NCLEX Drug Cards

Drug Med Cards
Drug Med Cards
Table of Contents
1.
Anti-Viral ........................................................................................................................................... 5
2.
Benzodiazepenes .............................................................................................................................. 6
3.
Diuretics ............................................................................................................................................ 8
4.
Antiseizure Meds .............................................................................................................................. 9
5.
Vitamins and Minerals .................................................................................................................... 13
6.
Steroid ............................................................................................................................................. 14
7.
Opiod............................................................................................................................................... 15
8.
Opiod Antagonists........................................................................................................................... 17
9.
NSAIDS ............................................................................................................................................ 18
10.
Analgesic, Antipyretic ..................................................................................................................... 19
11.
Anticholinergic ................................................................................................................................ 20
12.
Bronchodilator ................................................................................................................................ 21
13.
Thyroid Hormone Replacement ...................................................................................................... 22
14.
Alpha Adronergic Receptor Antagonist .......................................................................................... 23
15.
Antiparkinson (Cholinergic Receptor Antagonist............................................................................ 24
16.
Fluid and Electrolytes ...................................................................................................................... 26
17.
Antibiotics ....................................................................................................................................... 28
18.
Cholesterol Lowering Agents .......................................................................................................... 32
19.
Laxatives/ Stool Softeners............................................................................................................... 34
20.
Anti-Diarrheal.................................................................................................................................. 36
21.
Beta-Blockers .................................................................................................................................. 37
22.
Nitrates ........................................................................................................................................... 39
23.
ACE-Inhibitors ................................................................................................................................. 40
24.
Calcium Channel Blockers ............................................................................................................... 41
25.
Central Acting Antihypertensive ..................................................................................................... 42
26.
Antihypertensives ........................................................................................................................... 43
27.
Antipsychotics ................................................................................................................................. 44
28.
Anti-Coagulants ............................................................................................................................... 50
29.
Antiplatelets .................................................................................................................................... 51
30.
Proton Pump Inhibitor .................................................................................................................... 52
31.
H2- Receptor Antagonist ................................................................................................................. 53
32.
Cerebral Stimulant .......................................................................................................................... 54
33.
Antihistamines ................................................................................................................................ 55
34.
Antidiabetic ..................................................................................................................................... 57
35.
Antihypoglycemic ............................................................................................................................ 60
36.
Anti-fungal....................................................................................................................................... 61
37.
Eye Drops ........................................................................................................................................ 62
38.
Antidepressant ................................................................................................................................ 63
39.
Tricyclic Antidepressants ................................................................................................................ 65
40.
Selective Serotonin Reuptake Inhibitor (SSRI) ................................................................................ 67
41.
Monoamine Oxidase Inhibitors (MAOIs) ........................................................................................ 69
42.
Anti-Emetic...................................................................................................................................... 70
43.
Antituberculosis .............................................................................................................................. 71
44.
Substance Abuse Deterrent ............................................................................................................ 72
45.
Bone Metabolism Regulatory ......................................................................................................... 73
46.
Bacterial Collagenase Enzyme......................................................................................................... 74
Bibliography ................................................................................................................................................ 75
Page 2 of 75
Simplenursing.com 60% Less Study Time, Less Stress More Success!
Drug Med Cards

With over 8 years in the medical field, Mike Linares has worked both out in the
field on an Ambulance in the dangerous streets of Los Angeles County and the in
crazy busy the Emergency Rooms. Coupled with his passion for teaching & desire
to help other students and mixed with his chronic typpos and bad grammmer,
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"I hope you enjoy the valuable jewels that Simplenursing.com has to offer. If so
please let me know! I am a real person & Id love to hear your thoughts good or
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Committed to Your Success, Mike
P.S.Feel free to Face book, Twitter, or Youtube me!!
Mike Linares
Student Nurse Mentor & Certified EKG Instructor
HOW THIS WHOLE THING CAME TO BE...

Before Helping Multiple Successful Nursing Students
Excel I Was The "Drone" Nursing Student Working Too
Hard & Eventually I FAILED OUT of Nursing School.
Before Helping Hundreds of Struggling Nursing Students Reach Graduation Day & Before Becoming a
Student Nurse Mentor & Certified EKG Instructor, I Myself Was A Struggling "At Risk" Student Nurse
Drowning In My Books & Lost In Clinical.
I was that struggling student working full time in the Emergency Room at one of those
MEGA hospitals in Orange, California. I worked as an EMT aka a "medic" for 8 years
prior to failing out. I knew how to take care patients, I knew the basics of the ABCs of
basic life support, I knew how to take vital signs and how to fix minor injuries. I thought I
had enough experience to skate right through nursing school, I remember thinking "how
hard can it be" right?
After two semesters, I FAILED out of the Program.
I felt defeated, depressed and like a loser. It was one of the lowest points of my life.
Sitting in my room practically bawling my eyes out, I remember quotes my mom and
dad used to encourage me with, "son, whatever doesnt kill you, Makes you Stronger" &
" Failing is Not a Bad Thing, As long as learn, become better, and NEVER EVER QUIT"
Page 3 of 75
Drug Med Cards

My Clinial FAILURE form had bold red letters stating:
LACK In Prepared
LACK Organizational Skills
LACK Critical Thinking with Nursing Process
Ending with:
"able to return next semester contingent upon demonstrating INCREASED
COMPETANCIES in these core areas."
"NEVER GIVE UP!!" my mom & dad used to tell me, so I set out on a Quest
to develop a system to make Simplify Nursing School!
What Happened Next Might Surprise you,
In a systematic way to put all the "core competencies" of nursing school that instructors look for to pass
students. My quest was to make it SIMPLE first and foremost, by cutting out the fluff and getting down to
the nitty critty making it easier.
The Goal Was To Make A Simple System...
And the best part is it was really helping myself and other students in my class pass their tests when I would
share with them my strategies and systems to help them pass their tests without having to memorize
everything in the book!
This is where my mentoring for student nurses began.

That's when something clicked and everything changed for me.
It was like I had an Ah - HA moment!
At that moment I realized there are better, more predictable, and more low cost ways to get higher test
scores and have more critical thinking skills than the money I had been spending on dead end study
books that claimed to help but really just confuse me more.
I needed simplicity!!!
Within the next six months I had created over 27 different student help systems, strategies and tactics
that produced better results for me - some better than others.
Then over the next few semesters I tracked, tested, and tweaked each system until my students were
passing with a 82% or better on each and every test, 2 students being out of School for over 25 years &
coming back to score 94% on their EKG cardiac test! Truly amazing & truly making me proud to be their
mentor.
Page 4 of 75
Drug Med Cards
1.
Anti-Viral
1.1. Acyclovir
(Zovirax)
Class: Antiviral
Actions: reduces viral shedding and formation of new lesions and speeds healing time. Peak: 1.5-2hr.
Half-life: 2.5-5hr.
Indications: (IV treatment) viral encephalitis, herpes simplex, varicella-zoster virus (shingles/chickpox);
(orally) herpes simplex, varicella-zoster virus; (topically) herpes labialis (cold sores) and initial episodes of
herpes gentitalis
Norm. Dosage, Freq, Route, Range: PO 400mg bid Max: 800mg/day
Side Effects: headache, nausea, vomiting, diarrhea
Nursing Considerations: Monitor I&O & hydration status. Lab tests: baseline and periodic renal function
tests
1.2. Amantadine HCl

(Symmetrel)
Class: Antiviral; Central-Acting Cholinergic Receptor Antagonist; Antiparkinson
Actions: Because Amantadine does not suppress antibody formation, it can be administered for interim
protection
in
combination
w/
influenza.
Onset:
w/in
48hrs.
Peak: 1-4hrs
Indications:
Influenza A Treatment; Influenza A Preventative; Parkinsonism; Drug-Induced
Extrapyramidal Symptoms (EPS)
Norm. Dosage, Freq, Route, Range: PO 100mg 1-2times/day
Side Effects: dizziness, light-headedness, difficulty in concentrating, insomnia, leukopenia
Nursing Considerations: Lab tests: pH and serum electrolytes; monitor and report mental status changes,
nervousness, difficulty concentrating, or insomnia, loss of seizure control, S&S of toxicity, especially in
doses over 200mg/day
Page 5 of 75
Drug Med Cards
2.
Benzodiazepenes
1.3. Alprazolam
(Xanax)
Class: Anxiolytic; Sedative-Hypnotic; Benzodiazepine
Actions: A CNS depressant that appears to act at the limbic, thalamic, and hypothalamic levels of the
CNS. Has antianxiety and sedative effects w/ addictive potential. Peak: 1-2 hr. Halh-life: 12-15 hr.
Indications: Anxiety Disorders, Panic Attacks
Norm. Dosage, Freq, Route, Range: PO 0.25-5 mg tid Max: 4 mg/day
Side Effects: Drowsiness, sedation
Nursing Considerations: Monitor S&S of drowsiness and sedation, especially in older adults or the
debilitated, Lab tests: CBC, urinalysis and blood chemistry studies particularly during continuing therapy
1.4. Diazepam
(Diastat, Valium)
Class: Benzodiazepine Anticonvulsant; Anxiolytic
Actions: Long-acting benzodiazepine psychotherapeutic agent. Benzodiazepines act at the limbic.
Thalamic, and hypothalamic regions of the CNS and produce CNS depression resulting in sedation, and
anticonvulsant activity dependent on the dosage. Onset: PO 30-60 min Peak: PO 1-2 hr Duration: IV 15
min-1 hr PO up to 3 hr
Indications: Status Epilepticus, Muscle Spasm, Anxiety, Alcohol Withdrawal, Pre-op
Norm. Dosage, Freq, Route, Range: IV/IM 5-10 m, repeat if needed at 10-15 min intervals up to 30 mg,
then repeat if needed q2-4hr
Side Effects: Drowsiness, fatigue, confusion, vivid dreams, headache
Nursing Considerations: Monitor for adverse reactions, Monitor for therapeutic effectiveness-max effect
may require 1-2 week, monitor for and report promptly signs of suicidal ideation especially in those treated
for anxiety states accompanied by depression, observe patient closely and monitor vital signs when
diazepam is given parentally; hypotension, muscular weakness, tachycardia, and respiratory depression
may occur, Lab tests: periodic CBC and LFTs.
1.5. Lorazepam
(Ativan)
Class: Anxioltic; Sedative-Hypnotic; Benzodiazepine
Actions: most potent of the available benzodiazepine. Effects (antianxiety, sedative, hypnotic, and skeletal
muscle relaxant) are mediated by the inhibition neurotransmitter GABA. Action sites are thalamic,
hypothalamic, and limbic levels of CNS. Onset: IV 1-5 min. IM 15-30 min. Peak: IM 60-9 min. PO 2 hr
Duration 12-24 hr
Indications: Antianxiety, Insomnia, Premedication, Status Epilepticus
Norm. Dosage, Freq, Route, Range: PO 2-6 mg/day in divided doses Max: 10 mg/day
Side Effects: drowsiness, sedation, dizziness, weakness
Nursing Considerations: Supervise ambulation, Lab tests: Assess CBC and LFTs periodically
Page 6 of 75
Drug Med Cards
1.6. Temazepam
(Restoril)
Class: Benzodiazepine, Anxiolytic, Sedative-Hypnotic
Actions: reduces night awakenings and early morning awakenings; increases total sleep times, absence
of rebound effects. Onset: 30-50 min. Peak: 2-3hr. Duration: 10-12hr. Half-life: 8-24hr
Indications: to relieve insomnia
Norm. Dosage, Freq, Route, Range: PO 7.5-30mg at bedtime Max: 30mg/night
Side Effects: drowsiness, dizziness, lethargy
Nursing Considerations: hypersensitivity, Lab tests: LFTs and kidney function tests during long-term use,
be aware of S&S of overdose: weakness, confusion, slurred speech, ataxia, coma w/ reduced or absent
reflexes, hypertension and respiratory depression
Page 7 of 75
Drug Med Cards
3.
Diuretics
1.7. Furosemide
(Lasix)
Class: Loop diruetic
Actions: Inhibits NA & Cl reabsorption, urine, edema & intravascular volume. Onset: PO 30-60min. IV
5 min Peak: PO 60-70min IV 20-60min. Duration: 2hr.
Indications: promote urine output & decrease edema associated w/ CHF, cirrhosis of liver & kidney
disease, decrease CHF, decrease hypertension
Norm. Dosage, Freq, Route, Range: (Edema) PO: 20-80 mg in 1 or more divided doses Max: 600 mg/day
(Hypertension) PO: 10-40 mg/kg bid Max: 480 mg/day
Side Effects: Circulatory collapse, hypokalemia, aplastic anemia, agranulocytosis (rare)
Nursing Considerations: check K+ levels prior to adm., monitor I&O closely, rapid acting doses to prevent
sleep disturbance, Potassium rich foods: bananas, oranges, dried dates, etc., CBC, serum and urine
electrolytes, CO2 BUN, Blood Sugar, Uric Acid, Urine and Blood Glucose, HbA1C in diabetic patients w/
decompensated hepatic cirrhosis, may cause hyperglycemia
1.8. Hydrochlorothiazide
(Microzide, Oretic)
Class: Electrolytic and Water Balance; Thiazide Diuretic
Actions: Therapeutic effectiveness is measured by decrease in edema and lowering of blood pressure.
Onset: 2hr. Peak: 4hr. Duration: 6-12hr. Half-life: 45-120min.
Indications: adjunct treatment of edema associated with CHF, hepatic cirrhosis, renal failure, and in the
management of hypertension
Norm. Dosage, Freq, Route, Range: PO 25-100mg/day in 1-3 divided doses Max: 200mg/day
Side Effects: Hyperglycemia, hyperuricemia, hypokalemia
Nursing Considerations: Check BP, monitor I&O and check for edema, Lab tests: baseline and periodic
determinations of serum electrolytes, blood counts, BUN, blood glucose, uric acid, CO2, are recommended.
1.9. Spironolactone
(Aldactone)
Class: Electrolytic and water balance; Aldosterone Antagonist; Potassium-Sparing Diuretic
Actions: A diuretic agent that promotes sodium and chloride excretion w/o concomitant loss of potassium.
Lowers systolic and diastolic pressures in hypertensive patients. Effective in treatment of primary
aldosteronism. Onset: gradual Peak: 2-3days; Max effect may take up to 2 weeks Duration: 2-3 days or
longer
Indications: Edema due to CHF, Hypertension, Primary Aldosteronism, Hypokalemia
Norm. Dosage, Freq, Route, Range: PO 25-400mg/day in divided doses Max: 400mg/day
Side Effects: fluid and electrolyte imbalance, nausea, vomiting
Nursing Considerations: check BP, lab tests: monitor serum electrolytes (Na and K), assess for signs
and symptoms of fluid and electrolyte imbalance, monitor daily I&O and check for edema
Page 8 of 75
Drug Med Cards
4.
Antiseizure Meds
1.10. Carbamazepine
(Carbatrol, Tegretol, Epitol, Equetro, Mazepine)
Class: Anticonvulsant tricyclic
Actions: effective anticonvulsant for a range of seizure disorders and as an adjuvant reduces depressive
S&S and stabilizes mood. Peak: 2-8hr. Half-life: variable due to autoinduction 25-65hr. than 14-16he with
repeated use
Indications: Seizures; Trigeminal Neuralgia; Bipolar Disorder (Equetro)
Norm. Dosage, Freq, Route, Range: PO 200mg bid, gradually increase to 800-1200mg/day in 3-4 divided
doses Max: 1200mg/day
Side Effects: leukopenia, confusion, headache, dizziness
Nursing Considerations: Lab tests: baseline and periodic CBCs including platelets, reticulocytes, serum
electrolytes and serum iron, LFTs, BUN and complete urinalysis, attempt a dosage reduction after 3
months, monitor for toxicity, I&O and vital signs
1.11. Clonazepam
(Klonopin)
Class: Anticonvulsant; Benzodiazepine
Actions: Suppresses spike and wave discharge (petitmal) and decreases amplitude, frequency, duration,
and spread of discharge in minor motor seizures. Onset: 60 min Peak: 1-2 hr Duration up to 12 hr in adults;
6-8 hr in children
Indications: Seizures, Panic Disorders
Norm. Dosage, Freq, Route, Range: PO 1.5mg/day in 3 divided doses, increased by 0.5-1 q3days until
seizures are controlled or until intolerable adverse effects Max: 20 mg/day
Side Effects: Drowsiness, sedation, ataxia
Nursing Considerations: Monitor for signs of suicidal ideation in depressive individuals, Lab tests:
periodic LFTs, platelet counts, blood counts, and renal function tests, Monitor for S&S of overdose, including
somnolence, confusion, irritability, sweating, muscle and abdominal cramps, diminished reflexes, coma.
1.12. Gabapentin
(Neurontin)
Class: Anticonvulsant; Gaba Analog
Actions: Used in conjunction with other anticonvulsants to control types of seizure in patients with epilepsy.
Effective in controlling painful neuropathies
Indications: Seizure disorder, Past-Herpetic Neuralgia, Restless Leg Syndrome
Norm. Dosage, Freq, Route, Range: start at 300mg may slowly increase Max: 1,200mg/day
Side Effects: drowsiness, fatigue
Nursing Considerations: monitor for therapeutic effectiveness, may not occur until several weeks
following initiation of therapy, monitor for and report dizziness, somnolence, or other sign of CNS
depression
Page 9 of 75
Drug Med Cards
1.13. Lamotrigine
(Lamictal)
Class: Anticonvulsant
Actions: may act by inhibiting the release of glutamate and aspartate, excitatory neurotransmitters at
voltage-sensitive sodium channels, resulting in decreased seizure activity in the brain. Onset: 12wks. Peak:
1-4hr.
Indications: Seizures; Bipolar disorder
Norm. Dosage, Freq, Route, Range: PO start w/ 25mg daily for 2 wks, then 50mg daily for 2 wks, then
100mg daily for 1 wk, then 200mg daily (low and slow)
Side Effects: dizziness, ataxia, somnolence, headache, nausea, diplopia, blurred vision, Stevens-Johnson
syndrome, toxic epidermal necrolysis, rhinitis
Nursing Considerations: do not take med if skin rash develops, monitor pts. w/ bipolar disorder for
worsening of their symptoms and suicidal ideation, use protection from sunlight or ultraviolet light until
tolerance is known
1.14. Levetiracetam
(Keppra)
Actions: The precise mechanism of antiepileptic effects is unknown. Peak: 1hr.
Indications: Partial onset Seizures; Tonic Clonic Seizures; Myoclonic Seizures
Norm. Dosage, Freq, Route, Range:
3,000mg/day or 1,000 mg/day ER tablet
PO/IV 500mg bid may increase by 500mg bid q2wks. Max:
Side Effects: Asthenia, headache, infection, somnolence, suicidal ideation

