Generic Name:! !

metoprolol succinate

Trade Name:! ! Toprol!! ! ! ! ! ! !

!
Classification:! ! Anti-Hypertensive

Action:! ! ! Lowers B/P by blocking effects. Used to treat mild to moderate

! ! ! ! hypertension, acute MI to reduce cardiovascular mortality.

Route:! ! ! PO (Oral Route)

! ! ! ! Intravenous

Dosage:! ! ! PO 100mg/day. Maximum 450mg/day. Average dosage is 275mg.

Side Effect:! ! ! Insomnia, depression, bradycardia, pulmonary edema, diarrhea

Nursing Implication:! Monitor intake and output daily. Monitor B/P during initial treatment.
! ! ! ! Monitor pulse every four hours. Check apical and radial pulse
! ! ! ! before administration. Check for edema in feet or legs daily.
Generic Name:! ! amlodipine besylate

Trade Name:! ! Norvasc

Classification:! ! Anti-Anginal/ Anti-hypertensive

Action:! ! ! Inhibits calcium ion influx across cell membrane during cardiac
! ! ! ! depolarization. Produces relaxation of coronary vascular smooth muscle,
! ! ! ! peripheral vascular smooth muscle; dilates coronary vascular arteries

Route:! ! ! PO (Oral route) tablet

Dosage: ! ! ! PO 2.5 mg/day; Maximum: 10 mg/day; Average: 6.25 mg/day

Side Effect:! ! ! headache, dizziness, dysrhythmia, bradycardia, hypotension

Nursing Implication: ! Notify prescriber of irregular heartbeat, shortness of breath, swelling of

! ! ! ! feet and hands, severe dizziness, constipation, nausea, hypotension;
! ! ! ! Change positions slowly to prevent orthostatic hypotension; Monitor
! ! ! ! cardiac status (B/P, pulse, respiration, ECG); Assess I & O ratio, weight
! ! ! ! daily
Generic Name:! phenytoin sodium

Trade Name:! ! Dilantin

Classification:! Anticonvulsant, Antidysrhythmic

Action:! ! Inhibits spread of seizure activity in motor cortex by altering ion transport; increases AV
! ! ! conduction. Used for generalized tonic clonic seizure.

Route:!! ! PO (Oral Route) Suspension, tablet, chewable, Capsule, Extended Release

! ! ! Intravenous; Nasogastric; Intramuscular injections

Dosage:! ! PO 300-400mg/day. Maximum 600mg/day. Average dosage 433mg

Side Effects:! ! Dizziness, Hypotension, ventricular fibrillation, constipation, blurred vision

Nursing Implication:!Continuously monitor vital signs and symptoms during IV infusion and for an hour afterward.
Watch for respiratory depression. Constant observation and a cardiac monitor are necessary with
older adults or patients with cardiac disease. Margin between toxic and therapeutic IV doses is
relatively small. Observe patient closely for neurologic adverse effects following IV administration.
Have on hand oxygen, atropine, vasopressor, assisted ventilation, seizure precaution equipment
(mouth gag, nonmetal airway, suction apparatus). Make sure patients on prolonged therapy have
adequate intake of vitamin D-containing foods and sufficient exposure to sunlight.
Generic Name: furosemide

Trade name: Lasix

Classification: Loop Diuretic

Action: Inhibits reabsorption of sodium and chloride at proximal and distal tubule and in the loop
of Henle. Used in treatment of Pulmonary Edema in CHF, hepatic disease, nephrotic
syndrome, ascites, and hypertension.

Route: PO (Oral Route) Tablet or solution

Intramuscular injections
Intravenous

Dosage: PO 20-80mg/day. Maximum 600mg/day. Average dosage is 233mg.

Side Effects: Headache, Orthostatic Hypotension, loss of hearing, polyuria,

pruritus, diarrhea

Nursing Implication: closely monitor vital signs. Observe older adults closely during period of brisk diuresis.
Sudden alteration in fluid and electrolyte balance may precipitate significant adverse
reactions. Monitor for signs and symptoms of hypokalemia. Monitor Intake and output.
Report decrease or unusual increase in output. Excessive diuresis
can result in dehydration and hypovolemia, circulatory collapse, and hypotension. Weigh
patient daily under standard conditions.
Generic Name: docusate sodium

Trade Name: Colace

Classification: Laxative, Stool softener

Action: Increases water, fat penetration in intestine, allows for easier

passage of stool. Used to soften stools.

