MEDICATI MOA RT LABS SIDE NURSING

ON TO EFFECTS RESPONSIBILITIES
REVIEW
Misoprostol Action PO BUN, Frequent Baseline assessment
Replaces protective Hematocr Abdominal Question for possibility of
(Cytotec)
prostaglandins it, CBC pain pregnancy before initiating
consumed with ALT, AST, Diarrhea therapy (Pregnancy
Stage 3 prostaglandin- Hgb, Occasional Category X)
(Also used inhibiting therapies Creatinin Nausea,
in first (e.g., NSAIDs). e Flatulence
trimester to Therapeutic Effect: Dyspepsia
terminate Reduces acid Headache
pregnancy) secretion from gastric
parietal cells,
stimulates
bicarbonate
production from
gastric/duodenal
mucosa.
Uses
Prevention of NSAID-
induced gastric ulcers
and in pts at high risk
for developing gastric
ulcer/gastric ulcer
complications
Chemical termination
of pregnancy (in
conjunction with
mifepristone)
Bicitra Action PO sodium Nausea, During pregnancy, this
levels vomiting, medication should be used
(Cytra-2,
Liqui-Dual This medication is pH diarrhea, only when clearly needed.
Citra, used to make the (acidity) and stomach This medication may
Oracit) urine less acidic. of your pain worsen high blood
GI System urine pressure during pregnancy
(electrolyte This medication can blood (toxemia of pregnancy).
modifier) also prevent and electrolyt
treat certain e
Stage 1 metabolic problems bicarbona
(prior to (acidosis) caused by te levels
epidural) kidney disease.

Citric acid and citrate

salts (which
contain potassium an
 d sodium)

Methergine Action PO calcium Nausea, Baseline assessment

Stimulates alpha- levels uterine Determine baseline serum
(Methylergono adrenergic, serotonin cramping, calcium level, B/P, pulse.
vine)
receptors, producing vomiting Assess for any evidence of
arterial bleeding before
Stage 2 vasoconstriction administration.
Causes vasospasm of Intervention/evaluation
(, given coronary arteries Monitor uterine tone,
after Directly stimulates bleeding, B/P, pulse
delivery, uterine muscle. q15min until stable (about
shortens 3 rd 12 hrs)
stage of Assess extremities for
labor) color, warmth, movement,
pain.
Report chest pain
promptly
Provide support with
ambulation if dizziness
occurs.

Magnesium Action IV Mg, Common Baseline assessment

Essential for enzyme IM electrolyt Assess if pt is sensitive to
Sulfate Muscle
activity, nerve PO es magnesium.
(Epsom Salt) Weakness
conduction, muscle Antacid: Assess GI pain
Stage 1 Lack of
contraction (duration, location, quality,
Energy
Maintains and time of occurrence, relief
Blurry Vision
restores magnesium with food,
Slurred
levels. causative/excacerbative
Speech
Anticonvulsant: factors).
Headache
Blocks neuromuscular Laxative: Assess for weight
Nausea and
transmission, amount loss, nausea, vomiting, and
Vomiting
of acetylcholine history of recent
Flushing
released at motor abdominal surgery.
end plate. Systemic: Assess renal
Produces seizure function, serum
control magnesium.
Uses Intervention/evaluation
Treatment/prevention Antacid: Assess for relief of
of hypomagnesemia gastric distress. Monitor
Prevention and renal function (esp. if
treatment of seizures dosing is long term or
in eclampsia; frequent).
Torsade de pointes Laxative: Monitor daily
(atypical ventricular pattern of bowel activity,
tachycardia); stool consistency.
 Treatment of Maintain adequate fluid
arrhythmias due to intake. Systemic: Monitor
hypomagnesemia renal function, magnesium
(ventricular levels, EKG for cardiac
tachycardia/ventricul function.
ar fibrillation) Test patellar reflexes (knee
jerk reflexes) before giving
repeat parenteral doses
(used as indication of CNS
depression; suppressed
reflexes may be sign of
impending respiratory
arrest).
Patellar reflex must be
present, respiratory rate
should be 16/min or over
before each parenteral
dose. Initiate seizure
precautions.
Oxytocin Uses IV electrolyt Occasional: Baseline assessment
Induction of labor at es Tachycardia, Assess baselines for vital
(Pitocin, term, control of post- premature signs, B/P, fetal heart rate.
Syntocinon) partum bleeding. ventricular Determine frequency,
Adjunct in contractions, duration, strength of
Endocrine management of hypotension, contractions.
system abortion. nausea, Intervention/evaluation
(pituitary vomiting. Monitor B/P, pulse,
drug) Rare: Nasal: respirations, fetal heart
Lacrimation/ rate, intrauterine pressure,
(Stage 1 & tearing, contractions (duration,
3) nasal strength, frequency)
irritation, q15min. Notify physician of
rhinorrhea, contractions that last
unexpected longer than 1 min, occur
uterine more frequently than
bleeding/con every 2 min, or stop.
tractions. Maintain careful I&O; be
alert to potential water
intoxication. Check for
blood loss.
Terbutaline Action IV Frequent Baseline assessment
Stimulates beta2- PO (38%23%): Bronchospasm: Offer
(Brethine) adrenergic receptors, Tremor, emotional support (high
resulting in relaxation anxiety incidence of anxiety due to
(Bricanyl) of uterine, bronchial Occasional difficulty in breathing,
smooth muscle (11%10%): Sympathomimetics
Therapeutic Effect: Drowsiness, response to drug). Preterm
Inhibits uterine headache, labor: Assess baseline
(CNS
system. contractions
Stimulant) Relieves
bronchospasm,
(Stage 2) reduces airway
resistance.
Uses
Symptomatic relief of
reversible
bronchospasm due to
bronchial asthma,
bronchitis,
emphysema
Delays premature
labor in pregnancies
between 20 and 34
wks
Penicillin Action IM
Inhibits bacterial cell
G
wall synthesis by
benzathine
binding to one or
more of the penicillin-
(Stage 2) binding proteins of
bacteria.
Therapeutic Effect:
Bactericidal. Uses
Treatment of mild to
moderate severe
infections caused by
organisms
susceptible to low
concentrations of
penicillin including
streptococcal (Group
A) upper respiratory
infections, syphilis,
yaws. Prophylaxis of
nausea, maternal pulse, B/P,
heartburn, frequency and duration of
dizziness contractions, fetal heart
rate.
Intervention/evaluation
Bronchospasm: Monitor
rate, depth, rhythm, type
of respiration; quality, rate
of pulse. Assess lung
sounds for rhonchi,
wheezing, and rales.
Monitor ABGs. Observe
lips, fingernails for
cyanosis (blue or dusky
color in light-skinned pts;
gray in dark-skinned pts).
Observe for clavicular
retractions, hand tremor.
Evaluate for clinical
improvement (quieter,
slower respirations,
relaxed facial expression,
and cessation of clavicular
retractions). Preterm labor:
Monitor for frequency,
duration, strength of
contractions. Diligently
monitor fetal heart rate.
CBC, Baseline assessment
urinalysis Occasional: Question for history of
, renal Lethargy, allergies, particularly
function fever, penicillins, cephalosporins.
tests. dizziness,
rash, pain at
injection
site. Rare:
Seizures,
interstitial
nephritis.
 infections caused by
susceptible
organisms (e.g.,
rheumatic fever
prophylaxis).

