Medications: only need the meds YOU give during your shift. Include PRNs and designate as such.

Drug: astreonam: Azactam Classification: Antibiotic monobactams

Mechanism of action: !inds to bacterial cell "all membrane causing cell death# bactericidal action. Why is THIS pt taking?: U$I infection lo"er res%iratory infection se%ticemia s&in structure infections cause by '( bacteria )*.coli +. %neumoniae, Monitoring parameters: -onitor for s.s of ana%hyla/is monitor bo"el function assess res%iratory status obtain s%ecimen for culture 0 sensitivity assess for infection )vital signs urine a%%earance, Pt teaching side effects: may cause 1N2 seizures N.3 rash diarrhea dizziness headache blurred vision and redness.discomfort.%ain.s"elling at in4ection site. Drug: clindamycin: 1leocin Classification: antibiotic

Mechanism of action: !actericidal or bacteriostatic Why is THIS pt taking?: !acterial '( infection Monitoring parameters: -onitor bo"el elimination diarrhea fever abdominal cram%ing and bloody stools monitor 1!1. Pt teaching side effects: Instruct %atient to ta&e medication around the cloc& at evenly s%aced times and to

finish the drug com%letely as directed even if feeling better. Notify 51P immediately if 'I issues occur.
6izziness headache vertigo arrhythmias hy%otension NI3# %hlebitis at I3 site Pseudomembranous colitis resulting in diarrhea and bacterial gro"th of 1. difficile during treatment or "ee&s to months after treatment has sto%%ed,. Drug: 5e%arin )5e%(7oc&, Classification: anticoagulants antithrombotic

Mechanism of action: Prevention of thrombus formation and e/tension of e/isting thrombi Why is THIS pt taking?: Pro%hyla/is and treatment of venous and %eri%heral arterial thromboembolism Monitoring parameters: Assess for signs of bleeding and hemorrhage )bleeding gums# nosebleed# unusual bruising# blac& tatty stools# hematuria# fall in hematocrit or !P# guaiac %ositive stools,. -onitor for %atient for hy%ersensitivity reactions )chills fever urticarial,. -ay cause hy%er&alemia and 8 A2$ and A7$ levels# monitor for Platelet

count.
Pt teaching side effects: Advise %atient to re%ort any sym%toms of unusual bleeding or bruising to health

care A2AP. Instruct %atient not to ta&e medications containing as%irin or N2AI6s "hile on he%arin thera%y. *ffect: !leeding he%arin(induced thrombocyto%enia )5I$, )"ith or "ithout thrombosis, anemia %ain in
in4ection site osteo%orosis )long term, and fever hy%ersensitivity. Drug: acetamino%hen9$ylenol Classification: Non(o%ioid analgesic anti%yretics

Mechanism of action: Inhibits the synthesis of %rostaglandins that may serve as mediators of %ain and fever %rimary in the 1N2. It has no significant anti(inflammatory %ro%erties or 'I to/icity. Why is THIS pt taking?: Pain and fever Monitoring parameters: Assess liver function# assess %ain ty%e location and intensity %rior to and after :;(<; min follo"ing administration. Assess fever# note %resence of signs )dia%horesis tachycardia and malaise,.

Pt teaching side effects: Advise %atient to ta&e medication as directed and to avoid alcohol or avoid ta&ing it concurrently "ith salicylates or other N2AI62 for more than a fe" days. 2ide effects: an/iety headache fatigue insomnia s&in rash anemia %ancyto%enia ne%hroto/ic he%ato/icity )if overdose# antidote is acetyl cysteine )Acetadote,. Patients "ith diabetes that acetamino%hen may alter results of blood glucose

monitoring.agitation an/iety headache fatigue insomnia atelectasis dys%nea hy%er.hy%otension he%atoto/icity consti%ation.

Drug: meto%rolol9 7o%ressor

Classification: antianginals antihy%ertensive beta bloc&ers

Mechanism of action: !loc&s stimulation of beta= )myocardial,(adrenergic rece%tors. It decreased !P and heart rate# decreased fre>uency of attac&s of angina %ectoris. Why is THIS pt taking?: to decrease his cardiac "or&load )!P.5R, and %revention of -I. Monitoring parameters: : Instruct %atient to ta&e medication as directed# Assess and monitor !P# *1' and %ulse fre>uency during dose ad4ustment and %eriodically during thera%y. -onitor 3ital signs and *1' every ?(=? min during and for several hours after %arenteral administration. 5old if heart rate is less than <; b%m# systole less than =;; if cardiac out%ut is also decreased administer atro%ine ;.@?(;.? mg I3. -onitor I.O rations and daily "eights. Assess s.s of 5A )dys%nea rales.crac&les "eight gain %eri%heral edema 4ugular venous distention,. Pt teaching side effects: 1hange %ositions slo"ly to minimize orthostatic hy%otension may cause dizziness. Additional interventions for hy%ertension )lo" salt "eight loss etc., 1N2 fatigue "ea&ness an/iety de%ression dizziness dro"siness insomnia memory loss mental status changes nervousness nightmares blurred vision stuffy nose bronchos%asm "heezing bradycardia 5A %ulmonary edema hy%otension %eri%heral vasoconstriction consti%ation diarrhea N.3 hy%erglycemia hy%oglycemia bac& %ain 4oin %ain drug( induced lu%us syndrome. Drug: -or%hine Classification: o%ioid(analgesic and agonist

Mechanism of action: !inds to o%iate rece%tors in the 1N2. Alters the %erce%tion of and res%onse to %ainful stimuli "hile %roducing generalized 1N2 de%ression. Why is THIS pt taking?: Aor severe %ain# %ain associated "ith -I. Monitoring parameters: Assess and monitor res%iration 7O1 !P *1' and Pulse! Assess ty%e location intensity of %ain %rior to and @; min follo"ing I3 administration. Pt teaching side effects: Confusion sedation res%iratory de%ression hy%otension bradycardia consti%ation N.3 urinary retention flushing itching s"eating %hysical %sychological de%endency tolerance. Drug: Ondansetron9 Bofran Classification: Anti(emetics ?(5$: antagonist

Mechanism of action: !loc&s the effects of serotonin at ?(5$:(rece%tor sites located in vagal nerve terminals and the chemorece%tor trigger zone in the 1N2# decreased incidence and severity of N.3. Why is THIS pt taking?: Prevention of nausea and vomiting Monitoring parameters: Assess %atient for N.3 abdominal distension and bo"el sounds %rior to and follo"ing administration# monitor *1' in %atients "ith hy%o&alemia or hy%omagnesemia bradyarrhythmias or %atients ta&ing concomitant medications that %rolong the C$ interval. Pt teaching side effects: 5eadache dizziness dro"siness fatigue "ea&ness C$ interval %rolongation $orsade de Pointes 'I consti%ation diarrhea and abdominal %ain.

Drug: %olyethylene glycol ) 'lycola/

-irala/,

Classification: osmotic la/ative

Mechanism of action: Polyethylene glycol )P*', in solution. Acts as an osmotic agent dra"ing "ater into the lumen of the 'I tract# evacuation of the 'I tract "ithout "ater or electrolyte imbalance. Why is THIS pt taking?: $reatment of occasional consti%ation Monitoring parameters: Assess %atient for abdominal distention %resence of bo"el sounds and usual %attern of bo"el function# assess color consistency and amount of stool %roduced. 5old if diarrhea! Pt teaching side effects: Notify healthcare %rovider for the follo"ing adverse effects: urticarial abdominal

bloating cram%ing flatulence and nausea. Drug: docusate sodium )1olace 1orrectol 2ilace, Mechanism of action: 2oftening and %assage of stool. Why is THIS pt taking?: 1onsti%ation Monitoring parameters: Inform %atient that @(D days may be re>uired to %roduce a bo"el movement# Assess for abdominal distention %resence of bo"el sounds and usual %attern of bo"el function. Assess color consistency and amount of stool %roduced. Pt teaching side effects: Advise %atients that la/atives should be used only for short(term thera%y. *ncourage %atients to use other forms of bo"el regulation such as increasing bul& in diet. Advise %atient not to use la/atives "hen abdominal %ain nausea vomiting or fever is %resent. Advise %atient not to ta&e medication "ithin @hrsofother la/atives. Notify healthcare %rovider of the follo"ing adverse effects: throat irritation mild cram%s diarrhea and rashes.
Drug: Bol%idem9 Ambien Classification: sedative.hy%notics

