Note: Any up-dates are to be completed in different color ink.

k. The student is expected to document all meds the client is currently receiving.
MEDICATION NAME DOSE, ROUTE, TIMES EFFECTS
GENERIC/TRADE INDICATION/ ACTION DOSGE FOOD/DRUG SIDE EFFECTS PREGANCY FETUS NURSING CONSIDERATIONS
CLASSIFICATION RANGE INTERACTIONS AND/OR NEONATE
(PHARM) AND (include therapeutic dose
PREGNANCY calculation)
CATEGORY
Moderate or severe pain IV, IM, SUBCU, PO Do not use in patients Seizures, Widely distributed Assess type, location, and intensity
(alone or with non- opioid Adults-IM or subcut receiving MAO inhibitors confusion, crossing placenta, of pain prior to and 1hr following
Meperidine agents) Anesthesia Analgesia during labor or procarbazine (may cause sedation, enters breast milk. PO, subcut and IM doses and 5 min
(Demerol) adjunct. Analgesic during and when contractions fatal reaction – dysphoria, Neonates 52% (peak) following IV administration.
labor. Preoperative become regular, may contraindicated within 4-21 euphoria, floating protein binding When titrating opioid doses,
Opioid analgesis sedation (Rigors- repeat q 1-3 hr days of MAO inhibitor feeling, occurs, Infants 3- increases of 25-50% should be
Narcotics unlabeled use). Preoperative sedation therapy). Increase CNS hallucinations, 18 months 85% administered until there either a
Opioid agonists Binds to opioid receptors 1-2mg/kg 30-90 min depression with alcohol, headache, unusual protein binding 50% reduction in the patient’s pain
(schedule II) in the CNS, alters the before anesthesia (not to antihistamines and sedative/ dreams, blurred occurs. rating on a numerical or visual
perception of and response exceed adult dose) hypnotics. Administration vision, diplopia, analogue scale or the patient repots
Preg. Cat C to painful stimuli, while IV adults 15-35mg/hr as of agonist/antagonist opioid miosis, respiratory satisfactory pain relief. Repeat dose
producing generalized a continuous infusion, analgesics may precipitate depression can be safely administered at the
CNS depression. Decrease PGA 10mg initially opioid withdrawal in hypotension, time of the peak if previous dose is
in severity of pain. with range of 1- physically dependent bradycardia, ineffective and side effects are
Davis Drug Guide for 5mg/incremental dose, patients. Nalbuphine or constipation, minimal. An equianalgesic chart
NSG Page 784-787 recommended lockout pentazocin may decrease nausea, vomiting, should be used when changing
interval is 6-10 min analgesia. Protease inhibitor flushing, urinary routes or when changing form on
Mosby’s Nsg Drug (minimum 5min) anti retrovirals may increase retention, sweating, opioid to another. Assess BP, pulse,
Card 305 IV children Continuous effects an adverse reaction physical and respiration before and
infusion 0.5-1 mg/kg (concurrent use should e dependence, periodically during administration.
loading dose followed y avoided). Pheytoin increase psychological If respiratory rate is ,10/min, assess
0.3mg/kg/hr, titrate to metabolism and may dependence, level of sedation. Dose may need to
effect up to 0.5- decrease effects. tolerance. be decreased by 25-50%. Initial
0.7mg/kg/hr. Chlorpromazine and drowsiness will diminish with
thioridazine may increase continued use. Neonates and infants
risk of adverse reactions. are more susceptible to respiratory
depression. Assess respiratory rate
frequently.

PHARM