Penicillin G Action IV CBC, Baseline assessment

Inhibits bacterial cell urinalysis Occasional: Question for history of
potassium
wall synthesis by , renal Lethargy, allergies, particularly
binding to one or function fever, penicillins, cephalosporins.
(Stage 2) more of the penicillin- tests. dizziness,
binding proteins of rash, pain at
bacteria. injection
Therapeutic Effect: site. Rare:
Bactericidal. Seizures,
Uses interstitial
Treatment of nephritis.
susceptible infections
due to gram-positive
organisms, gram-
negative organisms,
actinomycosis,
clostridium,
diphtheria, Listeria,
N. meningitidis,
pasteurella including
anthrax, endocarditis,
respiratory tract
infections,
meningitis,
neurosyphilis,
skin/skin structure
infections.
Penicillin V Action PO Hgb Frequent: Baseline assessment
Inhibits cell wall levels Mild Question for history of
potassium
synthesis by binding hypersensiti allergies, particularly
to bacterial cell vity reaction penicillins, cephalosporins.
membranes. (chills, fever, Intervention/evaluation
(Stage 3) Therapeutic Effect: rash), Hold medication, promptly
Bactericidal. nausea, report rash
Uses vomiting, (hypersensitivity), diarrhea
Treatment of mild to diarrhea. (with fever, abdominal
moderate infections Rare: pain, mucus or blood in
of respiratory tract, Bleeding, stool may indicate
skin/skin structure, allergic antibiotic-associated
otitis media, reaction. colitis). Monitor I&O,
necrotizing ulcerative urinalysis, renal function
 gingivitis; prophylaxis tests for nephrotoxicity. Be
for rheumatic fever, alert for superinfection:
dental procedures. fever, vomiting, diarrhea,
anal/genital pruritus, oral
mucosal change
(ulceration, pain, and
erythema). Review Hgb
levels; check for bleeding
(overt bleeding,
ecchymosis, swelling of
tissue).

