STUDENT NURSE

VI. MEDICATIONS
Non IV Medication Template
Directions: List all routine meds scheduled to given on your shift including prn medications that the pt has received in the last 24hrs and complete each column.
Patient Allergies:
Lanolin, PCN, Silicone, Sulfa, Vicodin Response: UNK
IV Solution: LR 75 mL/hr

Agents:
Medication Names
Generic (Trade)
Time
Reference

General things to know before giving meds in this category:

Dose, Route,
Reason your patient is on this medication
Frequency, &
Dosage Range

Administration Considerations

enoxaparin (Lovenox) 40 mg/0.4

mL
Time: 2100

D: 40 mg
R: SubQ
F: q24hr
DR: 40 mg q24h in acute
ill pts.

Contraindicated/Caution: Hypersensitivity to pork products, bleeding, Hx. of

heparin-induced thrombocytopenia, severe hepatic or renal disease, retinopathy,
untreated HTN.

(Vallerand et al, 2013, p. 647)

DVT Prophylaxis

Adverse effects: BLEEDING, Anemia

Lab Test Considerations: Monitor CBC and Platelets, Sudden decrease of H&H
check for bleeding, May cause increase AST and ALT levels.
ANTIDOTE: 1mg of PROTAMINE SULFATE for each mg of enoxaparin by
slow IV.

lansoprazole (Prevacid Solutab)

(Vallerand et al, 2013, p. 763)

D: 15 mg
R: PEG
F: Before Breakfast
DR: 15 mg

GERD Prophylaxis

Contraindicated/Caution: Severe hepatic impairment.

Pt. was NPO

Adverse effects: dizziness, HA, diarrhea,

Lab Test Considerations: Increase AST, ALT, Alk Phos, LDH, Bili, Cr, May
alter RBC, WBC and platelets. May cause hypomagnesemia.

Oral Care: chlorhexidine (Peridex, Periogard) 0.12% 10mL q12h

Home Medds all suspended
Fluticasone (Flonase) 50 mcg/actuation Nasal SpSn 1 spray by both nares route daily.
Menthol-zinc oxide (Calmoseptine) 0.44-20.6% Topical Oint q6h PRN
Miscellaneous medication: 1 each once. Medical marijuana for spasms.
Ferrous sulfate ER (SLOW FE) 140 mg (45 mg iron) Oral TbSR 65 mg BID
Methadone (Dolophine) 10 mg PO q4hr PRN
Pregabalin (Lyrica) 75 mg PO 1 cap TID
Mirtazapine (Remeron) 7.5 mg Oral Tab 1 TAB HOS
Hydromorphone (Dilaudid) 2 mg Oral Tab 1 Tab by mouth q4h PRN
Baclofen Intrathecal

VI. Medications

STUDENT NURSE

Intravenous Medications and Medicated Infusions

Directions: List all IV medications and medicated infusions to be given on your shift including prn medications that the pt has received in the last 24hrs and
complete each column.
Patient Allergies:
Lanolin, PCN, Silicone, Sulfa, Vicodin Response: UNK
IV Solution: LR 75 mL/hr

Agents:
Medication Names
Generic (Trade)
Time
Reference

General things to know before giving meds in this category:

Dose, Route,
Reason your patient is on this
Frequency, &
medication
Dosage Range

Administration Considerations
Dilution: Rate of Administration: Compatibility with current Meds/IVs: Other:

hydrocortisone PF (SoluCORTEF) 100 mg/2mL

Time: 0900
(Vallerand et al, 2013, p.
363)

D: 100 mg
R: IV
F: q8h
DR: 100-500 mg q2-6
hr (Range 100-8000
mg/day)

Dilution: Reconstitute with provided solution or 2 mL of bacteriostatic water or saline for injection.
Concentration: 50 mg/mL

Tx. of Inflamatory Process r/t aspiration

Rate of Administration: 100 mg/30 sec. Doses >500 mg should be infused over at least 10 min.
Compatibility with current Meds/IVs: CHECK COMPATIBILITY CHART
Contraindicated/Caution: Active untreated infections, hypothyroidism, cirrhosis
Adverse Effects: CNS depression, CNS euphoria, HTN, PEPTIC ULCERATION, anorexia, n/v,
acne, decreased wound healing, ecchymosis, fragility, hirsutism, petichiae, adrenal suppression,
THROMBOEMBOLISM, muscle wasting, osteoporosis, cushingoid appearance.

