ACETAMINOPHEN ANTI-PYRETIC/ Take exactly as directed 1st Side Effects Constipation,

Non-Opioid Analgesic thing in AM. 30m before meds Common hypophosphatemia

Inhibit prostaglandin synthesis in & food/H2O Life Threatening 0
Mechanism CNS No double dose Unknown severe abdominal
Indication Mild pain, fever Patient Stay upright 30m after dose Contraindication pain, hypercalcemia,
Side Effects Agitation, constipation,  liver Teaching Balanced diet hypophosphatemia
Common enzymes, rash Encourage exercise PQRST of gastric pain, 
Advise dentist before surgery Assessment serum phosphate, serum
Hepatotoxicity, Stevens Johnson
Life Syndrome (SJS), toxic epidermal Use sunscreen gastrin, monitor pH
Threatening necrolysis Notify: pregnancy, Take missed dose ASAP
breastfeeding, eye/vision Patient Don’t take within 1-2h of other
Hypersensitive with aspartame /
change Teaching meds, Low Na+ / Phosphate
Contra- sugar Severe hepatic impairment,
indication alcoholics Potential constipation
Alcohol usage, liver enzymes, ALLOPURINOL XANTHINE OXIDASE
Assessment assess for rash, pain, fever Aloprim, Apo-Allopurinol, INHIBITOR/Anti-gout AMLODIPINE (Norvasc) ANTI-HTN/Ca+ Channel
May alter BG Lopurin, Purinol, Zyloprim Anti-hyperuricemics Blocker
Chronic use > 4g a day can lead to Inhibit Xanthine oxidase to prevent Inhibits transport of Calcium into
toxicity Avoid alcohol with ≥ 1-2 Mechanism uric acid production Mechanism myocardial & vascular smooth
Patient doses, assess for rash, check other Prevent gouty attacks, muscle cells
Teaching meds to avoid > 1 product with Indication hyperuricemia Indication HTN, angina, vasospastic angina
acetaminophen Call if fever doesn’t Rash (D/C @ 1st sign), hypotension, Peripheral edema, dizziness,
change (>39.5°C) or lasts >3 days Side Effects urticaria, flushing, bone marrow Side Effects fatigue, angina, palpitation,
Don’t take with NSAIDs and ASA Common depression, drowsiness Common flushing, hypotension, bradycardia
Adults: No longer than 10 days Life Life
Peds: No longer than 5 days Threatening Hepatitis, renal failure Threatening None
Contra- Hypersensitivity, renal Contra- Hypersensitivity, BP < 90 mmHg,
ALLENDRONATE BIOPHOSPHATE/Bone indication insufficiency, dehydration indication severe hepatic impairment
Fosamax Resorption Inhibitor I/O, rash/hypersensitivity, joint BP & pulse before & after, I/O,
Inhibits resorption of bone by Assessment pain, swelling, BG (hypoglycemia), Assessment daily weight, S/S of heart failure,
Mechanism inhibiting osteoclasts activity hematology, renal, hepatic labs angina
Postmenopausal osteoporosis, Patient Take missed dose ASAP ≤ 300 mg Report S/S of superinfection if
Indication Paget’s disease, corticosteroid- Teaching Take with NSAIDs, Alkaline diet Patient symptoms don’t improve, use
induced osteoporosis Teaching additional contraceptive
Side Effects A.fib., headache, ALLUMINUM (OH)3 Notify: diarrhea, abdominal
ANTACID PHOSPAHATE
Common photosensitivity, regurgitation cramping, fever, or bloody stool
AlternaGEL, Amphojel, BINDER/Anti-ulcer,
Life Threatening 0 Nephrox Hypophosphatemics
Lactation, abnormal Binds to phosphate in GI tract. AMOXICILLN AMINO-PENICILLINS/
Contraindication esophagus, can’t stand ≥ 30m, Mechanism  Serum phosphate level. Anti-infective Anti-ulcer
renal insuff, delayed Neutralize gastric acid. Mechanism Binds to cell wall to kill bacteria
esophageal emptying Inactivates pepsin w/ Mg Infections (skin, respiratory, otitis),
Bone mass, bone pain, visual  Phosphate in CRF Indication H. Pylori ulcers
Assessment acuity, hypocalcemia/Vit. D., Indication Treat ulcers, hyperactivity, Side Effects Diarrhea, rash, allergy,  liver
skull size reflux Common enzyme
Life Seizure, C.diff, anaphylaxis, serum
Threatening sickness
Hypersensitivity to penicillin,
Contra- severe renal impairment, leukemia,
indication lactation
Infection (before & during Tx),
Assessment history of anaphylaxis, bowel
function, C&S
Always finish, accurate dose, S/S of
superinfection, use alternative
birth control
Patient Notify: diarrhea, abdominal
Teaching cramps, fever, bloody stools, if
symptoms don’t improve, anti-
microbials pre-procedure for heart
disease
ANGIOTENSIN II RECEPTOR ANTAGONISTS
(ARBs)
Blocks the vasoconstricting effects
Mechanism of Angiotensin II at receptor sites,
including smooth muscle and
adrenals
Alone or with other HTN, diabetic
Indication nephropathy manage HF in those
who can’t handle ACE’s
Stroke prevention and  death
Side Effects due to MI, dizziness, weakness,
Common hypotension, N&V, hyperkalemia
Life impaired renal function, myalgia,
Threatening anxiety, angioedema
BP (lying, sit, stand) & pulse, daily
Assessment weight, fluid overload
S/S angioedema
No double dose, avoid Na+
substitute and  K+ / Na+
Slow position changes
Patient No driving, extra contraceptives,
Teaching additional HTN Tx
Proper BP monitoring
Notify: facial swelling, dyspnea,
SOB
Additional -sartan
Notes ARBs “Arabs wear a Tartan”
Hypotension, reflex
ANGIOTENSIN CONVERTING ENZYME Life Threatening tachycardia, syncope, pallor,
sweating,
INHIBITORS (ACE Inhibitors)
Methemoglobinemia, cyanosis
Block conversion of Angiotensin I
Hypersensitivity, avoid use of
Mechanism To Angiotensin II
β-BLOCKERS or CA+ CHANNEL
Prevents bradykinin degradation to
Contraindication BLOCKERS in advanced heart
promote systemic vasodilation and
block, cardiogenic shock or
 aldosterone
untreated HF
Indication Management of HTN
BP, pulse,
Cough, hypotension, taste
Assessment location/duration/intensity &
Side Effects disturbance, hyperkalemia,
ppt’ing factors of angina
Common dyspnea, dizziness, headache,
Continue taking meds as
vertigo, weakness
ordered & use SL nitro PRN for
Life
anginal attacks, Notify: chest
Threatening Agranulocytosis, angioedema
Patient pain does NOT
Monitor BP and pulse frequently,
Teaching IMPROVE/worsens after tx,
Assessment S/S of angioedema, weight
diaphoresis, SOB, severe
Take as directed (no double dose) headache, slow position
avoid salt subs High K+ / Na+ slow changes, orthostatic
position changes No alcohol or hypotension, do not use
Patient driving Diabetics: monitor glucose alcohol
Teaching closely Use extra contraceptive
Additional HTN Tx Learn to monitor
BP Notify: rash, sore throat, mouth ANTICOAGULANTS
sores Fever Prevent clot extension and
Additional -pril Mechanism formation, NOT dissolve clots
Notes By acting on clotting factors
and thrombin
Prevention and Treatment of
ANTI-ANGINALS thromboembolic disorders incl.
Nitrates: dilate coronary Indication DVT, PE, A.fib, MI Mgm’t (with
arteries & cause systemic thromboembolitic & anti-
Mechanism dilation (preload), Ca+
platelet agents)
channel blockers: same &
Hematoma, pain at site,  liver
some slow HR, β-blockers:
Side Effects fx’n test, ecchymosis, cramps,
myocardial O2 consumption
Common N&V, fever
via in HR, Ranolazine: same
Bleeding, Calciphylaxis
Nitrates: treat & prevent
Life Threatening (Warfarin) Coag disorders,
angina ONLY NITRATES may be
ulcers, malignancy, recent
Indication used in acute tx of angina
surgery, active
pectoris, Ca+ channel, beta
Contraindication Bleeding
blockers & Ranolazine:
Sx: bleeding / hematoma,
prophylactic & long-term
monitor PT, PTT, INR Antidotes:
Side Effects Headache, dizziness,
Common weakness, N&V, incontinence
Assessment Heparins (protaminesulfate)
Warfarin, Vit K
Dabigatran (Idarucizumab: for
Dabigatran reversal)
Avoid contact sports, injury
prevention No OTC medications
Absolutely NO NSAIDs / ASAs
Patient Teaching Review high Vit K foods
Importance of frequency of lab
monitoring Always carry
medical ID
Heparin (Tinzaparin Sodium)
Additional Notes Warfarin (Coumadin)
Rivaroxaban (Xarelto)
-arin, -aban
ANTICONVULSANTS
 abnormal neuronal discharges in
Mechanism CNS,  seizure threshold, alter
neurotransmitters
 incidence & severity of seizures
Indication due to various etiology, IV for
immediate tx of seizure, >1 Rx
sometimes for long term basis
Side Effects Dizziness, drowsy, lethargy,
Common headache, forgetfulness,
Life
Threatening Apnea, cardiac arrest
Contra- Previous hypersensitivity, severe
indication hypotension, sleep apnea,
Location/duration/characteristics of
Assessment seizure Monitor serum drug level
throughout therapy
Meds everyday same time, drowsy
Patient (driving), no alcohol / CNS
Teaching depressants, carry med ID
ANTIDEPRESSANTS
(Dopamine, Norepinephrine, Serotonin)
Re-uptake inhibition of
neurotransmitters Tri-cyclic: block
serotonin & NE re-uptake in
Mechanism synapse SSRIs: inhibit serotonin re-
uptake in synapse SNRIs: block Active pathological bleeds,
serotonin & NE re-uptake MAOIs: Contra- prosthetic heart valves, PE, use of
inhibit monoamine oxidase to indication strong dual inducers
prevent uptake of dopamine, NE S/S of stroke, DVT, PE, Peripheral
and serotonin Assessment Vascular Dse, toxicity
Depression, anxiety, chronic pain, May bleed/bruise more, no double
Indication OCD, bulimia, social anxiety Patient dose Notify: skin rash, surgery,
Anti-cholinergic symptoms, Teaching herbals (St. John’s Wort)
Side Effects sedation, insomnia, sexual pregnancy, breast feeding
Common dysfunction
Life Suicidal delineation, Tyramine
ARTIFICIAL TEARS (Ocular Lubricants)
Threatening toxicity (MAOIs)
Isotonic solution & wetting agents
MAOIs usage with any other
Mechanism provide lubrication & protection of
Contra- depressants – narrow angle
dry eyes
indication glaucoma
Keratitis,  corneal sensitivity,
Monitor mental status/affect,
Indication corneal erosion, foreign body
suicidal tendencies, toxicities
removal
Assessment MAOIs: HTN crisis, chest pain,
Side Effects Photophobia, lid edema, stinging,
severe headache, N&V,
Common transient blurring eye discomfort
photosensitivity and enlarge pupils
Life
No alcohol / CNS Depressants
Threatening None
Tyramine education (MAOIs)
Contra-
Dizziness, drowsiness Orthostatic
indication None
Patient hypotension  fluid, gum, candy for
Teaching Vision changes, discomfort, tear
dry mouth 2 weeks withdrawal
Assessment production
before anesthetics (MAOIs)
Stop using if excessive tearing,
Psychotherapy NEVER discontinue
Patient headache, redness, persistent
abruptly
Teaching discomfort
Bion Tears, Genteal Tears,
APIXABAN (Eliquis) ANTI-COAGULANT/ Additional Hypotears, Murine Tears, Sooth,
Factor Xa Inhibitor Notes Systane, Teardrops, Viva-drops
 thrombin generation & dev’t by
Mechanism acting as a selective / reversible
ASPIRIN (ASA) ANTI-PYRETICS NON-OPIOID
Factor Xa site inhibitor
ANALGESICS/Salicylates
 Stroke/systemic embolism in
Indication non-valvular A-fib Inhibit prostaglandins to reduce
Prevent PE after knee/hip Mechanism fever & inflammation & produce
replacement analgesic effect
Rheumatoid arthritis, osteoporosis,
Side Effects
Indication fever, mild-moderate pain,
Common Hypersensitivity Rx
prophylaxis for MI/TIA, Kawasaki
Life
disease
Threatening Bleeding, anaphylaxis
Side Effects Dyspepsia, epigastric distress,
Common reflux
Life GI bleed, anaphylaxis, laryngeal
Threatening edema
Hypersensitivity to
Contra- salicylates/NSAIDs, bleeding
indication disorder, thrombocytopenia,
Reye’s syndrome
Asthma, pain, fever, liver enzyme,
Assessment serums
Take with full glass of water, stay
Patient up for 15-30 mins, no alcohol
Teaching Notify: tinnitus, unusual gum
bleeding, bruising, black, tarry
stool, fever ≥ 38-39°C
If upcoming surgery
ATENOLOL (Tenormin) ANTI-ANGINA ANTI-
HTN/Beta-Blocker
Block B1 stimulation for cholinergic
Mechanism effects ( HR, BP, angina &
prevent MI)
Indication HTN/angina, MI prevention
Erectile dysfunction, fatigue,
Side Effects weakness, dizziness, depression,
Common drowsiness, blurred vision,
bronchospasm
Bradycardia, heart failure,
Life pulmonary edema
Threatening Uncompensated heart failure,
pulmonary edema, cardiogenic
shock, bradycardia
BP, pulse, ECG monitoring, I/O,
daily weight, Sx of HF,
Assessment Frequency & charac of angina,
BG, Sx of toxicity (bradycardia,
severe drowsiness, dyspnea,
cyanosis, seizure)
Always take, keep emergency back-
ups, BP & pulse
Patient Don’t drive when starting, Slow
Teaching position changes
Diabetic: close monitor BG
Notify: bradycardia, SOB,
wheezing, cold hands & feet,
dizziness, confusion, depression,
rash, sore throat, unusual
bleeding/bruise, pregnancy
ATORVASTATIN/ HMG-CoA REDUCTASE INHIBITORS/
Lipid Lowering Agent
EZETIMIBE (Lipitor)
Inhibit HMG-CoA reductase that
Mechanism catalyze an early step in cholesterol
synthesis
Primary hypercholesterolemia, 2°
Indication prevention of CV dse in Congenital
Heart Defects (CHD)
Abdominal pain, constipation,
Side Effects diarrhea, flatulence, heart burn,
Common altered taste, dizziness, headache,
weakness
Life
Threatening Rhabdomyolysis
Hypersensitivity, acute liver
Contra- disease, unexplained &
indication persistent  AST/ALT, pregnant,
breastfeeding
Diet hx, serum cholesterol, liver
Assessment function, muscle tenderness,
serum Creatine Kinase (CK) levels
No double dosing or grapefruit
juice, used w/ diet change,
Patient exercise, stop smoking
Teaching Notify: liver pain, S/S of liver injury,
unexplained muscle pain,
weakness, fever, malaise,
Rx/OTC/herbals before Tx or
surgery, pregnancy
ATROVENT (Ipratropium) ANTI-CHOLENERGIC/
Allergy/Cold Remedy Bronchodilator
Inhibit cholinergic receptor in
Mechanism bronchial
smooth muscle w/out systemic
effect
Maintenance of Tx of reversible
Indication airway obstruction from COPD,
rhinorrhea & asthma
Cough, sore throat, dizziness,
Side Effects headache, palpitation, dryness,
Common irritation, nervousness
Life
Threatening 0
Contra- Acute bronchospasm,
indication hypersensitivity, glaucoma
Allergy (peanuts/soy), respiratory
Assessment status, rhinorrhea
Patient Proper usage, missed dose ASAP,
Teaching oral hygiene, normal S/S
AZITHROMYCIN (Zithromax) ANTI-INFECTIVE/
Macrolides
Inhibit protein synthesis at 50S
Mechanism bacterial ribosome
Bacteriostatic action against
susceptible bacteria
Indication URTI, LRTI, gonorrhea, pneumonia
Side Effects Abdominal pain, N&V, diarrhea,
Common liver enzymes, hyperkalemia
Life Acute generalized pustulosis, SJS,
Threatening TEN, hepatotoxicity, CDAD,
hypersensitivity reaction
Hypersensitivity to macrolide,
Contra- hypokalemia, hypomagnesemia,
indication bradycardia, QT prolongation
Symptoms of infection, C&S, Sx of
Assessment anaphylaxis,  bilirubin,
AST/ALT/LDH, phosphatase conc’n,
creatinine,  WBC & platelet
Finish drug completely, NO
Patient antacids, drowsiness, dizziness, NO
Teaching driving, photosensitivity
Notify: diarrhea, rash, fever, sx of
superinfection
ANTI-INFECTIVE/
BACITRACIN + POLYMYXIN B
Ophthalmic
(Polysporin Drops)
Bacteriostatic/inhibit cell wall
Mechanism synthesis (Bacitracin)
Cell wall binding on gram (-)
bacteria (Polymyxin B)
 Indicated for most bacterial eye Patient Always take meds, low sodium diet,
Indication infections BENZODIAZEPINES SEDATIVE & HYPNOTIC/ Teaching smoking cessation, orthostatic
Side Effects Ocular pruritis, rash, pruritis, Anti-Convulsants hypotension, monitor BG closely
(Xanax, Valium, Ativan)
Common erythema Additional -olol : Carvedilol, Metoprolol,
 effectiveness of GABA to 
Life Notes Bisoprolol
Mechanism excitability of neurons & cause a
Threatening Anaphylaxis
calming effect on the brain
Contra- Viral, fungal, mycobacterial, TB, BISACODYL (Dulcolax) LAXATIVE/Stimulant
Panic disorder, generalized anxiety
indication varicella, infections Laxative
Indication disorder (GAD), insomnia, seizure,
Irritation, vision changes,
alcohol withdrawal, anxiety Stimulates peristalsis, alters F&E
Assessment discharge, pain
Side Effects Sedation, dizziness, weakness, Mechanism transport to accumulate in the
Remove debris before admin, thin
Common unsteady, headache, irritability colon
Patient layer, no occlusive dressing, no
Life Constipation, colon prep for
Teaching sharing
Threatening Apnea, cardiac arrest Indication radiologic study or surgery, spinal
Notify: persistent pain, unrelieved
Contra- Myasthenia gravis, sleep apnea, injury regimen
vision change, swelling
indication bronchitis, COPD Side Effects Abdominal cramps, nausea,
Health hx, insomnia, anxiety, drug Common diarrhea, rectal burn, hypokalemia
BACLOFEN ANTI-SPASTICITY AGENT Assessment abuse/dependence, baselins V/S & Life
(Gablofen, Lioresal) SKELETAL MUSCLE RELAXANT LOC, ensure safety Threatening 0
(centrally-acting) No skipping, double dose, usually Contra- Abdominal pain, obstruction, N&V
Inhibit reflexes at spinal level to  Patient short-term,  gradually, coping indication (esp w/ fever)
Mechanism muscle spasticity, bowel & bladder Teaching skill improvement, NO driving, NO Abdominal distention, bowel
improvement alcohol/CNS depressants Assessment sounds, bowel pattern, COCA
MS & spinal cord lesions, pain in Notify: pregnancy (stool)
Indication trigeminal neuralgia Additional (-pam, -lam) Short-term use (except spinal) 
Dizziness, drowsiness, fatigue, Notes “benzo, pam & lam” fluid intake (1500-2000 mL), use
Side Effects weakness, headache, pruritis, rash, Patient alternative bowel regulator, no
Common tinnitus, hyperglycemia, sweat BETA BLOCKERS Teaching straining (cardiac)
Life Do not use with abdominal pain +
Compete with adrenergic
Threatening Seizures fever+ N&V
Mechanism neurotransmitters for adrenergic
Contra- Hypersensitivity, epilepsy, renal receptor sites to  HR & BP thru
indication impairment, < 4 years relaxing smooth muscles BISOPROLOL ANTI-HTNs/Beta
Spasticity, observe drowsiness, HTN, angina, tachyarrhythmia, Blockers
Assessment dizziness, ataxia Indication migraine, HF Blocks stimulation of β1
 Serum glucose, liver enzyme Fatigue, weakness, bronchospasm, (myocardial)-adrenergic receptors.
