PHARMACOLOGIC STUDY

NAME OF GENERAL SPECIFIC INDICATIONS CONTRAINDICATIONS SIDE EFFECTS ADVERSE NURSING

DRUG ACTION ACTION EFFECTS RESPONSIBILITIES
Tramadol Centrally Binds to mu-  Indicated for  Acute alcohol  Dizziness  Seizures  Assess onset, type,
50mg per 8 acting opioid receptors, the intoxication  Vertigo reported in location, duration of
hours synthetic inhibits reuptake management  Concurrent use of  Nausea patients pain.
opioid of norepinephrine, of moderate centrally acting  Constipation receiving  Assess drug history, esp.
analgesic serotonin, to analgesics, hypnotics,  Headache tramadol within carbamazepine,
inhibiting moderately s opioids, psychotropic  Drowsiness recommended analgesics, CNS
ascending and evere pain in drugs, hypersensitivity  Vomiting dosage range. depressants, MAOIs.
descending pain adults. to opioids.  Pruritus  May have  Review past medical
pathways.  CNS prolonged history, esp. epilepsy,
Stimulation duration of seizures.
 Asthenia action,  Assess renal function,
 Diaphoresis cumulative LFT.
 Dyspepsia effect in  Monitor pulse, BP,
 Dry mouth patients with renal/hepatic function.
 Diarrhea hepatic/renal  Assist with ambulation
 Malaise impairment, if dizziness, vertigo
 Vasodilation serotonin occurs. Dry crackers,
 Anorexia syndrome cola may relieve nausea.
 Flatulence (agitation,  Palpate bladder for
 Rash hallucinations, urinary retention.
 Blurred vision tachycardia,  Monitor daily pattern of
 Urinary hyperreflexia) bowel activity, stool
Retention consistency.
 Menopausal  Sips of water may
symptoms relieve dry mouth.
Assess for clinical
improvement, record
onset of relief of pain.
 Avoid alcohol, OTC
medications
 Report severe
constipation, difficulty
breathing, excessive
sedation, seizures.
 NAME OF GENERAL SPECIFIC INDICATIONS CONTRAINDICATIONS SIDE EFFECTS ADVERSE NURSING
DRUG ACTION ACTION EFFECTS RESPONSIBILITIES
Clindamycin Antibiotic Inhibits protein  Treatment of  Hypersensitivity  Abdominal  CNS: dizziness,  Assess for infection
600 mg per 8 synthesis of Pneumocystic  Regional enteritis or pain headache, (vital signs; appearance
hours bacterial cell wall carinii ulcerative colitis  Nausea vertigo of wound, sputum, urine
by binding to pneumonia,  Previous  Vomiting  CV: PSEUDO- and stool; WBC) at
bacterial ribosomal CNS pseudomembranous  Diarrhea MEMBRANO beginning of and during
receptor sites. toxoplasmosis colitis  Pruritus US COLITIS, therapy
Topically, , and  Severe liver impairment  Phlebitis diarrhea, bitter  Obtain specimens for
decreases fatty babesiosis.  Diarrhea taste (IV only). culture and sensitivity
acid concentration  Known alcohol  Derm: rash. prior to initiating
on skin. intolerance (topical therapy. First dose may
Bacteriostatic or solution, suspension) be given before
bactericidal. receiving results.
 Monitor bowel
elimination. Diarrhea,
abdominal cramping,
fever and bloody stools
should be reported to
health care professional
promptly as a sign of
pseudomembranous
colitis. This may begin
up to several weeks
following the cessation
of therapy.
 Assess patient for
hypersensitivity (skin
rash, urticaria)
 Monitor CBC; may
cause transient  in
leukocytes, eosinophils,
and platelets.
 May cause  alkaline
phosphatase, bilirubin,
CPK, AST, and ALT
concentrations.
 NAME OF GENERAL SPECIFIC INDICATIONS CONTRAINDICATIONS SIDE EFFECTS ADVERSE NURSING
DRUG ACTION ACTION EFFECT RESPONSIBILITIES
Digoxin Antiarrhythmi Increases the force  Heart failure  Hypersensitivity  Dizziness  CNS: fatigue,  Monitor apical pulse for
125mcg 1 tab cs, inotropics of myocardial  Atrial  Uncontrolled  Headache headache, 1 full min before
OD contraction. fibrillation ventricular  Diarrhea weakness. administering. Withhold
Prolongs  Atrial flutter arrhythmias; AV block  Rash  EENT: blurred dose and notify health
refractory period (slows (in absence of  Visual vision, yellow care professional if
of the AV node. ventricular pacemaker) disturbances or green vision. pulse rate is <60 bpm in
Decreases rate)  Idiopathic hypertrophic .  CV: an adult. Also notify
conduction  Paroxysmal subaortic stenosis Arrhythmias, health care professional
through the SA atrial  Constrictive bradycardia, promptly of any
and AV nodes. tachycardia. pericarditis ECG changes, significant changes in
 Known alcohol AV block, SA rate, rhythm, or quality
intolerance block. of pulse.