Nursing Considerations: Lab tests: periodic CBC w/ diff, Hct, and Hgb, LFTs; monitor individuals w/ a
history of psychosis or depression for S&S of suicidal tendencies, suicidal ideation, and suicidality
1.15. Oxcarbazepine
(Trileptal)
Actions: Anticonvulsant properties may result from blockage of voltage-sensitive sodium channels, which
results in stabilization of hyper-excited neural membranes. Peak: steady-state level reached in 2-3 days
Indications: Partial Seizures
Norm. Dosage, Freq, Route, Range: PO start w/ 300mg bid and increase by 600mg/day qwk. To
2,400mg/day in 2 divided doses for monotherapy or 1,22mg/day as adjunctive therapy
Side Effects: fatigue, nausea, vomiting, abdominal pain, headache, dizziness, somnolence, ataxia,
nystagmus, abnormal gait, Stevens-Johnson syndrome, toxic epidermal necrolysis, diplopia, vertigo,
abnormal vision
Nursing Considerations: Monitor for & report S&S of hyponatremia or CNS impairment; monitor
phenytoin levels; Lab tests: periodic serum sodium, T4 level; monitor plasma level
Page 10 of 75
Drug Med Cards
1.16. Phenobarbital
(Solfoton)
Class: Anticonvulsant; Sedative-Hypnotic; Barbiturate
Actions: have anticonvulsant properties. Sedative and hypnotic effects appear to be due primarily to
interference w/ impulse transmission of cerebral cortex by inhibition of reticular activating system. Limiting
the spread of seizure activity results by increasing the threshold of motor cortex stimulation. Peak: PO 812 hr, IV 30 min Duration: IV 4-6 hr
Indications: Anticonvulsant, Status Epilepticus, Sedative/Hypmotic
Norm. Dosage, Freq, Route, Range: PO/IV 1-3 mg/kg/day in divided doses
Side Effects: Somnolence, nightmares, insomnia, hangover, headache, anxiety
Nursing Considerations: Observe patients receiving large doses for at least 30 min to ensure that
sedation is not excessive, keep under observation, check IV site frequently, monitor serum drug levelsgreater than 50 mcg/mL may cause coma, expect restlessness
1.17. Phenytoin
(Dilantin)
Class: Anticonvulsant; Hydantoin
Actions: Anticonvulsant action elevates the seizure threshold and/or limits the spread of seizure discharge.
Accompanied by reduced voltage, frequency, and spread of electrical discharges w/in the motor cortex.
Peak: Prompt Release: 1.5-3 hr Sustained Release: 4-12 hr
Indications: To control tonic-clonic (grand mal) seizures, psychomotor and nonepileptic seizures (ex:
Reyes syndrome). Used to prevent or treat seizures occurring during or after neurosurgery. Not effective
for absence seizures.
Norm. Dosage, Freq, Route, Range: PO 15-20 mg/kg loading dose than 300 mg/day in 1-3 divided doses,
may be gradually increased by 100 mg/week until seizures are controlled IV: 10-15 mg/kg then 300 mg/day
in divided doses
Side Effects: drowsiness, gingival hyperplasia, thrombocytopenia, leukopenia
Nursing Considerations: Monitor Vital signs, Lab tests: periodic serum phenytoin concent., CBC w/
differential, platelet count, Hct, Hgb, serum glucose, serum calcium, serum magnesium, and LFTs
1.18. Pregabalin
(Lyrica)
Class: Anticonvulsant; Gaba-analog; Analgesic/Miscellaneous; Anxiolytic
Actions: an analog of GABA that increases GABA levels and reduces calcium currents in the calcium
channels of neurons. Peak: 1.5hr. Half-life:6hr.
Indications: management of neuropathic pain associated with diabetic peripheral neuropathy or spinal
cord injury, adjunctive therapy for adult patietns w/ partial-onset seizures, management of postherpetic
neuralgia, fibromyalgia
Norm. Dosage, Freq, Route, Range: PO 50-100mg tid Max: 300mg/day
Side Effects: accidental injury, ataxia, dizziness, somnlonce, peripheral edema, weight gain, diplopia,
blurry vision
Nursing Considerations: Monitor for and report promptly mental status or behavior changes (e.g.,
anxiety, panic attacks, restlessness, irritability, depression, suicidal thoughts). Monitor for weight gain,
peripheral edema and S&S of heart failure. Monitor diabetics for increased incidences of hypoglycemia.
Page 11 of 75
Drug Med Cards
1.19. Primidone
(Mysoline)
Class: Anticonvulsant; Barbiturate
Actions: effective as an anticonvulsant in all types of seizure disorders except absent seizure. Peak: 4hr
Half-life: 3-24hr
Indications: management of complex partial and generalized tonic-clonic seizure
Norm. Dosage, Freq, Route, Range: PO 250mg/day increased by 250mg/wk Max: 2g/day in 2-4 divided
doses
Side Effects: drowsiness, sedation, vertigo, ataxia, headache, nausea, vomiting, anorexia, leukopenia,
thrombocytopenia
Nursing Considerations: Lab tests: baseline and periodic CBC, complete blood chemistry (q6mo), and
primidone blood levels (Therapeutic blood levels 5-10 mcg/mL). Monitor primidone plasma levels
(concentrations greater than 10mcg/mL are usually associated w/ significant ataxia and lethargy). Observe
for S&S of folic acid deficiency: mental dysfunction, psychiatric disorders, neuropathy, and megaloblastic
anemia.
1.20. Valproic Acid

(Depakote, Depacon, Depakene)
Class: Anticonvulsant; GABA inhibitor
Actions: Anticonvulsant w/ increased bioavailability of the inhibitory neurotransmitter GABA to brain
neurons. Peak: 1-4hrs.
Indications: Management of seizures; Migraine headache prophylaxis; Mania
Norm. Dosage, Freq, Route, Range: (seizures) PO/IV: 10-15mg/kg/day in divided doses when total is
greater than 25mg. increase at 1wk. intervals bu 5-10mg/kg/day until seizures are controlled Max:
60mg/kg/day (Mania) PO: 750mg/day administered in divided doses
Side Effects: sedation, drowsiness, deep coma, death (w/ overdose), nausea, vomiting, indigestion, liver
failure, pancreatitis, prolonged bleeding time, bone marrow depression
Nursing Considerations: Lab tests: baseline platelet count, bleeding time, coagulation, parameters, and
serum ammonia, LFTs, then repeat at least q2months of therapy, avoid alcohol
Page 12 of 75
Drug Med Cards
5.
Vitamins and Minerals
1.21. Multivitamin
(One-A-Day)
Class: Vitamins
Actions: Contain fat-soluble vitamins (A, D and E) and most water-soluble vitamins (B-Complex vitamins
B1, B2, B3, B5, B6, B12, Vitamin C, Biotin, and Folic Acid). These vitamins are a diverse group of
compounds necessary for growth and development. May act as coenzymes or catalysts in numerous
metabolic processes. Onset, Peak, Duration: Unknown
Indications: Treatment and prevention of vitamin deficiencies.
recommended by individual manufacturer
1 dose unit (capsule, tablet, dropperful)/day or amount
Side Effects: Urine discoloration, allergic reactions to preservatives, additives, or colorants

Nursing Considerations: Asses patient for signs of nutritional deficiency before and throughout therapy.
1.22. Omega-3 Fatty Acids

(Fish Oil, Omega-3 Fatty Acids)
Class: Nutritional Supplement, Omega-3 Fatty Acids
Actions: is not completely understood. May include inhibition of acetyl-CoA and increased peroxisomal
beta-oxidation in the liver.
Indications: Hypertriglyceridemia
Norm. Dosage, Freq, Route, Range: PO 4 g daily as single or divided doses Max: 4 g/day
Side Effects: Back pain, flu syndrome, unspecified pain
Nursing Considerations: Monitor for S&S of hypersensitivity in those w/ known allergy to fish, Lab tests:
baseline and periodic lipid profile
Page 13 of 75
Drug Med Cards
6.
Steroid
1.23. Dexamethasone Sodium Phosphate

(Baycadron, Decadron, Dexamethasone)
Class: Adrenal Corticosteroid; Glucocorticoid
Actions: Long-acting synthetic adrenocorticoid with intense anti-inflammatory activity and minimal
mineralocorticoid activity. Onset: Rapid Peak: PO 1-2 hr IM 8 hr Duration: PO 2.75 days IM 6 days Intra
lesional Intra-articular 1-3 weeks
Indications: Allergies, Inflammation, Neoplasias, Adrenocorticol Function Abnormalities, Cerebral Edema,
Shock
Norm. Dosage, Freq, Route, Range: PO 0.25-4mg bid to qid IM 8-16mg q1-3weeks IV 0.75-0.9mg/kg/day
divided q6-12hr. Max: 16mg/day
Side Effects: Nasal Irritation, edema, hyperglycemia, impaired wound healing, subacapsular cataract, oral
candidiasis
Nursing Considerations: take drug exactly as prescribed, report lack ir response to med or malaise,
orthostatic hypotension, muscular weakness and pain, nausea, vomiting, anorexia, hypoglycemic reaction,
or mental depression to prescriber, report any changes in appearance and easy bruising
1.24. Fluticasone
(Flonase, Flovent)
Class: Synthetic steroids of glucocorticoid family of drugs
Actions: Fluticasone mimics the naturally-occurring hormone produced by the adrenal glands, cortisol or
hydrocortisone. The exact mechanism of action of fluticasone is unknown. Fluticasone has potent antiinflammatory actions. Onset: 1-3 wk. Peak: 4-8hr.
Indications: Seasonal allergy rhinitis
Norm. Dosage, Freq, Route, Range: Intranasal 100 mcg (1 inhalation) per nostril 1-2 times daily Max: 4
times daily
Side Effects: transient nasal irritation, burning, sneezing, epitaxis, bloody mucous, nasopharyngeal
itching, dryness, crusting, and ulceration, headache, nausea, vomiting
Nursing Considerations: oral and nasal inhalers are not to be used interchangeably, use of oral and
nasal inhaler provided by manufacturer should be carefully reviewed with patient
1.25. Triamcinolone Acetonide

(Nasacort HFA)
Class: Adrenal Corticosteroid, Glucocorticoid
Actions: Anti-inflammatory and immunosuppressant drug that is effective in the treatment of bronchial
asthma. Onset: PO & IM 24-48hr. Peak: PO 1-2hr. IM 8-10hr. Duration: PO 2.25 days IM 1-6wks.
Indications: Anti-inflammatory or immunosuppressant agent. Orally inhaled: Bronchial asthma in patient
who has responded to conventional inhalation treatment. Does not suppress hypothalamic-pituitaryadrenal axis
Inhaled 2-4 inhalations
IM/SQ/Intra-auricle/Intradermal 4-48 mg/day in divided doses
Side Effects: headache, nausea, vomiting, insomnia, confusion, peptic ulcer

Nursing Considerations: notify prescriber if wheezing occurs immediately following a dose, monitor for
signs of negative nitrogen balance, lab tests: periodic serum electrolytes and blood glucose
Page 14 of 75
Drug Med Cards
7.
Opiod
1.26. Fentanyl
(Duragesic)
Class: Opioid Analgesic
Actions: Binds to opiate receptors in the CNS, alters response and perception of pain. Onset: IV
immediate, IM min. Transdermal: 12-24hr. Peak: IV 3-5min. Transdermal: 24-72hrs. Duration: IV 30-60min
IM 1-2hr. Transdermal 72hrs.
Indications: For moderate to severe chronic pain requiring continuous opioid analgesic therapy.
Norm. Dosage, Freq, Route, Range: 25-100mcg/hr. for 72hr. transdermal patch
Side Effects: CNS depression, do not drink or eat grapefruit, polypharmacy
Nursing Considerations: BP, Pulse, Respirations <6 need Narcan
1.27. Hydrocodone Bitartrate

(Mycodone)
Class: Narcotic (Opiate Agonist) Analgesic; Antitussive
Actions: CNS suppressant with moderate to severe pain relief of pain. Suppress cough reflex by direct
action on cough center in medulla. Onset: 10-20 min Duration: 3-6 hr
Indications: Mild to Moderate pain, Cough
Norm. Dosage, Freq, Route, Range: 5-10 mg q4-6hr PRN Max: 60 mg/day
Side Effects: constipation, nausea, drowsiness, respiratory depression
Nursing Considerations: Monitor for effectiveness of drug for pain relief, nausea and vomiting, respiratory
status and bowel elimination
1.28. Hydromorphone
(Dilaudid)
Class: Narcotic, Analgesic
Actions: Potent opiate receptor agonist that does not alter pain threshold but changes the perception of
pain in CNS. An effective narcotic analgesic that controls mild to moderate pain; has antitussive properties.
Onset: IV 15min., PO 30min. Peak: 30-90min. Duration: 3-4hrs.
Indications: Relief of moderate to severe pain
Norm. Dosage, Freq, Route, Range: PO 2.5-10 mg q4-6hr Max: 60mg/day
SQ/IM/IV 0.75-2 mg q4-6hr Max: 12 mg/day
Side Effects:
depression
Nausea, vomiting, constipation, drowsiness, hypotension, tachycardia, respiratory
Nursing Considerations: Baseline respiratory rate, rhythm, and depth & size of pupils; respirations
12/min. or less & mitosis are signs of toxicity, monitor vital signs at reg. intervals, monitor I&O ratio & pattern
for urinary retention, monitor bowel pattern, for nausea/vomiting and orthostatic hypotension.
Page 15 of 75
Drug Med Cards
1.29. Morphine Sulfate

(Astramorph PF, Avinza, Depo-Dur, Duromorph)
Class: Analgesic, Narcotic (opiate agonist)
Actions: Controls severe pain, also used as an adjunct to anesthesia. Peak: PO 60min. PR 20-60min.
SQ 30-60min. IM 30-60min. IV 20min. Duration: 7hr.
Indications: Pain relief
Norm. Dosage, Freq, Route, Range: PO 10-30 mg q4hr or 15-30 mg sustained release q8-12hr Max:
180 mg/day IV 2.5-15 mg/70kg q2-4hr or 0.8-10 mg/hr by continuous infusion, may increase PRN to control
pain or 5-10 mg given epidurally q24hr IM/SQ 5-20 mg q4hr PRN Max: 120 mg/day PR10-20 mg q4hr PRN
Max: 120 mg/day
Side Effects: hypersensitivity, nausea, vomiting, constipation, urinary retention
Nursing Considerations: Baseline respiratory rate, rhythm and depth and size of pupils, respirations
12/min and and miosis are signs of toxicity, assess vital signs at regular intervals, encourage changes in
positions, deep breathing, and coughing at regular intervals, Monitor I&O, for nausea and orthostatic
hypotension
1.30. Oxycontin
Class: Narcotic (opiate agonist); Analgesic
Actions: Semisynthetic derivative of an opium agonist the binds with stereo-specific receptors in various
sites of CNS to alter both perception of pain and emotional response to pain. Onset: 10-15 min. Peak: 3060 min. Duration: 4-5 hr.
Indications: Moderate to severe pain
Norm. Dosage, Freq, Route, Range: PO 5-10 mg q6hr (may titrate up to 10-30 mg q4hr PRN) Immediaterelease 10 mg q12hr (may titrate up) Max: 180 mg/day
Side Effects: sedation, constipation, light-headedness, dizziness, fainting, hepatotoxicity
Nursing Considerations: Monitor patients response closely, especially to sustained-release preparations,
Lab tests: monitor LFTs and hematologic status periodically in patients on high dose, evaluate patients
continued need
Page 16 of 75
Drug Med Cards
8.
Opiod Antagonists
1.31. Naloxone
(Narcan)
Class: Opioid Antagonist
Actions: A potent narcotic antagonist, essentially free of agonistic (morphine-like) properties. Reverses
the effects of opiates, including respiratory depression, sedation, and hypotension. Onset: 2 min Duration:
45 min
Indications: Opiate Overdose
Norm. Dosage, Freq, Route, Range: IV 0.4-2mg, may repeat q2-3min up to 10mg if necessary Max:
10mg
Side Effects: increased BP, tachycardia, nausea, vomiting
Nursing Considerations: Observe patient closely; duration of action of some narcotics may exceed that
of naloxone. Keep prescriber informed
1.32. Naltrexone HCL

(Vivitrol)
Class: Narcotic (opiate Antagonist)
Actions: Weakens or completely and reversibly blocks the subjective effects (the high) of IV opioids and
analgesics possessing both agonist and antagonist activity. Onset: 15-30min Peak: 1hr. Duration: PO 2472hr. IM 4wk.
Indications: Opioid Dependence; Alcohol Dependence
Norm. Dosage, Freq, Route, Range: PO 25mg followed by another 25mg in 1hr. if no withdrawal
response; maintenance regimen of 50-150mg/day is individualized Max: 800mg/day IM 380mg q4wk
Side Effects: nausea, vomiting, abdominal cramps/pain, hepatotoxicity, muscle & joint pains, difficulty
sleeping, anxiety, headache, nervousness
Nursing Considerations: Lab tests: check LFTs before the treatment is started, at monthly intervals for 6
months, and then periodically as indicated; do not self-medicate w/ OTC drugs; report promptly onset of
signs of hepatic toxicity to prescriber
Page 17 of 75
Drug Med Cards
9.
NSAIDS
1.33. Celecoxib
(Celebrex)
Class: Analgesic; NSAID; Cyclooxygenase-2 (Cox-2) Inhibitor; Anti-inflammatory
Actions: Exhibits anti-inflammatory; analgesic, and antipyretic activities. Reduces or eliminates the pain
of rheumatoid and osteoarthritis. Peak: 3 hr
Indications: Osteoarthritis/Arthritis/Ankylosing Spondylitis, Rheumatoid Arthritis
Norm. Dosage, Freq, Route, Range: PO 100mg bid Max: 200mg
Side Effects: back pain, dizziness, headache, insomnia, diarrhea, abdominal pain
Nursing Considerations: Lab tests: periodically monitor Hct and Hgb, Lfts, BUN, and Creatinine and
serum electrolytes, monitor closely lithium levels, monitor closely PT/INR, monitor for fluid retention and
edema
1.34. Indomethacin
(Indocin)
Class: Analgesic, Non-steroidal Anti-inflammatory (NSAID)
Actions: It is a potent analgesic, anti-inflammatory, and antipyretic agent. Promotes closure of persistent
patent ductus arteriosus. Onset 1-2 hr. Peak: 3 hr. Duration: 4-6 hr.
Indications: palliative treatment in active stages of moderate to severe rheumatoid arthritis, ankylosing
rheumatoid spondylitis, acute gouty arthritis, and osteoarthritis of hip in patients intolerant to or
unresponsive to adequate trials with salicylates and other therapy. Also used IV to close patent ducus
arteriosus in the premature infant.
Norm. Dosage, Freq, Route, Range: PO/PR: 50 mg tid until pain is tolerable, then rapidly taper Max: 150
mg/day
Side Effects: dizziness, tinnitus, nausea, vomiting
Nursing Considerations: Monitor for effectiveness, question patient carefully regarding aspirin sensitivity
before initiation of therapy, observe patients carefully, Lab tests: monitor renal function, LFTs, CBC w/
differential, BP and HR, visual and hearing acuity periodically
1.35. Ketorolac
(Acular, Acuvail, SPRIX)
Class: Analgesic, NSAID, Anti-inflammatory, Antipyretic
Actions: It inhibits synthesis of prostaglandins by inhibiting both COX-1 and COX-2 enzymes. Is a
peripherally acting analgesic. It inhibits platelet aggregation and prolongs bleeding time. Peak: 46-60 min
Indications: Pain
Norm. Dosage, Freq, Route, Range: IV loading dose 30mg Max: 150mg/day on the first day then
120mg/day subsequent days
Side Effects: drowsiness, nausea
Nursing Considerations: Lab tests: periodic serum electrolytes and LFTs; urinalysis (for hematuria and
proteinuria) with long-term use, monitor urine output, monitor for S&S of GI distress or bleeding including
nausea, GI pain, diarrhea, melena, or hematemesis, GI ulceration with perforation can occur anytime during
treatment
Page 18 of 75
Drug Med Cards
10. Analgesic, Antipyretic

