DRUG NAME/ DRUG ACTION INDICATION CONTRAINDICATION SIDE EFFECT/ NURSING

CLASSIFICATION/ ADVERSE EFFECT CONSIDERATION

DOSAGE ROUTE AND
FREQUENCY

Enalapril 1. Hypertension 1. Diabetes (it can Side effect: Baseline assessment:

Orally-active 2. Heart failure lower the sugar level Frequent: Headache, Obtain B/P
Classification: ↓ in your blood) dizziness. immediately before
Pharmacotherapeutic Long-acting non 2. Heart, liver or Occasional: each dose (be alert to
: sulfhydryl kidney problems Orthostatic fluctuations). In pts
Angiotensin-converti antihypertensive hypotension, fatigue, with renal
ng enzyme (ACE) agent diarrhea, cough, impairment,
inhibitor. ↓ syncope autoimmune disease,
Clinical: That suppresses the Rare: Angina, or taking drugs that
Antihypertensive, renin-angiotensin-ald abdominal pain, affect
vasodilator. osterone system vomiting, nausea, leukocytes/immune
↓ rash, asthenia (loss of response, CBC should
Dosage route and To lower blood strength, energy). be performed before
frequency: pressure beginning therapy,
PO: Adults, elderly: ↓ Adverse effect: q2wks for 3mos, then
2.5-5 mg/day Makes it easier for - Excessive periodically
Children 1mo-16 your heart to pump hypotension thereafter.
years: 0.08 blood around your (“first-dose syncope”) Intervention/
mg/kg/day in 1-2 body. may occur in pts with Evaluation: Assist
divided doses CHF, severe salt or with ambulation if
IV: Adults, elderly: volume depletion. dizziness occurs.
0.625-1.25 mg q6h - Angioedema (facial, Monitor serum
up to 5 mg q6h. lip swelling), potassium, BUN,
Children: 5-10 hyperkalemia occur serum creatinine,
mcg/kg/dose rarely. CBC, B/P. Monitor
q8h-24h. - Agranulocytosis, daily pattern of
neutropenia may be bowel activity, stool
noted in pts with consistency.
renal impairment,
collagen vascular Patient/Family
diseases teaching: To reduce
(scleroderma, hypotensive effect,
systemic lupus rise slowly from lying
erythematosus). to sitting position,
- Nephrotic syndrome permit legs to dangle
may be noted in from bed
those with a history momentarily before
of renal disease. standing.
: Several
weeks may be
needed for the full
therapeutic effect of
B/P reduction.
: Skipping
doses or voluntarily
discontinuing drugs
 may produce severe,
rebound
hypertension.
: Inform
physician if vomiting,
diarrhea, diaphoresis,
persistent cough,
swelling of face, lips,
tongue, difficulty in
breathing occurs.

Amlodipine 1. Hypertension NONE KNOWN Side effect: Baseline assessment:

Lowers blood 2. Angina Frequent: Peripheral Assess baseline
Classification: pressure 3. Hepatic edema, headache, renal/hepatic
Pharmacotherapeutic ↓ Impairment flushing. function tests, B/P,
: Calcium channel By relaxing the blood Occasional: Dizziness, apical pulse.
blocker. vessels palpitations, nausea,
Clinical: ↓ unusual fatigue or Interventions/
Antihypertensive, So the heart does not weakness (asthenia). Evaluation: Assess
antianginal have to pump as hard Rare: Chest pain, B/P (if systolic B/P is
↓ bradycardia, less than 90 mmHg,
Dosage route and Controls chest pain orthostatic withhold medication,
frequency: ↓ hypotension. contact physician).
PO: Adults: 5 mg/day By increasing the Assess for peripheral
in single dose. supply of blood to Adverse effect: edema behind medial
: Children: 2.5-5 the heart - Overdose may malleolus (sacral area
mg/day produce excessive in bedridden pts).
*Availability: Tablets: peripheral Assess skin for
2.5 mg, 5 mg, 10 mg. vasodilation, marked flushing. Question for
 hypotension with headache, asthenia
reflex tachycardia. (loss of strength,
energy).

