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Class Notes

Med and Patho

Comprehensive drug profiles for Sumatriptan (Imitrex), Acetaminophen (Tylenol), and others—covering classification, uses, dosages, interactions, adverse effects, nursing implications, and patient teaching. Ideal for nursing and pharmacology study.

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    Generic: Sumatriptan Brand name : Imitrex Classification: Serotonin receptor agonist Therapeutic use: Treatment of acute migraine and cluster headaches Action: causes vasoconstriction of large intracranial arteries Safe dosage : PO- 25mg ID, may increase to lOOmg q2h max (300mg/day) SC- 6mgqlh(mx 12mg q 24h) Nasal- 5-20mg in one nostril q2h (max 40mg q 24h) Onset Peak Duration 30 min PO/SC 2-4h up to 24h 60 rain nasal Patient teaching : should only be used during migraine attack; used for relief not prophylaxis. Advise of adverse reactions and administration technique Generic: Acetaminophen Brand name : Tylenol Classification: Non-opioid analgesic Therapeutic use: Treatment of mild pain and fever Action; Inhibits prostaglandin synthesis that may serve as mediators of pain and fever, primarily in the CNS Safe dosage : PO- 325-650mg PO Q 4-6 Hr Do not exceed 3g per/day Ppset Peak Duration 30-60 minutes 1-3 hours 3-8 hours Patient teaching : long term use can cause liver damage. Many OTC's contain acetaminophen, do not use longer then 10 days, avoid alcohol, if not effective seek medical care ______________________________________________________ Adverse reactions ; Nausea, vomiting, diarrhea, constipation Contraindications : Renal impairment, alcohol abuse Precautions : do not take more then 3 grams per 24 hours Interaction s: Increased risk of bleeding with warfarin, NSAID's, ibuprofen Nursing Implications: Complete pain assessment, monitor BP, temperature, OTC use Why this patient takes this medication : frequent migraines, pains and aches and fever Adverse reactions : Dizziness, vertigo, Ml, tingling, warm sensation, injection site reaction Contraindications : hypersensitivity, ischemic heart disease, Prinzmetal's angina, uncontrolled HTN, concurrent MAOI therapy Precautions : History of CV disease, child bearing potential, pregnancy, lactation, children < 18y Interactions : ergotamine, lithium, MAOI, SSRI Nursing Implications: Complete pain assessment, monitor BP one hr. before and 1 hr. after initial SC injection Why this patient takes this medication : frequent migraines not responsive to OTC medication treatment Downloaded by Winkle Wong (wkwinkie@gmail.com)

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    Patient teaching : take medication as directed. Avoid alcohol or other CNS depressants. Report suicidal thoughts IMMEDIATELY Unknown unknown unknown Patient teaching ; side effects of hypercalcemia and extra calcium should be avoided, taken with or without meal take as directed Adverse reactions : seizures, abnormal dreams, anxiety, dizziness, headache, NV, worsening depression, weakness, abdominal pain Contraindications : MAOI or MAO-like drugs Precautions : hypertension, hepatic impairment, impaired renal function, history of mania, seizures or neuro impairment Interactions : concurrent use with MAOIs MAO-like drugs (linezolid or methylene blue, Alcohol, NSAIDs, aspirin, clopidogrel, warfarin, St. Johns wort Nursing Implications: Assess mental status and mood changes, assess suicidal tendencies, Assess for Serotonin syndrome. Why this patient takes this medication : Depression A d v e r s e r e a c t i o n s ; constipation, bloating, milk-alkali syndrome, rebound hyperacidity Contraindications : severe renal disease Precautions : report all calcium supplements and calcium-fortified food, too much calcium causes hypercalcemia Interaction s- blood pressure medications, synthetic thyroid hormones, bisphosphonates, antibiotics and calcium channel blockers Nursing Implications: assess lab values, diet and overall health status. Report any signs and symptoms of hyper/hypocalcemia, constipation, hyperacidity Why this patient takes this medication : calcium imbalance, indigestion, heartbum Downloaded by Winkle Wong (wkwinkie@gmail.com)

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    Generic: Acetylsalicylic Acid Brand name : Aspirin Classification: Antipyretics, non-opioid analgesic, anti-platelet aggregator Therapeutic use: Reduction of inflammation, reduction of fever. Decreased incidence of transient ischemic attacks and MI Action: Produce analgesia and reduce inflammation and fever by inhibiting the production of prostaglandins. Decreases platelet aggregation. Keeps blood thin to prevent blood clots thus preventing emboli and thrombosis Safe dosage : 325-1000mg once daily Onset Peak Duration 5-30 minutes 1-2 hours 1-4 Hours Patient teaching : Instruct patient to take salicylate with a full glass of water. Do not crush or chew enteric coated tablets. Generic: Warfarin Brand name : Coumadin Classification: Anticoagulant Therapeutic use- Prophylaxis and treatment of: venous thrombosis, pulmonary embolism, atrial fibrillation with embolization. Management of myocardial infarction. Action: Interferes with hepatic synthesis of vitamin K-dependent clotting factors - prevents clotting Safe dosage : 2-5 rng/day for 2-4 days Onset ____________________________Peak ________________________ Duration Within 24 hours 4 hours 2-5 days Patient teaching : Review foods high in vitamin K (can reverse effects of med) green leafy vegetables. Advise to report any signs of bleeding or bruising, do not drink alcohol Adverse reactions : Tinnitus. GI bleeding, dyspnea, nausea, dermatitis, anaphylaxis, agitation, dizziness Contraindications : Hypersensitivity to aspirin or other salicylates; Cross- sensitivity with other NSAIDs may exist (less with non-aspirin salicylates); Bleeding disorders or thrombocytopenia. Precautions : History of GI bleeding or ulcer disease; Chronic alcohol use/ abuse; Severe hepatic or renal disease Interactions : May increase the risk of bleeding with warfarin, heparin and other NSAlDs Nursing Implications: Assess pain and limitation of movement, assess for bleeding, monitor bloodwork Why this patient takes this medication : to decrease platelet aggregation Adverse reactions : Abnormal bleeding such as nose bleeds, bleeding gums, black and tarry stools, tea-colored urine, nausea, cramps. Contraindications : Uncontrolled bleeding, open wounds, recent brain, eye, or spinal injury or surgery, uncontrolled hypertension, liver or kidney disease Precautions : history of ulcer or liver disease, women in child bearing potential Interaction s: Androgens, thrombolytic, sulfonamides, NSAIDS. chronic use of acetaminophen Nursing Implications: Signs of bleeding and hemorrhage. Monitor PT/1NR. Why this patient takes this medication : to prevent blood coagulation, prevent embolism and thrombosis. Downloaded by Winkie Wong (wkwinkie@gmail.com)

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    contact lenses. Avoid alcohol. If using other ophthalmic drags wait at least 5 minutes before instilling others. Adverse reactions : asthenia, dizziness, headache, fatigue, allergic conjunctivitis, abnormal vision, burning, pruritus, ocular hyperemia Contraindications : neonates and children under the age of 2. Precautions : Use cautiously in patients with CV disease, hypersensitivity, depression, hepatic or renal impairment Interactions : antihypertensive, CNS depressants, alcohol use Nursing Implications: monitor IOP Why this patient takes this medication . : the patient has glaucoma therefore this medication will lower IOP Adverse reactions : Headaches, diarrhea, nausea, vomiting, frequent urination Contraindications : Hypersensitivity to donepezil or piperidine derivatives Precautions : Cardiac diseases, history of ulcer disease. COPD, asthma, or seizures, concurrent use of NSAIDS Interaction s: NSAIDS, rifampin, anticholinergics, dexamethasone Nursing Implications: Assess cognitive function periodically during therapy. Monitor heart rate, may cause bradycardia Why this patient takes this medication : To delay the progression of Alzheimer's disease and aid in memory Downloaded by Winkle Wong (wkwinkie@gmail.com)