Classification: la/atives .stool softeners

Mechanism of action: Produces 1N2 de%ression by binding to 'A!A rece%tors# sedation and induction of slee%. Why is THIS pt taking?: Insomnia Monitoring parameters: Assess mental status slee% %atterns and %otential for abuse %rior to administration. Assess %atient for %ain alertness at time of %ea& effect notify %rovider if desired sedation does not occur. Pt teaching side effects: 6aytime dro"siness dizziness abnormal thin&ing amnesia behavior changes EdruggedF feeling hallucinations N.3 ana%hylactic reactions hy%ersensitivity reactions and tolerance. Drug: 5ydrocortisone91ortef Classification: antiasthmatics# corticosteroids )systemic,

Mechanism of action: 2u%%ress inflammation and the normal immune res%onse# su%%ress adrenal function at chronic doses. Why is THIS pt taking?: -anagement of adrenocortical insufficiency.su%%ression of inflammation and modification of the normal immune res%onse. Monitoring parameters: Assess for signs of adrenal insufficiency )hy%otension "eight loss "ea&ness n.v anore/ia lethargy confusion restlessness, before and %eriodically during thera%y. -onitor I.O ratios and daily "t. Observe %atient for %eri%heral edema rales.crac&les or dys%nea. Assess sym%toms of ulcerative colitis guaiac(test stools# su%%ress reactions to allergy s&in test. Pt teaching side effects: 6e%ression eu%horia headache %ersonality changes restlessness cataracts %e%tic

ulceration anore/ia n.v decrease "ound healing ecchymosis fragility adrenal su%%ression fluid retention hy%o&alemia hy%o&alemic al&alosis thromboembolism increase susce%tibility to infection.

Drug: "spirin

other: #cotrin Classification: $hera%eutic: anti%yretics non(o%ioid analgesics Pharmacologic: salicylates

Mechanism of action: Irreversibly inhibits cycloo/ygenase(= and @ )1OG(= and @, enzymes via acetylation "hich results in decreased formation of %rostaglandin %recursors# irreversibly inhibits formation of %rostaglandin derivative thrombo/ane A@ via acetylation of %latelet cycloo/ygenase thus inhibiting %latelet aggregation. Why is THIS pt taking?: Pro%hyla/is to %revent recurrence of his myocardial infarction also reduces his blood clotting )thrombi formation,. Monitoring parameters: -onitor for s.s of 'I u%set and bleeding.bruising liver A/. Pt teaching side effects: Instruct %atient to ta&e "ith a full glass of "ater and in u%right %osition )if %ossible, for =?(:; minutes after administration. 7imit alcohol use to decrease gastric irritation. Advise health care %rofessionals of medication use %rior to surgery. 2ide *ffects: hearing loss tinnitus 'I bleeding dys%e%sia e%igastric distress heartburn nausea increased bleeding time. Drug: 7asi/ )furosemide, Classification: thera%eutic: diuretics %harmacologic: loo% diuretics

Mechanism of action: Inhibits the reabsor%tion of sodium and chloride from the loo% of 5enle and distal renal tubule. Increases renal e/cretion of "ater sodium chloride magnesium %otassium and calcium. Why is THIS pt taking?: Increase urine out%ut )diuresis, "hile ridding the body of e/cess fluid to decrease his cardiac "or&load. Monitoring parameters: Assess fluid status during thera%y )daily "eight I.O amount and location of edema lung sounds s&in turgor mucous membranes. Assess elderly for fall ris&. Assess for tinnitus and hearing loss. -onitor electrolytes renal and he%atic function serum glucose and uric acid. -onitor serum %otassium calcium magnesium !UN serum glucose creatinine and uric acid levels. Pt teaching side effects: Instruct %atient to ta&e as directed. 1onsult health care %rofessional regarding a diet high in %otassium. 1hange %ositions slo"ly to minimize orthostatic hy%otension may cause dizziness. 2ide *ffects ( fluid and electrolytes: dehydration hy%ochloremia hy%o&alemia hy%omagnesemia hy%onatremia hy%ovolemia metabolic al&alosis# life threatening: 2tevens(Hohnson syndrome to/ic e%idermal necrolysis a%lastic anemia agranulocytosis. Drug: lisino%ril )Bestril, Classification: thera%eutic: antihy%ertensive %harmacologic: A1*(Inhibitor Mechanism of action: !loc&s the formation of angiotensin II and inhibits the brea&do"n of brady&inin )vasodilator,. $he anti(hy%ertensive action of A1* inhibitors is %rimarily caused by a reduction in %ulmonary vascular resistance )P3R, decreasing both arterial and venous %ressure. !y reducing angiotensin(stimulated aldosterone secretion A1* inhibitors %revent the com%ensatory increase in NaI retention and %lasma volume seen "ith other agents. In %atients treated "ith A1* inhibitors renal NaI retention is decreased "hereas renal +I retention is increased. Why is THIS pt taking?: A1*(I vasodilation decreases his cardiac "or&load# lo"ers !P and treats 15A Monitoring parameters: -onitor !P %ulse "eight edema lung sounds )rales crac&les, dys%nea

A2$.A7$ increases H36. -onitor !UN and creatinine for renal function and electrolyte levels %eriodically. 2erum %otassium !UN and creatinine may be 8 "hereas sodium levels may be J. Pt teaching side effects: 1hange %osition slo"ly avoid O$1 cough meds that can raise blood %ressure additional interventions for hy%ertension )lo" salt e/ercise."eight loss no smo&ing lo" stress, monitor !P %eriodically. 2ide effects: the most common side effect of A1* inhibitors is a dry non%roductive cough )@;K of %atients, caused by increased brady&inin levels. 1ause fetal and neonatal morbidity and mortality "hen administered to %regnant "omen. Rash first dose hy%otension cough hy%er&alemia renal failure dizzy fatigue headache. Drug: magnesium chloride )-A' delay, Classification: mineral and electrolyte re%lacements.su%%lements Mechanism of action: *ssential for the activity of many enzymes# im%ortant role in neurotransmission and muscular e/citability. Why is THIS pt taking?: $o treat or %revent hy%omagnesemia# treats hy%otension and consti%ation. Monitoring parameters: 3ital signs and labs Pt teaching side effects: 6o not crush %ill it is time released. 1onsult %rescriber before using magnesium if heLs ta&ing other drugs. -agnesium may delay or enhance absor%tion of other drugs. 2ide effects: Abru%t elevation of %lasma -g can remove the stimulus for -g retention and lead to increased e/cretion# 6iarrhea# 6rug interactions# -agnesium into/ication Aluminum into/ication. Drug: %i%eracillin.tazobactam )Bosyn, Classification: anti(infectives 0 e/tended s%ectrum %enicillins

Mechanism of action: Pi%eracillin: !inds to bacterial cell "all membrane causing cell death. 2%ectrum is e/tended com%ared "ith other %enicillins. $azobactam: Inhibits beta(lactamase an enzyme that can destroy %enicillins. Why is THIS pt taking?: -anagement of sus%ected %neumonia. Monitoring parameters: Assess %atient for infection at beginning of and during thera%y )vital signs,. Obtain a history before initiating thera%y to determine %revious use of and reactions to %enicillins or ce%halos%orins. Observe %atient for signs and sym%toms of ana%hyla/is )rash %ruritus laryngeal edema "heezing,. *valuate renal and he%atic function 1!1 serum %otassium and bleeding times %rior to and routinely during thera%y. Pt teaching side effects: Advise %atient to re%ort signs of su%erinfection )blac& furry overgro"th on tongue vaginal itching or discharge loose or foul(smelling stools, and allergy. 1aution %atient to notify health care %rofessional if fever and diarrhea occur es%ecially if stool contains blood %us or mucus. Advise %atient not to treat diarrhea "ithout consulting health care %rofessional. -ay occur u% to several "ee&s after discontinuation of medication. 2ide effects: diarrhea rashes %ain and %hlebitis at I3 site M life threatening: %seudomembranous colitis seizures ana%hyla/is and serum sic&ness. Drug: %regabalin )7yrica, stabilizer Classification: thera%eutic: analgestic anticonvulsant mood Pharmacologic: 'A!A analogues non(o%ioid analgesic Mechanism of action: !inds to calcium channels in 1N2 tissues "hich regulate neurotransmitter release. 6oes not bind to o%ioid rece%tors. $hera%eutic *ffects: 6ecreased neuro%athic or %ost(her%etic