 GI: anorexia,  Monitor BP periodically
nausea, in patients IV digoxin.
vomiting,  Monitor ECG
diarrhea. throughout IV
 Hemat: administration and 6 hr
thrombocytopen after each dose. Notify
ia health care professional
 Metab: if bradycardia or new
electrolyte arrhythmias occur.
imbalances with  Monitor intake and
acute digoxin output ratios and daily
toxicity. weights. Assess for
peripheral edema, and
auscultate lungs for
rales/crackles
throughout therapy.
 Before administering
initial loading dose,
determine whether
patient has taken any
digitalis preparations in
the preceding 2-3 wk.
 Teach patient to take
pulse and to contact
HCP before taking med.
 NAME OF GENERAL SPECIFIC INDICATIONS CONTRAINDICATIONS SIDE EFFECTS ADVERSE NURSING
DRUG ACTION ACTION EFFECTS RESPONSIBILITIES
Prednisone Adrenal Inhibits  Acute or  Acute superficial  Insomnia  Long-term  Obtain baselines for
20 mg 1 tab corticosteroid accumulation of chronic herpes simples keratitis  Heartburn therapy: height, weight, BP,
OD inflammatory cells adrenal  Systemic fungal  Nervousness muscle wasting serum glucose,
at inflammation insufficiency infections  Abdominal (esp. in arms, electrolytes.
sites,  Congenital  Varicella distention legs)  Check results of initial
phagocytosis, adrenal  Administration of live  Diaphoresis  Osteoporosis tests (TB skin test,
lysosomal enzyme hyperplasia or attenuated virus  Acne  Spontaneous EKG). Never give live
release/synthesis,  Adrenal vaccines  Mood swings fractures virus vaccine.
release of insufficiency  Increased  Amenorrhea  Monitor BP, serum
mediators of secondary to Cautions: appetite  Cataracts electrolytes, glucose,
inflammation. pituitary  Hyperthyroidism  Facial  Glaucoma results of bone mineral
Prevents/suppreses insufficiency  Cirrhosis flushing  Peptic ulcer density test, height,
cell-mediated   Delayed  HF weight, in children. Be
Arthritis  Ocular herpes simplex
immune reactions.  wound  Abrupt alert to infection; assess
Rheumatic  Respiratory
Decreases/prevents carditis healing withdrawal oral cavity daily for
tuberculosis
tissue response to   Increased following long- signs of candida
inflammatory
Prevention of  Untreated systemic susceptibility infection.
postherpetic term therapy:
infections
process. to infection Anorexia,  Report fever, sore
neuralgia,  Renal/hepatic  Diarrhea nausea, fever, throat, muscle aches,
relief of impairment
acute pain in  Constipation headache, sudden weight, swelling,
pts with  Headache rebound loss of appetite, or
herpes  Edema inflammation, fatigue.
zoster,  Change in fatigue,  Avoid alcohol, minimize
autoimmune skin color weakness, use of caffeine
hepatitis.  Frequent lethargy,  Maintain fastidious oral
urination dizziness, hygiene.
 Tachycardia orthostatic  Do not abruptly
 Allergic hypotension. discontinue without
reaction (rash, Sudden physician’s approval.
urticarial) discontinuance  Avoid exposure to
 Psychological may be fatal. chickenpox, measles.
changes
 Hallucinations
 Depression
 NAME OF GENERAL SPECIFIC INDICATIONS CONTRAINDICATIONS SIDE EFFECTS ADVERSE NURSING
DRUG ACTION ACTION EFFECTS RESPONSIBILITIES
Atorvastatin Anti- Inhibits HMG-  Primary  Active hepatic disease  Headache  Potential for  Obtain baseline
20mg 20 mg hyperlipidemi CoA reductase, the prevention of  Breastfeeding  Myalgia cataracts, cholesterol,
1tab OD HS a enzyme that cardiovascul  Pregnancy  Rash photosensitivity triglycerides, LFT.
catalyzes the early ar disease in  Unexplained elevated  Pruritus ,myalgia,  Question for possibility
step in cholesterol high-risks LFT results  Allergy rhabdomyolysis of pregnancy before
synthesis. pts. . initiating therapy.
 Reduces risk Cautions: Obtain dietary history.
of stroke and  Anticoagulant therapy  Monitor for headache.
heart attack  History of hepatic Assess for rash, pruritus,
in pts with disease malaise.
type 2  Monitor cholesterol,
 Substantial alcohol
diabetes with triglyceride lab values
consumption
or without for therapeutic response.
evidence of  Monitor hepatic
heart disease. function tests, CPK.
