Generic

Name

Brand
Name

Classifica
tion

Dosag
e

Mechanis
m of
Action


Indication


Contraindications


S.E/ A.R
Nursing
Implications/Respo
nsibilities
paraceta
mol
tylenol

Paraminop
henol
derivatives

300mg
TIV q4

Thought to
produce
analgesia
by blocking
pain
impulses
by
inhibiting
synthesis
of
prostaglan
din in the
CNS/ other
subs. that
sensitize
pain
receptors
to
stimulation
. The drug
may
relieve
fever
through
central
action in
the
hypothala

Mild pain
or fever

Hypersensiti
ve to drug
Use
cautiously in
patients with
long term
alcohol use
because
therapeutic
doses cause
hepatotoxicit
y in these
patients

Hematolog
ic:
hemolytic
anemia
Hepatic:
jaundice
Metabolic:
hypoglyce
mia
Skin:rashe
s, urticaria

Alert: many
OTC
prescriptions
contain
acetaminophe
n, be aware of
this when
calculating
total daily
dose
Warn patients
that high-dose
can cause
liver damage.
excessive
alcohol intake
increase risk
of liver
disease.

mic heat-
regulating
center



Generic
Name

Brand
Name

Classifica
tion

Dosag
e

Mechanis
m of
Action


Indication


Contraindications


S.E/ A.R
Nursing
Implications/Respo
nsibilities
Nimodipin
e
Nimoto
p

Calcium
channel
blocking
agent
30
mg/tab
2tabs
Q4

Has a
greater
effect on
cerebral
arteries
than
arteries
elsewhere
in the body
(probably
due to its
highly
lipophilic
properties)
.
Mechanis
m to
reduce
neurologic
deficits
following
subarachn
oid
hemorrhag
e not
known.
prevention
of cerebral
vasospasm
and
resultant
ischemia
contraindicated in
unstable angina or
an episode of
myocardial
infarction more
recently than one
month
CV:
Hypotensio
n,
peripheral
edema,
CHF, ECG
abnormaliti
es,
tachycardia
,
bradycardia
,
palpitations
, rebound
vasospasm
,
hypertensio
n,
hematoma,
DIC, DVT.
GI:
Nausea,
dyspepsia,
diarrhea,
abdominal
discomfort,
cramps, GI
hemorrhag
Take the
history of the
client if he
has unstable
angina or an
episode of
myocardial
infarction.
The client may
experience
side effects
May cause
reductions in
blood
pressure. Use
caution in
hepatic
impairment.
Intestinal
pseudo-
obstruction
and ileus have
been reported
during the use
of nimodipine.
Use caution in
patients with
decreased GI
e vomiting.
CNS:
Headache,
depression,
lightheaded
ness,
dizziness.
Hepatic:
Abnormal
LFT,
hepatitis,
jaundice.
Hematologi
c:
Thrombocyt
openia,
anemia,
purpura,
ecchymosis
motility of a
history of
bowel
obstruction.
Use caution
when treating
patients with
increased
intracranial
pressure.


Generic
Name

Brand
Name

Classifica
tion

Dosag
e

Mechanis
m of
Action


Indication


Contraindications


S.E/ A.R
Nursing
Implications/Respo
nsibilities
phenytoin Dilantin

anticonvul
sant
100
mg IV
Q8

The
mechanis
m of action
is not
definitely
known, but
extensive
research
strongly
suggests
that its
main
mechanis
m is to
block
frequency-,
use- and
voltage-
dependent
neuronal
sodium
channels,
and
therefore
limit
repetitive
firing of
action
Dilantin is
indicated
for the
control of
generalize
d tonic-
clonic
(grand
mal) and
complex
partial
(psychomo
tor,
temporal
lobe)
seizures
and
prevention
and
treatment
of seizures
occurring
during or
following
neurosurge
ry.


Phenytoin is
contraindicat
ed in those
patients who
are
hypersensitiv
e to
phenytoin or
other
hydantoins.

CNS:
nystagmus,
ataxia,
slurred
speech,
decreased
coordinatio
n, and
mental
confusion.
Dizziness,
insomnia,
transient
nervousnes
s, motor
twitchings,
and
headaches
Phenytoin
should not be
given at the
same time as
a "tube
feeding,"
since this
may decrease
the level of
the medicine
in your blood.
The
medication
should be
taken at the
same times
each day to
maintain
even levels
of phenytoin
in your
blood.
potentials.
At usual
levels,
there is
little or no
change in
normal
patterns of
firing. At
high or
toxic
levels,
however,
phenytoin
can impair
the
function of
healthy
neurons.


For the
medication
to work
properly, it
must be
taken as
prescribed.
Phenytoin
will not work
if you stop
taking it.




