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Generic Name: Esomeprazole (Astrazeneca)

Brand Name: Prilosec, Omepron

Pregnancy Category: C; not for use in nursing
Dosage: Injection: 20mg, 40mg; Oral: 10-, 20-, L40mg sustained-released capsules
Classification: Proton pump inhibitor
Indication: Short-term treatment of gasteosophageal reflux disease with erosive esophagitis treats
patients with H pylori infections, duodenal ulcer, hypersecretory conditions.
Mode of Action: Suppresses gastric acid secretion by specific inhibition of the H+/L+- ATPase in the
gastric parietal cell. Blocks the final step of acid prduction
Side Effects: Headache, flatulence, nausea, abdominal pain, diarrhea, dry mouth
Pharmacokinetics: Absorption: max= 3.86 umol/L (20mg), 7.5 umol/L (40mg)
Half-life: Variable ; 0.85-2 hr Onset: 2hrs ; unknown Peak: 5.35 hrs ; 1 ½ hr Duration: up to 72 hrs
Nursing Intervention: Asses for hypersensitivity to the drug. Obtain baseline Magnesium levels. Monitor
for signs and symptoms of atrophis gastritis, bone fracture, hypomagnesemia. Monitor
Magnesium levels periodically. Monitor LFTs.
Patient Counseling: Advise to notify physician if taking other medications. Inform that antacid may be
used while on therapy. Advice to report and seek care for diarrhea that does not improve.
**All PPI’s are given 30 minutes before meals.

Reference: PDR 2014 EDITION NURSE’S DRUG HANDBOOK, Copyright 2013 PDR Network, LLC.
Published by PDR Network, LLC at Monticale, NJ 07645-1725. All rights reserved. None of the content of
this publication may be reproduces. Physicians’ Desk Reference and PDR are registered trademarks
of PDR Network, LLC.

Generic Name: Morphine Sulfate

Brand Name: Avinza, Kadian, Astramorph PF
Pregnancy Category: C
Dosage: Embeda = 20mg/0.8mg, 30mg/1.2g, 50mg/2mg, 60mg/2.4mg,
80mg/3.2mg, 100mg/4mg
Classification: Chemical: Phenanthrene derivative; Therapeutic: Analgesic; Clinical: Opioid Agonist
Indication: To relieve acute/chronic moderate to severe pain. To supplement general, local, or
regional anesthesia. To relieve MI pain. To provide preoperative analgesia. To provide
analgesia during labor.
Mode of Action: Binds with and activates opioid receptors (mainly mu receptors) in the brain and
spinal cord to produce analgesia and euphoria. // OR // Binds with opioid receptors within
CNS, inhibiting ascending pain pathways. Thus altering pain perception, and emotional
response to pain.
Side Effects: Sedation, decreased BP, diaphoresis, facial flushing, constipation, dizziness, drowsiness,
nausea, vomiting
Pharmacokinetics: Half-life: 2-4 hrs
Route Onset Peak Duration
Tablets 30 min 1 hr 3-5 hrs
I.V. Rapid 0.3 hr 3-5 hrs
I.M. 5-30 min 0.5-1hr 3-5 hrs
Nursing Intervention: Monitor vital signs 5-10 min after I.V. administration, 15-30 min after subcutaneous,
I.M. Be alert for decrease respirations, BP. Check for adequate voiding. Monitor daily pattern of
bowel activity, stool consistency. Initiate DBE and coughing exercises. WOF signs of Morphine
Sulfate toxicity such as Hypotension, Bradypnea, Pinpoint pupils, and Bronchial oversecretion

Reference: Kizior, R.J. and Hodgson, K.J. (2016). Saunders Nursing Drug Handbook. ELSEVIER, USA.
Generic Name: Atorvastatin
Brand Name: Lipitor
Pregnancy Category: X
Dosage: Adults: 10-20 mg PO daily. May increase to 10-80 mg PO daily. Children (10-17): 10 mg PO OD.
Adjustment intervals should be at least 4 weeks. Maximum daily dose is 20 mg.
Classification: Antilipemics, HMG-CoA reductase inhibitors
Indication: To control lipid levels as adjunct to diet in primary (heterozygous familial and nonfamilial)
hypercholesterolemia and mixed dyslipidemia. To reduce debilitating cardiovascular events
such as stroke and MI in patients with multiple risk factors but without known coronary artery
Mode of Action: Inhibits HMG-CoA reductase, an enzyme responsible for cholesterol production. When
inhibited, cholesterol production is decreased
Side Effects: CNS: headache, asthenia, insomnia. CV: peripheral edema. EENT: pharyngitis, rhinitis,
sinusitis, nasopharyngitis. GI: abdominal pain, constipation, diarrhea, dyspnepsia, flatulence,
nausea. GU: UTI. Masculoskeletal: rhabdomyolysis, arthritis, arthralgia, myaglia, extremity pain.
RESP: bronchitis. Skin: rash. Other: allergic reactions, flu-like syndrome, infection
Pharmacokinetics: Route: PO Onset: 1-2 hrs Peak: 2 wks Duration: unknown
Nursing Intervention: Before treatment, assess patient for underlying causes for hyoercholesterolemia
and obtain a baseline lipid profile. Obtain periodic LFT results and lipid levels before starting
treatment and at 6 and 12 weeks after initiation, or after an increase in dosage and
periodically there after.

Reference: Lilley, L.L., et. al. (2005). Pharmacology and the Nursing Process; 4th edition

Generic Name: Regular Insulin

Brand Name: Gumulin R, Novolin R
Dosage: 100 units/ml
Classification: Exogenous insulin, Antidiabetic, Human recombinant short-acting insulin
Indication: Treatment of Insulin-dependent type I Diabetes Mellitus. Non-insulin dependent type II
Diabetes Mellitus to improve glycemic control.
Mode of Action: Act via specific receptor to regulate metabolism of carbohydrates, protein and fats.
Liver: stimulates hepatic glycogen synthesis, synthesis of fatty acids. Muscle: increase protein,
glycogen synthesis. Adipose tissue: stimulates lipoproteins to provide free fatty acids,
triglyceride synthesis. Therapeutic effect: controls serum glucose levels
Side Effects: Hypoglycemia resulting from overdose may lead to shock and possible death.
Pharmacokinetics: Onset: 30-60 min Peak: 1-5 hrs Duration: 6-10 hrs
Nursing Intervention: Alcohol/ginger may increase risk of hypoglycemia. Beta-adrenergic blockers may
alter effect, prolong periods of hypoglycemia. Glucocorticoids, thiazide diuretics may increase
serum glucose.
Patient Counseling: Prescribe diet and exercise. Do not delay of skip meals.

Reference: 2016 Saunder’s Nursing Drug Handbook

Generic Name: Metroprolol
Brand Name: Apo-Metroprolol, Betaloc, Lopressor, Toprol XL
Pregnancy Category: C
Dosage: Tablet: 25mg, 50ng, 100mg, 200mg. Sustained release tabs: 1mg/ml injection
Classification: Beta-adrenergic antagonist, Antihyoertensive, Antianginal
Indication: Management of mild to severe hypertension, long term treatment of angina pectoris and
prophylactic. Management of stable angina pectoris reduce the risk of mortality after an MI.
Mode of Action: Reduces or blocks SNS stimulation to the heart and the heart’s conduction system. By
doing this, beta blockers present catecholamine-mediated actions to the heart. This decreases
heart rate, delayed AV conduction, reduced myocardial contractility.
Side Effects: Body: hypersensitivity. CNS: dizziness, fatigue, insomnia. CV: bradycardia, palpitation, cold
extremities, cardiac arrest. GI: nausea, heartburn, gastric pain, diarrhea, constipation. Skin: dry
skin, pruritus. Metabolic: hypoglycemia
Pharmacokinetics: Onset: 15min Peak: 1.5hr; 20min (IV) Duration: 13-19 hr Half-life: 3-4 hr
Nursing Intervention: Withdraw drug if patient presents symptoms of mental depression because it can
progress to catatonia. Report to physician significant changes in rate, rhythm, or quality of
pulse of variations in BP to administration.

Reference: Wilson, B. (2010). Pearson Nurse’s Drug Guide.USA. Pearson Education, Inc.

Generic Name: Clonidine HCL

Brand Name: Catapres, Duraclon
Pregnancy Category: C
Dosage: 0.1 mg PO BID, then increased by 0.1 mg daily on a weekly basis. Usual range is 0.2 to 0.6 mg
daily in divided doses, infrequently dosages as high as 2.4 mg daily are used or apply
transdermal patch once every 7 days starting with 0.2 mg system and adjustd with another 0.2
mg or larger system after 1 or 2 weeks if desired BP reduction is not achieved
Classification: Calcium channel blocker/ Centrally acting alpha 2 receptor agonist
Indication: To manage HTN. To treat ADHD alone or as adjunct therapy with stimulant drugs. As adjunct
to relieve severe pain (in cancer patients) that is not adequately relieved by opioid analgesics
Mode of Action: Inhibits calcium influx in the cardiac muscle, causing relaxation making coronary
arteries dilate. This will increase oxygen supply, decrease in force and decrease in blood
pressure. Decrease in force (systemic vascular resistance) decrease workload of the heart
therefore reduces myocardial oxygen demand.
Side Effects: CV: palpitation, bradycardia, heart failure. GI: constipation, nausea. Other: dermatitis,
dyspnea, rash, flushing, wheezing
Pharmacokinetics: Onset: 30-60min Peak:2-4hr Duration: 8hrs Half-life: 6-20 hr
Nursing Intervention: Do not discontinue abruptly. Discontinue therapy by reducing the dosage
gradually over 2-4 days to avoid rebound hypertension, tachycardia, flushing, nausea,
vomiting, cardiac arrhythmias (hypertensive encephalopathy and death have occurred after
abrupt cessation of Clonidine). Check BP and hearth rate before and after administration

Reference: 2015 Nurse’s Drug Handbook and 2016 Nurse’s Drug Handbook
Generic Name: Celecoxib
Brand Name: Celebrex
Pregnancy Category: C
Dosage: Up to 200 mg BID even without meals
Classification: COX-2 inhibitor NSAID
Indication: To relieve signs and symptoms of osteoarthritis. To relieve signs and symptoms of rheumatoid
arthritis (RA), Ankylosing Spondylitis, and juvenile RA. Acute pain and primary dysmenorrhea
Mode of Action: Inhibits prostaglandin synthesis via inhibition of COX-2 but not COX-1
Side Effects: CNS: headache, dizziness, insomnia. CV: hypertension, peripheral edema. EENT:
pharyngitis, rhinitis, sinusitis. GI: abdominal pain, diarrhea, dyspepsia, flatulence, GI reflux,
nausea. Metabolic: hyperchloremia. Musculoskeletal: Back pain. Respiratory: dyspnea, upper
respiratory tract infections. Skin: erythema, multiforme, exfoliative dermatitis, Steven-Johnson
syndrome, toxic epidermal necrolysis, rash. Other: accidental injury
Pharmacokinetics: Route: P.O. Onset: Unknown Peak: 3 hrs. Duration: 4-8 hrs. Half-life: 11 hr
Nursing Intervention: Tell patient to report history of allergic reactions to sulfonamides, aspirin, or other
NSAIDs before therapy. ACE inhibitors, angiotensin II antagonists: May decrease
antihypertensive effects.Monitor BP

