HOI: Hoag Orthopedic Institute Medications List
1. Aspirin, Chewable Aspirin tablet
Classification: Antipyretic, non-opioid
analgesic
Dosage: 80-325 mg/daily
Physiological Activity: Inhibit the
production of prostaglandins and
decreases platelet aggregation
Side effect: EENT: Tinnitus, GI:
increased bleeding, dyspepsia,
epigastric distress, HEMAT: Anemia,
hemolysis, DERM: rash, urticaria
Nursing Implications: Assess renal and
liver functions for long term use, assess
pain and limitation of movement,
monitor hematocrit for prolonged use for
GI blood loss
2. docusate sodium, Senokot S.
-Classification: Laxative, stool softener
-Dosage: 2 tablets once daily at
bedtime, not to exceed 4 tablets twice daily
Physiological Activity: local irritant in the
colon to stimulate peristalsis, promotes
incorporation of water in stool resulting
in softer fecal mass
Side effect: GI: abdominal cramps,
nausea, vomiting, DERM: rashes, GI:
urine discoloration
Nursing Implications: Assess bowel
sounds, check for abdominal distention,
assess color, consistency, and amount
of stool produced
3. Ascorbic acid, Vitamin C
-Classification: Water-soluble vitamin
-Dosage: 500 mg/day for 14 days
-Physiological Activity: Involved in
oxidation reduction reactions: iron,
carbohydrate metabolism, lipid and
protein synthesis.
-Side Effects: CNS: headache,
insomnia, GI: Cramps, diarrhea, nausea,
vomiting, GU: kidney stones, HEMAT:
deep vein thrombosis
-Nursing Implications: Assess for signs
of vitamin C deficiency; (gingivitis,
bleeding gums, loose tooth), Mega
doses may cause false-negative results for
occult blood stool test.
4. ferrous Sulfate EC / FeSO4
Classification: antianemic, iron
supplements
p.
Range: Deficiency 2 3 mg/kg/day in
2 4 divided doses or 60 100 mg
elemental iron twice daily. Prophylaxis
60 100 mg elemental iron daily.
Physiologic activity: An essential mineral
found in hemoglobin, myoglobin, and
many enzymes.
Purpose: A type of Iron that is an
essential body mineral. Used to treat
Iron deficiencies, anemia (Lack of RBC
bc of little Iron in the body)
Side Effects: CNS: dizziness, headache,
syncope. GI: nausea, constipation, dark
stools, epigastric pain
Nursing Implications: Assess bowel
function for constipation or diarrhea,
Assess nutritional status and dietary
history to determine possible cause of
anemia and need for pt. teaching
5. Multivitamins and Chloraseptic Throat
Lozenges (Menthol, Benzocaine,
Dextromethorphan Hydrobromide)
Multivitamins
Purpose: Supplementing people,
particularly the elderly, with additional
vitamins and minerals not taken in
through the diet.
Side Effects: Mild diarrhea, Upset
stomach, Nausea
Nursing Implications: Prevent vitamin
overdose / watch dosage, Assess bowel
sounds
Chloraseptic Throat Lozenges
Purpose: Oral Anesthetic / Analgesic
Side Effects: Dizziness, Nausea
Nursing Implications: Assess frequency
and nature of cough, lung sounds, and
amount and type of sputum
6. Acetaminophen / Tylenol
Purpose: Pain reliever and fever
reducer. Used to treat headache,
muscle aches, arthritis, back ache,
toothache, colds, and fevers
Side Effects: Nausea, Upper stomach
pain, Itching, Loss of appetite, Dark
urine, Jaundice, Skin rashdexa
Nursing Implications: Assess overall
health status and alcohol use of pt.
before administering the drug as it can
cause serious problems if the pt. is
malnourished and an alcohol abuser.
7. celecoxib / Celebrex
 HOI: Hoag Orthopedic Institute Medications List
Classification: NSAID
Range: 50 mg twice daily
Physiological activity: Inhibits the
enzyme COX-2. This enzyme is required
for the synthesis of prostaglan- dins.