Generic
Name

Brand
Name

Classifica
tion

Dosag
e

Mechanis
m of
Action


Indication


Contraindications


S.E/ A.R
Nursing
Implications/Respo
nsibilities
Lactulose
Cephul
ac


Laxative
30 cc
ODHS

Produces
increased
osmotic
pressure
within
colon and
acidifies its
contents,
resulting in
increased
stool water
content
and stool
softening.
Causes
migration
of
ammonia
from blood
into colon,
where it is
converted
to
ammonium
ion and
expelled
through
laxative

Treatment
of
constipation
; prevention
and
treatment of
portal-
systemic
encephalopa
thy,
including
stages of
hepatic
precoma
and coma.

Use in patients who
require low-galactose
diet.

Gaseous
distention
with
flatulence or
belching,
abdominal
discomfort
and
cramping;
diarrhea;
nausea;
vomiting.

Advise patient
that drug can be
mixed with fruit
juice, water, or
milk to make it
more palatable.
Inform patient
that drug may
cause belching,
flatulence, or
abdominal
cramps. Instruct
patient to notify
health care
provider if
these symptoms
become
bothersome or
if diarrhea
occurs.
Instruct patient
not to take other
laxatives while
receiving
lactulose
therapy.
Encourage
patient to
action.

increase dietary
fiber and fluid
intake and
participate in
regular
exercise.



Generic
Name

Brand
Name

Classifica
tion

Dosag
e

Mechanis
m of
Action


Indication


Contraindications


S.E/ A.R
Nursing
Implications/Respo
nsibilities
Celecoxib Celcoxx

NSAID

200mg
/tab
Q8

Celecoxib is
a highly
selective
COX-2
inhibitor
and
primarily
inhibits this
isoform of
cyclooxyge
nase
(inhibition
of
prostaglandi
n
production),
whereas
traditional
NSAIDs
inhibit both
COX-1 and
COX-
2.
[citation
needed]

Celecoxib is
approximate
ly 7.6 times
more

osteoarthritis
, rheumatoid
arthritis,
acute pain,
painful
menstruation
and
menstrual
symptoms,
and to
reduce the
number of
colon and
rectal polyps
in patients
with familial
adenomatou
s polyposis.
Allergy to
celecoxib or
any of its
ingredients;
allergy to
sulfonamides;
aspirin triad
(eg, asthma,
nasal polyps,
allergy to
aspirin);
previous
allergic
reactions
following
aspirin or other
NSAID use (eg,
asthma, hives,
rash).
CNS:
Dizzi
ness;
head
ache;
sleep
lessn
ess.
GI:
Stom
ach
pain;
diarr
hea;
indig
estio
n;
gas;
nause
a.
RESP:
Sinus
infect
ion;
cong
ested
or
runn
Assess for signs
and symptoms
of
hypersensitivity
.
Take a
complete drug
history and
monitor
potential
drug/drug
interactions and
contraindication
s that should be
reported to the
primary care
provider.
Monitor for
signs of GI
bleeding,
adverse CNS
symptoms, and
any other
adverse events.
Monitor for
signs of skin
rash.
Monitor for
selective for
COX-2
inhibition
over COX-
1.
[citation
needed]
In
theory, this
selectivity
allows
celecoxib
and other
COX-2
inhibitors to
reduce
inflammatio
n (and pain)
while
minimizing
gastrointesti
nal adverse
drug
reactions
(e.g.
stomach
ulcers) that
are common
with non-
selective
NSAIDs.
Celecoxib
inhibits
y
nose;
upper
respir
atory
tract
infect
ion;
sore
throa
t.
OTHER:
Back
pain;
swell
ing
of
arms
or
legs;
accid
ental
injur
y;
rash.

signs and
symptoms of
decreased renal
function: Serum
creatinine,
BUN,
unexpected
weight gain,
edema.
Monitor for
signs of
hypophosphate
mia and
hyperchloremia.
Monitor hepatic
function, as
decreased
hepatic function
may require a
reduced dose.

COX-2
without
affecting
COX-1.
COX-1 is
involved in
synthesis of
prostaglandi
ns and
thromboxan
e, but COX-
2 is only
involved in
the
synthesis of
prostaglandi
n.
Therefore,
inhibition of
COX-2
inhibits only
prostaglandi
n synthesis
without
affecting
thromboxan
e and thus
has no
effect on
platelet
aggregation
or blood
clotting.