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    Generic Gabapentin Brand name : Neurontin Classification: Analgesic adjuncts, therapeutic, anticonvulsants, mood stabilizers ___________________________________________________________ Generic: Levodopa-Carbidopa Brand name : Duopa (tlSSSSffiltfifi '81 >a08«¥a fiiiSIP i d e n c e o f seizures. Decreased post-herpetic pain. Decreased leg restlessness. Unlabeled Use: Neuropathic pain. Therapeutic use: Anti-parkinson agonist Action- Mechanism of action is not known. May affect transport of amino acids tB 1 in the CNS, which helps to control r lovements. Carbidopa, a decarboxylase inhibitor, prevents peripheral de fettaWleOflj®. 3 times daily initially Generic: Fludrocortisone Brand name : Florinef Classification: mineralocorticoids Gelibeiiapdnttaniqffl:optifti ()58 1aphrtiii0diitntila:erapyBondlircaiueoi25aidritiHiifficiency (11 t h e treatment of renal salt wasting syndrome ociPsjpn and water. Transport thus raising extracellular fluid volume and blood pressure and lowering potassium - makes your body hold on to sodium and AtStfif Vc§ift * l * n l e§‘ , tfe flow of fluid in the eye decreasing 1OP SafetfofJigdgfl ttfixJpQnhP&filJfiSdlwfel sac of affected eye(s) once daily in the evening Onset _________________________ Peak ______________________ Duration Q j aknown p&fopown DArMlfs Unknown unknown unknown cause conjunctival sac and don't let the top touch your eye. Wait at least 15 minutes before using contacts Adverse reactions : upset stomach, headache, changes in skin appearance, dizziness, slow wound healing Adverse reactions : blurred vision, burning, stinging, eyelid changes, crusting or < i&fiS & iaSSs allergies C<fesa«ieffida99iliP K'ftlll Sifi 1 ll?6flAft 1 »rififii dncy disease, low blood minerals precautions : history of other ocular problems, infection Interactions : drugs that cause bleeding or bruising easily, NSAID's, immune / W B thalmic medication for potential interactions Nursing Implications: monitor lab results for potassium and sodium I iursing Implications: regular eye exams and eye tests to monitor IOP Why this patient takes this medication . : the patient has low blood pressure \Vhy this patient takes this medication : to reduce the IOP for glaucoma J af&gSjage : 100/25 three times a dayP c a k Duration Rapid 2-4 hours unknown Qnset Peak Duration le\?4l«tftf D o n °t discoO puptly; may cause inersajq jfofequency C:iV|t>itffifWttnfifoWJf t a k e within 2 hr of an antacid. May cause dizziness and drowsiness. Patient teaching : take medication with food to decrease nausea. May cause sle ¥®Si e di e a i i4ifffl&s t HSt4illil q ¥WSjlteitWi l ?' lls ' 01 T depression, dizziness, drowsiness, sedation, anxiety, malaise, vertigo, weakness, abnormal vision, AclUl?t,f-tf l Rk w tWNT' l d j l >i&4I 1 ?(->4! l OIPixWt a ii C hypotension, hemorrhage, constipation, nausea, vomiting Contraindications : Hypersensitivity Contraindications : hypersensitivity, angle closure glaucoma, malignant t i tSWShft o n s : May increase risk of suicidal thoughts/behaviors): Renal insufficiency. May be more susceptible to toxicity due to age-related in renal Pr&Sfif/Sfls : history of cardiac disease I jtWflbtiofl ite s uft b i ! tPli >eftafs8 i IEgP{ianM a y increase risk of CNS depression with other CNS depressants, Morphine may increase Nigah ffitpiiMfis : assess Parkinson's symptoms, blood pressure and pulse frequently Nursing Implications: Monitor changes in behavior that could indicate suicidal Wffy’flfi ateftPYdkEiifffi IifitllE'tftfjW 1 - : piitWfft s has Parkinson's disease Why this patient takes this medication : relief of muscle spasms and neurologic pain Downloaded by Winkle Wong (wkwinkie@gmail.com)

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    Generic: Lubricating Tears Eye Drops Brand name : Ispoto Tears Classification: Ocular Lubricant Therapeutic use: to moisten and lubricate dry eyes and to relief irritation, burning and discomfort Action; the lubricant stays on the surface of the eye to protect and maintain moisture Safe dosage : use as often Onset Peak Duration Unknown unknown unknown Patient leaching : wait at least 5 minutes before using other ophthalmic medications, drop into conjunctival sac and don't let the top touch your eye. Wait at least 1 5 minutes before using contacts, instruct patient how to properly use eye drops Adverse reactions : blurred vision, redness, minor burning or stinging Contraindications : allergies Precautions : do not drive or use machinery if vision is blurry from medication Interactions : unknown Nursing Implications: monitor patient use and eye assessments Why this patient takes this medication : to prevent dry eyes Generic: Melatonin Brand name : Classification: natural hormone Therapeutic use: generally, melatonin is used for jet lag or to help with sleep Action: hormone naturally produced to regulate sleep-wake cycles Safe dosage : 5-10mg taken 1 hours before bedtime Onset Peak Duration Unknown unknown unknown Patient teaching : instruct patient to use medication one hour before bed Adverse reactions : day time drowsiness, headache, dizziness Contraindications : can worsen depressive symptoms Precautions : Interaction s- Nursing Implications: ensure patient takes medication at the correct time Why this patient takes this medication : helps aid in sleep Downloaded by Winkle Wong (wkwinkie@gmail.com)

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    Generic: Trazodone Brand name : Desyrel Classification: antidepressant Therapeutic use: treat depression Action: alters the effects of serotonin in the CNS Safe dosage : 1 50mg once daily Onset Peak Duration 1-2 weeks 2-4 weeks weeks Patient teaching : may cause drowsiness and blurred vision Generic: Vitamin B12 Brand name : Cyanocobalamin Classification: Vitamins Therapeutic use: Vitamin B12 deficiencies Action: Necessary coenzyme for metabolic processes, including fat and carbohydrate metabolism and protein synthesis Safe dosage : Adults with deficiency (depends on severity of deficiency) up to 1000 mcg QD Onset Peak Duration Unknown 3-10 days unknown Patient leaching : Encourage to comply with diet, foods high in vit B1 Adverse reactions : drowsiness, hypotension, dry mouth, nausea, vomiting Contraindications : hypersensitivity, concurrent use of other MAO's, angle glaucoma Precautions : cardiovascular disease, suicidal behavior Interactions : MAO inhibitors, CNS depressants Nursing Implications: monitor for serotonin syndrome. BP, pulse, pain lab values Why this patient takes this medication : depression Adverse reactions : Hypertension, erythema, rash, red urine, diarrhea, heart failure, restlessness, memory impairment Contraindications : Hypersensitivity Precautions : Uremia, folic acid deficiency, iron deficiency, concurrent infection, renal deficiency Interaction s: Chloramphenicol, and antineoplastic. colchicine, cimetidine, alcohol or vitamin C Nursing Implications: Assess for signs of vit B12 deficiency, lab tests to tell Why this patient takes this medication : Vitamin B12 deficiency Downloaded by Winkle Wong (wkwinkie@gmail.com)

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    Generic: Memantine Brand name : Ebixa Classification: anti-Alzheimer's Therapeutic use: moderate to severe Alzheimer dementia Action: antagonizes N-methyl-D-asparate receptors, the persistent activation of which seems to increase Alzheimer symptoms Safe dosage : 5mg once daily, increasing by 5mg per week until at target dose, Maximum 1Omg twice daily Onset Peak Duration Unknown 3-7 hours unknown Patient leaching : drug does not cure Alzheimer's, but may aid to maintain function in the patient Generic: Pantoprazole Magnesium Brand name : Tecta Classification: PPI - anti-ulcer drug Therapeutic use: short or long term maintain of healing erosive esophagitis and nighttime heartbum effects in patients with GERD Action- inhibits proton pump activity by binding to hydrogen-potassium adenosine triphosphate located at secretory surface of gastric parietal cells to suppress gastric acid secretion Safe dosage : 40mg once daily or twice daily Onset _________________________ Peak ______________________ Duration Unknown 2.5 hours unknown Patient teaching : medication can be taken regardless of meals, must be swallowed whole Adverse reactions : agitation, aggressiveness, heart failure, hyper/hypotension, headache, hallucinations, dizziness, constipation, diarrhea, anemia, coughing Contraindications : hypersensitivity, seizures, CV disease, hepatic or renal impairment Precautions : use cautiously in patients with increased urine pH Interactions : cimetidine, hydrochlorothiazide, quinidine, ranitidine, alcohol use Nursing Implications: monitor patient carefully for adverse effects Why this patient takes this medication : to slow the process of Alzheimer's Adverse reactions : anxiety, chest pain, dyspnea, flulike symptoms, headache, dizziness Contraindications : hypersensitivity Precautions : may be associated with osteoporosis - related fractures, should use the lowest dose for the shortest period Interaction s: azole antifungals, methotrexate, salicylates, warfarin Nursing Implications: monitor patient's magnesium levels, do not confuse with look-alike sound Why this patient takes this medication : GERD Downloaded by Winkle Wong (wkwinkie@gmail.com)

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    Generic: Zopiclone Brandname: Imovane _ _ Classification: hypnotic sedative Therapeutic use- For treating insomnia. Imovane helps induce sleep Action: Decreases the time it takes to fall asleep, increases the duration of sleep, and decreases awakenings in the night by depressing the central nervous system. Safe dosage : 3.7mg at bedtime orally. Max 7.5mg Ousel Peak Duration Immediately 1-2 hours 10 hours Patient teaching : Inform patient that effects can last for 12 hours after taking zopiclone so take caution when operating a vehicle. Encourage patient to let you know if they are experiencing serious side effects Adverse reactions : difficulty waking in the morning, bitter taste, dry mouth, palpitations, limb heaviness, withdrawal symptoms. Contraindications ■ Hypersensitivity to zopiclone or other ingredients in the container of the medication Precautions : Use caution with patients who have a history of alcohol abuse. Do not give to patients with severe respiratory issues. Not to be used during pregnancy. Interactions : Should not be taken with grapefruit juice/foods. St. Johns worts will decrease the effectiveness of immovane. Nursing Implications: Assess patient's quality of sleep and vitals Why this patient takes this medication : if patient is having troubles sleeping, falling asleep, and staying asleep. Generic: Bisacodyl Brand name : Ducolax Classification: Stimulant laxative Therapeutic use- to soften stool to relief constipation Action: promotes peristalsis, movement of intestinal contents through the colon and rectum Safe dosage : PO: 5mg daily PR: lOmg daily Onset ____________________________Peak ________________________ Duration PO: 6-12 Hours PR: 15-60minutes Patient teaching : Laxative should only be used for short time use and use as directed Adverse reactions : abdominal cramping, nausea, diarrhea and muscle weakness Contraindications : Hypersensitivity, abdominal pain, obstruction, nausea or vomiting Precautions : severe cardiovascular disease, anal or rectal fissures Interaction s: when taken with antacids both drugs will become inactive, resulting in GI irritation. Milk may remove enteric coating of tablet Nursing Implications: assess GI, bowel sounds, monitor stools and electrolyte balance. Why this patient takes this medication : to relief constipation Downloaded by Winkle Wong (wkwinkie@gmail.com)