Take missed dose w/in 1 hour, no Side Effects dry mouth, hyperglycemia,  liver Mechanism Does not usually affect β2
Patient double dose Common enzymes (pulmonary, vascular, uterine)-
Teaching Avoid driving, Avoid alcohol/drugs Life receptor sites,  BP & HR
Change position slowly because of Threatening Bradycardia, HF, pulmonary edema
orthostatic hypotension Monitor BP & pulse, I/O, daily Indication Management of HTN
Notify: frequent/painful urination, Assessment weight, respiratory changes, Fatigue, weakness, ED, blurred
constipation, nausea, headache, headache freq, angina freq, Side Effects vision, stuffy nose, anxiety,
insomnia, tinnitus, depression,
Common depression, bronchospasm,
confusion, hypersensitivity,
rash/itching, don’t abruptly D/C
 wheezing, constipation, diarrhea,
rash, arthralgia
Life
Threatening Bradycardia, HF, pulmonary edema
Uncompensated HF, pulmonary
Contra- edema, cardiogenic shock,
indication bradycardia or heart block
Monitor BP, ECG, pulse,
periodically & during tx, I/O, daily
Assessment weight, S/S of HF: dyspnea,
crackles, weight gain, peripheral
edema, jugular vein distention –
JVD
Do not w/draw abruptly, take meds
as directed, do not skip or double
Patient dose, take missed dose ASAP or up
Teaching to 4 h before next dose, Notify:
slow pulse, dyspnea, wheezing,
cold hands, feet, dizzy, light-head,
confusion
BRIMONIDINE, topical α-ADRENERGIC
(Mirvaso, Onreltea) AGONIST
Highly selective alpha-2 adrenergic
Mechanism agonist to reduce intraocular
pressure
Lower IOP in open angle glaucoma
Indication or ocular HTN sometimes w/
brinzolamide
Blurry vision, dry/itchy eyes,
Side Effects disturbed color perception, double
Common vision, halos, night blindness
Life
Threatening 0 insoluble Ca+ Phosphate that can
Contra- Depression, facial
indication erythema/rosacea
Hypersensitivity, breastfeeding,
Assessment antidepression, cardiovascular
disease
Proper application, possibility of
Patient erythema, Rx/OTC/Herbals
Teaching Notify: before and after pregnancy
BUDESONIDE ANTI-ASTHMA ANTI- Ca+ supplement replacement, BP,
(Pulmicort) INFLAMMATORY / Corticosteroid ECG, pulse, IV site, antacid use,
Potent, long-acting anti- Assessment serum level, toxicity, bone pain,
Mechanism inflammatory & immune modifier stomach pain, confusion, muscle
Asthma maintenance,  need for weakness, high BP, abnormal
Indication systemic steroids rhythm
Headache, dysphonia, hoarseness, No eating within 1 hour of dose
Side Effects dry mouth, sinusitis, pharyngitis, No food high in oxalic acid, phytic
Common dizziness, esophageal candidiasis, Patient acid, phosphorous, or milk, may
otitis media Teaching cause constipation, avoid excess
Anaphylaxis, laryngeal edema, tobacco, alcohol, and caffeine,
Life urticaria, bronchospasm, adequate Vit. D, avoid Ca+
Threatening Churg Strauss syndrome (blood supplements including antacids
vessel inflammation)
Respiratory & lung sounds, adrenal CALCIUM CHANNEL BLOCKERS
insufficiency (anorexia, nausea, Block Ca+ from entering the cell
Assessment weakness, fatigue, hypoglycemia) of vascular & myocardial
bone density, growth (kids) Sx Mechanism smooth muscle, dilates
hypersensitivity (rash, pruritus, coronary artery,  AV nodal
swelling, dyspnea) conduction
Don’t discontinue without HTN prophylaxis, angina,
consultation Indication antiarrhythmics
Patient Use bronchodilator FIRST, Not for Peripheral edema, dizziness,
Teaching ACUTE asthma attack Side Effects fatigue, palpitation, flushing,
No smoking/triggers, rinse mouth Common bradycardia, hypotension
Notify: sore throat, mouth sores, Life Threatening 0
hypersensitivity 2°/3° heart block,
Contraindication decompensated HF, bradycardia
CALCIUM ANTACID/Mineral & Electrolyte BP & HR, I/O. daily weight, fluid
CARBONATE Replacement & Supplement Assessment retention, angina, ECG,
Maintain cell membrane & capillary Neurovitals
permeability Continue taking meds even if
Mechanism Binds to dietary phosphate to make Patient well, slow position changes
Teaching (orthostatic hypotension),
be excreted in feces &  serum Nitrate Tx, low sodium diet
phosphate - dipine, verapamil, diltiazem
Tx & prevention of hypokalemia & Additional Amlodipine, Felodipine,
Indication hyperphosphatemia Notes Isradipine, Nicardipine,
Side Effects Arrhythmia, hypercalcemia, Nimodipine (prevent
Common phlebitis, tingling neurological damage from CV)
Life
Threatening Cardiac arrest CALCITONIN HORMONE
Contra- Hypercalcemia, renal calculi, V-fib,
indication Ca supplements
 Promotes renal excretion of Ca+ &
Mechanism inhibits osteoclasts bone
reabsorption
Tx of Paget’s disease of bone,
Indication hypercalcemia, osteoporosis
Side Effects Rhinitis, vomiting, headache, facial
Common flushing, injection site reactions
Life
Threatening Malignancy, anaphylaxis
Contra- Hypersensitivity, gelatin allergy,
indication breastfeeding, pediatrics
Sx of hypersensitivity, tetany,
Assessment serum Ca+ & alkaline phosphate
(Parenteral) procedure & disposal
Patient Reassure a/p flushing for 1 hour
Teaching Nausea dissipates with treatment
Low Ca+ diet
Possibility for malignancy
CAPTOPRIL ANTI-HTN/
(Capoten) ACE Inhibitor
Block conversion of angiotensin
Mechanism I to angiotensin II, 
aldosterone level, resulting in
systemic vasodilation
 progression of diabetic
Indication nephropathy in px w/ T1 DM,
retinopathy, manage & reduce
risk of HF
Cough, hypotension, taste
Side Effects disturbance, pruritis, fatigue,
Common flushing
Life Threatening Agranulocytosis, angioedema
Hypersensitivity, aliskiren use in
Contraindication px with diabetes,
sacubitril/valsartan, pregnancy
Correct volume depletion, BP 
1-3h after 1st dose, may require
volume expansion
Discontinue diuretics or
cautiously  salt intake 2-3
Assessment before initiation, monitor BP
closely for 1st hour before meal
or 2 hours after meal
No double dose, avoid salt subs,
slow position changes, may
Patient cause dizziness (don’t drive)
Teaching Notify: hypersensitivity
reaction, impaired taste,
pregnancy
Diabetes: monitor for
hypoglycemia
CARBIDOPA/LEVODOPA ANTI-PARKINSON’S/
Sinemet, Duodopa Dopamine Agonist
Levodopa: converted to dopamine
in CNS to act as neurotransmitter
Mechanism Carbidopa: inhibits decarboxylase
to prevent the destruction of
Levodopa
Indication Parkinson’s
Depression, involuntary
Side Effects movements, orthostatic
Common hypotension, constipation, N&V,
dyskinesia, drowsiness, dizziness
GI hemorrhage, ischemia,
Life obstruction, and perforation,
Threatening hepatotoxicity, Intussusception,
pancreatitis, peritonitis, melanoma
Angle closure glaucoma, MAOIs,
Contra melanoma, skin lesions,
indication Tartrazine/Phenylamine/Aspartame
Parkinsonian sx, BP & pulse, S/S of
GI complication,  serum glucose,
hepatic/renal function,  Hb &
Assessment HCT  WBC, S/S of toxicity
(twitching, grimacing, wink, tardive
dyskinesia, behavioral changes)
Take missed dose w/in 24 h, no
double doses
GI irritation maybe better if with
food soon after meals (No high
protein), sudden sleep/drowsiness
(don’t drive), slow position
Patient changes, frequent mouth rinse
Teaching Sugarless gum/candy may help dry
mouth
Dark saliva/urine may happen
Notify: GI complications,
palpitation, urine retention,
involuntary movements, behavioral
changes, severe N&V
CARVEDILOL (Coreg) ANTI-HTN/Beta
blocker
Blocks stimulation of
beta1 (myocardial) and
Mechanism beta2 (pulmonary, vascular, and
uterine)-adrenergic receptor
sites. Also has alpha1 blocking
activity, which may result in
orthostatic hypotension
Hypertension, HF (ischemic or
cardiomyopathic) with digoxin,
Indication diuretics, and ACE inhibitors,
left ventricular dysfunction
after myocardial infarction
Hyperglycemia, diarrhea, ED
Side Effects erectile dysfunction, dizziness,
Common fatigue, weakness
Bradycardia, HF pulmonary
Life Threatening edema, SJS, TEN,
hypersensitivity rxn
Hx of serious hypersensitivity
rxn (Stevens-Johnson
syndrome, angioedema,
anaphylaxis);
Contraindication Pulmonary edema, cardiogenic
shock, bradycardia, heart block
or sick sinus syndrome (unless a
pacemaker is in place), severe
hepatic impairment, asthma or
other bronchospastic disorders
Monitor BP, pulse, I/O, daily
weights, fluid overload,
(peripheral edema, dyspnea,
crackles, fatigue, weight gain,
Assessment jugular venous distension,
worsening sx for HF
Do no withdraw abruptly may
precipitate arrhythmia, HTN or
MI. D/C slowly
Patient Notify: if slow pulse, dyspnea,
Teaching wheezing, cold hands & feet,
dizziness, confusion,
depression, rash, fever, sore
throat, unusual bleeding or
bruising
CEFADROXIL, CEFAZOLIN, ANTI-INFECTIVE/
1ST GEN CEPHALOSPORINS
CEPHALEXIN
Mechanism Bind to bacterial wall → cell
death
Skin & skin structure infection,
pneumonia, UTI, bone & joint
Indication infection, septicemia,
pharyngitis, tonsilitis, pre-op, GI
infection, otitis media
Side Effects Diarrhea, nausea, rash, cramps,
Common anemia
SJS, seizure, C.diff, anaphylaxis,
Life Threatening serum sickness
Hypersensitivity to
Contraindication cephalosporin/penicillin, renal
impairment, hx of GI disease
Infection, hx of penicillin
Assessment sensitivity, C&S prior,
anaphylaxis, bowel fx’n, rash,
liver enzyme
Notify: immediately a/p rash,
Patient bloody/pus mucous diarrhea or
Teaching fever develop
Finish medication completely
Do not double dose
Report signs of superinfection
CEFAZOLIN 1ST GEN
(Cefadroxil, Cephalexin) CEPHALOSPORINS
Mechanism Bind to bacterial wall → cell
death
Skin/skin structure infection,
pneumonia, UTI, bone/joint
ST
Indication infection, septicemia, 1 GEN
Cephalosporins
pharyngitis, tonsillitis, pre-op GI
infection, otitis media
Side Effects Diarrhea, nausea, rash, cramps,
Common anemia
SJ Syndrome, seizure, C. diff,
Life Threatening anaphylaxis, serum sick
Hypersensitivity to
Contraindication cephalosporin/penicillin, renal
impairment, hx of GI disease
Infection, hx of penicillin, C&S
Assessment prior anaphylaxis, bowel
function, rash, liver enzymes
Notify: immediately a/t rash,
Patient bloody pus, mucous diarrhea, or
Teaching fever develop
Finish medication completely
Do NOT double dose
Report signs of superinfection
CEFTRIAXONE, CEFRADINE,
CEFDITOREN, CEFPODOXIME ANTI-INFECTIVES/
CEFTAZIDIME 3rd GEN Cephalosporins
Binds to cell wall, causing cell
Mechanism death
Intra-abdominal infection,
sepsis, prophylaxis, meningitis,
Indication UTI, GU skin infection,
respiratory infection, bone &
joint infection
Diarrhea, N&V, phlebitis, pain,
Side Effects cholelithiasis, headache, rash,
Common pain at IM site, superinfection
Seizure (high dose), CDAD, SJS,
Life Threatening anaphylaxis, serum sickness
Cephalosporin hypersensitivity,
Contraindication penicillin hypersensitivity
Sx infection, hx previous use,
Assessment C&S, sx of anaphylaxis, bowel
fx’n, rash, SJS, PTT, Crea/BUN
Missed dose ASAP, Notify: rash,
Patient fever, diarrhea, sx of
Teaching superfinfection
CELECOXIB (Celebrex) ANTI-RHEUMATICS,
NON-STEROIDAL ANTI-INFLAMMATORY AGENT/
COX-2 Inhibitor
Inhibits COX-2 enzyme →
Mechanism prevents synthesis of
prostaglandins
Arthritis, ankylosing spondylitis,
Indication acute pain
Dizziness, insomnia, headache,
Side Effects edema, HTN, abdominal pain,
Common flatulence, rash, hyperkalemia
HF, MI. CVA, thrombosis, GI
Life Threatening bleed, exfoliative dermatitis,
SJS, necrosis
CABG, pregnancy, liver disease,
Contraindication renal disease
Rash, allergy to
Assessment aspirin/NSAIDs/sulfonamide,
AST&ALT values, K+ levels
Notify: immediately for rash, GI
toxicity, chest pain, unexplained
Patient weight gain
Teaching Take ONLY prescribed dose
Notify: if pregnant/planning
D/C & call if jaundice, URQ
tenderness, swelling abdominal
& flu-like symptoms
CEPHALEXIN ANTI-INFECTIVES/
Keflex 1ST GEN Cephalosporins
Cause cell death by binding to
Mechanism cell wall
Treatment of infection
Indication especially otitis media
Side Effects Diarrhea, N&V, rash, phlebitis,
Common pain at site
Seizure, SJS, C.Diff,
Life Threatening anaphylaxis, serum sickness
Hypersensitivity to
Contraindication cephalosporin & penicillin
Infection Hx w/ cephs & pens,
Assessment C&S, anaphylaxis, bowel fxn,
rash, hepatic & renal fxn
Complete all meds, take at
even intervals, S/Sx of
Patient superinfection, Notify:
Teaching diarrhea, w/ blood, mucus,
pus, fever or rash
CETIRIZINE (Reactine) ANTI-HISTAMINE/
Piperazine Peripherally Selective
Antagonizes H+ receptor
Mechanism (doesn’t bind to H+)
Minimal anticholinergic effect
Indication Allergies caused by histamine
release chronic urticaria
Side Effects Drowsiness, dizziness, fatigue,
Common pharyngitis, dry mouth
Life Threatening 0 Mechanism
Contraindication Hypersensitivity, breastfeeding
Allergy symptoms, lung sounds,
Assessment fluid intake
Take as directed, oral hygiene,
Patient rash, dizziness, avoid driving,
Teaching avoid alcohol
CITALOPRAM ANTI-DEPRESSANTS/Selective
Serotonin Reuptake Inhibitor SSRI
(Celexa)
Selectively inhibits the reuptake
Mechanism of serotonin in the CNS
Depression, PMDD, OCD, panic
Indication disorder, GAD, PTSD, social
phobia
Apathy, confusion, dry mouth,
Side Effects insomnia, tremor,  libido,
Common yawning, drowsiness, flatulence
Neuroleptic malignant
Life Threatening syndrome, suicidal thoughts,
Torsades de pointes, serotonin
syndrome
MAOIs, hypersensitivity,
Contraindication bradycardia, hyperK+, recent
MI, hypoMg+, HF
Suicidal tendencies, sexual
Assessment dysfx’n, serotonin syndrome,
electrolyte imbalance
Do not double dose/ stop
abruptly
Patient Avoid driving @ start of
Teaching medication
Change position slowly
Notify: ASAP a/p
suicidal/homicidal thoughts
Wear sunscreen protection
Female: notify a/p pregnancy
plans
CLARITHROMYCIN ANTI-INFECTIVE, ANTI-ULCER,
(Biaxin) ATYPICAL MYCOBACTERIUM AGENT/
Macrolides
Inhibits protein synthesis at
level of 50s bacterial ribosomes,
bacteriostatic action
Respiratory infections,
Indication mycobacterium avium complex
(MAC), otitis media, sinusitis,
pharyngitis, H. Pylori
Side Effects Headache, prolong QT,
Common abdominal pain, diarrhea,
pruritis
Torsades de pointes, SJS,
Life Threatening hepatotoxicity, CDAD,
angioedema
Thromycin hypersensitivity,
jaundice, hepatic/renal
Contraindication disorder, -statin, -tamine, -
sotalol usage, QT prolong,
hypoK+, hypoMg+, bradycardia,
pregnancy
Bowel fx’n (C.diff), rah (SJS),
Assessment liver fx’n, infection, C&S
Always finish dosage give even
if feeling better, report signs of
superinfection, Notify: rash,
Patient fever, diarrhea (esp. bloody),
Teaching pregnancy, no s/s improvement
Zidovudine must be taken ≥ 4
hours apart
CLONAZEPAM ANTI-CONVULSANT/
(Klonopin, Rivotril) Benzodiazepine
Presynaptic inhibition &
potentially inhibiting GABA
Mechanism receptors, sedates CNS &
causes anticonvulsive effects,
prevent seizure, 
manifestation of panic disorder
Seizure treatment, panic
Indication disorders
Behavior changes, drowsiness,
Side Effects slurred speech, ataxia,
Common abnormal eye movements,
dependence
Life Threatening Suicidal thoughts, palpitations
Hypersensitivity, liver
Contraindication impairment, pregnancy,
breastfeeding, hx of
dug/alcohol abuse
Seizure intensity, duration,
Assessment location, anxiety signs/hx of
dependence, behavior change
Missed dose w/in 1 h or skip it
Do not stop abruptly
Patient Short-term prescription
Teaching Notify: ASAP for
