WESLEYAN

AN AUTONOMOUS METHODIST UNIVERSITY

COLLEGE OF NURSING AND ALLIED MEDICAL SCIENCES

DRUG STUDY
WARD
SCORE: _________

Name of Generic Name Dosage Action/Contraindication/ Shape & Color of Nursing Implications/
Medication Side Effects the Medication Nursing Responsibilities
(Brand Name) Card to be Used
Vancocin, Firvanq Vancomycin Adult: 500 mg to 2,000 Action Green, Oral Assess:
mg in 3-4 divided doses Vancomycin is a glycopeptide
for 7-10 days. antibiotic which binds tightly to • Infection: WBC, urine, stools,
D-alanyl-D-alanine portion of cell sputum, characteristics of wound
Administration: wall precursor, blocking throughout treatment; obtain C&S
• May be taken with glycopeptide polymerisation before starting treatment
or without food. leading to the inhibition of
bacterial cell wall synthesis. It • Nephrotoxicity: I&O ratio; report
• Use only for also impairs bacterial-cell- hematuria, oliguria;
susceptible nephrotoxicity may occur; BUN,
membrane permeability and
organisms to
RNA synthesis. creatinine
prevent product-
resistant bacteria
Contraindications: • Serum levels: peak 1 hr after 1-
• Antihistamine if Hypersensitivity to vancomycin hr infusion 25-40 mg/L, trough
red-man syndrome and to other glycopeptide before next dose 5-10 mg/L,
occurs: decreased antibiotics (e.g. teicoplanin) especially in renal disease; no
B/P, flushing of trough levels are needed for oral
neck, face; stop or Special Precautions: form
slow infusion Patient with inflammatory
disorders of the intestinal • Pseudomembranous colitis:
 WESLEYAN
AN AUTONOMOUS METHODIST UNIVERSITY

COLLEGE OF NURSING AND ALLIED MEDICAL SCIENCES

• Dose based on mucosa, underlying hearing loss watery or bloody diarrhea,
serum or prior deafness, acute anuria, abdominal cramps, fever, pus,
concentration cochlear damage. Renal mucus, nausea, dehydration;
impairment. Children and discontinue immediately
•PO: without regard
elderly. Pregnancy and lactation. • Auditory function during,
to food, after treatment; hearing loss,
swallow whole ringing, roaring in ears;
Side effects:
(used only for product should be
Clostridium dif Vancomycin may cause any of
the following side effects: discontinued
icile)
headache, nausea, vomiting,
• B/P during administration;
• Store at room stomach pain, back pain, chills,
sudden drop may indicate red-
temperature for ≤2 wk fever, tiredness, and noisy
after l reconstitution man syndrome.
breathing (high-pitched sound).

Storage: Cap: Store below 25°C.

Inj: Store below 25°C. Protect
from light. Reconstituted
solution: Store between 2-8°C.

Azactam, Azitram Aztreonam Dosage: Action: Aztreonam is bactericidal • Watch for seizures; notify
IV/IM A single dose and acts similarly to the physician immediately if
greater than 1 g IV, penicillins by inhibiting synthesis patient develops or increases
continued for at least 48 of the bacterial cell wall; it has a seizure activity.
• Monitor signs of
hr after the patient high affinity for the penicillin-
pseudomembranous colitis,
becomes asymptomatic binding protein 3 (PBP-3) of
including diarrhea,
or evidence of bacterial Gram-negative bacteria. The abdominal pain, fever, pus or
eradication has been activity of aztreonam is mucus in stool, and other
obtained. restricted to Gram-negative severe or prolonged GI
Urinary tract infections aerobic organisms, including
 WESLEYAN
AN AUTONOMOUS METHODIST UNIVERSITY