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    Generic: Diclofenac Brand name : Voltaren Classification: non-steroid anti-inflammatory agent Therapeutic use: suppression of pain and inflammation Action: inhibits prostaglandin synthesis resulting in decrease in inflammation resulting in decrease in pain Safe dosage : topical gel - apply to affected area four times a day Onset Peak Duration Unknown 10-12 hours unknown Patient teaching : avoid the use of alcohol, aspirin, other NSAID's, do not apply heat after use Generic: Metoclopramide Brand name : Metonia Classification: Antiemetic Therapeutic use: post-surgical and diabetic gastric stasis, management of gastroesophageal reflux, treatment and prevention of post-operative nausea and vomiting Action: Blocks dopamine receptors in the chemoreceptor trigger zone in the CNS. Safe dosage : 10-1 5mg 30 minutes before or after meals or at bedtime. Do not exceed 0.5,g/kg/day Onset _________________________ Peak ______________________ Duration 30-60min unknown 1-2 hours Patient teaching : may cause drowsiness, avoid alcohol, risk of extrapyramidal symptoms tardive dyskinesia Adverse reactions : drowsiness, restlessness, anxiety, depression, hyper/hypotension, constipation, diarrhea, dry mouth Contraindications : hypertension, possible GI obstruction/hemorrhage, seizure history Precautions : History of depression, diabetes, renal impairment Interaction s: assess for nausea, vomiting, abdominal distension, bowel sounds, assess for extrapyramidal effects Nursing Implications: assess bowel frequency, consistency of stool prior to and during therapy, assess fluid and electrolyte balance, skin turgor and dehydration. Why this patient takes this medication : to prevent or treat nausea Adverse reactions : headache, skin irritation Contraindications : dermatitis, bums, wounds, other NSAID's Precautions : hypersensitivity Interactions : NSAID's Nursing Implications: assess skin for irritation, pain assessment Why this patient takes this medication : for relief of pain and inflammation on joints and muscles Downloaded by Winkie Wong (wkwinkie@gmail.com)

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    Generic: Atorvastatin Brand name : Lipitor Classification: Antilipemics. Therapeutic use- Helps lower cholesterol or other fats in the blood (such as triglycerides) and lower the risk of heart attacks and strokes Action: Increased the good cholesterol in the body and reduces the bad cholesterol. Safe dosage : 10-20 mg once daily, should not exceed 40 mg/day. Onset _______________________________Peak ___________________________ D u r a t i o n Unknown unknown unknown Patient teaching : Take medication as directed, do not double up on missed doses, do not drink grapefruit juice or eat grapefruits, use medication with diet restrictions, notify healthcare professionals if signs of liver injuiy, muscle pain, tenderness, weakness Generic: Cholecalciferol Brand name : Vitamin D3 Classification: fat-soluble vitamin Therapeutic use- treatment and prevention of deficiency states, particularly bone manifestations. Improved calcium and phosphorus homeostasis in patients with chronic kidney disease. Action: Cholecalciferol requires activation in the liver and kidneys to create the active form of vitamin D3. Vitamin D: promotes the absorption of calcium and decreases parathyroid hormone concentration. Safe dosage : 400-1000 units a day Onset _________________________ Peak ______________________ Duration Unknown unknown unknown Patient teaching : Review diet modifications considering vitamin D. should not self-medicate with other vitamins. Avoid concurrent use of antacids containing magnesium. Adverse reactions : headache, dizziness, fatigue, malaise, dyspnea, pancreatitis, abdominal pain, nausea, vomiting, bradycardia, weight loss, dry mouth. Contraindications : hypersensitivity, hypercalcemia, lactation Precautions concurrent use of magnesium, ergocalciferol, cholecalciferol. Use cautiously: in calcitriol, doxercalciferol. Interactions: cholestyramine, colestipol, mineral oil, thiazide diuretics, corticosteroids, Nursing Implications: assess for symptoms of vitamin deficiency, bone pain, weakness, hypocalcemia, rickets, osteomalacia, serum phosphate product levels, cholesterol levels. Why this patient takes this medication : vitamin D deficiency Adverse reactions : abdominal cramps, constipation, diarrhea, flatus, heartbum, dizziness, confusion, headache, weakness, insomnia, chest pain, peripheral edema. Contraindications : Do not use while prcgnant/brcastfccding. Use cautiously in patients with renal impairment, advanced age, or hypothyroidism Precautions : In patient's hypersensitive to drug or its components, with active liver disease, and those with unexplained increased transaminase levels Interactions : Antacids: can decrease rosuvastatin levels, give 2 hours after drug. Cyclosporine, Colchicine: may increase rosuvastatin level and risk myopathy Nursing Implications: Assess for underlying causes of hypercholesterolemia including poorly controlled diabetes, hypothyroidism, nephrotic syndrome, dyslipoproteinemias, obstructive liver disease Downloaded by Winkle Wong (wkwinkie@gmail.com)

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    Why this patient takes this medication : lower cholesterol Generic: Perindopril Brand name : Coversyl Classification: antihypertensive (ACE inhibitor) Therapeutic use: Used to treat and lower high blood pressure Action; Prevents vasoconstriction by stopping the conversion of angiotensin, which also helps decrease peripheral arterial resistance and decreases aldosterone secretion, lowering sodium and water retention as well as BP. Safe dosage : 4 mg once daily, may be slowly titrated up tol6 mg/day 1 to 2 divided doses, (cannot exceed 8mg/day in elderly patients) Onset Peak Duration 1-2 hours 3-7 hours 24 hours Patient teaching : Avoid salt substitute, as it could lead to high potassium levels. Light-headedness can occur, get up slowly. Monitor fluid intake and excretion as too much can cause light-headedness and fainting. Female patients to alert provider if they suspect pregnancy, drug will need to be stopped. Adverse reactions : Headache, dizziness, drowsiness, orthostatic hypotension Contraindications : Hypersensitivity to ACE inhibitors and in those with a history of angioedema regardless of prior ACE inhibitor use. Not to use during pregnancy Precautions : Impaired hepatic or renal function-if jaundice occurs or liver enzymes are markedly up, discontinue. Small amounts can be found in breast milk Interactions : other anti-hypertensives, diuretics, NSAID and lithium. Salt substitutes containing potassium. Nursing Implications- Monitor for hypotension. Measure BP just before you give the dose and at peak level. Assess renal and hepatic function. Monitor potassium levels Generic: Bupropion Hydrochloride Brand name : Wellbutrin XL Classification: Antidepressant Therapeutic use: Treatment of depression, depression with seasonal affect disorder Action - Decreases neuronal reuptake of dopamine in the CNS. Diminished neuronal uptake of serotonin and norepinephrine Safe dosage : 150mg-450mg once daily Onset Peak Duration Unknown unknown unknown Patient teaching : observe for suicidal behavior, hostility, agitation, advise to not use alcohol while on medication, report mood swings, teach about serotonin toxicity. Adverse reactions : abnormal dream, seizures, suicidal behavior, arrhythmias, constipation, arthritis, confusion, anxiety, hyper/hypotension, chills, hot flashes. Contraindications.: hypersensitivity, those who have taken MAO inhibitors within 14 days previous, do not use with other drugs containing bupropion Precautions : is not approved for children, use cautiously in patients with unstable heart disease, renal or hepatic impairment, a history of seizure, head trauma Interaction s: amantadine, levodopa, antidepressants, beta blockers, carbamazepine, phenobarbital, phenytoin, linezolid Nursing Implications: patient may experience restlessness, agitation, insomnia, anxiety, do not exceed max dose, monitor patient for signs of depression and suicidal behavior. Downloaded by Winkle Wong (wkwinkie@gmail.com)

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    Why this patient takes this medication : high blood pressure Why this patient takes this medication : depression Generic: Citalopram Hydrobromide Brand name : Celexa Classification- antidepressant - SSRI Therapeutic use: depression and OCD Action: inhibits the reuptake of serotonin in the CNS Safe dosage : 20-40mg once daily. Max dose of 40mg once daily. Onset _________________________ Peak ______________________ Duration I -4 weeks several weeks 1-2 days Patient teaching : observe for suicidal behavior, teach patient signs and symptoms of serotonin syndrome and to report. Continue therapy as prescribed. Avoid alcohol. Generic: Polyethylene Glycol Brand name : Restoralax Classification- Osmotic diuretic Therapeutic use: laxative Action: draws water into the GI tract to help with evacuation without water or electrolyte imbalance Safe dosage : 17g a day Onset _________________________ Peak ______________________ Duration Unknown unknown unknown Patient teaching : may take 2-4 days for BM, do not use for > 2 wk, can create dependence & electrolyte imbalance. Notify he prof if unusual cramps, bloating, or diarrhea occur Adverse reactions : abdominal, bloating, cramping, nausea, flatulence Contraindications : GI obstruction, Gastric retention, megacolon etc Precautions : abdominal pain of uncertain cause, especially if accompanied by fever, safety not known for OB, pediatric Interaction s: none significant Nursing Implications: assess bowel sounds and usual bowel pattern, access color, consistency, and amount of stool produced. Why this patient takes this medication : constipation Adverse reactions : suicidal attempt, migraine, serotonin syndrome, impaired concentration, depression, apathy, tachycardia, orthostatic hypotension, dry mouth, nausea Contraindications : hypersensitivity, congenital prolonged QT syndrome, bradycardia Precautions : recent acute MI, uncompensated heart failure. Interactions : amphetamines, anticmctic, antipsychotics, buspironc, opioids. SSRI's, TCA Nursing Implications: combining SSRI's could cause serotonin syndrome (symptoms include: restlessness, hallucinations, fast heart rate, loss of coordination, increase body temperature, nausea) Why this patient takes this medication : depression Downloaded by Winkle Wong (wkwinkie@gmail.com)