Generic Name: Moringga Oleifera

Brand Name: Moringana, Mrozon +
Pregnancy Category: A
Dosage: 2-5 g powder
Classification: Food suppliment
Indication: Patient who has anemia, anxiety, asthma, chest congestion, and abnormal BP. Helps
increase milk production to lactating mothers.
Mode of Action: As an antioxidant, it helps protect cells from damage
Side Effects: Induce genetic transcription same with sulforaphane
Pharmacokinetics: Onset: unknown Peak: unknown Half-life: unknown
Nursing Intervention: No known therapeutic effect but still work in hypersensitivity reactions
Generic Name: Docusate Sodium
Brand Name: Colace, Diocto,
Pregnancy Category: C
Dosage: PO (adult and children >12 yrs) 50-400 mg in 1-4 divided doses
Classification: Therapeutic: Laxatives Pharmacologic: Stool softeners Emollient laxative
Indication: Prevention of constipation, used as enema to soften fecal impaction
Mode of Action: Provides incorporation of water and lipids (fats) into stool, resulting in softer fecal mass
Side Effects: Throat; irritation. GI: mild cramps. Skin: rashes, decrease absorption of vitamins.
Other: electrolyte imbalance
Pharmacokinetics: Half-life: unknown
Route Onset Peak Duration
P.O. 24-48 hr unknown unknown
Rectal 2-15 min unknown unknown
Nursing Intervention: Assess for abdominal distention, presence of bowel sounds and usual pattern of
bowel function

Reference: Davi’s Drug Guide for Nurse’s 12th edition

Generic Name: Glimepiride

Brand Name: Amaryl
Pregnancy Category: C
Dosage: Available: 1, 2, 4 mg tabs. Adults: 1 or 2 mg P.O. OD; usual maintenance. Dose is 1-4 mg
P.O. OD. After reaching six 2 mg every 1-2 weeks, based on patient’s glucose level.
Maximum= 8mg daily
Classification: Sulfonylurea (2nd generation)
Indication: Adjunct to diet and exercise to lower glucose level in patients with type II Diabetes whose
hyperglycemia can’t be managed by diet and exercise alone.
Mode of Action: Lowers glucose level, possibly by stimulating release of insulin from functioning
pancreatic beta cells, and may lead to increased sensitivity of peripheral tissues to insulin
Side Effects: CNS: dizziness, asthenia, headache. EENT: changes in accommodation. GI: nausea.
Hematologic: leucopenia, hemolytic anemia, aplastic anemia, thrombocytopenia,
pancytopenia. Hepatic: cholestatic jaundice. Metabolic: hypoglycemia. Skin: erythema,
urticaria, pruritus, phostosensitivity reactions
Pharmacokinetics: Onset: 1 hr Peak: 2-3 hr Duration: >24 hrs Half-life: 9 hr
Nursing Intervention: Monitor fasting glucose level periodically to determine therapeutic response. Also
monitor glycosylated hemoglobin level, usually every 3-6 months to precisely assess long-term
glycemicortirol. Gumepride and insulin may be used together in patient’s whose glucose
control after firtst responding to therapy. When changing patient from other sulfonylureas to
glimarise, atransition period isn’t needed. Monitor patient carefully to 1-2 weeks when
changing from longer half-life sulfonylureas such as chlorpropamide

Reference: Williams, L., Wilkins (2010). Nursing 2010 Drug Handbook. 30th Anniversary Edition. C&E
Publishing, Inc.
Generic Name: Ferrous fumarate
Brand Name: Ferrous fumarate
Pregnancy Category:
Dosage: Adult: 325 mg daily Child: syrup containing 140 mg/5ml Neonate: 0.6 – 2.4 mg/kg daily
6 yrs: 2.5 – 5 ml BID Oral: 60-, 195, 200, 300-, 324, 329 mg
Classification: Anti-anemics, Iron supplement
Indication: To prevent iron deficiency. To replace iron deficiency states. To provide iron
supplementation during pregnancy
Mode of Action: It is a synthetic molecule used for treating iron-deficiency anemia. It works as a
reducing agent and co-enzyme in various metabolic pathways
Side Effects: CNS: dizziness, headache CV: hypotension, HTN Other: Gastrointestinal
disturbances, constipation, black-tarry stool, discoloration of urine, temporary staining of teeth.
Pharmacokinetics: Half-life: 6hr
Route Onset Peak Duration
P.O. 4 day 7-10 day 2-4 mos
IM/IV 4 day 1-2 wk wk-mos
Nursing Intervention: Not given in patients with anemia not due to iron deficiency, in those receiving
repeated blood transfusion, people with hypersensitivity. Inform client that it causes black-tarry
Patient Counseling: Don’t take it with milk for it decreases absoption

Generic Name: Clindamycin

Brand Name: Cleonin, Cleocin T, Clinda-Derm, Clin-dagel, Clindase, Clinda Max, Clindets, C/T/S
Pregnancy Category: B
Dosage: Adults: IV/PO= 300 – 900 mg BID – QID Pedia: IV/PO= 8 – 25 mg/kg/day
Classification: Anti-infectives, Licosamides
Indication: POM, IM, IV: Treatment of skin and skin structure infections; Respiratory Tract Infection;
Septicemia; Intra-abdominal infections; Gynecologic infections; Osteomyelitis, endocarditis,
prophylaxis. Topical: severe acne Vag: bacterial vaginosis Others: Treatment of
pneumocytosis carinii, pneumonia, CNS taxoplasmosis and babesiosis
Mode of Action: Inhibits protein synthesis in susceptible bacteria by binding to 50s ribosomal subunits
Side Effects: CNS: dizziness, headache, vertigo. CV: arrhythmias, hypotension. GI: pseudomembranous
colitis, diarrhea, bitter taste (IV only), nausea, vomiting. Derm: rashes Local: phlebitis at IV side
Pharmacokinetics: Half-life: 3.6 – 8.7 hr; infants: 3hr; children and adults: 2-3hr
Route Onset Peak
P.O. Rapid 60 min
I.M. Rapid 1-3 hr
I.V. Rapid End of infusion
Nursing Intervention: P.O.: Administer with a full glass of water. May be given with or without meals.
Shake liquid preparations well. Do not refrigerate. Stable for 14 days at room temperature.
I.M: Do not administer >600 mg in a single IM injection. Assess for hypersensitivity, patient’s
reaction such as rashes, prumtus

Reference: Nurse’s Drug Handbook 2011

Generic Name: Losartan - Hydrochlorothiazide
Brand Name: Hyzaar, Pritor +
Pregnancy Category: C (1st trimester); D (2nd and 3rd trimester)
Dosage: Tab: 12.5 mg, 25 mg, 50 mg, 100 mg
Classification: Angiotensin II receptor blocker
Indication: Hypertension, Hypertensive patients with left ventricular hypertrophy.
Mode of Action: Blocks vasoconstriction and aldosterone-secreting effects of angiotensin II at various
receptor sites, including vascular smooth muscle and adrenal glands. Also increase urinary flow
and enhances excretion of chloride, magnesium, calcium, and phosphate.
Side Effects: Back pain, Dizziness, Upper respiratory infection, Anemia, Hyperglycemia.
Pharmacokinetics: Onset: 2hrs Peak: 4hrs Duration: 6-12hrs Half-life: 2hr
Nursing Intervention: Assess for volume depletion. CHF,DU, unilateral or bilateral renal artery stenosis.
Monitor BP, Ferum electrolyte imbalance, Hypotension, Hypersensitivity, Oliguria. Inform of
pregnancy risk and instruct to report pregnancy to their physician immediately.

Reference: 2016 Saunder’s Nursing Drug Handbook

Generic Name: Methylgonovine maleate

Brand Name: Methergine
Pregnancy Category: C
Dosage: IM/IV: 0.2 mg after delivery of placenta
Classification: Therapeutic: Oxytocics. Pharmacologic: Ergot alkalosis
Indication: To prevent and treat PP hemorrhage caused by uterine atomy/subinvolution
Mode of Action: Increases motor activity of the uterus by direct stimulation of the smooth muscle and
reduce blood loss after delivery of placenta
Side Effects: CN: seizures, stroke with IV use, dizziness, headache, hallucinations. CV: hypertension,
transient, chest pain, palpitations, hypotension, thrombophlebitis, MI. EENT: tinnitus, nasal
congestion. GV: nausea, vomiting, diarrhea, foul taste. GU: hamaturia. Musculoskeletal: leg
cramps. Respiratory: dyspnea. Skin: diaphoresis
Pharmacokinetics: Half-life: 1.5 hr - 12.75 hr
Route Onset Peak Duration
P.O. 5-10min 30min 3hr
I.V. immediate unknown 45min
I.M. 2-5min unknown 3hr
Nursing Intervention: Monitor and record BP, pulse rate, and urine response. Report sudden change in
vital signs. Do not give to patients with the BP of 140/

Reference: 2016 Nursing Drug Handbook

Generic Name: Aspirin
Brand Name: Aspilet, Ecotrin
Pregnancy Category: D
Dosage: 325 – 650mg / 4 hrs
Classification: Chemical: Salicylate.
Therapeutic: Anti-inflammatory, antiplatelet, antipyretic, nonopiod analgesic
Indication: To relieve mild pain or fever. To relieve mild to moderate pain from inflammation, as in
theumatois arthritis and osteoarthritis. To treat juvenile theumatoid arthritis. To treat acute r
heumatic fever. To reduce risk of recurrent transient ischemic attacks or stroke in men. To r
educe severity of or prevent acute MI. To reduce risk of MI in patients with previous MI or
unstable angina.
Mode of Action: Aspirin’s effect may vary by dose. Low doses (75 – 81 mg/day) inhibits platelet
generation of thromboxane A2 resulting in anti-thrombotic effects.
Intermediate doses (650mg – 4mg/day) have analgesic and antipyretic effects
Side Effects: Acute aspirin toxicity: Respiratory alkalosis, tachypnea, hyperpnea. Aspirin intolerance
exacurbator of bronchospasm, rhinitis. GI: nausea, vomiting, dyspepsia, heartburn,
hypertoxicity, hemalogic occult blood loss, homeostatic defect, hypersensitivity and salicylism
Pharmacokinetics: Half-life: 1-4 hrs Onset: <5min Peak: 2hr Duration: 6-8 hrs
Nursing Intervention: Monitor if patient shows contraindications to the drug. Teach patient proper time
of drug intake. Do not give if client has signs of bleeding such as epistaxis

Reference: 2016 Nursing Drug Handbook

Generic Name: Metformin HCl

Brand Name: Fortamet, Glucophage
Pregnancy Category: B
Dosage: 850mg / 200mg daily
Classification: Chemical: Dimethylbiguanide Therapeutic: Antidiabetic
Indication: To reduce blood glucose level in type II diabetes mellitus. As adjunct to insulin therapy in
type II diabetes mellitus.
Mode of Action: Decreases hepatic production of glucose. Decreases intestinal absorption of glucose,
improves insulin sensitivity. Therapeutic effect: improves glycemic control, stabilizes/decrease
body weight, improves lipid profile.
Side Effects: Headache, metallic taste, hypoglycemia, nausea and vomiting, anorexia, abdominal
distention, diarrhea, constipation, aplastic anemia, thrombocytopenia
Pharmacokinetics: Route: P.O. Onset: unknown Peak: 2wk
Duration: 2wks after drug discontinued Half-life: 9-17hr.
Nursing Intervention: Give tablets with food, which delay and decreases absorption. Assess BUN and
serum creatinine levels before and during long-term therapy. Monitor hepatic function as
ordered. Monitor blood glucose

Reference: 2016 Nursing Drug Handbook

Generic Name: Paracetamol
Brand Name: Calpol, Biogesic, Tempra
Pregnancy Category: B
Dosage: Caplets: 325mg, 500mg, 650mg Elixir: 160mg/5ml
Classification: Therapeutic: Analgesics, Antipyretic Pharmacologic: Para-aminophenol derivatives
Indication: Mild pain and fever, arthritis, mild to moderate pain with or without adjunctive opioid
analgesic, fever, prevention of adverse reactions with diphteria, tetanus toxoids, and pertusis.
Mode of Action: Produce analgesia by inhibiting prostaglandin and other substances that are sensitive
pain receptors. Drug may relieve fever through central action in the hypothalamic heat-
regulating center. Appears to inhibit impulses through peripheral action. Acts centrally in
hypothalamic heat regulating center, producing peripheral vasodilation (heat loss, skin
erythema, diaphoresis)
Side Effects: CNS: anciety, fatigue, headache, insomnia, pyrexia. CV: hypertension, hypotension,
peripheral edema, periorbital edema, tachycardia (IV). GI: nausea, vomiting, abdominal pain,
diarrhea, constipation (IV). GU: oliguria (IV). Hematologic: hemolytic anemia, leucopenia,
neutropenia, pancytopenia, anemia (IV). Metabolic: hypoglycemia, hypokalema,
hypomagnesemia, hypophosphatemia (IV). Musculoskeleta: muscle spasms, extremity pain.
Respiratory: abnormal breath sound, dyspnea, hypoxia, atelectasis, pleural affision, stridor,
wheezing (IV). Skin: rash, urticaria, infusion site pain, pruritus
Pharmacokinetics: Route: P.O, I.V, P.R Onset: unknown Peak: ½ - 2hr Duration: 3-4hrs
Half-life: P.O, P.R: 1-4hr I.V: 2.4-7hr
Nursing Intervention: If given for analgesia, assess onset, type, location, duration of pain. Assess for
fever, alcohol usage, clinical improvement and relief of pain and fever. Consult physician for
use in children younger than 2 years, oral use longer than 5 days (children) or longer than 10
days (adults) or fever lasting longer than 3 days.

