GENERIC NAME: Acetaminophen TRADE NAME: Tylenol INDICATIONS: mild pain, fever MECHANISM OF ACTION: Inhibits synthesis of prostaglandins

that may serve as mediators of pain and fever, primarily in the CNS. SIDE EFFECTS: hepatic failure, hepatotoxicity (over dose). Renal failure (high doses/chronic use), neutropenia, pancytopenia (shortage of all types of blood cells), leukopenia, rash, urticaria (hives) RN INTERVENTIONS: if overdose occurs, acetylcusteine (Acetadote) is antidote, administer with full glass of water, may be taken with food or on an empty stomach. Inform patients with diabetes may alter results of blood glucose monitoring.

GENERIC NAME: Aspirin (Salicylates) TRADE NAME: ASA, Bayer Aspirin, Aspercin, Aspergum INDICATIONS: inflammatory disorders including: rheumatoid arthritis, osteoarthritis; mild to moderate pain; fever; prophylaxis of transient ischemic attacks and MI MECHANISM OF ACTION: produce analgesia and reduce inflammation and fever by inhibiting production of prostaglandins SIDE EFFECTS: tinnitus, GI bleeding, abdominal pain, hepatotoxicity, anemia, increased bleeding time RN INTERVENTIONS: administer with food or after meals or an antacid to minimize gastric irritation. Food slows absorption.

GENERIC NAME: Benzocaine TRADE NAME: Dermoplast Spray INDICATIONS: Reduce pain or discomfort caused by minor skin irritations, vaginal or rectal irritation, hemorrhoids, and many other sources of minor pain on a surface of the body. MECHANISM OF ACTION: Local anesthetics block both the initiation and conduction of nerve impulses by decreasing the neuronal membrane's permeability to sodium ions. This reversibly stabilizes the membrane and inhibits depolarization, resulting in the failure of a propagated action potential and subsequent conduction blockade. SIDE EFFECTS: angioedema, contact dermatitis & urticaria (hives), edema, burning and stinging, and methemoglobinemia RN INTERVENTIONS: Obtain a careful history of previous response to local anesthetics. Monitor the BP and P. Tell the cl to report any rash or skin irritation occurring

GENERIC NAME: Docusate TRADE NAME: Colace INDICATIONS: Prevention of constipation and may be used as enema to soften fecal impaction MECHANISM OF ACTION: Promotes incorporation of water into stool, resulting in softer fecal mass. May also promote electrolyte and water secretion into the colon. SIDE EFFECTS: throat irritation, mild cramps, and rashes RN INTERVENTIONS: Assess for abd distention, BS, & usual pattern of bowel function. Assess color, consistency, and amount of stool produced. Admin with full glass of water or juice. May be given on empty stomach for more rapid results. Oral solution may be diluted in milk or fruit juice to decrease bitter taste. Do not administer within 2 hrs of another laxative

GENERIC NAME: Carbonyl Iron TRADE NAME: Feosol INDICATIONS: Prevention/treatment of iron deficiency anemia MECHANISM OF ACTION: Essential mineral found in hemoglobin, myoglobin, and many enzymes. Enters bloodstream and is transported to the liver, spleen, & bone marrow, where separated out and becomes part of iron stores SIDE EFFECTS: seizures, hypotension, nausea, constipation, dark stools, diarrhea, epigastric pain, GI bleeding, skin staining if given IM at site RN INTERVENTIONS: Assess nutrional status & dietary hx to determine possible cause of anemia and need for patient teaching. Assess bowel function for constipation or diarrhea, Monitor Hbg, Hct, & reticulocyte values prior to and every 3 weeks during first 2 months of therapy. Serum ferritin & iron levels may also be monitored. GENERIC NAME: Ibuprofen TRADE NAME: Advil, Motrin, Excedrin, Midol INDICATIONS: mild to moderate pain; fever; inflammatory disorders including: rheumatoid arthritis, osteoarthritis; dysmenorrhea MECHANISM OF ACTION: inhibits prostaglandin synthesis SIDE EFFECTS: headache, GI bleeding, hepatitis, constipation, dyapepsia, nausea, vomiting, dermatitis, anaphylaxis RN INTERVENTIONS: Assess pain prior ro and 1-2hr following administration, monitor temperature, BUN/Creatinine levels, admin 30 min before or 2hrs after meals. May be admin with food, milk, or antacids to decrease GI irritation

