insulin
when either drug alone
cannot control glucose
Classification: levels in patients with
Antidiabetic type 2 DM.
Contraindications:
Contraindicated with
allergy to metformin; CHF;
diabetes complicated by
fever, severe infections,
severe trauma, major
surgery, ketosis, acidosis,
coma (use insulin); type 1
(insulindependent)
diabetes, serious hepatic
impairment, serious renal
impairment, uremia,
thyroid or endocrine
impairment, glycosuria,
ADVERSE EFFECT NURSING
Dose: Endocrine: Assessment: History of
Tablet: 500 mg hypoglycemia, lactic allergy to metformin;
acidosis. GI: anorexia, CHF; diabetes complicated
Route: nausea, vomiting, by fever, severe
 Oral epigastric discomfort, infections, severe trauma,
heartburn, diarrhea, major surgery, ketosis,
flatulence. acidosis, coma; type 1
Hypersensitivity: diabetes, serious hepatic
allergic skin reactions, impairment, serious renal
eczema, pruritus, impairment, uremia,
erythema, urticaria. thyroid or endocrine
impairment, glycosuria,
hyperglycemia associated
with primary renal disease;
lactation. Skin color,
lesions; T, orientation,
reflexes, peripheral
sensation; R, adventitious
sounds; liver evaluation,
bowel sounds; urinalysis,
BUN, serum creatinine,
LFTs, blood glucose,
CBC.
Interventions: Monitor
urine or serum glucose
levels frequently to
determine effectiveness of
hyperglycemia associated
with primary renal disease;
labor and delivery (if
metformin is used during
pregnancy; discontinue
drug at least 1 mo before
delivery); lactation (safety
not established). Use
cautiously with the elderly.
drug and dosage
(Warning: arrange for
transfer to insulin therapy
during periods of high
stress [infections, surgery,
trauma]; use IV glucose if
severe hypoglycemia
occurs as a result of
overdose). Teaching
points: Do not discontinue
this medication without
consulting your health
care provider. Monitor
blood for glucose and
ketones as prescribed.
Swallow extended-release
tablets whole; don’t crush,
cut, or chew. Don’t use
this drug during
pregnancy; if you become
pregnant, consult your
health care provider for
appropriate therapy. Avoid
using alcohol while
taking this drug. Report
fever, sore throat, unusual
bleeding or bruising, rash,
dark urine, lightcolored
stools, hypo- or
hyperglycemic reactions.
 DRUG NAME DRUG ACTION INDICATION and DOSE and ROUTE ADVERSE EFFECT NURSING
CONTRAINDICATION And SIDE EFFECT RESPONSIBILITIES

Generic Name: . A selective beta blocker Indications: Dose: . GI and sleep pattern  Check for the patient’s
Metropolol tartrate that selectively blocks Hypertension and chronic Tablet: 500 mg disturbances apical pulse before giving
beta 1 receptors, angina pectoris headache, dizziness, the medication; if pulse is
Brand Name: decreases cardiac output, Route: and weakness. slower do not give the
Neobloc peripheral resistance and Contraindications:  Oral drug.
cardiac oxygen Heart block> 1st degree,  In diabetic patients,
Classification: consumption AV block II and III, monitor the glucose level
Anti-hypertensive drug, and depresses rennin cardiogenic shock, overt closely because the drug
Beta-blocker secretion. cardiac failure, sinus, masks common sign and
bradycardia, symptoms of
bronchospastic disease. hypoglycemia.
 Monitor the BP
frequently, the drug masks
common signs and
symptoms of shock.
 Beta blockers may
mask tachycardia caused
by hyperthyroidism.
 When teraphy is
stopped, reduce dose
gradually for 1-2 weeks.
 Instruct patient to take
drug exactly as prescribed.
 Caution patient to avoid
tasks requiring mental
alertness until response to
therapy has been
established.
 Instruct patient not to
stop drug suddenly.
 DRUG NAME DRUG ACTION INDICATION and DOSE and ROUTE ADVERSE EFFECT NURSING
CONTRAINDICATION And SIDE EFFECT RESPONSIBILITIES

Generic Name: Cloxacillin is resistant to Indications: Dose:

Cloxacillin degradation by
penicillinases. It is
Brand Name: particularly useful
Cloxapen, against
Tegopen penicillinase-producing
staphylococci. Highly
Classification: active against S aureus, S
Antibiotic pyogenes, S viridans
and S pneumoniae.
Treatment of susceptible Tablet: 500 mg Cardiovascular: Antibiotic
bacterial infections, Hypotension
including beta-hemolytic Route: Pain as well as
streptococci, pneumococci,  Oral Central nervous inflammation and its signs
and penicillinase-producing system: Confusion, and symptoms - redness,
staphylococci causing fever, lethargy, swelling, fever, and pain
respiratory tract, skin and seizure (high doses are reduced.
skin structure, bone and and/or renal failure)
joint, urinary tract Every 6 hour
infections Dermatologic:
Pruritus, rash, Instruct client tonreport
Contraindications: urticaria any adverse reaction to the
Hypersensitivity to physician or nurse. Tell
cloxacillin, other Gastrointestinal:
patient that Antibiotic
penicillins, cephalosporins, Abdominal pain,
or any component of the black or hairy tongue, medicines can cause
formulation diarrhea, flatulence, diarrhea, which may be a
nausea, oral sign of a new infection.
candidiasis,
pseudomembranous Do not take the medication
colitis, stomatitis, in larger
vomiting
amounts, or take it for
Hematologic: longer than recommended
Agranulocytosis, bone by your doctor.
marrow depression,
eosinophilia,
 Tell patient that
granulocytopenia, medication may cause
hemolytic anemia, nausea or vomiting (small,
leukopenia, frequent meals, frequent
neutropenia,
thrombocytopenia mouth care, sucking
lozenges, or chewing gum
Local: may help); or diarrhea
Thrombophlebitis (buttermilk, boiled milk,
or yogurt may help).
Neuromuscular &
skeletal: Arthralgia, Instruct client to maintain
myalgia, myoclonus adequate hydration (2-3
L/day of fluids) unless
Renal: Hematuria,
instructed to restrict fluid
interstitial nephritis,
proteinuria, renal intake.
insufficiency, renal
tubular damage

Respiratory:
Bronchospasm,
laryngeal edema,
laryngospasm,
sneezing, wheezing
 DRUG NAME DRUG ACTION
Generic Name: Analgesic and anti-
Celecoxib inflammatory activities
related to inhibition of
Brand Name: the COX-2 enzyme,
Celebrex which is activated in
inflammation to cause
Classification: the signs and symptoms
NSAID associated with
Analgesic (nonopioid) inflammation; does not
Specific COX-2 enzyme affect the COX-1
blocker enzyme, which protects
the lining of the GI
tract and has blood
clotting and renal
functions.
INDICATION and DOSE and ROUTE ADVERSE EFFECT NURSING
CONTRAINDICATION And SIDE EFFECT RESPONSIBILITIES
Indications: Dose: · CNS: Headache, Assessment
· Acute and long-term Capsule: 500 mg dizziness, · History: Renal
treatment of signs and somnolence, impairment, impaired
symptoms of rheumatoid Route: insomnia, fatigue, hearing, allergies, hepatic
arthritis and  Oral tiredness, dizziness, and CV
osteoarthritis tinnitus, conditions, lactation
· Reduction of the number ophthamologic effects · Physical: Skin color and
of colorectal polyps in · Dermatologic: lesions; orientation,
familial adenomatous Rash, pruritus, reflexes, ophthalmologic
polyposis sweating, dry mucous and
(FAP) membranes, stomatitis audiometric evaluation,
· Management of acute · GI: Nausea, peripheral sensation; P,
pain abdominal pain, edema; R, adventitious
· Treatment of primary dyspepsia, flatulence, sounds;
dysmenorrhea GI bleed liver evaluation; CBC,
· Hematologic: renal and liver function
Contraindications: Neutropenia, tests; serum electrolytes
· Contraindicated with eosinophilia, Interventions
allergies to sulfonamides, leukopenia, · Administer drug with
celecoxib, NSAIDs, or pancytopenia, food or after meals if GI
aspirin; significant renal thrombocytopenia, upset occurs.
impairment; pregnancy; agranulocytosis, · Establish safety measures
lactation. granulocytopenia, if CNS, visual
· Use cautiously with aplastic anemia, disturbances occur.
impaired hearing, hepatic decreased · Arrange for periodic
and cardiovascular hemoglobin or ophthalmologic
conditions. hematocrit, bone examination during long-
marrow depression, term therapy.
menorrhagia · If overdose occurs,
institute emergency
· Other: Peripheral procedures—gastric
edema, anaphylactoid lavage, induction of
reactions to emesis, supportive
anaphylactic shock therapy.
· Provide further comfort
measures to reduce pain
(eg positioning,
environmental
control), and to reduce
inflammation (eg warmth,
positioning, rest).