Purpose: decreases pain and
inflammation caused by arthritis or
ankylosing spondylitis. Also relieves
menstrual pain (primary dysmenorrhea)
Side Effects: CNS: dizziness, headache,
insomnia, CV: MYOCARDIAL
INFARCTION, STROKE,
THROMBOSIS, edema. GI: GI
BLEEDING, abdominal pain, diarrhea,
Nursing Implications: Assess ROM,
degree of swelling and pain in joints
before and periodically throughout
therapy. Assess for skin rash frequently
and d/c at first sign of rash. Advise pt to
notify HCP if pregnancy planned or
suspected.
8. Hydrocodone w/ Acetaminophen / Norco
Classification: opioid agonists/nonopioid
analgesic combinations
Range: 2.510 mg q 36 hr as needed
Physiological Activity: Bind to opiate
receptors in the CNS.
Purpose: manages moderate to severe
pain. Also suppresses cough reflex
Side Effects: CNS: confusion, dizziness,
sedation, Resp: respiratory depression.
CV: hypotension, bradycardia. GI:
constipation, dyspepsia, nausea,
Nursing Implications: Assess BP, pulse
and respiration before and periodically
during administration. Assess bowel
function routinely. Assess pain type,
location and intensity prior and following
administration. Assess risk for
addiction. Assess cough and lung
sounds during antitussive use.
9. Famotidine / Pepcid
Classification: Histamine H2 antagonist
Range: 40 mg/day at bedtime or 20 mg
twice daily for up to 8 wk
Physiological Activity: Inhibits the action
of histamine at the H2-receptor site
located primarily in gastric parietal cells,
resulting in inhibition of gastric acid
secretion.
p. 2
Purpose: Heal and prevent stress-
induced upper GI bleeding in critically ill
pt
Side Effects: CNS: confusion, dizziness,
drowsiness, Endo: gynecomastia.
Hemat: AGRANULOCYTOSIS,
APLASTIC ANEMIA
Nursing Implications: Assess for
epigastric or abdominal pain, frank or
occult blood in stool, emesis, or gastric
aspirate. In geriatric pts, assess for
confusion. Administer with meals and at
bedtime to prolong effect.
10. Oxycodone CR / Oxycontin
- Purpose: control of moderate to severe
pain
- Side effect: severe stomach pain,
constipation, vomiting, black, bloody, or tarry
stools, coughing up blood or vomit that
looks like coffee grounds, weak or shallow
breathing, tachycardia, bradycardia,
confusion, hallucinations, feeling like you
might pass out, easy bruising or bleeding,
seizures,
decreased hearing, tinnitus
Nursing implication: Assess pain prior
and 1 hour post administration, assess
BP, HR, respiration prior and periodically
after administration, assess for
constipation, assess risk for opioid
addiction
11. Oxycodone with Acetaminophen /
Percocet
Purpose: control of moderate to severe
pain
Side effect: severe stomach pain,
constipation, vomiting, black, bloody, or
tarry
stools, coughing up blood or vomit that
looks like coffee grounds, weak or shallow
breathing, tachycardia, bradycardia,
confusion, hallucinations, feeling like you
might pass out, easy bruising or
bleeding, seizures,
decreased hearing, tinnitus
Nursing implication: Assess pain prior
and 1 hour post administration, assess
BP,
HR, respiration prior and periodically
after administration, assess for constipation,
assess risk for opioid addiction
 HOI: Hoag Orthopedic Institute Medications List
12. Hydroxyzinehydrochloride / Vistaril
Purpose: Treatment of anxiety,
preoperative sedation, antiemetic effect,
antipruritic
effect
Side effect: restless muscle movements
in eyes, tongue, jaw or neck, tremors,
confusion, seizures, dizziness,
drowsiness, blurred vision, dry mouth, stomach
upset, headache
Nursing implication: Assess for over
sedation and provide safety precautions,
geriatric pts more sensitive to CNS and
anti-cholinergic effects
13. oxycodone IR / Roxicodone
Classification: opioid agonists, opioid
agonists/nonopioid analgesic
combinations
Range: 510 mg q 34 hr initially, as
needed.