1.36. Acetominophen
(Tylenol)
Class: Nonnarcotic analgesic, Antipyretic
Actions: provides temp. relief for mild to mod. pain, body temp. in indiv. w/ fever. Peak: 0.5-2 hr. Duration:
3-4 hr.
Indications: Fever Reduction. Temporary relief of mild to moderate pain. Generally as substitute for
aspirin when the latter is not tolerated or is contraindicated
Norm. Dosage, Freq, Route, Range: PO: 325-650 mg q4h Max: 4 g/day PR: 650 mg q4h Max: 4 g/day
Side Effects: Hepatotoxicity, hepatic coma, acute renal failure
Nursing Considerations: Hepatotoxicity, even w/ mod. acetaminophen doses, especially in individuals
with poor nutrition or who have ingested alcohol (3+ drinks daily) over prolonged periods; poisoning, usually
from accidental ingestion or suicide attempts; potential abuse from psychological depend., do not take other
meds containing acetaminophen, do not self-medicate adults for pain more than 10 days w/o consulting a
doctor, do not use this med w/o medical direction for: fever persisting longer than 3 days, fever over 103,
or recurrent fever
1.37. Acetaminophen Suppository

(Tylenol Suppository)
Class: Antipyretic, Non-opioid Analgesic
Actions: Analgesic; Antipyresis. Peak: 0.5-2hrs. Duration: 3-4hrs.
Indications: Mild pain, fever
Norm. Dosage, Freq, Route, Range: PR 325-650mg q4-6hr. or 1gram 3xday
Side Effects: Hepatic failure, renal failure, neutropenia, rash urticaria
Nursing Considerations: Polypharmacy, renal-liver function, pain level, toxicity
1.38. Aspirin
(ASA)
Class: Non-narcotic, Antiplatelet, Antipyretic
Actions: inhibiting the formation of prostaglandins involved in the production of inflammation, pain and
fever, powerfully inhibits platelet aggregation. High serum salicylate concentrations can impair hepatic
synthesis of blood coagulation factors VII, IX, X. Peak: 15min-2hr.
Indications: Anti-inflammatory action, pain, fever reducer, antiplatelet
Norm. Dosage, Freq, Route, Range: PO: 350-650 mg q4h Max: 4 g/day
Side Effects: Bronchospasm, anaphylactic shock (laryngeal edema), nausea, heartburn, stomach pains,
thrombocytopenia, hemolytic anemia
Nursing Considerations: Allergy to any ASA, monitor for salicylate toxicity. In adults, a sensation of
fullness in the ears, tinnitus, and decreased or muffled hearing are the most frequent symptoms.
Page 19 of 75
Drug Med Cards
11. Anticholinergic
1.39. Oxybutynin Cl
(Anutrol, Ditropan, Gelnique, Oxytrol)
Class: Anticholinergic; Antimuscaring; GU Antispasmodic
Actions: Synthetic tertiary amine that exerts direct antispasmodic action and inhibits muscarinic effects of
acetylcholine on smooth muscle of the urinary muscle. Onset: 0.5-1hr. Peak: 3-6hrs. Duration: 6-10hrs.
Indications: Overactive Bladder
Norm. Dosage, Freq, Route, Range: PO 5mg 2-4x/day Max: 20mg/day
Side Effects: drowsiness, blurred vision, dry mouth, constipation, pruritus at application site (topical)
Nursing Considerations: periodic interruptions of therapy are recommended to determine pt.s need for
continued treatment, tolerance has occurred in some pt.s; keep prescriber informed of expected responses
to drug therapy (e.g., effect on urinary frequency, urgency, urge incontinence, nocturia, completeness of
bladder emptying)
1.40. Glycopyrrolate
(Robinul, Robinul Forte)
Class: Anticholinergic, Antimuscarinic, Antipasmodic
Actions: Inhibits motility of GI and genitourinary tract, it also decreases volume of gastric and pancreatic
secretions, saliva, and perspiration. Onset: PO: 1 hr., IV: 1 min., IM/SQ: 15-30 min Peak: PO: 1 hr., IM/SQ:
30-45 min. Duration: PO: 8/12 hr., IM/SQ: 2-7 hr.
Indications: Adjunctive management of peptic ulcer and other GI disorders associated with hyperacidity
Norm. Dosage, Freq, Route, Range: PO: 1 mg tid or 2 mg bid or tid in equally divided intervals Max; 8
mg/day
Side Effects: Decreased sweating, Xerostomia, Urinary hesitancy or retention
Nursing Considerations: Monitor I&O ratio and pattern particularly in older adults, Monitor vital signs,
especially when drug is given parenterally. Report any changes in heart rate and rhythym.
Page 20 of 75
Drug Med Cards
12. Bronchodilator
1.41. Albuterol
(Proventil, Ventolin)
Class: Bronchodilator (Resp. Smooth Muscle Relaxant); Beta-Adrenergic Agonist
Actions: Bronchodilation decreased airway resistance; facilitates mucous drainage, and increases vital
capacity. Onset: Inhaled 5-15 min PO 30 min Peak: 0.5-2 hr PO 2.5 hr Duration: inhaled3-6 hr PO 4-6 hr
(8-12hr w/ sustained release)
Indications: Bronchospasm
Norm. Dosage, Freq, Route, Range: PO 2-4 times/day, 4-8 mg sustained release 2 times/day Inhaled:
1-2 inhalations q4-6hr
Side Effects: Tremor, anxiety, nervousness, headache, restlessness
Nursing Considerations: Monitor effectiveness, Monitor S&S of fine tremor in fingers, Lab Tests: periodic
ABGs, PFTs, pulse oximetry
Page 21 of 75
Drug Med Cards
13. Thyroid Hormone Replacement

1.42. Levothyroxine
(Synthroid)
Class: Thyroid Hormone Replacement
Actions: Raises T3 and T4 levels, Normal levels: 0.3-3, Restores metabolic rate. Peak: 3-4wks. Duration:
1-3wks.
Indications: Specific replacement therapy for diminished or absent thyroid function
Norm. Dosage, Freq, Route, Range: PO 25-50 mcg/day Max: 400 mcg/day
Side Effects: insomnia, headache, irritability, nervousness, palpitations
Nursing Considerations: monitor T3, & T4 levels, H.R., B.P., PT/INR
Page 22 of 75
Drug Med Cards
14. Alpha Adronergic Receptor Antagonist

1.43. Tamsulosin HCL
(Flomax)
Class: Alpha Adrenergic Receptor Antagonist
Actions: effectiveness is indicated by improved voiding. Improves symptoms related to BPH related to
bladder outlet obstruction. Peak: 4-5hr. fasting 6-7hr. fed Half-life: 14-15hr.
Indications: BPH
Norm. Dosage, Freq, Route, Range: PO 0.4mg daily 30 min after meal Max 0.8mg/day
Side Effects: headache, dizziness, orthostatic hypotension, rhinitis, abnormal ejaculation
Nursing Considerations: Monitor for signs of orthostatic hypotension
Page 23 of 75
Drug Med Cards
15. Antiparkinson (Cholinergic Receptor Antagonist

1.44. Benztropine Mesylate
(Cogentin)
Class: Centrally Acting Cholinergic Receptor Antagonist; Antiparkinson
Actions: Synthetic centrally acting anticholinergic agent that acts by diminishing excess cholinergic effects
associated w/ dopamine deficiency. Onset: IM/IV 15min. PO 1hr. Duration: 6-10hrs.
Indications: Parkinsonism; Extrapyramidal reactions; Acute Dystonia
Norm. Dosage, Freq, Route, Range: PO/IM 0.5-1mg/day may gradually increase as needed up to
6mg/day
Side Effects: sedation, constipation, dry mouth, paralytic ileus
Nursing Considerations: Monitor I&O ratio and pattern, monitor HR, monitor and report for muscle
weakness
1.45. Donepezil
(Aricept)
Class: Central Acting Cholinergic; Cholinesterase Inhibitor
Actions: improves global function, cognition, and behavior of patients with mild to moderate Alzheimers.
Peak: 3-4hr. Half-life: 70hr.
Indications: mild, moderate, or severe dementia of Alzheimers type.
Norm. Dosage, Freq, Route, Range: PO 5-10mg at bedtime Max: 10mg/day
Side Effects: headache, insomnia, nausea, diarrhea, vomiting, muscle cramps, anorexia
Nursing Considerations: Monitor closely for S&S of GI ulceration and bleeding, monitor cardiovascular
status, exercise caution
1.46. Ropinirole HCL

(Requip)
Class: Dopamine Receptor Agonist; Antiparkinson
Actions: effectiveness indicated by improvement in idiopathic Parkinsons disease. Peak: 1-2hr. Half-life:
6hr.
Indications: Idiopathic Parkinsons disease, restless leg syndrome
Norm. Dosage, Freq, Route, Range: PO 0.25-4mg Max: 4mg
Side Effects: fatigue, viral infection, dizziness, somnolence, sudden sleep attacks, syncope, nausea,
vomiting, dyspepsia
Nursing Considerations: Lab tests: periodically monitor BUN and creatinine, hepatic function and cardiac
status
Page 24 of 75
Drug Med Cards
1.47. Trihexyphenidyl HCL

(Artane)
Class: Centrally Acting Cholinergic Receptor Antagonist; Antiparkinson Agent; Antispasmodic
Actions: thought to act by blocking excess of acetylcholine at certain cerebral synaptic sites. Relaxes
smooth muscle by direct effect and by atropinelike blocking action on the PNS. Onset: w/in 1 hr. Peak: 23hr. Duration: 6-12hrs.
Indications: Parkinsonism; Extrapyramidal reactions
Norm. Dosage, Freq, Route, Range: PO 1mg day 1, 2mg day 2 then increased 2mgq3-5days up to 610mg/day in 3 or more divided doses Max: 15mg/day
Side Effects: dry mouth, nausea, blurred vision, dizziness, nervousness
Nursing Considerations: Monitor vital signs, assess and report severe CNS stimulation, monitor daily
I&O if pt. develops urinary hesitancy
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Drug Med Cards
16. Fluid and Electrolytes

1.48. Calcium Acetate
(Norvasc)
Class: Calcium Channel Blocker; Antihypertenive
Actions: reduces systolic, diastolic, and mean arterial blood pressure. It also decreases pain due to
angina. Peak: 6-9hr. Duration: 24hr. Half-life: less than 45yrs: 28-69hr. greater than 60yrs: 40-120hr.
Indications: treatment of mild to moderate hypertension and stable angina
Norm. Dosage, Freq, Route, Range: PO 5-10mg once daily Max: 10mg
Side Effects: peripheral or facial edema, headache, abdominal pain, nausea
Nursing Considerations: Monitor BP& HR, monitor for S&S of dose-related peripheral or facial edema,
monitor BP w/ postural changes
1.49. Dextrose 50%

(Dextrose, D50, D50W, Glucose)
Class: Monosaccharide, principal form of charbohydrate used in the body
Actions: Increase blood serum glucose levels. Onset: 5-20min
Indications: hypoglycemia, coma or seizure of unknown etiology, refractory cardiac arrest
Norm. Dosage, Freq, Route, Range: to 1 full amp slow IV (25-100mL of 50% solution)
Side Effects: pain, warmth, burning upon admin, phlebitis, sclerosis, thrombosis,
Nursing Considerations: if smaller veins are used, local venous irritation may occur, infiltration may cause
necrosis
1.50. Ergocalciferol
(Calcidol, D-ViSol, Vitamin D2)
Class: Vitamin D Analog
Actions: distributed through the circulation and plays a major regulatory role. Responsible for regulation
of serum calcium level.
Indications: Nutritional Rickets, Osteomalacia, Hypoparathyroidism
Norm. Dosage, Freq, Route, Range: PO 25-125 mcg/day for 6-12 weeks; may need to increase to 7.5
mg/day in patients w/ malabsorption. Peak: after 4 weeks Duration: 2 months or more.
Side Effects: fatigue, weakness, vertigo, tinnitus, ataxia, muscle and joint pain
Nursing Considerations: Monitor closely patients receiving therapeutic doses of Vitamin D, must remain
under close medical supervision, Lab tests: Serum calcium, phosphorus, magnesium, alkaline,
phosphatase, BUN, periodic urine calcium, casts, albumin, and RBC, Monitor for hypercalcemia
Page 26 of 75
Drug Med Cards
1.51. Ferrous Sulfate

(Feosol)
Class: Iron prepartion
Actions: Standard iron preparation that corrects erythropoietic abnormalities induced by iron deficiency
but does not stimulate erythropoiesis. Absorption: 5-10% absorbed in healthy individuals; 10-30%
absorbed in iron deficiency; food decreases amount absorbed
Indications: Iron deficiency, Iron supplement
Norm. Dosage, Freq, Route, Range: PO 750-1500 mg/day in 1-3 divided doses Max: 1500 mg
Side Effects: nausea, heartburn, constipation, black stools
Nursing Considerations: Lab tests: monitor Hgb and reticulocyte values during therapy, continue iron
therapy for 2-3 months after the hemoglobin level has returned to normal, monitor bowel movements as
constipation is common
1.52. Magnesium Hydroxide

(Magnesia, Magnesia Magna, Milk of Magnesia, M.O.M.)
Class: Saline Cathartic; Antaid
Actions: Aqueous suspension of magnesium hydroxide w/ rapid and long-acting neutralizing action.
Causes osmotic retention of fluid, which distends colon, resulting in mechanical stimulation of peristaltic
activity. Onset: 3-6hrs.
Indications: Laxative
Norm. Dosage, Freq, Route, Range: PO 2.4-4.8g/day (30-60mL) in 1 or more divided doses.
Side Effects: nausea, diarrhea, complete heart block, other ECG abnormalities, respiratory depression,
coma
Nursing Considerations: Lab tests: monitor serum magnesium w/ signs of hypermagnesemia such as
bradycardia, especially w/ frequent use of any degree of renal impairment
1.53. Potassium Chloride

(KCl)
Class: Electrolytes replacement solution
Actions: For maintenance of intracellular isotonicity, transmission of nerve impulses, contraction of
cardiac, skeletal and smooth muscles, normal kidney function and enzyme activity
Indications: Potassium replacement
Norm. Dosage, Freq, Route, Range: PO 10-100 mEq/day in divided doses Max: 100 mEq/day in divided
doses
Side Effects: Bacteremia, dizziness, edema, fatigue, fever, headache, infection, insomnia, rigors,
hypertension, hypotension, tachycardia, abdominal pain, anorexia, constipation, diarrhea, dyspepsia,
mucositis, nausea, anemia, febrile neutropenia, neutropenia, petechiae, thrombocytopenia, bilirubinemia,
hyperglycemia, hypokalemia, hypomagnesemia, arthralgia, back pain, musculoskeletal pain, cough,
dyspnea, epistaxis, pharyngitis, pruritus, rash, vaginal hemorrhage
Nursing Considerations: Check serum K+ level, Normal level: 3.5-5.0, monitor I&O renal function
Page 27 of 75
Drug Med Cards
17. Antibiotics
1.54. Amoxicillin & Clavulanic Acid
(Augmentin)
Class: Beta-Lactam, Antibiotic, Aminopenicillin
Actions: Inhibits the final stage of bacterial cell wall synthesis , which leads to cell lysis and death. Peak:
1-2hrs.
Indications: Infections caused by susceptible beta-lactamase-producing organisms, lower respiratory tract
infections, acute bacterial sinusitis, community acquired pneumonia, otitis media, sinusitis, skin and skin
structure infections, UTI
Norm. Dosage, Freq, Route, Range: PO: 250-500 mg tablet Max:1500 mg/day
Side Effects: Diarrhea, agranulocytosis (rare)
Nursing Considerations: determine previous hypersensitivity reactions to penicillins, cephalosporins and
other allergens prior to therapy, Lab tests: baseline C&S prior to initiation of therapy; start drug pending
results, monitor for S&S of an urticarial rash (usually occurring within a few days after start of drug)
suggestive of a hypersensitivity reaction, monitor for and report diarrhea which may indicate
pseudomembranous colitis
1.55. Amoxicillin
(Amoxil)
Class: Antibiotic, Aminopenicillin
Actions: Inhibits the final stage of bacterial cell wall synthesis, which results in bacterial cell lysis and
death. Active against both aerobic gram-positive & aerobic gram negative bacteria. Onset: 1-2hr. Duration:
1-1.3hr.
Indications: mild to moderate infections of ear, nose, throat, GU tract, skin, and soft tissue caused by
susceptible bacteria, used in uncomplicated Gonorrhea
Norm. Dosage, Freq, Route, Range: PO 250-500 mg q8h Max: 60-80 mg/kg/day
Side Effects: Anaphaylaxis, pseudomembranous colitis (rare), agranulocytosis (rare), hypersensitivity
Nursing Considerations: determine previous hypersensitivity reactions to penicillins, cephalosporins and
other allergens prior to therapy, Lab tests: Baseline C&S tests prior to initiation of therapy; start drug
pending results, periodic assessment of renal, hepatic and hematologic functions w/ prolonged therapy.
1.56. Ampicillin
(Principen)
Class: Antibiotic; Aminopenicillin
Actions: A broad-spectrum, semi synthetic aminopenicillin that is bactericidal but is inactivated by
penicillinase. Inhibits final stage of bacterial cell wall synthesis by binding to specific penicillin-binding
proteins located inside the bacteria cell wall resulting in lysis and death of bacteria. Peak: Immed. After IV
Duration: 6-8hrs.
Indications: Infections of the GU, respiratory and GI tracts, and skin and soft tissues; gonococcal
infections, bacterial meningitis, otitis media, sinusitis and septicemia and for prophylaxis of bacterial
endocarditis. Used parentally only for moderately severe to severe infections.
Norm. Dosage, Freq, Route, Range: PO/IV/IM 250-500 mg q6hr Max: 2000 mg/day
Side Effects: Diarrhea, nausea, vomiting, rash
Page 28 of 75
Drug Med Cards

Nursing Considerations: for allergies to penicillins, cephalosporins and other allergens prior to
therapy, monitor closely for signs of hypersensitivity during the first 30 min. after admin., Lab tests: baseline
C&S prior to admin., baseline & periodic renal assessment, monitor for diarrhea (may indicate
pseudomembranous colitis)
1.57. Ceftriaxone Sodium

(Rocephin)
Class: Antibiotic, 3rd generation Cephalosporin
Actions: preferentially binds to one or more of the penicillin-binding proteins located on the cell walls on
susceptible organisms. Peak: 1.5-4hr after IM, immediately after IV Half-life: 5-10hr
Indications: infections in lower respiratory tract, skin and skin structures, urinary tract, bones and joints,
intra-abdominal infections, pelvic inflammatory disease, uncomplicated gonorrhea, meningitis, and surgical
prophylaxis
Norm. Dosage, Freq, Route, Range: IV/IM: 1-2g q12hr x 4-14days Max: 4g/day
Side Effects: diarrhea, abdominal cramps
Nursing Considerations: hypersensitivity, Lab tests: culture & sensitivity before initiation of therapy,
periodic PT & INR, report diarrhea promptly
1.58. Clindamycin HCL