Betamethas Action: IM Calcium Frequent: Baseline assessment

Controls rate of PO levels, Systemic: Question for
one
protein synthesis, TOPICA Hematocr Increased hypersensitivity to any
(Celestone, depresses migration L it, Hgb, appetite, corticosteroid, sulfite.
Celestone of polymorphonuclear RBC, PT, abdominal Obtain baseline values for
Phosphate, leukocytes/fibroblasts PTT distention, height, weight, B/P, serum
Celestone , reverses capillary nervousness glucose, electrolytes.
Soluspan) permeability, , insomnia, Obtain baseline results of
prevents or controls false sense initial tests (tuberculosis
(Stage 3)
inflammation. of well- [TB] skin test, X-rays,
Therapeutic Effect: being. EKG).
Decreases tissue Topical: Intervention/evaluation
response to Burning, Monitor B/P, blood glucose,
inflammatory stinging, electrolytes.
process. pruritus. Apply topical preparation
Uses sparingly. Do not use on
Systemic: broken skin or in areas of
Anti-inflammatory, infection.
immunosuppressant, Do not apply to wet skin,
corticosteroid face, and inguinal areas.
replacement therapy.
Topical:
Relief of
inflammatory and
pruritic dermatoses.
Foam: Relief of
inflammation, itching
 associated with
dermatosis.
Ropivacaine Action Nerve
Most local block
(Naropin,
anesthetics fall into
Naropin
one of two groups:
Polyamp, esters or amides.
Naropin SDV, Both provide
Naropin anesthesia and
Novaplus) analgesia by
reversibly binding to
and blocking sodium
(Na) channels. This
slows the rate of
depolarization of the
nerve action
potential; thus,
propagation of the
electrical impulses
needed for nerve
conduction is
prevented.
Uses
Local anesthetics
suppress pain by
blocking impulses
along axons.
Suppression of pain
does not cause
generalized
depression of the
entire nervous
system. Local
anesthetics may be
given topically and by
injection (local
infiltration, peripheral
nerve block [axillary], IV
regional [Bier block],
epidural, and spinal).
Demerol Action
Binds to opioid
(meperidine) receptors within CNS.
Therapeutic Effect:
Alters pain
(Isonipecain
e) perception, emotional
response to pain.
Uses
Hypotension Baseline assessment
, Pt should be in recumbent
bradycardia, position before drug is
headache, administered by parenteral
pruritus, route. Assess onset, type,
nausea, location, duration of pain.
vomiting, Obtain vital signs before
dizziness, giving medication. If
anxiety, respirations are 12/min or
tinnitus, less (20/min or less in
dyspnea, children), withhold
cardiac medication, contact
arrest, physician. Effect of
arrhythmias, medication is reduced if
seizures, full pain recurs before next
syncope, dose.
chills Intervention/evaluation
Monitor vital signs 1530
min after subcutaneous/IM
dose, 510 min after IV
dose (monitor for
hypotension, change in
rate/quality of pulse).
Monitor pain level,
sedation response. Monitor
daily pattern of bowel
activity, stool consistency;
avoid constipation. Check
for adequate voiding.
Initiate deep breathing,
coughing exercises,
particularly in pts with
pulmonary impairment.
Therapeutic serum level: 100
550 ng/ml; toxic serum level:
greater than 1,000 ng/ml.
IV plasma Frequent: Baseline assessment
IM amylase Sedation, Pt should be in recumbent
PO & lipase hypotension position before drug is
concentrat (including administered by parenteral
ion orthostatic route. Assess onset, type,
hypotension location, duration of pain.
), Obtain vital signs before
diaphoresis, giving medication. If
 Relief of moderate to facial respirations are 12/min or
(Pethidine) severe pain. flushing, less (20/min or less in
dizziness, children), withhold
(Neperdine) nausea, medication, contact
vomiting, physician. Effect of
Analgesic constipation. medication is reduced if
full pain recurs before next
NARCAN dose.
is Intervention/evaluation
antidote Monitor vital signs 1530
min after subcutaneous/IM
dose, 510 min after IV
dose (monitor for
hypotension, change in
rate/quality of pulse).
Monitor pain level,
sedation response. Monitor
daily pattern of bowel
activity, stool consistency;
avoid constipation. Check
for adequate voiding.
Initiate deep breathing,
coughing exercises,
particularly in pts with
pulmonary impairment.
Therapeutic serum level:
100550 ng/ml; toxic
serum level: greater than
1,000 ng/ml.
Morphine Action IV plasma Ambulatory Baseline assessment
Binds with opioid amylase pts, that not Pt should be in recumbent
sulfate
receptors within CNS & lipase in severe position before drug is
Therapeutic Effect: concentrat pain may given by parenteral route.
(Avinza,
Alters pain ion experience Assess onset, type,
Kadian,
perception, emotional nausea, location, duration of pain.
Morphine IR, response to pain vomiting Obtain vital signs before
MS Contin, Uses more giving medication. If
MSIR, Relief of moderate to frequently respirations are 12/min or
Oramorph severe, acute, or than those less (20/min or less in
chronic pain; in supine children), withhold
SR, Roxanol)
analgesia during position or medication, contact
NARCAN labor who have physician. Effect of
is Drug of choice for severe pain. medication is reduced if
antidote pain due to MI, Frequent: full pain recurs before next
dyspnea from Sedation, dose.
pulmonary edema decreased Intervention/evaluation
not resulting from B/P Monitor vital signs 510
chemical respiratory (including min after IV administration,
 irritant orthostatic 1530 min after
DepoDur: Epidural hypotension subcutaneous, IM. Be alert
(lumbar) single dose ), for decreased respirations,
management of diaphoresis, B/P. Check for adequate
surgical pain. facial voiding.
Infumorph: Use in flushing, Monitor daily pattern of
devices for managing constipation, bowel activity and stool
intractable chronic dizziness, consistency.
pain drowsiness,
nausea,
vomiting..
ketorolac Action IV Frequent Baseline assessment
Inhibits prostaglandin IM BUN, (17%12%): Assess onset, type,
(Toradol) synthesis, reduces PO serum Headache, location, duration of pain.
prostaglandin levels creatine, nausea, Obtain baseline
in aqueous humor. CBC with abdominal renal/hepatic function
Therapeutic Effect: diff, cramps/pain, tests.
Immune Reduces intensity of electrolyt dyspepsia Intervention/evaluation
system pain stimulus, es, (heartburn, Monitor renal/hepatic
drug, Anti- reduces intraocular bleeding indigestion, function tests, urinary
inflammator inflammation. time, & epigastric output. Monitor daily
y& Uses liver pain). pattern of bowel activity,
Disease- PO, injection: Short- function stool consistency. Observe
modulating term (5 days or less) tests for occult blood loss.
Agent relief of mild to Assess for therapeutic
moderate pain. response: relief of pain,
Ophthalmic: Relief of stiffness, swelling;
ocular itching due to increased joint mobility,
seasonal allergic reduced joint tenderness,
conjunctivitis. improved grip strength. Be
Treatment postop for alert to signs of bleeding
inflammation (may also occur with
following cataract ophthalmic route due to
extraction, pain systemic absorption).
following incisional
refractive surgery.
Hydralazine Action PO None Frequent: Baseline assessment
Competes with IM significan Drowsiness, Anxiety: Offer emotional
(Apresoline)
histamine for t dry mouth, support to anxious pt.
receptor sites in GI marked Assess motor responses
tract, blood vessels, discomfort (agitation, trembling,
respiratory tract with IM tension), autonomic
Diminishes vestibular injection. responses (cold/clammy
stimulation, Occasional: hands, diaphoresis).
depresses Dizziness, Antiemetic: Assess for
labyrinthine function. ataxia, dehydration (poor skin
Therapeutic Effect: asthenia turgor, dry mucous
Produces anxiolytic, (loss of membranes, and
 anticholinergic, strength, longitudinal furrows in
antihistaminic, energy), tongue).
analgesic effects; slurred Intervention/evaluation
relaxes skeletal speech, For those on long-term
muscle; controls headache, therapy, hepatic/renal
nausea, vomiting. agitation, function tests, blood
Uses increased counts should be
Treatment of anxiety, anxiety. performed periodically.
preop sedation, Monitor lung sounds for
antipruitic signs of hypersensitivity
reaction. Monitor serum
electrolytes in pts with
severe vomiting. Assess
for paradoxical reaction,
particularly during early
therapy. Assist with
ambulation if drowsiness,
light-headedness occur.