Physiological Activity: Binds to opiate
receptors in the CNS. Alters the
perception of and response to painful
stimuli, while producing generalized
CNS depression.
Purpose: Opiod analgesic for moderate
to severe pain
Side effects: CNS: confusion, sedation,
CV: orthostatic hypotension. GI:
constipation, dry mouth
Nursing implication: Assess type,
locations, and intensity of pain prior to
and 1 hour after administration. Assess
BP, pulse and respirations before and
periodically after administration. Assess
for constipation. Assess risk for opiod
addiction
14. Dexamethasone / Decadron
Purpose: Corticosteroid that prevents
the release of substances in the body
that cause inflammation
Side Effects: Aggression, agitation,
anxiety, blurred vision, decrease in the
amount of urine, dizziness, irregular
heartbeat or pulse, headache,
irritability, mental depression, mood
changes, nervousness, shortness of
breath, swelling of the fingers, hands,
feet, or lower legs
Nursing Implications: Monitor intake
and output of patient. Assess breath
sounds for rales, crackles or dyspnea.
p. 3
Monitor for peripheral edema or steady
weight gain.
15. Diazepam / Valium
Purpose: Adjunct in the management of
anxiety disorder. Treatment of status
epilepticus/uncontrolled seizures.
Skeletal muscle relaxant. Management
of alcohol withdrawals
Side Effects: Dizziness, drowsiness,
lethargy, respiratory depression, blurred
vision, constipation, rashes, pain
Nursing Implications: Monitor BP, pulse
and respiratory rate prior to and
periodically throughout therapy. Assess
mental status. Assess for falls risk and
institute fall precautions for elderly.
16. Gabapentin/ Neurotonin
Purpose: Analgesic adjuncts,
anticonvulsants, mood stabilizers
Side Effects: suicidal thoughts,
confusion, depression, dizziness,
drowsiness, rhabdomyolysis, ataxia,
multiorgan hypersensitivity reactions
Nursing Implications: Monitor closely for
notable changes in behavior that could
indicate the emergence or worsening of
suicidal thoughts or behavior or
depression
17. Warfarin/ Coumadin
Purpose: Anticoagulation
Side Effects: bleeding, cramps, nausea,
dermal necrosis, fever
Nursing Implications: Assess for signs of
bleeding and hemorrhage (bleeding
gums; nosebleed; unusual bruising;
tarry, black stools; hematuria; fall of
hematocrit or BP; guaiacpositive stools,
urine, or nasogastric aspirate)
18. Prochlorperazine/ Compazine
Purpose: Antiemetics, antipsychotics
Side Effects: Neuroleptic Malignant
syndrome, extrapyramidal reactions,
blurred vision, dry eyes, constipation,
dry mouth
Nursing Implications: Monitor for
development of neuroleptic malignant
syndrome (fever, respiratory distress,
tachycardia, seizures, diaphoresis,
 HOI: Hoag Orthopedic Institute Medications List
hypertension or hypotension, pallor,
tiredness, severe muscle stiffness, loss
of bladder control). CBC and liver
function tests should be evaluated
periodically during therapy. May cause
blood dyscrasias, especially between wk
4 and 10 of therapy. Hepatotoxicity is
more likely to occur between wk 2 and 4
of therapy. May recur if medication is
restarted. LIver function abnormalities
may require discontinuation of therapy.
19. Meloxicam / Mobic
Purpose: Relief of osteoarthritis and
rheumatoid arthritis (including juvenile
rheumatoid arthritis)
Side effect: HF, MI, CVA, edema, HTN,
increased liver enzymes, diarrhea, GI
bleeding, exfoliative dermatitis, Stevens-
johnsons syndrome, toxic epidermal
necrolysis.
Implications: Pts. With asthma, ASA
allergies, nasal polyps are at risk for
hypersensitivity reactions. Assess for
rhinitis, asthma, urticaria. Assess for
rash periodically during tx. Discontinue if
S&S associated with Stevens-Johnson
syndrome occur along with fever,
malaise, fatigue, muscle or joint aches,
blisters, oral lesions, conjunctivitis.