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    Generic: Pancrelipase Brand name : Cotazym; Pancrease MT Classification: pancreatic enzymes Therapeutic use: digestive agent Action: increase digestion of fats, carbohydrates, and proteins in GI tract Safe dosage : Initiate with 500 lipase units/kg/meal, adjust based on weight, symptoms, stool fat content. Max dose 2500/kg/meal Onset Peak Duration Rapid unknown unknown Patient teaching : look for symptoms of fibrosing colonopathy, encourage compliance with diet recommendation (high calories, high protein, low fat) diet. Generic: Lamotrigine Brand name : Lamictal Classification: anticonvulsant Therapeutic use: decreases incidence of seizures Action: stabilizes neuronal membranes by inhibiting sodium transport, therefore, decreasing seizures Safe dosage : depends on reason and other medications taken Onset Peak Duration Unknown 1.4-4.8 hours unknown Patient teaching : Report immediately if skin rash, fever, or swollen lymph glands develop, or if seizure activity increases; watch for suicidal thoughts, depression, anxiety, agitation, restlessness, etc. Adverse reactions : aseptic meningitis, suicidal thoughts, ataxia, dizziness, headache, hepatic failure, Steven's Johnson syndrome, nausea, vomiting, etc. Contraindications : hypersensitivity, acute manic episodes Precautions : risk for suicide, renal dysfunction, impaired cardiac function, hepatic dysfunction Interaction s' carbamazepine, phenobarbital, phenytoin, primidone, rifampin, lopinavir, etc. Nursing Implications: monitor closely for behavior changes and suicidal thoughts or depression, monitor for skin rash frequently, Why this patient takes this medication : management of partial seizures in adults and children with epilepsy Adverse reactions : fibrosing colonopathy (high doses only), abdominal pain (high dose only), diarrhea, nausea, stomach cramps, rash Contraindications : hypersensitivity Precautions : gout, renal impairment, hyperuricemia, lactation Interactions : antacids (calcium carbonate or magnesium hydroxide) may decrease effectiveness of pancrelipase, may decrease absorption of iron supplements Nursing Implications: assess nutritional status (height, weight, skin fold thickness, arm muscle circumference and lab values) prior to and during; monitor stools for stool fat content, foul-smelling and frothy Why this patient takes this medication . : aid in digestion Downloaded by Winkle Wong (wkwinkie@gmail.com)

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    Generic: Omeprazole Brand name : Prilosec, Losec Classification: Antiulcer agents/Proton-pump inhibitor Therapeutic use: Prevention and/or treatment of ulcers Action: Slows or prevent the production of acid in the stomach Safe dosage : 20-60mg once daily, may increase to 120mg X3 daily (less then 80mg/day should be divided given in doses) Onset Peak Duration Within 1 hour Within 2 hours 72-96 hours Patient teaching : Take medication as prescribed; may cause drowsiness or dizziness; check with health care professional before starting any new medication; avoid alcohol and NSAIDS. Inform health care provider of onset of black tarry stool, diarrhea, abdominal pain or persistent headaches Generic: Ipratropium Brand name : Atrovent (MDI/NEB) Classification: Allergy, cold and cough remedies, bronchodilators Therapeutic use: Treats COPD, bronchitis, emphysema, asthma and allergies Action: Opens air passages to make breathing easier. Safe dosage : MDI: 2 inhalations X4 daily (not to exceed 12 inhalations/24hr or more frequently than q4h). Ned: nonacute 500mcg 3-4X daily acute- 500mcg q30 min for 3 doses then q2-4hrs PRN Onset Peak Duration Inhalation 1-3 min 1-2 hours 4-6 hours P.atient teaching : Proper use of inhalers, nebulizer; do not double dose; advise rinsing of mouth after inhaler use; notify it stomatitis occurs or dry mouth persist more then 2 weeks; no more than 12 inhalations per day; notify if condition does not improve within 30 minutes; explain need for pulmonary function tests; avoid spraying in eyes; notify if cough, nervousness, headache, dizziness, nausea, or GT distress occurs. Adverse reactions : Dizziness, headache, nervousness, blurred vision, sore throat, epistaxis, nasal dryness, bronchospasms, cough, hypotension, palpitations, GI irritation, nausea, rash, allergic reactions Contraindications : Hypersensitivity to ipratropium, soy or peanuts; atropine, belladonna alkaloids, bromide. Precautions : Bladder neck obstruction, prostatic hyperplasia, glaucoma, urinary retention Interaction s: (anticholinergic properties) Antihistamines, phenothiazines, disopyramide Nursing Implications: Assess for soy. peanut, atropine, belladonna, alkaloid allergies; assess respiratory status before admin and at peak. Adverse reactions : Dizziness, drowsiness, fatigue, weakness, chest pain, abdominal pain, acid regurgitation, constipation, diarrhea, nausea, vomiting, itching, rash Contraindications : Hypersensitivity to omeprazole or benzimidazoles Precautions : Liver disease, patients using high dosage for more than one year, patients using for more than 3 years, pregnant or breast feeding. Interactions : Antifungal agents, diazepam, digoxin, flurazepam, triazolam, cyclosporine, phenytoin, saquinavir, tacrolimus, warfarin, atazanavir, antacids, nelfinavir, rifampin, methotrexate Nursing Implications: Epigastric and abdominal pain assessments, monitor bowel function; blood in stool, emesis or gastric aspirate, diarrhea, abdominal cramping, fever, should be reported immediately. Monitor CBC with differential periodically Downloaded by Winkle Wong (wkwinkie@gmail.com)

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    Why this patient takes this medication : Ineffective airway clearance and/or activity intolerance. Why this patient takes this medication : To control acid reflux Generic: Phosphatc/biphosphatc Brand name : Fleet enema Classification: Laxative Therapeutic use: Laxative Action: Produces laxative effect by causing water retention and stimulation of peristalsis. Inhibits fluid and electrolyte absorption from small intestine. Sale dosage : 7.5 ml as single dose Onset Peak Duration 30 minutes- 3 hours Unknown Unknown Patient teaching : Should be used only for short term therapy. Avoid using more than 1 dose of OTC laxatives/day. Long term may cause electrolyte imbalance and dependence. Caution patient on sodium restriction. If constipation unrelieved or rectal bleeding or some symptoms of electrolyte imbalance are present, see physician. Generic: Scnnosidcs Brandname : Scnokot Classification: Laxative Therapeutic use: Laxative Action: Uses Senna (laxative) to accumulate water in large intestines to increase peristalsis Sale dosage : 12mg-50mg once or twice daily Onset Peak Duration 6-1 2 hours Unknown 3-4 days (may take up to 24 hours) Patient teaching : Advise patient that laxatives should be used for a short-term therapy. Encourage patient to increase bulk in the diet and increase fluid intake and to become more mobile. May cause a change in urine color. Cardiac patients should avoid straining with bowel-movements. Do not use if fever, nausea, abdominal pain or vomiting is present. Adverse reactions : Cramping, diarrhea, nausea, pink-red/black-brown urine color, electrolyte abnormalities, laxative dependency Contraindications : Abdominal pain or unknown cause, rectal fissures, ulcerated hemorrhoids, alcohol intolerance Precautions : Chronic use may lead to laxative dependency and possible intestinal obstruction Interactions : May decrease absorption of other orally administered drugs due to decrease transit time Nursing Implications: Presence of bowel sounds and unusual pattern of bowel function. Assess color, consistency, and amount Why this patient takes this medication : Treatment of constipation with slow transit time, use of constipation drugs or irritable/spastic bowel syndrome and Adverse reactions : Dizziness, headache, heart arrhythmias, cramping, nausea, ischemic colitis, hyperphosphatemia, hypocalcemia, hypokalemia, sodium retention, renal dysfunction Contraindications : Abdominal pain, nausea, vomiting, severe renal or cardiovascular disease, intestinal obstruction. Precautions : Excessive use can lead to laxative dependency. Renal or cardiovascular disease, dehydration or concurrent use of diuretics known to alter electrolytes, renal dysfunction, bowel obstruction, active colitis Interaction s: Nursing Implications: Assess for fever, abdominal distention, present bowel sounds, and unusual bowel movement patterns. Assess stool for color, consistency and amount produced. Downloaded by Winkle Wong (wkwinkie@gmail.com)