Nubain Action IV plasma Frequent Baseline assessment

Binds with opioid IM amylase Sedation. Obtain vital signs before
(Nalbuphine )
receptors within CNS. & lipase Occasional giving medication. If
Short acting concentrat
May displace opioid Diaphoresis, respirations are 12/min or
agonists, ion cold/clammy less (20/min or less in
competitively skin, children), withhold
inhibiting their nausea, medication, contact
action; may vomiting, physician. Assess onset,
precipitate dizziness, type, location, duration of
withdrawal vertigo, dry pain. Effect of medication
symptoms. mouth, is reduced if full pain
Therapeutic Effect: headache. recurs before next dose.
Alters pain Low abuse potential.
perception, emotional Intervention/evaluation
response to pain. Monitor for change in
Uses respirations, B/P,
Relief of moderate to rate/quality of pulse.
severe pain, preop Monitor daily pattern of
analgesia, obstetric bowel activity and stool
analgesia, adjunct to consistency. Initiate deep
anesthesia. OFF- breathing, coughing
LABEL: Opioid- exercises, particularly in
induced pruritus. pts with pulmonary
 impairment. Assess for
clinical improvement,
record onset of relief of
pain. Consult physician if
pain relief is not adequate.
Ritodrine Action PO Frequent: Baseline assessment
Inhibits HIV-1 and GI Pts beginning combination
HIV-2 proteases, disturbances therapy with ritonavir and
rendering these (abdominal nucleosides may promote
used to stop
enzymes incapable of pain, GI tolerance by beginning
premature
processing anorexia, ritonavir alone and
labor
polypeptide diarrhea, subsequently adding
precursors leading to nausea, nucleosides before
production of vomiting), completing 2 wks of
noninfectious, circumoral ritonavir monotherapy.
immature HIV and Obtain baseline laboratory
particles. peripheral testing, esp. serum hepatic
Therapeutic Effect: paresthesias function tests, triglycerides
Slows HIV replication, , altered before beginning ritonavir
reducing progression taste, therapy and at periodic
of HIV infection. headache, intervals during therapy.
Uses Treatment of dizziness, Offer emotional support to
HIV infection in fatigue, pt/family.
combination with asthenia Intervention/evaluation
other antiretroviral (loss of Closely monitor for
agents. strength, evidence of GI
energy). disturbances, neurologic
abnormalities (particularly
paresthesias). Monitor
serum hepatic function
tests, serum glucose, CD4
cell count, plasma levels of
HIV RNA.

Calcium Action: IV electrolyt Frequent: Baseline assessment

Essential for function, es, serum PO: Chalky Assess
Gluconate
integrity of nervous, Mg, Ph, taste. B/P, EKG and cardiac
(Tums) muscular, skeletal &K Parenteral: rhythm, renal function,
systems. Plays an concentra Pain, rash, serum magnesium,
GI Drug, important role in tions redness, phosphate, potassium
electrolyte normal cardiac/renal burning at concentrations.
modifier function, respiration, injection Intervention/evaluation
 blood coagulation, site, Monitor B/P, EKG, cardiac
Therapeutic cell membrane and flushing, rhythm, serum
Effect: capillary permeability. feeling of magnesium, phosphate,
Replaces Assists in regulating warmth, potassium, renal function.
calcium in release/storage of nausea, Monitor serum, urine
deficiency neurotransmitters/hor vomiting, calcium concentrations.
states; mones. diaphoresis, Monitor for signs of
controls Neutralizes/reduces hypotension hypercalcemia.
hyperphosph gastric acid
atemia in (increases pH).
end-stage Calcium acetate:
renal disease, Combines with
relieves dietary phosphate,
heartburn, forming insoluble
indigestion. calcium phosphate.
Uses:
Parenteral: Acute
hypocalcemia (e.g.,
neonatal
hypocalcemia tetany,
alkalosis), electrolyte
depletion, cardiac
arrest (strengthens
myocardial
contractions),
hyperkalemia
(reverses cardiac
depression),
Hypermagnesemia
(aids in reversing
CNS depression).
Stadol Action IV plasma Frequent: Baseline assessment
Binds to opiate Nasal amylase Parenteral: Obtain vital signs before
(Butorphanol)
receptor sites in CNS. Spray & lipase Drowsiness, giving medication. If
Short acting concentrat
Reduces intensity of (Stadol dizziness. respirations are 12/min or
pain stimuli incoming NS): ion Nasal: less (20/min or less in
from sensory nerve 10 Nasal children), withhold
endings. Therapeutic mg/ml. congestion medication, contact
Effect: Alters pain physician. Assess onset,
perception, emotional . type, location, duration of
response to pain pain. Effect of medication
Uses is reduced if full pain
Management of pain recurs before next dose.
(including postop Protect from falls. During
pain). Nasal: labor, assess fetal heart
Management of tones, uterine
moderate to severe contractions.
pain, including Intervention/evaluation
 migraine headache Monitor for change in
pain. Parenteral: respirations, B/P,
Preop, preanesthetic rate/quality of pulse.
medication, Initiate deep breathing,
supplement balanced coughing exercises,
anesthesia, relief of particularly in those with
pain during labor. pulmonary impairment.
Change pts position q2
4h. Assess for clinical
improvement, record onset of
relief of pain.
Phytonadio IM PT Occasional: Intervention/evaluation
Action IV IR Pain, Monitor PT, international
ne Aqua
PO soreness, normalized ratio (INR)
(Vitamin Promotes hepatic swelling at routinely in those taking
formation of IM injection anticoagulants. Assess skin
K 1)
coagulation factors II, site, pruritic for ecchymoses,
VII, IX, X. Therapeutic erythema petechiae. Assess gums for
stage 2
Effect: (with gingival bleeding,
First hour repeated erythema. Assess urine for
Essential for normal injections), hematuria. Assess Hct,
after birth
clotting of blood. facial platelet count, urine/stool
flushing, culture for occult blood.
Uses altered Assess for decrease in B/P,
Cardiovascu taste. increase in pulse rate,
lar Drug, Prevention, treatment complaint of
Affecting of hemorrhagic states abdominal/back pain,
coagulation in neonates; antidote severe headache (may be
for hemorrhage evidence of hemorrhage).
Antidote induced by oral Question for increase in
for anticoagulants, amount of discharge
WARFARIN hypoprothrombinemi during menses. Assess
c states due to peripheral pulses. Check
vitamin K deficiency. for excessive bleeding
Will not counteract from minor cuts, scratches.
anticoagulation effect
of heparin.
PNV Prenatal vitamins are PO None Avoid taking any other
used to provide the significan Upset multivitamin product
additional vitamins t stomach; within 2 hours before or
needed after you take your
prenatal vitamins. Taking
during pregnancy. headache;
similar vitamin products
Minerals may also be or together at the same time
contained in prenatal can result in a vitamin
multivitamins. Unusual or overdose or serious side
unpleasant effects.
taste in your
mouth. Avoid the regular use of
 salt substitutes in your diet
if your multivitamin
contains potassium. If you
are on a low-salt diet, ask
your doctor before taking a
vitamin or mineral
supplement.