 Reduces risk  Follow special diet
of stroke in  Periodic lab tests are
patients with essential part of therapy
or without  Do not take other
evidence of medications without
heart disease consulting physician.
with multiple  Do not chew, crush,
risk factors dissolve or divide
other than tablets.
diabetes.  Report dark urine,
 Adjunct to muscle fatigue, bone
diet therapy pain.
in manage-  Avoid excessive alcohol
ment of intake, large quantities
hyperlipidem of grapefruit products.
ias,
homo/hetero
zygous
familial
hypercholest
erolemia
 NAME OF GENERAL SPECIFIC INDICATIONS CONTRAINDICATIONS SIDE EFFECTS ADVERSE NURSING
DRUG ACTION ACTION EFFECTS RESPONSIBILITIES
Lactulose Hyperosmotic Inhibits diffusion  Prevention,  Pts requiring a low-  Abdominal  Severe diarrhea  Encourage adequate
70mg OD HS laxative, of NH3 into blood treatment of galactose diet. cramping indicates fluid intake.
ammonia by converting NH3 portal-  Flatulence overdose  Assess bowel sounds for
detoxicant. to NH4+; enhances systemic Cautions:  Increased  Long-term use peristalsis.
diffusion of NH4+; encephalopat  Diabetes mellitus, thirst may result in  Monitor daily pattern of
produces osmotic hy (including hepatic impairment,  Abdominal laxative bowel activity, stool
effect in colon. hepatic pre- dehydration. discomfort dependence consistency; record time
coma, coma)  Nausea  Chronic of evacuation.
 Treatment of  Vomiting constipation  Assess for abdominal
constipation.  Loss of normal disturbances.
bowel function  Monitor serum
electrolytes in pts with
prolonged, frequent,
excessive use of
medication.
 Evacuation occurs in 24-
48 hrs of initial dose.
 Institute measures to
promote defecation:
increase fluid intake,
exercise, high-fiber diet.
 NAME OF GENERAL SPECIFIC INDICATIONS CONTRAINDICATIONS SIDE EFFECTS ADVERSE NURSING
DRUG ACTION ACTION EFFECTS RESPONSIBILITIES
Enalapril Antihypertens Suppresses renin-  Treatment of  History of angioedema  Headache  Excessive  Obtain BP immediately
5 mg 1 tab ive, angiotensin- hypertension from previous  Dizziness hypotension before each dose.
OD vasodilator aldosterone system alone or in treatment with ACE  Orthostatic may occur in  Assist with ambulation
(prevents combination inhibitors. hypotension pts with HF if dizziness occurs.
conversion of with other  Idiophatic/hereditary  Fatigue  Severe salt or  Monitor CBC, serum
angiotensin I to antihypertens angioedema.  Diarrhea volume BUN, potassium,
angiotensin II, a ives.  Concomitant use of  Cough depletion creatinine, BP.
potent Adjunctive aliskerin in pts with  Syncope  Angioedema  Monitor daily pattern of
vasoconstrictor; therapy for diabetes.  Angina (facial, lip bowel activity, stool
may inhibit symptomatic  Abdominal swelling), consistency.
angiotensin II at HF. Cautions: pain hyperkalemia  To reduce hypotensive
local vascular,  Treatment of  Renal impairment  Vomiting occur rarely effect, go from lying to
renal sites). left  Hypertrophic  Nausea  Agranulocytosis standing slowly.
Decreases plasma ventricular cardiomyopathy  Rash  Neutropenia  Several weeks may be
angiotensin II, dysfunction. with outflow tract  Asthenia  Collagen needed for full
increases plasma  Treatment of obstruction vascular therapeutic effect of BP
renin activity, hypertension diseases reduction.
decreases in adults and  Nephrotic  Skipping doses or
aldosterone children syndrome voluntarily
secretion. older than 1 discontinuing drug may
mo. produce severe, rebound
hypotension.
 Limit alcohol intake
 Report vomiting,
diarrhea, diaphoresis,
persistent cough,
difficulty breathing;
swelling of face, lips,
tongue.
 NAME OF GENERAL SPECIFIC INDICATIONS CONTRAINDICATIONS SIDE EFFECTS ADVERSE NURSING
DRUG ACTION ACTION EFFECTS RESPONSIBILITIES
Isosorbide Antianginal Stimulates  Prevention of  Hypersensitivity to  Headache  Blurred vision  Record onset, type
mononitrate intracellular cyclic angina nitrates, concurrent use Transient  Severe (sharp, dull, squeezing),
30 mg OD guanosine pectoris. of sildenafil, tadalafil, flushing of orthostatic radiation, location,
monophosphate. verdenafil. face/neck, hypotension intensity, duration of
Relaxes vascular dizziness, manifested by anginal pain;
smooth muscle of Cautions: weakness, syncope, precipitating factors
atrial, venous  Inferior wall MI, orthostatic pulselessness, (exertion, emotional
vasculature. head trauma, hypotension, cold/clammy stress).
Decreases preload, increased ICP, nausea, skin, and  If headache occurs
afterload, cardiac orthostatic vomiting, diaphoresis has during management
oxygen demand. hypotension, blood restlessness. been reported. therapy, administer
volume depletion GI upset,  Tolerance may medication with meals.
from diuretic blurred vision, occur with  Assist with ambulation
therapy, systolic BP dry mouth. repeated, if light headedness,
less than 90 mmHg,  Burning, prolonged dizziness occurs.
hypertrophic tingling at therapy, but  Assess for facial/neck
cardiomyopathy. oral point of may not occur flushing.
dissolution. with extended-  Monitor number of
release form. anginal episodes,
 Minor tolerance orthostatic BP.
with  Do not chew, crush,
intermittent use dissolve or divide
of sublingual sublingual, extended-
tablets. release-sustained-release
 High dose tends forms.
to produce  Take sublingual tablets
severe while sitting down.
headache.  Go from lying to
standing slowly.