suicidal/homicidal thoughts,
signs of hepatic impairment,
trouble sleeping, or impulsitivity
Carry ID if you have seizures
CLONIDINE ANTI-HTN/ Adrenergic
(Catapres, Duraclon) (centrally-acting)
Inhibition of cardio-acceleration
Mechanism & vasoconstriction centers by
stimulating α-adrenergic
receptors in the CNS
Mild-moderate HTN, ADHD,
Indication cancer pain
Drowsiness, dry mouth,
Side Effects withdrawal, depression, Na+
Common retention, nightmares, ED
Life Threatening 0
HTN, edema, weight loss, pain,
Assessment opioid withdrawal
Patient Same time daily, avoid quick Patient H2O/juice, not within 2 hrs of Periodic deficiency, serum B12,
Teaching moves, avoid alcohol Teaching laxatives & mineral oil, can be Assessment Hb & HCT, iron
an enema Comply with diet,  B12 diet,
Patient don’t exceed RDA, life-long
CODEINE OPIOID AGONIST
COLCHICINE *HIGH ALERT MEDS* ANTI-GOUT Teaching need, follow admin instruction,
Generalized CNS depression, 
Colcrys, Gloperba, Mitigare AGENT skin redness
Mechanism cough reflex,  GI motility ->
alerts pain perception Interferes w/ WBC in
Mgm’t of mild-mod pain, Mechanism inflammatory response to CYCLOPENTOLATE OPTHALMIC/
Indication antitussive monosodium urate crystals (Cyclogyl) Anticholinergic
Confusion, sedation, Indication Prophylaxis of acute attacks of Blocks sphincter muscle
Side Effects hypotension, vomiting, gout responses in iris &
Common constipation OPIOID AGONIST Side Effects Diarrhea, N&V, alopecia, Mechanism accommodative muscles in
Physical & psychological Common abdominal pain ciliary muscle that dilate pupils
Life Threatening dependence Agranulocytosis, Aplastic & relax eye muscles
Hypersensitivity, breast feeding, Life Threatening anemia, “-avirs” (strong CYP3A4 Indication Anterior uveitis
Contraindication hx of substance abuse, inhibitors) Side Effects Irritation, blurred vision,
MAO Inhibitors, renal Hypersensitivity, renal & liver Common photophobia
impairment Contraindication impairment Life Threatening 0
VS bowel function, pain, cough Baseline CBC ( platelet, Closed angle glaucoma, Down
Assessment & lung sounds Assessment anemia), toxicity, AST/alkaline Contraindication Syndrome
Abusive, potential orthostatic phosphate, gout, I/O Ensure contact lenses are out,
Patient hypotension Do not double dose, avoid Assessment pre-existing cardiac condition,
Teaching Avoid alcohol, avoid driving Patient grapefruit, report pain or Monitor BP & pulse
post dose Teaching weakness Do not touch dropper, avoid
Notify: pregnancy or planning driving, wear sunglasses, no
COLACE STOOL SOFTENER/
Patient contact lenses, no
CYANOCOBALAMIN H2O SOL VIT/ Teaching breastfeeding
(Docusate Na+ Dosolax ) Laxative
(Vit B12) Anti-Anemic Notify: SOB, swelling, hives,
Incorporates H2O into stool to
Co-enzyme required for palpitations
Mechanism soften
Promote electrolyte & H2O Mechanism metabolic process & protein
Indication secretion synthesis & hematopoiesis DABIGATRAN ANTI-COAGULANT/Thrombin
Prevent constipation/straining Vit B12 deficiency tx due to (Pradaxa) Inhibitor
Side Effects Throat irritation, mild cramp, Indication malabsorption, pernicious Mechanism Direct inhibitor of Thrombin
Common diarrhea, rash anemia, Schilling’s test, cyanide  stroke/systemic embolization
Life Threatening 0 poisoning Indication risk w/
Hypersensitivity, abdominal HTN, erythema, rash, red urine, non-vascular A-fib, DVT, PE
Contraindication pain, vomiting, fever w/ other Side Effects headache, restlessness, Abdominal pain, diarrhea,
signs of acute abdomen Common tachycardia, pulmonary edema, Side Effects dyspepsia, gastritis, esophageal
Abdominal distention, bowel abdominal discomfort Common ulcer, hypersensitivity
Assessment sound, BM pattern, stool Life Threatening Anaphylaxis Bleeding, angioedema,
Use for short-term, long-term Hypersensitivity, optic nerve Life Threatening anaphylaxis
dependant, doesn’t stimulate Contraindication atrophy, uremia, renal Hypersensitivity, active
peristalsis, full glass of dysfunction Contraindication pathologic bleeding, P-
 glycoprotein (P-gp) inducers
prosthetic heart valves
Bleeding, blood loss, stroke,
Assessment peripheral vascular disease,
aPTT/ECT- ecarin clotting time,
renal function
May bleed easily, take missed
Patient dose w/in 6h of scheduled dose
Teaching Do not suddenly D/C
Notify: HCP prior to surgery,
ASAP a/p pregnancy or planning
DEXAMETHASONE ANTI-ASTHMA/
(Dexasone) Corticosteroid Systemic
Suppress inflammation &
Mechanism normal immune response
Systemic and local affects in lots
of chronic disorders incl:
Indication inflammation, allergy,
hematologic, neoplastic,
autoimmune,
depression, Euphoria,
hallucinations, HTN, anorexia,
Side Effects acne,  wound healing,
Common ecchymosis, fragile hirsutism,
petechiae, muscle wasting,
adrenal suppression, OP,
Cushingoid appearance, 
susceptibility to infection
Peptic ulcer,
Life Threatening pheochromocytoma,
thromboembolism
Contraindication Active untreated infection
Sx adrenal insufficiency, I/O
pulmo & peripheral edema,
growth (kids), cerebral edema,
Assessment  LOC, headache, ulcerative
Colitis, hypergly,
Dexamethasone test (admin &
Cortisol IV)
Correct admin
Never stop abruptly (adrenal
insufficiency)
Immunosuppression (monitor
Patient for infection)
Teaching No live vaccines
Possible body changes
Carry ID
Diet: protein/ Ca+ / K+ / and Na+
carbs
Notify: black, tarry stool,
Rx/OTC. Chickenpox, measles
exposure before surgery,
underlying Sx worsens
DICLOFENAC Na+ NON-OPIOID ANALGESICS, NSAIDs/
(Voltaren) Topical Phenylacetic acid derivative
Mechanism Inhibits prostaglandin synthesis
Suppression of pain &
Indication inflammation
Relief of acute migraine attacks
Topical (3%) clearance of actinic
keratosis lesions
Mgm’t of acitinic keratoses (3%)
OA (for knees)
Pruritus, rashes, contact
Side Effects dermatitis, dry skin exfoliation,
Common tinnitus, hyperkalemia
HF, MI, stroke, drug rxn
eosinophilia & systemic sxs
Life Threatening (DRESS), exfoliative dermatitis,
SJS, TEN, GI bleeding,
hepatotoxicity, anaphylaxis
Hypersensitivity to diclofenac,
Contraindication cross-sensitivity w/ other
NSAIDs incl ASA, active GI
bleeding/ulcer, CABG, burns
Risk for hypersensitivity rxn in
Assessment asthma, rash, SJS, S&S of DRESS:
fever, rash lymphadenopathy,
facial swelling
D/C if sx occurs, Hb & HCT
Patient Minimize use of NSAIDs 3% gel
Teaching may take 60-90 days for
complete healing
DIGOXIN *HIGH ALERT MEDS* ANTI-ARRHYTHMIC
(Lanoxin, Toloxin) INOTROPICS/Digitalis Glycosides
 myocardial contraction by 
Mechanism conduction thru SA/AV nodes
Indication HF, A-fib/A-flutter, Paroxysmal
Atrial Tachycardia
Side Effects Fatigue, bradycardia, anorexia,
Common blurred vision, N&V
Life Threatening Arrhythmias
HR  60 bpm, AV block,
Contraindication idiopathic hypertrophic
subaortic stenosis, uncontrolled
ventricular arrhythmia
1 min apical pulse, monitor
Assessment ECG, I/O, daily weight,
rales/crackles, periodic BP
Take pulse prior to dose, S/S of
Patient toxicity
Teaching Do not double dose, keep in
original package
DIMENHYDRINATE ANTI-EMETIC/
Gravol Anti-histamine
Inhibit vestibular stimulation
Mechanism to depress CNS & cause
anticholinergic, antihistamine
& anti-emetic properties
Motion sickness caused N&V,
Indication vertigo, dizziness
Side Effects Drowsiness, anorexia, dry
Common mouth, photosensitivity
Life Threatening 0
Hypersensitivity, alcohol
Contraindication
intolerance, angle closure
glaucoma, seizure, prostatic
hyperplasia
N&V, bowel sounds,
Assessment abdominal pain (a/p admin),
I/O, emesis, dehydration
Take as directed, avoid driving
(dizziness, drowsiness), may
Patient cause dry mouth, avoid
Teaching alcohol & CNS depressants,
 wear sunscreen, monitor
closely in 65+ years
DIPENHYDRAMINE ANTI-HISTAMINE/
Anti-tussive
(Aller-Aide, Benylin)
Antagonizes effects of
histamine @ receptor
Mechanism Site → doesn’t bind/inactivate
histamine, CNS depressant &
anticholinergic
Relief of allergy symptoms,
Indication Parkinson’s mild sedation,
prevent morning sickness
Drowsiness, anorexia, dry
Side Effects mouth, hypotension,
Common palpitation, tinnitus, blurred
vision, urine retention, tight
chest
Life Threatening 0 Hypersensitivity Ketoconazole,
Asthma attacks, liver disease,
Contraindication CNS depressants
Airway patency, nasal stiffness,
Assessment nausea, pain
Avoid driving, teach sleep
hygiene techniques, sunscreen
Patient Avoid alcohol & other CNS
Teaching depressants
Drink lots of fluids
Good oral hygiene
DIURETICS
Enhance selective secretion of
Mechanism various electrolytes & water by
impacting tubular secretion /
reabsorption
Thiazide/Loop: HTN/edema
from HF/other causes
Indication K+ sparring: K+ conservation &
mild diuretic. Anti-HTN effect
on those taking Thiazide/Loops
Osmotic: cerebral edema
Side Effects Dehydration, cardiac disease: don’t strain,
Common hypo/hyperkalemia, cramps, with water or juice
dizziness, headache
Stevens Johnson Syndrome-SJS,
DOMPERIDONE BUTYROPHENONE DOPAMINE
Life Threatening aplastic anemia, Toxic
(Motilium) AGONIST/Gastric Stimulant
epidermal necrolysis-TEN
Peripheral dopamine blocker to 
Thiazide/Loop maybe cross
GI motility, peristalsis, LES – lower
Contraindication sensitive with Sulfonamide
Mechanism esophageal sphincter pressure,
Fluid status, daily weight, I/O,
gastric emptying,  prolactin levels
amount & location of edema
Manage GI motility symptoms, tx of
Lung sounds, skin turgor
Indication N&V assoc w/dopamine agonist
Assessment mucous membranes, anorexia,
anti-Parkinson’s tx, stimulate
BP and pulse (before & during
lactation
admin), ICP, electrolytes &
Side Effects Headache, insomnia, dry mouth,
kidney function
Common amenorrhea, impotence, hot
Always take even if feeling
flushes, galactorrhea, gynecomastia
Patient better controls, NOT cure HTN,
Life
Teaching Slow position changes, Review
Threatening 0
K+ foods guidelines
(-Thiazide)
Contra Prolactinoma, GI
Additional Loop (-ide)
indication hemorrhage/perfusion/obstruction,
Notes K+ sparring (Amiloride,
Hx of breast CA
Spironolactone, Triamterene)
Osmotic (Mannitol) N&V, distention, bowel sounds, BP,
Assessment S/S hyperprolactinemia serum liver
levels, serum prolactin
DOCUSATE STOOLSOFTENER/ Avoid grapefruit juice
Colace Laxative Patient Notify: galactorrhea, gynecomastia,
Promotes water incorporation Teaching menstrual abnormality, palpitation,
Mechanism into stool irregular heartbeat, dizziness,
Promote electrolyte & water fainting, pregnancy a/p
excretion
Indication Prevention of constipation, as DONEPEZIL CHOLINESTERASE
an enema (Aricept) INHIBITOR/Anti-Alzheimer’s
Side Effects Throat irritation, mild cramps, Inhibit acetylcholinesterase to
Common diarrhea, rash Mechanism make more acetylcholine
Life Threatening 0 available
Contraindication Hypersensitivity, abdominal Indication Alzheimer’s
pain, N&V, fever Headache, N&V, diarrhea,
Abdominal distention, bowel Side Effects drowsiness, dreams,
Assessment sounds, bowel fx’n, color, Common depression, dizziness, A.fib,
consistency, amount of stool anorexia, syncope
Short-term therapy, Life Threatening 0
Patient dependency, fluid intake,
Teaching
 Hypersensitivity, lactation, Hx of Major depressive disorder, Mgm’t of sx of BPH in men w/
Contraindication heart dse, ulcers, seizures, Indication diabetic peripheral neuropathy, Indication enlarged prostate gland (alone
asthma generalized anxiety disorder, or w/ tamsulosin)
Cognitive function, heart rate fibromyalgia, chronic MS pain libido, ejaculation disorder,
Assessment (bradycardia) Fatigue, drowsiness, insomnia, Side Effects ED, testicular pain/swelling,
Importance of taking meds as Side Effects appetite, constipation, dry Common rash, urticaria, depressed mood
prescribed Common mouth, nausea, dysuria, Prostate CA, allergic rxns,
Patient Do not double dose, may cause libido, ICP, dizziness Life Threatening angioedema
Teaching dizziness Neuroleptic malignant Hypersensitivity, cross
Notify: N&V, diarrhea, changes syndrome, seizure, suicidal Contraindication sensitivity w/ other 5-alpha-
in stool, all Rx/OTC/herbals Life Threatening thought, hepatotoxicity, reductase inhibitors, women,
before Tx or surgery pancreatitis, erythema hepatic impairment
multiforme, SJS, serotonin Sx of prostatic hyperplasia
syndrome (urinary hesitancy, feeling of
DORZOLAMIDE CARBONIC ANHYDRASE
INHIBITOR
MAOIs, severe renal incomp bladder emptying,
(Trusopt)
Contraindication impairment, chronic hepatic Assessment interruption of urinary stream,
Ubiquitous enzyme that
impairment, alcohol abuse dysuria, urgency), rectal exam
Mechanism catalyzes CO2 to
Sexual dysfx’n, BP, before & during BPH tx,
HCO3- & dehydrate carbonic
appetite/nutrition, notable prostate specific antigen (PSA)
acid
behavior changes, serotonin conc’n – used to screen
Manage IOP in ocular HTN &
Assessment syndrome (mental changes, prostate CA
Indication open angle glaucoma
autonomic instability, Same time each day as directed,
Blurry vision, burning/stinging, neuromuscular aberration), take missed dose ASAP in the
Side Effects redness, watery eyes, light rash, SJS, mental status, pain, Patient day or omit dose, sharing of
Common sensitivity, dry eyes, headache, blood sugar Teaching dutasteride is dangerous, 
bitter taste
Do not stop abruptly, Be aware ejaculate vol, avoid donating
Anaphylaxis, eye discharge, of any new agitation, anxiety, blood (6 mos fr last dose) to
Life Threatening eyelid swelling Patient May cause drowsiness, prevent female fr receiving
Hepatic & renal impairment, Teaching orthostatic hypotension dutasteride through a blood
Contraindication hypersensitivity, close angle Notify: serum sickness, suicidal transfusion,  risk in high-
glaucoma, contact lens, corneal ideation grade prostate CA, importance
abrasion, pregnancy of F/U
Sulfonamide hypersensitivity,
Assessment monitor CBC, electrolytes, renal DUTASTERIDE (Avodart) BPH AGENT/
Androgen Inhibitors EMPAGLIFLOZIN ANTI-DIABETIC/Na+-glucose co-
& liver functions
Inhibit the enzyme 5-alpha- Jardiance transporter 2 (SGLT2) inhibitor
Proper administration
Patient technique reductase, which is responsible Inhibits SGLT2, the transporters
Teaching Notify: Ocular irritation, S/S of Mechanism for converting testosterone to Mechanism 1° responsible for the
hypersensitivity its potent metabolite 5-alpha- absorption of glucose in the
dihydrotestosterone in the kidney,  blood sugar by
prostate gland & other tissues, causing the kidneys to get rid of
DULOXETINE NON-OPIOPID  prostate size w/ assoc  in > glucose in the urine
Cymbalta ANALGESIC/NSAIDs urinary sx With diet & exercise, control
Inhibits serotonin & norepi Indication sugar in DM2 in adults,  risk
Mechanism reuptake in CNS
 of CV death w/ DM2 &
established CV disease
Dehydration, dizziness,
Side Effects weakness, yeast infection,
Common BG, URTI, cholesterol,
nausea, joint pain, urination,
UTI, thirst, BP
AKI, hypotension, ketoacidosis,
anaphylaxis, SOB, serious
Life Threatening infection around penis/vagina,
pain, swelling of genital area
Hypersensitivity to Jardiance,
Contraindication severe renal impairment, ESRD
or dialysis
Monitor blood glucose for
Assessment hypo/hyperglycemia, V/S, Sx of
dehydration, Sx of UTI
Empagliflozin can also be used
in the treatment of certain
types of heart failure.
