Drug Name (trade & generic) Dose/Route/Schedule Pharmacologic Classification Specific Patient Indications Mechanism of Action

Bisac 10mg Rectally PRN (Fleet Bisacodyl Suppository) Stool Softener Constipation increases peristalsis

Patient Medication Report Mapap 500mg tab Q 6hrs PRN (Acetaminophen) Anaglesic Chronic Back Pain UNK; antipyretic effect via direct action on the hypothalamic heat-regulating center Nausea, Rash, Headache

Hydrocodone/APAP 7.5-325mg PO Q 4hrs PRN (Vicodin) Opioid/Analgesic Combo Chronic Back Pain UNK produces analgesia and anti-pyretic effects; hydrocodone binds to various opioid receptors, producing analgesia and sedation Lightheadedness, dizziness, sedation, nausea/vomiting, constipation, drowsiness, dependence/tolerance respiratory depression, hepatotoxicity, dependency, abuse, agranulocytosis, thrombocytopenia, hypersensitivity rxn, anaphylaxis Cr at baseline, then if severe renal dz or >65 yo cont. periodically; LFTs if severe hepatic dz Taper off drug do not abruptly stop. Can be administered with apple sauce or pudding do not crush. Sedating drugs and ETOH

Hydroxyzine HCl 25mg PO TID PRN (Atarax) Antihistamine Unrelieved Itching non-selectively antagonizes central and peripheral histamine H1 receptors

Expected Side Effects

Nausea, Vomit, Cramping, Diarrhea

dry mouth, drowsiness, dizziness, ataxia, weakness, slurred speech, headache, agitation, bitter taste, nausea Wheezing, dyspnea, seizures, heat stroke

Adverse Effects

Electrolyte Imbalance, Cathartic Colon

anaphylactic rxns, hepatotoxicity, renal tubular necrosis, acute, analgesic nephropathy, chronic anemia, thrombocytopenia

Assessments (Labs/Monitoring) Implementation Considerations (e.g. taking with food, crushing tablets etc.) Potential Interactions (with currently ordered meds/food) Patient Teaching

Drug Interaction, Bowel Movements, Adverse Reactions Lubricate when administering

Cr at baseline; LFTs if highdose or long-term tx, especially if pre-existing hepatic dz Given with food when possible can be crushed if not enteric coated. Sedating drugs and ETOH

Cr at baseline monitor for drowsiness Do not administer with acidifiers suck as Na and K drugs take with a glass of water Sedating drugs

Antacids when taken orally, N+, K+, Ma+ Sulfates Avoid prolonged use and report any bowel movement N/A

Do not exceed 3250 mg for 24 hours N/A

Do not take OTC APAP without consulting doctor N/A

Report any excessive drowsiness and avoid ETOH N/A

Cost of Med per month (as directed by CI)

Drug Name (trade & generic) Dose/Route/Schedule Pharmacologic Classification Specific Patient Indications Mechanism of Action

Loperamide 2mg Cap. Q 3hrs PRN (Imodium) Anti-diarrheal Diarrhea/Loose Stools binds gut wall opioid receptor, inhibiting peristalsis; increases anal sphinctor tone Constipation, nausea, abdominal cramps, dizziness

Albuterol Inhaler Q 6hrs PRN (AccuNeb) Bronchodilator Shortness of Breath selectively stimulates beta-2 adrenergic receptors, relaxing airway smooth muscle throat irritation, URI sx, cough, bad taste, tremor, dizziness, nervousness, nausea, headache, palpitations, tachycardia hypersensitivity rxns, bronchospasm, paradoxical, HTN, angina, MI, hypokalemia, arrhythmias, metabolic acidosis (nebulized use) N/A or are recommended

Isopto tears Eyedrops- 2 drops in each eye TID PRN (hypromellose) Lubricant Dry eye Lubricates eye surface

Glucagen Kit 1mg if BGL is <70 (Glucagon) Anaphylaxis Hypoglycemia converts hepatic glycogen to glucose

Expected Side Effects

None reported

Nausea, vomiting, urticarial, rash, hyperglycemia

Adverse Effects

Assessments (Labs/Monitoring) Implementation Considerations (e.g. taking with food, crushing tablets etc.) Potential Interactions (with currently ordered meds/food) Patient Teaching

toxic megacolon, paralytic ileus, angioedema, anaphylactic rxns, toxic epidermal necrolysis, Stevens-Johnson syndrome, erythema, multiforme, urinary retention, heat stroke s/sx CNS toxicity if hepatic impairment Dosage based on need reduce after loose stools end.