COLLEGE OF NURSING AND ALLIED MEDICAL SCIENCES

• Adult: IM/IV 500 mg-1 beta-lactamase-producing problems (nausea, vomiting,
g q8-12hr Systemic strains, with poor or no activity heartburn).
infections against Gram-positive aerobes or • Notify physician or nursing
• Adult: IM/IV 1-2 g q8- anaerobic organisms. It is active staff immediately of these
signs. Monitor signs of
12hr against most Enterobacteriaceae
allergic reactions and
anaphylaxis, including
Dosage in the Elderly: Indications/Uses: To reduce the
pulmonary symptoms
Renal status is a major development of drug-resistant (tightness in the throat and
determinant of dosage bacteria and maintain the chest, wheezing, cough
in the elderly; these effectiveness of AZITRAM. For dyspnea) or skin reactions
patients in particular Complicated & uncomplicated (rash, pruritus, urticaria).
may have diminished UTI including pyelonephritis & • Notify physician or nursing
renal function. Serum cystitis (initial & recurrent). staff immediately if these
creatinine may not be an Lower resp tract infections reactions occur.
accurate determinant of including pneumonia &
renal status. Therefore, bronchitis.
as with all antibiotics
eliminated by the Contraindications:
kidneys, estimates of Hypersensitivity to aztreonam,
creatinine clearance other β-lactam antibiotics or
should be obtained, and penicillin &/or cephalosporins.
appropriate dosage
modifications made if Special Precautions: History of
necessary. history of hypersensitivity to β-
Storage: Powd for lactams (eg, penicillins,
inhalation: Store cephalosporins, &/or
between 2-8°C. Powd for carbapenems). Discontinue if
inj: Store below 25°C. allergic reaction occurs.
 WESLEYAN
AN AUTONOMOUS METHODIST UNIVERSITY

COLLEGE OF NURSING AND ALLIED MEDICAL SCIENCES

Reconstituted inj soln:
Store between 2-8°C for
not more than 24 hr.

Azo Standard, Phenazopyridine Dosage: Action: Acts locally on the
Pyridium, Oral (Adults) 200 mg 3 urinary tract mucosa to produce
Prodium, times daily for 2 days. analgesic or local anesthetic
Pyridiate, Administration: Give effects. Has no antimicrobial
Baridium, Uricalm, after food/meals to activity
Urodine, UTI Relief minimize GI side effects Contraindications/Precautions
Oral: Administer Contraindicated in:
medication with or Hypersensitivity;Glomeruloneph
following meals to ritis;Severe hepatitis, uremia, or
decrease GI irritation. renal failure;Renal
Do not crush, break, or insufficiency;Glucose-6–
chew tablet. phosphate dehydrogenase
Storage: Store between (G6PD) deficiency.
15-30°C. Renal insufficiency or
impairment; severe hepatitis.
Adverse Reactions/Side Effects
Central nervous system:
headache, vertigo
Gastrointestinal: hepatotoxicity,
nausea Genitourinary: bright-
orange urine (most frequent),
renal failure
Assess patient for urgency,
frequency, and pain on urination
prior to and throughout therapy
Medication should be
discontinued after pain or
discomfort is relieved (usually 2
days for treatment of urinary tract
infection). Concurrent antibiotic
therapy should continue for full
prescribed duration.
Patient/Family Teaching: Instruct
patient to take medication exactly
as directed. If a dose is missed,
take as soon as remembered
unless almost time for next dose.
Inform patient that drug causes
reddish-orange discoloration of
urine that may stain clothing or
bedding. Sanitary napkin may be
worn to avoid clothing stains. May
also cause staining of soft contact
lenses.