 Dissolve sublingual
tablet under tongue; do
not swallow.
 Avoid alcohol
 Report signs/symptoms
of hypotension, angina.
 NAME OF GENERAL SPECIFIC INDICATIONS CONTRAINDICATIONS SIDE EFFECTS ADVERSE NURSING
DRUG ACTION ACTION EFFECTS RESPONSIBILITIES
Verapamil Calcium Inhibits calcium  Treatment of  Atrial fibrillation/flutter  Constipation  Rapid  Check BP for
500 mg 1 tab channel ion entry cross hypertension, in presence of  Dizziness ventricular rate hypotension, pulse for
OD blocker; cardiac, vascular angina accessory bypass tract  Light- in atrial bradycardia immediately
Antihypertens smooth-muscle pectoris,  Severe left ventricular headedness flutter/fibrillatio before giving
ive, cell membranes, supraventricu dysfunction  Asthenia n, marked medication.
Antianginal, dilating coronary lar  Cardiogenic shock  Nausea hypotension,  Assess pulse for quality,
antiarrhythmi arteries, peripheral tachyarrhyth  Second- or third-degree  Peripheral extreme rate, rhythm.
c, arteries, arterioles. mias (SVT), heart block edema bradycardia,  Monitor BP. Monitor
hypertrophic Decreases heart atrial  Hypotension  Hypotension HF, asystole, EKG for cardiac
cardiomyopat rate, myocardial fibrillation/fl  Sick sinus syndrome  Bradycardia second- or changes, particularly
hy therapy contractility; slow utter (rate  Dermatitis third-degree AV prolongation of PR
adjunct. SA, AV control) Cautions:  Rash block occur interval. Notify
conduction. rarely. physician of any
 Renal/hepatic
Decreases total significant EKG interval
impairment
peripheral vascular changes.
 Concomitant use of
resistance by  Assist with ambulation
beta blockers
vasodilation. if dizziness occurs.
and/or digoxin
 Assess for peripheral
 Myasthenia Gravis edema.
 Hypertrophic  Monitor daily pattern of
cardiomyopathy bowel activity, stool
consistency.
 Do not abruptly
discontinue medication.
 Compliance with
therapy regimen is
essential to control
anginal pain.
 Avoid tasks that require
alertness, motor skills
until response to drug is
established.
 Limit caffeine.
 Report continued,
persistent angina pain
and irregular heartbeats,
SOB, swelling.
 NAME OF GENERAL SPECIFIC INDICATIONS CONTRAINDICATIONS SIDE EFFECTS ADVERSE NURSING
DRUG ACTION ACTION EFFECTS RESPONSIBILITIES
Colchicine Antigout Decreases  Prevention,  Concomitant use of a  Nausea  Long-term  Obtain baseline
1 tab OD leukocyte motility, treatment of P-glycoprotein (e.g.,  Vomiting therapy: bone laboratory studies.
phagocytosis, acute gouty cyclosporine) or strong  Abdominal marrow  Assess involved joints
lactic acid arthritis. CYP3A4 inhibitor in discomfort depression for pain, mobility, and
production. Used to presence renal/hepatic  Anorexia  Burning feeling edema.
Decreases urate reduce impairment  Hypersensitivi in skin/throat  Assess abdominal pain,
crystal deposits, frequency of ty reaction,  Severe diarrhea fever, chills, erythema,
reduces recurrence of Cautions: including  Abdominal pain swollen skin lesions.
inflammatory familial  Hepatic impairment, angioedema.  Fever  Discontinue medication
process. Mediterranea elderly, debilitated,  Seizures immediately if GI
n fever renal impairment.  Delirium symptoms occur.
 Renal Encourage high fluid
impairment intake (3L/day).
 Hair loss  Monitor I&O, BC,
 Leukocytosis hepatic/renal function
 Stomatitis tests.
 Monitor serum uric acid.
 Assess for therapeutic
response: relief of pain,
stiffness, swelling;
increased joint mobility;
reduced joint
tenderness; improved
grip strength.
 Report skin rash, sore
throat, fever unusual
bruising/bleeding,
weakness, fatigue,
numbness.
 Stop medication as soon
as gout pain is relieved
or at first sign of nausea,
vomiting, diarrhea.
 Avoid grapefruit
products.