%ain. 6ecreased %artial(onset seizures. Why is THIS pt taking?: 5e is ta&ing this for %ain management. Monitoring parameters: -onitor for and %rom%tly re%ort mental status or behavior changes. -onitor for "eight gain %er%heral edema and 2.2 of heart failure es%ecially ". concurrent thiazolidinedione thera%y. -onitor baseline and %eriodic &idney f/n tests# %eriodic %latelet counts. -onitor diabetics for increased incidences of hy%oglycemia. 2u%ervise ambulation es%ecially "hen other 1N2 drugs are used concurrently. Pt teaching side effects: 6o not discontinue abru%tly# may cause insomnia nausea headache or diarrhea. -ay cause dizziness dro"siness and blurred vision. Avoid driving or activities re>uiring alertness until res%onse to medication is &no"n. Notify health care %rofessional if changes in vision occur. Prom%tly re%ort une/%lained muscle %ain tenderness or "ea&ness es%ecially if accom%anied by malaise or fever. Notify health care %rofessional if thoughts about suicide or other unusual changes in behavior or mood occur. -ay cause edema and "eight gain. Avoid alcohol or other 1N2 de%ressants. Notify health care %rofessional of medication regimen before treatment or surgery. 1arry identification describing disease %rocess and medication regimen at all times. 2ide effects: 2UI1I6A7 $5OU'5$2 dizziness dro"siness im%aired attention.concentration.thin&ing# edema# blurred vision# dry mouth abdominal %ain consti%ation 8 a%%etite vomiting# thrombocyto%enia# "eight gain# allergic reactions fever. Drug: sertraline $%oloft& )22RIs, Classification: antide%ressants# selective serotonin reu%ta&e inhibitors

Mechanism of action: Inhibits neuronal u%ta&e of serotonin in the 1N2 thus %otentiating the activity of serotonin. 5as little effect on nore%ine%hrine or do%amine. $hera%eutic *ffects: Antide%ressant action. 6ecreased incidence of %anic attac&s. 6ecreased obsessive and com%ulsive behavior. 6ecreased feelings of intense fear hel%lessness or horror. 6ecreased social an/iety. 6ecrease in %remenstrual dys%horia. Why is THIS pt taking?: 6e%ression Monitoring parameters: -onitor mood suicidal tendencies a%%etite nutritional inta&e "ee&ly "eights fre> of O16 behaviors fre> of %anic attac&s sym%toms of fear hel%lessness 0 horror blushing s"eating trembling tachycardia during social interactions feeling angry tense tired crying easily sad or ho%eless arguing for no reason. Pt teaching side effects: $he drug "ill achieve ma/imum effectiveness after several "ee&s of thera%y. 6o not abru%tly sto% medication. Notify health care %rofessional immediately if you have thoughts about suicide. 2ide effects: dizziness dro"siness fatigue headache insomnia diarrhea dry mouth nausea se/ual dysfunction increased s"eating tremor# life threatening: N*URO7*P$I1 -A7I'NAN$ 2YN6RO-* 2UI1I6A7 $5OU'5$2 2*RO$ONIN 2YN6RO-*. Drug: %otassium chloride )+lor(1on, Classification: $hera%eutic: mineral and electrolyte re%lacement.su%%lement

Mechanism of action: -aintain acid(base balance isotonicity and electro%hysiologic balance of the cell. *ssential to transmission of nerve im%ulses# contraction of cardiac s&eletal and smooth muscle# gastric secretion# renal function# tissue synthesis# and carb metabolism. Why is THIS pt taking?: 5e is ta&ing this because his %otassium lab results "ere lo".

Monitoring parameters: -onitor for 2.2 of hy%o&alemia )"ea&ness fatigue arrhythmias %olyuria %olydi%sia, and hy%er&alemia. -onitor %ulse !P and *1'. 7abs: %otassium before and during. Renal function bicarbonate and %5. -agnesium levels and chloride levels. -onitor for to/icity and overdose )slo" irregular heart rate fatigue muscle "ea&ness,. Pt teaching side effects: $a&e as directed es%ecially "hen concurrent digo/in or diuretics are ta&en. A missed dose should be ta&en as soon as remembered "ithin @ hr# if not return to regular dose schedule. 6o not double dose. 'I irritation or ulceration may result from che"ing enteric(coated tablets or insufficient dilution of li>uid or %o"der forms. Avoid salt substitutes or lo"(salt mil& or food unless a%%roved by health care %rofessional. Read all labels to %revent e/cess %otassium inta&e. $each %otassium food sources. 1om%ly "ith recommended diet. Re%ort dar& tarry or bloody stools# "ea&ness# unusual fatigue# or tingling of e/tremities. Notify health care %rofessional if nausea vomiting diarrhea or stomach discomfort %ersists. Regular follo"(u% e/ams are im%ortant to monitor serum levels and %rogress. 2ide effects: confusion restlessness "ea&ness ab %ain diarrhea gas n.v# life threatening: ARR5Y$5-IA2.

6rug: Albuterol 2ulfate: Proventil 5AA inhaler

1lassification: !ronchodilator adrenergic

-echanism of action: !inds to beta@(adrenergic rece%tors# bronchodilator that rela/es muscles in the air"ays and increases air flo" to the lungs. Nhy is $5I2 %t ta&ingO: Nheezing -onitoring %arameters: Assess lung sounds %ulse and !P before administering and during %ea& of medication. Note amount color and character of s%utum %roduced# monitor %ulmonary function tests before initiating thera%y and %eriodically# observe for %arado/ical bronchos%asm )"heezing, Pt teaching.side effects: Instruct %atient to ta&e albuterol doses as directed not double doses or increase fre>uency of doses. Advise %atient to rinse mouth "ith "ater after each use to minimize dry mouth and clean mouth%iece "ith "ater at least once a "ee&. 2ide effects: Nervousness restlessness headache insomnia Nheezing chest %ain %al%itations angina arrhythmias hy%ertension n.v hy%erglycemia hy%o&alemia and tremors.
Drug: diltia'em Cardi'em $other Dilacor( Tia'ac& Classification: antianginals( anti(arrhythmic antihy%ertensive Pharmacologic: calcium channel bloc&ers
Mechanism of action: systemic vasodilation resulting in decreased !P. 1oronary vasodilation resulting in

decreased fre>uency and severity of attac&s of angina# Reduction of ventricular rate in atrial fibrillation or flutter. Why is THIS pt taking? 5y%ertension Angina and A(Aib Monitoring parameters: -onitor !P and %ulse %rior to thera%y and %eriodically# -onitor *1' %eriodically# may cause %rolonged PR interval. -onitor I.O ratios and daily "eight. Assess for signs of 5A )%eri%heral edema rales.crac&les dys%nea "t. gain 4ugular venous distention,. Assess for rash %eriodically during thera%y# 6iscontinue if severe or accom%anied "ith fever general malaise fatigue oral lesions blisters he%atitis and.or eosino%hilia. Pt teaching side effects: Advise %atient to ta&e medication as directed at same time each day even if

feeling "ell do not double doses discontinued gradually avoid large amounts of gra%efruit 4uice.day during thera%y and monitor %ulse change %ositions slo"ly to minimize orthostatic hy%otension avoid alcohol O$1 med vitamins or herbal %roducts. Side #ffects: %eri%heral edema bradycardia chest %ain hy%otension %al%itations synco%e tachycardia increase liver enzymes anore/ia consti%ation diarrhea dry mouth dys%e%sia N.3 dysuria nocturia %olyuria 2tevens(Hohnsons syndrome dermatitis flushing s"eating rash hy%erglycemia "eight gain muscle cram%s %aresthesia tremor gingival hy%er%lasia.

