Top 10 Drugs Administered in a Long-Term Care Facility

Drug Name Mechanism of Action Use Notable Side Things to Monitor Patient Teaching
Effects

1 acetominophen Nonopioid Analgesic: •Relieves pain •Rash •Monitor liver enzymes •Maximum dose is 4g/day
(Tylenol) Analgesic action unknown, •Relieves discomfort •Low incidence of (AST, ALT, ALP, & serum •Avoid alcohol
direct action on the •Fever reducer GI distress bilirubin)
hypothalamic heat regulating •Hepatotoxicity
center for an antipyretic effect •Thrombocytopenia

2 docusate sodium Laxative: •Constipation •Abdominal •Assess for abdominal •Should only be used short-term
(Colace, Dulcolax) Coats & softens stools •Reduces post-op or cramping distension •Don’t take within 2 hours of
MI straining •Nausea & vomiting •Monitor bowel sounds other laxatives
•Hemorrhoids •Diarrhea

3 aspirin NSAID (Salicylates): •Pain •Tinnitus, hearing •Monitor serum salicylate •Avoid taking with
Anti-inflammatory, antiplatelet, •Fever loss level anticoagulants
and antipyretic effects •Inflammation •Dizziness •Monitor liver function •Avoid other NSAIDs
•TIA prevention •Confusion •Avoid during the 3rd trimester
•MI prevention •GI distress of pregnancy
•Hepatotoxicity •Limit intake of foods containing
salicylates

4 metoprolol tartrate Antihypertensive: •Hypertension •Bradycardia •Blood pressure (<100) •In diabetics, hypoglycemia
(Lopressor) Antagonizes beta 1 adrenergic •Angina •Bronchospasm •Heart rate (>60) symptoms will be blocked
receptors. Blocks the effects of •Acute MI •Hypotension •Avoid abrupt withdrawal
epinephrine (adrenaline) •Congestive Heart •Fatigue,
slowing the heart's rate, thereby Failure depression, anxiety
decreasing the heart’s demand •Migraine headache •ED
for oxygen.

5 levothyroxine Thyroid hormone replacement: •Diminished or •Arrhythmias •Monitor Thyroid •Take 30 minutes prior to
sodium Replaces thyroxine (synthetic absent thyroid •Tachycardia Stimulating Hormone breakfast each day
(Synthroid) T4) function •Hyperthyroidism •Monitor heart rate for •Avoid OTC medications
(hypothyroidism) •Hypertension arrhythmias •Report signs of
•Myxedema coma •Monitor blood glucose in hyperthyroidism
diabetic patients
6 furosemide Diuretic: •Edema •Fluid & electrolyte •Electrolytes (especially •Older patients should stand up
(Lasix) Act on the loop of henle to •Hypertension imbalance Potassium) slowly
inhibit sodium and chloride •Decreased cardiac •Do not take with Digoxin
reabsorption output and Blood •Report signs & symptoms of
Pressure hyperkalemia
•Orthostatic
hypotension
•Ototoxicity

7 pantoprazole Antiulcer: •GERD •Hypocalemia •Monitor epigastric and •Avoid foods and other drugs
sodium Proton pump inhibitor that •Osteoporosis abdominal pain that may cause GI upset
(Protonix) reduces gastric acid by •C. Diff •Take about 30 minutes prior to
inhibiting hydrogen/potassium •Hyperglycemia eating or drinking
ATPase in gastric parietal cells

8 albuterol sulfate Bronchodilator: Relaxes •Asthma •Bronchospasm •Monitor patient for •Teach patient to perform oral
(Proventil HFA, bronchial, uterine, and vascular •COPD •Tachycardia effectiveness inhalation correctly
Ventolin HFA) smooth muscle by stimulating •Palpitations •Monitor for bronchospasm
beta2 receptors

9 lisinopril Antihypertensive: Causes
(Prinivil, Zestril) decreased production of
angiotensin II and suppression
of the renin-angiotensin-
aldosterone system
•High blood pressure •Hyperkalemia •Monitor blood pressure
•Angioedema before and after giving
medication
•Monitor WBC before and
during therapy
•Do not stop drug suddenly
•Do not use salt substitutes
containing Potassium
•Dry, nonproductive cough may
develop

10 apixaban Anticoagulant: Selectively •Thrombus •Major bleeding •Monitor patient for bleeding •Do not stop drug suddenly
(Eliquis) inhibits facter Xa, decreasing prevention •Anemia •Monitor patient for •Caution that bruising and
thrombin generation and neurologic impairment bleeding may occur more easily
thrombus development
 Top 10 Drugs Administered in a Hospital

Drug Name Mechanism of Action Use Notable Side Things to Monitor Patient Teaching
Effects