 NAME OF GENERAL SPECIFIC INDICATIONS CONTRAINDICATIONS SIDE EFFECTS ADVERSE NURSING
DRUG ACTION ACTION EFFECTS RESPONSIBILITIES
Aspirin Anti- Inhibits cyclo-  Treatment of  Hypersensitivity to  GI distress  GI bleeding  Assess type, location,
80 mg OD inflammatory, oxygenase enzyme mild to salicylates, NSAIDs.  Abdominal and/or gastric duration of pain,
antipyretic, via acetylation. moderate  Asthma distention mucosal lesions inflammation.
anticoagulant Inhibits formation pain, fever.  Rhinitis  Cramping  Dehydration  Inspect appearance of
of prostaglandin  Reduces  Nasal polyp  Heartburn  Reye’s affected joints for
derivative inflammation  Inherited or acquired  Mild nausea syndrome immobility, deformities,
thromboxane A. related to bleeding disorders  Allergic  Vomiting skin condition.
Reduces rheumatoid  Avoid use in reaction  Tinnitus  Do not chew, crush,
inflammatory arthritis, pregnancy, esp. third  Bronchospas  Headache dissolve or divide
response, intensity juvenile trimester. m  Dizziness tablets.
of pain; decreases arthritis,  Pruritus  Flushing  Avoid alcohol
fever; inhibits osteoarthritis, Cautions:  Urticaria  Hyperventilatio  Report tinnitus or
platelet rheumatic n persistent abdominal GI
 Platelet/bleeding
aggregation. fever.  Diaphoresis pain, bleeding
disorder
 Used as  Thirst  Behavioral changes,
 Severe hepatic/renal
platelet  Hyperthermia persistent vomiting may
impairment
aggregation  Restlessness be early signs of Reye’s
 Dehydration  Seizures syndrome; contact
inhibitor in
 Erosive gastritis  Abnormal physician.
the
 Peptic ulcer disease breathing
prevention of
transient pattern
ischemic  Respiratory
attacks, failure
cerebral  Coma
thromboemb
olism, MI or
reinfarction.
 NAME OF GENERAL SPECIFIC INDICATIONS CONTRAINDICATIONS SIDE EFFECTS ADVERSE NURSING
DRUG ACTION ACTION EFFECTS RESPONSIBILITIES
Omeprazole Proton pump Inhibits hydrogen-  Short-term  Hypersensitivity to  Headache  Pancreatitis  Evaluate for therapeutic
40 mg 1 tab inhibitor potassium treatment (4- other proton pump  Diarrhea  Hepatotoxicity response (relief of GI
OD adenosine 8 wks) of inhibitors.  Abdominal  Interstitial symptoms).
triphosphatase erosive pain nephritis occur  Questions if GI
(H+/K+ ATP esophagitis Cautions:  Nausea rarely. discomfort, nausea,
pump), and  Symptomatic  May increase risk of  Dizziness diarrhea occurs.
enzyme on the GERD fractures,  Asthenia (loss  Report headache, onset
surface of gastric poorly gastrointestinal of strength, of black, tarry stools,
parietal cells. responsive to infections energy) diarrhea, and abdominal
Increases gastric other  Hepatic impairment,  Vomiting pain.
pH, reduces gastric treatment esp. of Asian  Constipation  Avoid alcohol intake.
acid production.  Long-term descent.  Upper  Swallow capsules
treatment of respiratory whole; do not chew,
pathologic tract infection crush, dissolve, or
hypersecretor  Back pain divide.
y conditions,  Rash  Take before eating.
treatment of  Cough
active
duodenal
ulcer or
active benign
gastric ulcer.
 Maintenance
healing of
erosive
esophagitis.
 Treatment of
frequent
uncomplicate
d heartburn
occurring 2
or more
days/wk
 NAME OF GENERAL SPECIFIC INDICATIONS CONTRAINDICATIONS SIDE EFFECTS ADVERSE NURSING
DRUG ACTION ACTION EFFECTS RESPONSIBILITIES
Spironolacton Potassium- Interferes with  Management  Acute renal  Hyperkalemia  Severe  Weight pt; initiate strict
e 25 g per tab sparing sodium of edema insufficiency  Dehydration hyperkalemia I&O.
BID diuretic, reabsorption by associated  Anuria  Hyponatremia may produce  Evaluate hydration
antihypertensi competitively with  Hyperkalemia  Lethargy arrhythmias, status by assessing
ve, inhibiting action of excessive  Addison’s disease  Nausea bradycardia, mucous membranes,
antihypokale aldosterone in aldosterone  Concomitant use of  Vomiting EKG changes skin turgor.
mic. distal tubule, excretion or eplerenone  Anorexia  May proceed to  Obtain baseline serum
promoting sodium with HF;  Abdominal cardiac electrolytes,
and water hypertension; Cautions: cramps standstill, renal/hepatic function,
excretion, cirrhosis of  Dehydration  Diarrhea ventricular and urinalysis.
increasing liver with  Headache fibrillation  Assess for edema; note
 Hyponatremia
potassium edema or  Ataxia  Cirrhosis pts at location, extent.