6rug: 5ydrocodone.Acetamino%hen )Norco 7ortab Bydone., analgesics

1lassification: O%ioid

-echanism of action: 6ecrease in severity of moderate %ain 0 su%%ression of the cough refle/ Nhy is $5I2 %t ta&ingO Pain management -onitoring %arameters: Assess ty%e location and intensity of %ain %rior to and = hr. after administration. Assess !P %ulse and res%irations before and %eriodically during administration. Assess level of sedation. -onitor for he%atic to/icity liver function. Pt teaching.side effects: Advise %atient to ta&e medications as directed and not to ta&e more than the recommended amount. 2evere and %ermanent liver damage may result from %rolonged use or high doses of acetamino%hen or ibu%rofen. Advise %atient to change %ositions slo"ly to minimize orthostatic hy%otension. -ay cause dro"siness or dizziness call for assistance "hen ambulating 0 &ee% good oral hygiene. 2ide *ffects: confusion dizziness sedation eu%horia hallucinations headache res%iratory de%ression hy%otension bradycardia consti%ation dys%e%sia nausea vomiting 0 tolerance.
Drug: losartan )1ozaar, Classification: Antihy%ertensive) angiotensin rece%tor bloc&ers

)AR!s,
Mechanism of action: !loc&s vasoconstrictor and aldosterone(%roducing effects of angiotensin II at

rece%tor sites including vascular smooth muscle and adrenal glands. $hera%eutic: 7o"ers !P. 2lo"ed %rogression of diabetic ne%hro%athy. 6ecreased ris& of stro&e in %atients "ith hy%ertension and left ventricular hy%ertro%hy. Why is THIS pt taking? Aor hy%ertension to %revent stro&e and left ventricular hy%ertro%hy Monitoring parameters: -onitor %otassium )hy%er&alemia, !UN and serum creatinine may be elevated. assess for signs of angioedema )dys%nea facial s"elling, rarely though monitor daily "eight and resolution of fluid overload )crac&les dys%nea 4ugular venous distention,# may cause increase uric acid slight decrease in hemoglobin and hematocrit neutro%enia and thrombocyto%enia. -onitor renal function and electrolyte levels %eriodically. Pt teaching side effects: instruct %atient to notify %rovider if s"elling of face eyes li%s or tongue occurs or difficulty s"allo"ing or breathing. Instruct %atient and family on %ro%er techni>ue for monitoring !P. Advise them to chec& !P at least "ee&ly and to re%ort significant changes. 1aution %atient to avoid sudden changes in %osition to decrease orthostatic hy%otension# may cause dizziness no driving avoid

salt substitutes containing %otassium or sodium in high >uantities unless directed by %hysician. Narn %atient not to discontinue thera%y unless directed encourage %atient to com%ly "ith additional interventions for hy%ertension )"t. reduction lo" sodium diet 6.1 smo&ing or alcohol use regular e/ercise stress management,. Re%ort any O$1 %roducts being ta&en es%ecially cough cold or allergy remedies. Drug: montelukast $Singulair& P*+ Classification: Allergy cold 0 cough remedies

bronchodilators 7eu&otriene antagonist

Mechanism of action: It bloc&s the binding of some leu&otrienes to cells that cause inflammation#

6ecrease severity of acute asthma and allergic rhinitis. Why is THIS pt taking? Patient ta&ing it for asthma and allergic rhinitis Monitoring parameters: assess lung sounds and res%iratory function %rior to and %eriodically during thera%y# assess allergy sym%toms )rhinitis con4unctivitis hives, before and %eriodically monitor closely for changes in behavior that could indicate the emergence or "orsening of de%ression or suicidal thoughts. Pt teaching side effects: instruct %atient to ta&e medication daily in the evening even if not e/%eriencing sym%toms of asthma. 6o not double doses discontinue thera%y "ithout consulting %rovider it is not used to treat acute asthma attac&s but may be continued during an acute e/acerbation. Patient should carry ra%id(acting thera%y for bronchos%asm at all times. Side #ffects: suicidal thoughts agitation aggression an/iety de%ression disorientation headache fatigue insomnia irritability "ea&ness rash eosino%hilic conditions including 1hurg(2trauss syndrome fever. Drug: modafinil9Provigil Classification: central nervous system stimulants

Mechanism of action: %roduces 1N2 stimulation# Im%roves "a&efulness in %atients "ith e/cessive

daytime dro"siness due to narcole%sy 0 obstructive slee% a%nea. Why is THIS pt taking? Pt is slee%y and needs to be stimulated to stay a"a&e during the day Monitoring parameters: observe and document fre>uency of narcole%tic e%isodes )brain disorder involving %oor control of slee%("a&e(cycles, monitor for s.s of angioedema or ana%hyla/is )s"elling on face, elevated liver enzymes and changes in behavior that "ould indicate the emergence or "orsening of suicidal thoughts or de%ression assess for rash %eriodically during thera%y and discontinue if severe or accom%anied "ith fever general malaise fatigue muscle or 4oint aches oral lesions blisters con4unctivitis he%atitis and or eosino%hilia occurs. Pt teaching side effects: Instruct %atient to ta&e medication as directed# medication may im%air 4udgment encourage %atient and family to be alert for emergence of an/iety agitation %anic attac&s insomnia irritability hostility im%ulsivity hy%omania mania "orsening of de%ression and suicidal ideation# assess s.s on a day to day basis as changes may be abru%t and notify %rovider if rash or sym%toms of ana%hyla/is occur. Side #ffects: suicidal ideation headache aggression amnesia an/iety cata%le/y confusion delusion de%ression dizziness hallucinations insomnia seizures rhinitis e%ista/is %haryngitis dys%nea lung disorder arrhythmias chest %ain hy%ertension hy%otension

synco%e vasodilation increase liver enzymes nausea anore/ia mouth ulcers thirst vomiting urinary retention hy%erglycemia nec& %ain tremor and infection. Drug: pento'ifylline $Trental& Classification: anti%latelet

Mechanism of action: !ound to erythrocyte membrane# it inhibits %hos%hodiesterase resultanting in the

increase in cyclic A-P in red blood cells reduces blood viscosity due to decreased %lasma fibrinogen concentrations and inhibition of red blood cell and %latelet aggregation. Why is THIS pt taking? Aor treatment of intermittent claudication caused by %eri%heral artery diseas e 0 %romoting healing of stasis ulcers associated "ith venous insufficiency Monitoring parameters: monitor 5eart beat if fast heartbeat and c.o chest %ain call %rovider immediately. Pt teaching side effects: 6o not ta&e double dose# ta&e %ento/ifylline "ith meals to %revent u%set stomach. 1ommon adverse effects include nausea vomiting dizziness headache diarrhea blurred vision agitation insomnia and dro"siness. Rarely %atients may e/%erience abnormal heartbeats

elevation of liver function test 4aundice and he%atitis.

Drug: ampicillin $Sul,actam& inhibitors Classification: anti(infectives# amino%enicillin.beta lactamase

Mechanism of action: binds to bacterial cell "all resulting in cell death# bactericidal action.

Why is THIS pt taking? Patient is ta&ing it for %ro%hyla/is for s&in structure infection r.t surgery# soft tissues intra(abdominal res%iratory 0 'I infection. Monitoring parameters: Assess %atient for infection )vital signs "ound a%%earance s%utum urine stool and N!1s, at beginning and throughout thera%y# -onitor A2$ A7$ 765 bilirubin al&aline %hos%hatase !UN and creatinine. Pt teaching side effects: Advice %atient to re%ort signs of su%er infection )furry overgro"th on the tongue foul smelling stools and allergy. Side #ffects: seizures %seudomembranous colitis diarrhea n.v rashes urticarial blood dyscrasias %ain at I- site %ain at I3 site allergic reactions including ana%hyla/is and serum sic&ness su%er(infection elevated liver enzymes. Drug: hydromorphone $Dilaudid& agonist Classification: opioid analgesics )antitussives, o%ioid

Mechanism of action: binds to o%iate rece%tors in the 1N2. Alters the %erce%tion of and res%onse to

%ainful stimuli "hile %roducing generalized 1N2 de%ression# su%%resses the cough refle/ via a direct central action. Why is THIS pt taking? $he decrease in moderate to severe %ain 0 su%%ression of cough Monitoring parameters: Assess !P Pulse 0 res%irations before and %eriodically during administration #

assess ty%e location and intensity of %ain %rior to and = hr. after PO or ? mins after I3 administration.
Pt teaching side effects: Instruct %atient on ho" and "hen to as& for %ain medication# change %ositions slo"ly to minimize orthostatic hy%otension encourage %atient to turn cough and breathe dee%ly every

t"o hours to %revent atelectasis. 2ide effects: confusion sedation dizziness dys%horia eu%horia floating feeling hallucinations headache blurred vision res%iration de%ression hy%otension and consti%ation. Drug: le-oflo.acin $/e-a0uin& Classification: anti(infectives# fluoro>uinolones