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    neurological constipation. Why this patient takes this medication : Intermittent treatment of chronic constipation. Generic: Heparin Brand name : Hcpalcan ZD Classification: anticoagulants Therapeutic use: Prevention and treatment of various thromboembolic disease Action: Prevention of thrombus formation. Neutralizes thrombin preventing the conversion of fibrinogen to fibrin. Prevents conversion or prothrombin to thrombin Safe dosage : 20 000 to 40 000 units over 24 hours Onset _________________________ Peak ______________________ Duration 20-60 minutes 2 hours 8-12 hours Patient teaching : Advise patient to report any symptoms of unusual bleeding or bruising. Instruct patient not to take any medications containing aspirin or NSAIDS while on heparin therapy. Caution patient to avoid IM injections and activities leading to injuries. Patients to use soft toothbrush and electric razor during therapy. Generic: Digoxin Brand name : Toloxin . Classification: antiarrhythmic, inotropic Therapeutic use: Heart failure, atrial fibrillation, and atrial flutter Action: Increases the force of myocardial contraction. Increased cardiac output and slowing of heart rate. Sale dosage : Digitalizing dose- 0.75 -1.5 mg given as 50% of dose initially and on quarter of initial dose in each 2 subsequent doses at 6-12hour intervals. Maintenance Dose- 0.125-0.5 mg/day Onset Peak Duration 30-120 minutes 2-8 hours 2-4 days Patient teaching : Teach patient to take pulse and report to physician if pulse less than 60 and more than 100. Take meds as directed at the same time each day. Take missed doses within 12 hours of scheduled dose, do not double doses. Emphasize the importance of routine follow up exams to determine effectiveness and to monitor toxicity. Adverse reactions : Bradycardia, fatigue, headache, weakness, blurred vision. Nausea, vomiting, diarrhea, anorexia, thrombocytopenia Contraindications : Hypersensitivity, uncontrolled ventricular arrhythmias, known alcohol intolerance. AV block, constrictive pericarditis. Precautions : Hypokalemia, hypercalcemia, hypomagnesemia (increases risk of toxicity). Diuretic use- may cause electrolyte abnormalities. Hypothyroidism, myocardial infarction. Interaction s: Thiazide and look diuretics, piperacillin, ticarcillin, amphotericin B, Corticosteroids and excessive use of steroids may cause hypokalemia. Nursing Implications: Monitor apical pulse for a full minute before administration. Monitor intake and output ratios and daily weights. Assess for edema and auscultate lungs for rale/crackles throughout therapy. Obsetve for signs and symptoms in toxicity, (abdominal pain) Adverse reactions : Drug induced Hepatitis, hives, rashes, spot baldness, bleeding, heparin-induced reduction of platelets. Fever and hypersensitivity Contraindications : Hypersensitivity, uncontrolled bleeding, severe thrombocytopenia, open wounds. Precautions : Severe liver or kidney disease. Retinopathy, untreated hypertension, ulcer disease, spinal cord or brain injury. History of congenital or acquired bleeding disorder. Interactions : Risk of bleeding may increase by concurrent use of drugs that affect platelet function including aspiring, NSAIDS, Clopidogrcl. Nursing Implications: Assess for signs of bleeding and hemorrhage. Bleeding gums, nose bleeds, unusual bruising. Monitor client for hypersensitivity reactions (chills, fever and hives). Observe injection sites for hematomas, ecchymosis and inflammation. Monitor platelet count every 2-3 days throughout therapy. Downloaded by Winkle Wong (wkwinkie@gmail.com)

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    Why this patient takes this medication : Prevention and treatment of blood clots. Why this patient takes this medication : Heart failure. Generic: Nitroglycerin Patch Brand name : Trinipatch/ Nitro-dur Classification: Nitrates - antianginal Therapeutic use: MI and irregular heart rhythm Action: Increases coronary blood flow by dilating coronary arteries and improving collateral flow to ischemic regions. Sale dosage : 0.4 -0.4mg/hours initially; may titrate up to 0.4 -0.8mg/hour. Patch to be worn for 12-14 hours/day and then removed for 10-12 hours/day Onset Peak Duration 40-60 minutes Unknown 8-24 hours Patient teaching : Take as directed even if feeling better. Take missed doses as soon as remembered unless next dose is due within 6 hours with extended release preparations. Avoid concurrent use of alcohol. Consult healthcare professional before taking OTC's. Advise physician of severe/persistent headache, blurred vision, or dry mouth. Adverse reactions : CNS: dizziness, headache. CV: hypotension, tachycardia Contraindications : Hypersensitivity, severe anemia, pericardial tamponade, constrictive pericarditis, concurrent use of PDE-5 inhibitor or riociguat (a tx for chronic thromboembolic pulmonary arterial hypertension) Precautions : Head trauma, cerebral hemorrhage, remove patch before cardioversion Interaction s: Concurrent use of sildenafil. Tadalafil, vardenafil, Viagra/Cialis/Levitra or riociguat may result in severe hypotension. Nursing Implications: May be applied to any hairless site (avoid distal extremities or areas with cuts or callouses). Apply with firm pressure and ensure edges are well adhered. Apply a new dose if the 1st one becomes loose of falls off Why this patient takes this medication : Long-term prophylactic management of angina pectoris. Generic: Gentamicin Brand name : Garamycin Classification: Antibiotic Therapeutic use: TX of gram-negative bacterial infections and infections caused by staphylococci; used when penicillin or other less toxic drugs are contraindicated. Action: Inhibits bacterial proteins synthesis Safe dosage : Solution: 1-2 drops of 0.3% q2-4h; ointment: !4 inch strip q8-12h Onset _________________________ Peak ______________________ Duration Immediate 30-60 minutes unknown Patient teaching : Report signs of hypersensitivity; vertigo; hearing loss; rash; dizziness; difficulty voiding. Increase water intake; wash hands prior to instilling medication Adverse reactions : Irritation; headache; lower visual acuity; taste disturbance Contraindications : Hypersensitivity to aminoglycosides; renal impairment; hearing impairment. Precautions : Blood level monitoring to prevent ototoxicity and nephrotoxicity; clean area before application of ointment Interactions : Inactivated by penicillin use with renal insufficiency; possible respiratory paralysis after inhalation of anesthetics Nursing Implications: Evaluate eighth cranial nerve function by audiometry before and throughout therapy; monitor for nausea, vomiting, ataxia, vertigo. Why this patient takes this medication . : bacterial infections. Downloaded by Winkle Wong (wkwinkie@gmail.com)

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    Generic: Prednisone Brand name : Winipred Classification- Corticosteroid Therapeutic use: anti-asthmatics, corticosteroid Action: suppress inflammation and the normal immune response Safe dosage : 5 to 60mg/day as a single dose or in divided doses. Multiple Sclerosis: 200mg/day for 1 week then 80 mg every other day for 1 month Onset _________________________ Peak ______________________ Duration Unknown 1-2 hours unknown Patient teaching : Take missed doses asap (do not double dose). Do not stop medication suddenly - may result in adrenal insufficiency (anorexia, nausea, weakness, fatigue, dyspnea, hypotension, hypoglycemia), may be life - threatening. May mask infection, avoid people with known infections Generic: Lorazepam Brand name : Ativan P Classification- Therapeutic-anesthetic adjuncts, antianxiety Therapeutic use: Anxiety disorder, acute psychosis Action: Decreases anxiety, depresses CNS Safe dosage : 2-3 mg/day in divided doses, not to exceed 6mg/day Onset _________________________ Peak ______________________ Duration 1 5-60 min PO/SL 1-6 hours 8-12 hours Patient teaching : Short term use, does not cure underlying problem, take as directed, do not skip or double up doses, and may cause drowsiness, no alcohol Adverse reactions : heart failure, hypertension, insomnia, hypokalemia, euphoria, vertigo, headache, seizures Contraindications : hypersensitivity Precautions : use cautiously with recent MI, GI ulcer, renal disease. Interactions : NSAlDs, anticoagulants, ketoconazole, salicylates Nursing Implications: give a once daily dose in the morning. Patients with diabetes, thyroid disorder may need to adjust dosage. Why this patient takes this medication . : severe inflammation, immunosuppression Adverse reactions : Rashes, drowsiness, lethargy, respiratory depression, ataxia, confusion and depression. Contraindications. : Severe renal impairment, end stage renal disease, pregnancy, lactation. Precautions : History of drug abuse, history of suicide attempt, COPD. Interaction s: Alcohol, antihistamines, antidepressants, smoking, sedatives. Nursing Implications: Assess for continued need of treatment, degree of anxiety, lab tests. Why this patient takes this medication : Anxiety, sedation. Downloaded by Winkle Wong (wkwinkie@gmail.com)

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    pain/fever occur, do not take while pregnant, and avoid grapefruit juice. Adverse reactions : Dizziness, drowsiness, lethargy, depression, ataxia, slurred speech, rash. Contraindications : Sleep apnea, depression, hypersensitivity Precautions : Severe renal impairment, history of suicide, drug dependence Interactions : Drug-drug-alcohol, antihistamines, opioid analgesics Nursing Implications: Monitor BP, pulse and respiratory rate prior to and periodically throughout therapy, mental status, muscled spasm, alcohol withdrawal, lab tests. Why this patient takes this medication • Decrease anxiety, control seizures, decreased muscle spasm. Adverse reactions : Confusion, chest pain, bronchitis, diarrhea, ED, rash, rhabdomyolysis. Contraindications : Hypersensitivity, active liver disease or increased AST/AST, pregnancy. Precautions : History of liver disease, alcoholism, Asian ancestry, childbearing age Interaction s: St. John's wort decreases effectiveness, grapefruit juice contraindicated Nursing Implications: Monitor muscle weakness, take with magnesium. Antacid within 2 hour Why this patient takes this medication : Decrease in LDL and cholesterol. Increase HDL. Decrease triglyceride, prevent DV disease, showing progression of coronary artery disease. Downloaded by Winkle Wong (wkwinkie@gmail.com)