GENERIC NAME: Hepatitis B Vaccine (10mcg/mL) TRADE NAME: HepB, Engerix-B, Recombivax HB INDICATIONS: Immunization against infection caused by all known subtypes of hepatitis B virus, in individuals considered at high risk of potential exposure to hepatitis B virus or HBsAg-positive materials MECHANISM OF ACTION: Recombinant hepatitis B vaccine is a noninfectious subunit viral vaccine. The vaccine is derived from hepatitis B surface antigen (HBsAg) produced through recombinant DNA techniques from yeast cells. The portion of the hepatitis B gene which codes for HBsAg is cloned into yeast which is then cultured to produce hepatitis B vaccine. SIDE EFFECTS: Fever, malaise, fatigue, headache, Mild local tenderness, local inflammatory reaction, Nausea, vomiting, Pharyngitis RN INTERVENTIONS: Rare chance of anaphylactoid reaction; have epinephrine available

GENERIC NAME: Measles, Mumps, and Rubella Vaccines TRADE NAME: M-M-R II INDICATIONS: Measles, mumps, and rubella prophylaxis MECHANISM OF ACTION: Vaccine, MMR contains live attenuated measles, mumps and rubella viruses. It is used in the active immunisation against these diseases. SIDE EFFECTS: burning, stinging, pain at injection site, arthritis/arthralgia, fever, encephalitis, allergic reactions RN INTERVENTIONS: Federal law requires that the date of administration, the vaccine manufacturer, lot number of vaccine, and the administering person's name, title and address be entered into the patient's permanent medical record

GENERIC NAME: Simethicone TRADE NAME: Degas; Flatulex; Gas Relief; Gas-X; Maalox Anti-Gas; Mylanta Gas; Mylicon; Phazyme INDICATIONS: Relieves flatulence and functional gastric bloating, and postoperative gas pains MECHANISM OF ACTION: Decreases the surface tension of gas bubbles thereby disperses and prevents gas pockets in the GI system SIDE EFFECTS: no data reported RN INTERVENTIONS: Shake suspension before using; mix with water, infant formula or other liquids. Assess patient for abdominal pain, distention, and BS prior to and periodically throughout course of therapy. Frequency of belching and flatulence should also be assessed. Administer after meals and at bedtime for best results. GENERIC NAME: Oxycodone TRADE NAME: OxyContin; OxyIR; Percolone; Roxicodone, Percocet INDICATIONS: Management of moderate to severe pain, normally used in combination with non-narcotic analgesics MECHANISM OF ACTION: Binds to opiate receptors in the CNS, causing inhibition of ascending pain pathways, altering the perception of and response to pain; produces generalized CNS depression SIDE EFFECTS: confusion, sedation, respiratory depression, constipation RN INTERVENTIONS: Observe patient for excessive sedation, respiratory depression, implement safety measures, and assist with ambulation. If respiratory rate <10/min, assess level of sedation. Physical stimulation may be sufficient to prevent significant hypoventilation. May be administered with food or milk to minimize GI irritation.

