Med and Patho

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Generic: SumatriptanBrand name : ImitrexClassification: Serotonin receptor agonistTherapeutic use:Treatment of acute migraine and cluster headachesAction: causes vasoconstriction of large intracranial arteriesSafe 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)OnsetPeakDuration30 min PO/SC2-4hup to 24h60 rain nasalPatient teaching : should only be used during migraine attack; used for reliefnot prophylaxis. Advise of adverse reactions and administration techniqueGeneric: AcetaminophenBrand name : TylenolClassification: Non-opioid analgesicTherapeutic use:Treatment of mild pain and feverAction; Inhibits prostaglandin synthesis that may serve as mediators of pain andfever, primarily in the CNSSafe dosage : PO- 325-650mg PO Q 4-6 Hr Do not exceed 3g per/dayPpsetPeakDuration30-60 minutes1-3 hours3-8 hoursPatient teaching : long term use can cause liver damage. Many OTC's containacetaminophen, do not use longer then 10 days, avoid alcohol, if not effectiveseek medical care ______________________________________________________Adverse reactions ; Nausea, vomiting, diarrhea, constipationContraindications : Renal impairment, alcohol abusePrecautions : do not take more then 3 grams per 24 hoursInteraction s: Increased risk of bleeding with warfarin, NSAID's, ibuprofenNursing Implications: Complete pain assessment, monitor BP, temperature, OTCuseWhy this patient takes this medication: frequent migraines, pains and achesand feverAdverse reactions : Dizziness, vertigo, Ml, tingling, warm sensation, injectionsite reactionContraindications : hypersensitivity, ischemic heart disease, Prinzmetal'sangina, uncontrolled HTN, concurrent MAOI therapyPrecautions : History of CV disease, child bearing potential, pregnancy,lactation, children < 18yInteractions : ergotamine, lithium, MAOI, SSRINursing Implications: Complete pain assessment, monitor BP one hr. beforeand 1 hr. after initial SC injectionWhy this patient takes this medication: frequent migraines not responsive toOTC medication treatmentDownloaded by Winkle Wong (wkwinkie@gmail.com)

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Patient teaching : take medication as directed. Avoid alcohol or other CNSdepressants. Report suicidal thoughts IMMEDIATELYUnknownunknownunknownPatient teaching ; side effects of hypercalcemia and extra calcium should beavoided, taken with or without meal take as directedAdverse reactions : seizures, abnormal dreams, anxiety, dizziness, headache,NV, worsening depression, weakness, abdominal painContraindications : MAOI or MAO-like drugsPrecautions : hypertension, hepatic impairment, impaired renal function,history of mania, seizures or neuro impairmentInteractions : concurrent use with MAOIs MAO-like drugs (linezolid ormethylene blue, Alcohol, NSAIDs, aspirin, clopidogrel, warfarin, St. Johns wortNursing Implications: Assess mental status and mood changes, assess suicidaltendencies, Assess for Serotonin syndrome.Why this patient takes this medication: DepressionA d v e r s e r e a c t i o n s; constipation, bloating, milk-alkali syndrome, reboundhyperacidityContraindications : severe renal diseasePrecautions : report all calcium supplements and calcium-fortified food, toomuch calcium causes hypercalcemiaInteraction s- blood pressure medications, synthetic thyroid hormones,bisphosphonates, antibiotics and calcium channel blockersNursing Implications: assess lab values, diet and overall health status. Reportany signs and symptoms of hyper/hypocalcemia, constipation, hyperacidityWhy this patient takes this medication: calcium imbalance, indigestion,heartbumDownloaded by Winkle Wong (wkwinkie@gmail.com)

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Generic: Acetylsalicylic AcidBrand name : AspirinClassification: Antipyretics, non-opioid analgesic, anti-platelet aggregatorTherapeutic use:Reduction of inflammation, reduction of fever. Decreasedincidence of transient ischemic attacks and MIAction: Produce analgesia and reduce inflammation and fever by inhibiting theproduction of prostaglandins. Decreases platelet aggregation. Keeps blood thinto prevent blood clots thus preventing emboli and thrombosisSafe dosage : 325-1000mg once dailyOnsetPeakDuration5-30 minutes1-2 hours1-4 HoursPatient teaching : Instruct patient to take salicylate with a full glass of water. Donot crush or chew enteric coated tablets.Generic: WarfarinBrand name : CoumadinClassification: AnticoagulantTherapeutic use-Prophylaxis and treatment of: venous thrombosis, pulmonaryembolism, atrial fibrillation with embolization. Management of myocardialinfarction.Action: Interferes with hepatic synthesis of vitamin K-dependent clotting factors- prevents clottingSafe dosage : 2-5 rng/day for 2-4 daysOnset ____________________________Peak ________________________DurationWithin 24 hours4 hours2-5 daysPatient 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 notdrink alcoholAdverse reactions : Tinnitus. GI bleeding, dyspnea, nausea, dermatitis,anaphylaxis, agitation, dizzinessContraindications : 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 diseaseInteractions : May increase the risk of bleeding with warfarin, heparin andother NSAlDsNursing Implications: Assess pain and limitation of movement, assess forbleeding, monitor bloodworkWhy this patient takes this medication: to decrease platelet aggregationAdverse 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, orspinal injury or surgery, uncontrolled hypertension, liver or kidney diseasePrecautions : history of ulcer or liver disease, women in child bearing potentialInteraction s: Androgens, thrombolytic, sulfonamides, NSAIDS. chronic use ofacetaminophenNursing Implications: Signs of bleeding and hemorrhage. Monitor PT/1NR.Why this patient takes this medication: to prevent blood coagulation, preventembolism 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 5minutes before instilling others.Adverse reactions : asthenia, dizziness, headache, fatigue, allergicconjunctivitis, abnormal vision, burning, pruritus, ocular hyperemiaContraindications : neonates and children under the age of 2.Precautions : Use cautiously in patients with CV disease, hypersensitivity,depression, hepatic or renal impairmentInteractions : antihypertensive, CNS depressants, alcohol useNursing Implications: monitor IOPWhy this patient takes this medication . : the patient has glaucoma thereforethis medication will lower IOPAdverse reactions : Headaches, diarrhea, nausea, vomiting, frequent urinationContraindications : Hypersensitivity to donepezil or piperidine derivativesPrecautions : Cardiac diseases, history of ulcer disease. COPD, asthma, orseizures, concurrent use of NSAIDSInteraction s: NSAIDS, rifampin, anticholinergics, dexamethasoneNursing Implications: Assess cognitive function periodically during therapy.Monitor heart rate, may cause bradycardiaWhy this patient takes this medication: To delay the progression of Alzheimer'sdisease and aid in memoryDownloaded by Winkle Wong (wkwinkie@gmail.com)

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Generic GabapentinBrand name : NeurontinClassification: Analgesic adjuncts, therapeutic, anticonvulsants, moodstabilizers ___________________________________________________________Generic: Levodopa-CarbidopaBrand name : Duopa(tlSSSSffiltfifi '81 >a08«¥afiiiSIPi d e n c eo fseizures. Decreased post-herpeticpain. Decreased leg restlessness. Unlabeled Use: Neuropathic pain.Therapeutic use:Anti-parkinson agonistAction- Mechanism of action is not known. May affect transport of amino acidstB1in the CNS, which helps to controlr lovements. Carbidopa, a decarboxylase inhibitor, prevents peripheraldefettaWleOflj®.3times daily initiallyGeneric: FludrocortisoneBrand name : FlorinefClassification: mineralocorticoidsGelibeiiapdnttaniqffl:optifti ()58 1aphrtiii0diitntila:erapyBondlircaiueoi25aidritiHiifficiency(11t h etreatment of renal salt wasting syndromeociPsjpn and water. Transport thus raising extracellular fluid volume and bloodpressure and lowering potassium - makes your body hold on to sodium andAtStfif Vc§ift*l*nle§‘,tfe flow of fluid in the eye decreasing 1OPSafetfofJigdgfl ttfixJpQnhP&filJfiSdlwfel sac of affected eye(s) once daily in theeveningOnset _________________________Peak ______________________DurationQ jaknownp&fopownDArMlfsUnknownunknownunknowncauseconjunctival sac and don't let the top touch your eye.Wait at least 15 minutes before using contactsAdverse reactions : upset stomach, headache, changes in skin appearance,dizziness, slow wound healingAdverse reactions : blurred vision, burning, stinging, eyelid changes, crusting or<i&fiS&iaSSs allergiesC<fesa«ieffida99iliPK'ftlll Sifi1ll?6flAft1»rififiidncy disease, low bloodmineralsprecautions : history of other ocular problems, infectionInteractions : drugs that cause bleeding or bruising easily, NSAID's, immune/ W Bthalmic medication forpotential interactionsNursing Implications: monitor lab results for potassium and sodiumI iursing Implications: regular eye exams and eye tests to monitor IOPWhy this patient takes this medication . : the patient has low blood pressure\Vhy this patient takes this medication: to reduce the IOP for glaucomaJ af&gSjage : 100/25 three times a dayPc akDurationRapid2-4 hoursunknownQnsetPeakDurationle\?4l«tftfD on°t discoOpuptly; may cause inersajq jfofequencyC:iV|t>itffifWttnfifoWJft akewithin 2 hr of an antacid. May cause dizziness anddrowsiness.Patient teaching : take medication with food to decrease nausea. May causesle¥®Siedieaii4ifffl&stHSt4illilq¥WSjlteitWil?'lls'01T depression, dizziness,drowsiness, sedation, anxiety, malaise, vertigo, weakness, abnormal vision,AclUl?t,f-tflRkwtWNT'ld jl>i&4I1?(->4!lOIPixWtaiiChypotension, hemorrhage,constipation, nausea, vomitingContraindications : HypersensitivityContraindications : hypersensitivity, angle closure glaucoma, malignantt i tSWShfto n s:May increase risk of suicidal thoughts/behaviors): Renalinsufficiency. May be more susceptible to toxicity due to age-related in renalPr&Sfif/Sfls : history of cardiac diseaseI jtWflbtioflitesuftbi!tPli>eftafs8iIEgP{ianMay increaserisk of CNS depression with other CNS depressants, Morphine may increaseNigahffitpiiMfis : assess Parkinson's symptoms, blood pressure and pulsefrequentlyNursing Implications: Monitor changes in behavior that could indicate suicidalWffy’flfiateftPYdkEiifffi IifitllE'tftfjW1-: piitWfftshas Parkinson's diseaseWhy this patient takes this medication: relief of muscle spasms and neurologicpainDownloaded by Winkle Wong (wkwinkie@gmail.com)