Do not take this

medication with milk, other
dairy products, calcium
supplements, or antacids
that contain calcium.
Calcium may make it
harder for your body to
absorb certain ingredients
of the prenatal vitamin.

Iron Sulfate Uses PO Serum Constipation Although symptoms of iron

Ferrous sulfate
(ferrous
provides the iron
sulfate)
needed by the body
to produce red blood
cells.
It is used to treat or
prevent iron-
deficiency anemia, a
condition that occurs
when the body has
too few red blood
cells because of
pregnancy, poor diet,
excess bleeding, or
other medical
problems.
Ducolax Action PO
iron, total Stomach deficiency usually improve
iron- Upset within a few days, you may
binding have to take ferrous
capacity, sulfate for 6 months if you
reticulocy have severe iron
te count, deficiency.
Hgb, This medication should be
ferritin. taken on an empty
stomach, at least 1 hour
before or 2 hours after
eating.
Ferrous sulfate drops come
with a special dropper for
measuring the dose. Ask
your pharmacist to show
you how to use it. The
drops may be placed
directly in the mouth or
mixed with water or fruit
juice (not with milk).
electrolyt Frequent: Intervention/evaluation
 Direct effect on es Some Encourage adequate fluid
colonic smooth degree of intake. Assess bowel
musculature by abdominal sounds for peristalsis.
stimulating discomfort, Monitor daily pattern of
intramural nerve nausea, mild bowel activity and stool
plexi. Therapeutic cramps, consistency; record time of
GI system, Effect: Promotes fluid faintness. evacuation. Assess for
Laxative/ and ion accumulation Occasional: abdominal disturbances.
bowel in colon increasing Rectal Monitor serum electrolytes
preps/ peristalsis, producing administrati in those exposed to
Anitflatulen laxative effect. on: burning prolonged, frequent, or
ts Uses of rectal excessive use of
Treatment of mucosa, medication.
constipation, colonic mild
evacuation before proctitis.
examinations or
procedures.
(Reglan Action IV ALERT Baseline assessment
(Metocloprami Stimulates motility of PO Doses of 2 Antiemetic: Assess for
upper GI tract
de) mg/kg or dehydration (poor skin
Decreases reflux into
Routes greater, or turgor, dry mucous
esophagus. Raises
threshold activity in increased membranes, and
chemoreceptor trigger length of longitudinal furrows in
zone therapy, tongue). Assess for
Therapeutic Effect: may result nausea, vomiting,
Accelerates intestinal
in a greater abdominal distention, and
transit, gastric emptying.
Relieves nausea, incidence of bowel sounds.
vomiting. side effects. Intervention/evaluation
Uses Frequent Monitor for anxiety,
Facilitates placement of (10%): restlessness,
enteral feeding tubes;
Drowsiness, extrapyramidal symptoms
stimulates gastric
emptying, intestinal
restlessness, (EPS) during IV
transit in conjunction fatigue, administration. Monitor
with radiography; lethargy daily pattern of bowel
treatment of activity and stool
gastroparesis, consistency. Assess skin
gastroesophogeal reflux
for rash. Evaluate for
disease (GERD); prevents
or treats cancer therapeutic response from
chemotherapy-induced gastroparesis (nausea,
nausea, vomiting; vomiting, bloating).
prevents or treats postop Monitor renal function, B/P,
nausea, vomiting. Orally- heart rate.
Disintegrating Tablets:
Treatment of gastroparesis,
GERD.
Methyldopa ORAL You should not take
Lowers blood slow heart this medication if you are
(Aldomet)
pressure by rate; allergic to methyldopa, or
decreasing the levels if you have liver disease
 (especially cirrhosis), or a
of certain chemicals pale or history of liver problems
in your blood. This yellowed caused by taking
allows your blood skin, fever, methyldopa. Do not use
vessels (veins and confusion or methyldopa if you have
arteries) to relax weakness; used an MAO inhibitor such
(widen) and your as furazolidone (Furoxone),
heart to beat more nausea, isocarboxazid (Marplan),
slowly and easily. upper phenelzine (Nardil),
stomach rasagiline (Azilect),
Methyldopa is used to pain, itching, selegiline (Eldepryl,
treat hypertension (hi loss of Emsam, Zelapar), or
gh blood pressure). appetite, tranylcypromine (Parnate)
dark urine, in the last 14 days. A
clay-colored dangerous drug interaction
stools, could occur, leading to
jaundice serious side effects.
(yellowing of
the skin
or eyes);

skin rash,
bruising,
severe
tingling,
numbness,
pain, muscle
weakness;

feeling short
of breath,
even with
mild
exertion;

swelling in
your hands,
ankles, or
feet;

easy bruisin
g, unusual
bleeding
(nose,
mouth,
vagina, or
rectum),
purple or red
 pinpoint
spots under
your skin; or

Muscle
movements
you cannot
control.