Remember to follow any advice
you have been given about your
diet and taking exercise.
Patient Recognize the symptoms of low
Teaching blood sugar: feeling shaky or
anxious, sweating, looking pale,
feeling hungry, a feeling that
your heart is pounding
(palpitations), and feeling dizzy.
Do not drive if blood sugar ,
be careful in hot weather, drink
lots of fluids, kidney problems
may happen.
ENOXAPARIN (LMW Heparin) ANTI-THROM
Lovenox BOTIC/Anti-Coagulant
Mechanism Inhibit thrombin & Factor Xa
Tx of pulmonary embolism w/
or w/out Warfarin, prevent
Indication ischemic complication w/
unstable angina, tx of acute ST
segment elevation MI (STEMI)
Anemia, headache, dizziness,
Side Effects bleeding at site, liver enzymes,
Common ecchymosis, pruritis, rash
Life Threatening Bleeding
Hypersensitivity to
Contraindication pork/sulfite/benzyl alcohol,
active major bleed, Hx of
heparin induced clot
Bleeding, hemorrhage,
Assessment thrombosis, hypersensitivity,
hematoma, labs
Technique for self admin,
Patient report abdominal bleeding,
Teaching bruising, dizziness, itchy rash,
fever, swelling, SOB
Do NOT take NSAIDs & Aspirin
(ASA) w/out notifying HCP
ENTACAPONE CATECHOL-O, METHYLTRANSFERASE
Comtan INHIBITOR/Anti-Parkinson’s
Inhibits COMT enzyme to
Mechanism prevent Levodopa breakdown
&  CNS availability
Tx of Idiopathic Parkinson’s
Indication Disease & used w/ Levidopa &
Carbidopa
Agitation, confusion, delirium,
Side Effects dizziness, colitis,
Common brown/orange urine, syncope,
paranoia, hallucinations
Life Threatening Rhabdomyolysis, neuroleptic
malignant syndrome
Hypersensitivity, MAOIs
Contraindication therapy, psycho, pregnant
Parkinsonian &
Assessment extrapyramidal, monitor for
diarrhea, signs of neuroleptic
malignant synd
Take missed dose ≤ 2h after
missing, advise against driving
because of
dizziness/hallucination, inform
nausea/diarrhea, to  fluids &
monitor for weight loss,
Patient change position slowly b/c of
Teaching orthostatic hypotension
Notify: skin changes, agitation,
aggression, delirium,
hallucination, new/
gambling, intense urges,
pregnancy, breastfeeding, F/U
important
ERYTHROMYCIN MACROLIDE/Anti-Infective
Suppress protein synthesis at
Mechanism 50S bacterial ribosome level
Useful when penicillin can’t be
Indication used for susceptible organisms
& topically for acne
Side Effects N&V, phlebitis, abdominal
Common pain, rash, ototoxicity
Torsades de Pointe, ventricular
Life Threatening arrhythmia, C.Diff
Hypersensitivity, hypokalemia,
Contraindication hypomagnesemia, HR < 50
bpm, liver/renal dse,
Myasthenia Gravis
Infection, C&S, bowel function,
Assessment liver levels
Take completely, may cause
Patient N&V, diarrhea, cramps
Teaching Notify: signs of C.Diff,
superinfection
ESCITALOPRAM ANTI-
DEPRESANT/SSRI
Lexapro
Selectively inhibits the
Mechanism reuptake of serotonin
Major depressive disorder,
Indication generalized anxiety, panic
disorder, OCD, PTSD, social
anxiety
Side Effects Insomnia, diarrhea, nausea,
Common libido, dry mouth
Neuroleptic malignant
Life Threatening syndrome, suicidal thoughts,
serotonin synd
 Concurrent MAOIs, concurrent
Contraindication Citalopram, angle closure
glaucoma, Pimozide
Monitor mood & anxiety
Assessment closely, suicidal
thoughts/tendencies, sexual
dysfxn, serotonin syndrome
(hallucination, tachycardia)
Take missed dose in same day
May cause dizziness, don’t
Patient drive, patient, family,
Teaching caregivers observe for suicidal
tendencies, F/U very
important, avoid alcohol
Notify: Rx/OTC/Herbals,
pregnancy
EZETIMIBE LIPID LOWERING AGENT/Cholesterol
Ezetrol, Zetia Absorption Inhibitor
Inhibits cholesterol absorption
Mechanism in small intestine
Management of dyslipidemias
Indication (w/ other agent)
Side Effects Cholecystitis,  liver enzyme,
Common nausea, pancreatitis, rash
Life Threatening Angioedema
Hypersensitivity, acute liver
Contraindication dse, moderate/severe hepatic
insuff, use of fibrates,
pregnancy
Diet hx, serum cholesterol,
Assessment liver enzymes
No more than 1 dose/day,
Patient used w/ diet restriction,
Teaching doesn’t help weight loss
Notify: Unexplained muscle
pain/tenderness, OTCs,
pregnancy
FENOFIBRATE
LIPID LOWERING AGENT/
Fibric Acid Derivatives
Fenomax, Lipidil
Mechanism Inhibits triglyceride synthesis
With diet to  LDL, Type IV &
Indication V hyperlipidemia in at risk for
pancreatitis w/out tx response
Side Effects Fatigue, weakness, DVT, rash,
Common rhabdomyolysis, HDL
Life Threatening Pulmonary embolism
Hypersensitivity, hepatic
Contraindication impairment, severe renal
impairment, use of HMC-CoA
reductase inhibitors
Diet hx, baseline triglyceride
level, cholelithiasis, CPK
Assessment (rhabdomyolysis), mild-
moderate  H&H,
prothrombin level
Controls (not cures) serum
Patient triglyceride, use w/ diet
Teaching Notify: pain, tenderness,
weakness, pregnancy,
breastfeeding, treatment
FENTANYL ANALGESIC, OPIOID/
(Transdermal, Patch) General Anesthetic
Bind to opiate receptors in CNS
Mechanism to alter response & perception
of pain
Moderate – severe chronic pain
Indication in opiate tolerant pxs but need
constant relief
Confusion, sedation, weakness,
Side Effects anorexia, constipation, dry
Common mouth, sweat, N&V
Life Threatening Apnea, respiratory depression
Hypersensitivity, not opioid
Contraindication tolerant,
acute/mild/intolerance pain,
respiratory depression, asthma,
hepatic & renal impairment,
alcohol intolerance
Pain, VS, dependant, bowel,
Assessment respiratory depression
How / when to get pain mgm’t
Correct application & usage
(shower/swim)
Avoid grapefruit and driving,
Patient CNS depressant
Teaching Addiction potential & theft
prevention
Heat Fentanyl release
Oral hygiene
Notify: Rx/OTC/HR,
pregnant/breast feeding, before
MRI
FERROUS GLUCONATE 12% IRON SUPPLEMENT/
Fergon, Ferralet, Simron Anti-Anemic
Enters bloodstream→organs
Mechanism (liver, spleen, marrow) that
becomes a part of iron stores
Prevention/treatment of iron
Indication deficiency anemia
Hypotension, nausea,
Side Effects constipation, dark stools,
Common diarrhea, epigastric pain, skin
stain, myalgia, dyspnea
Life Threatening Seizure, anaphylaxis
Hemochromatosis, iron
Contraindication overload (hemosiderosis),
non-iron deficiency anemia,
alcohol intolerance
Nutritional/diet hx, bowel
Assessment function, S/Sx anaphylaxis,
H&H, reticulocyte level occult
stool,  liver enzyme toxicity
Explain purpose & compliance,
Patient take missed dose w/in 12h, no
Teaching double dose, high iron diet,
risk of OD - overdose
FINASTERIDE ANDROGEN INHIBITOR/Hair
Propecia, Proscar Growth Stimulants
Inhibit enzyme 5-alpha-
Mechanism reductase that converts
testosterone to potent
metabolite
 Benign prostatic hyperplasia inhibiting NaCl+ reabsorption in Suicidal thoughts,
Indication (BPH) * androgenic alopecia Loop of Henle Life Threatening rhabdomyolysis, anaphylaxis,
(male pattern baldness) Indication Reduce edema & HTN angioedema, multi-organ
Side Effects Gynecomastia,  libido,  Dehydration, hypocalcemia, hypersensitivity
Common ejaculate ED, infertility hypochloremia, hypokalemia, Hypersensitivity, renal
Prostate CA, angioedema, Side Effects hypomagnesemia, Contraindication insufficiency, pregnant,
Life Threatening breast CA Common hyponatremia, hypovolemia, breastfeeding
Hypersensitivity, women, metabolic alkalosis, muscle Monitor behavior changes,
Contraindication hepatic impairment cramps, paresthesia, dizzy, seizures, postherpetic
S/Sx of prostatic hyperplasia, headache Assessment neuralgia,
Assessment BPH Life Threatening Erythema multiforme, SJS, Toxic Neuro pain, migraine, restless
Need 6-12m, advise a/t sexual Epidermal Necrosis, aplastic legs
changes (even after), anemia, agranulocytosis No more than 12 hours
Patient importance of checking Hypersensitivity, between doses
Teaching breasts,  risks of CA, male Thiazide/sulfonamide Don’t double dose, don’t stop
fetus can be hurt by exposure Contraindication sensitivity, hepatic coma, abruptly
(birth defects) anuria, alcohol intolerance Not within 2 hours of antacids
Fluid status BP & pulse, fall risk Don’t drive (dizzy/drowsy)
(geriatric), hypokalemia (with K+ Patient Watch for behavioral/mood
FOLIC ACID VIT B9 SUPP/ H2O Sol Vit, wasting drugs) Tinnitus/hearing Teaching changes
Folvate Anti-Anemic
Assessment loss, sulfonamide allergy, rash, Carry med alert ID
Required for erythropoiesis, electrolyte levels, renal fx’n Notify: Before treatment or
Mechanism WBC, RBC, & platelets surgery, pregnancy or
Take missed dose ASAP (no
Anemia from folate deficiency, double dose) breastfeeding
Indication erythema Orthostatic hypotension, talk to
Side Effects General malaise, rash pruritis, MD about K+ diet
Common erythema GLICLAZIDE ANTI-DIABETIC/
Patient Notify: ≥ 3 lbs in 1 day, Sulfonylureas
Life Threatening Bronchospasm Diamicron MR
Teaching Rx/OTC/HR, before Tx or
Contraindication Undiagnosed anemia  BG by  insulin release &
surgery, rash, muscle weakness,
Hx of folic acid allergy, anemia Mechanism sensitivity
cramp, monitor BG, use
(pernicious, aplastic, DM2 when not controlled by
sunscreen, fall risk, constant
Assessment megaloblastic, normocytic) Indication diet/lifestyle/insulin
need for HTN tx
lesions, color, respiratory Hypoglycemia, abdominal
sounds, CBC, Vit B12 Side Effects pain, liver enzymes, N&V,
GABAPENTIN ANALGESIC ADJUNCTS Common photosensitivity
When cause of megaloblastic
(Gralise, Horizant, ANTI-CONVULSANT/ Life Threatening 0
Patient anemia passes supplement Mood Stabilizer
Teaching may not be needed Neurontin) Unstable DM, DM1,
Notify: rash, SOB, pain MOA not known, potentially acidosis, diabetic coma,
Mechanism impacts amino acid transport Contraindication severe hepatic & renal
Partial seizures, restless legs, impairment, alcohol use,
FUROSEMIDE LOOP DIURETIC/ Indication neuropathic pain, prevent
Lasix Diuretic phenylbutazone
migraines, bipolar, anxiety,
Increases renal excretion of Hypoglycemia, sulfonylureas
diabetic neuropathy
water, Na+, Cl+, Mg+, and K+ by Assessment allergy, liver fxn, renal fxn
Side Effects Confusion, depression,
Mechanism Common dizziness, drowsiness, ataxia
 Same time every day, not a colored stool, dark urine, Side Effects Hypokalemia, lipodystrophy,
cure, close glucose monitoring, menstrual abnormality, sexual Common pruritus, swelling
Patient follow prescribed lifestyle, dysfx’n, chew gum, candies for Life Threatening Hypoglycemia, anaphylaxis
Teaching avoid sun, wear SPF, no dry mouth Hypoglycemia, allergy to insulin
alcohol, no aspirin, carry sugar Contraindication / preservatives
Notify: swelling, unusual Hypoglycemia, weight, BG,
HMG-CoA REDUCTASE INHIBITORS
weight gain, SOB, muscle Assessment Hg1Ac, potassium
Inhibit HMG-CoA reductase
cramps Administration, insulin mixing,
Mechanism that is responsible for the
early stages of cholesterol no sharing, not a cure, proper
HALOPERIDOL ANTI-PSYCHOTIC/ synthesis Patient testing, diet & exercise
(Haldol) Butyrophenone Adjunctive management of Teaching Notify: Rx/OTC/HR, pregnant,
Indication primary Tx or surgery, cool storage, med
Anticholinergic & alpha-
hypercholesterolemias & alert, carry candy
Mechanism adrenergic blocking to alter
effects of dopamine in the CNS dyslipidemias
Acute & chronic psychotic Abdominal cramps, HUMULIN R- Short Acting PANCREATIC/
Indication disorders, Tx of aggression, Side Effects constipation, diarrhea, flatus, Regular Insulin Anti-diabetic hormone
Tourette mgm’t 2nd line tx of Common heartburn, headache,  liver Stimulate glucose uptake in
atypical anti-psychosis failure enzymes Mechanism muscle & fat. Inhibit hepatic
Extrapyramidal synd (EPS), Life Threatening Rhabdomyolysis glucose production
Side Effects blurred vision, dry eyes, dry Dietary hx, monitor liver fxn if Control of hyperglycemia in
Common mouth, constipation, weight muscle tenderness happens, Indication diabetics
gain, tardive dyskinesia, Assessment monitor CK (if levels > IOx Side Effects Hypokalemia, lipodystrophy,
restless, drowsy, confused upper limits discontinue), sx of Common pruritis, erythema
Seizure, agranulocytosis, liver injury Life Threatening Hypoglycemia, anaphylaxis
Life Threatening neuroleptic malignant Drinking extra grapefruit juice Hypoglycemia,
syndrome can impair absorption, can Contraindication hypersensitivity to
Angle closure glaucoma, bone help manage but won’t cure
insulin/preservative
marrow depression, CNS Patient levels, use in conjunction w/
Hypoglycemia, body weight,
Contraindication depression, Parkinson’s, liver & Teaching diet & lifestyle, importance of
Assessment BG, Hgl Ac, serum potassium
CV dse, tartrazine, sesame, and F/U exams
Notify: liver injury, muscle Administration, mixing insulin,
alcohol intake
pain/weakness, pregnancy Patient discard vials ≥ 1 month, no
Mental status +/- Schizo sx, BP,
Take at night Teaching swapping, BG & ketone
pulse, hoarding, I/O, weight,
monitoring, diet & exerciser,
Assessment bowel fx’n, akathisia, Additional -statins
S/Sx of hypoglycemia
neuroleptic malignant synd Notes
(NMS), falls, hyperprolactinemia
May require weeks to reach HUMULIN N – Intermediate PANCREATIC/
Rapid Acting Insulin Peak Duration
therapeutic effects, no driving,
(NPH INSULIN) Anti-diabetic hormone Onset
slow position changes, fall risk Lispro (Humalog, 5m 60- 4-6h
Stimulates glucose uptake in
Patient educ, no alcohol/CNS Admelog) 90m
Mechanism tissues and inhibits hepatic
Teaching depressants, sunscreen, Aspart (Novolog) 10-20 1-3 h 3- h
glucose production
sunglasses, protective clothes, m
Hyperglycemia control in
freq mouth rinse/oral hygiene Short Acting
Indication diabetes
Notify: weakness, tremor, clay-
Regular (Humulin R) SQ 30- SQ 2- SQ 5-7h severe renal & hepatic & response to painful stimuli w/
60m, 4h IV 30- impairment CNS depression
IV 10- IV 60m Monitor BP, pulse, freq of Moderate-severe pain, chronic
30m 15- prescription refills to determine Indication pain, anti-tussive
30m Assessment adherence, CBC, electrolyte, LE Confusion, sedation,
Conc (4-500) 30- 2-3h 5-7h cell prep, & ANA titer prior to & Side Effects hypotension, constipation,
60m periodically during tx Common flushing
Intermediate Continue meds even if feeling Life Threatening Respiratory depression
Acting well, same time each day, Hypersensitivity, respiratory
NPH (Humulin N, 1-2h 8- 18-24h missed dose taken ASAP, Contraindication depression, bronchial asthma,
Novolin R) 12h comply w. other HTN head trauma,  ICP, addiction,
Long Acting Patient intervention: weight reduction, GI surgery, hepatic impairment
Glargine (Lantus, 3-4h 0 24h Teaching smoking cessation,  alcohol BP, pulse, RR, pain, bowel,
Basaglar) intake, reg exercise & stress Assessment addiction, cough
Detemir (Levemir) 3-4h 3- 24h mgm’t How/when to ask pain meds,
14h Notify: fever, muscle or joint addiction potential, drowsiness,
pain, tiredness, chest pain, rash, dizziness, orthostatic
Pre-mixed
sore throat hypotension, safe dosage,
NPH / Regular
Humulin 50/50, 30m 4-8h 24h Patient Notify: pain mgm’t not
70/130 HYDROCORTISONE CREAM CORTICOSTEROID/ Teaching adequate, side effects,
Novolin 70/30 Anti-Inflammatory constipation, Rx/OTC/HR, 
Aspart (Novolog 15m 1-4h 24h fluid intake, turning, deep
Suppress normal immune
70/30) breaths, coughing exercises
Mechanism response & inflammation
Lispro (Humalog 15- 2-8h 24h Q2h, avoid concurrent alcohol
Manage inflammation &
75/25) 30m use
Indication pruritis
Side Effects Contact dermatitis, atrophy,
HYDRALAZINE ANTI-HTN/ Common burning, dry HYDROXYCHLOROQUINE ANTI-MALARIAL
Apresoline Vasodilators Life Threatening 0 Plaquenil QUINOLINES/
Hypersensitivity, untreated Anti-Rheumatics
Direct-acting peripheral
Mechanism arteriolar vasodilator Contraindication bacterial/viral infection Inhibits protein synthesis in
Lowering of BP in HTN px &  Affected skin before & after, susceptible organisms by
afterload in px with HF Assessment adrenal function inhibiting DNA & RNA
Correct medication admin, Mechanism polymerase. Death of
Moderate to severe HTN (w/ a
Patient only as directed, no tight plasmodia responsible for
Indication diuretic)
Teaching diapers, only small amount for causing malaria. Has
Tachycardia, drug-induced
pregnant, wash hands, use inflammatory properties
lupus synd, angina, arrhythmia,
gloves, notify if worsens Suppression/chemophylaxis of
Side Effects edema, orthostatic
Indication malaria. Tx of severe
Common hypotension, diarrhea, N&V,
rheumatoid arthritis/systemic
rash, arthritis, dizziness, HYDROMORPHONE HCl- OPIOID AGONIST/Allergy, lupus erythematosus
drowsiness, headache (Dilaudid, Exalgo) Cold, Cough, Opioid Analgesic
Aggressiveness, anxiety,
Life Threatening 0 Opiate receptors bind to alter Side Effects fatigue, headache,
Hypersensitivity, Tartrazine Mechanism perception Common hypotension, abdominal
Contraindication avoided, cardio or CV dse,
 cramps, anorexia, diarrhea,
N&V, ECG changes, SJS
Life Threatening Seizure, Agranulocytosis,
Aplastic anemia
Hypersensitivity to 4-
Contraindication aminoquinoline compounds
Monitor Sx of agranulocytosis
& leukopenia, rashes &
Assessment peripheral neuropathy, be
alert for new seizure activity,
BP, ECG, CBC w/ differential,
LFT, ophthalmology exam,
muscle weakness
Take only as directed by your
doctor. Do not take more or
more often, and do not take it
for a longer time than your
doctor ordered.