levofloxacin (Levaquin)
Time: 1300
(Vallerand et al, 2013, p.
580)

D: 750 mg at 100
mL/hr
R: IV
F: q24h
DR: 250-750 mg q24h

Tx. of Respiratory Infection

Lab Test Considerations: Monitor electrolytes and glucose (hyperglycemia), hypokalemia, monitor
CBC, may decrease WBC, hypernatremia,
Dilution: Dilute with NS, D5W, or D5NS. Also available in premised bottles and flexible containers
with D5W which need no further dilution. Concentration: 5 mg/mL
Rate of Administration: Adm. AT LEAST over 60 min for doses of 250-500 mg and AT LEAST
over 90 min for doses of 750 mg
Compatibility with current Meds/IVs: CHECK COMPATIBILITY CHART
Contraindicated/Caution: Hypersensitivity, Hx. of myasthenia gravis, concurrent use of Class IA or
Class III antiarrhythmics, Known QT interval prolongation or use of agents that lead to
prolongation, known or suspected CNS disorder, renal impairment, Cirrhosis, concurrent use of
erythromycin, antipsychotics, and tricyclic antidepressants, acute myochardial ischemia, concurrent
use of corticosteroids (increase risk of tendinitis/tendon rupture), transplant pts.,
Adverse Effects: ELEVATED ICP, SEIZURES, dizziness, HA, insomnia, TORSADE DEPOINTS,
HEPATOTOXICITY, PSEUDOMEMBRANOUS COLITIS, diarrhea, nausea, ANAPHYLAXIS,
STEVENS-JOHNSON SYNDROME
Lab Test Considerations: Increase AST, ALT, LDH, Bili, and Alk. Phos, alter glucose levels.

VI. Medications

STUDENT NURSE
Potassium chloride 40
mEq in 100 mL
Time: Once
(Vallerand et al, 2013, p.
1036 and Lexicom
Online)

fentanyl (Sublimaze) 50
mcg/mL
(Vallerand et al, 2013, p.
552)

D: 40 mEq
R: IV
F: Once
DR: IV intermittent
infusion (must be
diluted prior to
administration):
5-10 mEq/dose
(maximum: 40
mEq/dose) to infuse
over 2-3 hours
(maximum: 40 mEq
over 1 hour)

D: 25 mcg
R: IVP
F: PRN
DR: 0.51mcg/kg/dose

Tx. of Hyperkalemia

Dilution: maximum concentration for peripheral infusion is 10 mEq/100 mL and 20-40 mEq/100
mL for central infusions
Rate of Administration: Over 2-3 hours
Compatibility with current Meds/IVs: CHECK COMPATIBILITY CHART
Contraindicated/Caution: Hyperkalemia, severe renal impairment, addisons disease, severe tissue
trauma, known hypersensitivity. Vesicant ensure proper catheter or needle position. People taking
potassium sparing drugs. Cardiac disease, renal impairment, DM as some medications include sugar,
Hypomagnesemia may make correction of hypokalemia more difficult.Close monitoring to avoid
hyperkalemia
Adverse Effects: Confusion, restlessness weakness, ARYTHMIAS, ECG changes. Irritation at IV
site. GI ulcerations, stenotic lesions. Paralysis, paresthesia.