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Generic: Lubricating Tears Eye DropsBrand name : Ispoto TearsClassification: Ocular LubricantTherapeutic use:to moisten and lubricate dry eyes and to relief irritation,burning and discomfortAction; the lubricant stays on the surface of the eye to protect and maintainmoistureSafe dosage : use as oftenOnsetPeakDurationUnknownunknownunknownPatient leaching : wait at least 5 minutes before using other ophthalmicmedications, drop into conjunctival sac and don't let the top touch your eye.Wait at least 15 minutes before using contacts, instruct patient how to properlyuse eye dropsAdverse reactions : blurred vision, redness, minor burning or stingingContraindications : allergiesPrecautions : do not drive or use machinery if vision is blurry from medicationInteractions : unknownNursing Implications: monitor patient use and eye assessmentsWhy this patient takes this medication: to prevent dry eyesGeneric:MelatoninBrand name :Classification: natural hormoneTherapeutic use:generally, melatonin is used for jet lag or to help with sleepAction: hormone naturally produced to regulate sleep-wake cyclesSafe dosage : 5-10mg taken 1 hours before bedtimeOnsetPeakDurationUnknownunknownunknownPatient teaching : instruct patient to use medication one hour before bedAdverse reactions : day time drowsiness, headache, dizzinessContraindications : can worsen depressive symptomsPrecautions :Interaction s-Nursing Implications: ensure patient takes medication at the correct timeWhy this patient takes this medication: helps aid in sleepDownloaded by Winkle Wong (wkwinkie@gmail.com)

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Generic: TrazodoneBrand name : DesyrelClassification: antidepressantTherapeutic use:treat depressionAction: alters the effects of serotonin in the CNSSafe dosage : 150mg once dailyOnsetPeakDuration1-2 weeks2-4 weeksweeksPatient teaching : may cause drowsiness and blurred visionGeneric: Vitamin B12Brand name : CyanocobalaminClassification: VitaminsTherapeutic use:Vitamin B12 deficienciesAction: Necessary coenzyme for metabolic processes, including fat andcarbohydrate metabolism and protein synthesisSafe dosage : Adults with deficiency (depends on severity of deficiency) up to1000 mcg QDOnsetPeakDurationUnknown3-10 daysunknownPatient leaching : Encourage to comply with diet, foods high in vit B1Adverse reactions : drowsiness, hypotension, dry mouth, nausea, vomitingContraindications : hypersensitivity, concurrent use of other MAO's, angleglaucomaPrecautions : cardiovascular disease, suicidal behaviorInteractions : MAO inhibitors, CNS depressantsNursing Implications: monitor for serotonin syndrome. BP, pulse, pain labvaluesWhy this patient takes this medication: depressionAdverse reactions : Hypertension, erythema, rash, red urine, diarrhea, heartfailure, restlessness, memory impairmentContraindications : HypersensitivityPrecautions : Uremia, folic acid deficiency, iron deficiency, concurrent infection,renal deficiencyInteraction s: Chloramphenicol, and antineoplastic. colchicine, cimetidine,alcohol or vitamin CNursing Implications: Assess for signs of vit B12 deficiency, lab tests to tellWhy this patient takes this medication: Vitamin B12 deficiencyDownloaded by Winkle Wong (wkwinkie@gmail.com)

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Generic:MemantineBrand name : EbixaClassification: anti-Alzheimer'sTherapeutic use:moderate to severe Alzheimer dementiaAction: antagonizes N-methyl-D-asparate receptors, the persistent activation ofwhich seems to increase Alzheimer symptomsSafe dosage : 5mg once daily, increasing by 5mg per week until at target dose,Maximum 1Omg twice dailyOnsetPeakDurationUnknown3-7 hoursunknownPatient leaching : drug does not cure Alzheimer's, but may aid to maintainfunction in the patientGeneric: Pantoprazole MagnesiumBrand name : TectaClassification: PPI - anti-ulcer drugTherapeutic use:short or long term maintain of healing erosive esophagitis andnighttime heartbum effects in patients with GERDAction- inhibits proton pump activity by binding to hydrogen-potassiumadenosine triphosphate located at secretory surface of gastric parietal cells tosuppress gastric acid secretionSafe dosage : 40mg once daily or twice dailyOnset _________________________Peak ______________________DurationUnknown2.5 hoursunknownPatient teaching : medication can be taken regardless of meals, must beswallowed wholeAdverse reactions : agitation, aggressiveness, heart failure, hyper/hypotension,headache, hallucinations, dizziness, constipation, diarrhea, anemia, coughingContraindications : hypersensitivity, seizures, CV disease, hepatic or renalimpairmentPrecautions : use cautiously in patients with increased urine pHInteractions : cimetidine, hydrochlorothiazide, quinidine, ranitidine, alcohol useNursing Implications: monitor patient carefully for adverse effectsWhy this patient takes this medication: to slow the process of Alzheimer'sAdverse reactions : anxiety, chest pain, dyspnea, flulike symptoms, headache,dizzinessContraindications : hypersensitivityPrecautions : may be associated with osteoporosis - related fractures, shoulduse the lowest dose for the shortest periodInteraction s: azole antifungals, methotrexate, salicylates, warfarinNursing Implications: monitor patient's magnesium levels, do not confuse withlook-alike soundWhy this patient takes this medication: GERDDownloaded by Winkle Wong (wkwinkie@gmail.com)

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Generic: ZopicloneBrandname: Imovane_ _Classification: hypnotic sedativeTherapeutic use-For treating insomnia. Imovane helps induce sleepAction: Decreases the time it takes to fall asleep, increases the duration ofsleep, and decreases awakenings in the night by depressing the central nervoussystem.Safe dosage : 3.7mg at bedtime orally. Max 7.5mgOuselPeakDurationImmediately1-2 hours10 hoursPatient teaching : Inform patient that effects can last for 12 hours after takingzopiclone so take caution when operating a vehicle. Encourage patient to letyou know if they are experiencing serious side effectsAdverse reactions : difficulty waking in the morning, bitter taste, dry mouth,palpitations, limb heaviness, withdrawal symptoms.Contraindications■Hypersensitivity to zopiclone or other ingredients in thecontainer of the medicationPrecautions : Use caution with patients who have a history of alcohol abuse. Donot give to patients with severe respiratory issues. Not to be used duringpregnancy.Interactions : Should not be taken with grapefruit juice/foods. St. Johns wortswill decrease the effectiveness of immovane.Nursing Implications: Assess patient's quality of sleep and vitalsWhy this patient takes this medication: if patient is having troubles sleeping,falling asleep, and staying asleep.Generic: BisacodylBrand name : DucolaxClassification: Stimulant laxativeTherapeutic use-to soften stool to relief constipationAction: promotes peristalsis, movement of intestinal contents through the colonand rectumSafe dosage : PO: 5mg daily PR: lOmg dailyOnset ____________________________Peak ________________________DurationPO: 6-12 HoursPR: 15-60minutesPatient teaching : Laxative should only be used for short time use and use asdirectedAdverse reactions : abdominal cramping, nausea, diarrhea and muscle weaknessContraindications : Hypersensitivity, abdominal pain, obstruction, nausea orvomitingPrecautions : severe cardiovascular disease, anal or rectal fissuresInteraction s: when taken with antacids both drugs will become inactive,resulting in GI irritation. Milk may remove enteric coating of tabletNursing Implications: assess GI, bowel sounds, monitor stools and electrolytebalance.Why this patient takes this medication: to relief constipationDownloaded by Winkle Wong (wkwinkie@gmail.com)