Swallow the tablet whole. Do
not crush, break, or chew it.
Take with meals or milk to
Patient lessen stomach upset.
Teaching Keep using for the full
treatment time, even if you
feel better after the first few
doses. Your infection may not
clear up if you stop using the
medicine too soon.
Have your blood works
checked, will make you
sunburn more easily
HYDROXYZINE ANTI-ANXIETY, ANTIHISTAMINE,
Atrax, Multipax, Vistaril SEDATIVE/Hypnotic
Subcortical level CNS
Mechanism depression w/ anti-cholinergic
antihistamine & anti-emetic
properties
Anxiety, pre-op sedation, anti-
Indication emetic, anti-pruritic
Side Effects Drowsy, dry mouth, pain,
Common bitter taste, dizziness
Life Threatening 0
Hypersensitivity, pregnancy,
Contraindication hepatic dysfunction,
geriatric caution
Safety due to sedation,
Assessment drowsiness, agitation, anxiety,
N&V, pruritis
Missed dose ASAP, no double
Patient dose, don’t drive
Teaching (dizzy/drowsy) fall risk , no
alcohol/CNS depressant, oral
hygiene, coping skills
HYOSCINE BUTYLBROMIDE
ANTI-SPASMODIC/
Buscopan, Scapalamine Anticholinergic
Anti-muscarinic
Binds to muscarinic receptors
Mechanism acetylcholine receptors to
smooth muscle contraction &
serotonin
Cramping, abdominal pain,
Indication esophageal spasm, renal colic
Side Effects Drowsiness, vision change, dry
Common mouth, tachycardia
Life Threatening 0 IBUPROFEN
Angle closure glaucoma,
acute hemorrhage,
tachycardia (cardiac
Contraindication insufficiency), prostatic
hyperplasia
Sx urinary retention, HR
Assessment monitor, pain before admin
Drowsiness, blurred vision, no
alcohol/CNS depressants, freq
Patient mouth rinses/oral hygiene
Teaching Notify: Sx acute angle
glaucoma, pain & reddening of
eyes, pupil dilation
HYPOTONIC SOLUTIONS
Solutions has 
concentration of solute & 
Mechanism osmolarity than bodily fluids
causing water to move into
cells→”hypo swells like a
hippo”
0.45% NaCl Treatment of hypernatremia
May cause fluid
Life Threatening overload→electrolyte/overh
ydration/pulmonary edema
HF, severe renal
Contraindication insufficiency, edema,
sodium retention, rapid
infusion (RBC hemolysis)
Allow kidneys to retain Na,
0.33% NaCl dextrose toxicity
May cause pulmonary
Life Threatening edema, febrile reaction
Contraindication HF, severe renal failure
Most hypotonic solution
0.22% NaCl available, maintenance for
peds, mix w/ dextrose
Contraindication Rapid infusion (hemolysis)
Dehydration,  sodium &
D25W potassium
Contraindication Blood products (hemolysis)
NON-OPIOID/ Anti-pyretic
(Advil, Motrin) ANALGESIC/Anti-rheumatic/NSAID
Mechanism Inhibit prostaglandin synthesis
Fever & mild-moderate pain,
Indication inflammation
Side Effects Headache, constipation,
Common dyspepsia, nausea, drowsiness
HF, MI, CVA, GI bleed, hepatitis,
Life Threatening exfoliative dermatitis, SJS, toxic
epidermal necrosis, anaphylaxis
Hypersensitivity, GI bleed/ulcer,
Contraindication CABG, recent MI, bad HF, >30
weeks pregnant
Rhinitis, asthma & urticaria, S/S
Assessment of GI bleed, Creatinine/BUN,
liver enzymes, rash, pain,
arthritis, fever, bleeding
Take with full glass of water and
sit up for 30 mins
No double dose
 Avoid driving id dizzy/drowsy broncho-dilating effect &  No double dose, avoid Na+
Don’t take with alcohol, aspirin, bronchospasm substitute and  K+ / Na+
Patient acetaminophen Treatment for chronic Slow position changes
Teaching If use with 3+ glasses of alcohol Indication obstruction & pulmonary Patient No driving, extra
GI bleeding risk disease Teaching contraceptives, additional HTN
Notify: rash, itching, tinnitus, Headache, dizziness, nausea, Tx
epigastric pain, black stool, flu- Side Effects dry mouth, nervousness, Proper BP monitoring
like sx, pregnant Common shaking Notify: facial swelling, dyspnea,
Don’t give to kids with Life Threatening Hypokalemia, anaphylaxis SOB
dehydration Hyperthyroid, diabetes,
Contraindication ketoacidosis, acidosis, HTN, IRON SUPPLEMENTS
IPRATROPIUM Br- ALLERGY, COLD & seizure, glaucoma, enlarge Essential mineral in Hgb,
Atrovent COUGH, BRONCHODILATOR/ prostate Mechanism myoglobin & enzymes that
Anticholinergic Assessment Baseline RR, lung sounds becomes part of iron stores in
Proper use,  fluids, no more liver spleen, bone marrow
Inhibit cholinergic receptors in
Patient than 2 inhalers, rinse mouth,  Prevention & treatment of
bronchial smooth muscle to 
Teaching caffeine,  smoking Indication iron deficiency anemia
Mechanism cGMP for bronchodilation
w/out systemic anticholinergic Hypotension, constipation,
effects IRBESARTAN ANTI-HTN/ARBs
Side Effects dark stools, epigastric pain,
Indication COPD, rhinorrhea, asthma Avapro Common nausea
Dizziness, headache, sore Blocks vasoconstrictor & Life Threatening Seizure, anaphylaxis
Side Effects throat, blurred vision, aldosterone-secreting effect of Hemochromatosis, iron
Common palpitation, Mechanism Angiotensin II at various Contraindication overload, alcohol
Life Threatening 0 receptor site, incl vascular intolerance
Hypersensitivity, acute smooth muscle & adrenal Nutrition & diet hx, bowel fxn,
Contraindication bronchospasm glands BP & HR (rapid infusion can
Allergy, soy/peanut allergy Lowering of BP in HTN px,  cause hypotension & flushing),
Assessment (Combivent), respiratory progression of diabetic sx anaphylaxis, monitor H&H,
status before & after admin & neuropathy Assessment brownish hue to blood <4h
at peak 1-2h Management of HTN, Tx of admin, Toxic (pain, fever, N&V,
Proper use of Indication diabetic neuropathy in DM2 & diarrhea, cyanosis,
inhaler/nebulizer, spray, HTN px tachycardia, seizure),
Patient mouth rinse, importance of Anxiety, dizziness, fatigue, Coma/seizure: gastric lavage &
Teaching PFT, spray may cause blurred headache, chest pain, Na+ bicarb, Deferoxamine is an
vision, Notify: no Side Effects hypotension, tachycardia, antidote
improvement/worsening, Common rashes, abdominal pain, Explain purpose of tx, missed
headache, cough, GI distress dyspepsia, N&V, hyperkalemia Patient dose w/in 12h, stool may get
Impaired renal function, Teaching darker, follow  iron diet,
Life Threatening myalgia, anxiety, ANGIOEDEMA Children high risk of overdose
IPRATROPIUM Br- & Albuterol SO4 BROCHO BP (lying, sit, stand) & pulse,
Combivent Respimat Inhaler DILATOR Assessment daily weight, fluid overload
Anticholinergic & ISONIAZID
S/S angioedema, assess for ANTI-TUBERCULARS
Mechanism sympathomimetic, produce peripheral edema
INH, Isotamine, Nydrazid
 Inhibit mycobacterial cell wall
Mechanism synthesis & metabolism
1st line of treatment of TB w/
Indication other drugs & prevention
Peripheral neuropathy, fever,
Side Effects psychosis, gynecomastia, rash,
Common vision disturbance
Hepatitis, drug reaction, toxic
Life Threatening epidermal necrolysis,
pancreatitis
Hypersensitivity, acute liver
Contraindication disease, hx of hepatitis
S/Sx of DRESS, rash, hepatic
Assessment fxn, toxicity
Treatment for 6m-2y, avoid
Patient alcohol, Notify: hepatitis, no
Teaching Swiss/Cheshire cheese
ISOTONIC SOLUTIONS
When solutions on both sides
of a selectively permeable
membrane are equal in
concentration
Mechanism/Uses Normal Saline – fluid
replacement for hemorrhage,
dehydration, severe vomiting,
diarrhea, heavy drainage,
blood products, mild
hyponatremia (Na+), metabolic
acidosis
Contraindication Cardiac and renal disease
LR (Ringer’s Lactate) –
burn/trauma, acute blood loss,
Mechanism/Uses hypovolemia, (3rd space), GI
loss, fistula drainage,
electrolyte loss, metabolic
acidosis
Can’t give met lactate (liver
Contraindication disease) lactic acidosis, severe
metabolic acidosis or alkalosis
pH > 7.5 RF
D5W (Dextrose 5% in water) –
Mechanism/Uses free water for kidneys,
hypernatremia, some calories, Patient Notify: If pregnancy is planned
hypoglycemia Teaching or suspected or if breastfeeding
Fluid volume deficit, LANTUS (Glargine) Long Acting Insulin
Indication resuscitation Stimulates of glucose by
Mechanism tissues to BG & inhibit hepatic
glucose production
KETOCONAZOLE ANTI-FUNGAL
Hyperglycemia, control of DM
Ketoderm, Nizoral, Extina
Indication (type 1&2)
Affect cell wall of fungus to
Side Effects Hypokalemia, pruritis,
Mechanism allow leakage
Common swelling, erythema
Treatment of various
Life Threatening Hypoglycemia, anaphylaxis
Indication cutaneous fungal infection
Hypoglycemia, allergy,
Side Effects Burning, itchy, local
Common hypersensitivity, red, stingy Contraindication hypersensitivity to insulin
Life Threatening 0 Hypo/hyperglycemia, body
Contraindication Assessment weight, BG, Hg1Ac, potassium
Hypersensitivity
Proper admin, no sharing, not
Skin & mucous membrane
a cure, monitor BG & ketones,
Assessment before, after & during
Take full course, may stain, Patient compliance, diet & exerciser,
Patient Athlete’s foot, should wear Teaching med alert, Notify: before
Teaching well fitted/vented shoes, no treatment or surgery,
nail polish, report irritation pregnancy
LATANOPROST PROSTAGLANDIN/
LACTULOSE OSMOTIC/
Xalatan Eye Preparation
(Cholac, Consilac) Laxative
 water content to soften stool Reduces intraocular pressure
Mechanism (IOP) by  outflow of aqueous
Mechanism &  pH of the colon to inhibit
ammonia diffusion humour
Open angle glaucoma, ocular
Chronic constipation, manage
Indication portal systemic (hepatic) Indication HTN & elevated IOP
Headache, rash, dry eye, vision
encephalopathy (PSE)
Belching (burps), cramps, Side Effects disturbance, pain, irritation,
Common tearing, photophobia, 
Side Effects flatulence, distention (bloating),
Common diarrhea, hyperglycemia brown pigment
Life Threatening 0
(diabetics)
0 or no life-threatening side Hypersensitivity, pregnant,
Contraindication
Life Threatening effects intraocular infection,
Patients in low-galactose diet, conjunctivitis
Contraindication diabetics Withhold if acute
Abdominal distention, stool inflammation,  pigment of
Assessment characteristics, BG in DM, Assessment iris &  eyelid, 7 eyelash may
serum electrolytes happen over months→ years
 fluid intake, fiber, and Eye receiving treatment
mobility should be aware of
Patient hyperpigmentation, no
Teaching breastfeeding, contact HCP if
ocular rxn occurs, incl
conjunctivitis, eyelid rxn
LEVOFLOXACIN ANTI-INFECTIVE/
Fluoroquinolones
Levaquin
Mechanism Inhibit bacterial DNA synthesis
UTI, gonorrhea, GU, RTI, acute
exacerbations of chronic
bronchitis, pneumonia,
Indication skin/structure & joint
infection, diarrhea, intra-
abdominal infection, post-
exposure anthrax & plague
Dizziness, headache, insomnia,
Side Effects diarrhea, nausea, abdominal
Common pain, agitation, vasodilation,
myalgia, tremor, phlebitis
 ICP, seizure, suicidal
Life Threatening tendencies, Torsades, hepatic
toxicity, C.Diff, SJS, anaphylaxis
Myasthenia Gravis, IA
Contraindication antiarrhythmia, end stage
CKD, QT prolong
Sx anaphylaxis, bowel fxn, rash
Assessment (SJS), suicide, sx peripheral
neuropathy, C&S, sx infection
Monitor for behavior changes,
always complete course, 
fluids 1500-2000mL/day to
prevent crystalluria, antacids
Patient  absorption, dizziness,
Teaching drowsiness, (wait to drive),
Stop immediately at Sx of
peripheral neuropathy, Notify:
Hx of QT prolongation,
Theophylline, fever, diarrhea
(w/ pus, blood, mucous), rash,
suicidal tendencies,
superinfection, jaundice,
LEVOTHYROXINE HORMONE/Thyroid
T4, Synthroid, Eltroxin Preparations
Replacement/supplementation
of endogenous thyroid
hormones to  metabolic rate,
Mechanism gluconeogenesis, utilize &
mobilization of glycogen,
stimulate protein synthesis, cell
growth/differentiation, brain &
CNS dev’t
Hypothyroidism, goiter
Indication prevention & Tx, thyroid CA
(only excessive doses)
Side Effects headache, tachycardia, angina,
Common colds, weight loss, arrhythmia,
irritable, insomnia
Life Threatening 0
Contraindication Recent MI, hyperthyroid
Apical pulse & BP (before &
during), blood glucose (diabetic)
Assessment Toxic: (hyperthyroid,
tachycardia, chest pain, tremor,
weight loss)
Same time everyday
Life-long Tx
4h between antacids, Ca+ & iron
Patient Importance of F/U Tx
Teaching Notify: missed 2-3 consecutive
doses, headache, diarrhea,
nervousness, excessive
sweating, other thyroid Sx
LIDOCAINE (Topical) ANESTHETIC/ ANTI-
(Betacaine, Cathejell, Glydo) (Local) ARRHYTHMIC
Produces local anesthetic by
inhibiting transport of ions
Mechanism across neuronal membranes to
prevent initiation & conduction
of normal nerve impulses
Infiltration/mucosal/topical
Indication anesthetic, postherpetic
neuralgia
Side Effects Confusion, dizziness,
Common drowsiness, agitated, stinging
Seizure, Cardiac arrest,
Life Threatening anaphylaxis
3rd degree heart block, Wolff-
Contraindication Parkinson-White syndrome
Degree of numbness, pain at
Assessment site during therapy
Patient No water with patch, start 
Teaching dose, no heat ( absorption)
LINAGLIPTIN ANTI-DIABETIC/
Dipeptidyl peptidase-4 Inhibitor
Tradjenta
 incretin levels by inhibiting DPP-
4, w/c  insulin release & 
Mechanism glucagon levels to improve
intestinal; release & regulation of
hormones
Adjunctive treatment of DM2 along
Indication w/ exercise, diet
Side Effects Hypoglycemia, bronchial
Common hyperactivity,  lipase
Pancreatitis, angioedema,
Life anaphylaxis, urticaria,
Threatening bronchospasm
DM1, Diabetic-ketoacidosis,
Contra- Sitagliptin/Alogliptin/Saxogliptin
indication sensitivity
Sx hypoglycemia (abdominal pain,
sweat, hunger, weakness,
Assessment tachycardia, dizziness), Sx of
pancreatitis ( N&V, severe
abdominal pain, anorexia),
arthralgia,  uric acid
Long-term therapy, do not share
medication, follow diet/lifestyle
changes, Sx of
Patient hyper/hypoglycemia,
Teaching Hypoglycemia: drink OJ w/
sugar/honey, Notify: Pancreatitis:
rash, hive, blisters, facial swelling,
pregnancy, breastfeeding
LISINOPRIL ANTI-HTN/
Prinivil ACE Inhibitors
 Blocks conversion of
Angiotensin I to Angiotensin II,
Mechanism  aldosterone levels &
prevents bradykinin
degradation to cause systemic
vasodilation
Indication  risk of death/HF after MI
Cough, hypotension, taste
Side Effects disturbance, hyperkalemia,
Common edema, dizziness, fatigue,
flushing, pruritis, N&V,
tachycardia
Life Threatening Agranulocytosis, angioedema
Hx of angioedema, Aliskiren,
Contraindication Sacubitril
HTN assessment, monitor
Assessment weight, S/Sx of angioedema
No double dose, avoid salt
subs, slow position changes,
avoid high potassium, Notify:
Patient rash, mouth sores, sore throat,
Teaching fever, swelling Diabetic:
monitor BG regularly, teach
how to monitor BP, extra
contraceptives
LITHIUM CARBONATE MOOD STABILIZER/
Carbolith, Duralith Anti-manic Agents
Alters cation transport in
Mechanism nerve & muscle
Manic episodes of Bipolar
Indication Disorder (I), manic depressive
illness (tx, maint, prophylaxis)
Fatigue, headache, impaired
memory, ECG changes,
Side Effects abdominal pain, anorexia,
Common bloating diarrhea, nausea,
polyuria, acneiform eruption,
folliculitis, hypothyroidism,
leukocytosis, weakness,
tremor
Life Threatening Seizure
Hypersensitivity, CV/renal dse,
dehydration, debilitated, Na+
Contraindication depletion, Brugada syndrome,
use only when blood/tx can be
closely monitored
Mental status, I/O, renal &
Assessment thyroid fxn, serum lithium 2x
weekly & q2m S/Sx lithium
toxicity (vomit, poop, slurring)
Take dose ASAP (unless w/in
2h of next dose), avoid driving,
low Na+ can predispose to
Patient toxicity, weight gain may
Teaching happen, knows S/Sx of toxicity,
use alternative contraception,
Notify: pregnancy, tx/surgery,
fainting irregular pulse,
dyspnea
LOPERAMIDE ANTI-
(Imodium) DIARRHEAL
Inhibit peristalsis & prolong
Mechanism transit time by effecting nerves
in intestinal wall,  fecal
volume,  viscosity & bulk to 
fluids & electrolytes loses
Acute diarrhea, chronic
Indication diarrhea, from Inflammatory
Bowel Disease-IBD,  ileostomy
drainage
Drowsiness, constipation,
Side Effects dizziness, abdominal pain, dry
Common mouth, syncope
Cardiac arrest, QT prolong,
Life Threatening Torsade, Ventricular arrhythmia
Px who can’t get constipated,
Contraindication unknown cause
Abdominal pain, alcohol
intolerance
Frequency & consistency, bowel
Assessment sound before & after, fluid &
electrolyte balance
No double doses
Do not exceed max dose
Causes drowsiness (no driving)
Patient Frequent mouth rinses, oral
Teaching hygiene, sugarless gum for dry
mouth
Avoid alcohol & CNS depression
Notify: diarrhea persists, fever,
abdominal pain, distention
LORAZEPAM BENZODIAZEPINE/Anesthetic
(Ativan) Anti-anxiety/Sedative
Potentiates GABA causing CNS
Mechanism depression
Indication Anxiety disorders
Side Effects Dizziness, drowsiness, lethargy,
Common headache, forgetfulness
Life Threatening Apnea, cardiac arrest
Hypersensitivity, cross
sensitivity with benzos, CNS
Contraindication depression, uncontrolled severe
pain, angle closure glaucoma,
severe hypotension, sleep
apnea
Anxiety, dependence, epilepsy,
Assessment toxicity
No skipping or double doses,
usually short term,  gradually,
Patient coping skills, no driving
Teaching Avoid alcohol and other CNS
depressants
Notify: pregnancy
Mg+ SUPP (ORAL) MINERAL & ELECTROLYTE
REPLACEMENT/Supplements
Antacids, in decreasing order
Mechanism of their ability to neutralize a
given amount of acid, ex: Mg+
salts,  serum Mg+ levels
Mineral supplement used to
prevent and treat low
Indication amounts of Mg+ in the blood.