Generic Name: Clopidogrel

Brand Name: Plavix
Pregnancy Category: B
Dosage: Tablet: 75 mg, 300 mg
Classification: Pharmacotherapeutic: Thienopyridine derivative
Clinical: Antiplatelet; Platelet aggregation inhibitor
Indication: To reduce atherosclerotic events such as stroke and MI, in patients with atherosclerosis
documented by recent stroke, MI, or peripheral artery disease. To reduce rate of death,
reinfarction, or stroke in patients with ST-segment elevation acute MI.
Mode of Action: Inhibits the binding of adenosine diphosphate (ADP) to its platelet receptor, impeding
ADP-mediated activation and subsequent platelet aggregation, and irreversibly modifies
platelet ADP receptor
Side Effects: Frequent: Skin disorders. Occasional: Upper respiratory tract infection, chest pain, flu-like
symptoms, headache, dizziness, arthralgia. Rare: Fatigue, edema, hypertention, abdominal
pain, dyspepsia, diarrhea, nausea, epistaxis, dyspnea, rhinitis
Pharmacokinetics: Half-life: 8hr Onset: 2hr Peak: unknown Duration: 5 days
Nursing Intervention: Monitor platelet count for evidence of thrombocytopenia. Assess Hgb, Hct, WBC;
serum ALT, AST, bilirubin, BUN, creatinine; signs/symptoms of hepatic insufficiency during

Reference: 2016 Nursing Drug Handbook

Generic Name: Calcium Carbonate
Brand Name: Titralac, Tums
Pregnancy Category: C
Dosage: Tablets: 1,250mg ; 1,500mg (Caltrate 600). Chewable Tablets: 500mg (Tums). 1,250mg
Classification: Pharmacotherapeutic: Electrolyte replenisher. Clinical: Antacid, Antihypocalcemic,
Antihyperkalemic, Antihypermagnesemic, Antihyperphosphatemic
Indication: To treat hyperphosphatemia. To prevent hypocalcemia. To provide antacid effects. To
replace calcium in hypocalcemia. As adjunct to treat magnesium intoxication. As adjunct in
cardiac resuscitation. As adjunct in exchange transfusion
Mode of Action: Essential for function, integrity of nervous, muscular, skeletal systems. Plays an
important role in normal cardiac/renal function, respiration, blood coagulation, cell membrane
and capillary permeability. Assists in regulating release/storage of hormones or
neurotransmitters. Neutralized or reduces gastric acid (increases pH)
Side Effects: Frequent: Chalking taste (P.O.), pain, rash, redness, burning at injection site, flushing,
nausea, vomiting, diaphoresis, hypotension. Occasional: Mild constipation, fecal impaction,
peripheral edema, metabolic alkalosis. Rare: Urinary urgency, painful urination. Others: Milk-
alkali syndrome (headache, decreased appétit, nausea, vomiting, unusual fatigue).
Pharmacokinetics: Half-life: unknown Onset: unknown Peak: 20min-1hr Duration: unknown
Nursing Intervention: Monitor serum BMP, calcium, ionized calcium, magnesium, phosphate; BO,
cardiac rhythm, renal function. Monitor for signs of hypercalcemia

Reference: 2016 Nursing Drug Handbook

Generic Name: Eperisone HCl

Brand Name: Rapisone, Enzoril
Pregnancy Category: Unknown
Dosage: 50mg – 150mg after meals
Classification: Therapeutic: Skeletal muscle relaxant. Antispasmotic
Indications: Spastic paralysis in conditions such as cerebrovascular disease, spasticspinal paralysis,
cervical spondylosis, post-operative sequelae (includingcerebrospinal tumour), sequelae to
trauma (spinal trauma, head injury), amyotrophic lateral sclerosis, cerebral palsy,
spinocerebellar degeneration, spinal vascular diseases and other
encephalomyelopathies;improvement of muscular hypertonic symptoms in conditions such
ascervical syndrome, periarthritis of the shoulder, lumbago.
Mode of Action: Inhibits the vicious cycle of myotonia by decreasing pain, ischaemia, and hypertonia
in skeletal muscles, thus alleviating stiffness and spasticity, and facilitating muscle movement.
Improves dizziness and tinnitus associated with cerebrovascular disorders or cervical
spondylosis. Facilitates voluntary movement of the upper and lower extremities without
reducing muscle power; it is therefore useful during the initial stage of rehabilitation and as a
supporting drug during subsequent rehabilitative therapy.
Side Effects: CNS: Weakness, dizziness, sleeplessness, drowsiness, numbness or trembling in the
extremities. Other: Liver, kidney dysfunction; changes in blood counts, skin rashes, itching,
gastrointestinal disturbances and urinary disorders.
Pharmacokinetics: Half-life: 1.87hr Onset: Rapid Peak: unknown Duration: unknown
Nursing Interventions:

Generic Name: Ibuprofen
Brand Name: Advil, Caldor, Mortin
Pregnancy Category: C (before 30wks gestation); D (starting at 30wks gestation)
Dosage: 200 mg
Classification: Pharmacotherapeutic: NSAID. Clinical: Anirheumatic, Analgesic, Antipyretic, Antipyretic,
Antidysmenorrheal, Vascular headache suppressant. Others: Propionic acid derivative,
Indications: To relieve pain in rheumatoid arthritis and osteoarthritis. To relieve mild to moderate pain.To
relieve acute migraine pain. To relieve pain in primary dysmenorrheal. To relieve pain in juvenile
arthritis. To relieve minor aches, pain, and dysmenorrhea and to reduce fever. To relieve
moderate to severe pain as an adjunct to opioid analgesics. To reduce fever.
Mode of Action: Inhibits prostaglandin synthesis. Therapeutic Effect: Produces analgesic, anto-
inflammatory effects; decreases fever.
Side Effects: Occasional: Nausea, vomiting, dyspepsia, dizziness, rash. Rare: Diarrhea or constipation,
flatulence, abdominal cramps or pain, pruritus, increases BP
Pharmacokinetics: Half-life: 2-4 hrs
Route Onset Peak Duration
P.O. (analgesic) 0.5 hr N/A 4-6 hrs
P.O. (anti-rheumatic) 2 days 1-2wks N/A
Nursing Interventions: Monitor for evidence of nausea, dyspepsia. Monitor CBC, renal function, LFT.
Assess skin for rash, Observe bleeding, bruising, occult blood loss. Evaluate for therapeutic
response: relief of pain, stiffness, swelling; increased joint mobility; reduced joint tenderness;
improved grip strength. Monitor for fever.

Reference: 2016 Nursing Drug Handbook

Generic Name: Naproxen Sodium

Brand Name: Aleve, Anaprox, Naprelan, Naprosyn
Pregnancy Category: C
Dosage: Tablets: 220 mg
Classification: Pharmacotherapeutic: NSAID. Clinical: Analgesic, anti-inflammatory. Others: Proionic
acid derivative, Antipyretic
Indications: To relieve mild to moderate musculoskeletal inflammation, including ankylosing spondylitis,
osteoarthritis, and rheumatoid arthraitis. To relieve symptoms of juvenile rheumatoid arthritis and
other inflammatory conditions in children. To relieve symptoms of acute gouty arthritis. To
relieve mild to moderate pain, indcluding acute tendinities and bursits, arthralgia,
dysmenorrheal, and myalgia. To relieve fever.
Mode of Action: Produces analgesic, anti-inflammatory effects by inhibiting prostaglandin synthesis.
Therapeutic Effect: Reduces inflammatory response, intensity of pain.
Side Effects: Frequent: Nausea, constipation, abdominal cramps/pain, heartburn, dizziness, headache,
drowsiness. Occasional: Stomatitis, diarrhea, indigestion. Rare: Vomiting, confusion.
Pharmacokinetics: Half-life: 13 hr
Route Onset Peak Duration
P.O. (analgesic) 1 hr 2-4 hrs 7 hrs or less
P.O. (anti-rheumatic) 2 wks 2-4 wks 12 hrs
Nursing Interventions: Assist with ambulation if dizziness occurs. Monitor CBC, renal function, LFT, daily
pattern of bowel activity, stool consistency. Evaluate for therapeutic response: relief of pain,
stiffness, swelling; increased joint mobility; reduced joint tenderness; improved grip strength.

Reference: 2016 Nursing Drug Handbook

Generic Name: Ketorolac
Brand Name: Acular, Acuvail, Sprix, Toradol
Pregnancy Category: C
Dosage: Tablet: 10 mg
Classification: Pharmacotherapeutic: NSAID. Clinical: Analgesic, intraocular anti-inflammatory.
Other: Acetic acid derivative
Indications: To treat moderate to severe pain.
Mode of Action: Inhibits prostaglandin synthesis, reduces prostaglandin levels in aqueous humor.
Therapeutic Effect: Reduces intensity of pain stimulus, reduces intraocular inflammation
Side Effects: Frequent: Headache, nausea, abdominal pain/cramps, dyspepsia (heartburn, indigestion,
epigastric pain). Occasional: Diarrhea. Nasal: Nasal discomfort, rhinalgia, increased
lactimation, throat irritation, rhinitis. Ophthalmis: Transient stinging, burning. Rare: Constipation,
vomiting, flatulence, stomatitis. Ophthalmic: Ocular irritation, allergic reactions (manifested by
pruritus, stinging), superficial ocular infection, keratitis.
Pharmacokinetics: Half-life: 2-8 hr
Route Onset Peak Duration
P.O. 30-60 min 2-3 hr 5-6 hrs
I.M/I.V 30-60 min 1-2 hr 4-6 hrs
Nursing Interventions: Monitor renal function, LFT, urinary output. Monitor daily pattern of bowel activity,
stool consistency. Observe for occult blood loss. Assess for therapeutic response: relief of pain,
stiffness, swelling; increased joint mobility; reduced joint tenderness; improved grip strength.
Monitor for bleeding (may also occur with ophthalmic route due to systemic absorption).

