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RATIONALES FOR PRESCRIBED MEDICATIONS: Routine meds (scheduled) and any PRN given within past 24 hours DIRECTIONS: add pages as needed to include all you client’s current prescribed meds and PRNs
|MEDICATION (generic and Trade name, drug|Dose, route, |MECHANISM OF ACTION |EFFECT ON CLIENT |WHY CLIENT IS TAKING THIS MED |
|classification |frequency | | | |
|Loperamide, Imodium; anti- diarrheal |2 mg PO per loose |Inhibits peristalsis and prolongs transit |Relief of diarrhea |Loose stool |
| |stool PRN up to 20 |time by a direct effect on nerves, reduces| | |
| |mg/day |fecal volume, increases fecal viscosity | | |
|calcium carbonate/ |30 cc PO Q 4hrs PRN |neutralizing the acid in the stomach. |Reduction in gastric acid |Upset GI |
|magnesium carbonate, Mylanta; | | | | |
|mineral/electrolyte supplement | | | | |
|Acetaminophen, Tylenol; analgesics |500 mg PO TID |Inhibits synthesis of prostaglandins |Severs pain reception and reduces fever |Pain, discomfort |
|NTG, Nitrostat; vasodilator, organic |0.4 mg SLQ up to 3x |Increases coronary blood and |Relief or prevention of angina attacks, |Angina |
|nitrate, anti-anginal | |vasodilatation |lowers BP | |
|saccharomyces boulardii lyo, Florastor; |1 cap PO BID for 11 |maintain normal bowel function and promote|maintain normal bowel function and promote|GI prophylaxis due to ABO use |
|probiotic |days |intestinal health |intestinal health | |
|Fludrocortisones, Florinef; |0.2 mg PO daily |Causes sodium reabsorption, hydrogen and |Maintains sodium balance and BP |Orthostatic hypotension |
|corticosteroid | |potassium excretion and water retention | | |
|Polyvinyl alcohol, artificial tears; |2 drops bilat daily |lubricant for the relief of symptoms of |lubricant for the relief of symptoms of |Eye dryness and irritation |
|ocular lubricant | |dry eye and for artificial eyes |dry eye and for artificial eyes | |
|Sertraline, Zoloft; antidepressant |125 mg PO Q AM |Inhibits neuronal uptake of serotonin in |Decreases depression, social anxiety, |Depression and tearful |
| | |CNS |helplessness and panic behavior. | |
|Gabapentin, Gralise; analgesic adjunct |100 mg PO Q hrs. |Unk, may affect amino acids transport |Reduces pain |pain |
|NTG, Nitrostat; vasodilator, organic |0.4 mg SLQ up to 3x |Increases coronary blood and |Relief or prevention of angina attacks, |Chest pain |
|nitrate, anti-anginal | |vasodilatation |lowers BP | |
|MEDICATION (generic and Trade name, drug|Dose, route, |MECHANISM OF ACTION |EFFECT ON CLIENT |WHY CLIENT IS TAKING THIS MED |
|classification |frequency | | | |
|Oxycontin-brand name time release form |10 mg PO BID |Bonds to opiate receptors-alters pain |Alters pain perception and response to |Chronic pain treatment |
|or Oxycodone; opioid analgesics | |perception, 12 hr release form |stimuli | |
|Acetaminophen, Tylenol; analgesics |650mg PO PRN Q4 |Inhibits synthesis of prostaglandins |Severs pain reception and reduces fever |Temperature greater than 100 |
|levothyroxine sodium, Synthyroid; |50 mcg PO daily |Replace/supplant endogenous thyroid |Increases metabolism, restores hormonal |Hypothyroidism |
|hormone | |hormones |balance | |
|Mirtazapine, Remeron; antidepressant |22.5 mg PO daily |Potentiates effect of norepinephrine and |Antidepressant effect |Depression and appetite stimulator |
| | |serotonin | | |
|Allopurinol, Zyloprim, Aloprim; |100 mg PO daily |Inhibits production of uric acid |Prevents gouty arthritis |Gout |
|anti-gout agent | | | | |
|Omeprazole, Prilosec; anti-ulcder agent |20 mg PO daily |Binds to enzymes in presence of gastric |Lessen accumulation of gastric acid |GERD |
| | |acid | | |
|morphine sulfate, MSContin (after |15 mg Q 10 hrs |Depresses pain impulse transmission @ |Alters pain perception and response to |Chronic pain |
|Oxycontin gone); opioid analgesics | |spinal cord |stimuli Time release | |
|Donepezil, Aricept; anti-Alzheimer's |5 mg PO daily |Elevates acetylcholine concentration |Slows degradation of acetylcholine |Dementia |
|agent | | |released by neurons | |
|Aggrenox, aspirin and dipyridamole |25mg Aspirin/ |Aspirin reduces substances in the body |reduce the risk of stroke in people who |Resident has Hx of transient ischemic attack or TIA |
|salicylates; |200 |that cause pain, fever, and inflammation. |have had blood clots or TIA | |
|antiplatelet agent |mg PO daily |Dipyridamole keeps platelets in your blood| | |
| | |from sticking together to form clots | | |
|calcium carbonate/ |33 cc PO Q 4hrs PRN |neutralizing the acid in the stomach. |Reduction in gastric acid |For heartburn |