20. Atenolol / tenormin
Purpose: management of Hypertension.
Side effect: bradycardia, HF, pulmonary
edema, fatigue, weakness, erectile
dysfunction, hypotension,
bronchospasm, wheezing.
Implications: monitor bp, ecg, pulse,
I&Os, daily weight, assess for HF,
(dyspnea, rales/crackles, weight gain,
peripheral edema, Jugular vein
distention(JVD). Monitor for signs of
overdose (bradycardia, severe
dizziness, fainting, drowsiness,
dyspnea, bluish fingernails, palms,
seizures).
21. Lisinopril / Prinivil
Purpose: management of hypertension.
Reduction of risk of death or
development of HF following MI.
Side effect: agranulosis, angioedema,
cough, hypotention, taste disturbances,
erectile dysfunction.
p. 4
Implication: monitor bp, pulse, signs of
angioedema, monitor weight, jugular
vein distention, HF.
22. Calcium Channel Blockers for
Hypertension such as (Amlodipine) Norvasc
or
Diltiazem
Purpose - For hypertension
Side Effects - Peripheral edema,
bradycardia, hypotension, nausea
Implications - Monitor BP and pulse
before drug therapy, monitor I & O,
assess for dyspnea
23. Dulcolax Suppository (bisacodyl)
Classification: Stimulant laxative
Range: 515 mg/day (up to 30 mg/day)
as a single dose.
Physiological activity: Stimulates
peristalsis. Alters fluid and electrolyte
transport, producing fluid accumulation
in the colon.
Side Effects: GI: abdominal cramps,
nausea, Misc: protein-losing
enteropathy
Nursing Implications - Assess pt for
abdominal distention, presence of bowel
sounds, usual pattern of bowel function.
Assess color, consistency, amount of
stool produced.
24. Miralax (polyethylene glycol)
Purpose - Treatment of occasional
constipation
Side effects - Urticaria, abdominal
bloating, cramping, flatulence, nausea
Implications - Assess pt for abdominal
distention, presence of bowel sounds,
usual pattern of bowel function. Assess
color, consistency, amount of stool
produced.
24-1. (Hydromorphone) Dilaudid, Dilaudid-HP,
Exalgo, Hydrostat IR, Jurnista
Classification: opioid agonists
Range: 4 8 mg q 3 4 hr initially
Physiological Activity: Binds to opiate
receptors in the CNS.
Purpose: - Moderate to severe pain
(alone and in combination with
 HOI: Hoag Orthopedic Institute Medications List
nonopioid analgesics); extended release
product for opioid-tolerant patients
requiring around-the-clock management
of persistent pain. Antitussive (lower
doses).
Side Effects: - CNS: confusion,
sedation, dizziness, dysphoria,
euphoria, floating feeling, hallucinations,
headache, unusual dreams. EENT:
blurred vision, diplopia, miosis. Resp:
respiratory depression. CV:
hypotension, bradycardia. GI:
constipation, dry mouth, nausea,
vomiting. GU: urinary retention. Derm:
flushing, sweating. Misc: physical
dependenc
Implications: - Assess BP, pulse, and
respirations before and periodically
during administration. If respiratory rate
is 10/min, assess level of sedation.
Dose may need to be decreased by 25
50%. Initial drowsiness will diminish with
continued use.
25. (Enoxaparin) Lovenox (subcu)
Purpose: Prevention of venous
thromboembolism (VTE) (deep vein
thrombosis (DVT) and/or pulmonary
embolism (PE)) in surgical or medical
patients. Treatment of DVT with or
without PE (with warfarin). Prevention of
ischemic complications (with aspirin)
from unstable angina and non-
STsegment-elevation MI. Treatment of
acute ST-segment-elevation MI (with
thrombolytics or percutaneous coronary
intervention).
Side Effects: CNS: dizziness, headache,
insomnia. CV: edema. GI: constipation,
qliver enzymes, nausea, vomiting. GU:
urinary retention. Derm: ecchymoses,
pruritus, rash, urticaria. Hemat:
BLEEDING, anemia, thrombocytopenia.