 Renal/hepatic
retention. Produces ascites,  Drowsiness risk for hepatic  Check baseline vital
impairment
diuresis, lowers hypokalemia,  Confusion decompensation signs, note pulse
BP.  Concurrent use of  Fever if dehydration, rate/regularity.
nephrotic
supplemental
syndrome,  Gynecomastia hyponatremia  Monitor BP.
potassium, elderly.
severe HF;  Impotence, occurs.  Monitor serum
primary decreased  Pts with electrolytes values, esp.
hyperaldoster libido. primary for increased potassium,
onism. aldosteronism BUN, creatinine.
may experience  Monitor for signs of
rapid weight hyperkalemia.
loss, severe  Obtain daily weight.
fatigue during  Note changes in edema,
high-dose skin turgor.
therapy.  Avoid foods high in
potassium, such as
whole grains, legumes,
meat, bananas, apricots,
orange juice, potatoes
and raisins.
 Avoid tasks that require
alertness, motor skills
until response to drug is
established (may cause
drowsiness).
 NAME OF GENERAL SPECIFIC INDICATIONS CONTRAINDICATIONS SIDE EFFECTS ADVERSE NURSING
DRUG ACTION ACTION EFFECTS RESPONSIBILITIES
Potassium Potassium Necessary for  Treatment,  Severe renal  Nausea  Hyperkalemia  Assess for hypokalemia.
chloride tab replenisher multiple cellular prevention of impairment  Vomiting manifested as  PO should be given with
TID metabolic hypokalemia  Adrenal insufficiency  Diarrhea paresthesia, food or after meals with
processes. Primary when  Hyperkalemia  Flatulence feeling of full glass of water, fruit
action is necessary to  Abdominal heaviness in juice (minimizes GI
intracellular. avoid Cautions: discomfort lower irritation)
Required for nerve chloride or  Cardiac disease, with extremities,  Monitor serum
impulse acid/base acid-base disorders distention cold skin, potassium.
conduction, imbalance.  Potassium-altering  Rash grayish pallor,  Be alert to decreased
contraction of disorders hypotension, urinary output
cardiac, skeletal, confusion,  Monitor daily pattern of
smooth muscle; irritability, bowel activity, stool
maintains normal flaccid consistency.
renal function, paralysis,  Assess I&O diligently
acid-base balance. cardiac during diuresis.
arrhythmias.  Report paresthesia,
feeling of heaviness of
lower extremities, tarry
or bloody stools,
weakness, unusual
fatigue.
 NAME OF GENERAL SPECIFIC INDICATIONS CONTRAINDICATIONS SIDE EFFECTS ADVERSE NURSING
DRUG ACTION ACTION EFFECTS RESPONSIBILITIES
Carvedilol Antihypertens Possess  Treatment of  Bronchial asthma or  Fatigue  Bradycardia  Assess BP, apical pulse
6.25 mg 1 tab ive nonselective beta- mild to related bronchospastic  Dizziness  Hypotension immediately before drug
BID blocking and severe HF, conditions, cardiogenic  Diarrhea  Bronchospasm is administered.
alpha-adrenergic left shock, decompensated  Bradycardia  Cardiac  Monitor BP for
blocking activity. ventricular HF requiring  Rhinitis insufficiency hypotension,
Cause dysfunction intravenous inotropic  Back pain  Cardiogenic respirations for dyspnea.
vasodilation. following therapy, severe hepatic  Orthostatic shock  Assess pulse for quality,
Reduces cardiac MI, impairment, second- or hypotension  Cardiac arrest regularity, rate; monitor
output, exercise- hypertension. third-degree AV block,  Drowsiness  Abrupt for bradycardia.
induced  Treatment of severe bradycardia, or  UTI withdrawal may  Monitor EKG for
tachycardia, reflex angina sick sinus syndrome.  Viral result in cardiac arrhythmias.
orthostatic pectoris, infection diaphoresis,  Assist with ambulation
tachycardia; idiopathic Cautions: palpitations, if dizziness occurs.
reduces peripheral cardiomyopa  Concurrent use of headache, and  Assess for evidence of
vascular thy. digoxin, diltiazem, tremors. HF: Dyspnea, night
resistance. or verapamil;  May precipitate cough, peripheral
diabetes, HF, MI in pts edema, distented neck
myasthenia gravis, with cardiac veins.
psychiatric disease, disease; thyroid  Monitor I&O.
mild to moderate storm in pts  Monitor renal/hepatic
hepatic impairment. with function tests.
Withdraw gradually thyrotoxicosis;  Avoid tasks that require
to avoid acute peripheral alertness, motor skills
tachycardia, vascular until response to drug is
hypertension, disease. established.
and/or ischemia. Hypoglycemia  Report excessive
may occur in fatigue, prolonged
pts with dizziness.
previously  Do not use nasal
controlled decongestants, OTC
diabetes. cold preparations
(stimulants) without
physician’s approval.
 Restrict salt, alcohol
intake.