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Generic: DiclofenacBrand name : VoltarenClassification: non-steroid anti-inflammatory agentTherapeutic use:suppression of pain and inflammationAction: inhibits prostaglandin synthesis resulting in decrease in inflammationresulting in decrease in painSafe dosage : topical gel - apply to affected area four times a dayOnsetPeakDurationUnknown10-12 hoursunknownPatient teaching : avoid the use of alcohol, aspirin, other NSAID's, do not applyheat after useGeneric: MetoclopramideBrand name : MetoniaClassification: AntiemeticTherapeutic use:post-surgical and diabetic gastric stasis, management ofgastroesophageal reflux, treatment and prevention of post-operative nauseaand vomitingAction: Blocks dopamine receptors in the chemoreceptor trigger zone in theCNS.Safe dosage : 10-15mg 30 minutes before or after meals or at bedtime. Do notexceed 0.5,g/kg/dayOnset _________________________Peak ______________________Duration30-60minunknown1-2 hoursPatient teaching : may cause drowsiness, avoid alcohol, risk of extrapyramidalsymptoms tardive dyskinesiaAdverse reactions : drowsiness, restlessness, anxiety, depression,hyper/hypotension, constipation, diarrhea, dry mouthContraindications : hypertension, possible GI obstruction/hemorrhage, seizurehistoryPrecautions : History of depression, diabetes, renal impairmentInteraction s: assess for nausea, vomiting, abdominal distension, bowel sounds,assess for extrapyramidal effectsNursing Implications: assess bowel frequency, consistency of stool prior to andduring therapy, assess fluid and electrolyte balance, skin turgor anddehydration.Why this patient takes this medication: to prevent or treat nauseaAdverse reactions : headache, skin irritationContraindications : dermatitis, bums, wounds, other NSAID'sPrecautions : hypersensitivityInteractions : NSAID'sNursing Implications: assess skin for irritation, pain assessmentWhy this patient takes this medication: for relief of pain and inflammation onjoints and musclesDownloaded by Winkie Wong (wkwinkie@gmail.com)

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Generic: AtorvastatinBrand name : LipitorClassification: Antilipemics.Therapeutic use-Helps lower cholesterol or other fats in the blood (such astriglycerides) and lower the risk of heart attacks and strokesAction: Increased the good cholesterol in the body and reduces the badcholesterol.Safe dosage : 10-20 mg once daily, should not exceed 40 mg/day.Onset _______________________________Peak ___________________________D u r a t i o nUnknownunknownunknownPatient teaching : Take medication as directed, do not double up on misseddoses, do not drink grapefruit juice or eat grapefruits, use medication with dietrestrictions, notify healthcare professionals if signs of liver injuiy, muscle pain,tenderness, weaknessGeneric: CholecalciferolBrand name : Vitamin D3Classification: fat-soluble vitaminTherapeutic use-treatment and prevention of deficiency states, particularlybone manifestations. Improved calcium and phosphorus homeostasis inpatients with chronic kidney disease.Action: Cholecalciferol requires activation in the liver and kidneys to create theactive form of vitamin D3. Vitamin D: promotes the absorption of calcium anddecreases parathyroid hormone concentration.Safe dosage : 400-1000 units a dayOnset _________________________Peak ______________________DurationUnknownunknownunknownPatient teaching : Review diet modifications considering vitamin D. should notself-medicate with other vitamins. Avoid concurrent use of antacids containingmagnesium.Adverse reactions : headache, dizziness, fatigue, malaise, dyspnea, pancreatitis,abdominal pain, nausea, vomiting, bradycardia, weight loss, dry mouth.Contraindications : hypersensitivity, hypercalcemia, lactationPrecautions concurrent use of magnesium, ergocalciferol, cholecalciferol. Usecautiously: 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 productlevels, cholesterol levels.Why this patient takes this medication: vitamin D deficiencyAdverse 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 inpatients with renal impairment, advanced age, or hypothyroidismPrecautions : In patient's hypersensitive to drug or its components, with activeliver disease, and those with unexplained increased transaminase levelsInteractions : Antacids: can decrease rosuvastatin levels, give 2 hours afterdrug. Cyclosporine, Colchicine: may increase rosuvastatin level and riskmyopathyNursing Implications: Assess for underlying causes of hypercholesterolemiaincluding poorly controlled diabetes, hypothyroidism, nephrotic syndrome,dyslipoproteinemias, obstructive liver diseaseDownloaded by Winkle Wong (wkwinkie@gmail.com)

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Why this patient takes this medication: lower cholesterolGeneric: PerindoprilBrand name : CoversylClassification: antihypertensive (ACE inhibitor)Therapeutic use:Used to treat and lower high blood pressureAction; Prevents vasoconstriction by stopping the conversion of angiotensin,which also helps decrease peripheral arterial resistance and decreasesaldosterone 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 2divided doses, (cannot exceed 8mg/day in elderly patients)OnsetPeakDuration1-2 hours3-7 hours24 hoursPatient teaching : Avoid salt substitute, as it could lead to high potassiumlevels. Light-headedness can occur, get up slowly. Monitor fluid intake andexcretion as too much can cause light-headedness and fainting. Femalepatients to alert provider if they suspect pregnancy, drug will need to bestopped.Adverse reactions : Headache, dizziness, drowsiness, orthostatic hypotensionContraindications : Hypersensitivity to ACE inhibitors and in those with ahistory of angioedema regardless of prior ACE inhibitor use. Not to use duringpregnancyPrecautions : Impaired hepatic or renal function-if jaundice occurs or liverenzymes are markedly up, discontinue. Small amounts can be found in breastmilkInteractions : other anti-hypertensives, diuretics, NSAID and lithium. Saltsubstitutes containing potassium.Nursing Implications- Monitor for hypotension. Measure BP just before yougive the dose and at peak level. Assess renal and hepatic function. Monitorpotassium levelsGeneric: Bupropion HydrochlorideBrand name : Wellbutrin XLClassification: AntidepressantTherapeutic use:Treatment of depression, depression with seasonal affectdisorderAction - Decreases neuronal reuptake of dopamine in the CNS. Diminishedneuronal uptake of serotonin and norepinephrineSafe dosage : 150mg-450mg once dailyOnsetPeakDurationUnknownunknownunknownPatient teaching : observe for suicidal behavior, hostility, agitation, advise to notuse alcohol while on medication, report mood swings, teach about serotonintoxicity.Adverse reactions : abnormal dream, seizures, suicidal behavior, arrhythmias,constipation, arthritis, confusion, anxiety, hyper/hypotension, chills, hot flashes.Contraindications.: hypersensitivity, those who have taken MAO inhibitorswithin 14 days previous, do not use with other drugs containing bupropionPrecautions : is not approved for children, use cautiously in patients withunstable heart disease, renal or hepatic impairment, a history of seizure, headtraumaInteraction s: amantadine, levodopa, antidepressants, beta blockers,carbamazepine, phenobarbital, phenytoin, linezolidNursing Implications: patient may experience restlessness, agitation, insomnia,anxiety, do not exceed max dose, monitor patient for signs of depression andsuicidal behavior.Downloaded by Winkle Wong (wkwinkie@gmail.com)

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Why this patient takes this medication: high blood pressureWhy this patient takes this medication: depressionGeneric: Citalopram HydrobromideBrand name : CelexaClassification- antidepressant - SSRITherapeutic use:depression and OCDAction: inhibits the reuptake of serotonin in the CNSSafe dosage : 20-40mg once daily. Max dose of 40mg once daily.Onset _________________________Peak ______________________DurationI-4 weeksseveral weeks1-2 daysPatient teaching : observe for suicidal behavior, teach patient signs andsymptoms of serotonin syndrome and to report. Continue therapy asprescribed. Avoid alcohol.Generic: Polyethylene GlycolBrand name : RestoralaxClassification- Osmotic diureticTherapeutic use:laxativeAction: draws water into the GI tract to help with evacuation without water orelectrolyte imbalanceSafe dosage : 17g a dayOnset _________________________Peak ______________________DurationUnknownunknownunknownPatient teaching : may take 2-4 days for BM, do not use for > 2 wk, can createdependence & electrolyte imbalance.Notify he prof if unusual cramps,bloating, or diarrhea occurAdverse reactions : abdominal, bloating, cramping, nausea, flatulenceContraindications : GI obstruction, Gastric retention, megacolon etcPrecautions : abdominal pain of uncertain cause, especially if accompanied byfever, safety not known for OB, pediatricInteraction s: none significantNursing Implications: assess bowel sounds and usual bowel pattern, accesscolor, consistency, and amount of stool produced.Why this patient takes this medication: constipationAdverse reactions : suicidal attempt, migraine, serotonin syndrome, impairedconcentration, depression, apathy, tachycardia, orthostatic hypotension, drymouth, nauseaContraindications : hypersensitivity, congenital prolonged QT syndrome,bradycardiaPrecautions : recent acute MI, uncompensated heart failure.Interactions : amphetamines, anticmctic, antipsychotics, buspironc, opioids.SSRI's, TCANursing Implications: combining SSRI's could cause serotonin syndrome(symptoms include: restlessness, hallucinations, fast heart rate, loss ofcoordination, increase body temperature, nausea)Why this patient takes this medication: depressionDownloaded by Winkle Wong (wkwinkie@gmail.com)