(Cleocin)
Class: Lincosamide Antibiotic
Actions: Semisynthetic derivative if lincomycin that suppresses protein synthesis by binding to 50 S
subunits of bacterial ribosomes, and, therefore, inhibits other antibiotics (ex: erythromycin) that act at this
site. Peak: PO 45-60 min IM 3 hr Duration: PO 6 hr IM 8-12 hr
Indications: Moderate to severe infections, Acne Vulgaris, Bacterial Vaginosis
Norm. Dosage, Freq, Route, Range: PO 150-450 mg q6hr IM/IV 600-1,200 mg/day in divided doses Max:
2,700 mg/day
Side Effects: Diarrhea, nausea, vomiting, skin rashes
Nursing Considerations: Lab tests: C&S susceptibility testing should be performed initially, periodic CBC
with differential, liver and kidney function tests, monitor BP and pulse in patients receiving drug parenterally,
report diarrhea immediately with or w/o fever, be alert for signs of superinfection and anaphylactoid
reactions
1.59. Cortisporin gtts

(Cortisporin-TC)
Class: Ophthalmic steroid, antibiotic (Suspension Only)
Actions: Ear drops used to treat outer ear infections caused by bacteria (aka swimmer's ear). Contains
neomycin and colistin, which are antibiotics that work by stopping the growth of bacteria. Also
contains hydrocortisone, which is an anti-inflammatory corticosteroid that works by reducing ear swelling
and discomfort, and thonzonium, which helps this med pass through dead cells and pus inside the ear.
Indications: Only works for bacterial ear indications
Norm. Dosage, Freq, Route, Range: 4 drops in affected ear 3-4 times daily Max: 16 drops/day
Side Effects: This medication may temporarily sting or burn your ear for a minute or two when applied.
Hearing problems, rash, itching/swelling, redness of the ears, dizziness
Nursing Considerations: for allergies, rash, redness, itching or swelling to the ears, or any hearing
problems
Page 29 of 75
Drug Med Cards
1.60. Doxycycline Hyclate

(Doryx, Doxy)
Class: Antibiotic; Tetracycline
Actions: blocks the binding of transfer RNA to the messenger RNA of bacteria, resulting in inhibition of
bacterial protein synthesis. Peak: 1.5-4hr Half-life 14-24hr
Indications: treatment of chlamydial and mycoplamal infections, gonorrhea, syphilis in penicillin-allergic
patients, rickettsial diseases, acute exacerbations of chronic bronchitis
Norm. Dosage, Freq, Route, Range: PO/IV 100mg q12hr on day 1, than 100mg/day as single dose Max:
100mg/q12hr
Side Effects: nausea, vomiting, diarrhea
Nursing Considerations:
superinfections
report sudden onset of painful or difficult swallowing and evidence of
1.61. Gentamicin Ointment

(Garamycin Ophthalmic)
Class: Aminoglycoside Antibiotic
Actions: Active against a wide variety of aerobic gram-negative but not anaerobic gram-negative bacteria.
Also effective against certain gram-positive organisms, particularly penicillin-sensitive bacteria
Indications: Moderate to Severe Infection
Norm. Dosage, Freq, Route, Range: Topical 1-2 drops of solution in eye q4hr up to 2 drops q1hr or small
amount of ointment bid or tid
Side Effects: decreased creatinine clearance
Nursing Considerations: Lab tests: perform C&S and renal function prior to first dose and periodically
during therapy, watch Creatinine clearance levels, report S&S of ototoxic effect
1.62. Levofloxacin
(Levaquin, Iquix, Quixin)
Class: Quinolone Antibiotic
Actions: A broad-spectum fluoroquinolone antibiotic that inhibits DNA-gyrase, an enzyme necessary for
bacterial replication, transcription, repair, and recombination. Peak: PO 1-2 hr. Half-life: 6-8 hr.
Indications: treatment of maxillary sinusitis, acute exacerbations of bacterial bronchitis, communityacquired pneumonia, uncomplicated skin/skin structure infections, UTI, acute pyelonephritis caused by
susceptible bacteria, acute bacterial sinusitis, chronic bacterial prostatitis, nd bacterial conjunctivitis,
treatment of pneumonic and septicemic plague.
Norm. Dosage, Freq, Route, Range: PO: 500 mg q24hr x 10 days
Side Effects: abdominal pain, nausea, headache, depression
Nursing Considerations: Monitor for decreases pulse, perspiration, or pallor during insertion. Keep
patient supine until these signs disappear, Monitor BP
Page 30 of 75
Drug Med Cards
1.63. Linezolid
(Zyvox)
Class: Oxazolidinone Antibiotic
Actions: Synthetic antibiotic that binds to a site on the 23S ribosomal RNA of bacteria, which prevents the
bacterial RNA translation process, thus preventing further growth. Peak: PO 1-2 hr. Half-life: 6-7 hr.
Indications: Vancomycin-Resistant Enterococcus faecium,
pneumonia, complicated and uncomplicated skin infections
Nosocomial
or
community-acquired
Norm. Dosage, Freq, Route, Range: PO/IV: 600 mg q12hr x 14-28 days Max: 1,200 mg/day
Side Effects: diarrhea, nausea, vomiting, constipation, taste alteration
Nursing Considerations: Monitor S&S of bleeding, hypertension, or pseudomembranous colitis that
begins w/ diarrhea, Lab tests: CBC, platelet count, Hgb, and Hct
1.64. Ofloxacin
(Floxin)
Class: Quinolone Antibiotic
Actions: Inhibits DNA gyrase, an enzyme needed for bacterial DNA replication, broad spectrum against
gram +&- most effective against gram aerobic and anaerobic bacteria. Peak 1-2hr. Half-life: 5-7.5hr.
Indications: Gonorrhea; Prosistitis; RTI (PO) OTIC (Tympanic) and Ocular; PID
Norm. Dosage, Freq, Route, Range: 0.3% Opthalmic solution 1-2GTTs q2-4hr, qid
0.3% Otic solution GTTS q12hr. x days
Side Effects: Dizziness, N&V, DTS menorrhea, menorrhagia, dysuria, urinary frequency
Nursing Considerations: C&S, tendon PN, rash, seizures, S&S super infection
1.65. Vancomycin
(Vancocin)
Class: Antibiotic, Bacteriocidal
Actions: Active against many gram-positive organisms. Inhibits cell-wall biosynthesis and alteration of
bacterial cell-membrane permeability and RNA synthesis. Peak: 30min after end of infusion Half-life: 4-8hr.
Indications: Infections
Norm. Dosage, Freq, Route, Range: (C. Diff.) PO 125-500 mg q6h (Staph) PO 500 mg-2 g in 3-4 divided
doses x 7-10 days Max: 2 g/day
Side Effects: Nephrotoxicity leading to uremia, shock-like state, anaphylactoid reaction w/ vascular
collapse, leukopenia, hypotension accompanied by flushing and erythematous rash on face and upper body
(red-man syndrome) following rapid IV infusion
Nursing Considerations: Allergy, monitor BP and HR, take peak & trough levels, assess hearing. Be
aware that serum levels of 60-80 mcg/ml are associated w/ ototoxicity, monitor I&O. Oliguria or cloudy or
pink urine may be a sign of nephrotoxicity
Page 31 of 75
Drug Med Cards
18. Cholesterol Lowering Agents

1.66. Atorvastatin
(Lipitor)
Class: Anti-lipemic, HMG-COA, Reductase Inhibitor (statin)
Actions: Adjunct to diet for reduction of LDL cholesterol and triglycerides in patients with primary
hypercholesterolemia and mixed dyslipidemia, prevention of cardiovascular disease in patients with
multiple risk factors. Onset: 2 wk. Peak: Plasma concentration 1-2 hr. effect 2-4 wk.
Indications: Lowers LDL cholesterol, prevention of cardiovascular disease
Norm. Dosage, Freq, Route, Range: PO start w/ 10-40 mg daily may increase up to 80 mg/day Max: 80
mg/day
Side Effects: Back pain, hypersensitivity reaction, headache, abd. pain, constipation, diarrhea, flatulence,
increased liver function tests, sinusitis, pharyngitis, rash
Nursing Considerations: Lab tests: monitor lipid levels within 2-4 weeks after initiation of therapy or upon
change in dosage, assess muscle pain, tenderness or weakness and if present, monitor CPK level (d/c
drug with marked elevations of CPK or if myopathy is suspected, monitor carefully for digoxin toxicity with
concurrent digoxin use, monitor prediabetics and diabetics for loss of glycemia.
1.67. Cholestyramine
(Questrane, Prevalite)
Class: Antilipemic; Bile Acid Sequestrant
Actions: increase fecal loss of bile acids, which leads to lowered serum total cholesterol by decreasing
LDL cholesterol, and reducing bile acid deposit in dermal tissues.
Indications: as adjunct to diet therapy in management of patients w/ primary hypercholesterolemia w/ a
significant risk of atherosclerotic heart disease and MI; for relief of pruritus secondary to partial biliary stasis
Norm. Dosage, Freq, Route, Range: PO 4-8g bid to qid and before meals and at bedtime Max: 32g/day
Side Effects: constipation, flatulence, abdominal pain
Nursing Considerations:
membranes, tarry stools
Monitor for petechiae, ecchymoses, abnormal bleeding from mucous
1.68. Fenofibrate
(Tricor)
Class: Antilipemic; Fibrate
Actions: Fibric acid derivative w/ lipid-regulating properties. Lowers plasma triglycerides by inhibiting
triglycerides synthesis and, as a result, lowers VLDL production as well as stimulates the catabolism of
triglyceride-rich lipoprotein. Produces a moderate increase of HDL cholesterol levels in most patients.
Peak: 6-8 hr. Half-life: 20 hr.
Indications: Hypertriglyceridemia
Norm. Dosage, Freq, Route, Range: PO 43-200 mg/day depending on product Max: 200 mg/day
Side Effects: fatigue, headache, nausea, vomiting, flatulence, constipation
Nursing Considerations: La tests: periodically monitor lipid levels, LFTs, and CBC w/ differential, assess
for muscle pain, tenderness or weakness and if present monitor CPK level.
Page 32 of 75
Drug Med Cards
1.69. Niacin
(Niacor, Niaspan)
Class: Vitamin B3; Antilipemic
Actions: produces vasodilation by direct action on vascular smooth muscles. Inhibits hepatic synthesis
of VLDL, cholesterol, and triglyceride, and indirectly LDL.
Peak: 20-70 min. Half-life: 45 min.
Indications: Niacin deficiency, Pellagra, Hyperlipidemia
Norm. Dosage, Freq, Route, Range: PO 10-20 mg/day (Niacin Deficiency) 1.5-3g/day in divided doses,
may increase up to 6 g/day if necessary (Hyperlipidemia) Max: 6 g/day
Side Effects: headache, tingling, flushing with sensation of warmth, bloating, flatulence, itchy palms
Nursing Considerations: monitor therapeutic effectiveness, Lab tests: obtain baseline and periodic blood
glucose and LFTs in patients receiving prolonged high dose therapy, monitor diabetics, and monitor closely
for evidence of liver dysfunction
Page 33 of 75
Drug Med Cards
19. Laxatives/ Stool Softeners

1.70. Bisacodyl Suppository
(Dulcolax)
Class: Stimulant Laxative
Actions: Expands intestinal fluid volume by increasing epithelial permeability. Induces peristaltic
contractions by direct stimulation of sensory nerve endings in the colonic wall. Onset: PO 6-8hrs. PR 1560min.
Indications: Temporary relief of acute constipation and for evacuation of colon before GI procedures.
Norm. Dosage, Freq, Route, Range: PO 5-15 mg PRN Max: 30 mg for special procedures PR 10 mg
PRN
Side Effects: Mild cramping, nausea, vomiting, diarrhea, fluid and electrolyte disturbances (especially
potassium and calcium)
Nursing Considerations: evaluate periodically patients need for continued use of drug, add high-fiber
foods slowly to regular diet to avoid gas and diarrhea, adequate fluid intake includes at least 6-8
glasses/day, use of laxatives results in absorption of Vitamin K
1.71. Docusate Sodium

(Colace)
Class: Stool softener
Actions: detergent action lowers surface tension, permitting water and fats to penetrate and soften stools
for easier passage
Indications: prophylactically in patients who should avoid straining during defecation and for treatment for
constipation
Norm. Dosage, Freq, Route, Range: PO 50-500mg/day PR 50-100mg added to enema fluid Max:
500mg/day
Side Effects: diarrhea, nausea, bitter taste, abdominal cramps
Nursing Considerations: Withhold if diarrhea develops and notify prescriber. Take sufficient liquid with
each dose. So not take for prolonged periods (causes slowed bowel mobility).
1.72. Lactulose
(Cephulac; Chronulac)
Class: Hyperosmotic Laxative; Neurologic
Actions: Osmotic effect on lactulose moves water from plasma to intestines, softening stools, and
stimulates peristalsis by pressure from water content of stool.
Indications: Chronic Constipation, prevention and treatment of portal-systemic encephalopathy (PSE)
including stages of hepatic precoma and come
Norm. Dosage, Freq, Route, Range: PO 30-60mL/day PRN Max: 60mL/day
Side Effects: diarrhea, nausea, vomiting, flatulence
Nursing Considerations: promote fluid intake (1,500-2,000mL/day or greater) during drug therapy for
constipation
Page 34 of 75
Drug Med Cards
1.73. Metoclopramide
(Metozolv, Reglan)
Class: GI Stimulant; Prokinetic agent
Actions: potent central dopamine receptor antagonist that increases resting tone of esophageal sphincter,
and tone and amplitude of upper GI contractions. Thus gastric emptying and intestinal transit are
accelerated. Antiemetic action results from druf-induced elevation of CTZ threshold and enhanced gastric
emptying. Onset: 30-60 min. Peak: 1-2 hr.Duration: 1-3 hr.
Indications: GERD, Diabetic gastroparesis, Small bowel intubation/Radiologic Exam, ChemotherapyInduced Emesis, Postoperative Nausea/ Vomiting
Norm. Dosage, Freq, Route, Range: PO 10-15 mg qid before meals and at bedtime IM/IV 10 mg qid Max:
60 mg
Side Effects: mild sedation, fatigue, restlessness, diarrhea
Nursing Considerations: report S&S immediately, lab tests: periodic serum electrolytes, monitor for
possible hypernatremia and hypokalemia, avoid alcohol and other CNS depressants, avoid driving for a
few hours after drug admin.
1.74. Polyethylene Glycol

(Miralax)
Class: Laxatives, Osmotics
Actions: Acts as an osmotic agent, drawing water into the lumen of the GI Tract. Peak: 2-4days
Indications: Indicated for evacuation of GI Tract w/o water or electrolyte imbalance.
Norm. Dosage, Freq, Route, Range: 17g w/ 8oz of water
Side Effects: abdominal bloating, cramping, flatulence, nausea
Nursing Considerations: GI obstruction, gastric retention, toxic colitis, megacolon, use cautiously in
patients w/ abdominal pain of uncertain cause, particularly if accompanied w/ fever.
1.75. Sennosides
(Senokot)
Class: Stimulant Laxative
Actions: Peristalsis stimulated by conversion of drug to active chemical. Onset: 6-10hr; may take up to
24hr.
Indications: Acute constipation and preoperative and preradiographic bowel evacuation
Norm. Dosage, Freq, Route, Range: PO 1-2 tabs at bedtime Max 4 tabs
Side Effects: nausea, abdominal cramps, flatulence, watery diarrhea
Nursing Considerations: Reduce dose in patients who experience considerable abdominal cramping
Page 35 of 75
Drug Med Cards
20. Anti-Diarrheal
1.76. Diphenoxylate
(Diphenatol, Lofene, Lomanate)
Class: Antidiarrheal
Actions: reduces GI motility. Onset: 45-60 min Peak: 2hr. Duration: 3-4hr.
Indications: management of diarrhea
Norm. Dosage, Freq, Route, Range: PO 5-10mL 3-4 times daily Max: 40mL/day
Side Effects: hypersensitivity, flushing, palpitation, headache, dizziness
Nursing Considerations: Assess GI function, monitor for S&S of dehydration, frequency and consistency
of stools
1.77. Loperamide
(Maalox, Imodium, Kaopectate, Pepto)
Class: Antidiarrheal
Actions: Inhibits GI peristaltic activity by direct action on circular and longitudinal intestinal muscles.
Prolongs transit time of intestinal contents, increases consistency of stools, and reduces fluid and
electrolyte loss. Onset: 30-60min. Peak: 2.5hrs (solution), 4-5hrs. (Capsules) Duration: 4-5hrs.
Indications: Acute Diarrhea; Chronic Diarrhea
Norm. Dosage, Freq, Route, Range: PO 4mg followed by 2mg after each unformed stool Max: 16mg/day
Side Effects: Toxic megacolon, abdominal pain or discomfort, constipation
Nursing Considerations: monitor fluid and electrolyte balance, record number and consistency of stools
Page 36 of 75
Drug Med Cards
21. Beta-Blockers
1.78. Atenolol
(Tenormin)
Class: Beta-Adrenergic Antagonist; Antihypertensive
Actions: reduces rate & force of cardiac contractions (negative inotropic action); cardiac output is reduced
as well as systolic and diastolic BP. Decreases peripheral vascular resistance both at rest and with
exercise. Peak: 2-4hr. Duration: 24hr. Half-life: 6-7hr.
Indications: management of hypertension as a single agent or concomitantly w/ other antihypertensive
agents, especially a diuretic, and in treatment of stable angina pectoris, MI
Norm. Dosage, Freq, Route, Range: PO 25-50mg/day, may increase to 100mg/day Max: 100mg/day
Side Effects: Bradycardia, hypotension, CHF, pulmonary edema, nausea, vomiting
Nursing Considerations: Measure trough BP, check apical pulse before admin., monitor BP, monitor
diabetics for loss of glycemic control
1.79. Carvedilol
(Coreg, Coreg CR)
Class: Alpha and Beta Adrenergic Antagonist; Antihypertensive
Actions: An effective antihypertensive agent reducing BP to normotensive range and useful in managing
some angina, dysrhythmias, and CHF by decreasing myocardial oxygen demand and lowering cardiac
workload. Peak: Antihypertensive effect 7-14 days
Indications: CHF, Left Ventricular Dysfunction, Post MI, Hypertension
Norm. Dosage, Freq, Route, Range: PO start w/ 3.125mg bid Max: 50mg/day
Side Effects: Dizziness
Nursing Considerations: Monitor for therapeutic effectiveness, lab tests: LFTs and digoxin levels w/
concurrent use, monitor for worsening of symptoms in patients w/ PVD
1.80. Metoprolol Tartrate