Procardia Action PO LFT, RFT, Frequent Baseline assessment

Inhibits calcium ion SUB CBC, Peripheral Concurrent therapy of
(Nifedipine) movement across cell LINGUA serum edema, sublingual nitroglycerin
membranes, L glucose, headache, may be used for relief of
Cardiovascu depressing K flushed skin, anginal pain
lar system, contraction of dizziness. Record onset, type (sharp,
Affecting cardiac, vascular Occasional dull, squeezing), radiation,
contractility smooth muscle Nausea, location, intensity,
/ rhythm/ Therapeutic Effect: shakiness, duration of anginal pain;
circulating Increases heart rate, muscle precipitating factors
blood cardiac output cramps/pain, (exertion, emotional
volume Decreases systemic drowsiness, stress)
vascular resistance, palpitations, Check B/P for hypotension
B/P nasal immediately before giving
Uses congestion, medication.
 Treatment of angina cough, Intervention/evaluation
due to coronary dyspnea, Assist with ambulation if
artery spasm wheezing. light-headedness,
(Prinzmetals variant dizziness occurs
angina), chronic Assess for peripheral
stable angina (effort- edema. Assess skin for
associated angina) flushing. Monitor serum
Extended-release hepatic enzymes,
Treatment of signs/symptoms of CHF.
essential
hypertension
Bupivacaine Nerve Mild Baseline assessment
Inducing spinal block dizziness or Pt should be in recumbent
(Marcaine anesthesia for drowsiness. position before drug is
HCl, Marcaine certain medical or administered by parenteral
Spinal, surgical procedures. route. Assess onset, type,
Sensorcaine, location, duration of pain.
Sensorcaine- Bupivacaine Solution Obtain vital signs before
MPF, is an anesthetic. It giving medication. If
Sensorcaine- works by blocking the respirations are 12/min or
MPF Spinal) generation and less (20/min or less in
conduction of nerve children), withhold
impulses. medication, contact
physician. Effect of
medication is reduced if
full pain recurs before next
dose.
Intervention/evaluation
Monitor vital signs 1530
min after subcutaneous/IM
dose, 510 min after IV
dose (monitor for
hypotension, change in
rate/quality of pulse).
Monitor pain level,
sedation response. Monitor
daily pattern of bowel
activity, stool consistency;
avoid constipation. Check
for adequate voiding.
Initiate deep breathing,
coughing exercises,
particularly in pts with
pulmonary impairment.
Therapeutic serum level:
100550 ng/ml; toxic
serum level: greater than
1,000 ng/ml.
 Action IV plasma Frequent: Baseline assessment
Fentanyl
Binds to opioid receptors in IM amylase & IV: Postop Resuscitative equipment, opiate
( Fentora, CNS, reducing stimuli from BUCAL lipase drowsiness, antagonist (naloxone 0.5 mcg/kg)
sensory nerve endings, nausea, must be available. Establish
Onsolis)
inhibits ascending pain vomiting. baseline B/P, respirations. Assess
CNS,
pathways. Therapeutic Transdermal type, location, intensity, duration
Analgesics
Effect: Alters pain (10%3%): of pain.
reception, increases pain Headache, Intervention/evaluation
NARCAN is
threshold. pruritus, Assist with ambulation.
antidote
Uses nausea, Encourage post-op pt to turn,
For sedation, pain relief, vomiting, cough, deep breathe q2h. Monitor
preop medication; adjunct diaphoresis, respiratory rate, B/P, heart rate,
to general or regional dyspnea, oxygen saturation. Assess for
anesthesia. Duragesic: confusion, relief of pain.
Management of chronic dizziness,
pain (transdermal). Actiq: drowsiness,
Treatment of breakthrough diarrhea,
pain in chronic cancer or constipation,
AIDS-related pain. Fentora: decreased
Breakthrough pain in pts appetite.
on chronic opioids. Onsolis: Occasional: IV:
Breakthrough pain in pts Postop
with cancer currently confusion,
receiving opioids and blurred vision,
tolerant to opioid therapy. chills,
orthostatic
hypotension,
constipation,
difficulty
urinating.
Transdermal
(3%1%): Chest
pain,
arrhythmias,
erythema,
pruritus,
syncope,
agitation, skin
irritations.

Action PO Serum Expected: Baseline assessment

Phenergan
Antihistamine: Inhibits IV electrolytes Drowsiness, Assess allergy symptoms. Assess
histamine at histamine , serum disorientation; B/P, pulse for bradycardia,
(Promethazin receptor sites. Antiemetic: bilirubin, hypotension, tachycardia if pt is given
e) Diminishes vestibular AST, ALT confusion, parenteral form. If used as
stimulation syncope in antiemetic, assess for
GI System, Depresses labyrinthine elderly dehydration (poor skin turgor, dry
Antiemetics/ function Frequent: mucous membranes, and
Antihistamine Acts on chemoreceptor Dry mouth, longitudinal furrows in tongue).
trigger zone nose, throat; Intervention/evaluation
Sedative-hypnotic: urinary Monitor serum electrolytes in pts
Produces CNS depression retention; with severe vomiting. Assist with
by decreasing stimulation thickening of ambulation if drowsiness, light-
to brain stem reticular bronchial headedness occurs. Monitor for
formation secretions relief of nausea, vomiting, allergic
Therapeutic Effect: symptoms
Prevents allergic responses
mediated by histamine
 (urticaria, pruritus).
Prevents, relieves
nausea/vomiting
Produces mild sedative
effect
Uses
Treatment of allergic
conditions,
Motion sickness,
Nausea
Vomiting
May be used as mild
sedative
RhoGAM Action
Prevent production of anti-
Rh(D) antibodies in Rh(D)-
negative patients who
were exposed to Rh(D)-
(RHo (D) positive blood. Increase
immune platelet counts in patients
with ITP. Therapeutic
globulin)
Effects: Prevention of
antibody response and
hemolytic disease of the
newborn (erythroblastosis
fetalis) in future
pregnancies of women who
have conceived a Rh (D)-
positive fetus. Prevention
of Rh(D) sensitization
following transfusion
accident. Decreased
bleeding in patients with
ITP.
Zofran Action
(Ondansetron Blocks serotonin,
IV CNS: dizziness, Assessment
IM headache. IV: Assess vital signs periodically
CV: during therapy in patients
hypertension, receiving IV Rh(D) immune
hypotension. globulin .ITP: Monitor patient for
Derm: rash. signs and symptoms of
GI: diarrhea, intravascular hemolysis (IVH)
nausea, (back pain, shaking chills, fever,
vomiting. hemoglobinuria), anemia, and
Hemat: ITP: renal insufficiency. If transfusions
anemia, are required, use Rh(D) negative
intravascular packed red blood cells to prevent
hemolysis. exacerbation of IVH.
MS: arthralgia, Lab Test Considerations:
myalgia. Local: Pregnancy: Type and crossmatch
pain at injection of mother and newborns cord
site. blood must be performed to
Misc: fever. determine need for medication.
Mother must be Rh (D)-negative
and Du-negative. Infant must be
Rh(D)-positive. If there is doubt
regarding infants blood type or if
father is Rh(D)-positive,
medication should be given. An
infant born to a woman treated
with Rh(D) immune globulin
antepartum may have a weakly
positive direct Coombs test result
on cord or infant blood.ITP:
Monitor platelet counts, RBC
counts, hemoglobin, and
reticulocyte levels to determine
effectiveness of therapy .
IV Serum Frequent Baseline assessment
PO electrolyt (13%5%): Assess degree of nausea,
) both peripherally on es, serum Anxiety, vomiting. Assess for
vagal nerve terminals bilirubin, dizziness, dehydration if excessive
and centrally in AST, ALT drowsiness, vomiting occurs (poor skin
GI System, chemoreceptor headache, turgor, dry mucous
Antiemetics trigger zone fatigue, membranes, and
/ Therapeutic Effect: constipation, longitudinal furrows in
Antihistami Prevents diarrhea, tongue). Provide emotional
ne nausea/vomiting hypoxia, support.
Uses urinary Intervention/evaluation
Prevention/treatment retention. Monitor pt in environment.
of nausea/vomiting Occasional Assess bowel sounds for
due to cancer (4%2%): peristalsis. Provide
chemotherapy Abdominal supportive measures.
(including high-dose pain, Assess mental status.
cisplatin) xerostomia, Monitor daily pattern of
Prevention of postop fever, bowel activity and stool
nausea, vomiting. feeling of consistency.
Prevention of cold, Record time of evacuation
radiation-induced redness/pain
nausea, vomiting. at injection
Treatment of postop site,
nausea, vomiting. paresthesia,
OFF-LABEL: asthenia
Postanesthetic (lack of
shivering, vomiting strength,
due to viral illness energy)
Treatment of early- Rare (1%):
onset alcoholism, Hypersensiti
Hyperemesis vity reaction
gravidarum (rash,
pruritus),
blurred
vision