Mechanism of action: Inhibits bacterial 6NA synthesis by inhibiting 6NA gyrase: 6eath of susce%tible

bacteria broad activity includes many gramI %athogens. Why is THIS pt taking? Aor s&in and s&in structure infection r.t surgery other: res%. tract bone and 4oint infection. Monitoring parameters: assess for infection )vital signs a%%earance of "ound s%utum urine and stool# N!1 urinalysis fre>uency and urgency of urination cloudy or foul smelling urine and %rior and during thera%y. Obtain s%ecimens for culture and sensitivity before initiating thera%y. -onitor !o"el function diarrhea abdominal cram%ing fever bloody stools should be re%orted to %hysician %rom%tly as a sign of 1. diff. s.s of ana%hyla/is )rash "heezing laryngeal edema, &ee% e%ine%hrine and antihistamine close by in case of ana%hylactic e%isode. Pt teaching side effects: Instruct the %atient to ta&e medications as directed at evenly s%aced times and to finish drug com%letely even "hen feeling better do not double dose notify %rovider if ta&ing theo%hylline advise %t. that antacids or med containing iron or zinc "ill decrease absor%tion. Notify %rovidr if C$ %rolongation or %roarrhythmic conditions such as recent hy%o&alemia significant bradycardia or recent -I or fainting s%ells or %al%itations occur. Notify %rovider if su%er infection )furry overgro"th on tongue foul smelling stool occurs. As "ell as rashes 4aundice %ain s"elling occurs. Side effects: elevated intracranial %ressure seizure dizziness headache insomnia acute %sychoses agitation confusion de%ression dro"siness tremor C$ %rologation vasodilation he%atoto/ity diarrhea nausea abdominal %ain increase liver enzymes hy%oglycemia %hlebitis at I3 site tendinitis hy%ersensitivity reactions. Drug: Clopidogrel Pla-i. inhibitor Classification: anti%latelet agent %latelet aggregation

Mechanism of action: inhibits %latelet aggregation by irreversibly inhibiting the binding of A$P to %latelet

rece%tors. Why is THIS pt taking? Reduction of atherosclerotic events r.t -I acute coronary syndrome unstable angina stro&e and P36 Monitoring parameters: assess %atient for sym%toms of stro&e P36 -I %eriodically during thera%y. -onitor for signs of thrombocyto%enia neurologic findings fever etc. 7ab test: bleeding time during thera%y# 1!1 "ith differential and %latelet count %eriodically# -ay cause increase of bilirubin he%atic enzymes total cholesterol non%rotein nitrogen and uric acid concentrations. Pt teaching side effects: advise %atient to notify %rovider %rom%tly if fever chills sore throat or unusual bleeding or bruising occurs also any R/ or O$1 medications herbal vitamins %roducts ta&en ! Side effects: de%ression dizziness fatigue headache e%ista/is cough dys%nea chest %ain edema hy%ertension bleeding abdominal %ain diarrhea dys%e%sia gastritis %ruritis %ur%ura rash neutro%enia thrombotic thrombocyto%enic %ur%ura hy%ercholesterolemia arthralgia bac& %ain fever hy%ersensitivity reaction.

Drug: Bylo%rim.allo%urinol

Classification: Anti(gout agents antihy%er(uricemics

Mechanism of action: Inhibits %roduction of uric acid by inhibiting the action of /anthine o/idase. Why is THIS pt taking?: Prevention of attac& of gouty arthritis# to %revent ne%hro%athy. Monitoring parameters: I.O(+idney failure monitor 4oint for %ain and s"elling !2 Pt teaching side effects: 6rin& lots of fluid "ith %ill ta&e "ith a meal may be crushed if cannot s"allo" "hole. rash hy%otension bradycardia diarrhea flushing and dro"siness.

-ore meds.-egan
Drug: 7i%itor.atorvastatin Classification: li%id(lo"ering agents

Mechanism of action: Inhibit the enzyme 5-'(1oA reductase that is res%onsible for catalyzing an early ste% in the synthesis of cholesterol. Why is THIS pt taking?: 5as multi%le ris& factors for coronary heart disease. Monitoring parameters: *valuate cholesterol and triglyceride levels monitor liver function test muscle tenderness and 1+ levels. Pt teaching side effects: Notify us if une/%lained muscle %ain tenderness or "ea&ness occurs es%ecially "ith fever.abdominal cram%s consti%ation diarrhea flatus heartburn rashes. Drug: Rocaltrol.calcitriol Classification: fat(souble vitamins

Mechanism of action: Promotes the absor%tion of 1aI 0 decreased %arathyroid hormone concentrations Why is THIS pt taking?: Prevention or treatment of secondary hy%er%arathyroidism for 1+6. Monitoring parameters: Assess for bone %ain 0 "ea&ness hy%ercalcemia hy%er%hos%hatemia. Pt teaching side effects: 6o not e/ceed R6A avoid concurrent use for antacids containing magnesium. 6izziness malaise dys%nea. Drug: car-edilol )Coreg& Classification: antihy%ertensives.beta bloc&er

Mechanism of action: !loc&s stimulation of beta= and beta @ rece%tor sites. It decreases heart rate and !P. Im%roved cardiac out%ut slo"s the %rogression of 5A and decreased ris& of death. Why is THIS pt taking? Patient has 15A and hy%ertension. Monitoring parameters: -onitor !P 5R I.Os 0 daily "eights along "ith !2. . 1hec& %ulse and !P before ta&ing the medication hold meds if 5R P<; or systolic P=;; . 6izziness fatigue "ea&ness erectile dysfunction diarrhea. Pt teaching side effects: Instruct %atient to ta&e medication as directed abru%t "ithdra"al may %reci%itate life(threatening arrhythmias hy%ertension or myocardial ischemia. Patient should change %ositions slo"ly to minimize orthostatic hy%otension

Drug: Neurotin.gaba%entin

Classification: analgesic ad4uncts mood stabilizer thera%eutic anti(convulsant

Mechanism of action: not &no"n may affect trans%ort of amino acid across and stabilze neuronal membranes

Drug: Ativan.loraze%am

Classification: anesthetic ad4uncts anti(an/iety agents sedative. hy%notic

Mechanism of action: 6e%resses the 1N2 %otentiating 'A!A Why is THIS pt taking?: Restlessness and to hel% him slee%. Monitoring parameters: 1N2 reactions an/iety and s Why is THIS pt taking?: Used to relieve neuro%athic %ain Monitoring parameters: 1hanges in behavior seizures %ain )location intensity ty%e, Pt teaching side effects: 6o not ta&e med "ithin @ hours of ta&ing antacid. Notify 51P if thoughts of suicide or an/iety "orsen. 1onfusion ata/ia de%ression 0 dro"siness. Pt teaching side effects: $a%er off of the med to decrease "ithdra"al sym%toms avoid *$O5 "hile ta&ing the med. 6izziness dro"siness and lethargy. Drug: citalo%ram )1ele/a, Classification: antide%ressants . selective serotonin reu%ta&e inhibitors )22RIs,

Mechanism of action: Antide%ressant action. Why is THIS pt taking?: 6e%ression Monitoring parameters: Assess for suicidal tendencies es%ecially during early thera%y and dose changes. Assess for serotonin syndrome. -onitor mood changes during thera%y. Pt teaching side effects: Instruct %atient to ta&e medication as directed. 1aution %atient to change %ositions slo"ly to minimize dizziness. Advise %atient family and caregivers to loo& for suicidality es%ecially during early thera%y or dose changes. Notify the healthcare %rovider for the follo"ing adverse effects: neurole%tic malignant syndrome suicidal thoughts a%athy confusion dro"siness insomnia "ea&ness abdominal %ain anore/ia diarrhea dry mouth dys%e%sia flatulence increased saliva nausea s"eating and tremor.

