Clinical Medications Worksheets

Generic Name Trade Name Classification Dose Route Time/frequency

propoxyphene Darvocet-N opioid analgesics 100-200 mg PO q 4 hours PRN
napsylate/acetaminophen
Peak Onset Duration For IV meds, compatibility with IV drips and /or
2-3 hr 15-60 min 4-6 hr solutions
N/A
Mechanism of action and indications Nursing Implications (what to focus on)
(Why med ordered) Contraindications/warnings/interactions
Mild to moderate pain Appears on Beers list. Elderly or debilitated patients require
Binds to opiate receptors in the CNS reduced dosages
Alters the perception of and response to painful stimuli, while producing Undiagnosed abdominal pain, Hypothyroidism,
generalized CNS depression Common side effects
dizziness, weakness, nausea
Interactions with other patient drugs, OTC or herbal medicines (ask Lab value alterations caused by medicine
patient specifically) May cause ↑ serum amylase and lipase levels, May cause ↑
Lisinopril: Many psychotherapeutic and CNS-active agents (e.g., AST, ALT, serum alkaline phosphatase, LDH, and bilirubin
anxiolytics, sedatives, hypnotics, antidepressants, antipsychotics, opioids,
alcohol, muscle relaxants) exhibit hypotensive effects, especially during Be sure to teach the patient the following about this
initiation of therapy and dose escalation. Coadministration with medication
antihypertensive agents, in particular vasodilators and alpha-blockers, Instruct patient on how and when to ask for pain medication
may result in additive effects on blood pressure and orthostasis. Encourage patient to turn, cough, and breathe deeply every
Lexapro, Restoril, Percocet, morphine, Reglan, Phenergan: Sedatives, 2 hr to prevent atelectasis
tranquilizers, muscle relaxants, antidepressants, and other central nervous Advise patient to change positions slowly to minimize
system (CNS) depressants may have additive CNS- and/or respiratory- orthostatic hypotension
depressant effects with propoxyphene. Misuse of propoxyphene, either Advise patient that good oral hygiene, frequent mouth
alone or in combination with other CNS depressants, has been a major rinses, and sugarless gum or candy may decrease dry mouth
cause of drug-related deaths, particularly in patients with a history of
emotional disturbances, suicidal ideation, or alcohol and drug abuse.
Nursing Process- Assessment Assessment Evaluation
(Pre-administration assessment) Why would you hold or not give this Check after giving
Assess type, location, and intensity of pain prior to and 2 hr med? Decrease in severity of pain
(peak) following administration. Assess blood pressure, pulse, and without a significant
Assess bowel function routinely. Prevention of constipation respirations before and periodically alteration in level of
should be instituted with increased intake of fluids and bulk, during administration. If respiratory rate consciousness
and laxatives to minimize constipating effects. Stimulant is <10/min, assess level of sedation.
laxatives should be administered routinely if opioid use Physical stimulation may be sufficient to
exceeds 2-3 days, unless contraindicated prevent significant hypoventilation. Dose
Geriatric patients may be more sensitive to CNS effects; may need to be decreased by 25-50%.
monitor closely and assess falls risk Initial drowsiness will diminish with
continued use