Motrin Action PO Serum, Occasional: Baseline assessment

(Diphenhydra Inhibits prostaglandin plasma, Nausea with Assess onset, type,
mine synthesis. Produces URINE or without location, duration of pain,
Ibuprofen ) vasodilation acting on vomiting, inflammation. Inspect
heat-regulating dyspepsia, appearance of affected
center of dizziness, joints for immobility,
hypothalamus. rash. Rare deformities, skin condition.
Therapeutic Effect: (less than Assess temperature.
Produces analgesic, 3%): Intervention/evaluation
anti-inflammation Diarrhea or Monitor for evidence of
effects, decreases constipation, nausea, dyspepsia. Monitor
fever. flatulence, CBC, hepatic/renal function
Uses abdominal tests, occult blood loss.
 Treatment of fever, cramps or Monitor daily pattern of
juvenile rheumatoid pain, bowel activity and stool
arthritis (JRA), pruritus. consistency. Assess skin
osteoarthritis, minor for rash. Observe for
pain, mild to bleeding, bruising.
moderate pain, Evaluate for therapeutic
primary response: relief of pain,
dysmenorrheal. stiffness, swelling;
NeoProfen: Closes increased joint mobility;
clinically significant reduced joint tenderness;
patent ductus improved grip strength.
arteriosus (PDA) in Monitor temperature for
premature infants fever.
weighing between
500 and 1,500 g who
are no more than 32
wks gestational age
when usual medical
management is
ineffective.
Zantac Action PO serum Occasional Baseline assessment
Inhibits histamine IM AST, ALT (2%): Obtain history of
(ranitidine) action at histamine 2 IV levels, Diarrhea. epigastric/abdominal pain.
receptors of gastric
creatinin Rare (1%): Obtain baseline
parietal cells.
e, BUN Constipation hepatic/renal function
Therapeutic Effect:
Inhibits gastric acid
, headache tests.
secretion (fasting, (may be Intervention/evaluation
nocturnal, when severe). Monitor. Assess mental
stimulated by food, status in elderly. Question
caffeine, insulin). . present abdominal pain, GI
Reduces volume, distress
hydrogen ion
concentration of gastric
juice.
Uses
Short-term treatment of
active duodenal ulcer.
Prevention of duodenal
ulcer recurrence.
Treatment of active
benign gastric ulcer,
pathologic GI
hypersecretory
conditions, acute
gastroesophageal reflux
disease (GERD),
includes erosive
esophagitis.
Maintenance of healed
erosive esophagitis.
 Part of regimen for H.
pylori eradication to
reduce risk of duodenal
ulcer recurrence. OTC:
Relieve heartburn, acid
indigestion, sour
stomach.
Pepcid Action PO Occasional Baseline assessment
Inhibits histamine IM (5%): Assess
action H2 receptors IV Headache. epigastric/abdominal pain.
(Famotidin of parietal cells. Intervention/evaluation
e, calcium, Therapeutic Effect: Monitor daily pattern of
and Inhibits gastric acid bowel activity and stool
magnesium) secretion (fasting, consistency. Monitor for
nocturnal, or diarrhea, constipation, and
stimulated by food, headache. Assess
caffeine, insulin). confusion in elderly.
Uses
Short-term treatment
of active duodenal
ulcer. Prevention,
maintenance of
duodenal ulcer
recurrence.
Treatment of active
benign gastric ulcer,
pathologic GI
hypersecretory
conditions. Short-
term treatment of
gastroesophageal
reflux disease
(GERD), including
erosive esophagitis.
OTC formulation for
relief of heartburn,
acid indigestion, sour
stomach.
Beractant Action Intra Frequent: Baseline assessment
Lowers alveolar trache Transient Drug must be administered
(Survanta)
surface tension al bradycardia, in highly supervised
during respiration, oxygen (O2) setting. Clinicians caring
stabilizing alveoli. desaturation for neonate must be
Therapeutic Effect: , increased experienced with
Improves lung carbon intubation, ventilator
compliance, dioxide management. Offer
respiratory gas (CO2) emotional support to
exchange. retention. parents.
Uses Intervention/evaluation
 Prevention and Occasional: Monitor infant with arterial
treatment (rescue Endotrachea or transcutaneous
therapy) of l tube reflux. measurement of systemic
respiratory distress O2, CO2. Assess for
syndrome (RDS adventitious breath sounds
hyaline membrane (rales, rhonchi).
disease) in premature
infants. Prevention:
Body weight less
than 1,250 g in
infants at risk for
developing or with
evidence of
surfactant deficiency
(give within 15 min of
birth). Rescue
Therapy: Treatment
of infants with RDS
confirmed by X-ray,
requiring mechanical
ventilation (give
within 8 hrs of birth).