Drug: 1ytotec.miso%rostol

Classification: antiulcer agents

Mechanism of action: Acts as %rostaglandin analogue decreasing gastric acid secretion and increase %roduction of %rotective mucus. Why is THIS pt taking?: Patient is diagnosed "ith '*R6 Monitoring parameters: Assess for e%igastric or abdominal %ain and for fran& or occult blood in stool emesis or gastric as%irate.

Pt teaching side effects: 6o not share may cause diarrhea avoid alcohol and foods that may increase 'I irritation "hile ta&ing the med.abdominal %ain and diarrhea. Drug: Protoni/.%anto%razole Classification: anti(ulcer agents

Mechanism of action: !inds to enzyme in the %resence of acidic gastric %5 %reventing the final trans%ort of 5I into gastric lumen# Proton(%um% inhibitor. Why is THIS pt taking?: $o treat his '*R6. Monitoring parameters: -onitor for e%igastric and abdominal %ain fran& or occult blood and s.s of hy%omagnesemia Pt teaching side effects: $a&e medication as directed for the full course of thera%y even if feeling better. Advise to avoid alcohol %roducts containing as%irin or N2AI6s 0 foods that may cause an increase in 'I irritation. Re%ort onset of blac& tarry stools diarrhea or abdominal %ain.headache abdominal %ain diarrhea flatulence. Drug: 3ancocin.vancomycin Classification: Anti infective

Mechanism of action: !inds to bacterial cell "all destroying the "all resulting in cell death. Why is THIS pt taking?: $a&ing to treat 1lostridium difficile Monitoring parameters: Assess %atient for infection !P es%ecially stool I.Os "eight and s.s of su%er( infection. Pt teaching side effects: $a&e as directed ta&e missed dose as soon as remembered unless close to loss.ne%hroto/icity ototo/icity hy%otension nausea vomiting and %hlebitis.

Drug: 1oumadin."arfarin

Classification: anticoagulant

Mechanism of action: Interferes "ith he%atic synthesis of vitamin + de%endent clotting factors. Why is THIS pt taking?: $he %atient has atrial fibrillation "hich %uts him at ris& for blood clots so this hel%s thin the blood and %revent clots. Monitoring parameters: -onitor P$.INR: If above :.; hold. Assess for signs of bleeding and hemorrhage. Assess for evidence of additional or increased thrombosis. Pt teaching side effects: Instruct %atient to ta&e medication as directed. 6o not double dose. Revie" foods high in vitamin +. *ducate that they should have consistent limited inta&e of these foods as vitamin + is the antidote for "arfarin. Re%ort any sym%toms of unusual bleeding or bruising. Instruct %atient not to drin& alcohol or ta&e other RG O$1 or herbal %roducts es%ecially those containing as%irin or N2AI6s or to start or sto% any ne" medication during "arfarin thera%y "ithout advice of 51P. *m%hasize the im%ortance of fre>uent lab test to monitor coagulation factors.cram%s nausea dermal necrosis bleeding and fever. Drug: allo%urinol )Alo%rim, Classification: $hera%eutic: antigout agents antihy%eruricemics Pharmacologic: /anthine o/idase inhibitors

Mechanism of action: Inhibits the %roduction of uric acid by inhibiting the action of /anthine o/idase. $hera%eutic *ffects: 7o"ering of serum uric acid levels. Why is THIS pt taking?: Prevention of attac& of gouty arthritis and ne%hro%athy )&idney disease,. PO I3: $reatment of secondary hy%eruricemia )high level of uric acid in the blood, "hich may occur during treatment of tumors or leu&emias. Monitoring parameters: -onitor I.O ratios. 6ecreased &idney function can cause drug accumulation and to/ic effects. Assess %atient for rash or more severe hy%ersensitivity reactions. -onitor for 4oint %ain and s"elling from gout. 7abs: 2erum and urine uric acid levels usually begin decrease @M: days after PO thera%y. -onitor blood glucose in %atients receiving oral hy%oglycemic agents. -ay cause hy%oglycemia. -onitor hematologic renal and liver function tests before and %eriodically during thera%y. -ay cause serum al&aline %hos%hatase bilirubin A2$ and A7$ levels. 1!1 and %latelets may indicate bone marro" de%ression. !UN serum creatinine may indicate ne%hroto/icity. Pt teaching side effects: Instruct %atient to ta&e as instructed increase fluids be a"are of side effects and follo" u% on e/ams. 2ide *ffects: dro"siness diarrhea nausea vomiting and rash.

Drug: e%oetin. *%ogen

Classification: antianemics hormones

Mechanism of action: 2timulates erythro%oiesis. Why is THIS pt taking?: 5as anemia related to her end stage renal failure her &idneys are not e/creting erythro%oietin. Monitoring parameters: -onitor !P during and after thera%y monitor for s.s of anemia )fatigue dys%nea %allor., -onitor dialysis shunts )thrill and bruit,. -onitor hemoglobin and hematocrit before and t"ice "ee&ly during intial thera%y. -onitor 1!1 "ith differential and %latelet count, If hemoglobin increase above ==g.d7 reduce dose by @?K and if continued increase hold. -onitor 'AR and electrolytes. Pt teaching side effects: Advise %t. to read the -edication 'uide %rior to initiation thera%y and "ith each R/ refill in case of changes. */%lain rationale for concurrent iron thera%y. 6iscuss "ays of %reventing self(in4ury in %atients at ris& for seizures. 6riving and activities re>uiring continuous alertness should be avoided. Advise %atient to notify 51P immediately if signs of blood clots )chest %ain trouble breathing or shortness of breath %ain in the legs etc.., occurs. 2tress im%ortance of com%liance "ith dietary restrictions medications and dialysis. Aoods high in iron and lo" in %otassium should be discussed. 2hould be taught %ro%er dosage administration techni>ue and di%osal of e>ui%ment. hy%ertension increased mortality and increased tumor gro"th seizures headache 15A -I 2tro&e thromboembolic events. Drug: letrozole.Aemara Classification: antineo%lastics aromatase inhibitors

Mechanism of action: Inhibits the enzyme aromatase "hich is %artially res%onsible for conversion of %recursors to estrogen. Why is THIS pt taking?: Nas diagnosed "ith !reast cancer in @;;Q trying to &ee% estrogen levels do"n. Monitoring parameters: Assess %atient for %ain and other side effects %eriodically throughout thera%y.

-onitor A2$ A7$ al&aline %hos%hatase bilirubin ''$ and cholesterol levels. Pt teaching side effects: Instruct %atient to ta&e medication as directed. 1aution %t to avoid driving and other activities re>uiring a"areness until res%onse to mediation is &no"n. Inform %atient of %otential for adverse reactions and advise her to notify health care %rofessional if side effects are %roblematic..An/iety de%ression dizziness dro"siness nausea musculos&eletal %ain. Drug: levothyro/ine.2ynthroid Classification: hormones thyroid %re%arations

Mechanism of action: Re%lacement of or su%%lementation to endogenous thyroid hormones. Princi%le effect is increasing metabolic rate of body tissues. Why is THIS pt taking?: Patient has hy%othyroidism Monitoring parameters: Assess a%ical %ulse and !P %rior to and %eriodically during thera%y. Assess for tachyarrhythmias and chest %ain. -onitor thyroid function $25 serum levels monitor blood and urine glucose in diabetics. Pt teaching side effects: Instruct %atient to ta&e medication as directed at the same time each day. */%lain to %atient that mediation does not cure hy%othyroidism %rovides thyroid hormone su%%lement. Notify 51P if headache nervousness diarrhea e/cessive s"eating heat intolerance chest %ain tachycardia %al%itations or "eight loss occur..headache insomnia irritability s"eating arrhythmias diarrhea vomiting angina %ectoris. Drug: ome%razole )Prilosec( %egerid& Classification: antiulcer agents %roton(%um% inhibitors

Mechanism of action: !inds to an enzyme on gastric %arietal cells in the %resence of acidic gastric %5 %reventing the final trans%ort of hydrogen ions into the gastric lumen. Why is THIS pt taking?: Acid reflu/ 0 relief '*R6 Monitoring parameters: Administer does before meals %referably in the morning must be s"allo"ed "hole. . -onitor 1!1 "ith differential %eriodically during thera%y. -onitor INR and %rothrombin time in %tLs ta&ing "arfarin. -onitor serum magnesium %rior to and %eriodically during thera%y. Assess for e%igastric or abd. Pain# and fran& blood in stools emesis or gastric as%irate. Pt teaching side effects: $a&e in the morning before brea&fast do not crush s"allo" "hole. $a&e for the full course thera%y even if feeling better. Advise to avoid alcohol %roducts containing as%irin or N2AI6s and food that may cause increase in 'I irritation. Re%ort onset of blac& tarry stools# diarrhea# abdominal %ain# or or %ersistent headache to 51P..dizziness dro"siness fatigue headache "ea&ness chest %ain abdominal %ain consti%ation diarrhea flatulence nausea vomiting. Drug: sevelamer )Renvela Renegel, Classification: electrolyte modifiers %hos%hate binders

Mechanism of action: A %olymer that binds %hos%hate in the 'I tract %reventing its absor%tion. Why is THIS pt taking?: 2he has end stage renal disease the &idney has an inability to e/crete the %hos%hate. Monitoring parameters: Assess %atient for 'I side effects %eriodically during thera%y. -onitor serum %hos%horous calcium bicarbonate and chloride levels %eriodically during thera%y.