Reference: 2016 Nursing Drug Handbook

Generic Name: Naloxone Hydrochloride

Brand Name: Narcan
Pregnancy Category: B
Dosage: 0.4 mg/ ml
Classification: Chemical: Thebaine derivative. Therapeutic: Opiod antagonist.
Indications: To treat known or suspected opioid overdose. Antidote to Morphine Sulfate intoxication. To
treat postoperative opioid-induced respiratory depression. To reverse opioid-induced asphyxia.
As adjunct to treat hypotension caused by sptic shock.
Mode of Action: Antagonizes MU, Kappa, and Sigma receptors in CNS, reversing analgesia,
hypotension, respiratory depression, and sedation caused by most opioids.
Side Effects: CNS: Excitement, irritability, nervousness, restlessness, seizures, tremor, violent behavior. CV:
Hypertention (severe), hypotension, ventricular fibrillation, ventriculat tachycardia. GI: nausea,
vomiting. RESP: Pulmonary edema. Skin: Diaphoresis. Others: Withdrawal symptoms
Pharmacokinetics: Half-life: 0.5 – 3.1 hr
Route Onset Peak Duration
I.V. 1-2 min 5-15 min 45 mins or longer
I.M. 2-5 min 5-15 min 45 min or SubQ longer
Nursing Considerations: Administer drug by I.V. route whenever possible. Anticipate that rapid reversal
of opioid effects can cause diaphoresis, nausea, and vomiting. Expect patient with hepatic or
renal dysfunction to have increased circulation blood naloxone level
Patient Counseling: Inform patient or family that naloxone will reverse opioid-induced adverse
reactions. Urge opioid-dependent patient to seek drug rehabilitation

Reference: 2016 Nursing Drug Handbook

Generic Name: Acetaminophen
Brand Name: Acephen, Feverall, Mapap, Tylenol
Pregnancy Category: B
Dosage: Caplets: 325 mg, 500 mg, 650 mg. Elixir: 160mg / 5ml
Classification: Pharmacotherapeutic: Central analgesic. Clinical: Non-narcotic analgesic, Antipyretic
Indications: To relieve mild to moderate pain from headache, muscle ache, backache, minor arthritis,
common cold, toothache, or menstrual cramps. To reduce fever.
Mode of 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 (heart loss, skin erythema, diaphoresis). Therapeutic
Effect: Results in antipyresis. Produces analgesic effect.
Side Effects: Hypersensitivity reaction
Pharmacokinetics: Half-life: 1-4 hrs
Route Onset Peak Duration
P.O. <60 min 1-3 hr 4-6 hrs
Nursing Interventions: Assess for clinical improvement and relief of pain, fever. Therapeutic serum level:
10-30 mcg/ml; Toxic serum: >200 mcg/ml. Do not exceed maximum daily recommended dose:
4g / day.

Reference: 2016 Nursing Drug Handbook

Generic Name: Tramadol

Brand Name: ConZip, Ryzolt, Ultram
Pregnancy Category: C
Dosage: 100mg / 2ml
Classification: Pharmacotherapeutic: Centrally acting synthetic opioid analgesic. Clinical: Analgesic.
Chemical: Cyclohexanol
Indications: To relieve moderate to moderately severe pain.
Mode of Action: Binds to mu-opioid receptors, inhibits reuptake of norepinephrine, serotonin, inhibiting
ascending and descending pain pathways. Therapeutic Effect: Reduces pain.
Side Effects: Frequent: Dizziness, vertigo, nausea, vomiting, constipation, headache, drowsiness.
Occasional: Vomiting, pruritis, CNS stimulation (nervousness, anxiety, agitation, tremor,
euphoria, mood swings, hallucinations), asthenia, diaphoresis, dyspepsia, dry mouth, diarrhea.
Rare: Malaise, vasodilation, anorexia, flatulence, rash, blurred vision, urinary
retention/frequency, menopausal symptoms
Pharmacokinetics: Half-life: 6-7 hr
Route Onset Peak Duration
P.O. <1 hr 2-3 hr 9 hrs
Nursing Interventions: Monitor pulse, BP, renal/hepatic function. Assist with ambulation if dizziness,
vertigo occurs. Dry crackers, cola may relieve nausea. Palpate bladder for urinary retention.
Monitor daily pattern of bowel activity, stool consistency. Sips of water may relieve dry mouth.
Assess for clinical improvement, record onset of relief of pain.

Reference: 2016 Nursing Drug Handbook

Generic Name: Captopril
Brand Name: Capoten, Apo-Capto
Pregnancy Category: D
Dosage: Tablets: 12.5mg, 25 mg, 50 mg, 100 mg
Classification: Pharmacotherapeutic: ACE inhibitor Clinical: Antihypertensive, Vasodilator
Indications: To control hypertension. To control accelerated or malignant hypertension when
temporary discontinuation of current antihypertensive therapy isn’t practical or when prompt
titration of blood pressure is needed. To treat heart failure that’s unresponsive to conventional
therapy. To treat left-sided heart failure after MI. To treat diabetic nephrapathy.
Mode of Action: Suppresses rennin-angiotensin-aldosterone system (prevents conversion of angiotensin
I to angiotensin II, a potent vasoconstrictor; may inhibit angiotensin II at local vascular and
renal sites). Decreases plasma angiotensin II, increases plasma rennin activity, decreases aldosterone
secretion. Therapeutic Effect: Reduces peripheral arterial resistance, pulmonary capillary
wedge pressure; improves cardiac output, exercise tolerance.
Side Effects: Frequent: Rash. Occasional] Prutritus, dysgeusia (altered taste). Rare: Headache, cough,
insomnia, dizziness, fatigue, paresthesia, malaise, nausea, diarrhea or constipation, dry mouth,
Pharmacokinetics: Half-life: Less than 3 hrs Onset: 0.25hr Peak: 0.5-1.5hr Duration: Dose-related
Nursing Interventions: Assess for skin for rash, pruritus. Assist with ambulation if dizziness occurs. Monitor
urinalysis for proteinuria. Monitor serum potassium levels in those on concurrent diuretic therapy.
Monitor BP, serumBUN, creatinine, CBC. Discontinue medication, contact physician if
angioedema occurs

Reference: Kizior, R.J. and Hodgson, K.J. (2016). Saunders Nursing Drug Handbook. ELSEVIER, USA.

Generic Name: Levodropropizine

Brand Name: Antux, Broncard, Danka, Levocof, Levoferin
Pregnancy Category: D
Dosage: 60 mg TID
Mode of Action: Levodropropizine is a cough suppressant that exerts peripheral action in
nonproductive cough.
Side Effects: Nausea, vomiting, heartburn, diarrhea, fatigue, weakness, drowsiness, dizziness,
headache, palpitations
Pharmacokinetics: Half-life: Onset: Rapid Peak: 40min Duration:
Nursing Interventions:

Reference: MIMS. Retrieved from
Generic Name: Nalbuphine
Brand Name: Nubain
Pregnancy Category:
Dosage: IM, Subcut, IV : usual dose is 10 mg q 3-6hrs
Classification: Opioid analgesics / Opioid agonists.
Chemical: Phenanthrene derivative. Therapeutic: Analgesic, Anesthesia adjunct
Indications: Moderate to severe pain. Also provides: analgesia during labor, sedation before surgery,
supplement to balance anesthesia
Mode of Action: Binds to optain receptors in the CNS. Alters the perception of and response to painful
stimuli while producing generalized CNS depression. Decreased pain
Side Effects: CNS: Dizziness, headache, sedation, confusion. EENT: blurred vision, diplopia, miosis ( high
doses). Resp: Respiratory depression. CV: Hypertension, orthostatic hypotension, palpitations.
GI: dry mouth, nausea, vomiting. Derm: Clammy feeling, sweating. Misc: physical dependence,
tolerance, psychological dependence
Pharmacokinetics: Half-life: 5hr
Route Onset Peak Duration
I.M. <15 min 60 min 5-6 hrs
I.V. 2-3 min 30 min 5-6 hrs
SubCut <15 min unknown 5-6 hrs
Nursing Interventions: Assess type, location, and intensity of pain before and 1 hr after IM or 30 min after
IV administration. Asses blood pressure, pulse, and respirations before and periodically during
administrations. Assess previous analgesic history. Administer O2 inhalation before giving.

Reference: Kizior, R.J. and Hodgson, K.J. (2016). Saunders Nursing Drug Handbook. ELSEVIER, USA.

Generic Name: Acetylcysteine

Brand Name: Acetadote , Mucomyst , Mucosil
Pregnancy Category: B
Dosage: Injectable: 300 mg/kg
Oral administration: 20% sol’n for inhalation:140 mg/kg
Classification: N-Acetyl Derivative of Cysteine / Mucolytic
Indications: To liquefy abnormal, viscid, or thickened mucus secretions in chronic pulmonary
disorders(including emphysema, bronchitis, tuberculosis, bronchiectasis, and cystic fibrosis) and
in pneumonia ,pulmonary complications of thoracic or cardiovascular surgery and
tracheostomy care. To treat acetaminophen overdose.
Mode of Action: Decreases viscosity of pulmonary secretions by breaking disulfide links that bind
glycoproteins in mucus. Reduces liver damage from acetaminophen overdose. Usually,
acetaminophen’s toxic metabolites bind with glutathione in the liver which detoxifies them.
When acetaminophen overdose depletes glutathione stores, toxic metabolites bind with
protein in liver cells, killing them. Acetylcysteine maintains or restores levels of glutathione or
acts as its substitute, which reduces liver damage from acetaminophen overdose.
Pharmacokinetics: Half-life: 6.25 hrs
Route Onset Peak Duration
P.O. 30 min 1-3 hr unknown
Inhalation 1 min 5-10 min 2-3 hrs
I.V immediate 5 min 2-3 hrs
Side Effects: CNS: Chills ,dizziness, drowsiness, fever, headache. CV: Edema, hypertension,
hypotension, tachycardia. EENT: Rhinorrhea, stomatitis, tooth damage. GI: Anorexia
,constipation, hepatotoxicity, nausea, vomiting. RESP: Bronchospasm, chest tightness, cough,
hemoptysis, respiratory distress, shortness of breath, stridor, wheezing. SKIN: Clammy skin, facial
flushing, pruritus, rash, urticaria. OTHERS: Anaphylaxis, angioedema
Nursing Interventions: Acetylcysteine should be used cautiously in patients with asthma or a history of
bronchospasm because drug may adversely affect respiratory function. WARNING: To avoid
fluid overload and possibly fatal hyponatremia or seizures, adjust total administered volume, as
ordered, for patients weighing less than 40 kg (88 lbs) and for those who need fluid restriction.