(Lopressor)
Class: Cardioselective; Beta-adrenergic antagonist; Antihypertensive; Antianginal
Actions: produces a decrease in the systolic and diastolic BPs, and reduces edema in CHF and kidney
failure patients. Onset: 15min. Peak: PO 1.5hr. IV 20min. Duration: 13-19hr.
Indications: management of hypertension
Norm. Dosage, Freq, Route, Range: PO 50-100mg/day in 1-2 divided doses, may increase weekly up to
100-450mg/day Max: 450mg/day
Side Effects: fatigue, insomnia, bradycardia, heartburn, shortness of breath
Nursing Considerations: Take apical pulse and BP before administering drug. Monitor BP q12hr
Page 37 of 75
Drug Med Cards
1.81. Propanolol
(Inderal, InnoPran XL)
Class: Beta-Adrenergic Receptor Antagonist; Antihypertensive; Class II Antiarrhythmic
Actions: Nonselective beta-blocker of both cardiac and bronchial adrenoreceptors that competes w/
epinephrine and norepinephrine for available beta receptor sites. In higher doses, it depresses cardiac
function including contractility and arrhythmias. Lowers both supine and standing BP in hypertensive
patients. Peak: 60-90 min immediate release, 6 hr sustained release, IV 5 min
Indications: Hypertension, Angina, Arrhythmias, Acute MI, Migraine Prophylaxis
Norm. Dosage, Freq, Route, Range: PO 40 mg bid, usually need 160-480 mg/day Max: 480 mg/day
Side Effects: confusion, fatigue, drowsiness, bradycardia, paresthesia of hands
Nursing Considerations: Monitor apical pulse, respirations, BP and circulation to extremities. Be aware
of adverse reactions, Lab tests: periodic hematologic, kidney, liver, and cardiac functions, monitor I&O
1.82. Sotalol
(Betapace)
Class: Beta-Adrenergic Antagonist; Class II and III Antiarrhythmic
Actions: slows heart rate, decreases AV nodal conduction, and increases AV nodal refractoriness.
Produces significant reduction in both systolic and diastolic blood pressure. Peak: 2-3 hr Duration: 24 hr
Indications: Ventricular Arrhythmias, Atrial Fibrillation/Flutter
Norm. Dosage, Freq, Route, Range: PO initial dose of 80 mg bid or 160 mg daily taken prior to meals,
may increase every 3-4 days in 40-160 mg increments Max: 240 mg/day in 1-2 divided doses
Side Effects: bradycardia, dyspnea, chest pain, palpation, fatigue, dizziness
Nursing Considerations: Monitor ECG baseline and periodically, Lab tests: baseline serum electrolytes,
monitor cardiac status throughout therapy, monitor patients w/ bronchospastic disease (ex: bronchitis,
emphysema) for inhibition of bronchodilation, monitor diabetics for loss of glycemic control.
Page 38 of 75
Drug Med Cards
22. Nitrates
1.83. Isosorbide Dinitrate
(Dilatrate-SR, IsoBid)
Class: Nitrate Vasodilator (prototype: Nitroglycerin)
Actions: has an anti-anginal effect as a result of vasodilation of the coronary arteries. Onset: SL 2-5min.
w/in 1hr. reg. tabs w/in 3 min. chewable tabs 30 min. sustained release tabs Duration: SL 1-2hr. Chewable
tabs: 1.5-2hrs. Sustained release tabs: 6-8hrs.
Indications: relief of acute anginal attacks and for management of long-term angina pectoris
Norm. Dosage, Freq, Route, Range: 5-30mg q2-3hr. Max: 360mg/day
Side Effects: light-headedness, flushing, headache, pallor
Nursing Considerations: Monitor for effectiveness, headaches tend to decrease in intensity and
frequency with continued use, may produce tolerance
1.84. Isosorbide Mononitrate

(Ismo, Imdur)
Class: Nitrate Vasodilator
Actions: Long acting metabolite of the coronary vasodilator isosorbide dinitrate. It decreases preload as
measured by pulmonary capillary wedge pressure and left ventricular end volume and diastolic pressure
with a consequent reduction in myocardial oxygen consumption. Onset: 1 hr. Peak: regular release 30-60
min; sustained release 3-4 hr Duration: regular release 5-12 hr, sustained release 12 hr
Indications: Prevention of Angina
Norm. Dosage, Freq, Route, Range: PO regular release 20 mg bid 7 hr apart; sustained release 30-60
mg early morning, may increase up to 120 mg after several days if needed Max: 240 mg/day
Side Effects: headache, anxiety, coughing, nasal congestion, dry mouth
Nursing Considerations: Monitor cardiac status, frequency and severity of angina and BP, assess for
S&S for toxicity, Lab tests: monitor serum electrolytes periodically.
1.85. Nitroglycerin
(Nitro-Dur, Nitrostat, Nitroquick)
Class: Nitrate Vasodilator
Actions: Organic nitrate and potent vasodilator that relaxes vascular smooth muscle. After conversion to
nitric oxide, it leads to dose-related dilation of both venous and arterial blood vessels. Promotes peripheral
pooling of blood, reduction of peripheral resistance, and decreased venous return to the heart. Both left
ventricular preload and afterload are reduced and myocardial oxygen consumption or demand is
decreased. Onset: SL 2 min PO 3 min Ointment 30 min Duration: SL 30 min PO 3-5 hr Ointment 3-6 hr
Indications: Angina
Norm. Dosage, Freq, Route, Range: SL 1-2 sprays (0.4-0.8 mg) or 0.3-0.6 mg tablet q3-5min as needed
Max: 3 doses in 15 min PO 1.3-9 mg q8-12 hr Ointment apply 1.5-5 cm of ointment q4-6hr
Side Effects: dizziness, headache, postural hypotension, Syncope, tachycardia
Nursing Considerations: Monitor BP, HR location, duration, pain
Page 39 of 75
Drug Med Cards
23. ACE-Inhibitors
1.86. Lisinopril
(Prinivil)
Class: Antihypertensive, ACE inhibitor
Actions: Lowers BP, improves cardiac output and exercise tolerance. Aldosterone is also reduced, thus
permitting a potassium-sparing effect. Onset: 1 hr. Peak: 6-8hr. Duration: 24hrs.
Indications: Hypertension, Heart Failure
Norm. Dosage, Freq, Route, Range: (Hypertension) PO 10 mg once/day, may increase up to 20-40 mg
1-2x/day (Heart Failure) PO 5-40 mg/day Max: 80 mg/day
Side Effects: Headache, dizziness, fatigue, hypotension, chest pain, nausea, vomiting, diarrhea, anorexia,
constipation, intestinal angioedema, dyspnea, cough, rash, hyperkalemia, increase BUN and creatinine
levels
Nursing Considerations: Check BP before giving med. With pt. in supine position, monitor serum Na and
K+ levels, Lab tests: WBC q month for the first 3-6 months of therapy and at periodic intervals for 1 yr.
1.87. Ramipril
(Altace)
Class: Angiotensin-Converting Enzyme (ACE) Inhibitor; Antihypertensive
Actions: lowers BP, and improves cardiac output as well as exercise tolerance. Onset: 2hr Peak: 6-8hr
Duration: up to 24hr Half-life: 2-3hr
Indications:
Norm. Dosage, Freq, Route, Range: PO 2.5-5mg daily, may increase up to 20 mg/day in 1-2 divided
doses Max: 20mg/day
Side Effects:
Nursing Considerations: Monitor BP, Lab Tests: BUN and serum creatinine periodically. Observe for
S&S of hyperkalemia
Page 40 of 75
Drug Med Cards
24. Calcium Channel Blockers

1.88. Amlopidine
(Norvasc)
Class: Calcium Channel Blocker; Antihypertensive
Actions: selectively block calcium influx across cell membranes of cardiac and vascular smooth muscle
without changing serum calcium concentrations. Peak: 6-9 hr. Duration: 24 hr.
Indications: Hypertension, Stable/Vasospastic Angina
Norm. Dosage, Freq, Route, Range: PO 5-10 mg once daily Max: 10 mg
Side Effects: peripheral and facial edema, headache
Nursing Considerations: Monitor BP & HR, monitor for S&S of peripheral and facial edema, monitor BP
with postural changes
Page 41 of 75
Drug Med Cards
25. Central Acting Antihypertensive

1.89. Clonidine
(Catapres)
Class: Central-Acting Antihypertensive; Analgesic
Actions: Decreases systolic and diastolic BP and HR. Reportedly minimizes or eliminates many of the
common clinical S&S associated w/ withdrawal of heroin, methadone, or other opiates. Onset: PO 3060min. Peak: PO 2-4hr. Duration: PO 8hr.
Indications: Hypertension, ADHD, Severe Pain
Norm. Dosage, Freq, Route, Range: PO 0.1mg Max: 2.4mg/day
Side Effects: Hypotension, dry mouth, drowsiness, sedation, constipation
Nursing Considerations: Monitor BP closely, monitor I&O during period of dosage adjustment
1.90. Guanfacine HCL

(Intuniv, Tenex)
Class: Alpha-Adrenergic Agonist; Central-Acting Antihypertensive
Actions: In cerebral cortex, stimulation of alpha2-adrenoreceptors triggers inhibitory neurons to reduce
central sympathetic outflow (ie., impulses from vasomotor center to heart * blood vessels) Onset: 2hr.; 6hr.
ER Peak: 6hr. Duration: Up to 24hr.
Indications: Hypertension; Attention Deficit Hyperactivity Disorder (ADHD)
Norm. Dosage, Freq, Route, Range: PO 1mg/day titrate up (Normal range: 1-4mg/day)
Side Effects: dizziness, sedation, fatigue, dry mouth, constipation, impotence
Nursing Considerations: do not d/c abruptly, may cause plasma & urinary catecholamine increases
leading symptoms of tachycardia, insomnia, anxiety, nervousness; monitor BP until stabilized; assess
mental status & alertness; employ measure to keep mouth moist; avoid alcohol & do not self-medicate w/
OTC drugs
Page 42 of 75
Drug Med Cards
26. Antihypertensives
1.91. Losartan
(Cozaar)
Class: Angiotensin II Receptor Antagonist; Antihypertensive
Actions: Antihypertensive effect is due to vasodilation and inhibition of aldosterone effects on sodium and
water retention. Peak: 6hr. Duration 24hr.
Indications: Hypertension
Norm. Dosage, Freq, Route, Range: PO 25-52mg in 1-2 divided doses Max: 100mg/day
Side Effects: dizziness, dyspepsia, insomnia, headache
Nursing Considerations: Monitor BP at drug trough, lab tests: monitor CBC, electrolytes, liver and kidney
functions w/ long-term therapy
1.92. Valsartan
(Diovan)
Class: Renin Angiotensin System Antagonist; Antihypertensive
Actions: Blocks angiotensin II receptors results in vasodilation as well as decreasing the aldosteronesecreting effects of angiotensin II. These actions result in the antihypertensive effect of valsartan. Onset:
BP decreased in 2 weeks. Peak: Plasma levels, 2-4hr; BP effect 4 weeks
Indications: Hypertension, Heart Failure
Norm. Dosage, Freq, Route, Range: PO 40-80mg daily Max: 320mg/day
Side Effects: headache, dizziness, nausea, vomiting
Nursing Considerations: monitor BP, lab tests: periodic LFTs, BUM, and creatinine, serum potassium,
and CNC w/ differential
1.93. Terazosin
(Prazosin)
Class: Alpha-Adrenergic Receptor Antagonist, Antihypertensive
Actions: Selectively blocks Alpha1-adrenergic receptors in vascular smooth muscle in many tissues,
including vascular smooth muscle, the bladder neck, and the prostate. Promotes vasodilation, thus
producing relaxation that leads to reduction of peripheral vascular resistance and lowers BP as well as
increased urine flow. Peak: 1-2 hr.
Indications: Hypertension, Benign Prostatic Hypertrophy
Norm. Dosage, Freq, Route, Range: PO start with 1 mg at bedtime, then 1-5 mg/day Max: 20 mg/day
Side Effects: Asthenia (weakness), dizziness, headache, 1st dose phenomenon syncope
Nursing Considerations: Monitor BP, be alert for possible 1st dose phenomenon
Page 43 of 75
Drug Med Cards
27. Antipsychotics
1.94. Aripiprazole
(Abilify)
Class: Atypical Antipsychotic; Dopamine System Stabilizer
Actions: combination of partial agonist activity at D2 and 5-HT1A receptors and antagonists activity at 5HT2A receptors. Peak: 3-5hrs.
Indications: Schizpphrenia; Bipolar Mania; Agitation associated w/ Schizophrenia/Bipolar; Adjunct in Major
Depression; Irritability associated w/ Autism
Norm. Dosage, Freq, Route, Range: PO 10-15mg once daily, may increase at 2wk intervals to Max:
30mg/day
Side Effects: headache, insomnia, light-headedness, somnolence, akathisia, risk of stroke in elderly w/
dementia-related-psychosis, N&V, constipation
Nursing Considerations: monitor cardiovascular status, Lab tests: periodic Hct and Hbg, and blood
glucose, monitor for elevated CPK and myoglobinuria if NMS is suspected.
1.95. Asenapine
(Saphris)
Class: Atypical Antipsychotic; Serotonin Antagonist; Antimanic; Antidepressant
Actions: thought to be related to antagonism to certain CND dopamine (D2) and serotonin (5-HT2a)
receptors. Peak: 0.5-1.5hr.
Indications: Schizophrenia; Bipolar Disorder
Norm. Dosage, Freq, Route, Range: SL 5mg bid
Side Effects: Extrapyramidal symptoms (EPS), headache, somnolence, insomnia
Nursing Considerations: monitor BP, HR, and weight; monitor for orthostatic hypotension; monitor
diabetes
1.96. Atomoxetine
(Strattera)
Class: Miscellaneous Psychotherapeutic
Actions: Selective inhibition of the presynaptic norepinephrine transporter, resulting in norepinephrine
reuptake inhibition. Peak: 1-2hr.
Indications: Attention Deficit Hyperactivity Disorder (ADHD)
Norm. Dosage, Freq, Route, Range: PO start w/ 40mg in a.m., may increase after 3 days to target dose
of 80mg/day given either in a.m. or divided dose. May increase to 100mg/day if needed.
Side Effects: headache, insomnia, suicidal ideation, upper abdominal pain, nausea, vomiting, decreased
appetite, severe liver failure, and cough
Nursing Considerations: evaluate therapeutic effectiveness; report increased aggression & irritability as
there may indicate need to d/c the drug; monitor children & adolescence for behavior changes that may
indicate suicidal ideation; monitor cardiovascular status especially w/ preexisting hypertension; monitor HR
& BP at baseline, following a dose increase, and periodically during therapy; Lab tests: periodic LFTs
Page 44 of 75
Drug Med Cards
1.97. Chlorpromazine
(Thorazine)
Class: Antipsychotic; Phenothiazine; Antiemetic
Actions: mechanism thought to be related to blockade of post-synaptic dopamine receptors in the brain.
Onset: 30-60min. Peak: PO 2-4hr. IM 15-20min. Duration: 4-6hr.
Indications: Psychotic disorder, agitation; nausea and vomiting; dementia; intractable hiccups; tetanus
Norm. Dosage, Freq, Route, Range: PO 25-100mg tid or qid, Max: 1,000mg/day IM/IV: 25-50mg Max:
600mg
Side Effects: Agranulocytosis,Neuroleptic malignant syndrome (NMS), hypothermia,adynamic ileus,
sedation, extrapyramidal symptoms (EPS)
Nursing Considerations: Lab tests: LFTs, periodic CBC w/ diff, and blood glucose, monitor cardiac status,
be alert for NMS and report immediately, report EPS, monitor BP frequently, may cause pink to red-brown
discoloration of urine, have pt. wear protective clothing and sunscreen when outdoors, have pt. practice
meticulous oral hygiene to prevent oral candidiasis
1.98. Clozapine
(Clozaril)
Class: Atypical Antipsychotic
Actions: Interferes w/ binding of dopamine to D1 and D2 receptors in the limbic region of the brain. Onset:
2-4 wk. Peak: 2.5 hr.
Indications: Schizophrenia
Norm. Dosage, Freq, Route, Range: PO initiate 12.5mg daily or bid and increase by 25-50mg/day and
titrate to a target of 350-400mg/day in 3 divided doses Max: 900mg/day
Side Effects: tachycardia, agranulocytosis, transient fever, neuroleptic malignant syndrome (NMS),
increased mortality from severe hematologic, cardiovascular, and respiratory adverse effects.
Nursing Considerations: Lab tests: baseline WBC and absolute neutrophil count must be made before
initial treatment q wk. for first 6 mon. then q2wk.for the next 6 mon. then q4wk.periodic blood glucose,
monitor cardiovascular and respiratory status,
1.99. Fluphenazine HCL

(Prolixin)
Class: Antipsychotic; Phenothiazine
Actions: thought to be related to blockade of post-synaptic dopamine receptors in the brain. Onset: 1hr.
Peak: 0.5hr. Duration: 6-8hr.
Indications: Psychosis; Dementia Behavior
Norm. Dosage, Freq, Route, Range: PO 0.5-10mg/day in 1-4 divided doses Max: 20mg/day
Side Effects: extrapyramidal symptoms (EPS), tardive dyskinesia, impaired thermoregulation, leukopenia,
agranulocytosis, photosensitivity
Nursing Considerations: report any EPS or mental depression, Lab tests: periodic WBC w/ diff, LFTs,
monitor renal function and notify prescriber if BUN is elevated, have pt. wear protective clothing and
sunscreen when outdoors, may discolor urine pink to red or reddish brown
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1.100. Haloperidol
(Haldol)
Class: Antipsychotic, Butyrophenone
Actions: Blocks postsynaptic dopamine receptors in the limbic system of the brain. in dopamine
neurotransmission has been correlated w/ its higher instance of extrapyramidal effects. Psychotic
manifestations & exerts strong antiemetic effect. Onset: IM 30-45min. Peak: PO 2-6hr., IM 10-20min.
Indications: Management of manifestations of psychotic disorders & for control of tics & vocal utterances
of Tourettes syndrome, for treatment of agitated state is acute and chronic psychoses.
Norm. Dosage, Freq, Route, Range: PO 0.2-5 mg bid or tid Max: 15 mg.day
IM 2-5 mg q4hr PRN Max: 30 mg/day
Side Effects: extrapyramidal reactions, tardive dyskinesia, agitation, drowsiness, lethargy, fatigue, tremor,
ataxia, headache, confusion, vertigo, tachycardia
Nursing Considerations: monitor for drug effectiveness (long half-life), monitor patients mental status
daily, be alert for behavioral changes
1.101. Iloperidone
(Fanapt)
Actions: is both a dopamine (D2) and serotonin (5-HT2) antagonist. Peak: 2-4hr.
Norm. Dosage, Freq, Route, Range: PO initial 1mg big, then titrated to 6-12mg bid
Side Effects: dizziness, somnolence, tachycardia
Nursing Considerations: monitor for suicidal ideation, monitor BP, HR, and weight, monitor for orthostatic
hypotension, Lab tests: baseline and periodic CBC w/ diff
1.102. Lithium Carbonate