Pt teaching side effects: Instruct %atient to ta&e sevelamer "ith meals as directed and to adhere to %rescribed dies. 1aution %atient to s%ace concurrent medications at least = hr before or : hr after sevelamer. Advise %atient to notify 51P if 'I effects are sever or %rolonged. Drug: ceftazidime.Aortaz Classification: anti(infectives third(gneration ce%halos%orins

Mechanism of action: !ind to the bacterial cell "all membrane causing cell death. Why is THIS pt taking?: $a&ing to treat 1elulitis Monitoring parameters: Assess for infection: 32 Observe for s.s of ana%hyla/is monitor bo"el function. Pt teaching side effects: Instruct %atient to ta&e mediation arund the cloc& and to finish the medication com%letely even if feeling better. Instruct %atients that concurrent use of alcohol "ith cefo%erazone may cause a disulfiram li&e reaction. Notify health care %rofessional if rash fever and diarrhea develo%. Drug: atenolol. $enormin Classification: antianginals antihy%ertensives beta bloc&ers

Mechanism of action: !loc&s stimulation of beta= rece%tors. Why is THIS pt taking?: tachycardia and hy%ertension Monitoring parameters: 3itals es%ecially 5R and !P and *1' I.Os daily "eights assess routinely for 5A angina. Pt teaching side effects: $a&e as directed at the same time each day even if feeling "ell# do not s&% or double u% on missed doses. $each %atient and family ho" to chec& %ulse and !P. 1hange %ositions slo"ly to minimize orthostatic hy%otension. Notify 51P of a ll R/ or O$1 meds vitamins or herbal %roducts being ta&en avoid alcohol. Advise %atient to notify 1P if slo" %ulse difficulty breathing "heezing cold hands and feet dizziness lightheadedness confusion de%ression rash feer sore throat unusual bleeding or bruising occurs.

Arom 7eslie
Drug: amlodi%ine $+or-asc& Classification: antihy%ertensives . calcium channel bloc&ers

Mechanism of action: 2ystemic vasodilation resulting in decreased !P. 1oronary vasodilation resulting in decreased fre>uency and severity of attac&s of angina. Why is THIS pt taking?: Patient has hy%ertension. Monitoring parameters: -onitor !P and %ulse before thera%y during dose titration and %eriodically during thera%y. -onitor *1' %eriodically. -onitor inta&e and out%ut ratios and daily "eight. Pt teaching side effects: Advise %atient to ta&e medication as directed to change %ositions slo"ly to minimize orthostatic hy%otension notify health %rofessional if any of the follo"ing adverse effects occur: headache dizziness fatigue %eri%heral edema angina bradycardia hy%otension %al%itations gingival hy%er%lasia nausea and flushing Drug: 2odium bicarbonate $anti1acid& Classification: antiulcer agents . al&alinizing agents

Mechanism of action: Al&alinization. Neutralization of gastricacid.

Why is THIS pt taking?: $o &ee% the %5 from getting too acidic. Monitoring parameters: Assess %atients for signs of acidosis )disorientation headache "ea&ness dys%nea and hy%erventilation, and al&alosis )confusion irritability %aresthesia tetany and altered breathing %attern,. Pt teaching side effects: Instruct %atient to ta&e medication as directed. Advise %atient not to ta&e mil& %roducts concurrently "ith this medication. Revie" sym%toms of electrolyte imbalance "ith %atients "ith this medication. Notify the healthcare %rovider is the follo"ing adverse effects occur: metabolic al&alosis edema flatulence gastric distention hy%ernatremia hy%ocalcemia and hy%o&alemia. Drug: Novolog insulin aspart Classification: antidiabetics hormones . %ancreatics

Mechanism of action: 1ontrol of hy%erglycemia in diabetic %atients. Why is THIS pt taking? Patient has diabetes mellitus. Monitoring parameters: Assess for sym%toms of hy%oglycemia. -onitor body "eight %eriodically. Assess %atient for signs of allergic reactions during thera%y. Pt teaching side effects: Instruct %atient on %ro%er techni>ue for administration. */%lain to %atient tha the medication controls hy%erglycemia but does not cure diabetes. Instruct %atient in %ro%er testing of serum glucose and &etones. Instruct %atient on sym%toms and signs of hy%oglycemia. Notify healthcare %rovider if the follo"ing adverse effects occur: hy%oglycemia erythema li%odystro%hy %ruritis s"elling allergic reactions including ana%hyla/is. Drug: sodium chloride Classification: -ineral and electrolyte re%lacement.su%%lements

Mechanism of action: Re%lacement in deficiency states and maintenance of homeostasis. Why is THIS pt taking?: 2cheduled to flush I3 line. Monitoring parameters: Assess fluid balance )inta&es and out%ut daily "eight edema lung sounds, throughout thera%y. Assess %atient for sym%toms of hy%onatremia )headache tachycardia lassitude dry mucous membranes,. Pt teaching side effects: */%lain to %atient %ur%ose of the infusion. 1ontact healthcare %rofessional for the follo"ing adverse effects: 5A %ulmonary edema edema hy%ernatremia hy%ervolemia e/travasation and irritation at I3 site. Drug: glucagon Classification: hormones . %ancreatics

Mechanism of action: Increase in blood glucose. Rela/ation of 'I musculature facilitating radiogra%hic e/amination. Why is THIS pt taking?: $o treat hy%oglycemia. Monitoring parameters: Assess for signs of hy%oglycemia %rior to and %eriodically during thera%y. Assess neurologic status throughout thera%y. Assess nutritional status. Assess for nausea and vomiting after administration of dose. Pt teaching side effects: $each %atient and family signs and sym%toms of hy%oglycemia. Notify the healthcare %rovider if the follo"ing adverse effects occur: hy%otension nausea vomiting hy%ersensitivity

reactions including ana%hyla/is. Drug: o/ycodone Classification: o%ioid analgesics . o%ioid agonists o%ioid agonists.nono%ioid analgesic combinations

Mechanism of action: 6ecreased %ain. Why is THIS pt taking?: Pain. Monitoring parameters: Assess ty%e location and intensity of %ain %rior to and = hr )%ea&, after administration. Assess !P %ulse and res%irations before and %eriodically during administration. Assess bo"el function routinely. Pt teaching side effects: Instruct %atient on ho" and "hen to as& for and ta&e %ain medication. Advise %atient that o/ycodone is a drug "ith &no"n abuse %otential. Advise %atient to ma&e %osition changes slo"ly to minimize orthostatic hy%otension. Notify healthcare %rofessional of the follo"ing adverse effects: confusion sedation consti%ation res%iratory de%ression. Drug: fentanyl M transdermal )6uragesic, Classification: o%ioid analgesics anesthetic ad4uncts . o%ioid agonists

Mechanism of action: 6ecrease in severity of chronic %ain. Why is THIS pt taking?: Pain. Monitoring parameters: Assess ty%e location and intensity of %ain before and @D hr after a%%lication and %eriodically during thera%y. Assess !P %ulse and res%iration before and %eriodically during administration. Prolonged use may lead to %hysical and %sychological de%endence and tolerance. Progressively higher doses may be re>uired to relieve %ain "ith long(term thera%y. Assess bo"el function routinely. Pt teaching side effects: Instruct %atient in ho" and "hen to as& for and ta&e %ain medication. Instruct %atient incorrect method for a%%lication and dis%osal of transdermal system. Advise %atient to change %ositions slo"ly to minimize dizziness. 1aution %atient to avoid concurrent use of alcohol or other 1N2 de%ressants "ith this medication. Notify healthcare %rovider of the follo"ing adverse effects: confusion sedation "ea&ness anore/ia consti%ation dry mouth nausea vomiting and s"eating. Drug: ferrous sulfate )2eosol( 2erata,( 2e34& Classification: anti(anemic.iron su%%lements