Local: erythema at injection site,
hematoma, irritation, pain. Misc: fever.
Implications: Assess for signs of
bleeding and hemorrhage (bleeding
gums; nosebleed; unusual bruising;
black, tarry stools; hematuria; fall in
hematocrit or BP; guaiac-positive
stools); bleeding from surgical site.
Notify health care professional if these
occur. Assess for thrombosis. Monitor
neurological impairment. Monitor Labs
for abnormality. High Alert: Unintended
p. 5
concomitant use of two heparin
products. Do not aspirate or massage.
26. Morphine Sulfate:
Purpose: treat severe pain, pulmonary
edema, pain associated with MI
Side effects: confusion, sedation,
dizziness, dysphoria, euphoria, floating
feeling, hallucinations, headache,
unusual dreams. EENT: blurred vision,
diplopia, miosis. Resp: RESPIRATORY
DEPRESSION. CV: hypotension,
bradycardia. GI: constipation, nausea,
vomiting. GU: urinary retention. Derm:
flushing, itching, sweating. Misc:
physical dependence, psychological
dependence, tolerance.
Implications: High Alert: Do not confuse
with other drugs! Duh! Extra precautions
for children. Have second practitioner
independently check original order, dose
calculations, and infusion pump settings.
27. Cefazolin/Ancef
Purpose: Treatment of perioperative prophylaxis,
biliary tract infections, genital infections,
bacterial endocarditis prophylaxis for dental and
upper respiratory tract procedures.
Adverse Rxns/ Side Effects: Seizures
(high doses), diarrhea, nausea,
vomiting, rashes, hemolytic anemia,
neutropenia, thrombocytopenia, pain at
IM site, phlebitis at IV site
Nursing Implications: Observe pt. for
s/sy of anaphylaxis. Monitor bowel
function. Assess pt. for skin rash
frequently during therapy.
28. Vancomycin/ Vancocin (IVPB)
Purpose: Useful in staphylococcal
infections: endocarditis, meningitis,
osteomyelitis, pneumonia, septicemia,
soft-tissue infection
Adverse Rxns/ Side Effects: ototoxicity,
hypotension, nausea, vomiting,
nephrotoxicity, rashes, phlebitis, back
and neck pain, chills, fever, anaphylaxis,
superinfection
Nursing Implications: Monitor IV site
closely, monitor BP throughout, monitor
I/O and daily weight, assess for
superinfection, anaphylaxis, assess
 HOI: Hoag Orthopedic Institute Medications List
bowel status throughout , monitor urine
lab tests
29. Ondansetron/ Zofran
Classification: antiemetics
Range: 24 mg 30
Physiological Activity: Blocks the effects
of serotonin at 5-HT3 Blocks the
effects of serotonin at 5-HT3 sites
(selective antagonist) located in vagal
nerve terminals and the chemoreceptor
trigger zone in the CNS.
s/e: CNS: headache, dizziness, GI:
constipation, diarrhea
Purpose: Prevention of nausea and
vomiting Adverse Rxns/ Side Effects:
serotonin syndrome, headache,
dizziness, drowsiness, fatigue, weaknes,
constipation, diarrhea, abdominal pain,
dry mouth
Nursing Implications: Assess pt for
nausea, vomiting, abdominal distention
and bowel sounds prior to and following
treatment, assess pt for extrapyramidal
effects periodically, monitor ECG pts.,
Monitor for s/sy of serotonin syndrome
30. Insulin / Novolog (short acting), Insulin /
Lantus or Levimir (long acting)
Novolog
Purpose: Fast acting drug that treats
Type 1 (adults and children age 2) and
Type 2 (adults) diabetes
Side Effects: Headache, Excessive
hunger, Confusion, Shakiness, Cold
sweats, Restlessness, Anxiety
Nursing Implications: Assess pt. for
signs of Hypoglycemia, Monitor body
weight, Monitor blood glucose
Levimir
Purpose: Man made form of Insulin.