Reference: Jones & Bartlett. (2015), 2015 Nurse's Drug Handbook, Jones & Bartlett Learning, 14th Edition

Generic Name: Loratidine

Brand Name: Alavert, Claritin, Loradamed
Pregnancy Category: C
Dosage: Capsule: 10mg. Syrup: 1mg/MI. Tablets: 10mg.
Classification: Therapeutic: Antihistamines. Pharmacologic: Piperidines.
Pharmacotherapeutic: H1 antagonist
Indications: Relief of nasal, non-nasal symptoms of seasonal allergic rhinitis (hay fever). Treatment of
idiopathic chronic urticaria (hives)
Mode of Action: Competes with histamine for H1 receptor sites on effector cells. Therapeutic Effect:
Prevents allergic responses mediated by histamine(e.g., rhinitis, urticaria, pruritus).
Side Effects: Frequent: Headache, fatigue, drowsiness. Occasional: Dry mouth, nose, throat. Rare:
Pharmacokinetics: Half-life: 8.4 hrs; metabolite, 28 hrs (increased in elderly hepatic impairment
Route Onset Peak Duration
P.O 1-3 hr 8-12 hr Longer than 24 hrs
Nursing Interventions: For upper respiratory allergies, increase fluids to decrease viscosity of secretions,
offset thirst, replenish loss of fluids from increased diaphoresis. Monitor symptoms for therapeutic

Reference: Kizior, R.J. and Hodgson, K.J. (2016). Saunders Nursing Drug Handbook. ELSEVIER, USA.
Generic Name: Alprazolam
Brand Name: Alprazolam Intensol, Nirvam, Xanax
Pregnancy Category: D
Dosage: Oral Solution: 1mg/ml Tablets: 0.25mg, 0.5mg, 1mg, 2mg
Classification: Benzodiazepine / Anxiolytic
Indications: Treatment of generalized anxiety disorder (GAD). For Panic disorders. Management of
anxiety associated with depression. Unlabeled use: Management of symptoms of premenstrual
syndrome (PMS). Insomia, irritable bowel syndrome (IBS) and other somatic symptoms
associated with anxiety. Used as an adjunt with acute mania, acute psychosis
Mode of Action: Acts at many levels in the CNS to produce anxiolytic effect. May produce CNS
dpression. Effects may be mediated by GABA, an inhibitory neurotransmitter.
Side Effects: CNS: dizziness, drowsiness, lethargy, confusion, hangover, headache, mental depression,
paeadoxical excitation. EENT: blurred vision. GI: constipation, diarrhea, nausea and vomiting,
weight gain. DERM: Rashes. Other: physical dependence, psychological dependence,
Pharmacokinetics: Half-life: 12-15 hr Onset: 1-2 hr Peak: 1-2 hr Duration: Up to 24 hrs
Nursing Interventions: Assess degree and manifestations of anxiety and mental status. Lab test
considerations: Monitor CBC, liver and renal function periodically during long-term therapy.
May cause decrease hematocrite and neutropenia. Toxicity and overdose: Flumazenil is the
antidote for alprazolam toxicity or overdose. PO: May be administered with food if GI upset
occurs. Administer greatest dose at bedtime to avoid daytime sedation.

Reference: Judith Hopfer Deglin. April Hazard Vallenard. Cynthia A. Sanoski (2011) Davis's Drug Guide
for Nurses 12th Edition. F.A Davis Company No. 8 Soi Krungthep Kreetha 8 Yaek 8
Huamark,Bangkapi,Bangkok 10240, Thailand

Generic Name: Levodropropizine

Brand Name: Rapitus, Q-RESP, Levopront
Pregnancy Category: D
Dosage: Adult: 60 mg TID. Children: 12yr/mg/kg TID; (12y/o) 60 mg TID
Classification: Antitissive
Indications: To treat cough in adults and children
Mode of Action: Exerts peripheral action and suppress cough in patient with non-productive
Side Effects: Weakness , dizziness, nausea, heartburn,headache, palpitation
Pharmacokinetics: Half-life: unknown Onset: 1 hr Peak: 15-60 min Duration: 6 hr
Nursing Interventions: Before giving the drug,ask the patient for allergic reaction. Caution should be
exercised in patient with severe history of kidney insufficiency , during pregnancy and

Reference: Vallerand, A., Sanoski, C. & Deglin, J. (2015). Davis's drug guide for nurses. Philadelphia: F.A.
Davis Company
Generic Name: Digioxin
Brand Name: Lanoxicaps, Lanoxin, Lanoxin injection, Novo-digoxin
Pregnancy Category: C
Dosage: Adult: 250 mcg 1-2 times daily, 0.5-1 mg by IV infusion
Child: <1.5 kg: 25 mcg/kg/day in divided doses
2-5 YR: 35 mcg/kg/day in 3 divided doses
10-18 YR: 0.75-1.5 mg/day in 3 divided doses
Classification: Chemical: Digitalis glycoside
Therapeutic: Antiarrythmic, Cardiotonic
Indications: To treat heart failure, atrial flutter, atrial fibrillation, and paroxysmal atrial tachycardia with
rapid digitalization.
Mode of Action: HF: Inhibits sodium/potassium ATPasc pump in myocardial cells. Promotes calcium
influx. Suppresses AV mode conduction. Increases effective refractory period/decreases
conduction velocity, decreases heart rate.
Side Effects: Anorexia, vomiting, dizziness, gynaecomastia, restlessness, Xanthochromia
Pharmacokinetics: Half-life: 36-48 hrs
Route Onset Peak Duration
PO 0.5-2 hrs 2-8 hrs 3-4 days
IV 5-30 min 1-4 hrs 3-4 days
Nursing Interventions: Monitor pulse for bradicardia,EKG for arrhythmias for 1-2 hrs after
administration. Assess for GI disturbances, neurologic abnormalities, q2-4h during loading dose.
Monitor serum potassium, magnesium, calcium, renal function. Assess for digoxin toxicity as
manifested by bradycardia, w/r, halovision or flickering lights, blood digoxin, level of more
than 2mg/ml.

Reference: Kizior, R. (2016). Saunders Nursing Drug Handbook. Retrived from NDH/

Generic Name: Phenylepinephrine Spray

Brand Name: Neo Synephrine, Rhinall, Vicks Sinex, Ultra fine mist
Pregnancy Category: C
Dosage: Adult: 1% spray Pediatric: 0.125
Classification: Nasal Decongestant, Alpha Adrenergic agonist
Indications: Symptomatic relief of nasal and nasopharyngeal mucosal congestion due to the common
cold, sinusitis, hay fever, or other respiratory allergies. Adjuncive therapy of middle ear
infections by decreasing congestion around the eustachian ostia
Mode of Action: Causes vasoconstriction of the mucous membranes, which in turnm relieves pressure
and promotes drainage of the nasal passages.
Side Effects: Temporary burning, stinging, dryness in the nose, and sneezing
Nursing Interventions: Do not administer nasal congestion for longer than 3-5 days. Monitor CV effects
carefully; patients with hypertension who take this drug may experience changes in BP
because of the additional vasoconstriction. If nasal decongestant is needed, pseudophedrine
is the drug of choice

Reference: Karch, A. (2010). 2010 Lippincott's Nursing Drug Guide. Wolters Kluwer Health:Lippincott
William and Wilkins
Generic Name: Cefuroxime
Brand Name: Ceftin, Zinacef
Pregnancy Category: B
Dosage: Tablets: 250 mg, 500mg; Oral Suspension: 125 mg/ml, 250mg/5ml;
Powder for injection: 750 mg, 7.5; Premixed containers: 750mg/50 ml , 1.5g/50ml
Classification: Therapeutic: Anti-infectives ; Pharmacologic: 2nd Generation Cephalosporins
Indications: Meningitis, Perioperative prophylaxis, Gynecologic infections, Septicemia, Lyme Disease,
Otitis Media
Mode of Action: Binds to bacterial cell wall membrane causing cell death
Side Effects: CNS: Seizures. GI: Pseudomembranous colitis, diarrhea, cramps, n/v. DERM: rashes,
urticaria. HEMAT: agranulocytosis, bleeding, hemolytic anemia, neutropenia,
thrombocytopenia. LOCAL: pain at IM site, phlebitis at IV site
Pharmacokinetics: Half Life: 60-120 mins
Route Onset Peak Duration
PO unknown 2-3 hr 8-12 hr
IM rapid 15-60 mins 6-12 hr
IV rapid end of infusion 6-12 hr
Nursing Interventions: Assess for infection at the beginning and during the therapy. Observe or s/s of
anaphylaxis. Discontinue the drug if s/s occurs. Keep epinephrine, an anti-histamine, and
resuscitation equipment close by in the event of anaphylactic reaction.

Reference: Judith Hopfer Deglin. April Hazard Vallenard. Cynthia A. Sanoski (2011) Davis's Drug Guide
for Nurses 12th Edition. F.A Davis Company No. 8 Soi Krungthep Kreetha 8 Yaek 8
Huamark,Bangkapi,Bangkok 10240, Thailand

Generic Name: Diazepam

Brand Name: Apo-Diazepam, Diastat, Diazemuls, Novodipam, PMS-Diazepam, Valium, Vivol
Pregnancy Category: D
Dosage: Tablets: 2mg, 5mg, 10mg oral sol: 1mg/ml, 5mg/ml sol. For injection: 5ml/mg rectal gel delivery
system: 2.5 mg, 10mg, 20mg
Classification: Therapeutic: Anxiety agents, Anticonvulsants, Sedative/Hypitonics, Skeletal muscle
relaxant (centrally acting) ; Pharmacologic: Benzodiazepines
Indications: Adjunct in the management of anxiety disorder, athetosis, anxiety relief prior to
cardioversion (injection); Stiffman syndrome, preoperative sedation, conscious sedation
(provides light anesthesia and antegrade amnesia). Treatment of status
epilepticus/uncontrolled seizures (injection). Skeletal muscle relaxant. Management of the
symptoms of alcohol withdrwal. Unabled use: anxiety associated with acute MI; insomnia.
Mode of Action: Depresses the CNS probably by potentiating GABA, an inhibitory neurotransmitter.
Produces skeletal muscle relaxation by inhibiting spinal polysynaptic afferent pathways. Has
anticonvulsant properties due to enhanced presynaptic inhibitionn. Therapeutic Effect: Relief of
anxiety, Sedation, Amnesia, Skeletal muscle relaxation, Decreased seizure activity.
Side Effects: CNS: Dizziness, drowsiness, lethargy, depression, hangover, ataxia, slurred speech,
headache, paradoxical excitation. EENT: Blurred vision Resp: Respiratory depression CV:
Hypotension (IV only) GI: Constipation, diarrhea (may caused by propylene glycol content in
oral solution) nausea, vomiting, weight gain Derm: Rashes Local: Pain(IM) phlebitis (IV) venous
thrombosis Other: Physical dependence, psychological dependence, tolerance
Pharmacokinetics: Half-life: (Neonates) 50-95hrs; (Infants) 40-50hr; (Children) 15-21hr(2-12 yrs old); 18-
20hr(12-16 yrs old); (Adults) 20-50 hr(up to 100 hr for metabolites)
Route Onset Peak Duration
PO 30-60min 1-2hr up to 24hr
IM w/n 20min 0.5-1.5hr unknown
IV 1-5 min 15-30min 15-60min
Rectal 2-10min 1-2hr 4-12hr

Nursing Interventions: Monitor BP, pulse, RR prior to and periodically throughout therapy and frequently
during IV therapy. Assess IV site frequently during administration. Conduct regular assessment of
continued need for treatment.

Reference: J.H. Deglin, A.H. Vallerand, C.A. Sanoski (2011) Davis's Drug guide for nurses 12th edition
Generic Name: Midazolam Hydrochloride
Brand Name: Versed
Pregnancy Category: D
Dosage: PO/IV/IM: 2-20 mg 0.5-0.35 mg/kg/IV
Classification: Sedative – hypnotic; Benzodrazepine
Indications: To induce preoperative sedation or amnesia, to control preoperative anxiety. To relieve
agitation and anxiety in mechanically ventilated patients
Mode of Action: Enhances action of gamma-aminobutyric acid (GABA), one of the major inhibitory
neurotransmitters in the brain. Therapeutic Effect: Produces anxiolytic, hypnotic, anticonvulsant,
muscle relaxant, amnestic effects.
Side Effects: Frequent: Decreased respiratory rate, tenderness at IM or IV injection site, pain during
injection, oxygen desaturation, hiccups. Occasional: Hypotension, paradoxical CNS reaction.
Rare: Nausea, vomiting, headache, coughing.
Pharmacokinetics: Half-life: 1-5 hr
Route Onset Peak Duration
P.O. 10-20min N/A N/A
I.V. 1-5 min 5-7 min 20-30 min
I.M. 5-15 min 30-60 min 2-6 hrs
Nursing Interventions: Monitor respiratory rate, oxygen saturation continuously during parenteral
administration for under ventilation, apnea. Monitor vital signs, level of sedation every 3-5 min
during recovery period.