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    Generic: Morphine Brand name : MS Contin, M-Elson Classification: Opioid analgesics. Opioid agonists Therapeutic use: Moderate to severe chronic pain in opioid-tolerant patients Action- Alters the perception and response to pain so it is more manageable Safe dosage : 30mg q3-4hr initially or once 24hr opioid requirement is determined convert to extended release Onset ____________________________Peak ________________________ Duration Unknown 60 minutes 4-5 hours Patient teaching : Highly addictive, may cause drowsiness so don't take when needing to preform alert activities, don't take with alcohol or CNS depressants, important to teach how and when to administer morphine Generic: Benazepril Brand name : Lotensin Classification: Anti-hypertensives: ACE inhibitors Therapeutic use: Management of hypcrtcnsion/lowcrs BP Action - Angiotensin-converting enzyme (ACE) inhibitors increases plasma renin levels and decrease aldosterone levels. Net result is systemic vasodilation Safe dosage : PO Adults: 1Omg once daily, increase gradually to maintenance dose of 20-40 mg/day in 1-2 divided doses (initiate therapy at 5mg once daily in patients receiving diuretics) Onset Peak Duration Within I hour 1-2 weeks 24 hour Patient teaching : Encourage: weight reduction, low sodium diet, discontinuation of smoking, moderation of alcohol consumption, regular exercise, and stress management. Check BP weekly. Avoid salt substitutes containing potassium, or foods containing high-levels of potassium or sodium; position changes; Adverse reactions : CNS: dizziness, drowsiness, fatigue, headache. Resp: cough. CV: hypotension. GI: nausea. GU: impaired renal function. Derm: rash. F and E: hyperkalemia (high blood potassium). Misc: Angioedema (swelling of the lips, eyes and face) Contraindications : Hypersensitivity: patients with diabetes or moderate-to- sever renal impairment (CCr 60ml/min); OB: can cause injury or death of fetus- if pregnant occurs, discontinue); Lactation: discontinue drug or use formula Precautions : Renal impairment, hypovolemia, hyponatremia, diuretic therapy; black heritage higher risk of angioedema Interaction s: Diuretics, antihypertensive, potassium, renal dysfunction, angiotensin 2 receptor antagonists, NSAIDs. Nursing Implications: Monitor BP and pulse, signs of angioedema (dyspnea, facial swelling), renal function, BUN and serum creatinine, CBC, WBC, AST, ALT, alkaline phosphates, serum bilirubin, uric acid, and glucose. Adverse reactions : Confusion, dizziness, respiratory depression, hypotension, constipation, physical dependence, urinary retention in elderly. Contraindications : Avoid if patient is known to have hypersensitivity, respiratory depression and acute or severe bronchial asthma. Precautions : Avoid if patient is known to have hypersensitivity, respiratory depression and acute or severe bronchial asthma Interactions : Use extreme caution in patients receiving MAO inhibitors within 14 days prior. Alcohol may increase toxicity and bring up the chances of CNS depression Nursing Implications: Assess pain before and after taking, assessing level of consciousness and all vital signs regularly, assess risk for opioid abuse Why this patient takes this medication : To control mild to severe pain Downloaded by Winkie Wong (wkwinkie@gmail.com)

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    Why this patient takes this medication : Treat hypertension Generic: Cephalosporin Brand name : Cephalexin Classification- antibiotic Therapeutic use: Treatment of infections caused by susceptible organisms, such as skin and skin structure infections, pneumonia, UTI's. bone & joint infection Action: Bacterial action against susceptible bacteria Sale dosage : PO: (adults) most infections: 250-500 mg every 6 hours. For skin and soft tissue 500 mg every 6 hours Onset _________________________ Peak ______________________ Duration Rapid 1 ?? - 2 hours 12-24 hours Patient teaching : Instruct patient to take medication around the clock at evenly spaced times and to finish the medication completely as directed, even if feeling better. Advice client to report signs of superinfection. Notify health care professional if rash or fever occurs or diarrhea. Especially if diarrhea contains blood, mucus or pus Generic: Diphenhydramine Brand name : Benadryl Classification- allergy, antihistamines and antitussives, cold and cough Therapeutic use: Allergic reaction Action: competes with histamine 1 receptor sites. Prevents histamine mediated responses particularly in bronchial tubes, GI tract, uterus and blood vessels. Safe dosage : PO: 25 - 59mg. Q 4-6Hr, not to exceed 300mg/day IM: 25-50mg, q4hr as needed up to lOOmg/day. Do not exceed 400mg/day Onset Peak Duration PO: 1 5-60 mins 2-4 hours 4-8 hours IM: 20-30 mins Patient teaching : avoid taking if breastfeeding or giving to their children under the age of 4yrs. May cause dry mouth, avoid alcohol, and practice good oral hygiene Adverse reactions : Can cause seizures, diarrhea, nausea, vomiting, cramps, rashes, or allergic reactions Contraindications : Hypersensitivity to cephalosporin; serious hypersensitivity to penicillin Precautions : Use cautiously in renal impairment, history of GI disease. In elderly, dose adjustment may be needed Interactions : Probenecid decreases excretion and increase blood levels of renal excreted cephalosporin. Concurrent use of loop diuretics or aminoglycosides may increase risk of renal toxicity Nursing Implications: assess for infection. Monitor bowel function, diarrhea, abdominal cramps, fever, and bloody stools. Observe for signs and symptoms of anaphylaxis (rash, pruritus, laryngeal edema, wheezing Adverse reactions : drowsiness, dizziness, headache, blurred vision, dry mouth, constipation Contraindications : hypersensitivity; acute attacks of asthma; lactation; alcohol intolerance Precautions : use cautiously in severe liver disease; Interaction s- increased risk of CNS depression with another antihistamine, alcohol, opioid analgesics, and sedatives. Herbals: kava-kava; valerian or chamomile can increase CNS depression Nursing Implications: alcohol use. herbal use, assess for airway/rash/reaction; assess sleep, nausea, vomiting, degree of itching and inflammation Why this patient takes this medication : decrease in allergic reaction; frequency and intensity of cough; nausea and vomiting. Downloaded by Winkle Wong (wkwinkie@gmail.com)

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    Why this patient takes this medication : bacterial infection Generic: Hydromorphone Brand name : Dilaudid I I Classification: opioid analgesics Therapeutic use- Moderate to severe pain Action: Alters the perceptions of and response to painful stimuli. CNS depression Safe dosage : PO: 4-8 mg q 3-4hr initially IM/SC: 1 .5mg q 3-4hr as needed Onset _________________________ Peak ______________________ Duration PO: 1 5-30 minutes 30-90 minutes 4-5 hours SC/IM: 12-30 minutes IM: 30-60 minutes Patient teaching : drug has an abusive potential. May cause drowsiness or dizziness. Avoid driving or other activities requiring alertness. Notify physician if pain control is not adequate or if side effects occur and of any Rx or OTC/herbal. Change positions slowly to prevent orthostatic hypertension. May cause Adverse reactions : Confusion, sedation, dizziness, dysphoria, euphoria, floating feeling, hallucinations, headache, unusual dreams. Sensory: blurred vision, diplopia, and Respiratory depression. CV: Hypotension, bradycardia. GI: constipation, dry mouth, nausea, vomiting. GU : urinary retention Contraindications : Hypersensitivity Precautions : respiratory depression Interaction s: caution with MAO inhibitors (may produce severe, unpredictable reactions- reduce initial dose of hydromorphone by 25% of usual dose, discontinue MAO inhibitors 2 weeks prior to hydromorphone) increase of CNS depression with alcohol, antidepressants, antihistamines, and sedative/hypnotics including benzodiazepine and phenothiazine's. Nursing Implications: Assess BP, pulse, and respirations. Why this patient takes this medication : Moderate to severe pain, cough suppression. Generic: Fluticasone Proprionate Brand name: Flonase Classification: Nasal Corticosteroid Therapeutic n w seasonal or perennial rhinitis, non-allergic rhinitis. Treatment of nasal polyps Action: anti-inflammatory, decreases symptoms of allergies, non-allergenic rhinitis and polyps Safe dosage : 1-2 sprays each nostril/day Onset _________________________ Peak ______________________ Duration Few days unknown unknown Patient teaching : blow nostrils first, temp. Nasal stinging may occur. Stop med asap & notify Dr. if signs of anaphylaxis (hives, rash, SOB, swollen lips/throat) or vision changes occur. Notify Dr. 1) OTC meds, Rx meds, vitamins, herbals 2) female- planning pregnancy 3) symptoms do not improve in 1 month Adverse reactions : dizziness, headache, nose bleeds, nasal burning, congestion, irritation, perforation or ulceration, pharyngitis, runny nose, sneezing, teary eyes Contraindications : Hypersensitivity/intolerance of alcohol, propylene Precautions : Untreated infections, diabetes pt, glaucoma pt, history of increased intraocular pressure, glaucoma or cataracts, underlying immunosuppression, recent nasal trauma, septal ulcers, surgery (slows down healing) Interactions : Ketoconazole & Ritonavir-increases effects Nursing Implications: monitor nasal congestion & discharge (colour, amount), Long-term pt: exam for infection & ulceration of nasal mucosa, adrenal function tests Why this patient takes this medication - : Reduce allergy symptoms, reduce nasal swelling & polyps Downloaded by Winkie Wong (wkwinkie@gmail.com)