Tx. of Severe Pain

Assess for S/S of hypokalemia weakness, fatigue U wave in ECG, arrhythmias, polyuria,
polydipsia. Monitor hyperkalemia (toxicity) slow, irregular heartbeat, fatigue, muscle weakness,
paresthesia, confusion peaked T wave, depressed ST segments, prolonged QT segments widened
QRS, loss of P waves, and cardiac arrhythmias.
Dilution: Administered undiluted. Concentration: 50 mcg/mL
Rate of Administration: over 1-3 minutes.
Com

patibility with current Meds/IVs: Look at compatibility chart

Contraindicated/Caution: Hypersensitivity, intolerance, debilitated or critically ill pts

Adverse Effects: APNEA, LARYNGOSPASM

fentanyl (Sublimaze) 25
mcg/mL
Lumen 2
(Vallerand et al, 2013, p.
552)

D: 25 mcg/hr 1mL/hr
R: IV
F: Continous
DR: 0.5-1
mcg/kg/dose may
repeat q30-60min

Sedation/Analgesia

NALOXONE (NARCAN) is the antidote

Dilution: May be diluted in D5W or NS. Concentration: up to 50 mcg/mL
Rate of Administration: Slow drip. Slow adm. may reduce the incidence and severity of muscle
rigidity, bradycardia, and hypotension.
Compatibility with current Meds/IVs: CHECK COMPATIBILITY CHART
Contraindicated/Caution: Hypersensitivity, intolerance, debilitated or critically ill pts
Adverse Effects: APNEA, LARYNGOSPASM

Midazolam NS
(Versed) 100 mg in 100
mL drip (conc: 1mg/mL)
Lumen 1
(Vallerand et al, 2013, p.
552)

D: 1 mg/hr
R: IV
F: Continous
DR: 0.01-0.05 mg/kg
(0.5-4 mg in most
adults) loading dose
may be repeated q1015 min until desired
effect is obtained.
0.02-0.1 mg/kg/hr (1-7
mg/hr)

Sedative for Mechanical Ventilation

NALOXONE (NARCAN) is the antidote

Dilution: Dilute with NS or D5W. Concentration 0.5-1 mg/mL.
Rate of Administration: Based on pt.s weight.
Compatibility with current Meds/IVs: CHECK COMPATIBILITY CHART
Contraindicated/Caution: Comatose/CNS Depression, Acute angle-closure glaucoma, pulmonary
disease, HF, Renal and Liver impairment.
Adverse Effects: APNEA, LARYNGOSPASM, RESPIRATORY DEPRESSION, CARDIAC
ARREST, phlebitis.
FLUMEZENIL (ROMAZICON) is the antidote.

VI. Medications

STUDENT NURSE
norepinephrine
(Levophed) 8000 mcg in
D5W mL drip (conc: 32
mcg/ml)
Lumen 1
(Vallerand et al, 2013, p.
933)
Propofol (Diprivan) 10
mg/ml drip
(Vallerand et al, 2013, p.
606 and Lexicom
Online)

Haloperidol (Haldol) 5
mg/mL injection 1 mg
(Vallerand et al, 2013, p.
641)

D: 5 mcg/min 9.38
mL/hr
R: IV
F: Continous
DR: 0.5-1 mcg/min
initially. Maintnance
dose 2-12 mcg/min
titrated by BP response
(avg. 2-4 mcg/min up
to 30 mcg/min)
D: 5 mcg/kg/min x
53.6 kg
268 mcg/min 1.61
mL/hr
R: IV
F: Continous
DR: IV: (Geriatric
Patients, Cardiac
patients, Debilitated
Patients, or
Hypovolemic
Patients): Induction
20 mg q 10 sec until
induction achieved (1
1.5 mg/kg total).
Maintenance 50100
mcg/kg/min (dose in
cardiac anesthesia
ranges from 50150
mcg/kg/min depending
on concurrent use of
opioid).
D: 1 mg
R: IV
F: PRN q2hr
DR: 0.5-5 mg, may be
repeated q30 min

Tx. of hypotension/shock (?)

Dilution: 4 mg in 1000 mL of D5W or D5NS. DO NOT DILUTE IN NS WITHOUT DEXTROSE!

Concentration: 4 mcg/mL
Rate of Administration: Titrate according to Pt.s response.
Compatibility with current Meds/IVs: CHECK COMPATIBILITY CHART
Contraindicated/Caution: Vascular, mesenteric or peripheral thrombosis, HTN, concurrent use of
MAO inhibitors, tricyclic antidepressants, cyclopropane or halothane anesthetics, hyperthyroidism,
cardiovascular disease.