Reference: Jones & Bartlett. (2015), 2015 Nurse's Drug Handbook, Jones & Bartlett Learning, 14th Edition

Generic Name: Nitroglycerin Patch

Brand Name: Minitran, Nitro-dur, Trinipatch
Pregnancy Category: C
Dosage: 0.2 to 0.4 mg/hr patch applied topically once a day for 12 to 14 hours per day; titrate as
needed and tolerated up to 0.8 mg/hr
Classification: Therapeutic: Vasodilator Pharmacologic: Nitrate
Indications: To prevent chronic angina attacks. Acute angina pectoris; to prevent or minimize angina
attacks before stressful events. Hypertension from surgery, heart failure after MI, angina pectoris
in acute situations; to produce controlled hypotension during surgery (by I.V infusion).
Moderate to severe pain from chronic anal fissure.
Mode of Action: Reduces cardiac oxygen demand by decreasing left ventricular end-diastolic
pressure(preload) and, to a lesser extent, systemic vascular resistance (afterload). Also
increases blood flow through the collateral coronary vessels.
Side Effects: CNS: headache, dizziness, syncope, weakness. CV: orthostatic hypotension, tachycardia,
flushing, palpitations. EENT: S.L burning. GI: nausea, vomiting. Skin: cutaneous vasodilation,
contact dermatitis, rash. Other: hypersensitivity reactions.
Pharmacokinetics: Route: Transdermal Onset: 30 minutes Peak: Unknown Duration: 24 hours
Nursing Interventions: Monitor BP and intensity and duration of drug response. Dosage may be
reduced temporarily, but tolerance usually develops. Treat headache with aspirin or
acetaminophen. Check with the prescriber for alterations, in dosage regimen if tolerance is
suspected. Wipe off nitroglycerin paste or remove patch before defibrillation to avoid patient

References: Nursing Drug Handbook 2013, 33rd edition (Lippincott Williams & Wilkins)
Nitrogylcerin.Retrieved from
Generic Name: Salbutamol + Ipratropium
Brand Name: Combivent
Pregnancy Category: B
Dosage: neb 200mcg/ml prn for DOB; neb q 4 hours
Classification: Bronchodilator + Anticholinergic
Indications: Treating chronic obstructive pulmonary disease (COPD). This is also used to prevent
wheezing, difficulty breathing, chest tightness, and coughing in people with chronic obstructive
pulmonary disease (COPD) such as chronic bronchitis (swelling of the air passages that lead to
the lungs) and emphysema (damage to the air sacs in the lungs).
Mode of Action: Reduces bronchospasm through both anticholinergic and sympathetic mechanisms.
Simultaneous administration of both drugs produces a greater bronchodilator effect. This also
maximizes the response to treatment in patients with chronic obstructive disease (COPD) by
reducing bronchospasm through two distinctly different mechanisms Para sympatholytic and
Side Effects: Headache, dizziness, nausea, dry mouth, shaking (tremors), nervousness, or cold symptoms
such as stuffy nose, sneezing, cough, or sore throat.
Pharmacokinetics: Half-life: 2-4 hours (nasal)
Route Onset Peak Duration
Inhalation 1-3 min 1-2 hr Up to 4 hrs
Nasal 5 min 1-4 hr 4-8 hrs
Nursing Interventions: Assess Vital Signs Before drug administration. Observe for paradoxical
bronchospasm (Wheezing). If Condition occurs, withhold Medication and notify physician or
other healthcare professional immediately. Instruct patient to contact health care professional
immediately if shortness of breath is not relieved by medication or is accompanied by
diaphoresis, dizziness, palpitations, or chest pain. Advise the patient to rinse mouth with water
after using the nebulizer to minimize dry mouth.

Reference: Hodgson B. and Kizior R. (2012). Sauder’s Drug Hand Book 2012

Generic Name: Phenytonin

Brand Name: Dilantin, Phenytek
Pregnancy Category: C
Dosage: Capsules: 30mg, 100mg. Injection: 50mg/ml. Oral: 100mg/4ml, 125mg/5ml. Tablets: 50mg
Classification: Chemical: Hydantoin derivative. Therapeutic: Anticonvulsant
Indications: To treat tonic-clonic, simple, or complex partial seizures in patients who have had no prior
treatment. To treat status epilepticus. To prevent or treat seizures during neurosurgery.
Mode of Action: Stabilizes neuronal membranes in motor cortex. Decreases influx of sodium during
generation of nerve impulses. Therapeutic Effect: Decreases seizure activity.
Side Effects: Frequent: Drowsiness, lethargy, confusion, slurred speech, irritability, gingival hyperplasia,
hypersensitivity reaction (fever, rash, lymphadenopathy), constipation, dizziness, nausea.
Occasional: Headache, hirsutism, coarsening of facial features, insomnia, muscle twitching.
Pharmacokinetics: Half-life: 7-42 hrs
Route Onset Peak Duration
P.O. unknown 1.5-12 hr unknown
I.V. immediate 1-2 hr unknown
I.M. unknown unknown unknown
Nursing Interventions: Observe frequently for recurrence of seizure activity. Assess for clinical I
mprovement (decrease in intensity/frequency of seizures). Monitor for signs and symptoms of
depression, suicidal tendencies, unusual behavior. Monitor CBC with differential, renal funcitons,
LFT, BP. Assist with ambulation if drowsiness, lethargy occurs. Monitor for therapeutic serum level.

Reference: Kizior, R.J. and Hodgson, K.J. (2016). Saunders Nursing Drug Handbook. ELSEVIER, USA.
Generic Name: Penicillin V Potassium
Brand Name: Beepen-VK, Betapen-VK, Ledercillin VK, Pen Vee K, Veetids
Pregnancy Category: B
Dosage: Tablets: 250mg, 500mg. Oral Sol’n: 125mg/5ml, 250mg/5ml
Classification: Chemical: Penicillin Therapeutic: Antibiotic
Indications: Treatment of infections of respiratory tract, skin/skin structure, otitis media, necrotizing
ulcerative gingivitis; pro-phylaxis for rheumatic fever, dental procedures. Off-label: Prosthetic
joint infection. To treat systemic infections caused by gram-positive organisms. To treat
moderately severe to severe streptococcal infections. To treat congenital syphilis. To treat
bacterial meningitis.
Mode of Action: Inhibits cell wall synthesis by binding to bacterial cell membranes.
Therapeutic Effect: Bactericidal
Side Effects: Frequent: Mild hypersensitivity reaction (chills, fever, rash), nausea, vomiting, diarrhea.
Rare: Bleeding, allergic reaction
Pharmacokinetics: Half-life: 30min Onset: unknown Peak: 30-60min Duration: unknown
Nursing Interventions: Hold medication, promptly report rash, diarrhea. Be alert for superinfection.
Review Hgb levels; check for bleeding. Monitor I&O, urinalysis, renal function tests for

Reference: Kizior, R.J. and Hodgson, K.J. (2016). Saunders Nursing Drug Handbook. ELSEVIER, USA.

Generic Name: Nystatin

Brand Name: Mycostatin, Nilstat, Nystex, Nystop, Pedi-Dri
Pregnancy Category: B Oral: C Vaginal: A
Dosage: Cream, Ointment, and Topical Powder: 100,000 units/g. Oral Suspension: 100,000 units/ml
Tablets: 500,000 units.
Classification: Chemical: Amohoteric polyene macrolide.
Therapeutic: Antifungal, Polyene antifungal antibiotic
Indications: Treatment of cutaneous, intestinal, oral cavity, infections caused by Candida spp.
To treat vulvovaginal candidiasis.
Mode of Action: Binds to sterols in cell membrane, increasing fungal cell membrane permeability,
permitting loss of potassium, other cellular components. Therapeutic Effect: Fungistatic.
Side Effects: Topical: Skin irritation. Vaginal: Vaginal irritation.
Pharmacokinetics: P.O: Poorly absorbed from GI tract. Eliminated unchanged in feces. Topical: Not
absorbed systemically from intact skin.
Nursing Interventions: Assess for increased skin irritation with topical, increased vaginal discharge with
vaginal application.

Reference: Kizior, R.J. and Hodgson, K.J. (2016). Saunders Nursing Drug Handbook. ELSEVIER, USA.
Generic Name: Metronidazole
Brand Name: Flagyl 375, Flagyl ER, MetroCream, MetroGel, MetroGel-Vaginal, Noritate, Vandazole
Pregnancy Category:
Dosage: Capsule: 375mg. Tabelt: 250mg, 500mg. Topical Cream & Gel, and Vaginal Gel : 0.75%
Classification: Pharmacotherapeutic: Nitroimidazole derivative. Clinical: Antibacterial, Antiprotozoal
Indications: To treat systemic anaerobic infections. To treat amebiasis. To treat trichomoniasis
(Trichomonas vaginalis). To prevent perioperative bowel infection. To treat acne in patients with
rosacea. To treat bacterial vaginosis.
Mode of Action: Disrupts DNA, inhibiting nucleic acid synthesis. Therapeutic Effect: Produces
bactericidal, antiprotozoal, amebicidal, trichomonacidal effects. Produces anti-inflammatory,
immunosuppressive effects when applied topically.
Side Effects: Frequent: Anorexia, nausea, dry mouth, metallic taste. Symptomatic cericitis/vaginitis,
abdominal cramps, uterine pain. Occasional: Diarrhea, constipation, vomiting, dizziness,
erythematous rash, urticaria, reddish-brown urine. Transient erythema, mild dryness, burning,
irritation, stinging, tearing. Viginal, perineal, vulvar itching; vulvar swelling. Rare: Mild, transient
leucopenia; thrombophlebitis
Pharmacokinetics: Half-life: 6-8 hrs
Route Onset Peak Duration
P.O. unknown 2hr unknown
I.V. immediate 1hr unknown
Nursing Interventions: Monitor daily pattern of bowel activity, stool consistency. Monitor I&O, assess for
urinary problems. Be alert to neurologic symptoms (dizziness, paresthesia of extremities). Assess
for rash, urticaria. Monitor for onset of superinfection.

Reference: Kizior, R.J. and Hodgson, K.J. (2016). Saunders Nursing Drug Handbook. ELSEVIER, USA.

Generic Name: Mebendazole

Brand Name: Vermox
Pregnancy Category: C
Dosage: Chewable Tablets: 100mg
Classification: Therapeutic: Antihelminthic. Pharmacologoc: Benzimidazole
Indications: Pinworm, Roundworm, Whipworm, Hookworm. Trichinosis, Capilliarasis, Dracunculiasis
Mode of Action: Selectively and irreversibly inhibits uptake of glucose and other nutrients by
susceptible helminths.
Side Effects: GI: Transient abdominal pain, diarrhea. Other: Fever
Pharmacokinetics: Half-life: 3-9hr Onset: unknown Peak: 2-4hr Duration: variable
Nursing Interventions: Assess for pregnancy, lactation, and allergy to mebendazole. Assess for
temperature, bowel sounds and output. Culture for ova and parasites.

Reference: Mebendazole (Vermox) Drug Study – Nurseslabs (2012). Retrieved from
Generic Name: Mannitol
Brand Name: Aridol, Osmitrol, Resectisol
Pregnancy Category: B
Dosage: Injection Sol’n: 20%, 25%
Classification: Chemical: Hexahudroxy alcohol, Polyol (sugar alcohol)
Therapeutic: Antiglaucoma, Diagnostic agent, Osmotic diuretic, Urinary irrigant
Indications: Prevention, treatment of oliguric phase of acute renal failure. Reduces increased ICP due
to cerebral edema; IOP due to acute glaucoma. Promotes urinary excretion of toxic
substances. Off-label: Improves renal transplant function.
Mode of Action: Elevates osmotic pressure of glomerular filtrate, inhibiting tubular reabsorption of
water and electrolytes, resulting in increased urine output. Reduces intracranial pressure by
decreasing blood viscosity, thereby increasing cerebral blood flow/oxygen transport.
Therapeutic Effect: Produces diuresis; reduces intraocular pressure (IOP), intracranial pressure
(ICP), cerebral edema.
Side Effects: Dry mouth, thirst, blurry vision, increased urinary frequency/volume, headache, arm pain,
backache, nausea, vomiting, urticaria, dizziness, hypotension, hypertension, tachycardia, fever,
angina-like chest pain
Pharmacokinetics: Half-life: 4.7 hr
Route Onset Peak Duration
I.V. (diuresis) 1-3hr N/A -----
I.V. (reduced ICP) 15-30min N/A 1.5-6 hrs
Nursing Interventions: Monitor urinary output, serum electrolytes, serum osmolarity, ICP, renal function,
LFT. Assess vital signs, skin turgor, mucous membranes. Weigh daily.