 NAME OF GENERAL SPECIFIC INDICATIONS CONTRAINDICATIONS SIDE EFFECTS ADVERSE NURSING
DRUG ACTION ACTION EFFECTS RESPONSIBILITIES
Clopidogrel Antiplatelet Inhibits binding of  Unstable  Active bleeding (e.g.,  Dizziness  Agranulocytosis  Obtain baseline
75 mg OD enzyme adenosine angina/non- peptic ulcer,  Skin disorders  Aplastic chemistries
phosphate (ADP) ST-segment intracranial  Upper anemia/  Platelet count
to its platelet elevation MI. hemorrhage) respiratory pancytopenia  PFA level
receptor and ST-segment tract infection  Thrombotic  Perform platelet counts
subsequent ADP- elevation, Cautions:  Chest pain thrombocytopen before drug therapy,
mediated acute MI.  Severe hepatic/renal  Flu-like ia purpura  Abrupt discontinuation
activation of a Recent MI, impairment symptoms (TTP) occur of drug therapy
glycoprotein stroke, or  Pts at risk of  Headache rarely produces elevated
complex. Inhibits established increased bleeding  Arthralgia  Hepatitis platelet count within 5
platelet peripheral  Concurrent use of  Fatigue  Hypersensitivit days.
aggregation. arterial anticoagulants  Edema y reaction  Monitor platelet count
disease.  Avoid concurrent  Hypertension  Anaphylactoid for evidence of
use of CYP2C19  Abdominal reaction have thrombocytopenia.
inhibitors. pain been reported.  Assess Hgb, Hct, WBC;
 Dyspepsia serum ALT, AST,
 Diarrhea bilirubin, BUN,
 Nausea creatinine;
 Epistaxis signs/symptoms for
 Dyspnea hepatic insufficiency
 Rhinitis during therapy.
 It may take longer to
stop bleeding during
drug therapy.
 Report any unusual
bleeding.
 Inform physicians,
dentists if clopidogrel is
being taken, esp. before
surgery is scheduled or
before taking any new
drug.
 NAME OF GENERAL SPECIFIC INDICATIONS CONTRAINDICATIONS SIDE EFFECTS ADVERSE NURSING
DRUG ACTION ACTION EFFECTS RESPONSIBILITIES
Diclofenac gel Analgesic, Inhibits  Treatment of  Asthmatic pts  nausea,  Rash  Evaluate therapeutic
on affected anti- prostaglandin acute pain  Hypersensitivity to  stomach pain,  Abdominal pain response by assessing
site every inflammatory. synthesis, intensity due to minor aspirin, diclofenac,  upset  Diarrhea pain, joint stiffness, joint
morning of pain stimulus strains, other NSAIDs stomach,  Dark urine swelling and mobility.
reaching sensory sprains,  CABG surgery  ulcers, or  Assess any worsening of
nerve endings. contusions.  itching, asthma in appropriate
Produces Cautions:  dryness, patients.
analgesic, anti-  HF  redness,  Regular full dosage has
inflammatory  Hypertension  scaling, both lasting analgesic
effects.  Renal/hepatic  numbness and and anti-inflammatory
impairment tingling, effects, making it useful
 cysts, for continuous pain
 Hepatic porphyria
 pimples, or associated with
 History of GI
other inflammation.
disease
 skin irritation  Nurses should refer to
where the manufacturer’s
medicine was summary of product
applied characteristics and to
appropriate local
guidelines.
 NAME OF GENERAL SPECIFIC INDICATIONS CONTRAINDICATIONS SIDE EFFECTS ADVERSE NURSING
DRUG ACTION ACTION EFFECTS RESPONSIBILITIES
Paracetamol Antipyretics, Inhibits the  Treatment of  Previous  Low fever  Allergic reactio  Assess patient’s fever or
500 mg 1 tab nonopioid synthesis of mild pain hypersensitivity  Nausea n, which can pain: typeof pain, location,
per 6H analgesics prostaglandins that  Fever  Products containing cause a rash and intensity, duration,
 Stomach pain temperature, and
may severe as alcohol, aspartame, swelling.
mediators of pain  Loss of flushing, low diaphoresis.
saccharin, sugar, or  Assess allergic reactions:
and fever, appetite blood pressure
tartrazine should be rash, urticaria; if these
primarily in the avoided in patients who  Dark urine and a fast occur, drug may have to
CNS. Has no have hypersensitivity  Clay-colored heartbeat be discontinued.
significant anti- intolerance to these stools.  Teach patient to recognize
inflammatory compounds  Jaundice (yell signs of chronic overdose:
properties or GI  Severe hepatic owing of the bleeding, bruising,
toxicity. impairments/active skin or eyes). malaise, fever, sore throat.
liver disease  Tell patient to notify
prescriber for pain/ fever
lasting for more than 3
days.
 NAME OF GENERAL SPECIFIC INDICATIONS CONTRAINDICATIONS SIDE EFFECTS ADVERSE NURSING
DRUG ACTION ACTION EFFECTS RESPONSIBILITIES
Erythromycin Antibiotic, Penetrates  Treatment of  Hepatic impairment  Nausea  Antibiotic-  Monitor daily pattern of
antiacne. bacterial cell susceptible  Concomitant  Vomiting associated bowel activity, stool
membranes, infections administration with  Diarrhea colitis consistency.
reversibly binds to  Treatment of ergot derivatives  Rash  Super infections  Assess skin for rash.
bacterial acne vulgaris  Urticaria  Reversible  Assess for
ribosomes,  Treatment of Cautions: cholestatic hepatotoxicity
inhibiting protein minor  Elderly hepatitis may  Be alert for
synthesis. bacterial skin  Myasthenia gravis occur superinfection: fever;
infections  Uncorrected  High dosage in vomiting, diarrhea,
hypokalemia pts with renal anal/genital pruritus,
impairment may oral mucosal changes
lead to  Check for phlebitis
reversible  Monitor for high-dose
hearing loss hearing loss.
