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Medication Sheet Medication/Dose/RouteClassificationGeneric/Trade Name | Action | ContraindicationAdverse Effects | Nursing Considerations | Acetaminophen/500mg/ By MouthAntipyretic& Analgesic (nonopioid)Acetaminophen/TylenolCarvedilol/6.25mg/By MouthAlpha- and beta-adrenergic blocker & AntihypertensiveCarvedilol/CoregDocusate Sodium/100mg/By MouthLaxative stool softenersDocusate Sodium/ColaceFurosemide/40mg/By MouthLoop diureticsFurosemide/Lasix | Reduces fever by acting directly on the hypothalamic heat-regulating center to cause vasodilation and sweating, which helps dissipate heat.Carvedilol causes vasodilation by blocking the activity of α-blockers, mainly at alpha-1 receptors. It exerts antihypertensive effect partly by reducing total peripheral resistance and vasodilation. It is used in patients with renal impairment, NIDDM or IDDM.Promotes incorporation of water into stool, resulting in softer fecal mass, may also promote electrolyte and water secretion into the colon. It increases the amount of water and fat absorbed by the feces, softening the stool and making it easier to pass.Inhibits the reabsorption of sodium and chloride from the loop of Henle and distal renal tubule. Increases renal excretion of water, sodium, chloride, magnesium, potassium, and calcium. | Contraindicated with allergy to acetaminophen. Use cautiously with impaired hepatic function, chronic alcoholism, pregnancy, lactation. Adverse effects CNS: Headache CV: Chest pain, dyspnea, myocardial damage when doses of 5–8 g/day are ingested daily for several weeks or when doses of 4 g/day are ingested for 1 yr GI: Hepatic toxicity and failure, jaundice GU: Acute kidney failure, renal tubular necrosis Contraindications Hypersensitivity; severe chronic heart failure, bronchial asthma or related bronchospastic conditions; severe hepatic impairment. Adverse effects Bradycardia, AV block, angina pectoris, hypervolemia, leucopenia, hypotension, peripheral edema, allergy, malaise, fluid overload, melena, periodontitis, vomiting, insomnia, hypercholesterolemia, weight gain, abnormal vision, rhinitis, pharyngitis and hypertriglyceridemia. Contraindicated: Colace should not be given if there is a suspicion of intestinal obstruction. It may interfere with the efficacy of aspirin, potassium supplements, potassium-sparing diuretics and mineral oil (liquid paraffin). Adverse Effects: Side effects include stomach ache, abdominal cramps, nausea and loss of appetite. Allergy to ingredients can cause skin rash; the medication should be stopped immediately and a doctor consulted. Hypocalcaemia (low calcium) may occur, leading to muscle cramps, muscle weakness and dizziness. Contraindicated in: Hypersensitivity; Cross-sensitivity with thiazides and sulfonamides may occur; Hepatic coma or anuria; Some liquid products may contain alcohol, avoid in patients with alcohol intolerance. Adverse Reactions/Side Effects: CNS: blurred vision, dizziness, headache, vertigo. EENT: hearing loss, tinnitus. CV: hypotension. GI: anorexia, constipation, diarrhea, dry mouth, dyspepsia, ↑ liver enzymes, nausea, pancreatitis, vomiting. | Assessment History: Allergy to acetaminophen, impaired hepatic function, chronic alcoholism, pregnancy, lactationImplementation Do not exceed the recommended dosage. Avoid using multiple preparations containing acetaminophen. Carefully check all OTC products. Give drug with food if GI upset occurs. Discontinue drug if hypersensitivity reactions occur.http://nurseslabs.com/acetaminophen-tylenol-drug-study/#_Assessment History: CHF, bronchial asthma, heart block, cardiogenic shock, hypersensitivity to carvedilol, pregnancy, lactation, hepatic impairment, peripheral vascular disease, thyrotoxicosis, diabetes, anesthesia or major surgery. Implementation: Consult with physician about withdrawing drug if patient is to undergo surgery (withdrawal is controversial).Give with food to decrease