Reference: Kizior, R.J. and Hodgson, K.J. (2016). Saunders Nursing Drug Handbook. ELSEVIER, USA.

Generic Name: Imipenem and Cilastatin Sodium

Brand Name: Primaxin
Pregnancy Category: C
Dosage: Powder for Injection: 250mg, 500mg, 750mg
Classification: Therapeutic: Antibiotic. Pharmacologic: Carbapenem, Beta-lactam
Indications: Treatment of serious infections caused by susceptible organisms in the urinary tract, lower
respiratory tract, bones and joints, skin/skin structures, also intraabdominal, gynecologic, and mixed
infections; bacterial septicema and endocarditis.
Mode of Action: Inhibits bacterial cell-wall synthesis; enzymatic breakdown of drug in the kidneys causes
adequate antibacterial levels of drug in the urine.
Side Effects: CNS: Seizures, dizziness, confusion, somnolence, encephalopathy, myoclonus, tremors, paresthesia,
headache. GI: Nausea, vomiting, diarrhea, pseudomembranous colitis, hemorrhagic colitis,
gastroenteritis, abdominal pain, glossitis, heartburn. RESP: Chest discomfort, hyperventilation, dyspnea.
SKIN: Rash, pruritus, urticaria, candidiasis, flushing, increased sweating, skin texture change, facial
edema. META: Hyponatremia, hyperkalemia. EENT: Transient hearing loss. CV: Increased WBC, AST, ALT,
alkaline phosphatase, BUN, LDH, creatinine; decreased Hgb, Hct, eosinophilla. OTHERS: Hypersensitivity,
weakness, oliguria/anuria, polyuria, polyarthralgia; phlebitis and pain at injection site, superinfections.
Pharmacokinetics: Half-life: 1hr after IV dose; 2-3hrs after IM dose
Route Onset Peak Duration
I.V. immediate immediate unknown
I.M. unknown 1-2hr unknown
Nursing Interventions: Determin previous hypersensitivity to beta-lactam antibiotics or allergens. Monitor for S/S of
superinfection, hypersensitivity. Discontinue drug and notify physician if S/S occur. Do not let patient breast
feed while taking this drug.

Reference: Lippincott, Williams, and Wilkins (2013). Nursing 2013 Drug Handbook. Philadelphia, PA
Generic Name: Doxycycline
Brand Name: Adoxa, Doryx, Monodox, Oracea, Periostat, Vibramycin
Pregnancy Category: D
Dosage: Capsule: 40mg, 50mg, 75mg, 100mg. Tablet: 20mg, 50mg, 75mg, 100mg, 150mg
Classification: Pharmacotherapeutic: Tetracycline. Clinical: Antibiotic
Indications: To treat susceptible infections. To treat inflammatory lesions in adults with rosacea. Off-
label: Sclerosing agent for pleural effusion; vancomycin-resistant eterococci (VRE); alternative
for MRSA, treatment of refractory periodontitis, juvenile periodontitis.
Mode of Action: Inhibits bacterial protein synthesis by binding to ribosomes. Therapeutic Effect:
Side Effects: Frequent: Anorezia, nausea, vomiting, diarrhea, dysphagia, photosensitivity. Occasional:
Rash, urticaria.
Pharmacokinetics: Half-life: 1.6-1.8 hr Onset: 1.6hr Peak: 1.6-1.9hr Duration: 1-2hrs
Nursing Interventions: Monitor daily pattern of bowel activity, stool consistency. Assess skin for rash.
Monitor LOC due to potential for increased intracranial pressure. Be alert for superinfection.
Monitor CBC, renal/hepatic function tests.

Reference: Kizior, R.J. and Hodgson, K.J. (2016). Saunders Nursing Drug Handbook. ELSEVIER, USA.

Generic Name: Cefixime

Brand Name: Suprax
Pregnancy Category: B
Dosage: Tablet: 400mg. Chewable Tab: 100mg, 200mg.
Oral Suspension: 100mg/5ml, 200mg/5ml, 500mg/5ml
Classification: Pharmacotherapeutic: 3rd generation cephalosporin. Clinical: Antibiotic
Indications: Treatment of susceptible infections including otitis media, acute bronchitis, acute
exacerbations of chronic bronchitis, pharyngitis, tonsillitis, uncomplicated UTI
Mode of Action: Binds to bacterial cell membranes, inhibits cell wall synthesis. Therapeutic Effect:
Side Effects: Frequent: Oral candidiasis (thrush), mild diarrhea, mild abdominal cramping, vaginal
candidiasis. Occasional: Nausea, serum sickness-like reaction. Rare: Allergic reaction (rash,
pruritus, urticaria)
Pharmacokinetics: Half-life: 3-4hr Onset: unknown Peak: 2-3hr Duration: unknown
Nursing Interventions: Assess oral cavity for thrush. Monitor daily pattern of bowel activity, stool
consistency. Monitor renal function tests for evidence of nephrotoxicity. Be alert for

Reference: Kizior, R.J. and Hodgson, K.J. (2016). Saunders Nursing Drug Handbook. ELSEVIER, USA.
Generic Name: Cefepime
Brand Name: Maxipime
Pregnancy Category:
Dosage: 500mg, 1g, 2g vials
Classification: Pharmacotherapeutic: 4th generation cephalosporin. Clinical: Antibiotic
Indications: Susceptible infections due to aerobic gram-negative organisms. Treatment of emipiric
febrile neutropenia, intra-abdominal infections, skin/skin structure infections, UTIs, pneumonia.
Off-label: Brain abscess, malignant otitis externa, sptic lateral/cavernous sinus thrombus.
Mode of Action: Binds to bacterial cell wall membranes, inhibits cell wall synthesis. Therapeutic Effect:
Side Effects: Frequent: Discomfort with IM administration, oral candidiasis, mild diarrhea, mild
abdominal cramping, vaginal candidiasis. Occasional: Nausea, serum sickness-like reaction.
Rare: Allergic reaction, thrombophlebitis.
Pharmacokinetics: Half-life: 2-2.5hr (adults); 1.5-2hr (children) Onset: unknown
Peak: 1-2hr Duration: unknown
Nursing Interventions: Evaluate IM site for induration and tenderness. Assess oral cavity for thrush.
Monitor daily pattern of bowel activity, stool consistency. Monitor I&O, CBC, renal function test
for nephrotoxicity. Be alert for superinfection.

Reference: Kizior, R.J. and Hodgson, K.J. (2016). Saunders Nursing Drug Handbook. ELSEVIER, USA.

Generic Name: Cefazolin Sodium

Brand Name: Ancef, Kefzol
Pregnancy Category: B
Dosage: Infusion: 1g/50ml bag Injection: 500mg, 1g
Classification: Pharmacotherapeutic: 1st generation cephalosporin. Clinical: Antibiotic
Indications: Susceptible infections including biliary tract, bone and joint, genetalia, respiratory tract,
skin/skin structure infections; UTIs, endocarditis, perioperative prophylaxis, septicema. Off-label:
Prophylaxis against infective endocarditis
Mode of Action: Binds to bacterial cell wall membranes, inhibits cell wall synthesis. Therapeutic Effect:
Side Effects: Frequent: Discomfort with IM administration, oral candidiasis (thrush), mild diarrhea, mild
abdominal cramping, vaginal candidiasis. Occasional: Nausea, serum sickness-like reaction.
Rare: Allergic reaction (rash, pruritus, urticaria), thrombophlebitis
Pharmacokinetics: Half-life: 1-2hr
Route Onset Peak Duration
I.V. immediate unknown immediate
I.M. unknown 1-2hr unknown
Nursing Interventions: Evaluate IM site for industrial and tenderness. Assess oral cavity for thrush.
Monitor daily pattern of bowel activity, stool consistency. Monitor I&O, CBC, renal function test
for nephrotoxicity. Be alert for superinfection.

Reference: Kizior, R.J. and Hodgson, K.J. (2016). Saunders Nursing Drug Handbook. ELSEVIER, USA.
Generic Name: Co-amoxiclav (Amoxicillin/Clavulanate)
Brand Name: Amocla, Apo-Amoxi-Clav, Clavulin
Pregnancy Category: B
Dosage: Powder for Oral Suspension: 125mg-31.25mg/5ml, 200mg-28.5mg/5ml, 250mg-62.5mg/5ml,
400mg-57mg/5ml, 600mg-42.9mg/5ml. Tablets: 250mg-125mg, 500mg-125mg, 875mg-125mg.
Chewable Tab: 200mg-28.5mg, 400mg-57mg
Classification: Pharmacotherapeutic: Penicillin. Clinical: Antibiotic
Indications: Treatment of susceptible infections including lower respiratory skin/skin structure, UTIs, otitis
media, sinusitis.
Mode of Action: Amoxicillin inhibits bacterial cell wall synthesis. Clavulanate inhibits bacterial bate-
lactamase. Therapeutic Effect: Amoxicillin is bactericidal in susceptible microbes. Clavulanate
protects amoxicillin from enzymatic degenaration
Side Effects: Occasional: Diarrhea, loose stools, nausea, skin rashes, urticaria. Rare: Vomiting, vaginitis,
abdominal discomfort, flatulence, headache.
Pharmacokinetics: Half-life: 1-1.3hr. Onset: rapid (within 2hr). Peak: unknown. Duraiton: up to 8hrs
Nursing Interventions: Question for history of allergies especially penicillin, cephalosporins. Hold
medication and promptly report rash, diarrhea, blood in stool and other side effects. Continue
for full-length treatment. Take with meals if GI upset occurs. Monitor reanal, hepatic tests with
prolonged therapy.

Reference: Kizior, R.J. and Hodgson, K.J. (2016). Saunders Nursing Drug Handbook. ELSEVIER, USA.

Generic Name: Amiodarone

Brand Name: Cordarone, Nexterone, Pacerone
Pregnancy Category: D
Dosage: Tablet: 100mg, 200mg, 400mg
Classification: Pharmacotherapeutic: Cardiac agent. Clinical: Antiarrhythmic
Indications: Management of life-threatening recurrent ventricular fibrillation, hemodynamically
unstable ventricular tachycardia, unresponsive to other therapy. Off-label: Treatment of atrial
fibrillation, proxysmal supraventricular tachycardia; ventriculat tachyrrhythmias
Mode of Action: Prolongs duration of myocardial cell action potential and refrectory period by acting
directly on all cardiac tissue. Therapeutic Effect: Suppresses arrhythmias
Side Effects: Expected: Corneal microdeposits noted in almost all patients treated for more than 6 mos.
Occasional: Constioation, headache, decreased appetite, nausea, vomiting, paresthesia,
photosensitivity, muscular incoordination. Rare: Bitter or metallic taste, decreased libido,
dizziness, facial flushing, blue-grey coloring of skin, blurred vision, bradycardia, asymptomatic
corneal deposits, rash, visual disturbances, halo vision
Pharmacokinetics: (PO) Half-life: 26-107 days; 61 days (metabolite) Onset: 3days-3wks
Peak: 1wk-5mos Duration: 7-50days after discontinuation
Nursing Interventions: Monitor for symptoms of pulmonary toxicity (progressively worsening dyspnea,
cough). Monitor EKG for cardiac changes.