 Ventricular
arrhythmias
 Prolonged QT
interval occur
 NAME OF GENERAL SPECIFIC INDICATIONS CONTRAINDICATIONS SIDE EFFECTS ADVERSE NURSING
DRUG ACTION ACTION EFFECTS RESPONSIBILITIES
Nicardipine Antianginal, Inhibits calcium  Treatment of  Advanced aortic  Headache  Overdose  Concurrent therapy with
antihypertensi ion movement chronic stenosis  Facial produces sublingual nitroglycerin
ve across cell stable flushing confusion may be used for relief of
membranes; anginas, Cautions:  Peripheral  Slurred speech angina pain.
depressing hypertension.  Cardiac/renal/hepat edema  Drowsiness  Record onset, type,
contraction of  HF ic dysfunction  Light-  Marked radiation, location,
cardiac, vascular  Control  HF headedness hypotension intensity, duration, of
smooth muscle. blood  Hypertrophic  Dizziness  Bradycardia angina pain,
pressure in cardiomyopathy  Asthenia precipitating factors.
acute  Aortic stenosis  Palpitations  Monitor BP during and
ischemic  Coronary artery  Angina following IV infusion.
stroke disease  Tachycardia  Assess for peripheral
 Nausea edema,
 Portal hypertension
 Abdominal  Assess skin for facial
cramps flushing, dermatitis,
 Dyspepsia rash.
 Dry mouth  Question for asthenia,
 Rash headache.
 Monitor LFT results.
 Assess EKG, pulse for
tachycardia.
 NAME OF GENERAL SPECIFIC INDICATIONS CONTRAINDICATIONS SIDE EFFECTS ADVERSE NURSING
DRUG ACTION ACTION EFFECTS RESPONSIBILITIES
Isosorbide Antianginal Stimulates  Prevention  Hypersensitivity to  Headache  Blurred vision  Record onset, type
dinitrate 30 intracellular cyclic and treatment nitrates, concurrent use Transient  Severe (sharp, dull, squeezing),
mg OD guanosine angina. of sildenafil, tadalafil, flushing of orthostatic radiation, location,
monophosphate. verdenafil. face/neck, hypotension intensity, duration of
Relaxes vascular dizziness, manifested by anginal pain;
smooth muscle of Cautions: weakness, syncope, precipitating factors
atrial, venous  Inferior wall MI, orthostatic pulselessness, (exertion, emotional
vasculature. head trauma, hypotension, cold/clammy stress).
Decreases preload, increased ICP, nausea, skin, and  If headache occurs
afterload, cardiac orthostatic vomiting, diaphoresis has during management
oxygen demand. hypotension, blood restlessness. been reported. therapy, administer
volume depletion GI upset,  Tolerance may medication with meals.
from diuretic blurred vision, occur with  Assist with ambulation
therapy, systolic BP dry mouth. repeated, if light headedness,
less than 90 mmHg,  Burning, prolonged dizziness occurs.
hypertrophic tingling at therapy, but  Assess for facial/neck
cardiomyopathy. oral point of may not occur flushing.
dissolution. with extended-  Monitor number of
release form. anginal episodes,
 Minor tolerance orthostatic BP.
with  Do not chew, crush,
intermittent use dissolve or divide
of sublingual sublingual, extended-
tablets. release-sustained-release
 High dose tends forms.
to produce  Take sublingual tablets
severe while sitting down.
headache.  Go from lying to
standing slowly.
 Dissolve sublingual
tablet under tongue; do
not swallow.
 Avoid alcohol
 Report signs/symptoms
of hypotension, angina.
 NAME OF GENERAL SPECIFIC INDICATIONS CONTRAINDICATIONS SIDE EFFECTS ADVERSE NURSING
DRUG ACTION ACTION EFFECTS RESPONSIBILITIES
Enoxaparin Anticoagulant Potentiates action  Prevention of  Active bleeding  Injection site  May lead to  Obtain baseline CBC.
of antithrombin postop DVT  Concurret hea\parin hematoma bleeding  Note platelet count
III, inactivates surgery therapy  Nausea complications  Assess potential risk of
coagulation factor  Acute ST-  Hypersensitivity to  Peripheral ranging from bleeding,
Xa. Produces segment heparin edema local  Assess for any signs of
anticoagulantion. elevation  Pork products ecchymoses to bleeding
Does not  Treatment of  Thrombocytopenia major  Do not take any OTC
significantly acute associated with positive hemorrhage medication without
influence PT, coronary in vitro test for  May cause consulting physician
aPTT. syndrome antiplatelet antibodies. heparin-induced  Report unusual bleeding
 Not for IM use. thrombocytopen or bruising.
ia