orthostatic hypotension and adverse effects. Monitor for orthostatic hypotension and provide safety precautions.Monitor diabetic patient closely; drug may mask hypoglycemia or worsen hyperglycemia.http://www.rnpedia.com/home/notes/pharmacology-drug-study-notes/carvedilolAssessment: Prior to administering Colace, the nurse should make a full assessment of the patient to identify possible causes of constipation. WD.com recommends enquiry into: diet and lifestyle; duration of constipation and whether it is acute or chronic; all medications taken, whether prescribed over the counter or recreational; associated symptoms such as bleeding from the rectum, abdominal pain, vomiting. Implementation: Oral preparations of Colace should be administered on an empty stomach at least one hour apart from other medications, meals, milk and antacids. It may be given in juice to prevent possible throat irritation. Six to eight ounces or 180-240 ml of water should be taken with oral preparations. When administering rectal preparations, beware of forcing past impacted feces. Discontinue the medication at the first sign of nausea and vomiting, abdominal cramps or rectal bleeding.http://preventconstipation.methodsofprevention.com/colace-nursing-considerations/Assessment: Assess fluid status. Monitor daily weight, intake and output ratios, amount and location of edema, lung sounds, skin turgor, and mucous membranes. Notify health care professional if thirst, dry mouth, lethargy, weakness, hypotension, or oliguria occurs. Monitor BP and pulse before and during administration. Monitor frequency of prescription refills to determine compliance in patients treated for hypertension. Assess patients receiving digoxin for anorexia, nausea, vomiting, muscle cramps, paresthesia, and confusion. Assess patient for tinnitus and hearing loss. Assess for allergy to sulfonamides. Assess patient for skin rash frequently during therapy. Implementation: Do not confuse Lasix with Luvox. If administering twice daily, give last dose no later than 5 pm to minimize disruption of sleep cycle. IV route is preferred over IM route for parenteral administration.http://www.drugguide.com/ddo/ub/view/Davis-Drug-Guide/51345/all/furosemide |

Medication Sheet Medication/Dose/RouteClassificationGeneric/Trade Name | Action | ContraindicationAdverse Effects | Nursing Considerations | Lisinopril/5mg/By MouthAntihypertensive & Angiotensin-Converting Enzyme (ACE) InhibitorsLisinopril/PrinivilTramadol/50mg/By MouthAnalgesics (centrally acting)Tramadol/RyzoltGabapentin/300mg/By MouthAnticonvulsant/ AntiepilepticGabapentin/NeurontinPotassium/20mEQ Tab/By MouthOral electrolyte supplementPotassium/Klor-conPravastatin/80mg/By MouthAntilipemic Agent (HMG-CoA Reductase Inhibitor)Pravastation/PravacholZolpidem/5mg/By MouthSedative or hypnotic (nonbarbiturate)Zolpidem/Ambien | Lisinopril competitively inhibits angiotensin-converting enzyme (ACE) from converting angiotensin I to angiotensin II resulting in decreased levels of angiotensin II (a potent vasoconstrictor). This increases plasma renin activity and reduces aldosterone secretion. It also increases bradykinin levels.Tramadol is a centrally acting synthetic opioid analgesic. Although its mode of action is not completely understood, from animal tests, at least two complementary mechanisms appear applicable: binding of parent and M1 metabolite to mu-opioid receptors and weak inhibition of reuptake of norepinephrine and serotonin.Gabapentin prevents seizures as do other marketed anticonvulsants. Gabapentin exhibits antiseizure activity in mice and rats in both the maximal electroshock and pentylenetetrazole seizure models and other preclinical models (e.g., strains with genetic epilepsy, etc.). The relevance of these models to human epilepsy is not known.Potassium is the major cation of intracellular fluid and is essential for the conduction of nerve impulses in heart, brain, and skeletal muscle; contraction of