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Generic: PancrelipaseBrand name : Cotazym; Pancrease MTClassification: pancreatic enzymesTherapeutic use:digestive agentAction: increase digestion of fats, carbohydrates, and proteins in GI tractSafe dosage : Initiate with 500 lipase units/kg/meal, adjust based on weight,symptoms, stool fat content. Max dose 2500/kg/mealOnsetPeakDurationRapidunknownunknownPatient teaching : look for symptoms of fibrosing colonopathy, encouragecompliance with diet recommendation (high calories, high protein, low fat)diet.Generic: LamotrigineBrand name : LamictalClassification: anticonvulsantTherapeutic use:decreases incidence of seizuresAction: stabilizes neuronal membranes by inhibiting sodium transport,therefore, decreasing seizuresSafe dosage : depends on reason and other medications takenOnsetPeakDurationUnknown1.4-4.8 hoursunknownPatient teaching : Report immediately if skin rash, fever, or swollen lymph glandsdevelop, 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 episodesPrecautions : risk for suicide, renal dysfunction, impaired cardiac function,hepatic dysfunctionInteraction s' carbamazepine, phenobarbital, phenytoin, primidone, rifampin,lopinavir, etc.Nursing Implications: monitor closely for behavior changes and suicidalthoughts or depression, monitor for skin rash frequently,Why this patient takes this medication: management of partial seizures inadults and children with epilepsyAdverse reactions : fibrosing colonopathy (high doses only), abdominal pain(high dose only), diarrhea, nausea, stomach cramps, rashContraindications : hypersensitivityPrecautions : gout, renal impairment, hyperuricemia, lactationInteractions : antacids (calcium carbonate or magnesium hydroxide) maydecrease effectiveness of pancrelipase, may decrease absorption of ironsupplementsNursing Implications: assess nutritional status (height, weight, skin foldthickness, arm muscle circumference and lab values) prior to and during;monitor stools for stool fat content, foul-smelling and frothyWhy this patient takes this medication . : aid in digestionDownloaded by Winkle Wong (wkwinkie@gmail.com)

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Generic:OmeprazoleBrand name : Prilosec, LosecClassification: Antiulcer agents/Proton-pump inhibitorTherapeutic use:Prevention and/or treatment of ulcersAction: Slows or prevent the production of acid in the stomachSafe dosage : 20-60mg once daily, may increase to 120mg X3 daily (less then80mg/day should be divided given in doses)OnsetPeakDurationWithin 1 hourWithin 2 hours72-96 hoursPatient teaching : Take medication as prescribed; may cause drowsiness ordizziness; check with health care professional before starting any newmedication; avoid alcohol and NSAIDS. Inform health care provider of onset ofblack tarry stool, diarrhea, abdominal pain or persistent headachesGeneric: IpratropiumBrand name : Atrovent (MDI/NEB)Classification: Allergy, cold and cough remedies, bronchodilatorsTherapeutic use:Treats COPD, bronchitis, emphysema, asthma and allergiesAction: Opens air passages to make breathing easier.Safe dosage : MDI: 2 inhalations X4 daily (not to exceed 12 inhalations/24hr ormore frequently than q4h). Ned: nonacute 500mcg 3-4X daily acute- 500mcgq30 min for 3 doses then q2-4hrs PRNOnsetPeakDurationInhalation 1-3 min1-2 hours4-6 hoursP.atient teaching : Proper use of inhalers, nebulizer; do not double dose; adviserinsing of mouth after inhaler use; notify it stomatitis occurs or dry mouthpersist more then 2 weeks; no more than 12 inhalations per day; notify ifcondition does not improve within 30 minutes; explain need for pulmonaryfunction tests; avoid spraying in eyes; notify if cough, nervousness, headache,dizziness, nausea, or GT distress occurs.Adverse reactions : Dizziness, headache, nervousness, blurred vision, sorethroat, epistaxis, nasal dryness, bronchospasms, cough, hypotension,palpitations, GI irritation, nausea, rash, allergic reactionsContraindications : Hypersensitivity to ipratropium, soy or peanuts; atropine,belladonna alkaloids, bromide.Precautions : Bladder neck obstruction, prostatic hyperplasia, glaucoma, urinaryretentionInteraction s: (anticholinergic properties) Antihistamines, phenothiazines,disopyramideNursing Implications: Assess for soy. peanut, atropine, belladonna, alkaloidallergies; 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, rashContraindications : Hypersensitivity to omeprazole or benzimidazolesPrecautions : 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, methotrexateNursing Implications: Epigastric and abdominal pain assessments, monitorbowel function; blood in stool, emesis or gastric aspirate, diarrhea, abdominalcramping, fever, should be reported immediately. Monitor CBC with differentialperiodicallyDownloaded by Winkle Wong (wkwinkie@gmail.com)

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Why this patient takes this medication: Ineffective airway clearance and/oractivity intolerance.Why this patient takes this medication: To control acid refluxGeneric: Phosphatc/biphosphatcBrand name : Fleet enemaClassification: LaxativeTherapeutic use:LaxativeAction: Produces laxative effect by causing water retention and stimulation ofperistalsis. Inhibits fluid and electrolyte absorption from small intestine.Sale dosage : 7.5 ml as single doseOnsetPeakDuration30 minutes- 3 hoursUnknownUnknownPatient teaching : Should be used only for short term therapy. Avoid using morethan 1 dose of OTC laxatives/day. Long term may cause electrolyte imbalanceand dependence. Caution patient on sodium restriction. If constipationunrelieved or rectal bleeding or some symptoms of electrolyte imbalance arepresent, see physician.Generic: ScnnosidcsBrandname : ScnokotClassification: LaxativeTherapeutic use:LaxativeAction: Uses Senna (laxative) to accumulate water in large intestines toincrease peristalsisSale dosage : 12mg-50mg once or twice dailyOnsetPeakDuration6-12 hoursUnknown3-4 days(may take up to 24 hours)Patient teaching : Advise patient that laxatives should be used for a short-termtherapy. Encourage patient to increase bulk in the diet and increase fluid intakeand to become more mobile. May cause a change in urine color. Cardiacpatients 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 urinecolor, electrolyte abnormalities, laxative dependencyContraindications : Abdominal pain or unknown cause, rectal fissures,ulcerated hemorrhoids, alcohol intolerancePrecautions : Chronic use may lead to laxative dependency and possibleintestinal obstructionInteractions : May decrease absorption of other orally administered drugs dueto decrease transit timeNursing Implications: Presence of bowel sounds and unusual pattern of bowelfunction. Assess color, consistency, and amountWhy this patient takes this medication: Treatment of constipation with slowtransit time, use of constipation drugs or irritable/spastic bowel syndrome andAdverse reactions : Dizziness, headache, heart arrhythmias, cramping, nausea,ischemic colitis, hyperphosphatemia, hypocalcemia, hypokalemia, sodiumretention, renal dysfunctionContraindications : Abdominal pain, nausea, vomiting, severe renal orcardiovascular disease, intestinal obstruction.Precautions : Excessive use can lead to laxative dependency. Renal orcardiovascular disease, dehydration or concurrent use of diuretics known toalter electrolytes, renal dysfunction, bowel obstruction, active colitisInteraction s:Nursing Implications: Assess for fever, abdominal distention, present bowelsounds, 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 chronicconstipation.Generic: HeparinBrand name : HcpalcanZDClassification: anticoagulantsTherapeutic use:Prevention and treatment of various thromboembolic diseaseAction: Prevention of thrombus formation. Neutralizes thrombin preventingthe conversion of fibrinogen to fibrin. Prevents conversion or prothrombin tothrombinSafe dosage : 20 000 to 40 000 units over 24 hoursOnset _________________________Peak ______________________Duration20-60 minutes2 hours8-12 hoursPatient teaching : Advise patient to report any symptoms of unusual bleedingor bruising. Instruct patient not to take any medications containing aspirin orNSAIDS while on heparin therapy. Caution patient to avoid IM injections andactivities leading to injuries. Patients to use soft toothbrush and electric razorduring therapy.Generic: DigoxinBrand name : Toloxin.Classification: antiarrhythmic, inotropicTherapeutic use:Heart failure, atrial fibrillation, and atrial flutterAction: Increases the force of myocardial contraction. Increased cardiac outputand slowing of heart rate.Sale dosage : Digitalizing dose- 0.75 -1.5 mg given as 50% of dose initially and onquarter of initial dose in each 2 subsequent doses at 6-12hour intervals.Maintenance Dose- 0.125-0.5 mg/dayOnsetPeakDuration30-120 minutes2-8 hours2-4 daysPatient teaching : Teach patient to take pulse and report to physician if pulseless than 60 and more than 100. Take meds as directed at the same time eachday. Take missed doses within 12 hours of scheduled dose, do not double doses.Emphasize the importance of routine follow up exams to determineeffectiveness and to monitor toxicity.Adverse reactions : Bradycardia, fatigue, headache, weakness, blurred vision.Nausea, vomiting, diarrhea, anorexia, thrombocytopeniaContraindications : Hypersensitivity, uncontrolled ventricular arrhythmias,known alcohol intolerance. AV block, constrictive pericarditis.Precautions : Hypokalemia, hypercalcemia, hypomagnesemia (increases risk oftoxicity). 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 beforeadministration. Monitor intake and output ratios and daily weights. Assess foredema and auscultate lungs for rale/crackles throughout therapy. Obsetve forsigns and symptoms in toxicity, (abdominal pain)Adverse reactions : Drug induced Hepatitis, hives, rashes, spot baldness,bleeding, heparin-induced reduction of platelets. Fever and hypersensitivityContraindications : Hypersensitivity, uncontrolled bleeding, severethrombocytopenia, open wounds.Precautions : Severe liver or kidney disease. Retinopathy, untreatedhypertension, ulcer disease, spinal cord or brain injury. History of congenital oracquired bleeding disorder.Interactions : Risk of bleeding may increase by concurrent use of drugs thataffect platelet function including aspiring, NSAIDS, Clopidogrcl.Nursing Implications: Assess for signs of bleeding and hemorrhage. Bleedinggums, nose bleeds, unusual bruising. Monitor client for hypersensitivityreactions (chills, fever and hives). Observe injection sites for hematomas,ecchymosis and inflammation. Monitor platelet count every 2-3 daysthroughout therapy.Downloaded by Winkle Wong (wkwinkie@gmail.com)