Nystatin 1. Intestinal infection NO KNOWN Side effect: Baseline assessment:

Used to treat fungal 2. Oral candidiasis Occasional: None Confirm that the
Classification: infections of the 3. Vaginal Infections known. cultures, histologic
Pharmacotherapeutic mouth or intestines 4. Cutaneous candida Topical: Skin tests were done for
: Polyene antifungal ↓ infections irritation. accurate diagnosis.
antibiotic. Works by stopping 5. Cutaneous candida Vaginal: Vaginal Inspect oral mucous
Clinical: Antifungal. the growth of fungus. infections irritation. membranes.

Dosage route and Adverse effect: Intervention/

frequency: - High doses of oral Evaluation: Assess
PO: form may produce for increased skin
500,000-1,000,000 nausea, vomiting, irritation with topical,
units 18h. diarrhea, GI distress. increased vaginal
discharge with
vaginal application.

Patient/Family
teaching: Do not miss
doses; complete full
length of treatment
(continue vaginal use
during menses).
: Notify the
physician if nausea,
vomiting, diarrhea,
 stomach pain
develops.
: Vaginal: Insert
high in vagina. Check
with a physician
regarding douching,
sexual intercourse.
: Topical: Rub
well into affected
areas. Avoid contact
with eyes. Use cream
or powder on
erythematous areas.
Keep areas clean, dry,
wear light clothing
for ventilation and
separate personal
items in contact with
affected areas.

Atenolol 1. Hypertension - Cardiogenic shock, Side effect: Baseline assessment:

Blocking the action of 2. Angina Pectoris uncompensated Atenolol is generally Assess B/P, apical
Classification: certain natural 3. Acute myocardial heart failure, well tolerated, with pulse immediately
Pharmacotherapeutic chemicals in your infarction` second-or mild and transient before drug is
: Beta1-adrenergic body third-degree heart side effects. administered.
blocker. ↓ block (except with a Frequent: Antianginal: Record
Clinical: Such as epinephrine functioning Hypotension onset, quality (sharp,
Antihypertensive, ↓ pacemaker), sinus manifests as cold dull, squeezing),
antianginal, On the heart and bradycardia, sinus extremities, radiation, location,
antiarrhythmic. blood vessels node dysfunction, constipation or intensity, duration of
↓ pulmonary edema, diarrhea, diaphoresis, anginal pain,
Dosage route and Lowers the heart rate and pregnancy. dizziness, fatigue, precipitating factors
frequency: ↓ headache, nausea. (exertion, emotional
PO: 25 mg once a day Lowers the blood Occasional: Insomnia, stress). Assess
*Availability: Tablets: pressure flatulence, urinary baseline
25 mg, 50 mg, 100 ↓ frequency, impotence renal/hepatic
mg. Lowers the strain on or decreased libido, function tests.
the heart depression.
Rare: Rash, Intervention/
arthralgia, myalgia, Evaluation:
confusion (esp. in the Monitor B/P for
elderly), altered hypotension, pulse
taste. for bradycardia,
respiration for
Adverse effect: difficulty in
- Overdose may breathing, EKG.
produce profound Monitor daily pattern
bradycardia, of bowel activity and
hypotension. Abrupt stool consistency.
withdrawal may Assess for evidence
result in diaphoresis, of CHF: dyspnea
palpitations, (particularly o
headache, tremors. exertion or lying
May precipitate CHF, down), night cough,
MI in pts with cardiac peripheral edema,
disease; thyroid distended neck veins.
storm in those with Monitor I&O
thyrotoxicosis; (increased weight,
peripheral ischemia decreased urinary
in those with existing output may indicate
peripheral vascular CHF). Assess
disease. extremities for
Hypoglycemia may coldness. Assist with
occur in previously ambulation if
controlled diabetes. dizziness occurs.
Thrombocytopenia
(unusual bruising, Patient/Family
bleeding) occurs teaching:
rarely. Do not abruptly
discontinue
medication.
Compliance with
therapy essential to
control hypertension,
angina. To reduce
hypotensive effect,
rise slowly from lying
to sitting position and
permit legs to dangle
from bed
momentarily before
standing. Avoid tasks
that require
alertness, motor skills
until response to
drug is established.
Advise diabetic pts to
 monitor blood
glucose carefully
(may mask signs of
hypoglycemia).
Report dizziness,
depresion, confusion,
rash, unusual
bruising/bleeding.
Outpatients should
monitor B/P, pulse
before taking
medication, following
correct technique.
Restrict salt, alcohol
intake. Therapeutic
antihypertensive
effect noted in 1-2
wks.