(Eskalith, Lithane, Lithobid, Lithonate, Lithotabs)
Class: Antipsychotic; Mood Stabilizer
Actions: The lithium ions behaves in the body much like the sodium ion: but its exact mechanism of action
is unclear. Peak: 0.5-3hrs.
Indications: Mania
Norm. Dosage, Freq, Route, Range: PO: Loading Dose 600mg tid or 900mg sustained release bid or
30mL of solution tid PO: Maintenance Dose 300mg tid or qid or 15-20mL solution in 2-4 divided dose Max:
2.4g/day
Side Effects: headache, lethargy fatigue, recent memory loss, peripheral circulatory collapse, nephrogenic
diabetes insipidus, nausea, vomiting, anorexia, abdominal pain, diarrhea, dry mouth, fine, hand tremors,
muscle weakness, reversible leukocytosis
Nursing Considerations: Lab tests: periodic lithium levels; periodic thyroid function tests; monitor for S&S
of lithium toxicity; be alert to and report symptoms of hypothyroidism; drink plenty of liquids (2-3L/day)during
stabilization and at least (1-1.5L/day) during ongoing therapy
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1.103. Lurasidone
(Latuda)
Actions: the mechanism of action is unknown but the efficacy of lurasidone in schizophrenia is thought to
be mediated through central dopamine type 2 (D2) and serotonin Type 2 (5HT2a) receptor antagonism.
Norm. Dosage, Freq, Route, Range: PO 40-160mg one daily
Side Effects: akathisia, dizziness, somnolence, parkinsonism, nausea
Nursing Considerations: monitor orthostatic VS, Lab tests: periodic blood glucose, lipid profile, LFTs,
and CBC w/ diff, monitor closely pts. w/ neutropenia, monitor weight, monitor for and report promptly seizure
activity, S&S of Neuroleptic Malignant Syndrome (NMS) or tardive dyskinesia
1.104. Olanzapine
(Zyprexa)
Actions: thought to be due to antagonism for both serotonin 5-HT2A/2C and dopamine D1-4 receptors.
Peak: 6hr.
Indications: Psychotic disorders; Bipolar Mania; Acute Agitation
Norm. Dosage, Freq, Route, Range: PO start w/ 5-10mg/day, may increase by 2.5-5mg q wk. until desired
response Max: 20mg/day
Side Effects: weight gain, somnolence, dizziness, agitation, insomnia, headache, nervousness, hostility,
Parkinsonism
Nursing Considerations: monitor cerebrovascular status closely, Lab tests: periodically monitor ALT,
blood glucose, monitor BP and HR periodically and monitor temp.
1.105. Paliperidone
(Invega)
Actions: Interferes w/ binding of dopamine to dopamine type 2 (D2) receptors, serotonin (5-HT2a)
receptors and alpha-adrenergic receptors. Peak: 24hrs
Indications: Schizophrenia; Schizoaffective Disorder
Norm. Dosage, Freq, Route, Range: PO initially 6mg/day, may adjust up/down in 3mg increments Max:
12mg/day
Side Effects: Akathisia, headache, somnolence
Nursing Considerations: Baseline ECG is recommended to rule out congenital long-QT syndrome; Lab
tests: baseline and periodic serum electrolytes, periodic blood glucose, and CBC; monitor diabetes and
loss of glycemic control
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1.106. Prochlorperazine Meleate

(Compazine)
Class: Antipsychotic; Phenothiazine, Antiemetic
Actions: Strong antipsychotic effects thought to be due to blockade of postsynaptic dopamine receptors
in the brain. Antiemetic effect is produced by suppression of the chemoreceptor trigger zone (CTZ). Onset:
PO 30-40 min, PR 60 min, IM 10-20 min Duration: PO 3-4 hr, Sustained Release PO 10-12 hr, PR 3-4 hr,
IM up to 12 hr
Indications: Severe Nausea/Vomiting, Psychotic Disorders
Norm. Dosage, Freq, Route, Range: PO 5-10 mg 3-4 times/day, Sustained Release PO 10-15 mg q 12
hr PR 25 mg bid IM 5-10 mg q3-4hr up to 40 mg/day IV 2.5-10 mg q3-4hr Max: 40 mg/day
Side Effects: drowsiness, extrapyramidal reactions (akathisia, dystonia or parkinsonism)
Nursing Considerations: position carefully to prevent aspiration, Lab tests: periodic CBC with diff in longterm therapy, be alert of high core temperature
1.107. Quetiapine
(Seroquel)
Actions: effectiveness indicated to a reduction in psychotic behavior. Peak: 1.5hr. Half-life: 6hrs.
Indications: management of schizophrenia, maintenance of acute bipolar disorder, and add-on therapy
for major depressive disorder
Norm. Dosage, Freq, Route, Range: 25-50mg dose and increase by 25-50mg/day Max: 800mg/day
Side Effects: dizziness, headache, somnolence, leukopenia
Nursing Considerations: Monitor for respiratory depression in patients with chronic respiratory
insufficiency and suicidal tendencies
1.108. Risperidone
(Risperdol)
Actions: interferes w/ binding of dopamine to D2-interlimbic region of the brain, serotonin (5-HT2)
receptors, and alpha-adrenergic receptors in the occipital cortex. Onset: therapeutic effect 1-2 wk. Peak: 12hr.
Indications: Schizophrenia; Bipolar Disorder; Irritability Associated w/ Autism
Norm. Dosage, Freq, Route, Range: PO 1-2mg/day in 1 or 2 doses then titrate up Max: 8mg/day
Side Effects: sedation, drowsiness, headache, insomnia, agitation, extrapyramidal symptoms (EPS),
neuroleptic malignant syndrome (NMS)
Nursing Considerations: monitor cardiovascular status closely, Lab tests: monitor periodically blood
glucose, serum electrolytes, LFTs, and CBC, be aware of risk for orthostatic hypotension
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1.109. Thioridazine HCL

(Mellaril)
Actions: blocks post-synaptic dopamine receptors in the mesolimbic system of the brain. Onset: days to
weeks
Indications: Psychotic disorders; moderate to marked depression; dementia behavior
Side Effects: sedation, paralytic ileus, urinary retention
Nursing Considerations: monitor I&O ratio and bowel elimination pattern, orthostatic hypotension may
occur, Lab tests: obtain periodic CBC and LFTs during therapy, avoid alcohol, may cause pink-red to
reddish-brown urine
1.110. Trifluoperazine HCL

(Stelazine)
Actions: thought to be related to blockade of post-synaptic dopamine receptors in the brain. Onset: Rapid
Peak: 2-3hr. Duration: up to 12hr.
Indications: Schizophrenia; Anxiety
Norm. Dosage, Freq, Route, Range: PO 1-2mg bid Max: 20mg/day
Side Effects: drowsiness, extrapyramidal symptoms (EPS), neuroleptic malignant syndrome (NMS), dry
mouth, hypotension
Nursing Considerations: monitor HR and BP, monitor I&O ratio and bowel elimination pattern, Lab tests:
periodic CBC and serum prolactin, cover as much skin surface as possible with clothing when you must be
in direct sunlight, urine may be discolored or reddish-brown
1.111. Ziprasidone HCL

(Geodon)
Actions: exerts antischizophrenic effects through dopamine (D2) and serotonin (5-HT2a) receptors
antagonism. Peak: 6-8hrs.
Indications: Schizophrenia; Acute episodes of Agitation/Acute psychosis, Acute Mania/Bipolar Disorder
Norm. Dosage, Freq, Route, Range: PO start w/ 20mg bid w/ food, may increase q2days up to 80mg bid
if needed Max: 160mg/day
Side Effects: somnolence, nausea
Nursing Considerations: Lab tests: baseline and periodic ECGs, serum potassium and serum
magnesium, periodically monitor blood glucose, monitor I&O ratio and pattern, monitor BP, monitor
cognitive status, monitor for loss of seizure control, avoid strenuous exercise, exposure to extreme heat, or
other activities that may cause dehydration
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28. Anti-Coagulants
1.112. Enoxaparin
(Lovenox)
Class: Anticoagulant; Low Molecular Weight Heparin
Actions: An effective anticoagulation agent, if is used for prophylactic treatment as an antithrombotic agent
following certain types of surgery. Peak: 3 hr. Duration 4-6 hr.
Indications: Prevention of DVT after Hip or Knee Surgery, Prevention of DVT after Abdominal Surgery,
Treatment of DVT and Pulmonary Embolus, Non-Q Wave MI Acute STEMI
Norm. Dosage, Freq, Route, Range: SQ 30 mg bid for 10-14 days starting 12-24 hr post-surgery Max:
60 mg/day
Side Effects: Dyskinesia, Hyperkinesia, Nausea, Diarrhea, Urine discoloration
Nursing Considerations: Monitor carefully for hyperpyrexia, confusion, or emergence of Parkinsons S&S
during drug w/drawal, monitor for orthostatic hypotension and worsening of dyskinesia, or hyperkinesia,
Lab tests: Hgb and serum ferritin levels w/ prolonged therapy
1.113. Heparin
(Heparin Sodium)
Class: Anticoagulant
Actions: Has rapid anticoagulant effect, does not lyse already existing thrombi but may prevent their
extension & propagation. Onset: SQ 20-60min. Peak: in min. Duration: SQ 8-12hr. IV 2-6hr.
Indications: prophylaxis and treatment of venous thrombosis and pulmonary embolism & to prevent
thromboembolic complications arising from cardiac & vascular surgery, frostbite, & curing acute stage of
MI
Norm. Dosage, Freq, Route, Range: IV 5,000 units bolus dose then 20,000-40,000 units infused over
24hr, dose adjusted to maintain desired aPTT or 5,000-10,000 units IV piggyback q4-6 hr Max: 60,000
units/day SQ 10,000-20,000 units/m2/24hr
Side Effects: spontaneous bleeding, fever, chills, numbness, elevated BP, headache
Nursing Considerations: Lab tests: baseline blood coag., Hct, Hgb, RBC, & platelet count prior to admin.,
monitor aPTT levels closely, blood draw for coag. test 30 min before each scheduled SQ or intermittent IV
dose, observe all needle sites daily, monitor vital signs
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29. Antiplatelets
1.114. Aspirin
(ASA)
Class: Non-narcotic, Antiplatelet, Antipyretic
Actions: inhibiting the formation of prostaglandins involved in the production of inflammation, pain and
fever, powerfully inhibits platelet aggregation. High serum salicylate concentrations can impair hepatic
synthesis of blood coagulation factors VII, IX, X. Peak: 15min-2hr.
Indications: Anti-inflammatory action, pain, fever reducer, antiplatelet
Norm. Dosage, Freq, Route, Range: PO: 350-650 mg q4h Max: 4 g/day
Side Effects: Bronchospasm, anaphylactic shock (laryngeal edema), nausea, heartburn, stomach pains,
thrombocytopenia, hemolytic anemia
Nursing Considerations: Allergy to any ASA, monitor for salicylate toxicity. In adults, a sensation of
fullness in the ears, tinnitus, and decreased or muffled hearing are the most frequent symptoms.
1.115. Clopidogrel
(Plavix)
Class: Antiplatelet
Actions: prolongs bleeding time, thereby reducing atherosclerotic events in high-risk patients. Onset: 2hr.
reaches steady state in 3-7 days Half-life: 8hr.
Indications: acute coronary syndrome (ST or non-ST elevations). Secondary of MI, stroke, and vascular
death
Norm. Dosage, Freq, Route, Range: PO 75mg/day Max: 75mg/day
Side Effects: fatigue, back pain, diarrhea, nausea, headache, dizziness
Nursing Considerations: Monitor for S&S of GI bleeding. Lab tests: platelet count, and lipid profile
1.116. Dipyridamole
(Apo-Dipyridamole)
Class: Antiplatelet; Platelet Aggregate Inhibitor
Actions: Nonnitrate coronary vasodilator that increase coronary blood flow by selectively dilating coronary
arteries, thereby increasing myocardial oxygen supply. Peak: 45-150 min.
Indications: Prevention of thromboembolism in cardiac valve replacement, Thromboembolic Disorders,
Thallium Stress Test
Norm. Dosage, Freq, Route, Range: PO 150-400 mg/day in divided doses Max: 400 mg/day
Side Effects: headache, dizziness, faintness, syncope, weakness
Nursing Considerations: monitor therapeutic effectiveness
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30. Proton Pump Inhibitor

1.117. Omeprazole
(Prilosec, Prilosec OTC)
Class: Proton Pump Inhibitor (PPI); Antisecretory
Actions: Suppresses gastric acid secretion relieving gastrointestinal distress and promoting ulcer healing.
Onset: 0.5-3.5hr. Peak: 5 days
Indications: GERD, Duodenal Ulcer, Erosive Esophagitis, Hyper secretory disease, gastric ulcer
Norm. Dosage, Freq, Route, Range: PO 20-40mg once/day for 4-8 weeks Max: 360mg/day
Side Effects: headache, dizziness, fatigue, diarrhea, abdominal pain, nausea
Nursing Considerations: Lab tests: monitor urinalysis for hematuria and proteinuria, periodic LFTs w/
prolonged use.
1.118. Pantoprazole
(Protonix)
Class: Gastric Proton Pump Inhibitor; Antisecretory
Actions: suppresses gastic acid secretion by inhibiting the acid (proton H+) pump in the parietal cells.
Peak: 2-4hrs.
Indications: short-term treatment of erosive esophagitis associated w/ gastroesphageal reflux disease
(GERD), hyper secretory
Norm. Dosage, Freq, Route, Range: PO 40mg daily for 7-10days Max: 40mg/day
Side Effects: diarrhea, flatulence, abdominal pain, headache, insomnia, rash
Nursing Considerations: Lab tests: Urea breath test 4-6 wks after completion of therapy. Monitor for
severe skin reaction
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31. H2- Receptor Antagonist

1.119. Famotidine
(Pepcid)
Class: Antisecretory (H2-Receptor Antagonist)
Actions: reduces parietal cell output if hydrochloric acid; thus, detrimental effects of acid on gastric mucosa
are diminished. Onset: 1hr Peak: 1-3hr Duration: 10-12hr
Indications: short-term treatment of active duodenal ulcer, GERD, gastritis
Norm. Dosage, Freq, Route, Range: PO 40mg at bedtime or 20mg bid IV 20 mg q12hr. Max: 40mg/day
Side Effects: dizziness, headache, confusion, depression, constipation, diarrhea
Nursing Considerations: Monitor for improvement in GI distress. Monitor for signs of GI bleeding. Be
aware that pain relief may not be experience for several days.
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32. Cerebral Stimulant

1.120. Amphetamine Sulfate
(Adderall)
Class: Cerebral Stimulant; Anorexiant
Actions: Marked stimulant effect on CNS thought to be due to action on cerebral cortex & possibly the
reticular activating system. Acts indirectly on adrenergic receptors by increasing synaptic release of
norepinephrine in the brain & by blocking reuptake of norepinephrine at the presynaptic membrane. Peak:
1-5hr. Duration: Up to 10hr.
Indications: Narcolepsy; Attention Deficit Disorder (ADD)
Norm. Dosage, Freq, Route, Range: PO 10mg ER once daily in a.m.; may increase by 5-10mg at weekly
intervals if need to max of 30mg/day
Side Effects: Sudden death; irritability; restlessness; insomnia; euphoria; palpitation
Nursing Considerations: Monitor S&S of toxicity in children; monitor for S&S of insomnia or anorexia;
monitor BP & HR; monitor diabetic closely; monitor growth in children; meticulous oral hygiene is required
because of decreased saliva; rinse mouth frequently with clear water; avoid caffeine-containing beverages
because caffeine increase amphetamine effects; taper drug on withdrawal
1.121. Methylphenidate HCL

(Ritalin, Focalin, Concerta)
Class: Cerebral Stimulant
Actions: Acts mainly on cerebral cortex exerting stimulant effect. Peak: 1.9hr. 4-7hr. sustained release,
2hr. transdermal Duration: 3-6hr., 8 hr. sustained release
Indications: Narcolepsy; Attention Deficit Disorder (ADD)
Norm. Dosage, Freq, Route, Range: PO immediate release products 20-30mg/day in divided doses
Concerta extended release 18-36mg/day
Side Effects: nervousness, insomnia, exfoliative dermatitis
Nursing Considerations: Monitor BP & pulse at appropriate intervals; Lab tests: obtain periodic CBC w/
diff & platelet counts during prolonged therapy; monitor closely pt. w/ history of alcoholism; supervise drug
withdrawal; check weight at least 2-3 times weekly & report weight loss; check height & weight in children,
failure to gain in either should be reported to prescriber; w/hold patch from an ADHD child who exhibits
anxiety, tension, or agitation & consult prescriber
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33. Antihistamines
1.122. Diphenhydramine
(Benadryl)
Class: Centrally acting cholinergic antagonist, Antihistamine, h1-receptor antagonist
Actions: suppresses central cholinergic activity and prolongs action of dopamine by inhibiting its reuptake
and storage. Onset: 15-30 min. Peak: 1-4hr. Duration: 4-7hr.
Indications: temporary symptomatic relief of various allergic conditions and to treat or prevent motion
sickness, vertigo, and reactions to blood or plasma in susceptible patients
Norm. Dosage, Freq, Route, Range: PO 25-50mg tid or qid Max: 300mg/day IV/IM 10-50mg q4-6hr Max:
400mg/day
Side Effects: drowsiness, tachycardia, dry mouth
Nursing Considerations: supervise ambulation, monitor cardiovascular status, do not use with alcohol
and other CNS depressants, increase fluid intake
1.123. Hydroxyzine HCL

(Atarax)
Class: Antihistamine, H1-receptor antagonist
Actions: H1 receptor antagonist blocks histamine. Onset: PO 15-30min. Duration: 4-6hrs.
Indications: Anxiety; Pruritus; Nausea
Norm. Dosage, Freq, Route, Range: PO 50-100mg tid IM 50-100mg q4-6hrs.
Side Effects: drowsiness, dizziness, headache, hypotension, urticarial, dyspnea, chest tightness,
wheezing, involuntary motor activity
Nursing Considerations: reduce if CNS depressants are prescribed concomitantly, monitor oral
membranes, alertness and drowsiness
1.124. Hydroxyzine Pamoate

(Vistaril)
Class: Antihistamine, H1-receptor antagonist
Actions: H1 receptor antagonist blocks histamine. Onset: PO 15-30min. Duration: 4-6hrs.
Indications: Anxiety; Pruritus; Nausea
Norm. Dosage, Freq, Route, Range: PO 50-100mg tid IM 50-100mg q4-6hrs.
Side Effects: drowsiness, dizziness, headache, hypotension, urticarial, dyspnea, chest tightness,
wheezing, involuntary motor activity
Nursing Considerations: reduce if CNS depressants are prescribed concomitantly, monitor oral
membranes, alertness and drowsiness
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1.125. Promethazine
(Phenergan)
Class: Antihistamine, Antiemetic, Antivertigo
Actions: Long-acting derivative of phenothiazine with marked antihistamine activity and prominent
sedative, amnesic, and anti-motion sickness actions. Onset: PO/PR/IM 20 min IV 5 min Duration: 2-8 hr
Indications: Motion sickness, nausea, pruritus sedation
Norm. Dosage, Freq, Route, Range: PO/PR 25mg q12hr Max: 50mg
Side Effects: drowsiness, blurred vision, dry mouth
Nursing Considerations: supervise ambulation, monitor respiratory function, drug may suppress cough
reflex and cause thickening of bronchial secretions
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34. Antidiabetic
1.126. Glipizide
(Glucotrol)
Class: Antidiabetic, Sulfonylurea
Actions: It lowers blood glucose level by stimulating pancreatic beta cells. Glipizide improves postprandial
glycemic control. Onset: 15-30 min. Peak: 1-2 hr. Duration up to 24 hr.
Indications: Adjunct to diet for control of hyperglycemia in patient with type 2 diabetes mellitus.
Norm. Dosage, Freq, Route, Range: PO: 2.5-5 mg/day 30 min. before breakfast, may increase by 2.5-5
mg q1-2 wk; greater than 15mg/day in divided doses before morning and evening meals Max: 40 mg/day
Side Effects: hypoglycemia, anorexia, nausea, epigastric discomfort, heartburn, diarrhea, allergic skin
reactions
Nursing Considerations: Observe for early signs of hypoglycemia, lab tests: monitor fasting and
postprandial blood glucose, and periodic HgbA1C, LFTs, electrolytes and serum osmolarity, must be made
aware of the potential for hypoglycemia responses.
1.127. Glyburide
(DiaBeta, Glynase)
Class: Antidiabetic; Sulfonylurea
Actions: One of the most potent of the 2nd generation sulfonylurea hypoglycemic agents. Appears to lower
blood sugar concentration in both diabetic and nondiabetic individuals by sensitizing pancreatic beta cells
to release insulin in the presence of elevated serum glucose levels. Onset: 15-60min. Peak: 1-2hr.
Duration: up to 24hr. Half-life: 10hr.
Indications: adjunct to diet and exercise to lower blood glucose in patients with type 2 diabetes mellitus.
Norm. Dosage, Freq, Route, Range: PO 1.25mg-5mg/day, may increase by 2.5-5mg q1-2wk; greater
than 15mg/day should be given in divided doses with morning and evening meal Max: 20mg/day
Side Effects: hypoglycemia, nausea, vomiting, blurred vision
Nursing Considerations: Monitor blood glucose levels carefully, monitor at regular intervals: Fasting and
postprandial blood glucose, HbA1C, and LFTs.
1.128. Insulin (Regular)