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    Generic: Insulin Brand name : HumuLIN N Classification- antidiabetics, hormones Therapeutic use: Controls hyperglycemia in patients with diabetes mellitus Action: Lowers blood glucose by: stimulating glucose uptake in skeletal muscle and fat, inhibiting hepatic glucose production. Inhibit lipolysis and proteolysis, enhanced protein synthesis Sale dosage : 0.5 - 1 Unit total insulin/kg/day Onset Peak Duration 2-4 Hours 4-10Hours 10-16Hours Patient teaching : Instruct on signs and symptoms of hypoglycemia and hyperglycemia and what to do if they occur. Instruct patient on proper technique for administration. Include type of insulin, equipment, storage, and place to discard syringes. Instruct patient to rotate injection sites. Caution patient not to share pen device with another person. Adverse reactions : Hypoglycemia, Hypokalemia, pruritus, erythema, swelling Contraindications : Hypoglycemia; Allergy or hypersensitivity to insulin, preservatives, or additives Precautions : Use cautiously in: Stress and infection (may temporarily increase insulin requirements); Renal/ hepatic impairment (may decrease insulin requirements) Interactions : Beta blockers, clonidinc and reserpine may mask some symptoms of hypoglycemia. Corticosteroids, thyroid supplements, estrogens, isoniazid, niacin, phenothiazine, and rifampin may increase insulin requirements. Alcohol, ACE inhibitors, MAO inhibitors, octreotide, oral hypoglycemic agents, and salicylates, may decrease insulin requirements Nursing Implications: Access patient periodically for symptoms of hypoglycemia and hyperglycemia Why this patient takes this medication : Control hyperglycemia in patients with diabetes mellitus. Generic: Cloxacillin Brand name : Novo-Cloxin Classification- Anti-invectives; penicillinase resistant penicillin Therapeutic use: Bactericidal action Action: Bind to bacterial cell wall, leading to cell death. Not inactivated by penicillinase enzymes. Safe dosage : 250 - 500 mg q 6 hr Onset _________________________ Peak Duration 30 min 30- 120 min 6 hours Patient teaching : Instruct patient to take medication around the clock and to finish drug completely as directed, even if feeling better. Missed doses should be taken as soon as remembered. Sharing of this medication could be dangerous. Adverse reactions : Seizures, Clostridium Difficile-Assoc Diarrhea, diarrhea, epigastric distress, nausea, vomiting. Interstitial nephritis, rash, urticaria, eosinophilia, leukopenia, anaphylaxis, scrum sickness, supcrinfcction Contraindications : Previous hypersensitivity to penicillin's. Cross sensitivity to cephalosporin's and other beta-lactam antibiotics. Precautions. : Severe renal or hepatic impairment; safe use in pregnancy has NOT been established; safe use in premature and newborn infants has NOT been established. Interaction s: May decrease effectives of oral contraceptives; Probenecid decreases renal excretion & increases blood levels of cloxacillin. Neomycin may decrease absorption. Use with Methotrexate decreases methotrexate elimination and increases risk of toxicity Nursing Implications: Assess V/S, wound, sputum, urine & stool; WBC throughout therapy. Observe pt for signs of anaphylaxis Downloaded by Winkle Wong (wkwinkie@gmail.com)

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    Why this patient takes this medication : bacterial infection Generic: Acetaminophen w/Codeine Brand name : Tylenol #3 H J Classification- Acetaminophen (A): antipyretics, non-opioid analgesic PO Codeine (C): Opioid agonists, opioid analgesic Therapeutic use: Acetaminophen (A): mild-moderate pain relief Codeine (C ): management of mild-moderate pain Action: A: reduces pain and fever-no inflame. Properties and GI toxicity C: alters perception and response to stimuli, decreases pain Safe dosage : Acetaminophen-325mg-650mg q6h Not exceed 3g/day. Codeine- 15-60mg q3-6h PRN Generic: Furosemide Brand name : Lasix Classification- Diuretic (increases passing of urine) - loop diuretic Therapeutic use; Subsequent mobilization of excess fluids (edema), lowers BP Action: Prevents reabsorption of fluids in the kidneys causing more frequent Urination Safe dosage : PO: Edema: 20-80 mg/day as a single dose initially, may repeat in 6-8 hrs. Hypertension: 40 twice daily initially (when added to regimen, decrease dose of other antihypertensive by 50%) Onset Peak Duration 30 - 60 mins 1 - 2 hours 6 - 8 hours Patient teaching : Change positions very slowly to minimize orthostatic hypotension (OH), take missed doses as soon as possible and DO NOT double dose. Contact IICP immediately if rash, muscle weakness, cramps, nausea, dizziness, numbness, or tingling of extremities Adverse reactions : Blurred vision, dizziness, headache, vertigo, hearing loss, tinnitus (ringing in ears), hypotension, anorexia, constipation, diarrhea, dry mouth, dyspepsia (feeling full), increase liver enzymes, nausea, pancreatitis, vomiting, excessive urination Contraindications : Hypersensitivity, cross-sensitivity with thiazides (diuretic) and sulphonamides may occur, hepatic coma or anuria (failure of kidneys to produce urine) Precautions : Severe liver disease, electrolyte depletion, diabetes mellitus, severe renal impairment (increased risk of ototoxicity [toxic to auditory nerves]) Interaction s: Increase risk of hypotension with an antihypertensive, nitrates or acute ingestion of alcohol, increase risk of hypokalemia with other diuretics; hypokalemia may increase the risk of digoxin toxicity. NSAID's Nursing Implications: Assess fluid status, monitor BP and pulse, assess for nausea, vomiting and muscle cramps, assess for hearing loss, assess patient for skin rash during therapy Onset Peak Duration A: 30min 1-3 hours 3-8 hours C: 30-45min 60-120 minutes 4 hours Patient teaching : may cause drowsiness/dizziness, avoid driving and alcohol, change position slowly to reduce orthostatic hypertension, dry mouth. Adverse reactions : A: rash hives C: resp. depression, confusion, sedation, dysphoria, euphoria, hallucinations, headaches, blurred vision, constipation, nausea, vomiting, urinary retention, flushing sweating, dependence, tolerance Contraindications : Severe hepatic impairment/active liver disease, allergy. Alcohol. Hypersensitivity Precautions : A: malnutrition, alcohol abuse (ETOH). liver/kidney failure C: geriatrics, liver/kidney failure, alcohol abuse, pulmonary disease, hypothyroidism, adrenal insufficiency Interactions : A: risk of bleeding w/ warfarin, increase risk of liver damage, NSAIDS C: MAO inhibitors- decrease dose by 25%, alcohol, antidepressants, antihistamines, sedatives and hypnotics-incrcase CNS depression, nalbuphine/pentazocine- may decrease analgesia Nursing Implications: assess for rashes, reassess pain, fever Why this patient takes this medication : Pain & Fever relief Downloaded by Winkle Wong (wkwinkie@gmail.com)

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    Why this patient takes this medication : To decrease blood pressure. or abdominal cramping Adverse reactions : GI: belching, cramps, distention, flatulence, diarrhea. Endo: hyperglycemia (diabetic patients) Contraindications : Patients on low-galactose diets Precautions : Use cautiously in: diabetes mellitus; excessive or prolonged use Interactions : Drug-Drug: should not be used with other laxatives in the treatment of hepatic encephalopathy ( leads to inability to determine optimal dose of lactulose ) Nursing Implications: abdominal assessment, monitor BMs. ensure patient has adequate diet of fluids and fiber. Why this patient takes this medication : to relieve constipation Adverse reactions : Confusion, Sedation, Constipation, nausea, Vomiting, Hypotension Contraindications : Hypersensitivity, Head trauma, Severe renal. Hepatic, or pulmonary disease Precautions : Hypersensitivity, Head trauma, Severe renal. Hepatic, or pulmonary disease Interaction s: CNS depression with alcohol, Antidepressant, Antihistamines, Sedation, Hypnotics Nursing Implications: Assess BP, Pulse, and Respiration before and during Administration, assess bowel function and pain. Toxicity and overdoes Why this patient takes this medication : To decrease pain and cough Downloaded by Winkle Wong (wkwinkie@gmail.com)

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    Generic: Salbutamol Brandname : Ventolin, Airomir Classification: Bronchodilators Therapeutic use: Bronchodilator to control & prevent airway obstruction Action; Relaxation of airway smooth muscle subsequent bronchodilation Safe dosage : 1-2 inhalations every 4-6 hours pin Onset Peak Duration 5-15 minutes 30-120 minutes 3-4 hours Patient teaching : may cause adverse effects, paradoxical bronchospasm or loss of effectiveness of medication Generic: Metoclopramide Brand name : Mctonia Classification: antiemetic Therapeutic use: Eases nausea, constipation, and passage of nasogastric tube. Off label use-hiccups and migraines Action - Blocks dopamine receptors in chemoreceptor trigger zone of the CNS Safe dosage : 10-15mg 30 min before meals and at bedtime (not to exceed 0.5rag/kg/day). A single dose of 20mg may be given preventatively, some respond to as little as 5mg Onset _________________________ Peak ______________________ Duration 30 - 60 min Unknown 1 -2 hours Patient teaching : Take medication as directed, take missed dose asap. Do not double dose. May cause drowsiness; do not drive or perform other activities requiring alertness. Adverse reactions : drowsiness, extrapyramidal reactions; restlessness; neuroleptic malignant syndrome; anxiety; depression, irritability, tardive dyskinesia CV: Arrhythmias; hypertension; hypotension GI: constipation, diarrhea, dry mouth, nausea Contraindications : Hypersensitivity; possible GI obstruction or hemorrhage; history of seizure disorders; Parkinson's disease. Precautions : Use with Caution: depression, diabetes, renal impairment, chronic use more than 3 months Interaction s: CNS depressants - alcohol - antidepressants - antihistamines - opioid analgesics - sedatives/hypnotics Nursing Implications: Assess for nausea, vomiting, abdominal distention, and bowel sounds. Monitor for neuroleptic malignant syndrome (hyperthermia, muscle rigidity, altered consciousness, irregular pulse or BP, tachycardia, diaphoresis) Why this patient takes this medication : Nauseated Adverse reactions : CNS: Nervousness, restlessness, tremor RES: paradoxical bronchospasm CV: chest pain, angina, High BP. GI: Nausea, vomiting. ENDO: Hyperglycemia. Contraindications : Hypersensitivity to adrenergic amines Precautions : Lactation, cardiac disease, seizure disorders Interactions : Concurrent use with other adrenergic agents will've increased adrenergic side effects, i.e hypokalemia increases the risk of digoxin toxicity. Nursing Implications: Observe for paradoxical bronchospasm (wheezing). Assess lung sounds, pulse & BP BEFORE administration during peak of medication. Why this patient takes this medication : to prevent or relief of bronchospasm Downloaded by Winkle Wong (wkwinkie@gmail.com)