Generic
Name

Brand
Name

Classifica
tion

Dosag
e

Mechanis
m of
Action


Indication


Contraindications


S.E/ A.R
Nursing
Implications/Respo
nsibilities
Mannitol
Osmitro
l
Paraminop
henol
derivatives

300mg
TIV q4

Thought to
produce
analgesia
by blocking
pain
impulses
by
inhibiting
synthesis
of
prostaglan
din in the
CNS/ other
subs. that
sensitize
pain
receptors
to
stimulation
. The drug
may
relieve
fever
through
central
action in
the
hypothala
Promotion
of diuresis,
in
promotion
or
treatment
of oliguric
phase

Reduction
of ICP and
treatment
of cerebral
edema by
reducing
brain mass

Reduction
of
intraocular
pressure
when it
cannot be
lowered by
any means


Well-
established
anuria due to
severe renal
disease.
Severe
pulmonary
congestion
or frank
pulmonary
edema.
Active
intracranial
bleeding
except
during
craniotomy.
Severe
dehydration.
Progressive
renal
damage or
dysfunction
after
institution of
Mannitol
therapy,
including
Metabolic:
fluid and
electrolyte
imbalance,
acidosis,
dehydratio
n.
Gastrointe
stinal:
dryness of
mouth,
nausea,
vomiting,
diarrhea.
Genitourin
ary:
osmotic
nephrosis,
urinary
retention.
Central
This
medication
can only be
given by
infusion.
Report
immediately
any muscle
weakness,
numbness,
tingling,
acute
headache,
nausea,
dizziness,
blurred
vision, eye
pain,
respiratory
difficulty,
chest pain, or
pain at
infusion site.
mic heat-
regulating
center

increasing
oliguria and
azotemia.

Nervous
System:
headache,
convulsion
s,
dizziness.
Special
Senses:
Blurred
vision,
rhinitis.
Cardiovasc
ular:
pulmonary
edema,
hypotensi
on,
hypertensi
on,
tachycardi
a, angina-
like chest
pains.
Dermatolo
gic: skin
necrosis,
thrombop
hlebitis.
Hypersens
itivity:
urticaria.
Miscellane
ous: thirst,
arm pain,
chills,
fever.



Generic
Name

Brand
Name

Classifica
tion

Dosag
e

Mechanis
m of
Action


Indication


Contraindications


S.E/ A.R
Nursing
Implications/Respo
nsibilities
Nicardipin
e
Carden
e

Calcium
channel
blockers

Drip
titrated

Inhibits
calcium ion
from
entering the
"slow
channels"
or select
voltage-
sensitive
areas of
vascular
smooth
muscle and
myocardium
during
depolarizati
on,
producing a
relaxation of
coronary
vascular
smooth
muscle and
coronary
vasodilation
; increases
myocardial
oxygen
delivery in
patients
with

hypertensi
on

Nicardipine
hydrochloride is
contraindicated in
patients with
hypersensitivity
to the drug.

Body
as a
Whol
e:
infecti
on,
allergi
c
reacti
on
Cardi
ovas
cular:
hypot
ensio
n,
postu
ral
hypot
ensio
n,
Report immediately
any swelling, redness,
burning, or pain at
infusion site.
vasospastic
angina
atypic
al
chest
pain,
perip
heral
vascu
lar
disord
er,
ventri
cular
extras
ystole
s,
ventri
cular
tachy
cardia
Diges
tive:
sore
throat
,
abnor
mal
liver
chemi
stries
Musc
ulosk
eletal
:
arthra
lgia
Nerv
ous:
hot
flashe
s,
vertig
o,
hyper
kinesi
a,
impot
ence,
depre
ssion,
confu
sion,
anxiet
y
Respi
rator
y:
rhiniti
s,
sinusi
tis
Speci
al
Sens
es:
tinnitu
s,
abnor
mal
vision
,
blurre
d
vision
Urog
enital
:
increa
sed
urinar
y
frequ
ency



Generic
Name

Brand
Name

Classifica
tion

Dosag
e

Mechanis
m of
Action


Indication


Contraindications


S.E/ A.R
Nursing
Implications/Respo
nsibilities
Esomepra
zole
Nexium

Proton
pump
inhibitor

10mg
IV OD

Esomepra
zole is a
proton
pump
inhibitor
that
suppresse
s gastric
acid
secretion
by specific
inhibition
of H+/K+-
ATPase in
the gastric
parietal
cell. By
acting
specifically
on the
proton
pump,
esomepraz
ole blocks
the final
step in
acid
production,

H. pylori
Eradication
to Reduce
the Risk of
Duodenal
Ulcer
Recurrence

Treatment
of
Gastroesop
hageal
Reux
Disease
(GERD)
(1.1)

Risk
Reduction
of NSAID-
Associated
Gastric
Ulcer

NEXIUM is
contraindicate
d in patients
with known
hypersensitivit
y to any
component of
the
formulation or
to substituted
benzimidazole
s. (
H
e
a
d
a
c
h
e

D
i
a
r
r
h
e
a

A
b
d
o
m
i
n
a
l

p
a
i
n

Alert: many
OTC
prescriptions
contain
acetaminophe
n, be aware of
this when
calculating
total daily
dose
Warn patients
that high-dose
can cause
liver damage.
excessive
alcohol intake
increase risk
of liver
disease.

thus
reducing
gastric
acidity.
This effect
is dose-
related up
to a daily
dose of 20
to 40 mg
and leads
to
inhibition
of gastric
acid
secretion.