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Why this patient takes this medication: Prevention and treatment of bloodclots.Why this patient takes this medication: Heart failure.Generic: Nitroglycerin PatchBrand name : Trinipatch/ Nitro-durClassification: Nitrates - antianginalTherapeutic use:MI and irregular heart rhythmAction: Increases coronary blood flow by dilating coronary arteries andimproving collateral flow to ischemic regions.Sale dosage : 0.4 -0.4mg/hours initially; may titrate up to 0.4 -0.8mg/hour. Patchto be worn for 12-14 hours/day and then removed for 10-12 hours/dayOnsetPeakDuration40-60 minutesUnknown8-24 hoursPatient teaching : Take as directed even if feeling better. Take missed doses assoon as remembered unless next dose is due within 6 hours with extendedrelease preparations. Avoid concurrent use of alcohol. Consult healthcareprofessional before taking OTC's. Advise physician of severe/persistentheadache, blurred vision, or dry mouth.Adverse reactions : CNS: dizziness, headache. CV: hypotension, tachycardiaContraindications : Hypersensitivity, severe anemia, pericardial tamponade,constrictive pericarditis, concurrent use of PDE-5 inhibitor or riociguat (a tx forchronic thromboembolic pulmonary arterial hypertension)Precautions : Head trauma, cerebral hemorrhage, remove patch beforecardioversionInteraction 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 distalextremities or areas with cuts or callouses). Apply with firm pressure and ensureedges are well adhered. Apply a new dose if the 1st one becomes loose of fallsoffWhy this patient takes this medication: Long-term prophylactic management ofangina pectoris.Generic: GentamicinBrand name : GaramycinClassification: AntibioticTherapeutic use:TX of gram-negative bacterial infections and infectionscaused by staphylococci; used when penicillin or other less toxic drugs arecontraindicated.Action: Inhibits bacterial proteins synthesisSafe dosage : Solution: 1-2 drops of 0.3% q2-4h; ointment: !4 inch strip q8-12hOnset _________________________Peak ______________________DurationImmediate30-60 minutesunknownPatient teaching : Report signs of hypersensitivity; vertigo; hearing loss; rash;dizziness; difficulty voiding. Increase water intake; wash hands prior to instillingmedicationAdverse reactions : Irritation; headache; lower visual acuity; taste disturbanceContraindications : Hypersensitivity to aminoglycosides; renal impairment;hearing impairment.Precautions : Blood level monitoring to prevent ototoxicity and nephrotoxicity;clean area before application of ointmentInteractions : Inactivated by penicillin use with renal insufficiency; possiblerespiratory paralysis after inhalation of anestheticsNursing Implications: Evaluate eighth cranial nerve function by audiometrybefore 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: PrednisoneBrand name : WinipredClassification- CorticosteroidTherapeutic use:anti-asthmatics, corticosteroidAction: suppress inflammation and the normal immune responseSafe dosage : 5 to 60mg/day as a single dose or in divided doses. MultipleSclerosis: 200mg/day for 1 week then 80 mg every other day for 1 monthOnset _________________________Peak ______________________DurationUnknown1-2 hoursunknownPatient teaching : Take missed doses asap (do not double dose). Do not stopmedication suddenly - may result in adrenal insufficiency (anorexia, nausea,weakness, fatigue, dyspnea, hypotension, hypoglycemia), may be life -threatening. May mask infection, avoid people with known infectionsGeneric: LorazepamBrand name : AtivanPClassification- Therapeutic-anesthetic adjuncts, antianxietyTherapeutic use:Anxiety disorder, acute psychosisAction: Decreases anxiety, depresses CNSSafe dosage : 2-3 mg/day in divided doses, not to exceed 6mg/dayOnset _________________________Peak ______________________Duration15-60 min PO/SL1-6 hours8-12 hoursPatient teaching : Short term use, does not cure underlying problem, take asdirected, do not skip or double up doses, and may cause drowsiness, no alcoholAdverse reactions : heart failure, hypertension, insomnia, hypokalemia,euphoria, vertigo, headache, seizuresContraindications : hypersensitivityPrecautions : use cautiously with recent MI, GI ulcer, renal disease.Interactions : NSAlDs, anticoagulants, ketoconazole, salicylatesNursing Implications: give a once daily dose in the morning. Patients withdiabetes, thyroid disorder may need to adjust dosage.Why this patient takes this medication . : severe inflammation,immunosuppressionAdverse 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 ofanxiety, 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, slurredspeech, rash.Contraindications : Sleep apnea, depression, hypersensitivityPrecautions : Severe renal impairment, history of suicide, drug dependenceInteractions : Drug-drug-alcohol, antihistamines, opioid analgesicsNursing Implications: Monitor BP, pulse and respiratory rate prior to andperiodically throughout therapy, mental status, muscled spasm, alcoholwithdrawal, 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, childbearingageInteraction s: St. John's wort decreases effectiveness, grapefruit juicecontraindicatedNursing Implications: Monitor muscle weakness, take with magnesium. Antacidwithin 2 hourWhy this patient takes this medication: Decrease in LDL and cholesterol.Increase HDL. Decrease triglyceride, prevent DV disease, showing progression ofcoronary artery disease.Downloaded by Winkle Wong (wkwinkie@gmail.com)

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Generic: MorphineBrand name : MS Contin, M-ElsonClassification: Opioid analgesics. Opioid agonistsTherapeutic use:Moderate to severe chronic pain in opioid-tolerant patientsAction- Alters the perception and response to pain so it is more manageableSafe dosage : 30mg q3-4hr initially or once 24hr opioid requirement isdetermined convert to extended releaseOnset ____________________________Peak ________________________DurationUnknown60 minutes4-5 hoursPatient teaching : Highly addictive, may cause drowsiness so don't take whenneeding to preform alert activities, don't take with alcohol or CNS depressants,important to teach how and when to administer morphineGeneric: BenazeprilBrand name : LotensinClassification: Anti-hypertensives: ACE inhibitorsTherapeutic use:Management of hypcrtcnsion/lowcrs BPAction - Angiotensin-converting enzyme (ACE) inhibitors increases plasma reninlevels and decrease aldosterone levels. Net result is systemic vasodilationSafe dosage : PO Adults: 1Omg once daily, increase gradually to maintenancedose of 20-40 mg/day in 1-2 divided doses (initiate therapy at 5mg once daily inpatients receiving diuretics)OnsetPeakDurationWithin I hour1-2 weeks24 hourPatient teaching : Encourage: weight reduction, low sodium diet,discontinuation of smoking, moderation of alcohol consumption, regularexercise, and stress management. Check BP weekly. Avoid salt substitutescontaining 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 formulaPrecautions : Renal impairment, hypovolemia, hyponatremia, diuretic therapy;black heritage higher risk of angioedemaInteraction 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, respiratorydepression and acute or severe bronchial asthmaInteractions : Use extreme caution in patients receiving MAO inhibitors within14 days prior. Alcohol may increase toxicity and bring up the chances of CNSdepressionNursing Implications: Assess pain before and after taking, assessing level ofconsciousness and all vital signs regularly, assess risk for opioid abuseWhy this patient takes this medication: To control mild to severe painDownloaded by Winkie Wong (wkwinkie@gmail.com)