Prinivil Lisinopril Tablet Action Assessment

Lisinopril inhibits angiotensin History: Allergy to lisinopril or
 WESLEYAN
AN AUTONOMOUS METHODIST UNIVERSITY
COLLEGE OF NURSING AND ALLIED MEDICAL SCIENCES
10 mg/12.5 mg converting enzyme (ACE) in human
20 mg/12.5 mg subjects and animals. ACE is a
20 mg/25 mg peptidyl dipeptidase that catalyzes
Hypertension the conversion of angiotensin I to
the vasoconstrictor substance,
10-80 mg
angiotensin II. Angiotensin II also
Lisinopril/6.25-50 mg
stimulates aldosterone secretion by
hydrochlorothiazide the adrenal cortex.
orally each day. Contraindications
Diabetic Nephropathy Do not take Lisinopril if:
Initial: 5 mg PO qDay Hypersensitive to angiotensin
(with diuretic) converting enzyme inhibitors,
May gradually increase thiazides or sulfonamides
dose according to blood Angiotensin-converting enzyme inhi
pressure response; bitors induced
dosage range is 20-40 rapid edema (angioedema),
hereditary or idiopathic
mg/day
Kidney failure or kidney stenosis
Geriatric patients and
Side Effects
patients with renal Cough
impairment Headache
Excretion is reduced in Dizziness
renal failure. Use smaller Depresses mood
initial dose, and adjust Drowsiness
upward to a maximum Nausea
of 40 mg/day PO. Upset stomach
Vomiting
Diarrhea
Mild itching or skin rash
enalapril, impaired renal function,
CHF, salt or volume depletion,
lactation, pregnancy
Physical: Skin color, lesions, turgor; T;
P, BP, peripheral perfusion; mucous
membranes, bowel sounds, liver
evaluation; urinalysis, LFTs, renal
function tests, CBC and differential
Interventions
• Monitor patients closely in
any situation that may lead
to a decrease in BP
secondary to reduction in
fluid volume (excessive
perspiration and dehydration,
vomiting, diarrhea) because
excessive hypotension may
occur.
• Monitor patients on diuretic
therapy for excessive
hypotension following the
first few doses of lisinopril.
Teaching points
Take this drug once a day. It may be
taken with meals. Do not stop taking
without consulting your health care
provider.
 WESLEYAN
AN AUTONOMOUS METHODIST UNIVERSITY
COLLEGE OF NURSING AND ALLIED MEDICAL SCIENCES
Fortamet Metformin Dosage Action
The recommended FORTAMET is indicated as an
starting dose of adjunct to diet and exercise to
FORTAMET is 500 mg improve glycemic control in
orally once daily with adults with type 2 diabetes
the evening meal. mellitus. Metformin is an
Increase the dose in antihyperglycemic agent which
increments of 500 mg improves glucose tolerance in
weekly on the basis of patients with type 2 diabetes
glycemic control and mellitus, lowering both basal
tolerability, up to a and postprandial plasma
maximum of 2,000 mg glucose. Metformin decreases
once daily with the hepatic glucose production,
evening meal. decreases intestinal absorption
Recommendations For of glucose, and improves insulin
Use In Renal sensitivity by increasing
Impairment peripheral glucose uptake and
Assess renal function utilization. With metformin
prior to initiation of therapy, insulin secretion
FORTAMET and remains unchanged while fasting
periodically thereafter. insulin levels and day-long
Storage plasma insulin response may
Store at 20° to 25°C (68° decrease
to 77°F) Contraindications
Avoid excessive heat and Severe renal impairment (eGFR
humidity. below 30 mL/min/1.73 m²)
Hypersensitivity to metformin
Acute or chronic metabolic
Assessment & Drug Effects
Lab tests: Obtain baseline and
periodic kidney and liver function
tests; drug contraindicated in the
presence of renal or hepatic
insufficiency. Monitor blood
glucose and HbA1C, and lipid
profile periodically.
Monitor known or suspected
alcoholics carefully for decreased
liver function.
Monitor cardiopulmonary status
throughout course of therapy;
cardiopulmonary insufficiency
may predispose to lactic acidosis.
Patient & Family Education
Be aware that hypoglycemia is not
a risk when drug is taken in
recommended therapeutic doses
unless combined with other drugs
which lower blood glucose.
Report to physician immediately
S&S of infection, which increase
the risk of lactic acidosis (e.g.,
abdominal pains, nausea, and
vomiting, anorexia).
Do not breast feed while taking
this drug without consulting
 WESLEYAN
AN AUTONOMOUS METHODIST UNIVERSITY

COLLEGE OF NURSING AND ALLIED MEDICAL SCIENCES

acidosis, including physician.
diabetic ketoacidosis, with or
without coma.
Side Effects
nausea
vomiting
stomach upset
diarrhea
weakness
metallic taste in the mouth
Lasix Furosemide Hypertensive Action Assess:
emergency/urgency Inhibits reabsorption of sodium • HF: weight, I&O daily to determine
(unlabeled) and chloride at proximal and fluid loss; effect of product may be
• Adult: IV 40-80 mg distal tubule and in the loop of decreased if used daily
• Hypertension: B/P lying, standing;
Acute/chronic renal Henle
postural hypotension may occur
failure Contraindications:
• Glucose in urine if patient
Adult: PO 20-80 mg/day Contraindications to furosemide diabetic
in AM; may give another use include patients with • Confusion, especially in
dose after 6 hr up to 600 documented allergy to geriatric patients; take safety
mg/day furosemide and patients with precautions if needed
Administer: anuria. Teach patient/family:
• In AM to avoid Side Effects: • To discuss the need for a
interference with sleep CNS: Headache, fatigue, high-potassium diet or
if using product as weakness, vertigo, paresthesias potassium replacement with
diuretic CV: Orthostatic hypotension, prescriber
• To rise slowly from lying or
• Potassium chest pain, ECG changes,
sitting position because
replacement if circulatory collapse EENT: Loss of
orthostatic hypotension may
potassium mg/dL PO hearing, ear pain, tinnitus, occur
 WESLEYAN
AN AUTONOMOUS METHODIST UNIVERSITY