Mg+ is very important for the
normal functioning of cells,
nerves, muscles, bones, and
the heart.
 - Stomach upset and diarrhea
may occur.
- Serious Allergic Reactions:
Side Effects rash, itching/swelling
Common (especially of the
face/tongue/throat), severe
dizziness, trouble breathing.
Life Threatening Cardiac arrest, silica renal
stones
Hypermagnesemia, renal
Contraindication calculi, V-fib, Mg+ supplements
Mg+ supplement replacement,
BP, ECG, pulse, IV site, antacid
Assessment use, serum level, toxicity, bone
pain, stomach pain, confusion,
muscle weakness, high BP,
abnormal rhythm
Taking this product with a
Patient meal helps to reduce these
Teaching effects. If either of these
effects persist or worsen, tell
your doctor or pharmacist
promptly.
METFORMIN ANTI-DIABETIC/
(Glycon, Fortamet) Biguanides
 hepatic glucose production,
Mechanism intestinal glucose absorption, &
 insulin sensitivity
DM2 mgm’t with lifestyle
Indication changes, insulin, & PO hypogly
Side Effects Abdominal bloating, diarrhea,
Common N&V, metallic taste, Vit B12 def
Life Threatening Lactic acidosis
Metabolic acidosis, severe renal
Contraindication impairment, iodine contrast, Hx
of liver dse, alcohol, heart
failure, hepatic impairment
IV / Sulfonylureas (Sx hypogly),
Assessment acidosis, folic acid, & Vit B12
Same time daily, helps control
hypergly NOT cure
Follow lifestyle changes, Sx
hyper/hypoglycemia
Hypoglycemia: Drink OJ with
sugar/honey then get help
Patient Test BG and ketones regularly
Teaching Always carry sugar (juice,
candy)
Follow ups are important
Notify: acidosis (chills, diarrhea,
dizziness, low BP, muscle pain,
abdominal pain,  HR, SOB)
METHADONE HCL OPIOID ANALGESIC/
Opioid Agonist
Dolophine, Metadol
Binds to opiate receptors in
Mechanism CNS to alter pain perception &
 CNS
Moderate-severer pain
(chronic) in opioid tolerant px
Indication that require round the clock tx
but other methods are
ineffective (ER=extended
release)
Confusion, sedation,
Side Effects hypotension, constipation,
Common blurred vision, urinary
retention, N&V, flushing
sweating
Respiratory depression,
Life Threatening Torsades
Respiratory depression,
Contraindication acute/severe bronchial
asthma, paralytic ileus, alcohol
intolerance, concurrent MAOIs
Pain (before & 1-2h after), BP,
pulse, RR, bowel fxn,
physical/psychological
Assessment dependence, hx of heart dse,
opioid
addiction/abuse/misuse,
opioid detox (irritable, runny
nose/eyes, cramps/aches,
tremors, dilated pupils)
How & when to take
medication, consult if dose is
ineffective after weeks, no
driving, slow position changes,
cough/turn/breath Q2h,
Patient Notify: arrhythmia, OD
Teaching (difficult/shallow breathing,
extreme fatigue, blurry vision,
confusion)
METHOTREXATE
ANTINEOPLASTIC,ANTI
Folex, Rheumatrex RHEUMATIC, DSE MODIFYING
ANTIRHEUMATIC DRUGS (DMARDS)/
Anti-metabolites
Interferes with folic acid
metabolism. Result in
inhibition of DNA synthesis &
Mechanism cell reproduction (cell-cycle S-
phase specific), has
immunosuppressive activity,
death of rapidly replicating
cells.
Tx of Trophoblastic neoplasms
Indication (choriocarcinoma,
chorioadenoma destruens,
hydatidform mole), severe
psoriasis, RA unresponsive to
conventional tx,
Dizziness, headache, malaise,
drowsiness, blurred vision,
Side Effects dysarthria, anorexia,
Common hepatotoxicity, stomatitis,
N&V, alopecia, rashes,
leukopenia, anemia,
thrombocytopenia,
nephropathy
Life Threatening Aplastic Anemia
Anaphylaxis, hypersensitivity
Contraindication to methotrexate, severe renal
impairment, ESRD w/out
dialysis
Dermatologic toxicity, sx of
Assessment hematologic toxicity, S&Sx of
infections, fever, dyspnea,
hypoxemia, S&Sx liver & renal
failure
 Regular blood work, Notify: if
Patient kidney problem present,
Teaching getting radiation, diarrhea,
N&V, bowel problems, new &
worsening condition, avoid
driving, no alcohol
METOLAZONE ANTI-HTN, DIURETIC/
Thiazide-like Diuretic
Zaroxolyn
Inhibit sodium reabsorption in
Mechanism distal tubule to  Na+
& H2O excretion,  Cl-
K+ Mg+ HCO- excretion
Mild-moderate HTN, edema
Indication from HF/nephrotic syndrome
Hypokalemia, hyperuricemia,
Side Effects drowsiness, lethargy, chest
Common pain, dehydration
Life Threatening 0 turn dark
Sulfonamide sensitivity,
Contraindication anuria, hypersensitivity
BP, I/O, daily weight, feet/legs,
Assessment Digoxin usage (K+),
Sulfonamide allergy,
electrolyte imbalance
Same time daily, monitor
weight biweekly, use
Patient sunscreen/glasses/clothes,
Teaching additional HTn intervention,
weekly BP, Notify: weakness,
cramps, N&V, diarrhea,
dizziness
METOPROLOL ANTI-ANGINAL
ANTI-HTN/β-blocker
(Lopressor, Betaloc)
Decreases HR & BP by blocking
Mechanism β1 (myocardial) adrenergic
receptors
HTN, angina, MI prevention, HF
mgm’t, ventricular arrhythmia,
Indication migraine prophylaxis, tremor,
aggression, drug induced
akathisia
Fatigue, weakness, erectile
Side Effects dysfunction, dry mouth,
Common flatulence, nervousness,
anxiety, bronchospasms,
wheezing
Bradycardia, HF, pulmonary
Life Threatening edema
Uncompensated HF, pulmonary
edema, cardiogenic shock,
bradycardia, heart block
Contraindication Monitor BP, ECG, pulse,
frequency of refills, vitals, &
ECG q 5-15 mins
Administer Atropine if HR < 40
bpm
Monitor I/O, daily weight, S/S of
Assessment HF, angina, BG 
NEVER stop abruptly
Missed dose up to 8h before
Patient next dose
Teaching Teach how to check pulse
Don’t drive Diabetics: Monitor
Slow position changes sugar
Notify: for signs of HF closely
METRONIDAZOLE ANTI-INFECTIVES, ANTI-
(Flagyl, Nidagel) PROTOZOALS/Anti-ulcer
Disrupts DNA & protein
synthesis in susceptible
Mechanism organisms, bactericidal,
trichomonacidal, or amebicidal
action
PO/IV: Tx of anaerobic inf: intra-
abdominal, gynecologic,
Indication skin&skin struct inf, LRTI, CNS,
septicemia, endocarditis, (IV):
peri-operative prophylactic
agent in colorectal surgery
Dizziness, headache, aseptic
Side Effects meningitis (IV), psychosis
Common Abdominal pain, anorexia, N&V,
diarrhea, dry mouth, phlebitis
@ IV site
Life Threatening Stevens-Johnson syndrome
Hypersensitivity, 1st trimester
Contraindication pregnancy, hx of blood
dyscrasias, hx of seizure,
neurologic problems
Assess for infection, V/S,
appearance of wound, sputum,
urine & stool @ beginning &
throughout tx, C&S, neuro
Assessment status, I/O, daily weight, D/C tx:
severe fever, malaise, fatigue,
muscle/joint aches, blisters, oral
lesions, conjunctivitis, hepatitis,
and/or eosinophilia, AST/ALT &
LDH tests
Take as directed, no alcohol,
may cause dizziness, no driving,
Patient metallic taste, frequent mouth
Teaching rinse, sugarless gum/candy for
dry mouth, can cause urine to
Notify: rash, sx of
superinfection, pregnancy
MIRABEGRON URINARY TRACT ANTI-
Myrbetriq SPASMODICS/β-Adrenergic Agonist
Acts as a selective beta-3
adrenergic agonist,  bladder
Mechanism capacity by relaxing detrusor
smooth muscle during storage
phase or bladder fill-void cycle,
 symptoms of OAB
Overactive bladder (OAB), incl
Indication urge incontinence, urgency, &
frequency
 BP, tachycardia,
Side Effects nasopharyngitis, constipation,
Common diarrhea, nausea, UTI, dizziness,
headache
Life Threatening Angioedema
Hypersensitivity, severe
Contraindication uncontrolled HTN, ESRD, severe
hepatic impairment
Monitor for S/Sx angioedema:
swelling of face, lips, larynx, D/C
 and treat symptomatically,
Assessment assess for urinary urgency,
monitor BP
Take as directed, missed dose
ASAP, may cause in BP,
Patient dizziness, avoid driving
Teaching Notify: Rx/OTC/herbal, difficulty
emptying bladder, plan or
suspected pregnancy,
breastfeeding, Sx of UTI,
tachycardia
MOMETASONE ANTI-ASTHMATIC/
(Asmanex) Corticosteroids
Potent, locally acting anti-
inflammatory & immune
Mechanism modifier,  freq & severity of
asthma attacks, improves
asthma symptoms
Maint. tx of asthma,  need for
Indication systemic corticosteroid in px w/
asthma
Headache, dysphonia,
Side Effects hoarseness, diarrhea, dry
Common mouth, bronchospasm, cough,
wheeze, dizziness
Hypersensitivity rxn incl
Life Threatening anaphylaxis, laryngeal edema,
urticaria, & bronchospasm
Hypersensitivity or intolerance
to drug or milk proteins, acute
Contraindication attack of asthma/status
asthmaticus, active untx’d
infection, diabetes or glaucoma
Respi status, lung sounds, PFTs,
sx of adrenal insuff (anorexia,
nausea, weakness, fatigue,
Assessment hypotension, hypogly),
withdrawal sx: (joint/muscular
pain, depression), S/S
hypersensitivity rxns: (rash,
pruritus, swelling of face, neck,
dyspnea)
Take meds as directed, gradual Notify: pain control NOT
 is req’d, use bronchod 1st adequate or severe side
Patient before corticosteroid effects occur
Teaching (inhalation), use reg PEFR
monitoring
MULTIPLE VITAMINS VITAMIN,
Notify: S/S hypersensitivity rxs, SUPPLEMENT
sore throat or mouth sores,
Centrum, One-A-Day
pregnancy planned or Used to help growth and good
suspected, breastfeeding Mechanism health
Treatment & prevention of
Indication vitamin deficiency due to poor
MORPHINE *High Alert Meds* OPIOID ANALGESICS/ diet or certain illnesses
Doloral, M-Ediat Opioid Agonists Side Effects Constipation, dark stools,
Binds to opiate receptors in Common N&V, abdominal pain
Mechanism the CNS, producing Life Threatening Overdose
generalized CNS depression, Impaired renal function,
severity of pain Contraindication nephrolithiasis
Severe pain, round-the-clock Assess for allergic reaction to
Indication long-term opioid tx & Assessment the drug, Inform MD of Rx
alternative tx are inadequate, drugs, OTC, herbal
pulmonary edema, pain assoc Take accdg. to recommended
w/ MI Patient daily allowance, take with
Side Effects Hypotension, constipation, Teaching meals to avoid stomach upset,
Common confusion, sedation signs of allergic reaction: rash,
Respiratory depression (incl: hives, itching, wheezing
Life Threatening central sleep apnea & sleep
related hypoxemia)
MUPIROCIN ANTI-INFECTIVES/
Hypersensitivity: Monoxycarbolic Acids
Tartrazine/Bisulfites/Alcohol, Bactroban, Centany
Contraindication acute, mild, Inhibits bacterial protein
intermittent/postop pain, Mechanism synthesis
respi depression, acute/severe Treatment of impetigo, 2°
BA, paralytic ileus Indication infection on skin
Type, location & intensity of lesions/eradicate MRSA nasal
Assessment pain, *High-Alert*: LOC, BP, colonization
pulse, RR, Topical: burning, itching, pain,
physical/psychological Side Effects stinging, Nasal: headache,
dependence, bowel fxn, risk Common cough, pharyngitis, rhinitis,
for opioid addiction URT congestion
How & when to ask for pain Life Threatening 0
meds, may cause withdrawal Hypersensitivity to
sx if D/C abruptly, known Contraindication Mupirocin/Polyethylene Glycol
Patient abuse potential, recognize Assessment Lesions before & after
Teaching respiratory depression & call
911, slow position changes,
 Correct application, hygiene to
Patient prevent spread of impetigo,
Teaching don’t touch eyes
NON-STEROIDAL ANTI-INFLAMMATORY
DRUGS (NSAIDs)
Analgesic, anti-pyretic, anti-
Mechanism inflammatory by inhibiting
prostaglandin synthesis &
vasodilation
Mild-moderate pain, fever,
& inflammation, conditions
Indication like RA & OA,
Side Effects Indigestion, headache,
Common drowsiness
GI bleeding, hepatotoxicity,
Life Threatening bleeding disorder
Aspirin sensitive, asthma,
Contraindication diuretics, HTN, nasal polyps
Asthma/allergy/nasal
Assessment polyps,  risks of
hypersensitivity, pain
assessment, fever, PTT, GI
bleeding
With full glass of water & sit
up at least 30 mins, avoid
Patient Teaching alcohol, GI irritants,
Acetaminophen, Salicylates
concurrently for days at time
NICOTINE
SMOKING DETERRENTS
Nicorette, Nicoderm
Source of nicotine for
Mechanism controlled withdrawal
Adjunct treatment for smoking
Indication withdrawal
Spray: (headache, insomnia,
pharyngitis, nasopharyngitis)
Side Effects Patch: (burning at site,
Common erythema, pruritis,
tachycardia),  appetite 
salivation, nervousness,
dizziness
Life Threatening 0 who have a high risk of getting
Recent MI, severe/worse
Contraindication angina/CV dse, pregnancy
Smoking hx, Withdrawal Sx:
(irritable, drowsy, fatigue)
Assessment Toxicity: (N&V, diarrhea,
auditory & visual changes,
SOB)
Encourage cessation
programs, proper disposal,
Gum: 1 pc when craving till it
tingles→ then squirrel in
cheek, avoid food/drink w/in
Patient 15mins before & after Patch:
Teaching apply same time daily on
torso/arm, apply & press 10
secs, no more than 10 patches,
wash w/ soap & water,
red/itch/burn should go away
w/in 1h Spray: Tilt back head
& don’t inhale/sniff when
spraying
NIRMATRELVIR & RITONAVIR ANTI-INFECTIVES/
Paxlovid Anti-viral combinations
Stimulant
COVID-19 is caused by aLaxative
virus
called a coronavirus.