GENERIC NAME: Nonsteroidal Anti-Inflammatory Agents TRADE NAME: INDICATIONS: mild to moderate pain; fever; inflammatory disorders including: rheumatoid arthritis, osteoarthritis MECHANISM OF ACTION: Analgesic and anti-inflammatory effects are due to inhibition of prostaglandin synthesis. Antipyretic action due to vasodilation and inhibition of prostaglandin synthesis in the CNS. SIDE EFFECTS: nausea, vomiting, diarrhea, constipation, decreased appetite, rash, dizziness, headache, & drowsiness. May also cause edema. Most serious side effects: kidney failure, liver failure, ulcers and prolonged bleeding after injury or surgery. RN INTERVENTIONS: Assess pain and limitation of movement, assess fever, may cause prolonged PT, administer with food or after meals or an antacid to minimize gastric irritation
GENERIC NAME: Oxytocin TRADE NAME: Pitocin INDICATIONS: Induces labor at term; controls postpartum bleeding; nasal preparation used to promote milk letdown in lactating females MECHANISM OF ACTION: Produces the rhythmic uterine contractions characteristic to delivery and stimulates breast milk flow during nursing SIDE EFFECTS: Fetal: Bradycardia, arrhythmias, intracranial hemorrhage, brain damage, neonatal jaundice, hypoxia, death. Maternal: seizures, coma, nausea, vomiting, pelvic hematoma, postpartum hemorrhage, increased uterine motility, fatal afibrinogenemia, increased blood loss, death, anaphylactic reactions RN INTERVENTIONS: monitor for s/s of water intoxication (drowsiness, listlessness, confusion, headache, anuria). Monitor electrolytes, water retention may result in hypochloremia or hyponatremia.

GENERIC NAME: Rho(D) Immune Globulin (Intramuscular) TRADE NAME: Gamulin Rh; HypRho-D; HypRho-D Mini-Dose; MICRhoGAM; MiniGamulin Rh; RhoGAM INDICATIONS: Prevention of isoimmunization in Rh-negative individuals exposed to Rh-positive blood during delivery of an Rh-positive infant; prevention of hemolytic disease of the newborn if there is a subsequent pregnancy with an Rh-positive fetus MECHANISM OF ACTION: Suppresses the immune response and antibody formation of Rh-negative individuals to Rh-positive red blood cells SIDE EFFECTS: Lethargy, splenomegaly, elevated bilirubin, pain at the injection site, myalgia, temperature elevation RN INTERVENTIONS: Assess V/S periodically, administer in deltoid muscle. Dose should be given within 3hr but may be given up to 72hr after delivery. Infant born to woman treated with Rho(D) may have a weakly positive direct Coombs Test
GENERIC NAME: Phytonadione (Vitamin K) TRADE NAME: AquaMEPHYTON Injection; Konakion Injection; Mephyton Oral INDICATIONS: Prevention and treatment of hypoprothrombinemia caused by drug-induced or anticoagulant-induced vitamin K deficiency, hemorrhagic disease of the newborn; phytonadione is more effective and is preferred to other vitamin K preparations in the presence of impending hemorrhage MECHANISM OF ACTION: Promotes liver synthesis of clotting factors (II, VII, IX, X); however, the exact mechanism as to this stimulation is unknown. SIDE EFFECTS: Transient flushing reaction, rarely hypotension, cyanosis, dizziness (rarely), pain, abnormal taste, GI upset (oral), hemolysis in neonates and in patients with G-6-PD deficiency, tenderness at injection site, dyspnea, diaphoresis, anaphylaxis, hypersensitivity reactions RN INTERVENTIONS: monitor for side effects and adverse reactions, monitor for frank and occult bleeding stools, pulse and BP frequently, apply pressure to puncture site for at least 5 min, avoid unnecessary IM injections, monitor PT prior and throughout therapy

GENERIC NAME: Witch Hazel TRADE NAME: Tucks INDICATIONS: After-stool wipe to remove most causes of local irritation; temporary management of vulvitis, pruritus ani and vulva; help relieve the discomfort of simple hemorrhoids, anorectal surgical wounds, and episiotomies MECHANISM OF ACTION: Witch hazel contains chemicals called tannins. When applied directly to the skin, witch hazel might help reduce swelling, help repair broken skin, and fight bacteria. SIDE EFFECTS: might cause minor skin irritation RN INTERVENTIONS: Consult physician if anorectal symptoms do not improve in 7 days, or if bleeding, protrusion or seepage occurs

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