(Humulin R, Novolin R)
Class: Antidiabetic, short-acting insulin
Actions: Lowers blood glucose levels by increasing peripheral glucose uptake and by inhibiting the liver
from changing glycogen to glucose. Onset: 0.5-1hr. Peak: 2-4hr. Duration: 5-7hrs.
Indications: Emergency treatment of diabetic ketoacidosis or coma, to initiate therapy in patient w/ insulindependent diabetes, an in combo w/ inter.-acting or long-acting insulin to provide better control of blood
glucose concentration.
Norm. Dosage, Freq, Route, Range: SQ 5-10 units 30-60 min a.c and at bedtime (dose adjustments
based on blood glucose determinations)
Side Effects: hypoglycemia, nausea, palpitation, profuse sweating, hunger, tremulousness, weakness,
fatigue, numb mouth and tongue
Nursing Considerations: lab tests: periodically monitor fasting and postprandial blood glucose and
HbA1C, test urine for ketones in new, unstable & Type 1 diabetes, if patient lost weight, exercises
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vigorously, or has an illness, whenever blood glucose is substantially elevated (Onset: 0.5-1 hr. Peak: 2-4
hr. Duration: 5-8 hr.)
1.129. Insulin (NPH)

(Humulin N, Novolin N)
Class: Antidiabetic, Intermediate-acting insulin
Actions: Controls post-pyramidal hyperglycemia, usually w/o supplemental doses of insulin injection.
Onset: 1-2hr. Peak: 4-12hrs. Duration: 18-24hrs.
Indications: Used to control hyperglycemia in the diabetic patient.
Norm. Dosage, Freq, Route, Range: SQ 5-10 units 30-60 min a.c and at bedtime (dose adjustments
based on blood glucose determinations)
Side Effects: hypoglycemia, nausea, palpitation, profuse sweating, hunger, tremulousness, weakness,
fatigue, numb mouth and tongue
Nursing Considerations: lab tests: periodically monitor fasting and postprandial blood glucose and
HbA1C, test urine for ketones in new, unstable and Type 1 diabetes, if patient lost weight, exercises
vigorously, or has an illness, whenever blood glucose is substantially elevated (Onset: 1-2 hr. Peak: 4-12
hr. Duration: 10-18hr.)
1.130. Insulin Detemir

(Levemir)
Class: Antidiabetic; Long-acting insulin
Actions: effective as a glucose-lowering agent, w/ glycemic control equivalent to that of NPH insulin. Peak:
6-8hrs.
Indications: treatment of diabetes mellitus
Norm. Dosage, Freq, Route, Range: SQ 0.1-0.2units/kg daily in evening or 10units daily or bid in evenly
spaced doses
Side Effects: hypoglycemia, weight gain, allergic reactions, rash
Nursing Considerations: Monitor for S&S of hypoglycemia. Periodic fasting blood glucose and HbA1C,
serum potassium with concurrent potassium-lowering drugs
1.131. Insulin Glargine

(Lantus)
Class: Antidiabetic long-acting insulin
Actions: Lowers blood glucose levels over an extended period of time. It also prevents the conversion of
glucagon to glucose in the liver. Onset: 3-4hrs. Duration: 10.4-24hrs.
Indications: Bedtime dosing of adults and children w/ type 1 diabetes, or adults w/ type 2 diabetes
Norm. Dosage, Freq, Route, Range: SQ for Type 1: if not taking insulin, give 10 units at same time each
day (usually at bedtime) once daily, adjust based on patient need and concurrent medication SQ Type 2: if
already taking oral hypoglycemic drugs, start w/ 10 units at same time each day (usually at bedtime) once
daily and adjust according to patients need
Side Effects: hypoglycemia, hypokalemia, injection site reaction
Nursing Considerations: monitor for S&S of hypoglycemia, lab tests: periodically monitor fasting and
postprandial blood glucose and HbA1C (Onset: 2-8 hr. Peak: none Duration: 5-24 hr.)
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1.132. Insulin Lispro

(Humalog)
Class: Antidiabetic; Rapid-Acting Insulin
Actions: It lowers blood glucose levels and inhibits liver from changing glycogen to glucose. Onset: less
than 15 minutes Peak: 0.5-1hr Duration: 3-4hr.
Indications: Diabetes Mellitus
Norm. Dosage, Freq, Route, Range: SQ 5-10 units 0-15min before meals (dose adjustments based on
blood glucose determinations)
Side Effects: hypoglycemia, hypokalemia, injection site reaction
Nursing Considerations: monitor for S&S of hypoglycemia, lab tests: periodically monitor fasting and
postprandial blood glucose and HbA1C
1.133. Metformin
(Glucophage)
Class: Antidiabetic; Biguanide
Actions: Effective in lowering serum glucose level and ultimately, the HbA1C valve. Peak: 1-3hr. Half-life:
6.2-17.6hr.
Indications: treatment of type 2 diabetes mellitus as adjunct to diet and exercise
Norm. Dosage, Freq, Route, Range: PO start w/ 500mg daily tid or 850mg daily bid w/ meals, may
increase by 500-850mg/day q1-3wk Max: 2550mg/day
Side Effects: nausea, vomiting, abdominal pain, diarrhea, bitter or metallic taste, bloatedness, anorexia
Nursing Considerations: Monitor vital signs and fasting and postprandial blood glucose valves, monitor
cardiopulmonary status, Lab tests: baseline and periodic LFTs, kidney function tests, hematologic
parameters for anemia, periodic fasting blood glucose, and HbA1C q3months.
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Drug Med Cards
35. Antihypoglycemic
1.134. Glucagon
(Glucagen)
Class: Antihypoglycemic
Actions: increases blood glucose secondary to gluconeogenesis, which is the breakdown of glycogen in
the liver. Onset: 5-20 min. Peak: 30 min. Duration: 1-1.5hr. Half-life: 3-10 min.
Indications: hypoglycemia, radiologic studies of GI Tract
Norm. Dosage, Freq, Route, Range: IM/IV/SQ 1mg may repeat q5-20min if no response for 1-2more
doses
Side Effects: nausea, vomiting, Stevens-Johnson syndrome
Nursing Considerations: be prepared to give IV glucose if patient fails to respond to glucagon
Page 60 of 75
Drug Med Cards
36. Anti-fungal
1.135. Metronidazole
(Flagyl)
Class: Antitrichomonal; Amebicide
Actions: Has direct trichomonacidal and amebicial activity; exhibits antibacterial activity against obligate
anaerobic bacilli, and Clostridia. Peak: 1-3 hr.
Indications: Trichomoniasis, Giardiasis, Amebiasis, Pseudomembranous Colitis, Rosacea
Norm. Dosage, Freq, Route, Range: PO 7.5 mg/kg q6hr. IV Loading Dose 1.5 mg/kg IV Maintenance
Dose 7.5 mg/kg q6hr. Max: 4 g/day
Side Effects: Candida, Nausea
Nursing Considerations: Discontinue therapy immediately if symptoms of CNS toxicity develop, Monitor
for seizures and peripheral neuropathy, Lab tests: obtain total and differential WBC count before, during,
and after therapy, monitor S&S of sodium retention, monitor patients on lithium, report appearance of
candidiasis, repeat feces exam, usually up to 3 months to ensure that amebae have been eliminated.
1.136. Ticonozole
(Monistat Cream)
Class: Anti-fungal
Actions: spectrum antifungal that inhibits the growth of yeast (Candida Albacans)
Indications: Vulvovaginal candidiasis
Norm. Dosage, Freq, Route, Range: 6.5% vaginal ointment, intra vaginal x1day (one full applicator at
bed time)
Side Effects: mild erythema, burning, discomfort, rash, and itching
Nursing Considerations: monitor for sensitization, and allergic response.
Page 61 of 75
Drug Med Cards
37. Eye Drops

1.137. Brimonidine Tartrate
(Alphagan P)
Class: Carbonic Anhydrase Inhibitor; Sulfonamide
Actions: to reduce IOP and to protect the lens during surgery and laser iridotomy; to counteract effects of
mydriatics and cycloplegics following surgery or, ophthalmoscopic exam
Indications: Intraoperative and postsurgical increase in IOP, Open-Angle Glaucoma, Glaucoma
Norm. Dosage, Freq, Route, Range: 1-2 drops per eye/day
Side Effects: diminished vision in poorly illuminated areas, headache, drowsiness
Nursing Considerations: Do not use in patients with Sulfa allergies
1.138. Timolol Maleate

(Timoptic GTTS)
Class: Beta-Adrenergic Antagonist, eye prep, miotic, antihypertensive, antuanginal
Actions: GTTS: lowers elevated and normal IOP by reducing formation of aqueous humor/may increase
out flow. Peak: PO 1-2hr. Topical: 1-5hrs.
Indications: Chronic, open angle glaucoma, sec. glaucoma, or ocular hypertension
Norm. Dosage, Freq, Route, Range: 0.25%, 0.5% one drop bid
Side Effects: eye irritant, conjunctivitis, blepharitis, keratitis, superficial punctuate
Nursing Considerations: pulse before administering oral or topical, BP for any extreme rates or
rhythm
Page 62 of 75
Drug Med Cards
38. Antidepressant
1.139. Bupropion HCL
(Wellbutrin, Zyban, Aplenzin, Budeprion)
Class: Antidepressant
Actions: The neurochemical mechanisms of bupropion is not fully understood. It selectively inhibits the
neuronal reuptake of dopamine. Onset: 3-4wks. Peak: 1-3hrs.
Indications: Depression/Seasonal Affective Disorder
Norm. Dosage, Freq, Route, Range: PO 100mg tid (immediate release) or 150mg bid (SR), or 300mg
daily (XL), doses greater than 450mg/day are associated w/ an increased risk of adverse reactions including
seizures Max: 300mg/day
Side Effects: agitation, insomnia, dry mouth, blurred vision, headache, dizziness, tremor, nausea,
vomiting, constipation.
Nursing Considerations: Lab tests: periodic renal function tests and LFTs; monitor for and report
delusions, hallucinations, psychotic, episodes, confusion, and paranoia; report significant restlessness,
agitation, anxiety, and insomnia; monitor weight weekly; report promptly suicidal thoughts; do not take any
OTC drugs w/o consulting physician.
1.140. Desvenlafaxine
(Pristiq)
Class: Antidepressant; Serotonin Norepinephrine Reuptake Inhibitor (SNRI)
Actions: Potent inhibitor of neuronal serotonin and norepinephrine reuptake. Onset: 2wks. Peak: 1-2hrs.
Duration: extensively tissue bound
Indications: Depression; Anxiety
Side Effects: increased BP & HR, dizziness, somnolence, suicidality, nausea, vomiting, dry mouth,
sweating
Nursing Considerations: Monitor for worsening of depression or emergence of suicidal ideation; monitor
cardiovascular status periodically w/ measurements of BP & HR; Lab tests: periodic lipid profile; monitor
neurologic status and report excessive anxiety, nervousness, and insomnia; monitor weight periodically
and report excess weight loss; avoid using alcohol
1.141. Duloxetine
(Cymbalta)
Class: Antidepressant; Selective Serotonin Norepinephrine Reuptake Inhibitor (SSNRI)
Actions: Causes potentiation of serotonergic and noradrenergic activity in the CNS. Antidepressant and
antianxiety effects are presumed to be due to its dual inhibition of CNS presynaptic neuronal uptake of
serotonin and norepinephrine, this increasing the serum levels of bith substances. Peak: 6hrs.
Indications: Depression; Generalized Anxiety/Diabetic Neuropathy/Musculoskeletal Pain; Fibromyalgia
Norm. Dosage, Freq, Route, Range: PO 40-60mg/day in 1-2 divided doses
Side Effects: insomnia, dry mouth, constipation
Nursing Considerations: Monitor for S&S of numerous drug-drug interactions; Lab tests: LFTs for
unexplained abdominal pain or enlarged liver; monitor closely for and report suicidal ideation; report
emergence of any of the following: anxiety, insomnia, agitation, panic attacks, irritability, hostility,
psychomotor restlessness, hypomania, and mania
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Drug Med Cards
1.142. Mirtazapine
(Remeron)
Class: Tetracyclic Antidepressant; Anxiolytic
Actions: Acts as antidepressant. Effectiveness is indicated by mood elevation. Peak: 2 hr.
Indications: Depression
Norm. Dosage, Freq, Route, Range: PO 15mg/day in a single dose at bedtime, may increase Q1-2week
Max: 45mg/day
Side Effects: Somnolence, increased appetite, constipation, dry mouth
Nursing Considerations: Lab tests: monitor WBC count w/ differential, lipid profile, and ALT/AST
periodically, monitor for worsening of depression or suicidal ideation, asses for weight gain and excessive
somnolence or dizziness, monitor for orthostatic hypotension w/ a Hx of cardiovascular disease or
cerebrovascular disease.
1.143. Trazadone
(Desyrel, Oleptro)
Class: Antidepressant
Actions: Centrally acting antidepressant that potentiates serotonin effects by selectively blocking its
reuptake at presynaptic membranes in CNS. Onset: 1-2wks. Peak: 1-2hrs.
Norm. Dosage, Freq, Route, Range: PO 150mg/day in divided doses, may increase by 50mg/day q34days Max: 400-600mg/day (Immediate release) PO 150mg/day may increase by 75mg/day at 3 day
intervals Max: 375mg/day (Extended release)
Side Effects: drowsiness, hypotension (including orthostatic hypotension), dry mouth
Nursing Considerations: Monitor BP & HR & rhythm; monitor for orthostatic hypotension; be aware that
overdose is characterized by an extension of common adverse effects: vomiting, lethargy, drowsiness, and
exaggerated anticholinergic effects.
1.144. Venlafaxine
(Effexor)
Class: Antidepressant; Serotonin Norepinephrine Reuptake Inhibitor (SNRI)
Actions: Potent inhibitor of neuronal serotonin and norepinephrine reuptake. Onset: 2wks. Peak: 1-2hrs.
Duration: extensively tissue bound
Indications: Depression; Anxiety
Side Effects: increased BP & HR, dizziness, somnolence, suicidality, nausea, vomiting, dry mouth,
sweating
Nursing Considerations: Monitor for worsening of depression or emergence of suicidal ideation; monitor
cardiovascular status periodically w/ measurements of BP & HR; Lab tests: periodic lipid profile; monitor
neurologic status and report excessive anxiety, nervousness, and insomnia; monitor weight periodically
and report excess weight loss; avoid using alcohol
Page 64 of 75
Drug Med Cards
39. Tricyclic Antidepressants

1.145. Amitriptyline HCL
(Elavil)
Class: Tricyclic Antidepressant
Actions: a tricyclic antidepressant that inhibits the reuptake of serotonin (5-HT) and norepinephrine from
the synaptic gap; also inhibits norepinephrine reuptake to a moderate degree. Peak: 2-12hrs.
Indications: Antidepressant
Side Effects: drowsiness, sedation, dizziness, orthostatic hypotension, dry mouth, constipation, urinary
retention, bone marrow suppression
Nursing Considerations: Lab tests: baseline and periodic leukocyte and differential counts, renal and
hepatic function tests, monitor BP and pulse rate, monitor I&O and bowel elimination pattern
1.146. Doxepin HCL

(Sinequan, Prudoxin, Silenor, Zonalon)
Class: Tricyclic Antidepressants; Anxiolytic
Actions: inhibits serotonin reuptake from the synaptic gap; also inhibits norepinephrine reuptake to a
moderate degree. Peak: 2hrs.
Indications: Depression/Anxiety; Insomnia (Silenor), Dermatitis
Norm. Dosage, Freq, Route, Range: PO 25-150mg/day in divided doses, may increase up to 300mg/day
Max: 300mg/day
Side Effects: drowsiness, orthostatic hypotension, dry mouth, blurring or stinging at application site
Nursing Considerations: monitor use of other CNS depressants, including alcohol; be alert to changes
in voiding and evaluate pt. for constipation and abdominal distention; maintain established dosage regimen
and avoid change of intervals, doubling, reducing, or skipping doses.
1.147. Imipramine HCL

(Tofranil)
Class: Tricyclic Antidepressant (TCA)
Actions: TCAs potentiate both norepinephrine and serotonin in the CNS by blocking their reuptake. Peak:
1-2hr.
Indications: Depression; enuresis
Norm. Dosage, Freq, Route, Range: PO 75-100mg/day Max: 300mg/day in 1 or more divided doses.
Side Effects: sedation, drowsiness, angioedema, orthostatic hypotension, arrhythmias, MI, heart block,
blurred vision, slight mydriasis, dry mouth, urinary retention, agranulocytosis, thrombocytopenia
Nursing Considerations: Lab tests: monitor periodic LFTs, renal function, CBC w/ diff, and fluid and
electrolyte balance, monitor HR and BP frequently, report EPS, Avoid exposure to sunlight and use
sunscreen
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Drug Med Cards
1.148. Nortriptyline HCL

(Aventyl, Pamelor)
Class: Tricyclic Antidepressant
Actions: Secondary amine derivative of amitriptyline that inhibits that action of many chemical agents
including catecholamines. Mood elevation may be due to its inhibition of reuptake of serotonin or another
neurotransmitter at the presynaptic membrane. Peak: 7-8.5hrs. Duration: Crosses placenta; distributed in
breast milk
Indications: Antidepressant; Nocturnal Enuresis
Norm. Dosage, Freq, Route, Range: PO 25mg tid or qid, gradually increase to 100-150mg/day
Side Effects: orthostatic hypotension, dry mouth, agranulocytosis, urinary retention
Nursing Considerations: monitor BP & pulse rate during adjustment period, if systolic BP fall more than
20mm Hg or if there is a sudden increase in pulse rate, w/hold medication and notify prescriber; inspect
oral membranes daily; monitor bowel elimination pattern and I&O ratio; do not use OTC drugs unless your
prescriber approves
Page 66 of 75
Drug Med Cards
40. Selective Serotonin Reuptake Inhibitor (SSRI)