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Why this patient takes this medication: Treat hypertensionGeneric: CephalosporinBrand name : CephalexinClassification- antibioticTherapeutic use:Treatment of infections caused by susceptible organisms,such as skin and skin structure infections, pneumonia, UTI's. bone & jointinfectionAction: Bacterial action against susceptible bacteriaSale dosage : PO: (adults) most infections: 250-500 mg every 6 hours. For skinand soft tissue 500 mg every 6 hoursOnset _________________________Peak ______________________DurationRapid1 ?? - 2 hours12-24 hoursPatient teaching : Instruct patient to take medication around the clock atevenly spaced times and to finish the medication completely as directed, evenif feeling better. Advice client to report signs of superinfection. Notify healthcare professional if rash or fever occurs or diarrhea. Especially if diarrheacontains blood, mucus or pusGeneric: DiphenhydramineBrand name : BenadrylClassification- allergy, antihistamines and antitussives, cold and coughTherapeutic use:Allergic reactionAction: competes with histamine 1 receptor sites. Prevents histamine mediatedresponses particularly in bronchial tubes, GI tract, uterus and blood vessels.Safe dosage : PO: 25 - 59mg. Q 4-6Hr, not to exceed 300mg/dayIM: 25-50mg, q4hr as needed up to lOOmg/day. Do not exceed 400mg/dayOnsetPeakDurationPO: 15-60 mins2-4 hours4-8 hoursIM: 20-30 minsPatient teaching : avoid taking if breastfeeding or giving to their children underthe age of 4yrs. May cause dry mouth, avoid alcohol, and practice good oralhygieneAdverse reactions : Can cause seizures, diarrhea, nausea, vomiting, cramps,rashes, or allergic reactionsContraindications : Hypersensitivity to cephalosporin; serious hypersensitivityto penicillinPrecautions : Use cautiously in renal impairment, history of GI disease. Inelderly, dose adjustment may be neededInteractions : Probenecid decreases excretion and increase blood levels of renalexcreted cephalosporin. Concurrent use of loop diuretics or aminoglycosidesmay increase risk of renal toxicityNursing Implications: assess for infection. Monitor bowel function, diarrhea,abdominal cramps, fever, and bloody stools. Observe for signs and symptomsof anaphylaxis (rash, pruritus, laryngeal edema, wheezingAdverse reactions : drowsiness, dizziness, headache, blurred vision, dry mouth,constipationContraindications : hypersensitivity; acute attacks of asthma; lactation; alcoholintolerancePrecautions : 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 orchamomile can increase CNS depressionNursing Implications: alcohol use. herbal use, assess for airway/rash/reaction;assess sleep, nausea, vomiting, degree of itching and inflammationWhy this patient takes this medication: decrease in allergic reaction; frequencyand intensity of cough; nausea and vomiting.Downloaded by Winkle Wong (wkwinkie@gmail.com)

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Why this patient takes this medication: bacterial infectionGeneric: HydromorphoneBrand name : DilaudidI IClassification: opioid analgesicsTherapeutic use-Moderate to severe painAction: Alters the perceptions of and response to painful stimuli. CNSdepressionSafe dosage : PO: 4-8 mg q 3-4hr initially IM/SC: 1.5mg q 3-4hr as neededOnset _________________________Peak ______________________DurationPO: 15-30 minutes30-90 minutes4-5 hoursSC/IM: 12-30 minutesIM: 30-60 minutesPatient teaching : drug has an abusive potential. May cause drowsiness ordizziness. Avoid driving or other activities requiring alertness. Notify physician ifpain control is not adequate or if side effects occur and of any Rx or OTC/herbal.Change positions slowly to prevent orthostatic hypertension. May causeAdverse reactions : Confusion, sedation, dizziness, dysphoria, euphoria, floatingfeeling, hallucinations, headache, unusual dreams. Sensory: blurred vision,diplopia, and Respiratory depression. CV: Hypotension, bradycardia. GI:constipation, dry mouth, nausea, vomiting. GU : urinary retentionContraindications : HypersensitivityPrecautions : respiratory depressionInteraction s: caution with MAO inhibitors (may produce severe, unpredictablereactions- reduce initial dose of hydromorphone by 25% of usual dose,discontinue MAO inhibitors 2 weeks prior to hydromorphone) increase of CNSdepression with alcohol, antidepressants, antihistamines, andsedative/hypnotics including benzodiazepine and phenothiazine's.Nursing Implications: Assess BP, pulse, and respirations.Why this patient takes this medication: Moderate to severe pain, coughsuppression.Generic: Fluticasone ProprionateBrand name: FlonaseClassification: Nasal CorticosteroidTherapeutic n wseasonal or perennial rhinitis, non-allergic rhinitis. Treatmentof nasal polypsAction: anti-inflammatory, decreases symptoms of allergies, non-allergenicrhinitis and polypsSafe dosage : 1-2 sprays each nostril/dayOnset _________________________Peak ______________________DurationFew daysunknownunknownPatient teaching : blow nostrils first, temp. Nasal stinging may occur. Stop medasap & notify Dr. if signs of anaphylaxis (hives, rash, SOB, swollen lips/throat) orvision changes occur. Notify Dr. 1) OTC meds, Rx meds, vitamins, herbals 2)female- planning pregnancy 3) symptoms do not improve in 1 monthAdverse reactions : dizziness, headache, nose bleeds, nasal burning,congestion, irritation, perforation or ulceration, pharyngitis, runny nose,sneezing, teary eyesContraindications : Hypersensitivity/intolerance of alcohol, propylenePrecautions : Untreated infections, diabetes pt, glaucoma pt, history ofincreased intraocular pressure, glaucoma or cataracts, underlyingimmunosuppression, recent nasal trauma, septal ulcers, surgery (slows downhealing)Interactions : Ketoconazole & Ritonavir-increases effectsNursing Implications: monitor nasal congestion & discharge (colour, amount),Long-term pt: exam for infection & ulceration of nasal mucosa, adrenalfunction testsWhy this patient takes this medication - : Reduce allergy symptoms, reducenasal swelling & polypsDownloaded by Winkie Wong (wkwinkie@gmail.com)

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Generic: InsulinBrand name : HumuLIN NClassification- antidiabetics, hormonesTherapeutic use:Controls hyperglycemia in patients with diabetes mellitusAction: Lowers blood glucose by: stimulating glucose uptake in skeletal muscleand fat, inhibiting hepatic glucose production. Inhibit lipolysis and proteolysis,enhanced protein synthesisSale dosage : 0.5 - 1 Unit total insulin/kg/dayOnsetPeakDuration2-4 Hours4-10Hours10-16HoursPatient teaching : Instruct on signs and symptoms of hypoglycemia andhyperglycemia and what to do if they occur. Instruct patient on propertechnique for administration. Include type of insulin, equipment, storage, andplace to discard syringes. Instruct patient to rotate injection sites. Cautionpatient not to share pen device with another person.Adverse reactions : Hypoglycemia, Hypokalemia, pruritus, erythema, swellingContraindications : Hypoglycemia; Allergy or hypersensitivity to insulin,preservatives, or additivesPrecautions : Use cautiously in: Stress and infection (may temporarily increaseinsulin requirements); Renal/ hepatic impairment (may decrease insulinrequirements)Interactions : Beta blockers, clonidinc and reserpine may mask somesymptoms of hypoglycemia. Corticosteroids, thyroid supplements, estrogens,isoniazid, niacin, phenothiazine, and rifampin may increase insulinrequirements. Alcohol, ACE inhibitors, MAO inhibitors, octreotide, oralhypoglycemic agents, and salicylates, may decrease insulin requirementsNursing Implications: Access patient periodically for symptoms ofhypoglycemia and hyperglycemiaWhy this patient takes this medication: Control hyperglycemia in patientswith diabetes mellitus.Generic: CloxacillinBrand name : Novo-CloxinClassification- Anti-invectives; penicillinase resistant penicillinTherapeutic use:Bactericidal actionAction: Bind to bacterial cell wall, leading to cell death. Not inactivated bypenicillinase enzymes.Safe dosage : 250 - 500 mg q 6 hrOnset _________________________PeakDuration30 min30- 120 min6 hoursPatient teaching : Instruct patient to take medication around the clock and tofinish drug completely as directed, even if feeling better. Missed doses shouldbe taken as soon as remembered. Sharing of this medication could bedangerous.Adverse reactions : Seizures, Clostridium Difficile-Assoc Diarrhea, diarrhea,epigastric distress, nausea, vomiting. Interstitial nephritis, rash, urticaria,eosinophilia, leukopenia, anaphylaxis, scrum sickness, supcrinfcctionContraindications : Previous hypersensitivity to penicillin's. Cross sensitivity tocephalosporin's and other beta-lactam antibiotics.Precautions. : Severe renal or hepatic impairment; safe use in pregnancy has NOTbeen established; safe use in premature and newborn infants has NOT beenestablished.Interaction s: May decrease effectives of oral contraceptives; Probeneciddecreases renal excretion & increases blood levels of cloxacillin. Neomycin maydecrease absorption. Use with Methotrexate decreases methotrexateelimination and increases risk of toxicityNursing Implications: Assess V/S, wound, sputum, urine & stool; WBCthroughout therapy. Observe pt for signs of anaphylaxisDownloaded by Winkle Wong (wkwinkie@gmail.com)