Route: PO (Oral Route) capsules, liquid, syrup, tablets

Enema

Dosage: PO 50-300mg/day. Average dose is 175mg

Side Effect: Nausea, throat irritation, diarrhea, rash, cramps

Nursing Implication: Assess for cramping rectal bleeding, nausea or vomiting

and discontinue this drug if any of these occur. Capsules should be
swallowed whole and not crushed or chewed. Capsules should be
stored in a cool place. Teach the patient that it can take several
days before their stools begin to soften.
Generic Name: lansoprazole

Trade Name: Pevacid

Classification: Anti-ulcer, proton pump inhibitor

Action: Suppresses gastric secretion by inhibiting hydrogen/potassium

ATPhase enzyme system in gastric parietal cell. Used to treat
Gastroesophageal reflux disease (GERDS). Also used to treat
gastric and duodenal ulcers.

Route: PO (Oral route) tablet, capsule, packet

Nasogastric

Dosage: PO 15-30mg/day. Average dose is 22.5mg

Side Effects: headache, angina, tachycardia, bradycardia, hematuria

Nursing Implication: Monitor bowel sounds every 8 hours. Monitor abdomen for pain,
swelling, anorexia. Swallow capsule whole before eating; don’t
crush or chew caps. Caps may be opened and contents sprinkled
on food.
Generic Name: sitagliptin

Trade Name: Januvia

Classification: Antidiabetic

Action: DPP-4 inhibitor, which is believed to exert its actions in patients with type
2 diabetes by slowing the inactivation of incretin hormones.

Route: PO (Oral route) tablet

Dosage: 100 mg/day; Average: 100 mg/day

Side Effect: allergic reactions, pancreatitis, diarrhea, headache, upper respiratory

infection

Nursing Implication: Patients be informed about the importance of adherence to dietary instructions, regular
physical activity, periodic blood glucose monitoring and A1C testing, recognition and
management of hypoglycemia and hyperglycemia, and assessment for diabetes
complications. Patients should be informed of the symptoms of acute pancreatitis and
! ! ! ! when to contact their prescriber. If symptoms of allergic reactions (including rash, hives,
! ! ! ! and swelling of the face, lips, tongue, and throat that may cause difficulty in breathing or
! ! ! ! swallowing) occur, patients should seek medical advice promptly
Generic Name: buspirone Hcl

Trade Name: Buspar

Classification: Antianxiety

Action: Inhibits the actions of serotonin (5-HT)

Route: PO (Oral Route) tablets

Dosage: PO 5 mg tid Maximum: 60 mg/day Average dose is 37.5 mg/day

Side Effect: depression, nervousness, tachycardia, blurred vision, palpitations

Nursing Implication: Assess for B/P, pulse, CNS reactions, mental status (mood, affect,
sleeping pattern); Administer with food or milk for GI symptoms; Crushed if
patient unable to swallow whole; Give sugarless gum, hard candy or
frequent sips of water for dry mouth; Assist with ambulation during
beginning therapy; Safety measures if drowsiness occurs; Avoid alcohol;
Medication should not be discontinued abruptly
Generic Name: duloxetine

Trade Name: Cymbalta

Classification: Antidepressant

Action: Unknown; may potentiate serotonergic, nonadrenergic activity in the CNS;

in studies, it is a potent inhibitor of neuronal serotonin and norepinephrine
reuptake

Route: PO (Oral Route) capsules

Dosage: PO 20 mg bid; Maximum: 30 mg bid; Average dose is 25 mg bid

Side Effect: insomnia, anxiety, decreased appetite, decreased weight, abnormal vision

Nursing Implication: Assess B/P, weight loss or gain; mental status (depression, panic, suicidal
tendencies) Capsules should be swallowed whole and not crushed or
chewed. Assist with ambulation during beginning therapy (dizziness);
Avoid alcohol ingestion; Teach patient not to discontinue quickly after long
term use (may cause nausea, headache, malaise)
Generic Name: digoxin

Trade Name: Lanoxin

Classification: Cardiac Glycoside

Action: Inhibits the sodium-potassium ATPase making more Ca available for

contractile proteins resulting in increased cardiac output; increases force
of contraction, decreases heart rate

Route: PO (Oral Route) capsules, tablets, elixir

Intravenous

Dosage: PO 0.75 - 1.25 mg, every 4 - 8 hrs; Maximum: 1.25 mg ; Average dose is
1 mg

Side Effect: headache, drowsiness, confusion, hypotension, dysrhythmias

Nursing Implication: Assess apical pulse for 1 min prior to giving drug; Monitor electrolytes, I & O
ratio, daily weights, turgor, lung sounds, edema and cardiac status; Do not break,
crush or chew caps; PO with or without foods (may crush tabs); Potassium
supplements if ordered; Teach patient toxic symptoms of drug and when to notify
prescriber and to report shortness of breath, difficulty breathing, weight gain,
edema and persistent cough; Maintain sodium-restricted diet as ordered