Erythromycin Action PO Frequent: Baseline assessment

Penetrates bacterial TOPICA IV: Question for history of
1%
cell membranes, L Abdominal allergies (particularly
stage 2
reversibly binds to cramping/dis erythromycins), hepatitis.
First hour
bacterial ribosomes, comfort, Intervention/evaluation
after birth
inhibiting protein phlebitis/thr Monitor daily pattern of
synthesis. ombophlebit bowel activity and stool
Therapeutic Effect: is. Topical: consistency. Assess skin
Bacteriostatic. Dry skin for rash. Assess for
Uses (50%). hepatotoxicity (malaise,
Treatment of Occasional: fever, abdominal pain, GI
susceptible infections Nausea, disturbances). Be alert for
due to S. pyogenes, vomiting, superinfection: fever,
S. pneumoniae, S. diarrhea, vomiting, diarrhea,
aureus, M. rash, anal/genital pruritus, oral
pneumoniae, urticaria. mucosal changes
Legionella, Rare: (ulceration, pain,
diphtheria, pertussis, Ophthalmic: erythema). Check for
chancroid, Sensitivity phlebitis (heat, pain, red
Chlamydia, N. reaction with streaking over vein).
gonorrheae, E. increased Monitor for high-dose
histolytica, syphilis, irritation, hearing loss.
nongonococcal burning,
urethritis, itching, .
 Campylobacter inflammatio
gastroenteritis. n. Topical:
Topical: Treatment of Urticaria.
acne vulgaris.
Ophthalmic:
Prevention of
gonococcal
ophthalmia
neonatorum,
superficial ocular
infections.
OFF-LABEL:
Systemic: Treatment
of acne vulgaris,
chancroid,
Campylobacter
enteritis,
gastroparesis, Lyme
disease, preoperative
gut sterilization.
Topical: Treatment of
minor bacterial skin
infections.
Ophthalmic:
Treatment of
blepharitis,
conjunctivitis,
keratitis, chlamydial
trachoma.
Narcan Action IV None known; Baseline assessment
Displaces opioids at IM little or no Maintain clear airway. Obtain
(Naloxone) opioid-occupied pharmacologi weight of children to calculate
CNS Drug, receptor sites in CNS. c effect in drug dosage.
Opioid Therapeutic Effect: absence of Intervention/evaluation
Reverses opioid-induced narcotics. Monitor vital signs, esp. rate,
Reversal
sleep/sedation, depth, rhythm of respiration,
Agent increases respiratory during and frequently
rate, raises B/P to following administration.
normal range. Carefully observe pt after
Uses satisfactory response
Complete or partial (duration of opiate may
reversal of opioid exceed duration of naloxone,
depression including
resulting in recurrence of
respiratory depression.
respiratory depression).
Diagnosis of suspected
opioid tolerance or acute Assess for increased pain with
opioid overdose. Neonatal reversal of opiate.
opiate depression. Coma of
unknown origin
Benadryl Action IV Frequent: Baseline assessment
Competitively blocks IM Drowsiness, If pt is having acute
(Diphenhydrami
ne) effects of histamine PO dizziness, allergic reaction, obtain
Respiratory at peripheral H1 muscle history of recently ingested
System, receptor sites. weakness, foods, drugs,
Anti- Therapeutic Effect: hypotension, environmental exposure,
allergy/ Produces urinary and emotional stress.
Anti- anticholinergic, retention, Monitor B/P rate, depth,
inflammator antipruritic, thickening of rhythm, type of
y Agent antitussive, bronchial respiration; quality, rate of
antiemetic, secretions, pulse. Assess lung sounds
antidyskinetic, dry mouth, for rhonchi, wheezing, and
sedative effects. nose, throat, rales.
Uses lips; in Intervention/evaluation
Treatment of allergic elderly: Monitor B/P, esp. in elderly
reactions, sedation, (increased risk of
parkinsonism; dizziness, hypotension). Monitor
prevention/treatment hypotension. children closely for
of nausea, vomiting, Occasional: paradoxical reaction.
vertigo due to motion Epigastric
sickness; antitussive; distress,
short-term flushing,
management of visual/hearin
insomnia. Topical g
form used for relief of disturbances
pruritus, insect bites, ,
skin irritations. paresthesia,
diaphoresis,
chills.
Percocet Action PO May ALERT Baseline assessment
Binds with opioid increase Effects are Assess onset, type,
receptors within CNS. serum dependent location, duration of pain.
(Acetaminophe
Therapeutic Effect: amylase, on dosage Effect of medication is
n/Oxycodone) Alters perception of lipase. amount. reduced if full pain recurs
and emotional Ambulatory before next dose. Obtain
response to pain. pts, those vital signs before giving
not in severe medication. If respirations
Uses pains may are 12/min or less (20/min
Relief of mild to experience or less in children),
moderately severe dizziness, withhold medication,
pain. nausea, contact physician.
vomiting, Intervention/evaluation
and Palpate bladder for urinary
hypotension retention. Monitor daily
more pattern of bowel activity
frequently and stool consistency.
than those Initiate deep breathing,
in supine coughing exercises, esp. in
position or pts with pulmonary
having impairment. Monitor pain
severe pain. relief, respiratory rate,
Frequent: mental status, B/P.
Drowsiness,
dizziness,
hypotension
(including
orthostatic
hypotension
), anorexia.