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Why this patient takes this medication: bacterial infectionGeneric: Acetaminophen w/CodeineBrand name : Tylenol #3H JClassification- Acetaminophen (A): antipyretics, non-opioid analgesic POCodeine (C): Opioid agonists, opioid analgesicTherapeutic use:Acetaminophen (A): mild-moderate pain reliefCodeine (C ): management of mild-moderate painAction: A: reduces pain and fever-no inflame. Properties and GI toxicity C:alters perception and response to stimuli, decreases painSafe dosage : Acetaminophen-325mg-650mg q6h Not exceed 3g/day. Codeine-15-60mg q3-6h PRNGeneric: FurosemideBrand name : LasixClassification- Diuretic (increases passing of urine) - loop diureticTherapeutic use;Subsequent mobilization of excess fluids (edema), lowers BPAction: Prevents reabsorption of fluids in the kidneys causing more frequentUrinationSafe dosage : PO: Edema: 20-80 mg/day as a single dose initially, may repeat in6-8 hrs. Hypertension: 40 twice daily initially (when added to regimen, decreasedose of other antihypertensive by 50%)OnsetPeakDuration30 - 60 mins1 - 2 hours6 - 8hoursPatient teaching : Change positions very slowly to minimize orthostatichypotension (OH), take missed doses as soon as possible and DO NOT doubledose. Contact IICP immediately if rash, muscle weakness, cramps, nausea,dizziness, numbness, or tingling of extremitiesAdverse reactions : Blurred vision, dizziness, headache, vertigo, hearing loss,tinnitus (ringing in ears), hypotension, anorexia, constipation, diarrhea, drymouth, dyspepsia (feeling full), increase liver enzymes, nausea, pancreatitis,vomiting, excessive urinationContraindications : Hypersensitivity, cross-sensitivity withthiazides (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 oracute ingestion of alcohol, increase risk of hypokalemia with other diuretics;hypokalemia may increase the risk of digoxin toxicity. NSAID'sNursing Implications: Assess fluid status, monitor BP and pulse, assess fornausea, vomiting and muscle cramps, assess for hearing loss, assess patient forskin rash during therapyOnsetPeakDurationA: 30min1-3 hours3-8 hoursC: 30-45min60-120 minutes4 hoursPatient 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, toleranceContraindications : Severe hepatic impairment/active liver disease, allergy.Alcohol. HypersensitivityPrecautions : A: malnutrition, alcohol abuse (ETOH). liver/kidney failure C:geriatrics, liver/kidney failure, alcohol abuse, pulmonary disease,hypothyroidism, adrenal insufficiencyInteractions : 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 analgesiaNursing Implications: assess for rashes, reassess pain, feverWhy this patient takes this medication: Pain & Fever reliefDownloaded by Winkle Wong (wkwinkie@gmail.com)

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Why this patient takes this medication: To decrease blood pressure.or abdominal crampingAdverse reactions : GI: belching, cramps, distention, flatulence, diarrhea.Endo: hyperglycemia (diabetic patients)Contraindications : Patients on low-galactose dietsPrecautions : Use cautiously in: diabetes mellitus; excessive or prolonged useInteractions : Drug-Drug: should not be used with other laxatives in thetreatment of hepatic encephalopathy (leads to inability to determine optimaldose of lactulose )Nursing Implications: abdominal assessment, monitor BMs. ensure patient hasadequate diet of fluids and fiber.Why this patient takes this medication: to relieve constipationAdverse reactions : Confusion, Sedation, Constipation, nausea,Vomiting, HypotensionContraindications : Hypersensitivity, Head trauma, Severe renal. Hepatic, orpulmonary diseasePrecautions : Hypersensitivity, Head trauma, Severe renal. Hepatic, orpulmonary diseaseInteraction s: CNS depression with alcohol, Antidepressant, Antihistamines,Sedation, HypnoticsNursing Implications: Assess BP, Pulse, and Respiration before and duringAdministration, assess bowel function and pain. Toxicity and overdoesWhy this patient takes this medication: To decrease pain and coughDownloaded by Winkle Wong (wkwinkie@gmail.com)

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Generic: SalbutamolBrandname : Ventolin, AiromirClassification: BronchodilatorsTherapeutic use:Bronchodilator to control & prevent airway obstructionAction; Relaxation of airway smooth muscle subsequent bronchodilationSafe dosage : 1-2 inhalations every 4-6 hours pinOnsetPeakDuration5-15 minutes30-120 minutes3-4 hoursPatient teaching : may cause adverse effects, paradoxical bronchospasm or lossof effectiveness of medicationGeneric: MetoclopramideBrand name : MctoniaClassification: antiemeticTherapeutic use:Eases nausea, constipation, and passage of nasogastric tube.Off label use-hiccups and migrainesAction - Blocks dopamine receptors in chemoreceptor trigger zone of the CNSSafe dosage : 10-15mg 30 min before meals and at bedtime (not to exceed0.5rag/kg/day). A single dose of 20mg may be given preventatively, somerespond to as little as 5mgOnset _________________________Peak ______________________Duration30 - 60 minUnknown1 -2 hoursPatient teaching : Take medication as directed, take missed dose asap. Do notdouble dose. May cause drowsiness; do not drive or perform other activitiesrequiring alertness.Adverse reactions : drowsiness, extrapyramidal reactions; restlessness;neuroleptic malignant syndrome; anxiety; depression, irritability, tardivedyskinesia CV: Arrhythmias; hypertension; hypotension GI: constipation,diarrhea, dry mouth, nauseaContraindications : Hypersensitivity; possible GI obstruction or hemorrhage;history of seizure disorders; Parkinson's disease.Precautions : Use with Caution: depression, diabetes, renal impairment, chronicuse more than 3 monthsInteraction s: CNS depressants - alcohol - antidepressants - antihistamines -opioid analgesics - sedatives/hypnoticsNursing Implications: Assess for nausea, vomiting, abdominal distention, andbowel sounds. Monitor for neuroleptic malignant syndrome (hyperthermia,muscle rigidity, altered consciousness, irregular pulse or BP, tachycardia,diaphoresis)Why this patient takes this medication: NauseatedAdverse reactions : CNS: Nervousness, restlessness, tremor RES: paradoxicalbronchospasm CV: chest pain, angina, High BP. GI: Nausea, vomiting. ENDO:Hyperglycemia.Contraindications : Hypersensitivity to adrenergic aminesPrecautions : Lactation, cardiac disease, seizure disordersInteractions : Concurrent use with other adrenergic agents will've increasedadrenergic 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 ofmedication.Why this patient takes this medication: to prevent or relief of bronchospasmDownloaded by Winkle Wong (wkwinkie@gmail.com)

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Adverse reactions : Suicidal thoughts, lethargy, sedation, blurred vision, dryeyes, dry mouth, hypotension, constipation, arrhythmiasContraindications : Angle closure glaucoma, recent MI or heart problemPrecautions : Increase risk of adverse effects: falls, increase risk of suicidalthoughtsInteractions : Antidepressants, MAO inhibitors, decrease rifampin, CNSdepressants, anticholinergicsNursing Implications: Weight, suicidal tendencies, depression, fasting glucoseand cholesterol levels, monitor BP and pulse prior and post med adminWhy this patient takes this medication: depression and to aid in sleepAdverse reactions : Dizziness, nausea, insomnia, anemia, bleeding, ecchymosisContraindications : Hypersensitivity, major bleeding, heparin inducedthrombocytopeniaPrecautions : Hepatic or renal disease, retinopathy, hypertensionInteraction s’ Drugs that affect platelet count, aspirin, NSAIDS, thrombolytics,chamomille, garlic, ginger, gingkoNursing Implications: Signs of bleeding, increase in thrombosis, hypersensitivityreactionsWhy this patient takes this medication: prevent blood clotsDownloaded by Winkle Wong (wkwinkie@gmail.com)