Sedation of intubated, mechanically

ventilated patients in ICUs

Adverse Effects: anxiety, dizziness

Dilution: Usually undiluted but if needed with D5W only.
Rate of Administration: Weight dependent.
Compatibility with current Meds/IVs: CHECK COMPATIBILITY CHART
Contraindicated/Caution: Contraindications: Hypersensitivity to propofol, soybean oil, egg lecithin
or glycerol. Cardiovascular disease, lipid disorders, increased intracranial pressure; cerebrovascular
disorders; hypovolemic patients.
Geri: lower induction and maintenance dose reduction recommended
Adverse Effects: dizziness, headache, APNEA, bradycardia, hypotension, Hypertension, N/V,
Hiccups, cramping, local burning, pain, stinging, coldness numbness, tingling at IV site, involuntary
muscle movements, urine discoloration (green). PROPOFOL INFUSION SYNDROME
Abrupt discontinuation may cause rapid awakening with anxiety, agitation, and resistance to
mechanical ventilation.
Monitor for propofol infusion syndrome severe metabolic acidosis, hyperkalemia, lipemia,
rhabdomyolysis, hepatomegaly, cardiac and renal failure.
If overdose occurs, monitor pulse, RR and BP contiuously

Agitation

Dilution: May be administered undiluted or diluted in 30-50 m of D5W. Concentration 5mg/mL.

Rate of Administration: Rate of 5mg/min or over 30 min.
Compatibility with current Meds/IVs: CHECK COMPATIBILITY CHART
Contraindicated/Caution: Hypersensitivity, angle-closure glaucoma, bone marrow depression, CNS
depression, Parkinsonism, severe liver or cardiovawscular disease, debilitated pt., diabetes,
respiratory insufficiency, prostatic hyperplasia, CNS tumors, intestinal obstruction, seizures.
Adverse Effects: SEIZURES, extrapyramidal reactions, blurred vision, dry eyes, constipation, dry
mouth, AGRANULOCYTOSIS, NEUROLEPTOC MALIGNANT SYNDROME (fever, respiratory
distress, tachy, seizures, diaphoresis, HTN or hypoTN, pallor, tiredness, severe muscle stiffness, loss
of bladder control.
Monitor CBC with differential and liver functions test. May increase prolactin levels.

VI. Medications

STUDENT NURSE
NEW MEDS
Agents:
Medication Names
Generic (Trade)
Time
Reference

General things to know before giving meds in this category:

Dose, Route,
Reason your patient is on this medication
Frequency, &
Dosage Range

Administration Considerations

QUEtiapine (Seroquel)
Time: 1500

D: 50 mg
R: PO
F: BID
DR: not to exceed 800
mg/day

Contraindicated/Caution: Hypersensitivity, Hx. of arrhythmias, Hypokalemia or

hypomagnesemia, CD, CVD, dehydration or hypovolemia, Hx. of seizures,
alzheimers, diabetes, Pt. at risk for aspiration PNA, hepatic impairement,
hypothyroidism, Hx. of suicide attempt.

(Vallerand et al, 2013, p. 1079)

Adjunctive treatment of pain (Calandre and

Rico-Villademoros, 2012)

Adverse effects: NEUROLEPTIC MALIGNANT SYNDROME, SEIZURES,

dizziness, weight gain.

Methadone (Dolophine)
(Vallerand et al, 2013, p. 833)

D: 10 mg
R: TID
F: Before Breakfast
DR: 15 mg

Severe pain

Lab Test Considerations: May increase AST, ALT, cholesterol, triglycerides,

and prolactin. Anemia, thrombocytopenia, leukocytosis, leukopenia,
Contraindicated/Caution: Hypersensitivity, structural heart disease,
hypokalemia, hypomagnesemia, Hx. of arrhythmias/syncope, head trauma,
increased ICP, severe renal, hepatic, or pulmonary disease, hypothyroidism,
adrenal insufficiency. .
Adverse effects: confusion, sedation, TORSADES DE POINTES, hypotension,
constipation
Lab Test Considerations: Increase amylase and lipase.
ANTIDOTE IS NALOXONE (NARCAN)

VI. Medications

STUDENT NURSE

VI. Medications