PAXLOVID contains two
antiviral medicines co-
Mechanism packaged together,
nirmatrelvir and ritonavir.
PAXLOVID stops the virus from
multiplying. This can help your
body to overcome the virus
infection and may help you get
better faster
used in adults to treat mild to
moderate COVID-19 in
patients who:
- have a positive result from a
severe acute respiratory
Indication syndrome coronavirus 2
(SARS-CoV-2) viral test and
severe COVID-19, including
hospitalization or death
Altered sense of taste,
Side Effects diarrhea, vomiting, headache,
Common high blood pressure, muscle
aches
Kidney, liver problems,
Life Threatening hepatitis, hepatotoxicity,
resistance to HIV medicines,
pregnancy, breastfeeding
Hypersensitivity to
nirmatrelvir and/or ritonavir
PAXLOVID IS NOT approved for
any of the following:
Contraindication - To treat patients who are
hospitalized due to severe or
critical COVID-19.
- To prevent COVID-19.
- To be used for longer than 5
days in a row.
For use in children and
adolescents less than 18 years
of age
S&Sx of anaphylaxis, BP,
Assessment respiratory abnormalities, V/S
Notify: Rx/OTC/herbals,
serious illness, S&Sx of allergy,
pregnancy, contraceptives, if
Patient better or worse after 5 days.
Teaching Do not chew, break or crush,
Can be taken with or w/out
food, Take missed dose ASAP,
Do not stop w/out talking to
MRP
NITROGLYCERIN ANTI-ANGINAL
Nitroject, Trinipatch AGENTS/Nitrates
Opioid
Nitroglycerin forms free Agonists
Mechanism radical nitric oxide. In smooth
muscle, nitric oxide produces
vasodilation, more prominent
on veins, may modestly
 afterload, dilates coronary
arteries
Treatment/prevention of
Indication angina pectoris
Hypotension, peripheral
Side Effects edema, syncope, abdominal
Common pain, dizziness, diaphoresis
Life Threatening Severe hypotension & shock,
paradoxical bradycardia &
angina pectoris
Nitrate allergy, acute
Contraindication circulatory failure or shock,
early MI, ICP, severe anemia
BP, HR, cardiac status, GI
Assessment disturbances,
Ask patient if allergic to
adhesive, Note: Rx meds, OTC,
Patient herbal, health problems,
Teaching alternate patch site, do not
start/stop or change the dose
w/out checking the doctor
NYSTATIN (TOPICAL)
ANTI-FUNGAL
Nyamyc, Nystop
Binds to sterols in fungal cell
membrane, changing cell wall
Mechanism permeability, allowing for
leakage of cellular contents,
sx of fungal infection
Tx of fungal infection of feet,
Indication candidiasis
Burning, itching, local
Side Effects hypersensitivity rxn, redness,
Common stinging, diarrhea, N&V,
stomach pain, contact
dermatitis, SJS, GI irritation,
sensitization
Life Threatening 0 Pain (before & 1h after), BP,
Contraindication Hypersensitivity to nystatin
Determine that cause of
Assessment infection is fungal. Avoid skin
contact when applying
Teach patient proper hygiene,
take full course, Notify: local
Patient sensitivity to drug, sx of skin
Teaching irritation, prolonged GI effects
OMEPRAZOLE PPI/
Anti-ulcer Agent
Losec
Binds to enzyme on gastric
Mechanism parietal cells to prevent final
transport of hydrogen ions
GERD & ulcers in heartburn ≥
Indication 2x/week
Abdominal pain, dizziness,
Side Effects fatigue, headache, weakness,
Common chest pain, flatulence,
hypoMg, Vit 12 deficiency
Life Threatening C.Diff
Hypersensitivity to Losec &
Contraindication Benzimidazoles, use of
Rilpivirine
Epigastric/abdominal pain,
Assessment bowel fxn,  liver enzyme, INR
& prothrombin, hypo Mg
Take full course of meds, no
double dose, avoid driving, St
John’s Wort can impact
Patient absorption, avoid NSAIDs,
Teaching alcohol & aspirin, & foods 
GI upset, Notify: black, tarry
stool, diarrhea, abdominal
persistent headache,
pregnancy
ONDANSETRON ANTI-EMETIC/
5-HT3 Receptor Antagonist
(Zofran)
Blocks vagal nerve terminal (5-
Mechanism HT3 or serotonin) &
chemoreceptor in the CNS
N&V caused by chemotherapy,
Indication radiation, post-op
Headache, constipation
Side Effects diarrhea, abdominal pain, dry
Common mouth,  liver enzyme, EPS
Serotonin syndrome, Torsade
Life Threatening de pointe, Stevens Johnson
synd, toxic epidermal necrolysis
Hypersensitivity,
Contraindication phenylketonuria, congenital
long QT syndrome,
apomorphine
N&V, abdominal distension,
bowel sounds, Extrapyramidal
syndrome side effects
Monitor: ECG (hypokalemia,
Assessment hypomagnesemia, heart failure,
bradycardia, meds that prolong
QT)
S/S of serotonin syndrome
Rash / SJS
Notify: Irregular heartbeat,
Patient serotonin synd, involuntary eye
Teaching movements, face, limbs
OXYCODONE OPIOID ANALGESICS/
OxyContin, Supeudol Opioid Agonists
Binds to opiate receptors in
Mechanism CNS to alter perception of pain
& depress CNS
Moderate-severe pain
Indication requiring long-term 24/7 Tx
where alternative treatments
are ineffective
Side Effects Confusion, sedation,
Common constipation, urinary retention
Life Threatening Respiratory depression
Alcohol/bisulfate intolerance,
Contraindication respiratory distress, paralytic
ileus, acute/severe BA,
acute/mild/postop pain
pulse, RR,
Assessment physical/psychological
dependence, bowel fxn, risk
for addiction
How/when to take medication,
known abuse potential, no
Patient driving, slow position changes,
Teaching no alcohol/CNS depressants,
cough/deep breathing/turn
Q2h, Notify: pregnancy
PANTOPRAZOLE Mg PPI/
Anti-ulcer Agent
(Pantoloc, Mylan)
Prevents final transport of H+
Mechanism ions into gastric lumen by
binding to an enzyme when
acidic gastric pH is present
Erosive esophagitis, GERD,
Indication healing erosive esophagitis,
gastric hypersecretory, H. Pylori
Headache, abdominal pain,
Side Effects diarrhea, flatulence, hypergly,
Common hypomagnesemia, B12 def,
bone fracture
Life Threatening Clostridium Difficile Assoc
Diarrhea (CDAD)
Hypersensitivity to
Contraindication Rabeprazole/ Benzimidazoles
Epigastric/abdominal pain,
Assessment bloody stool, hypomagnesemia,
bowel function
Take full course
Avoid: alcohol, aspirin, NSAIDs,
Patient foods causing GI irritation, OTC
Teaching drugs
Notify: black, tarry stool,
abdominal pain, rash, diarrhea,
cramping, pregnancy
PERCOCET *HIGH ALERT MEDS* ANALGESIC COMBI/
OxyIR, OxyNEO Opioid Analgesic
Oxycodone: Binds to opiate
receptors in the CNS, causing
inhibition of ascending pain
pathways, produces
generalized CNS depression
Mechanism Acetaminophen: analgesic
effect dur to activation of
descending serotonergic
inhibitory pathways in CNS.
Antipyresis is produced from
inhibition of the hypothalamic
heat-regulating center
Management of severe pain
Indication w/c alternative tx options are
inadequate
Dizziness, N&V, skin rash,
Side Effects drowsiness, liver enzyme,
Common constipation, hepatotoxicity
CNS depression, respiratory
Life Threatening depression
Hypersensitivity to oxycodone
Contraindication & acetaminophen
Pain, respi & mental status,
BP, bowel fxn, S&Sx of misuse,
Assessment abuse & addiction, S&Sx of
hypogonadism &
hypoadrenalism
Risk for addiction, abuse &
Patient misuse, breathing problems
Teaching (SOB), Notify: pregnancy, Rx
drugs, OTC, herbals, do not
take w/ alcohol
PHYTONADIONE FAT-SOL VIT/
Vitamin K Antidote Vitamins
Required for hepatic synthesis
Mechanism of prothrombin (Factor II), VII,
IX, & X to prevent bleeding
Prevention & treatment of
Indication hypoprothrombinemia assoc
w/ anticoags, salicylates, anti-
infectives, nutritional deficit
GI upset, unusual taste,
Side Effects flushing, rash,
Common hyperbilirubinemia, urticaria,
hemolytic anemia
Life Threatening 0 Patient
Hypersensitivity to Benzyl
Contraindication alcohol (IV only)
Bleeding, BP, & pulse, S/Sx
hypovolemic shock/internal
Assessment bleeding, avoid unnecessary
IMs, hold pressure at sites for
5mins PTT monitoring
Take missed dose ASAP (unless
Patient time for next dose) no IM
Teaching injection, use soft toothbrush,
no flossing, electric razor,
Notify: unusual/sudden
bleeds/bruises, blood in pee,
black, tarry stool, extra heavy
flow
PIPERACILLIN/TAZOBACTRAM ANTI-INFECTIVE/
Tazocin, Zosyn Extended Spectrum Penicillins
Binds to cell wall of bacteria
w/ a wider spectrum than
Mechanism most penicillins, Tazobactam
inhibits beta-lactamase that
destroys penicillin
Appendicitis, peritonitis,
Indication skin/structure infection,
gyneco, community-
acquired/HA pneumonia
Side Effects Diarrhea, rash (CF), pain,
Common phlebitis, bleeding, lethargy
Seizure (high dose), C,Diff,
general exanthematous
Life Threatening pustule, DRESS, SJS, TEN,
anaphylaxis, serum sickness
( in CF)
Cephalosporin/Penicillin/Beta-
Contraindication lactam/Tazo sensitivity
Infection Sx, drug hx, C&S
anaphylaxis, bowel fxn, skin
Assessment rxn, sx DRESS (fever, rash, face
swelling),  H&H,
hyperglycemia, abnormal
Na+/K+/Ca+
Report sx of superinfection,
Notify: fever, diarrhea (w/ pus,
Teaching blood, mucous)
POLYETHYLENE GLYCOL LAXATIVES/
(PEG 3350, Lax-a-Day, Restoralax) Osmotics
 (In sol’n) acts as an osmotic
Mechanism agent, drawing H2O into the
lumen of GI tract, evacuation of
GI tract w/out H2O or
electrolyte imbalance
Indication Tx of occasional constipation
Side Effects Urticaria, abdominal bloating,
Common cramping, flatulence, nausea
Life Threatening 0 Fe levels, occult blood in stools
GI obstruction, gastric
Contraindication distention, toxic colitis,
megacolon, bowel perforation
Abdominal distention, bowel
Assessment sounds, pattern of bowel fx’n,
COCA of stool
2-4 days before bowel
movement, best result 1-2
weeks of use, not be used > 2
Patient wks, prolonged, freq use =
Teaching electrolyte imbalance & laxative
dependence
Notify: unusual cramps,
bloating or diarrhea
POLYSACCHARIDE IRON ANTI-ANEMIC/Iron
(Hytinic, Niferex, Nu-Iron) supplement
Essential mineral found in Hb,
myoglobin, & many enzymes,
enters the bloodstream & is
Mechanism transported to the organs of the
reticuloendothelial system
(liver, spleen, bone
marrow)where it becomes part
of iron stores, resolution or
prevention of Iron def anemia
PO tx & prevention of Fe def
Indication anemia
N&V, constipation, dark stools,
Side Effects epigastric pain, GI bleeding,
Common dizziness, headache, syncope
Life Threatening 0 Assessment
Anemia not due to Fe def,
hemochromatosis,
Contraindication hemosiderosis, hypersensitivity
to Fe products, peptic ulcer,
severe hepatic, renal
impairment
Nutritional status, dietary hx,
Assessment assess bowel fxn for
constipation or diarrhea,
monitor hematocrit &
reticulocyte, serum ferritin and
Explain purpose of Fe tx, comply
w/ meds, take missed dose
Patient ASAP w/in 12h, do not double
Teaching dose, stools may become dark
green or black, follow diet high
in Fe
KCl+ (ORAL) MINERAL & ELECTROLYTE
Klor-Con, Micro-K REPLACEMENT/Supplement
Maintain A/B balance,
isotonicity & electro-
Mechanism physiologic balance of the cell,
activator in enzymatic rx’ns,
replacement, prevention of
deficiency
Indication Tx or prevention of K+ depletion
Abdominal pain, diarrhea,
Side Effects flatulence, N&V, confusion,
Common paralysis, paresthesia,
restlessness, weakness
Life Threatening Arrhythmias
HyperK+, severe renal
impairment, untreated
Addison’s disease,
Contraindication hypersensitivity/intolerance to
Tartrazine (FDC yellow dye #5),
cardiac disease, DM, hypoMg+,
K+ sparring drugs
S/S of hypoK+ (weakness,
fatigue, U wave on ECG,
arrhythmia, polyuria,
polydidpsia), hyperK+, maintain
serum K+ before & during tx,
hyperK+ (slow, irregular
heartbeat, fatigue, muscle
weakness, paresthesia,
confusion)
Do not double dose
Correct method of med admin,
Patient avoid salt subs, low salt diet,
Teaching comply w/ recommended daily
diet. Report: dark, tarry stool,
Importance of follow up
PREDNISOLONE ANTI-ASTHMA/
Corticosteroid (systemic)
Orapred, Omnipred
Suppress inflammation &
Mechanism normal immune response
Systemic & local use for
Indication chronic inflammation, allergy,
hematologic, neoplastic &
autoimmune
Depression, euphoria, HTN,
Side Effects anorexia, N&V, ecchymoses,
Common fragile, hirsutism, petechiae,
adrenal suppression, muscle
wasting, osteoporosis,
Cushingoid appearance
Peptic ulcer,
Life Threatening pheochromocytoma,
thromboembolism
Meningitis, live vaccines,
Contraindication lactation
System assessment, adrenal
insufficiency (weight loss,
Assessment weakness, vomiting), I/O, daily
weight, peripheral edema,
respiratory sounds,
hyperglycemia
Take missed dose ASAP,
stopping abruptly can cause
adrenal insufficiency, avoid
grapefruit,
Patient immunosuppression,
Teaching refrigerate, consult HCP
before/after vaccines,
Diabetics: monitor BG more
often, Notify: chicken
pox/measles exposure,
 underlying diagnosis gets
worse/returns, ASAP for
severe abdominal pain &
black, tarry stools
PSYLLIUM ANTI-DIARRHEAL, FIBER SUPP/
Mucil Laxative, Bulk-producing
Psyllium is a soluble fiber. It
Mechanism absorbs H2O in the intestine to
form viscous liquid w/c
promotes peristalsis &
transit time
Relief & tx of constipation, to
Indication risk of CHD, as dietary
supplement
Abdominal cramps,
Side Effects constipation, diarrhea,
Common esophageal/intestinal
obstruction, HTN, PKU
Rectal bleeding, severe
Life Threatening stomach pain
Hypersensitivity to psyllium,
Contraindication fecal impaction, GI obstruction
Bowel function, vital signs,
Assessment abdominal sounds, S&Sx of
esophageal/intestinal
obstruction
Notify: bowel block, belly pain,
Patient allergy to psyllium, rectal
Teaching bleeding, upset stomach or
change in bowel habits longer
than 2 weeks
QUETIAPINE ANTI-PSYCHOTIC/
Seroquel Mood Stabilizer
Dopamine antagonist &
Mechanism serotonin antagonist,
histamine & alpha-adrenergic
receptors antagonists
Schizophrenia, bipolar
Indication disorder, depression, acute
mania, BP1 mgm’t
Dizziness, weight gain, EPS, Patient sx hyper/hypoglycemia, no
tardive dyskinesia, Teaching breastfeeding
Side Effects palpitations, edema,
Common hyperglycemia, dyspnea,
RISPERIDONE ANTI-PSYCHOTIC, MOOD
cognitive impairment, rhinitis, STABILIZER/Benzisoxazoles
dry mouth
Risperdal
Antagonizes serotonin &
Neuroleptic malignant
Mechanism dopamine in CNS,  sx of
Life Threatening syndrome, seizure,
psychoses, bipolar mania or
pancreatitis, DRESS, SJS
autism
Contraindication Hypersensitivity
Schizophrenia in adult & ages
Mental status, suicidal
Indication 13-17, short-term acute
tendency, BMI, BP (sitting,
episodes (BP1)
standing, lying), not hoarding,
Aggressive behavior, dizziness,
Sx of EPS, TD, neuroleptic
EPS, headache, dream,
Assessment malignant synd, rash (SJS),
Side Effects sleep duration, insomnia,
anemia, cholesterol,
Common fatigue, pharyngitis, diarrhea,
respiratory depression, fall
dry mouth, libido, weight
risk, DRESS: (fever,
gain, photosensitivity,
lymphedema, swelling),
rash/itch
regular blood glucose
NMS, suicidal thoughts,
NOT for elderly w/ Dementia,
Life Threatening agranulocytosis, anaphylaxis,
inform before & after EPS side
angioedema
Patient effects, slow position changes,
Teaching avoid extreme temperature Risperidone/Paliperidone
changes, Notify: suicidal Contraindication sensitivity
thought, pregnancy Mental status, weight, BMI, BP
(sitting, standing, lying),
hoarding, EPS, TD, NMS:
REPAGLINIDE ANTI-DIABETIC/ Assessment (fever, respiratory distress),
Prandin Meglitinides tachycardia, seizure, sweating,
BG levels by release of pallor, tiredness, fall risk,
Mechanism insulin from pancreatic β cells AST & ALT, anemia, frequent
Indication DM2 with diet & exercise CBCs
Headache, N&V, constipation, Possible EPS, slow position
Side Effects stomach pain, back pain, chest changes, no driving, sunscreen
Common pain Patient & sunglasses, F/U are
Teaching important, Notify: suicidal
Pancreatitis, liver reactions,
thoughts, pregnancy, before
Life Threatening hypoglycemia
treatment/surgery
DM1, ketoacidosis,
Contraindication Gemfibrozil use, severe liver
dysfunction RIVAROXABAN
ANTI-COAGULANT/
BG monitoring, HbA1c, Sx of
Xarelto Anti-thrombotic, Factor Xa Inhibitor