Long acting Insulin that starts to work
several hours after injection
Side Effects: Same as above
Nursing Implications: Same as above
31. methocarbamol (Robaxin)
Classification: Skeletal muscle
relaxation
Range: 1.5 g 4 times daily initially (up to
8 g/day) for 2 3 days, then 4 4.5 g/
day in 3 6 divided doses
p. 6
Physiological Activity: Skeletal muscle
relaxation, probably as a result of CNS
depression.
s/e: CNS: dizziness, drowsiness, light-
headedness. GI: anorexia, GI upset,
nausea. GU: brown, black, or green
urine
Nursing Implications: Assess pt for pain,
muscle stiffness, ROM. Assess geriatric
pts for anticholinergic effects.
32. temazepam (Restoril)
Classification: benzodiazepines
Range: 1530 mg at bedtime initially if
needed; some patients may require only
7.5 mg.
Physiological Activity: Acts at many
levels in the CNS, producing
generalized depression. Effects may be
mediated by GABA, an inhibitory
neurotransmitter.
s/e: CNS: abnormal thinking, behavior
changes, hangover, EENT: blurred
vision. GI: constipation, diarrhea,
nausea, vomiting
Nursing Implications: Assess mental
status and potential for abuse, assess
sleep pattern prior to administration
33. alprazolam (Xanax)
Classification: benzodiazepines
Range: .25-.5 mg 2-3 times daily not to
exceed 4 mg/day
Physiological activity: acts at many
levels in the CNS to produce anxiolytic
effects. May produce CNS depression
s/e: CNS: Dizziness, lethargy,
drowsiness, EENT: Blurred vision, GI:
Diarrhea, vomiting, nausea
34. cyclobenzaprine/Flexeril
Classification: skeletal muscle relaxants
Range: 10 mg 3 times daily
Physiological activity: Reduces tonic
somatic muscle activity at the level of
the brainstem.
s/e: CNS: dizziness, drowsiness, CV:
arrhythmias. GI: constipation
Nursing implications: Assess geriatric pt
for anticholinergic effect, Assess for
serotonin syndrome like mental changes
35. simvastatin/ Zocor
 HOI: Hoag Orthopedic Institute Medications List
Classification: lipid-lowering agents
Range: 5 40 mg once daily in the
evening;
Physiological activity: Inhibits 3-hydroxy-
3-methylglutaryl-coenzyme A (HMG-
CoA) reductase, an enzyme which is
responsible for catalyzing an early step
in the synthesis of cholesterol.
s/e: GI: abdominal cramps, constipation,
diarrhea, flatus, heartburn, Derm:
rashes, pruritus. Endo: hyperglycemia.
MS: RHABDOMYOLYSIS
Nursing Implications: Evaluate liver
function test prior to start of therapy,
Obtain a diet history in regard to fat
consumption
36. clonazepam/Klonopin
Classification: Benzodiazepines,
anticonvulsant
Range: 0.5 mg 3 times daily; may q by
0.5 1 mg q 3 days.
Physiological activity: Anticonvulsant
effects may be due to presynaptic
inhibition. Produces sedative effects in
the CNS, probably by stimulating
inhibitory GABA receptors.
p. 7
s/e: CNS: SUICIDAL THOUGHTS,
behavioral changes, drowsiness,
Resp:secretions. CV: palpitations.
Derm: rash. GI: constipation, diarrhea
Nursing Implications: Observe and
record intensity, duration, and location of
seizure activity, monitor for changes in
behavior, assess need for continued
treatment regularly
37. escitalopram/ Lexapro
Classification: SSRI
Range: 10 mg once daily
Physiological activity: Selectively inhibits
the reuptake of serotonin in the CNS.
s/e: CNS: NEUROLEPTIC MALIGNANT
SYNDROME, SUICIDAL THOUGHTS,
insomnia, GI: diarrhea, nausea,
abdominal pain,
Nursing Implications: Advise patient to
look for signs of suicidality, may cause
dizziness, emphasize importance of
follow up exams.
Uses: Major depressive disorder.
Generalized anxiety disorder