None Reported

hyperglycemia, severe allergic rxns

Monitor for efficacy

Blood glucose to check efficacy

K+ Salts

If used as nebulizer plan on having pt. in one private spot for extended period. Instruct pt. on appropriate inhalation with inhaler Phenothiazine

Proper administration at the site of the eye for maximum effect

Injection needs to be mixed prior to administration

N/A

Warafin

Dose schedule not vital be sure to report any abnormal stools while or before taking N/A

Refill prescription before completely running out N/A

Administration must be done correctly for effect. N/A

Alert the nurse of any sign or symptoms of a low blood sugar N/A

Cost of Med per month (as directed by CI)

Drug Name (trade & generic) Dose/Route/Schedule Pharmacologic Classification Specific Patient Indications Mechanism of Action

Warfarin 4mg 2 Tab Daily Evenings PO (Coumadin) Anticoagulant Deep Vein Thrombosis Prevents the creation of Vitamin K clotting factors Bleeding, Easy Bruising, Abdominal Cramps Hemorrhage, Skin Necrosis, Gangrene Labs: Hct; PT/INR

Buspirone HCl 5 mg Tab 1.5 Tab Daily PO (Buspar) Non-benzodiazepine Anxiolytics Anxiety UNK: Binds and blocks Serotonin and Dopamine receptors in brain. Dizziness, Drowsiness, Headache Serotonin Syndrome

Estrace Cream .01% Apply Daily Mon, Wed, Fri days (Estradiol) HRT 2 Estrogens Vaginal Atrophy Binds to estrogen receptors, developing and maintaining female sex characteristics and reproductive systems Site rxn, Vaginal Spotting, Breast Pain Thromboembolism, Retinal Thrombosis, MI Free T4, free T3 if hypothyroidism tx; breast exam q12mo; mammography, frequency variable; bone maturation; BP regularly Apply three times a week on scheduled days monitoring if schedule needs to be changed/modified None; Aromatase Inhibitors Avoided This drug has the potential to cause serious side effects related to estrogen treatments including cardiovascular accidents N/A

Hydrocerin Cream Daily PRN (Eucerin) Topical Emollients Dry Skin Hydrophilic Substance

Expected Side Effects

None

Adverse Effects

Burning, Stinging, Redness

Assessments (Labs/Monitoring)

None recommended monitor for efficacy/sides

Monitor skin for any redness or reaction

Implementation Considerations (e.g. taking with food, crushing tablets etc.) Potential Interactions (with currently ordered meds/food) Patient Teaching

Administered in the evening given both tablets can be crushed as desired for patient

PRN APAP

Tab must be split to meet dosage requirement can be crushed as desired for patient timing of dosage can aid in preventing symptoms affecting daily activity None, MAOIs avoided

Administer as needed to clean dry surfaces

None

Alert patient of risk of bleeding and to avoid OTC drugs which may promote thinning of blood N/A

This drug affects the brain and can cause dizziness use caution when handling hot beverages or self-propelling N/A

Be sure skin is kept clean and dry to prevent buildup of dead skin and increase Eucerin effectiveness N/A

Cost of Med per month (as directed by CI)

Drug Name (trade & generic) Dose/Route/Schedule

Copaxone 20 mg Injection SQ Daily (Glatiramer)

Senna Tabs 8.6 mg Tab 4 Tabs PO with Lunch (Senokot)

Bisac-Evac Suppository 10 mg Tab Rectal Every Other Day (Bisacodyl Suppository) PRN Option Available Consitpation Constipation Increases Peristalsis

Gabapentin 100 mg Cap BID PO (Gralise)

Pharmacologic Classification Specific Patient Indications Mechanism of Action

Multiple Sclerosis Relapsing MS UNK

Consitpation Constipation Increases Peristalsis

Other Neurologic Pain UNK

Expected Side Effects

Injection Site rxn, Flushing, Chest Pains Syncope, HTN, Pancreatitis

Nausea, Bloating, Cramps

Nausea, Vomit, Cramps

Dizziness, Ataxia, Somnolence

Adverse Effects

Cathartic Colon

Cathartic Colon, Electrolyte Imbalance Monitor Bowel Movements

Leukopenia, Thrombocytopenia, Withdrawal Seizures Cr at Baseline; s/sx Depression, Behavior Changes, Suicidality Given twice a day in divided doses capsule can be opened and mixed PRN APAP

Assessments (Labs/Monitoring) Implementation Considerations (e.g. taking with food, crushing tablets etc.) Potential Interactions (with currently ordered meds/food) Patient Teaching

No Recommended Monitoring

Monitor Bowel Movements

Given thigh, hip, underarm or stomach SQ rotate site to avoid site rxn None

Given with Lunch can be crushed as desired

Lubricate sufficiently to prevent discomfort

None; Avoid Sulfates

None; Avoid Antacids

Cost of Med per month (as directed by CI)

This drug should not be abruptly stopped or administered w/o trained supervision N/A

Abuse can result in dependence and future difficulty voiding N/A

Long term use can cause electrolyte imbalance and dependence resulting in future difficulty voiding N/A

Drug should never be abruptly stopped but rather tapered off N/A

Drug Name (trade & generic) Dose/Route/Schedule Pharmacologic Classification Specific Patient Indications Mechanism of Action

Levetiracetam 1000 mg Tab BID PO (Keppra) Anticonvulsant Seizure UNK

DOK 100 mg Cap BID PO (Colace & Docusate Sodium) Constipation Constipation Promotes Mixture of Stool Fat and Water Diarrhea, Abdominal Cramps, Throat Irritation None Reported