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    Adverse reactions : Suicidal thoughts, lethargy, sedation, blurred vision, dry eyes, dry mouth, hypotension, constipation, arrhythmias Contraindications : Angle closure glaucoma, recent MI or heart problem Precautions : Increase risk of adverse effects: falls, increase risk of suicidal thoughts Interactions : Antidepressants, MAO inhibitors, decrease rifampin, CNS depressants, anticholinergics Nursing Implications: Weight, suicidal tendencies, depression, fasting glucose and cholesterol levels, monitor BP and pulse prior and post med admin Why this patient takes this medication : depression and to aid in sleep Adverse reactions : Dizziness, nausea, insomnia, anemia, bleeding, ecchymosis Contraindications : Hypersensitivity, major bleeding, heparin induced thrombocytopenia Precautions : Hepatic or renal disease, retinopathy, hypertension Interaction s’ Drugs that affect platelet count, aspirin, NSAIDS, thrombolytics, chamomille, garlic, ginger, gingko Nursing Implications: Signs of bleeding, increase in thrombosis, hypersensitivity reactions Why this patient takes this medication : prevent blood clots Downloaded by Winkle Wong (wkwinkie@gmail.com)

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    Generic: Domperidone Brand name : Motilium Classification: gastric stimulant Therapeutic use: improved GImotility. Decreased nausca/vomiting, associated with dopamine agonist anti-Parkinson therapy Action: Acts as a peripheral dopamine receptor blocker. Increases GT motility, peristalsis and lower esophageal sphincter pressure. Facilitates gastric emptying and decreases small bowel transit time. Safe dosage : 10 mg 3 to 4 times daily, may be increased to 20 mg Generic: Fragmin Brand name : Dalteparin Classification: Anticoagulant Therapeutic use Prevention of venous thromboembolism, deep vein thrombosis, and/or pulmonary embolism Action: prevents coagulation of blood Safe dosage : Depends on the patient's surgery or prevention reason for on the medication Onset _________________________ Peak ______________________ Duration Rapid 4 hours up to 24 hours Patient teaching : Advise to report any signs of unusual bleeding, bruising, dizziness, itching, rash, fever, swelling, or difficulty breathing. Instruct on correct technique for administration Closet _______________________________Peak ___________________________ Duration Unknown 30 min Unknown Patient teaching : Advise patient to avoid grapefruit juice during therapy. Advise patient to notify health care professional if galactorrhea, gynecomastia, menstrual irregularities, palpitations, irregular heartbeat, dizziness and if fainting appears. Adverse reactions : headache, insomnia, dry mouth, amenorrhea, impotence, hot flushes, rash Contraindications : known hypersensitivity and intolerance. Concurrent use of ketoconazole Precautions : history of breast cancer; hepatic impairment; severe renal impairment Interactions : increase blood levels and the risk of cardiovascular toxicity and is contradicted. Nursing Implications: assess for nausea, vomiting, abdominal distention and bowel. Why this patient takes this medication : management of symptoms associated with GI motility disorders Adverse reactions : Bleeding, dizziness, headache, insomnia, nausea, vomiting, anemia, fever, constipation, erythema at injection site, urinary retention, pain, irritation, hematoma. Contraindications : Hypersensitivity, cross sensitivity, Active major bleeding, heparin-induced thrombocytopenia Precautions : Severe hepatic or renal impairment, untreated hypertension, may have increased risk of bleeding Interaction s: Drugs that affect platelet function, NSA1DS. warfarin, aspirin, thrombolytics, chamomile, garlic, ginseng, feverfew, ginger Nursing Implications: Signs of bleeding and hemorrhage, monitor for hypersensitivity reactions, injection sites for hematomas, monitor levels Why this patient takes this medication . : to prevent blood clotting disorders Downloaded by Winkle Wong (wkwinkie@gmail.com)

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    Safe dosage : 40-80 mEq/day Onset ____________________________Peak ________________________ Duration Unknown 1-2 hours unknown Patient teaching : Explain the purpose of the medication and correct consumption of meds, avoid salt substitutes or low-salt milk or food unless approved (salts and certain foods contain potassium) Adverse reactions : Confusion, abdominal pain, diarrhea, flatulence, nausea, vomiting, arrhythmias, black stools Contraindications ■ Hyperkalemia, severe renal impairment, untreated Addison's Disease, severe tissue trauma Precautions : Cardiac disease, renal impairment, diabetes mellitus, hypomagnesemia, patients receiving potassium sparing drugs Interactions : Potassium sparing drugs, ACE inhibitors, angiotensin 2 receptor agonists, anticholinergics Nursing Implications: Monitor vital signs, Toxicity and overdose ability, lab tests: monitor serum Why this patient takes this medication : hypokalemia. Diuretics can remove the potassium from your blood and potassium is required to supplement O n s e t Peak Duration 30 min 1-2 hours 8-12 hours Patient teaching : Take med around the clock, finish the drug completely, report signs of superinfection, watch for diarrhea, females taking oral contraceptives to use alternative methods Adverse reactions : Seizures, diarrhea, nausea, rash, anaphylaxis, serum sickness Contraindications : Hypersensitivity to penicillin's Precautions : Severe renal insufficiency, infectious mononucleosis, Interaction s: Probenecid, warfarin, oral contraceptives Nursing Implications: Assess for infection, penicillin allergy? Observe for signs and symptom of anaphylaxis, monitor bowel function Why this patient takes this medication : bacterial infection Downloaded by Winkle Wong (wkwinkie@gmail.com)

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    Generic: CefTRIAXone Brand name : Rocephin Classification: Anti-infectives Therapeutic use: Treatment of infections Action: Bind to bacterial cell wall membrane, causing cell death Safe dosage : 1 g q 12 hr Onset Peak Duration Rapid 1-2 hours 12-24 hours Patient teaching : Take med as directed, report signs of supcrinfcction Generic: Metformin Brand name : Classification: Antidiabetic Therapeutic use: Management of type 2 diabetes mellitus, may be used with diet, insulin, or sulfonylurea Action- Decreases hepatic glucose production Safe dosage : IV/IM: 10 mg q6-8 hr, PO: 0.05-0.2 mg/kg/dose Onset Peak Duration 10-20 min 60-120 min 4-6 hours Patient teaching : On how and when to take med, may cause drowsiness, potential for arrhythmias, emphasize importance of ECG's, signs of overdose, change positions slowly, turn, caugh and breathe deeply to prevent atelectasis Adverse reactions : Abdominal bloating, diarrhea, nausea, vomiting, lactic acidosis Contraindications : Hypersensitivity, hypoxemia, sepsis, hepatic impairment Precautions : Concurrent renal disease, geriatric patients, chronic alcohol use Interaction s: Alcohol, iodinated contrast media, digoxin, morphine, calcium channel blockers, furosemide, glucosamine Nursing Implications: Signs and symptoms of hypoglycemic, patients who have been well controlled on metformin who develop an illness, advise HC provider of all medications currently on Why this patient takes this medication : patient needs glycemic control Adverse reactions : Seizures, diarrhea, nausea, vomiting, cramps, Steven- Johnsons syndrome, rash, uticaria, acute renal failure, hematuria, pain at IM site, phlebitis Contraindications : Hypersensitivity to cephalosporin, serious hypersensitivity to penicillin's Precautions : Renal impairment, colitis, diabetes Interactions : Probenecid, loop diuretics, aminoglycosides, NSAIDS, antacids, iron supplements, warfarin Nursing Implications: Assess for infection, obtain history, obtain specimen and culture of infection, signs and symptoms of anaphylaxis, monitor bowel function, assess for skin rash Why this patient takes this medication : Downloaded by Winkle Wong (wkwinkie@gmail.com)

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    Generic: Oxycodone Brandname: Classification: Opioid analgesic Therapeutic use: Moderate to severe pain Aclion: Binds to opiate receptors in the CNS. Alters the perception and response to the painful stimulus Safe dosage : 5-10 mg every 3-4 hours Onset Peak Duration 10-15 min 60-90 min 3-6 hours Patient teaching : Instruct how and when to ask for pain meds, may cause drowsiness, change positions slowly, notify the HC of a current med use, encourage to turn, cough, and deep breathe every 2 hours Adverse reactions : Confusion, sedation, dizziness, respiratory depression, constipation, dry mouth, choking, urinary retention, flushing, sweating, physical dependence Contraindications : Hypersensitivity, Alcohol, significant respiratory depression Precautions : Head trauma, increased intracranial pressure, undiagnosed abdominal pain, alcoholism, seizures, prostatic hypertrophy, difficulty swallowing Interactions : MAO inhibitors, alcohol, sedative/hypnotics, partial-antagonist opioid analgesics, erythromycin Nursing Implications: Type of pain, amount and level, assess vital signs, assess risk for opioid addiction Why this patient takes this medication : pain control Generic: Dimcnhydrinatc Brand name : Gravol Classification: Anti-emetics, antihistamines Therapeutic use: Nausea, vomiting, and vertigo accompanying motion sickness Aclion: Inhibits vestibular stimulation. Has significant CNS depressant, anticholinergic, antihistamine, and antiemetic properties Safe dosage : 50-100 mg eveiy 4 hours Onset Peak Duration 15-60 min 1-2 hours 3-6 hours Patient teaching : may cause drowsiness, dry mouth; drink lots of water, good oral hygiene, avoid concurrent alcohol use, use sunscreen Adverse reactions : Drowsiness, dizziness, headache, anorexia, palpitations, diarrhea, dry mouth Contraindications : Hypersensitivity, products containing alcohol; in patients with known intolerance Precautions : Angle-closure glaucoma, seizure disorder, prostatic hyperplasia Interaction s: Antihistamines, alcohol, opioid analgesics, sedative/hypnotics, ototoxic drugs, tricyclic antidepressants, MAO inhibitors Nursing Implications: Assess nausea, vomiting, bowel sounds, and abdominal pain, monitor intake and output levels Why this patient takes this medication : to control nausea Downloaded by Winkle Wong (wkwinkie@gmail.com)

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