COLLEGE OF NURSING AND ALLIED MEDICAL SCIENCES

route blurred vision •To avoid OTC medications
• PO with food if nausea unless directed by
occurs; absorption may prescriber Treatment of
be decreased slightly; overdose: Lavage if taken
orally; monitor
tabs may be crushed
electrolytes; administer
dextrose in saline;
monitor hydration, CV,
renal status
Lipitor Atorvastatin Dosage and routes Action: Assess
• Adult: PO 10-20 Inhibits HMG-CoA reductase Renal studies in patients with
mg/day, usual range 10- enzyme, which reduces compromised renal system: BUN,
80 mg/day, dosage cholesterol synthesis; high doses I&O ratio, creatinine
adjustments may be lead to plaque regression Hypercholesterolemia: diet,
made in 2- to 4- wk Contraindications: obtain diet history including fat,
intervals, max 80 Pregnancy, breastfeeding, cholesterol in diet; cholesterol
mg/day; patients who hypersensitivity, active hepatic triglyceride levels periodically
require >45% reduction disease during treatment; check lipid
in LDL may be started at Side effects: panel 6-12 wk after changing dose
40 mg/day CNS: Headache, asthenia, Evaluate:
Administer: insomnia Therapeutic response: decrease in
• Total daily dose at any EENT: Lens opacities LDL, total cholesterol,
time of day without GI: Abdominal cramps, triglycerides, CAD; increase in HDL
regard to meals constipation, diarrhea, flatus, Teach patient/family:
• Store in cool heartburn, dyspepsia, liver That blood work and eye exam
environment in tight dysfunction, pancreatitis, will be necessary during
container protected nausea, increased serum treatment
from light transaminase • To report blurred vision, severe
GU: Impotence, UTI INTEG: Rash GI symptoms, headache, muscle
 WESLEYAN
AN AUTONOMOUS METHODIST UNIVERSITY

COLLEGE OF NURSING AND ALLIED MEDICAL SCIENCES

pain, and weakness; to avoid
alcohol
• That previously prescribed
regimen will continue: low-
cholesterol diet, exercise program

Coreg, Coreg CR Carvedilol Essential hypertension Action: A mixture of Assess:

• Adult: PO 6.25 mg bid nonselective α-/β-adrenergic
× 7-14 days; if tolerated blocking activity; decreases
well, then increase to cardiac output, exercise-induced
12.5 mg bid × 7-14 days; tachycardia, reflex orthostatic
if tolerated well, may be tachycardia; causes vasodilation,
increased (if needed) to reduction in peripheral vascular
25 mg bid; not to exceed resistance
50 mg/day; EXT REL cap Contraindications:
20 mg/day, may increase Hypersensitivity, asthma, class IV
after 7-14 days to 40 decompensated cardiac failure,
mg/day, max 80 mg/day 2ndor 3rd-degree heart block,
Available forms: Tabs cardiogenic shock, severe
3.125, 6.25, 12.5, 25 mg; bradycardia, pulmonary edema,
ext rel cap 10, 20, 40, 80 severe hepatic disease, sick sinus
mg symptoms
Administer: Side effects
• With food to minimize CNS: Dizziness, fatigue,
orthostatic hypotension; weakness, somnolence,
regular tabs may be insomnia, ataxia, hyperesthesia,
crushed or swallowed paresthesia, vertigo, depression,
headache
• Hypertension: B/P when beginning
treatment, periodically thereafter;
pulse: note rate, rhythm, quality;
apical/radial pulse before
administration; in those with lower
heart rate (<55 bpm) dose may need
to be lowered; notify prescriber of
significant changes; identify
orthostatic hypotension when patient
rises
Evaluate:
Therapeutic response: decreased
B/P with hypertension; decreased
anginal pain
Teach patient/family:
• To comply with dosage schedule
even if feeling better; that
improvement may take several
weeks; not to crush, chew caps
• To rise slowly to sitting or standing
position to minimize orthostatic
hypotension
• To report slow pulse, dizziness,
 WESLEYAN
AN AUTONOMOUS METHODIST UNIVERSITY

COLLEGE OF NURSING AND ALLIED MEDICAL SCIENCES

CV: Bradycardia, postural confusion, depression, fever, weight
hypotension, dependent edema, gain, SOB, cold extremities, rash, sore
peripheral edema, AV block, throat, bleeding, bruising
extrasystoles,
hypo/hypertension, palpitations,
peripheral ischemia, HF,
pulmonary edema
angioedema
RESP: Rhinitis, pharyngitis,
dyspnea, bronchospasm, cough,
lung edema