Mechanism of action: Prevention.treatment of iron deficiency. Why is THIS pt taking?: Patient has anemia. Monitoring parameters: Assess nutritional status and dietary history to determine %ossible cause of anemia and need for %atient teaching. Assess bo"el functions for consti%ation or diarrhea. Assess %atient for signs and sym%toms of ana%hyla/is )rash %ruritus laryngeal edema "heezing, for at least :; minutes. -onitor hemoglobin hematocrit 0 reticulocyte values %rior to and every : "&s during the first @mo of thera%y and %eriodically thereafter. Pt teaching side effects: */%lain %ur%ose of iron thera%y to %atient. *ncourage %atient to com%ly "ith medication regimen. Advise %atient that stools may become dar& green or blac& and that this change is harmless. Instruct %atient to follo" a diet high in iron. Notify healthcare %rovider of the follo"ing adverse

effects: seizures ana%hyla/is hy%otension nausea consti%ation dar& stools diarrhea and e%igastric %ain. Drug: fludrocortisone )Alorinef, Classification: hormones . corticosteroids )mineralocorticoid,

Mechanism of action: -aintenance of sodium balance and !P in %atients "ith adrenocortical insufficiency. Why is THIS pt taking?: Patient has &idney failure. Monitoring parameters: -onitor !P %eriodically during thera%y. -onitor fluid retention. 1auses decrease in serum %otassium levels. Pt teaching side effects: Instruct %atient to ta&e medication as directed. Advise %atient to follo" dietary modifications %rescribed by healthcare %rofessional. Notify healthcare %rovider of the follo"ing adverse effects: dizziness headache arrhythmias edema hy%ertension anore/ia nausea "eight gain hy%o&alemia hy%o&alemic al&alosis and hy%ersensitivity reactions. Drug: mero%enem )-errem, Classification: anti(infectives. 1arba%enems are a class of R(lactam antibiotics "ith a broad s%ectrum of antibacterial activity. Mechanism of action: !actericidal action against susce%tible bacteria. Why is THIS pt taking?: Patient has a bacterial U$I. Monitoring parameters: Assess infection at beginning of and throughout thera%y. Obtain a history before initiating thera%y to determine %revious use of and reactions to %enicillins# Observe for signs and sym%toms of ana%hyla/is. !UN A2$ A7$ 765 serum al&aline %hos%hatase bilirubin and creatinine may be transiently increased. Pt teaching side effects: Advise %atient to re%ort the signs of su%er infection and allergy# -ay cause dizziness. Notify healthcare %rofessional for the follo"ing adverse effects: seizures a%nea dizziness diarrhea nausea vomiting and ana%hyla/is.

6rug: nystatin )-ycostatin Nysto%,

Classification: antifungals )to%ical,

Mechanism of action: 6ecrease in sym%toms of fungal infection. Why is THIS pt taking?: $o be a%%lied under the %atientSs folds to hel% "ith fungal infection. Monitoring parameters: Ins%ect involved areas of s&in and mucous membranes before and fre>uently during thera%y. Increased s&in irritation may indicate need to discontinue medication. Pt teaching side effects: Instruct %atient to a%%ly medication as directed for full course of thera%y even if feeling better. Advise %atient to re%ort increased s&in irritation or lac& of res%onse to thera%y to healthcare %rofessional. Notify healthcare %rofessional of the follo"ing adverse effects: burning itching local hy%ersensitivity reactions redness and stinging. 2ide effects: dizziness tachycardia sodium retention drug(induced lu%us syndrome dro"siness headache angina arrhythmias edema orthostatic hy%otension n.v %eri%heral neuro%athy.

6rug: 5ydralazine )A%resoline,

classification: antihy%ertensive.vasodilator

Mechanism of action: direct acting %eri%heral arteriolar vasodilator to lo"er !P in hy%ertensive %atients and decrease afterload in %atients "ith 5A. Why is this pt! taking? Aor moderate to severe 5y%ertension Monitoring parameters: monitor !P %ulse fre>uently )ethnic ris& of to/icity ie 1aucasians !lac& -e/ican slo" acetylators "hile Ha%anese 1hinese are ra%id acetylators at ris& for decreased levels and treatment failure,# labs: 1!1 electrolytes 7* cell %re% and ANA titer %rior to and %eriodically during %rolonged thera%y. Administer "ith meals consistently to enhance absor%tion. Pt! teaching side effects: *ncourage %atient to continue ta&ing medication on same time each day and even if feeling "ell. $o com%ly "ith additional interventions for hy%ertension )"eight reduction lo" sodium diet smo&ing cessation and moderation of alcohol inta&e e/ercise and stress management,# notify care %rovider of general tiredness fever muscle or numbness tingling %ain or "ea&ness of hands occurs and em%hasize im%ortance of follo" u% e/am to evaluate effectiveness of medication. Drug: fluo/etine )Prozac, Classification: $hera%eutic: antide%ressants Pharmacologic: selective serotonin reu%ta&e inhibitors )22RIs,

Mechanism of action: 2electively inhibits the reu%ta&e of serotonin in the 1N2. $hera%eutic *ffects: Antide%ressant action. 6ecreased behaviors associated "ith: %anic disorder bulimia. 6ecreased mood alterations associated "ith %remenstrual dys%horic disorder )P-66,. Why is THIS pt taking?: -ood enhancement. Monitoring parameters: -onitor mood changes. Assess for suicidal tendencies es%ecially during early thera%y. -onitor a%%etite and nutritional inta&e. Assess %atient for sensitivity reaction. Assess for se/ual side effects. Assess %atient for fre>uency of obsessive(com%ulsive behaviors. Note degree to "hich these thoughts and behaviors interfere "ith daily functioning. Assess fre>uency of binge eating and vomiting during thera%y. -onitor 1!1 and differential %eriodically during thera%y. Pt teaching side effects: It may ta&e u% to D "ee&s before the full effect occurs. $a&e in the morning. If you feel slee%y or tired you may ta&e it at night# If you are ta&ing the once("ee&ly ca%sule mar& calendar "ith reminders of drug day. 6o not ta&e this drug during %regnancy. If you thin& that you are %regnant or "ish to become %regnant consult your health care %rovider. +ee% this drug and all medications out of the reach of children. 2ide effects: 5eadache nervousness insomnia dro"siness an/iety tremor diarrhea se/ual dysfunction s"eating and %ruritus# life threatening: N*URO7*P$I1 -A7I'NAN$ 2YN6RO-* 2*IBUR*2 2UI1I6A7 $5OU'5$2 and 2*RO$ONIN 2YN6RO-*. Drug: isosorbide mononitrate )I-6UR, Classification: $hera%eutic: antianginals Pharmacologic: nitrates

Mechanism of action: Produce vasodilation )venous greater than arterial,. 6ecrease left ventricular end( diastolic %ressure and left ventricular end(diastolic volume )%reload,. Net effect is reduced myocardial o/ygen consum%tion. Increase coronary blood flo" by dilating coronary arteries and im%roving collateral flo" to ischemic regions. $hera%eutic *ffects: Angina ( relieve and %revention. Increase cardiac out%ut. Why is THIS pt taking?: Relief of angina. Monitoring parameters: Assess location duration intensity and %reci%itating factors of anginal %ain. -onitor !P and P routinely during %eriod of dosage ad4ustment.

Pt teaching side effects: $a&e as directed. Ris& of orthostatic hy%otension# -ay cause dizziness# 6riving caution. Avoid alcohol# O$1 herbal su%%l. revie" "ith 51P. 5eadache is a common side effect. A2A or acetamino%hen may be ordered to treat headache. Inform 51P if dry mouth or blurred vision occurs# side effects: dizziness headache a%%rehension restlessness "ea&ness blurred vision hy%otension tachycardia synco%e abd %ain N.3 flushing and tolerance