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Generic: DomperidoneBrand name : MotiliumClassification: gastric stimulantTherapeutic use:improved GImotility. Decreased nausca/vomiting, associatedwith dopamine agonist anti-Parkinson therapyAction: Acts as a peripheral dopamine receptor blocker. Increases GT motility,peristalsis and lower esophageal sphincter pressure. Facilitates gastricemptying and decreases small bowel transit time.Safe dosage : 10 mg 3 to 4 times daily, may be increased to 20 mgGeneric: FragminBrand name : DalteparinClassification: AnticoagulantTherapeutic usePrevention of venous thromboembolism, deep veinthrombosis, and/or pulmonary embolismAction: prevents coagulation of bloodSafe dosage : Depends on the patient's surgery or prevention reason for on themedicationOnset _________________________Peak ______________________DurationRapid4 hoursup to 24 hoursPatient teaching : Advise to report any signs of unusual bleeding, bruising,dizziness, itching, rash, fever, swelling, or difficulty breathing. Instruct on correcttechnique for administrationCloset _______________________________Peak ___________________________DurationUnknown30 minUnknownPatient 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 iffainting appears.Adverse reactions : headache, insomnia, dry mouth, amenorrhea, impotence,hot flushes, rashContraindications : known hypersensitivity and intolerance. Concurrent use ofketoconazolePrecautions : history of breast cancer; hepatic impairment; severe renalimpairmentInteractions : increase blood levels and the risk of cardiovascular toxicity and iscontradicted.Nursing Implications: assess for nausea, vomiting, abdominal distention andbowel.Why this patient takes this medication: management of symptoms associatedwith GI motility disordersAdverse 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 thrombocytopeniaPrecautions : Severe hepatic or renal impairment, untreated hypertension, mayhave increased risk of bleedingInteraction s: Drugs that affect platelet function, NSA1DS. warfarin, aspirin,thrombolytics, chamomile, garlic, ginseng, feverfew, gingerNursing Implications: Signs of bleeding and hemorrhage, monitor forhypersensitivity reactions, injection sites for hematomas, monitor levelsWhy this patient takes this medication .: to prevent blood clotting disordersDownloaded by Winkle Wong (wkwinkie@gmail.com)

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Safe dosage : 40-80 mEq/dayOnset ____________________________Peak ________________________DurationUnknown1-2 hoursunknownPatient teaching : Explain the purpose of the medication and correctconsumption of meds, avoid salt substitutes or low-salt milk or food unlessapproved (salts and certain foods contain potassium)Adverse reactions : Confusion, abdominal pain, diarrhea, flatulence, nausea,vomiting, arrhythmias, black stoolsContraindications■Hyperkalemia, severe renal impairment, untreatedAddison's Disease, severe tissue traumaPrecautions : Cardiac disease, renal impairment, diabetes mellitus,hypomagnesemia, patients receiving potassium sparing drugsInteractions : Potassium sparing drugs, ACE inhibitors, angiotensin 2 receptoragonists, anticholinergicsNursing Implications: Monitor vital signs, Toxicity and overdose ability, labtests: monitor serumWhy this patient takes this medication: hypokalemia. Diuretics can removethe potassium from your blood and potassium is required to supplementO n s e tPeakDuration30 min1-2 hours8-12 hoursPatient teaching : Take med around the clock, finish the drug completely, reportsigns of superinfection, watch for diarrhea, females taking oral contraceptives touse alternative methodsAdverse reactions : Seizures, diarrhea, nausea, rash, anaphylaxis, serum sicknessContraindications : Hypersensitivity to penicillin'sPrecautions : Severe renal insufficiency, infectious mononucleosis,Interaction s: Probenecid, warfarin, oral contraceptivesNursing Implications: Assess for infection, penicillin allergy? Observe for signsand symptom of anaphylaxis, monitor bowel functionWhy this patient takes this medication: bacterial infectionDownloaded by Winkle Wong (wkwinkie@gmail.com)

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Generic: CefTRIAXoneBrand name : RocephinClassification: Anti-infectivesTherapeutic use:Treatment of infectionsAction: Bind to bacterial cell wall membrane, causing cell deathSafe dosage : 1g q 12 hrOnsetPeakDurationRapid1-2 hours12-24 hoursPatient teaching : Take med as directed, report signs of supcrinfcctionGeneric: MetforminBrand name :Classification: AntidiabeticTherapeutic use:Management of type 2 diabetes mellitus, may be used withdiet, insulin, or sulfonylureaAction- Decreases hepatic glucose productionSafe dosage : IV/IM: 10 mg q6-8 hr, PO: 0.05-0.2 mg/kg/doseOnsetPeakDuration10-20 min60-120 min4-6 hoursPatient 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 atelectasisAdverse reactions : Abdominal bloating, diarrhea, nausea, vomiting, lacticacidosisContraindications : Hypersensitivity, hypoxemia, sepsis, hepatic impairmentPrecautions : Concurrent renal disease, geriatric patients, chronic alcohol useInteraction s: Alcohol, iodinated contrast media, digoxin, morphine, calciumchannel blockers, furosemide, glucosamineNursing Implications: Signs and symptoms of hypoglycemic, patients who havebeen well controlled on metformin who develop an illness, advise HC providerof all medications currently onWhy this patient takes this medication: patient needs glycemic controlAdverse reactions : Seizures, diarrhea, nausea, vomiting, cramps, Steven-Johnsons syndrome, rash, uticaria, acute renal failure, hematuria, pain at IMsite, phlebitisContraindications : Hypersensitivity to cephalosporin, serious hypersensitivityto penicillin'sPrecautions : Renal impairment, colitis, diabetesInteractions : Probenecid, loop diuretics, aminoglycosides, NSAIDS, antacids,iron supplements, warfarinNursing Implications: Assess for infection, obtain history, obtain specimen andculture of infection, signs and symptoms of anaphylaxis, monitor bowelfunction, assess for skin rashWhy this patient takes this medication:Downloaded by Winkle Wong (wkwinkie@gmail.com)

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Generic: OxycodoneBrandname:Classification: Opioid analgesicTherapeutic use:Moderate to severe painAclion: Binds to opiate receptors in the CNS. Alters the perception andresponse to the painful stimulusSafe dosage : 5-10 mg every 3-4 hoursOnsetPeakDuration10-15 min60-90 min3-6 hoursPatient teaching : Instruct how and when to ask for pain meds, may causedrowsiness, change positions slowly, notify the HC of a current med use,encourage to turn, cough, and deep breathe every 2 hoursAdverse reactions : Confusion, sedation, dizziness, respiratory depression,constipation, dry mouth, choking, urinary retention, flushing, sweating,physical dependenceContraindications : Hypersensitivity, Alcohol, significant respiratory depressionPrecautions : Head trauma, increased intracranial pressure, undiagnosedabdominal pain, alcoholism, seizures, prostatic hypertrophy, difficultyswallowingInteractions : MAO inhibitors, alcohol, sedative/hypnotics, partial-antagonistopioid analgesics, erythromycinNursing Implications: Type of pain, amount and level, assess vital signs, assessrisk for opioid addictionWhy this patient takes this medication: pain controlGeneric: DimcnhydrinatcBrand name : GravolClassification: Anti-emetics, antihistaminesTherapeutic use:Nausea, vomiting, and vertigo accompanying motion sicknessAclion: Inhibits vestibular stimulation. Has significant CNS depressant,anticholinergic, antihistamine, and antiemetic propertiesSafe dosage : 50-100 mg eveiy 4 hoursOnsetPeakDuration15-60 min1-2 hours3-6 hoursPatient teaching : may cause drowsiness, dry mouth; drink lots of water, goodoral hygiene, avoid concurrent alcohol use, use sunscreenAdverse reactions : Drowsiness, dizziness, headache, anorexia, palpitations,diarrhea, dry mouthContraindications : Hypersensitivity, products containing alcohol; in patientswith known intolerancePrecautions : Angle-closure glaucoma, seizure disorder, prostatic hyperplasiaInteraction s: Antihistamines, alcohol, opioid analgesics, sedative/hypnotics,ototoxic drugs, tricyclic antidepressants, MAO inhibitorsNursing Implications: Assess nausea, vomiting, bowel sounds, and abdominalpain, monitor intake and output levelsWhy this patient takes this medication: to control nauseaDownloaded by Winkle Wong (wkwinkie@gmail.com)

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