1 enoxaparin Factor Xa inhibitor (LMW •Deep vein •Dizziness, •Assess for bleeding and •Report unusual bruising,
sodium Heparin): thrombosis & headache, hemorrhage, black/tarry bleeding, black/tarry stools,
(Lovenox) Binds with antithrombin III pulmonary embolism insomnia stools, bruising, hematuria, epistaxis
which doesn’t allow thrombin prevention •Edema epistaxis, hematocrit •Do not take ibuprofen,
formation (especially post-op) •Constipation reduction naproxen, or aspirin w/o
•Osteoporosis •Assess for evidence of consulting PCP
additional or increased
thrombosis
•Hypersensitivity reactions

2 acetominophen Nonopioid Analgesic: •Relieves pain •Rash •Monitor liver enzymes •Maximum dose is 4g/day
(Tylenol) Analgesic action unknown, •Relieves discomfort •Low incidence of (AST, ALT, ALP, & serum •Avoid alcohol
direct action on the •Fever reducer GI distress bilirubin)
hypothalamic heat regulating •Hepatotoxicity
center for an antipyretic effect •Thrombocytopenia

3 pantoprazole Antiulcer: •GERD •Hypocalemia •Monitor epigastric and •Avoid foods and other drugs
sodium Proton pump inhibitor that •Osteoporosis abdominal pain that may cause GI upset
(Protonix) reduces gastric acid by •C. Diff •Take about 30 min prior to
inhibiting hydrogen/potassium •Hyperglycemia eating or drinking
ATPase in gastric parietal cells

4 metoprolol tartrate Beta Blocker: •Hypertension •Bradycardia •Blood pressure (<100) •In diabetics, hypoglycemia
(Lopressor) Antagonizes beta 1 adrenergic •Angina •Bronchospasm •Heart rate (>60) symptoms will be blocked
receptors. Blocks the effects of •Acute MI •Hypotension •Avoid abrupt withdrawal
epinephrine (adrenaline) •Congestive Heart •Fatigue,
slowing the heart's rate, thereby Failure depression, anxiety
decreasing the heart’s demand •Migraine headache •ED
for oxygen.
5 ondansetron Serotonin antagonist: •Nausea & vomiting •Headache, •Assess for nausea & •Notify PCP if symptoms of
hydrochloride Blocks the effects of serotonin prevention dizziness, vomiting, abdominal extrapyramidal syndrome
(Zofran) at receptor sites •Chemotherapy drowsiness, fatigue, distention, bowel sounds present
related nausea weakness •Assess for extrapyramidal •Notify PCP if irregular
•Constipation, effects heartbeat noted
diarrhea
•Extrapyramidal
reactions

6 levodopa- Anti Parkinson's: •Parkinson’s •Dyskinesia •Assess parkinsonian •Urine and sweat may become
carbidopa Levodopa enters the brain and (involuntary symptoms dark
(Sinemet) is converted to dopamine while movement) •Asses blood pressure and •Take on empty stomach
carbidopa increases its •Nausea pulse (30min prior to meals or 1 hour
effectiveness and prevents/ •Darkening of urine after)
lessens many of the side effects and sweat
of levodopa •Confusion

7 aspirin NSAID (Salicylates): •Pain •Tinnitus & hearing •Monitor serum salicylate •Avoid taking with
Anti-inflammatory, antiplatelet, •Fever loss level anticoagulants
and antipyretic effects •Inflammation •Dizziness •Monitor liver function •Avoid other NSAIDs
•TIA prevention •Confusion •Avoid during the 3rd trimester
•MI prevention •GI distress of pregnancy
•Hepatotoxicity •Limit intake of foods containing
salicylates

8 docusate sodium Laxative: •Constipation •Abdominal •Assess for abdominal •Should only be used short-
(Colace, Dulcolax) Coats & softens stools •Reduces post-op or cramping distension term
MI straining •Nausea & vomiting •Monitor bowel sounds •Don’t take within 2 hours of
•Hemorrhoids •Diarrhea other laxatives

9 magnesium Laxative: •Constipation •Fluid & electrolyte •Monitor for abdominal •Must take with water to be
hydroxide Osmotic •Antacid imbalances distension effective
(Milk of Magnesia) Hyperosmolar salts pull water •Flatulence •Monitor bowel sounds •Don’t take within 2 hours of
into colon, increase water in •Abdominal cramps taking other medications
feces to increase bulk, which •Hypotension
stimulates peristalsis
10 levothyroxine Thyroid hormone replacement: •Diminished or •Arrhythmias •Monitor Thyroid Stimulating •Take 30 minutes prior to
sodium Replaces thyroxine (synthetic absent thyroid •Tachycardia Hormone breakfast each day
(Synthroid) T4) function •Hyperthyroidism •Monitor Heart Rate for •Avoid OTC medications
(hypothyroidism) •Hypertension arrhythmias •Report signs of
•Myxedema coma •Monitor blood glucose in hyperthyroidism
diabetic patients