Assessment hypoglycemia
Take w/ meals hypoglycemia
chance, skip dose if not eating,
 Selective factor X inhibitor that
Mechanism blocks active site of Xa to
inactivate the Intrinsic Cascade
Prevent DVT ff hip/knee
Indication replacement,
stroke/systemic embolism in
A.fib, PE prevention
Side Effects Syncope, blister, pruritis,
Common extremity pain, spasm
Life Threatening Bleeding
Active major bleeding, severe
renal impairment, prosthetic
Contraindication valve, moderate-severe
hepatic impairment, unstable
PE
Sx bleeding/hemorrhage,
Assessment monitor epidural catheters,
AST/ALT, bilirubin/CGT,
monitor renal function
Patient
Teaching Report sx of bleeding,
ROSUVASTATIN LIPID-LOWERING AGENTS/
Crestor HMG CoA Reductase
Inhibits 3-hydroxy-3- Inhibitors
Stimulant Laxative
methylglutaryl coenzyme A
(MHG CoA) reductase, an
enzyme w/c is responsible for
Mechanism catalyzing an early step in the
synthesis of cholesterol,
lowering total & LDL
cholesterol & triglycerides,
slows progression of coronary
atherosclerosis
Adjunctive management of 1°
Indication hypercholesterolemia & mixed
dyslipidemias
Weakness, abdominal pain,
Side Effects constipation, nausea, rash,
Common myalgia
Life Threatening Rhabdomyolysis
Hypersensitivity, active liver
Contraindication dse or unexplained persistent
elevations in AST & ALT,
pregnancy, lactation
S&Sx of myopathy: muscle
pain, weakness, fatigue,
Assessment dietary assessment, F/U with
lipid panel w/in 2-4 wks of
initiation
Used for bad cholesterol &
good cholesterol (HDL),
Patient monitor blood sugar, have
Teaching blood works checked, avoid
alcohol, follow diet & workout
plan, Notify: allergic rection,
liver dse, pregnancy,
breastfeeding
SALBUTAMOL/ALBUTEROL BRONCHODILATOR/
(Ventolin) Adrenergic
Binds to β2 in airway smooth
Mechanism muscle to  intracellular Ca &
relax bronchioles
Tx & prevention of
Indication bronchospasm in asthma &
COPD
Side Effects Nerves, restlessness, tremor,
Common chest pain, palpitation,
hypokalemia
Life Threatening Paradoxical bronchospasm
(excessive use)
Adrenergic amine
Contraindication hypersensitivity
Lung sounds, BP, pulse (before
Assessment and at peak 60-90 mins),
sputum, wheezing (paradoxical
bronchospasm)
No double dosing or 
frequency, careful observation
after 1st dose from new
cannister, prime with 4 sprays,
Patient discard after 200 sprays
Teaching Notify: SOB, diaphoresis,
palpitation, pain, chest pain,
angina, no response to usual
dose or contents used within 2
weeks
Rinse mouth
May alter taste
Clean mouthpiece min 1x /
week
SENNOSIDES
LAXATIVE/
Ex-lax, Senna Stimulant Laxative
Alter water & electrolyte
Mechanism transport in large intestine to
accumulate water & stimulate
peristalsis
Constipation associated w/
Indication slow transit time, drugs, IBS,
neurological
Cramping, diarrhea, nausea,
Side Effects pink/red, black/brown urine,
Common electrolyte abnormalies
Life Threatening 0
Hypersensitivity, Crohn’s dse,
Contraindication abdominal pain, rectal fissures,
ulcerating hemorrhoids,
alcohol intolerance
Abdominal distention, bowel
Assessment sounds, usual bowel pattern,
color, consistency & amount of
stool
Short-term use only, bulking
Patient agent, may cause colorful
Teaching urine, avoid straining (cardiac
dse), DO Not give laxatives w/
abdominal pain, N&V, of fever
SITAGLIPTIN ANTI-DIABETIC/
Januvia Enzyme Inhibitor
Inhibits the enzyme dipeptidyl
peptidase-4 (DPP-4), w/c slows
the inactivation of incretin
Mechanism hormones, resulting in levels
of active incretin hormones,
improved control of blood
glucose
 Adjunct to diet & exercise to
Indication improve glycemic control in
patients w/ DM2
Side Effects Headache, nausea, diarrhea,
Common URTI, SJS, rash, urticaria
Anaphylaxis, angioedema,
Life Threatening hypoglycemia
Serious hypersensitivity to
Contraindication Sitagliptin
Blood glucose, Sx of
Assessment hypoglycemia, acidosis, S&Sx
of HF, pancreatitis &
hypersensitivity
Do not drive if BG , do not
Patient drink alcohol, blood work
Teaching checked, S&Sx of
hypersensitivity, Notify:
pregnancy, kidney problem
SODIUM BICARBONATE ALKALINIZING AGENT,
(Baking Soda, Bell-Ans, ANTACID/Electr Supp
Citrocarbonate, Neut, Soda Mint)
Act as an alkalinizing by
releasing bicarb ions, ff PO
Mechanism releases bicarb w/c is capable of
neutralizing gastric acid
(PO IV): Mgm’t of met acidosis,
used to alkalinize urine &
Indication promote excretion of certain
drugs in overdosage situation
(phenobarbital, aspirin)
Metabolic alkalosis, flatulence,
Side Effects gastric distension, edema,
Common hypernatremia, hypocalcemia,
hypokalemia, Na & H2O
retention
Life Threatening 0 narrow-angle glaucoma
Met or respi alka,
hypocalcemia, hypernatremia,
excessive Cl loss, as an antidote
Contraindication ff ingestion of strong mineral
acids, px on Na restricted diets,
RF, severe abdominal pain unk
cause, HF, renal insuff,
Fluid balance, I/O, daily weight,
edema, lung sounds, report sx
of fluid overload: (hypotension,
edema, dyspnea, crackles,
Assessment frothy sputum) signs of acidosis:
disorientation, headache,
weakness, dyspnea, hypervent,
alkalosis, hypernatremia,
hypokalemia, U wave on ECG,
arrhythmia, polyuria, observe IV
site, monitor serum
electrolytes, ABG, urine pH
Take meds as directed, take
missed dose ASAP, review sx of
Patient electrolyte imbalance, no milk
Teaching products, renal calculi or
hypercalcemia, importance of
F/U
SOLIFENACIN ANTICHOLINERGIC AGENT/
Urinary Tract Antispasmodics
VESIcare
Inhibits muscarinic receptors
Mechanism resulting in urinary bladder
contraction, residual urine
volume, detrusor muscle
pressure
Treatment of overactive
Indication bladder (OAB) symptoms
Constipation, HTN, abdominal
Side Effects pain, urinary retention,
Common depression, drowsiness,
blurred vision
Life Threatening Angioedma
Hypersensitivity, urinary
Contraindication retention (tablet only), gastric
retention, uncontrolled
Monitor urination pattern,
anticholinergic effects:
headache, confusion,
Assessment hallucinations, somnolence,
fixed & dilated pupils, blurred
vision, tremors, creatinine
clearance, hepatic function,
post-void residuals
Grapefruit juice may serum
level, Notify: glaucoma, liver
Patient dse, slow clearing of stomach,
Teaching trouble passing urine, long QT,
avoid driving, heatstroke, sx of
angioedema
SPIRONOLACTONE DIURETIC/K+ Sparring
(Aldactone) Diuretic
Inhibit Na+ reabsorption in the
Mechanism kidney while saving K+ & H+ by
antagonizing aldosterone
receptors
Counteract K+ by other diuretics
Indication to treat edema, HTN, & primary
hyperaldosteronism
Hyperkalemia, dizziness,
Side Effects clumsy, headache, diarrhea,
Common muscle cramps, erectile dysfx’n,
N&V
Life Threatening SJS, TEN
Hyperkalemia, anuria, acute
Contraindication renal impairment
I/O, daily weight, BP before
admin (w/ anti-HTN),
hyperkalemia, fatigue,
weakness, paresthesia,
Assessment confusion, dyspnea, ECG, *esp
diabetics & geriatrics*
Assess for rash, SJS, BUN,
creatinine,
D/C 3 days before glucose
tolerance test (GTT)
Platelet & leukocytes
Same time each day, no double
dose, Avoid salt subs & high
Patient K+/Na+ foods, May cause
Teaching dizziness, Add tx for HTN
(exercise, alcohol , stress ,
Na+)
 Notify: rash, muscle weakness,
cramps, fatigue, severe N&V,
diarrhea
T3, LIOTHYRONINE
THYROID PRODUCT
Cytomel
Unknown, believed the thyroid
Mechanism hormone exerts its many
metabolic effects through
control of DNA & protein
synthesis, promotes
gluconeogenesis, stimulates
protein synthesis, basal
metabolic rate
Replacement therapy in 1°
Indication (thyroidal), 2° (pituitary) & 3°
(hypothalamic) congenital or
acquired hypothyroidism
Cardiac arrhythmia,
Side Effects tachycardia, hypotension, MI,
Common angina pectoris, fever, HTN,
phlebitis, twitching, allergic
skin rxns
Life Threatening Myxedema
Hypersensitivity to
Contraindication liothyronine sodium,
uncorrected renal insuff,
untreated thyrotoxicosis
Thyroid-stimulating hormone
Assessment (TSH) 4-6 wks after tx, HR, BP,
cardiac sx: (chest pain,
palpitation, edema), clinical
signs of
hypo/hyperthyroidism, bone
mineral density
Do not use drug to treat
Patient obesity or for weight loss. May
Teaching take several weeks to see full
effects, check BG, blood
works, may cause weak bones,
may affect growth in children
TAMSULOSIN Peripherally acting Patient pork), don’t exceed RDA when
(Flomax) adrenergic Teaching using supplements
Contraction in smooth muscle
Mechanism in prostate by binding to alpha TIMOLOL 0.5% β BLOCKER, NONSELECTIVE/
1 adrenergic receptor APO-Timop Ophthalmic Agent, Antiglaucoma
Indication Benign Prostatic Hyperplasia
Blocks both β1 & β2
(BPH) mgm’t/tx Mechanism adrenergic receptors & IOP
Side Effects Dizziness, headache, rhinitis, by aqueous humor
Common orthostatic hypotension, production or possibly the
priapism outflow of aqueous humor
0 – no life-threatening side Treatment of intraocular
Life Threatening effects Indication pressure (IOP) in patients w/
Contraindication Hypersensitivity ocular HTN or open-angle
Sx BPH (urinary hesitancy, glaucoma
incomplete bladder emptying, Burning sensation of eyes,
Assessment stream interruption(, 1st dose Side Effects stinging, angina pectoris,
hypotension/syncope, I/O, daily Common bradycardia, confusion,
weights, rectal exams (before & depression,
during) Anaphylactic reaction,
Always take, may cause Life Threatening angioedema, HF
Patient dizziness, no driving, slow Hypersensitivity to Timolol,
Teaching position changes, follow-up Contraindication bronchial asthma, COPD, sinus
importance bradycardia, 2° or 3° AV block,
overt HF, cardiogenic shock
THIAMINE VITAMIN/ Monitor IOP, BP, Instruct
Betaxin, Vit B1 H2O Sol Vit diabetic patient that sx of
Required for carbohydrate hypoglycemia may be blunted
Mechanism metabolism Assessment while on tx, proper instillation
Thiamine deficit, prevent technique & to remove
Indication Wernicke’s encephalopathy, contact lenses prior to
diet supplement for GI dse, instillation
alcoholism, or cirrhosis Used to lower eye pressure,
Side Effects Restlessness, weakness, tight may hide sx of blood sugar,
Common throat (SE rare) Patient avoid driving, Notify: if you
Life Threatening Vascular collapse, angioedema Teaching have asthma, COPD,
Hypersensitivity, alcohol pregnancy, OTC, Rx, herbals,
Contraindication intolerance, Bisulfate etc. eye infection
intolerance
S/Sx of Thiamine deficiency: TINZAPARIN ANTI-COAGULANT/
ANTI-THROMBOTICS
Assessment (anorexia, GI distress, irritable, (Innohip)
palpitation, tachycardia), Inhibits effect of anti-thrombin
nutritional status, anaphylaxis Mechanism on factor X & thrombin
Comply w/ diet, eat food high
in thiamine (cereal, meat,
 Acute symptomatic DVT w/ or
Indication w/out PE (w/ Warfarin)
Hematoma, irritation at site,
Side Effects pain, liver function,
Common thrombocytosis, ecchymosis
Life Threatening Bleeding
Hypersensitivity, active
Contraindication bleeding, unknown origin of
bleeds
Sxn of hemorrhage, bleeding
gums, black tarry stool, no
S/S DVT, PE, hypersensitivity Rx,
Assessment assess injection site, no
debridement, early
mobilization, caution aerobic
exercise
Notify: bleeding, excessive
Patient bruising, dyspnea, chest pain,
Teaching unilateral leg pain
TIOTROPIUM BRONCHODILATOR/
Spiriva, Respimat Anticholinergic
Selectively & reversibly inhibit
Mechanism M3 receptors in smooth
muscles of the airway
Long-term bronchospasm
Indication mgm’t from COPD/Asthma,
Dry mouth, glaucoma,
Side Effects paradoxical bronchospasm,
Common rash, tachycardia, urinary
retention, constipation
Life Threatening Angioedema
Ipratropium/Tiotropium
Contraindication sensitivity
Respiratory status, (before &
Assessment 5mins after), bronchospasm,
paradoxical bronchospasm
(withhold meds)
Capsules for inhalation NOT
Patient swallowing, NOT for attacks,
Teaching rinse mouth, Notify:
angioedema
TRAZODONE ANTI-DEPRESSANT, SSRI/
Trazorel, Oleptro Antagonist
Alters effect of serotonin in
Mechanism the CNS, anti-depressant
action develop several weeks
Major depressive disorder,
Indication insomnia, chronic pain
Drowsiness, confusion,
Side Effects fatigue, hallucination,
Common hypotension, dry mouth,
tinnitus, weakness, headache
Life Threatening Suicidal thoughts
Recovery from MI, MAOIs,
Contraindication angle closure glaucoma
BP, pulse (before), sexual
dysfxn, serotonin synd,
Assessment (mental changes, agitation),
autonomic instability:
(hypothermia, tachycardia,
BP), GI sx: (N&V, diarrhea),
mental status, suicidal
tendencies, pain
Missed dose w/in 4h of next
dose, no driving
(drowsy/blurred vision,
orthostatic hypotension, no
Patient alcohol/CNS depressants, freq
Teaching mouth rinses/oral
hygiene/sugarless cady for dry
mouth, Notify: suicidal
thoughts, S/Sx of serotonin
syndrome, autonomic
instability, pregnancy, NEVER
abruptly stop
TROPICAMIDE OPHTHALMIC AGENT/
Mydriacyl Mydriatic
Prevents the sphincter muscle
of the iris & the muscle of the
Mechanism ciliary body from responding
to cholinergic stimulation,
produces dilation & prevents
accommodation
For mydriasis & cycloplegia in
Indication diagnostic procedures, topical
ophthalmic use
N&V, tachycardia, headache,
Side Effects pallor, blurred vision,
Common photophobia, stinging of eyes
Life Threatening 0
Hypersensitivity to
Contraindication Tropicamide, known or
suspected narrow angle
glaucoma
Ophthalmic exam, IOP, CNS
Assessment reactions (esp pediatrics)
Avoid driving or actions that
Patient call for clear eyesight,
Teaching photosensitivity, wear
sunglasses, Notify: pregnancy,
breastfeeding, allergic rxn
VITAMIN D VITAMIN/Fat soluble
(Drisdol, Calcijex) Calciferol, Ergocalciferol
Promotes absorption of Ca+ &
Mechanism  parathyroid hormone
concentration
Indication Vitamin D deficit, CKD,
hyperparathyroidism
Side Effects Dizziness, malaise, dyspnea, s/s
Common of hypercalcemia,
Life Threatening Pancreatitis, sensitivity reaction
Hypersensitivity, hypercalcemia,
Contraindication Vit D toxicity
Vit D deficiency, bone
Assessment pain/weakness, evidence of
hypocalcemia, rickets
Take dose missed same day,
Patient diet modification, don’t exceed
Teaching vitamin’s RDA, avoid antacids
with magnesium
WARFARIN ANTI-COAGULANT/ MG, Severe hepatic, and
Coumadin Vit. K Antagonist Contraindication respiratory impairment
Interferes w/ hepatic synthesis Mental status, sleep patterns,
Mechanism of Vit K dependant clotting previous sedative use
factors (II, VII, IX & X) Assessment > 7-10 days use may lead to
Prophylaxis & treatment of dependence, alertness at
Indication venous thrombosis, PE, A.fib, admin, pain assessment
& mgm’t of MI, prevent clot (untreated pain  effects)
formation & embolization Don’t take if someone can take
Side Effects Dermal necrosis, cramps, full night, 2+ week use may
Common nausea fever cause withdrawal, go to bed
Life Threatening Calciphylaxis, bleeding Patient immediately after taking, no
Uncontrolled bleeding, open Teaching driving, no alcohol/CNS
wound, recent brain/eye/spine depressants
Contraindication injury, severe kidney disease & Notify: anaphylactic reaction
liver disease, uncontrolled (tongue swelling, throat
HTN swelling, SOB, dyspnea, N&V).
Bleeding/hemorrhage, nose
Assessment bleeds, black, tarry stools,
additional/increased
thrombosis
NO double dose, review food
 in Vit.K, avoid IM injury &
contact activities, avoid
Patient cranberry juice & teach Vit.K
Teaching antidote, Notify: unusual
bleeding, pain,
color/temperature changes,
pregnancy, avoid alcohol &
ASA & NSAIDs, frequent labs
are important

ZOPICLONE (Imovane) SEDATIVE

Hypnotic/Cyclopyrrolones
Interacts with GABA not
Mechanism benzodiazepine
Short-term tx of insomnia (can’t
Indication fall asleep/wake up early)
Bitter taste, dry mouth,
Side Effects abnormal thought, behavior
Common changes
Anaphylaxis, anaphylactic Rx,
Life Threatening angioedema