|magnesium carbonate, Mylanta; | | | | |
|mineral/electrolyte supplement | | | | |
|Acetaminophen, Tylenol; analgesics |325-650mg PO PRN Q4 |Inhibits synthesis of prostaglandins |Severs pain reception and reduces fever |Pain, discomfort, temperature greater than 100 |
|Guaifenesin, Robitussin; expoctorant |10 cc PO Q 4hrs PRN |Reduce viscosity of tenacious secretions |Resident able to cough up sputum to clear |Cough and respiratory infection. |
| | |by increasing respiratory tract fluids |lungs and breather better | |
|MEDICATION (generic and Trade name, drug|Dose, route, |MECHANISM OF ACTION |EFFECT ON CLIENT |WHY CLIENT IS TAKING THIS MED |
|classification |frequency | | | |
|levothyroxine sodium, Synthyroid; |25 mcg PO daily |Replace/supplant endogenous thyroid |Increases metabolism, restores hormonal |Hypothyroidism |
|hormone | |hormones |balance | |
|Oseltamivir, Tamiflu; antiviral |75 mg PO dailyx14 |Inhibits enzyme neuraminidase, which may |Reduce duration or prevent flu symptoms | Precautionary: Resident may have influenza |
| | |alter virus particle aggregation and | | |
| | |release | | |
|Levofloxacin, Levaquin; antibiotics |250 mg PO dailyx7 |Inhibit bacterial DNA synthesis by |Reduce duration or prevent bacterial |Precautionary: Resident may have infection |
| | |inhibiting DNA gyrase |infection | |
|albuterol and ipratropium, Duoneb |NEB QID PRN |relax muscles in the airways and increase |Allow resident to breathe easier, slow |Resident has very labored respirations |
|Inhalation; bronchodilators | |air flow to the lungs |respiration rate. | |
|Metronidazole, Flagyl; antibiotic |500 mg PO BIDx7 |Disrupts DNA and protein synthesis |Reduce duration or prevent bacterial |Precautionary: Resident may have infection |
| | | |infection | |
|Lorazapam, Ativan Benzodiazepines | |Depresses CNS by potentiating GABA, | |Decrease anxiety |
| | |relaxes skeletal muscles, anticonvulsant | |Provide sedation, amnesia |
| | | | |Conscious sedation |
| | | | |Supplemental IV sedation |
| | | | |Post op agitation/anxiety |
|Diazepam, Valium (Benzodiazepines | |Depress CNS, sedative effect, decease | |Decrease anxiety |
| | |seizure, skeletal muscle relaxation | |Provide sedation, amnesia |
| | | | |Conscious sedation |
| | | | |Supplemental IV sedation |
| | | | |Post op agitation/anxiety |
|Midazelam, Versed | | | |Decrease anxiety |
|Benzodiazepines-conscious sedation | | | |Provide sedation, amnesia |
| | | | |Conscious sedation |
| | | | |Supplemental IV sedation |
| | | | |Post op agitation/anxiety |
|Fentanyl, Duragesic Narcotics/opioid | |Binds to opiate receptors in CNS, alters | |Relieve pain and discomfort |
|analgesics | |perception an response to pain, depresses | | |
| | |CNS | | |
|Atropine sulfate, Atropine | |competitive inhibitor of acetylcholine @ | |Decrease secretion of saliva, gastric juices and prevent |
|anticholinergics | |muscarinic receptor sites. | |bradycardia |
| | |The increase of sympathetic activity seen | | |
| | |with atropine administration is due to the| | |
| | |drug’s parasympatholytic effects. In the | | |
| | |setting of | | |
| | |symptomatic bradycardias, atropine | | |
| | |decreases vagal | | |
| | |effects on the heart resulting in | | |
| | |increased chronotropy & dromotropy (with | | |
| | |little or no inotropic effects). | | |
| | |It is postulated that in some cases, | | |
| | |asystole may be a result of a sudden & | | |
| | |massive increase in vagal tone. Despite | | |
| | |clear scientific | | |
| | |evidence of atropine’s effectiveness in | | |
| | |this instance, we still administer | | |
| | |atropine because there is little evidence | | |
| | |that it is harmful in | | |
| | |this setting. It is used in | | |
| | |cholinergic exposures | | |
| | |as a direct antidote for the poison. | | |
|Omeprazole, Prilosec, pantoprazole, | |decrease gastric acid secretions | |treat erosive esophagitis (damage to the esophagus from |
|Protonix Lansoprazole, Prevacid, | | | |stomach acid), and other conditions involving excess stomach|
|anti-ulcer, proton pump inhibitors | | | |acid such as Zollinger-Ellison syndrome. not for immediate |
| | | | |relief of heartburn symptoms. |
|Scopolamine patch | |Increase gastric emptying and decrease | | |
|Phenergan (Promethazine)* | |N/V. | | |
|Metoclopramide (Reglan) | | | | |
|Compazine* | | | | |
|Droperidol (Inapsine) | | | | |
|Zofran, antiemetics | | | | |
|Bisacodyl, Dulcolax, stimulant laxative |PO |works by increasing the movement of the | |treat constipation. It may also be used to clean out the |