Reference: Kizior, R.J. and Hodgson, K.J. (2016). Saunders Nursing Drug Handbook. ELSEVIER, USA.
Generic Name: Amikacin
Brand Name: Amikin
Pregnancy Category: D
Dosage: 250mg/ml
Classification: Pharmacotherapeutic: Aminoglycoside Clinical: Antibiotic
Indications: Treatment of susceptible infections due to gram-negative bacilli including biliary tract,
bone and joint, CNS, intra-abdominal, skin and soft tissue, urinary tract. Treatment of bacterial
pneumonia, septicemia. Off-label: Mycobacterium avium complex (MAC)
Mode of Action: Inhibits protein synthesis in susceptible bacteria by binding to 30S ribosomal unit.
Therapeutic Effect: Interferes with protein synthesis of susceptible microbes.
Side Effects: Frequent: Phlebitis, thrombophlebitis. Occasional: Rash, fever, urticaria, pruritus.
Rare: Neuromuscular blockade (difficulty breathing, drowsiness, weakness)
Pharmacokinetics: Half-life: 2-4hr Onset: rapid Peak: unknown Duration: unknown
Nursing Interventions: Monitor I&O, urinalysis. Monitor results of serum peak/through levels. Be alert of
ototoxic, neurotoxic, nephrotoxic symptoms. Check IM injection site for pain, induration.
Evaluate IV site for phlebitis. Assess for skin rash, diarrhea, superinfection, changes of oral

Reference: Kizior, R.J. and Hodgson, K.J. (2016). Saunders Nursing Drug Handbook. ELSEVIER, USA.

Generic Name: Acyclovir

Brand Name: Apo-Acyclovir, Novo-Acyclovir, Zovirax
Pregnancy Category: B
Dosage: Tablet: 400mg, 800mg. Capsule: 200mg. Cream/Ointment: 5% Injection: 500mg/vial, 1g/vial.
Suspension: 200mg/5ml
Classification: Pharmacotherapeutic: Synthetic nucleoside. Clinical: Antiviral
Indications: Recurrent genital herpes infection. Localized cutaneus hepes zoster infection (shingles).
Chickenpox. Severe initial episodes of genital herpes in nonimmunosuppressed patients. Herpes
simplex encephalitis. Recurrent herpes labialis (cold sores). Acute mucocutaneous HSV
infections in immunocompromised patients
Mode of Action: Interferes with DNA synthesis and inhibits viral multiplication
Side Effects: Dizziness, headache, trembling, diarrhea, nausea, vomiting, abdominal pain, anorexia,
acne, hives, unusual sweating, phlebitis, local pain, irritation (local)
Pharmacokinetics: Half-life: 2-3.5hrs with normal renal function; 19hrs with renal impairment
Route Onset Peak Duration
PO unknown 2.5hr unknown
IV immediate immediate unknown
Topical unknown unknown unknown
Nursing Interventions: Assess lesions before and daily during therapy. Watch out for signs of acyclovir
overdose which are agitation; seizures; extreme tiredness; loss of consciousness; swelling of the
hands, feet, ankles or lower legs; decreased urination

Reference: Lippincott, Williams, and Wilkins (2013). Nursing 2013 Drug Handbook. Philadelphia, PA
Generic Name: Propylthiouracil
Brand Name: PTU-Propyl-Thyracil
Pregnancy Category: D
Dosage: Tablet: 50mg, 100mg
Classification: Therapeutic: Antihyperthyroid. Pharmacologic: Thyroid hormone antagonist
Indications: Hyperthyroidism
Mode of Action: Inhibits oxidation of iodine in thyroid gland, blocking ability to combine with tyrosine to
form T4 and may prevent coupling of monoiodotyrosine and diodotyrosine to form T3 to T4
Side Effects: CNS: Headache, drowsiness, vertigo, parathesia, neutritis, neuropathies, CNS stimulation,
depression, fever. CV: Vasculitis. EENT: Visual disturbances, loss of taste. GI: Diarrhea, N/V,
epigastric distress, salivary gland enlargement. GU: Nephritis. HEMA: Agranulocytosis,
leucopenia, thrombocytopenia, aplastic anemia. HEPA: Jaundice, hepatoxicity. META: Dose-
related hypothyroidism. MS: Rash, urticaria, skin discoloration, pruritus, erythema nodosum,
exfoliative dermatitis. OTHER: Lymphadenopathy
Pharmacokinetics: Half-life: 1-2hr Onset: unknown Peak: 60-90min Duration: unknown
Nursing Interventions: Watch out for hypothyroidism. Monitor CBC periodically, hepatic function. Report
fever, sore throat, mouth sores, and skin eruptions, unusual bleeding or bruising.

Reference: Lippincott, Williams, and Wilkins (2013). Nursing 2013 Drug Handbook. Philadelphia, PA

Generic Name: Pyrimethamine

Brand Name: Daraprim
Pregnancy Category: C
Dosage: Tablet: 25mg
Classification: Therapeutic: Antimalarial. Pharmacologic: Folic Acid antagonist
Indications: To prevent and control transmission of infection of malaria. Acute attacks of malaria.
Mode of Action: Blocks creation of Folic Acid, which is required for the reproduction of the infecting
organism. Sulfadoxine competitively inhibits use of PABA.
Side Effects: GI: Anorexia, vomiting, atrophic glossitis, abdominal cramps, diarrhea. SKIN: Rashes.
HEMA: Folic acid deficiency. CNS: CNS stimulation including convulsions, respiratory failure.
Pharmacokinetics: Half-life: 4 days Onset: unknown Peak: 1.5-8hr Duration: 2wks
Nursing Interventions: Monitor patient response closely. Perform blood counts, including platelets, twixe
a week during therapy. Withhold drug and notify physician if hematologic abnormalities

Reference: Lippincott, Williams, and Wilkins (2013). Nursing 2013 Drug Handbook. Philadelphia, PA
Generic Name: Rifampin
Brand Name: Rifadin, Rimactane
Pregnancy Category: C
Dosage: Capsule: 150-300mg. Powder for Injections: 600mg
Classification: Therapeutic: Antituberculotic. Pharmacologic: Semisynthetic rifamycin
Indications: Treatment of Pulmonary TB in conjunction with at least one other effective antituberculotic.
Neisseria meningitiedis carriers, for asymptomatic carriers to eliminate meningococci from
nasopharynx; not for treatment of meningitis.
Mode of Action: Inhibits DNA-dependent RNA polymerase, which impairs RNA synthesis. Therapeutic
Effect: Bacteriacidal
Side Effects: CNS: Headache, drowsiness, fatigue, dizziness, inability to concentrate, mental confusion,
generalized numbness, muscle weakness, visual disturbances. SKIN: Rash, pruritus, urticaria,
flushing. GI: Heartburn, distress, anorexia, vomiting gas, cramps, diarrhea, hepatitis, pancreatitis.
OTHER: Pain in extremities, osteomalacia, myopathy, fever, fluke-like symptoms
Pharmacokinetics: Half-life: 1.25-5hrs
Route Onset Peak Duration
PO unknown 2-4hrs unknown
IV unknown unknown unknown
Nursing Interventions: Administer on an empty stomach, 1hr before or 2hrs after meals. Administer a
single dose daily. Consult pharmacist for rifampin suspension for patients who are unable to
swallow capsules. Prepare parient for the reddish-orange coloring of body fluids.

Reference: Lippincott, Williams, and Wilkins (2013). Nursing 2013 Drug Handbook. Philadelphia, PA

Generic Name: Spironolactone

Brand Name: Aldactone
Pregnancy Category: C
Dosage: Tablet: 25mg, 50mg, 100mg
Classification: Therapeutic: Diuretic. Pharmacologic: Potassium-sparing diuretic, Aldosterone receptor
Indications: Hirsutism, severe heart failure. To detect primary hyperaldosteronism, hypertension, edema
due to heart failure, hepatic cirrhosis or nephritic syndrome.
Mode of Action: Antagonizes aldosterone in the distal tubules, increasing sodium and water excretion
Side Effects: CNS: Headache, drowsiness, lethargy, confusion, ataxia. GI: Diarrhea, gastric bleeding,
ulceration, cramping gastritis, vomiting. GU: Inability to maintain erection, menstrual
disturbances. HEMA: Agranulocytosis. META: Hyperkalemia, dehydration, hyponatremia, mild
acidosis. SKIN: Urticaria, hirsurism, maculopapular eruption. Other: Anaphylaxis, gynecomastia,
breast soreness, drug fever
Pharmacokinetics: Half-life: 1.25-2hr Onset:1-2 days Peak:2-3days Duration: 2-3days
Nursing Interventions: Monitor electrolyte levels, fluid I&O, weight, and BP. Monitor elderly. Inform lab
that patient is taking in this medication that may interfere with digoxin levels. Watch out for
hyperchloeremic metabolic acidosis. Take drug in morning take it with food.

Reference: Lippincott, Williams, and Wilkins (2013). Nursing 2013 Drug Handbook. Philadelphia, PA
Generic Name: Trimethoprim
Brand Name: Primasol
Pregnancy Category: C
Dosage: Tablet: 100mg. Oral Sol’n: 50mg/5ml
Classification: Pharmacotherapeutic: Sulfonamide and Folate antagonist. Clinical: Antibacterial
Indications: Treatment of UTI. Off-label:Treatment of pneumonia
Mode of Action: Inhibits folic acid reduction to tetrahydrofolate, inhibiting microbial growth.
Therapeutic Effect: Bacteriostatic
Side Effects: Occasional: Nausea, vomiting, diarrhea, decreased appetite, abdominal cramps,
headache. Rare: Hypersensitivity reaction, methemoglobinemia, fever, pale skin, sore throat,
asthenia, photosensitivity
Pharmacokinetics: Half-life: 8-11hr (Trimethoprim); 10-13hr (Sulfamethoxazole)
Route Onset Peak Duration
PO unknown 1-4hr unknown
IV immediate 1-1.5hr unknown
Nursing Interventions: Assess skin for rash. Evaluate food tolerance. Monitor serum hematology reports,
renal function, LFT. Check for developing signs of hematologic toxicity.

Reference: Kizior, R.J. and Hodgson, K.J. (2016). Saunders Nursing Drug Handbook. ELSEVIER, USA.

Generic Name: Vancomycin

Brand Name: Vancocin
Pregnancy Category: C, B for capsules
Dosage: 125mg. Capsules: 250mg. Oral powder: 1g, 10g. Injection: 500mg, 1g
Classification: Therapeutic: Antibiotic. Pharmacologic: Tricyclic Glycopeptide antibiotic
Indications: Severe infection against Methicillin Resistant Staphylococcus aureus
Mode of Action: Hinders bacterial cell-wall synthesis, damaging the bacterial plasma membrane and
making the cell more vulnerable to osmotic pressure. Also interfered with RNA synthesis
Side Effects: Frequent: Bitter/unpleasant taste, nausea, vomiting, mouth irritation. Rare: Phlebitis,
thrombophlebitis, pain at peripheral IV site, dizziness, vertigo, tinnitus, chilld, fever, rash, necrosis
Pharmacokinetics: Half-life: 6hr
Route Onset Peak Duration
PO unknown unknown unknown
IV immediate immediate unknown
Nursing Interventions: Monitor serum renal function tests, I&O. Assess skin for rash. Check hearing acuity,
balance. Monitor BP carefully during infusion. Evaluate IV sire for phlebitis. Obtain vancomycin
peak/trough level as ordered by physician or pharmacist

Reference: Kizior, R.J. and Hodgson, K.J. (2016). Saunders Nursing Drug Handbook. ELSEVIER, USA.