cardiac, skeletal and smooth muscles; maintenance of normal renal function, acid-base balance, carbohydrate metabolism, and gastric secretion.It is effective in reducing total and LDL cholesterol in various forms of hypercholesterolemia. Competitively inhibits 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase, the enzyme that catalyzes cholesterol biosynthesis. HMG-Coa reductase inhibitors (statins) increase serum HDL cholesterol, decrease serum LDL cholesterol, VLDL cholesterol, and plasma triglyceride levels.Zolpidem acts by binding to the benzodiazepine (BZD) receptors of the GABA receptor complex. It has a selective affinity to BZD receptors prevalent in the cerebellum (omega-1 receptors). It has strong sedative actions but only minor anxiolytic properties. It has also less effects on skeletal muscle and seizure threshold. Zolpidem has a rapid onset but short duration of hypnotic action. | Contraindications: History of angioedema related to previous treatment with ACE inhibitors, hereditary or idiopathic angioedema. Bilateral renal artery stenosis. Pregnancy (2nd or 3rd trimester), lactation. Adverse effects Dizziness, headache, fatigue; cough, upper respiratory tract infection; rash; diarrhoea, nausea, vomiting, abdominal pain; chest pain, weakness; orthostatic effects; hypotension; hyperkalaemia; impotence; decreased haemoglobin; increased serum creatinine. CONTRAINDICATION Ultram should not be administered to patients who have previously demonstrated hypersensitivity to tramadol or in cases of acute intoxication with alcohol, hypnotics, centrally acting analgesics, opioids or psychotropic drugs. People who have a seizure disorder should not take Tramadol, because this medication can cause seizures. AE: It also causes shakiness, feelings of lightheadedness and dizziness in some users.Contraindications: Gabapentin is contraindicated in patients who have demonstrated hypersensitivity to the drug or its ingredients.AE: Dizziness, fatigue, and headache. No life-threatening idiosyncratic reactions have been reported. Dose-related neurotoxicity is usually mild. Gabapentin can cause dystonic reactions, which are reversible after drug withdrawal (Pina and Modrego 2005).Contraindication: Severe renal impairment, untreated Addison's disease, heat cramps, hyperkalemia, severe tissue trauma; solid oral dosage forms are contraindicated in patients in whom there is a structural, pathological, and/or pharmacologic cause for delay or arrest in passage through the GI tract. AE: Diarrhea, nausea, stomach pain, flatulence, vomiting (oral), Bradycardia, Hyperkalemia, Local tissue necrosis with extravasation, pain at the site of injection, Weakness, Dyspnea, Chest pain, arrhythmias, heart block, hypotension, mental confusion, alkalosis, abdominal pain, throat pain, phlebitis, paresthesias, paralysis.Contraindications Hypersensitivity to pravastatin or any component; active liver disease; unexplained persistent elevations of serum transaminases; pregnancy. AE: GI: Nausea, diarrhea, abdominal pain, vomiting, constipation, flatulence, heartburn, transient elevations in serum liver transaminase levels. Other: Fatigue, rhinitis, cough, transient elevations in CPK.Contraindications Severe hepatic insufficiency. AE: Amnesia, drowsiness, dizziness, diarrhea, nausea, vomiting, abnormal thinking and behavior, drugged feelings, back pain, ataxia, hiccups, confusion, euphoria, insomnia, vertigo, diplopia, abnormal vision.Potentially Fatal: Hepatitis, anaphylactic reactions, sleep-driving (driving while not fully awake after drug ingestion, with no recollection of the event). | Assessment History: Allergy to lisinopril or enalapril, impaired renal function, CHF, salt or volume depletion, lactation, pregnancy. Physical: Skin color, lesions, turgor; T; P, BP, peripheral perfusion; mucous membranes, bowel sounds, liver evaluation; urinalysis, LFTs, renal function tests, CBC and differential. Interventions Begin drug within 24 hr of