| | |intestines, helping the stool to come out.| |intestines before a bowel examination/surgery |
|Clindamycin, Cleocin, anti-infective | |Inhibits protein synthesis of bacteria. Do| |treat serious infections caused by bacteria, skin, |
| | |not take clindamycin together with | |Respiratory tract, Septicemia, Gyno infections, |
| | |erythromycin | |osteomyelitis, Intra-ab infections. endocarditis prophylaxis|
|MEDICATION (generic and Trade name, drug|Dose, route, |MECHANISM OF ACTION |EFFECT ON CLIENT |WHY CLIENT IS TAKING THIS MED |
|classification |frequency | | | |
|Dalteparin, Fragmin, anticoagulant, (low|SQ |acts by enhancing the inhibition of Factor| |helps prevent the formation of blood clots. |
|molecular weight heparin) | |Xa and thrombin by antithrombin | |used together with aspirin to prevent blood vessel |
| | | | |complications in people with certain types of angina (chest |
| | | | |pain) or heart attack. used to prevent a type of blood clot |
| | | | |called deep vein thrombosis (DVT), which can lead to blood |
| | | | |clots in the lungs (pulmonary embolism). A DVT can occur |
| | | | |after certain types of surgery, or in people who are |
| | | | |bed-ridden due to a prolonged illness. |
|Docusate Sodium, Colace; laxative, stool|100 mg PO |Increases water and fat penetration in |Soften stool, eases passage of hard stool |Acute constipation r/t opioids |
|softener | |intestine | | |
|Heparin, Hep-Lock, Hep Lock U/P, Heparin| |inhibits reactions that lead to the | |anticoagulant (blood thinner) that prevents the formation of|
|Sodium ADD-Vantage, anticoagulant | |clotting of blood and the formation of | |blood clots. treat and prevent blood clots in the veins, |
| | |fibrin clots | |arteries, or lung. Heparin is also used before surgery to |
| | | | |reduce the risk of blood clots |
|hydromorphone hydrochloride, Dilaudid | |Binds to opiate receptors in CNS, alters | |Relieve pain and discomfort |
|Narcotics/opioid analgesics, benzo | |perception an response to pain, depresses | | |
| | |CNS | | |
|Insulin NPH/Regular/Lispro) | | | | |
|Lorazepam, Ativan, anethetic adjunct, |PO, Injection, IV |Depress CNS, sedative effect, decease | |relieve anxiety |
|anti-anxiety, sedative/hyponotic | |seizure | | |
|Methadone, Dolophine, Methadose, |Opioid analgesics |Binds to opiate receptors in CNS, alters | |Sever pain, suppress withdrawal symptoms in opioid detox |
|Methadose Sugar-Free | |perception and sensation of pain and | | |
| | |depress CNS | | |
|Metoclopramide, Metozolv ODT, Reglan, | |Blocks dopamine receptors in chemoreceptor| |Prevent chemo emesis, treat post -surgical and diabetic |
|antiemetic | |trigger zones, stimulates motility of | |gastric stasis, manage GI reflux, prevent post-op N/V |
| | |upper GI and speed gastric emptying | | |
|Morphine, AVINza, Kadian, MS Contin, | |Binds to opiate receptors in CNS, alters | |Relieve pain and discomfort |
|MSIR, Oramorph SR Narcotics/opioid | |perception an response to pain, depresses | | |
|analgesics | |CNS | | |
|Ondansetron, Zofran, antiemetic, | |blocks the actions of chemicals in the | |used to prevent nausea and vomiting that may be caused by |
| | |body that can trigger nausea and vomiting.| |surgery or by medicine to treat cancer (chemotherapy or |
| | | | |radiation). |
|MEDICATION (generic and Trade name, drug|Dose, route, |MECHANISM OF ACTION |EFFECT ON CLIENT |WHY CLIENT IS TAKING THIS MED |
|classification |frequency | | | |
|Oxycodone, OxyContin, Roxicodone, |5-10 mg PO Q 4 hrs |Bonds to opiate receptors-alters pain |Alters pain perception and response to |Breakthrough pain, decreases moderate to severe pain |
|Oxecta; opioid analgesics | |perception |stimuli | |
|Sennosides, Senna; stimulant laxative |1 tabs PO |Stimulates peristalsis, soften feces by |Softens feces, eases passage of hard stool|Constipation Acute constipation r/t immobilty Acute |
| |Daily PRN |increasing water in gut. | |constipation r/t opioids |
|Vancomycin, Vancocin, antibiotic/ | |Binds to bacterial cell wall and results | |used to fight susceptible bacteria in the body that cause |
|anti-infective | |in death | |serious infections. used to treat infections of the |
| | | | |intestines that cause colitis (inflammation of the large |
| | | | |intestine). |
|Warfarin, Coumadin; anticoagulant |1.5 mg PO daily |Interferes with Vit K synthesis and |Thins blood prevents thromboembolic events|Afib |
| | |clotting | | |

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