1.149. Citalopram Hydrobromide
(Celexa)
Class: Selective Serotonin Reuptake Inhibitor (SSRI)
Actions: SSRI w/ an antidepressant effect presumed to be linked to its inhibition of CNS presynaptic
neuronal uptake of serotonin. Peak: steady-state serum concentrations in 1wk; peak blood levels at 4hrs.
Norm. Dosage, Freq, Route, Range: PO start at 20mg/day, may increase to 40mg/day if needed
Side Effects: nausea, dry mouth, insomnia, somnolence
Nursing Considerations: watch closely for worsening of depression or emergence of suicidal ideations;
Lab tests: monitor periodically hepatic function, CBC, serum sodium, and lithium levels when the two drugs
are given concurrently; monitor periodically HR & BP, and carefully monitor complete cardiac status in
person w/ known or cardiac disease; avoid alcohol
1.150. Escitalopram Oxalate

(Lexapro)
Class: Antidepressant; Selective Serotonin Reuptake Inhibitor (SSRI)
Actions: antidepressant effect is presumed to be linked to its inhibition of CNS presynaptic neuronal
uptake of serotonin. Onset: Approximately 1 wk. Peak: 3hr Half-life: 25hr
Indications: depression, generalized anxiety disorder
Norm. Dosage, Freq, Route, Range: PO 10mg daily, may increase to 20mg daily if needed after 1 wk
Max: 20mg/day
Side Effects: nausea, insomnia, somnolence, decreased libido
Nursing Considerations: closely observe for worsening of depression or suicide, Lab tests: monitor
periodically LFTs, serum sodium, and lithium levels, monitor periodically HR and BP and carefully monitor
complete cardiac status
1.151. Fluoxetine HCL

(Prozac)
Class: Selective Serotonin Reuptake Inhibitor (SSRI), Antidepressant
Actions: antidepressant effect is presumed to be linked to inhibition of CNS neuronal uptake of serotonin
Indications:
disorder
depression, gastric depression, OCD, bulimia, premenstrual dysphoric disorder, panic
Norm. Dosage, Freq, Route, Range: PO 20mg/day in AM, may increase by 20mg/day at weekly intervals
Max: 80mg/day
Side Effects: headache, nervousness, anxiety, insomnia, nausea, diarrhea
Nursing Considerations: Monitor renal and hepatic functions. Supervise patients closely who are high
suicide risks. Lab tests: periodic serum electrolytes, monitor closely plasma glucose in diabetes.
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1.152. Paroxetine
(Paxil, Pexeva)
Actions: It is highly potent and a highly selective inhibitor of serotonin reuptake by neurons in CNS. Onset:
2wks. Peak: 5-8hrs.
Indications: Depression; OCD; Panic Attacks; Social Anxiety; Generalized Anxiety, PTSD; Premenstrual
Dysphoric Disorder
Norm. Dosage, Freq, Route, Range: PO 10-50mg/day Max: 80mg/day
Side Effects: Headache, sedation, nausea, dry mouth
Nursing Considerations: monitor for worsening of depression or emergence of suicidal ideation; monitor
for significant weight loss; monitor pt. w/ history of mania for reactivation of condition; monitor pts. w/
preexisting cardiovascular disease carefully because paroxetine may adversely affect hemodynamics
status
1.153. Sertraline HCL

(Zoloft)
Actions: Effective in controlling depression, obsessive-compulsive disorder, anxiety, and panic disorder.
Onset: 2-4 weeks
Indications: Depression, Anxiety, Obsessive-Compulsive Disorder
Norm. Dosage, Freq, Route, Range: begin w/ 50mg/day, gradually increase every few weeks according
to response Max: 200mg/day
Side Effects: agitation, insomnia, headache, dizziness, somnolence, fatigue
Nursing Considerations: supervise patients at risk for suicide closely, monitor for worsening of
depression or emergence of suicidal ideation, monitor older adults for fluid and sodium imbalances, monitor
patients w/ a Hx of a seizure disorder closely, lab tests: monitor PT /INR w/ patients receiving concurrent
warfarin therapy
1.154. Vilazodone
(Vibryd)
Class: Selective Serotonin Reuptake Inhibitor (SSRI); Psychotherapeutic Agent; Antidepressant
Actions: Antidepressant is presumed to be linked to inhibition of CNS neuronal uptake of the
neurotransmitter, serotonin. Peak: 4-5hrs.
Indications: Major Depressive Disorder
Norm. Dosage, Freq, Route, Range: PO initial dose of 10mg/day for 7 days, increase to 20mg/day for 7
days, then to 40mg/day
Side Effects: dizziness, diarrhea, nausea
Nursing Considerations: monitor for worsening of depression or emergence of suicidal ideation; supervise
pts. Closely who are high suicide risks; do not stop medication abruptly
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Drug Med Cards
41. Monoamine Oxidase Inhibitors (MAOIs)

1.155. Isocarboxazid
(Marplan)
Class: Antidepressant; MAOI
Actions: Inhibits monoamine oxidase, the enzyme involved in the catabolism of catecholamine
neurotransmitters and serotonin. Duration: up to 2wks.
Indications: Refractory Depression
Norm. Dosage, Freq, Route, Range: PO 10-30mg/day in 1-3 divided doses Max: 30mg/day
Side Effects: drowsiness, overactivity, insomnia, orthostatic hypotension, paradoxical hypertension,
blurred vision, nausea, constipation, anorexia, urinary retention, dry mouth
Nursing Considerations: Monitor BP for orthostatic hypotension, monitor for therapeutic effectiveness,
monitor and report promptly signs of clinical deterioration or suicidal ideation, check for peripheral edema
daily and monitor weight several times weekly and monitor weight several times weekly, toxic symptoms
from over-dosage or from substances or from ingestion of contraindicated substances (e.g., foods high in
tyramine) may occur w/in hours
1.156. Phenelzine Sulfate

(Nardil)
Actions: potent hydrazine MAOI. Antidepressant action believed to be due to irreversible inhibition of
MAOI, thereby permitting increased conxentrations of endogenous epinephrine, norepinephrine, serotonin,
and dopamine w/in presynaptic neurons and at receptor sites. Onset: 2 weeks
Norm. Dosage, Freq, Route, Range: PO 1.5mg tid, rapidly increase to at least 60mg/day, may need up
to 90mg/day Max: 90mg/day
Side Effects: orthostatic hypotension, insomnia, respiratory depression, coma, hypertensive crisis,
circulatory collapse, constipation, dry mouth, nausea, vomiting, anorexia, leukopenia
Nursing Considerations: Monitor BP and Pulse, Lab tests: baseline and periodic CBC and LFTs; pts on
prolonged therapy should be checked periodically for altered color perception, changes in fundi or visual
fields, changes in red-green vision may be the 1st indication of eye damage, strict thymine diet
1.157. Tranylcypromine Sulfate

(Parnate)
Actions: Potent MAO w/ a antidepressant activity that arises from the increased availability of monoamines
resulting from the inhibition of the enzyme MAO. This leads to increased concentration of neurotransmitters,
such as epinephrine, norepinephrine, and dopamine in the CNS. Onset: 10 days
Indications: Severe Depression
Norm. Dosage, Freq, Route, Range: PO 30mg/day in 2 divided doses, may increase by 10mg/day at 23wk intervals Max: 60mg/day
Side Effects: Orthostatic hypotension, hypertensive crisis
Nursing Considerations: monitor BP closely, sever hypertensive reactions are known to occur with
MAOIs; monitor for changes in behavior; do not eat tyramine-containing foods; be aware of excessive use
of caffeine-containing beverages; make position changes slowly; avoid alcohol and other CNS depressants
Page 69 of 75
Drug Med Cards
42. Anti-Emetic
1.158. Ondansetron HCL
(Zofran)
Class: 5-HT3 Anatagonist, Antiemetic
Actions: Prevents nausea and vomiting associated with cancer chemotherapy and anesthesia. Peak: 11.5hr Half-life: 3hr
Indications: prevention of nausea and vomiting associated with initiation and repeated courses of cancer
chemotherapy, including high-dose cisplatin; postoperative nausea and vomiting
Norm. Dosage, Freq, Route, Range: PO 8-24mg 30 min before chemotherapy, than q8hr times 2 more
doses
Side Effects: headache, sedation, diarrhea
Nursing Considerations: monitor fluid and electrolyte status, cardiovascular status
Page 70 of 75
Drug Med Cards
43. Antituberculosis
1.159. Isoniazid
(INH, Laniazid)
Class: Anti-infective; Antituberculosis
Actions: Exerts bacteriostatic action against actively growing tubercle bacilli, may be bactericidal in higher
concentrations. Peak: 1-2 hr
Indications: Treatment of Active Tuberculosis, preventative therapy
Norm. Dosage, Freq, Route, Range: PO/IM 5mg/kg Max: 300 mg/day
Side Effects: Paresthesias, peripheral neuropathy, hepatotoxicity (elevated AST, ALT; bilirubinemia;
jaundice; hepatitis)
Nursing Considerations: Monitor for therapeutic effectiveness, w/hold drug and notify prescriber
immediately of a hypersensitivity reaction, Lab tests: monitor LFTs periodically, monitor for and report signs
of hepatotoxicity, monitor BP, check weight at least twice weekly under standard conditions
Page 71 of 75
Drug Med Cards
44. Substance Abuse Deterrent

1.160. Acamprosate Calcium
(Campral)
Class: Substance Abuse Deterrent
Actions: Reduces craving for alcohol intake due to chronic use, but does not cause alcohol aversion or a
disulfiram-like reaction as a result of alcohol ingestion. Half-life: 20-33hr.
Indications: Maintenance of Alcohol Abstinence
Norm. Dosage, Freq, Route, Range: PO 666mg tid
Side Effects: diarrhea, flatulence
Nursing Considerations: Monitor S&S of depression or suicidal thinking; monitor
or impaired judgment or thinking, dizziness or impaired motor skills; report promptly unusual anxiousness
or nervousness, depression or suicidal thoughts, burning or tingling sensations in arms, legs, hands or feet,
chest pains or palpitations, or difficulty urinating; report any alcohol consumption during therapy.
1.161. Antabuse
Class: Enzyme Inhibitor; Anti-Alcoholic Agent
Actions: Acts as a deterrent to alcohol ingestion by inhibiting the enzyme acetaldehyde dehydrogenase,
which normally metabolizes alcohol in the body. Onset: Up to 12hr. Duration: Up to 2wk. Onset: Up to 12hr.
Duration: Up to 2wk.
Indications: Alcoholism
Norm. Dosage, Freq, Route, Range: PO 500mg/day for 1-2wk, then 125-500mg/day Max: 500mg/day
Side Effects: marked respiratory depression, unconsciousness, convulsions, sudden death, hepatotoxicity
Nursing Considerations: Lab tests: baseline & follow-up transaminase studies every 10-14 days to detect
hepatic dysfunction; treat pt. w/ severe disulfiram reaction as though in shock, monitor potassium levels,
especially if pt. has diabetes mellitus; explain the danger of alcohol ingestion during treatment to pt.; report
promptly to prescriber the onset of nausea w/ RUQ pain or discomfort, itching, jaundiced sclera or skin,
dark urine or clay-colored stools, w/hold drug pending LFTs
Page 72 of 75
Drug Med Cards
45. Bone Metabolism Regulatory

1.162. Pamidronate
(Aredia)
Class: Bisphosphonate (Bone Metabolism Regulatory)
Actions: Reduces bone turnover and, when used in combination with adequate hydration, it increases
renal excretion of calcium, thus reducing serum calcium concentrations. Onset: 24-48 hr Peak: 6 days
Duration: 2 weeks-3months
Indications: Moderate to severe hypercalcemia of malignancy, Pagets Diease, Osteolytic Metastases
Norm. Dosage, Freq, Route, Range: IV 60-90 mg infused over 4-24 hr, may repeat in 7 days
Side Effects: fever w/ or w/o rigors, thrombophlebitis at injection site, hypocalcemia, epigastric discomfort
Nursing Considerations: Assess IV injection site for thrombophlebitis, Lab tests: monitor serm calcium,
phosphate, magnesium, and potassium at frequent intervals; CBC with defferential, Hct and Hgb; and
kidney function tests throughout course of therapy, monitor for S&S of hypocalcemia, hypokalemia,
hypomagnesemia and hypophosphatemia, monitor for seizures, monitor vital signs
Page 73 of 75
Drug Med Cards
46. Bacterial Collagenase Enzyme

1.163. Collagenase Clostridum Histolyticum
(Xiaflex)
Class: Bacterial Collagenase enzyme
Actions: Collagenases are proteinases that hydrolyze collagen in its native triple helical conformation
under physiological conditions, resulting in lysis of collagen deposits.
Indications: Dupuytrens contracture, Peyronies Disease
Norm. Dosage, Freq, Route, Range: Topical 1-3x daily to affected areas
Side Effects: mild pain or tenderness in treated hand, cracked skin, under arm pain
Nursing Considerations: call physician if fever, chills, body aches, flu symptoms, or swollen glands in
your elbow or under arm, watch for bleeding, bruising, swelling, redness, warmth, numbness, tingling, or
sudden pain or loss of movement
Page 74 of 75
Drug Med Cards
Bibliography
Ebersole, P., Hess, P., Touhy, T.A., Schmidt Logan, A., & Jett, K. (2008) Toward healthy aging: Human
needs and nursing response ( 7th ed.). St. Louis, MO: Mosby.
Eliopoulous C. (2009). Gerontological nursing. ( 7th ed.). Philadelphia, PA: Lippincott Williams & Wilkins.
Grodner, M., Long, S., & Walkingshaw,B.C. (2007). Foundations and clinical application of nutrition: A
nursing approach ( 4th ed.). St. Louis, MO: Mosby.
Ignatavicius, D. D., & Workman, M. L. (2010). Medical-Surgical nursing (6th ed.). St. Louis, MO:
Saunders.
Lowdermilk, D.L.,& Perry, S.E. ( 2007) . Maternity & womens health care (9th ed.). St. Louis, MO: Mosby.
Lehne, R.A. (2010). Pharmacology for nursing care (7th ed.). St. Louis, MO: Saunders.
Lilley, L. L., Harrington, S., & Snyder, J.S. (2007). Pharmacology and the nursing process (5th ED.). St.
Louis, MO: Mosby.
Roach, S. S.,& Ford, S. M. (2008). Introductory clinical pharmacology. Philadelphia, PA: Lippincott
Williams & Wilkins.
Smeltzer, S. C., Bare, B.G., Hinkle, J. L., & Cheever, K.H. ( 2008). Brunner and Suddarths textbook of
medical-surgical nursing ( 11th ed.). Philadelphia, PA: Lippincott Williams & Wilkins.
Page 75 of 75
Acyclovir
Amantadine HCl
(Zovirax)
(Symmetrel)
Class: Antiviral
Class: Antiviral; Central-Acting Cholinergic Receptor Antagonist; Antiparkinson
Actions: reduces viral shedding and formation of new lesions and speeds healing
time. Peak: 1.5-2hr. Half-life: 2.5-5hr.
Actions: Because Amantadine does not suppress antibody formation, it can be

administered for interim protection in combination w/ influenza. Onset: w/in 48hrs.
Peak: 1-4hrs
Indications: (IV treatment) viral encephalitis, herpes simplex, varicella-zoster virus

(shingles/chickpox); (orally) herpes simplex, varicella-zoster virus; (topically) herpes
labialis (cold sores) and initial episodes of herpes gentitalis
Indications: Influenza A Treatment; Influenza A Preventative; Parkinsonism; DrugInduced Extrapyramidal Symptoms (EPS)
Norm. Dosage, Freq, Route, Range: PO 400mg bid Max: 800mg/day
Norm. Dosage, Freq, Route, Range: PO 100mg 1-2times/day
Side Effects: headache, nausea, vomiting, diarrhea
Side Effects: dizziness, light-headedness, difficulty in concentrating, insomnia,

leukopenia
Nursing Considerations: Monitor I&O & hydration status. Lab tests: baseline and
periodic renal function tests
Nursing Considerations: Lab tests: pH and serum electrolytes; monitor and report
mental status changes, nervousness, difficulty concentrating, or insomnia, loss of
seizure control, S&S of toxicity, especially in doses over 200mg/day
Alprazolam
Diazepam
(Xanax)
(Diastat, Valium)
Class: Anxiolytic; Sedative-Hypnotic; Benzodiazepine
Class: Benzodiazepine Anticonvulsant; Anxiolytic
Actions: A CNS depressant that appears to act at the limbic, thalamic, and
hypothalamic levels of the CNS. Has antianxiety and sedative effects w/ addictive
potential. Peak: 1-2 hr. Halh-life: 12-15 hr.
Actions: Long-acting benzodiazepine psychotherapeutic agent. Benzodiazepines act

at the limbic. Thalamic, and hypothalamic regions of the CNS and produce CNS
depression resulting in sedation, and anticonvulsant activity dependent on the
dosage. Onset: PO 30-60 min Peak: PO 1-2 hr Duration: IV 15 min-1 hr PO up to 3 hr
Indications: Anxiety Disorders, Panic Attacks

Indications: Status Epilepticus, Muscle Spasm, Anxiety, Alcohol Withdrawal, Pre-op
Norm. Dosage, Freq, Route, Range: PO 0.25-5 mg tid Max: 4 mg/day
Norm. Dosage, Freq, Route, Range: IV/IM 5-10 m, repeat if needed at 10-15 min
intervals up to 30 mg, then repeat if needed q2-4hr
Side Effects: Drowsiness, sedation

Nursing Considerations: Monitor S&S of drowsiness and sedation, especially in
older adults or the debilitated, Lab tests: CBC, urinalysis and blood chemistry studies
particularly during continuing therapy
Side Effects: Drowsiness, fatigue, confusion, vivid dreams, headache

Nursing Considerations: Monitor for adverse reactions, Monitor for therapeutic
effectiveness-max effect may require 1-2 week, monitor for and report promptly
signs of suicidal ideation especially in those treated for anxiety states accompanied
by depression, observe patient closely and monitor vital signs when diazepam is
given parentally; hypotension, muscular weakness, tachycardia, and respiratory
depression may occur, Lab tests: periodic CBC and LFTs
Lorazepam
Temazepam
(Ativan)
(Restoril)
Class: Anxioltic; Sedative-Hypnotic; Benzodiazepine
Class: Benzodiazepine, Anxiolytic, Sedative-Hypnotic
Actions: most potent of the available benzodiazepine. Effects (antianxiety, sedative,

hypnotic, and skeletal muscle relaxant) are mediated by the inhibition
neurotransmitter GABA. Action sites are thalamic, hypothalamic, and limbic levels of
CNS. Onset: IV 1-5 min. IM 15-30 min. Peak: IM 60-9 min. PO 2 hr Duration 12-24 hr
Actions: reduces night awakenings and early morning awakenings; increases total
sleep times, absence of rebound effects. Onset: 30-50 min. Peak: 2-3hr. Duration:
10-12hr. Half-life: 8-24hr
Indications: to relieve insomnia
Indications: Antianxiety, Insomnia, Premedication, Status Epilepticus

Norm. Dosage, Freq, Route, Range: PO 7.5-30mg at bedtime Max: 30mg/night
Norm. Dosage, Freq, Route, Range: PO 2-6 mg/day in divided doses Max: 10
mg/day
Side Effects: drowsiness, sedation, dizziness, weakness
Nursing Considerations: Supervise ambulation, Lab tests: Assess CBC and LFTs
periodically
Side Effects: drowsiness, dizziness, lethargy

Nursing Considerations: hypersensitivity, Lab tests: LFTs and kidney function tests
during long-term use, be aware of S&S of overdose: weakness, confusion, slurred
speech, ataxia, coma w/ reduced or absent reflexes, hypertension and respiratory
depression

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