acute MI; ensure that patient is also receiving standard treatment (eg, aspirin, beta-adrenergic blockers, thrombolytics). Monitor patients on diuretic therapy for excessive hypotension following the first few doses of lisinopril.Monitor patients closely in any situation that may lead to a decrease in BP secondary to reduction in fluid volume (excessive perspiration and dehydration, vomiting, diarrhea) because excessive hypotension may occur.http://www.rnpedia.com/home/notes/ pharmacology-drug-study-notes/lisinoprilAssess type, location, and intensity of pain before and 2-3 hr (peak) after administration. Assess BP & RR before and periodically during administration. Assess bowel function routinely. Assess previous analgesic history. Monitor patient for seizures. May occur within recommended dose range. Risk increased with higher doses and inpatients taking antidepressants (SSRIs, tricyclics, or Mao inhibitors), opioid analgesics, or other durgs that decrese the seizure threshold.Overdose may cause respiratory depression and seizures. Naloxone (Narcan) may reverse some, but not all, of the symptoms of overdose. http://www.nursing-nurse.com/drug-study-tramadol-178/Assess History for Hypersensitivity to gabapentin; lactation, pregnancyPhysically assess Weight; T; skin color, lesions; orientation, affect, reflexes; P; R, adventitious sounds; bowel sounds, normal output. Give drug with food to prevent GI upset. Arrange for consultation with support groups for people with epilepsy. WARNING: If overdose occurs, hemodialysis may be an option.http://web.squ.edu.om/med-lib/med_cd/e_cds/Nursing%20Drug%20Guide/mg/gabapentin.htmMonitor I&O ratio and pattern in patients receiving the parenteral drug. If oliguria occurs, stop infusion promptly and notify physician. Lab test: Frequent serum electrolytes are warranted. Monitor for and report signs of GI ulceration (esophageal or epigastric pain or hematemesis). Monitor patients receiving parenteral potassium closely with cardiac monitor. Irregular heartbeat is usually the earliest clinical indication of hyperkalemia. Be alert for potassium intoxication (hyperkalemia, see S&S, Appendix F); may result from any therapeutic dosage, and the patient may be asymptomatic. The risk of hyperkalemia with potassium supplement increases (1) in older adults because of decremental changes in kidney function associated with aging, (2) when dietary intake of potassium suddenly increases, and (3) when kidney function is significantly compromised.http://www.robholland.com/Nursing/Drug_Guide/data/monographframes/P063.html Assessment: Lab tests: Perform liver function tests at start of therapy and then at 12 wk. If normal at 12 wk, may change to semiannual monitoring. Intervention: Monitor cholesterol levels throughout therapy. Monitor coagulation studies with patients receiving concurrent warfarin therapy. PT may be prolonged. Monitor CPK levels if patient experiences unexplained muscle pain. http://www.medpill.info/pravastatin-1785.htmAssessment History: Hypersensitivity to zolpidem, acute intermittent porphyria, impaired hepatic or renal function, addiction-prone patients, lactation, pregnancyPhysical: T; skin color, lesions; orientation, affect, reflexes, vision examination; P, BP; bowel sounds, normal output, liver evaluation; CBC with differential; LFTs, renal function tests. Interventions WARNING: Limit amount of drug dispensed to patients who are depressed or suicidal. WARNING: Withdraw drug gradually if patient has used drug long-term or if patient has developed tolerance. Supportive therapy similar to that for withdrawal from barbiturates may be necessary to prevent dangerous withdrawal symptoms.http://www.rnpedia.com/home/notes/pharmacology-drug-study-notes/zolpidem-tartrate |

Medication Sheet Medication/Dose/RouteClassificationGeneric/Trade Name | Action | ContraindicationAdverse Effects | Nursing Considerations | | | | |

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