Famotidine 20 mg Tab Tab BID PO (Pepcid) Anti-Ulcer GERD Selectively antagonizes histamine H2 receptors Headache, Dizziness, Constipation Anaphylaxis, Angioedema, Toxic Epidermal Necrolysis Cr at baseline, then in elderly pts consider periodically Tab must split can be crushed as desired for patient

Bethanechol 25 mg Tab TID PO (Urecholine) Cholinergic Agonist Spasm Stimulates cholinergic receptors, increasing detrusor muscle tone and GI motility Abdominal Cramps/Discomfort/Pain, Nausea, Belching Bronchospasm, Hypotension, Tachycardia, Seizures No Recommended Monitoring

Expected Side Effects

Somnolence, Asthenia, Vomiting Depression, Hostility, Aggressive Behavior Cr at Baseline; s/sx Depression, Behavior Changes, Suicidality Given in two divided doses can be crushed as desired for patient

Adverse Effects

Assessments (Labs/Monitoring) Implementation Considerations (e.g. taking with food, crushing tablets etc.) Potential Interactions (with currently ordered meds/food) Patient Teaching

Monitor Bowel Movements

Capsule can be opened and mixed

Given three times a day can be crushed as desired for patient

None

None

None

PRN APAP

Do not stop taking medication for any reason without consulting a physician N/A

Drug may cause some GI upset

Impairs coordination use caution with hot beverages and self-propelling N/A

Take on empty stomach 1-2 hours before meals to avoid GI distress N/A

Cost of Med per month (as directed by CI)

N/A

Drug Name (trade & generic) Dose/Route/Schedule Pharmacologic Classification Specific Patient Indications Mechanism of Action

Baclofen 20 mg Tab QID PO (Gablofen) Muscle Relaxant Spasm UNK: inhibits monosynaptic and polysynaptic spinal reflexes (centrally-acting muscle relaxant) Drowsiness, Transient, Dizziness, Weakness CNS depression, Respiratory Depression, Ataxia

Nystop 100,000 Units Apply to Red Area TID (Nistatin) Topical Antifungal Redness/Irritation Binds to cell membrane sterols, increasing permeability Skin irritation

APAP 650mg Suppository 1 PRN Q 4-6 Hours Rectally (Acetaminophen) Anaglesic Chronic Back Pain UNK; antipyretic effect via direct action on the hypothalamic heat-regulating center Nausea, Rash, Headache

MOM 30 mL Once Daily PRN (magnesium hydroxide) Constipation Constipation Neutralizes gastric acidity; causes water retention in stool, producing laxative effect (osmotic laxative) Diarrhea, Abdominal Pain, Dehydration Hypermnagesemia

Expected Side Effects

Adverse Effects

Hypersensitivity rxn

Anaphylactic rxns, Hepatotoxicity, Renal Tubular Necrosis Cr at baseline; LFTs if highdose or long-term tx, especially if pre-existing hepatic dz Lubricate sufficiently to prevent discomfort

Assessments (Labs/Monitoring) Implementation Considerations (e.g. taking with food, crushing tablets etc.) Potential Interactions (with currently ordered meds/food) Patient Teaching

Cr at baseline; EEG if epilepsy

No Recommended Monitoring

Monitor Bowel Movements

Given four times a day can be crushed as desired for patient

Keep area clean and dry as well as applying treatment

Given once daily as needed patient request and bowel monitoring PRN APAP

None

None

Sedating drugs and ETOH

Drug causes drowsiness use caution when handling hot beverages or self-propelling N/A

Watch for any increase in redness/irritation N/A

Do not exceed 3250 mg for 24 hours N/A

This should be taken only as needed when routines do not have affect in allotted time N/A

Cost of Med per month (as directed by CI)

Drug Name (trade & generic) Dose/Route/Schedule Pharmacologic Classification Specific Patient Indications Mechanism of Action

Enema Once Daily PRN Rectally (Fleets Bisacodyl Rectal) Constipation Constipation Increases peristalsis

APAP 325mg Tab 2 Tabs Q 6 Hours PRN (Acetaminophen) Anaglesic Chronic Back Pain UNK; antipyretic effect via direct action on the hypothalamic heat-regulating center Nausea, Rash, Headache

Expected Side Effects

Nausea, Abdominal Cramps, Vomiting Electrolyte Imbalance, Cathartic Colon

Adverse Effects

Anaphylactic rxns, Hepatotoxicity, Renal Tubular Necrosis Cr at baseline; LFTs if highdose or long-term tx, especially if pre-existing hepatic dz Given with food when possible can be crushed if not enteric coated Sedating drugs and ETOH

Assessments (Labs/Monitoring) Implementation Considerations (e.g. taking with food, crushing tablets etc.) Potential Interactions (with currently ordered meds/food) Patient Teaching

Monitor Bowel Movements

Lubricate sufficiently to prevent discomfort

None

Given once daily PRN when routines do not work in given time N/A

Do not exceed 3250 mg for 24 hours N/A N/A N/A

Cost of Med per month (as directed by CI)