Furosemide 1. Edema 1. Anuria Side effects: Baseline assessment:

Works by blocking 2. Heart failure Expected: Increased Check vital signs, esp.
Classification: the absorption of 3. Hypertension urinary/frequency B/P, pulse, for
Pharmacotherapeutic sodium volume. hypotension before
: Loop diuretic ↓ Frequent: Nausea, administration.
Clinical: Absorption of dyspepsia, abdominal Assess baseline
Diuretic chloride cramps, diarrhea, or serum electrolytes,
↓ constipation, esp. for hypokalemia.
Dosage route and Absorption of water electrolyte Assess skin
frequency: from the filtered fluid disturbances. turgor,mucous
PO: Adults, Elderly: ↓ Occasional: Dizziness, membranes for
20-80 mg/dose; may In the kidney tubules light-headedness, hydration status;
increase 20-40 ↓ headache, blurred observe for edema.
mg/dose q6-8h. Causing a profound vision, paresthesia, Assess muscle
IV, IM: Adults, increase in the photosensitivity, strength,mental
Elderly: 20-40 output of urine rash, fatigue, bladder status. Note skin
mg/dose; may (diuresis) spasm, restlessness, temperature,
increase 20 mg/dose diaphoresis. moisture. Obtain
q1-2h. Rare: Flank pain. baseline weight.
IV Infusion: Adults, Initiate I&O
Elderly: Bolus of Adverse effect: monitoring.
20-40 mg, followed - Vigorous diuresis
by infusion of 10-40 may lead to profound Intervention/
mg/hr; may double water loss/electrolyte Evaluation:
q2h. depletion, resulting Monitor B/P, vital
in hypokalemia, signs, serum
hyponatremia electrolytes, I&O,
dehydration. Sudden weight. Note extent
volume depletion of diuresis. Watch for
may result in changes from initial
increased risk of assessment
thrombosis, (hypokalemia may
circulatory collapse, result in changes in
and sudden death. muscle strength,
Acute hypotensive temor, muscle
episodes may occur, cramps, altered
sometimes several mental status, cardiac
days after beginning arrhythmias).
therapy. Ototoxicity Hyponatremia may
 (deafness, vertigo, result in confusion,
tinnitus) may occur, thirst, cold/clammy
esp. in pts with skin.
severe renal
impairment. Can Patient/Family
exacerbate diabetes teaching:
melitus, systemic Expect increased
lupus erythematosus, frequency, volume of
gout, pancreatitis. urination. Report
Blood dyscrasias have palpitations, signs of
been reported. electrolyte
imbalances (noted
previously), hearing
abnormalities (sense
of fullness in ears,
tinnitus). Eat foods
high in potassium
such as whole grains
(cereals), legumes,
meat, bananas,
apricots, orange
juice, potatoes
(white, sweet),
raisins. Avoid
sunlight, sunlamps.

Diphenhydramine 1. Moderate to - Acute exacerbation Side effects: Baseline assessment:

Works by blocking a severe allergic of asthma, neonates Frequent: If pt is having an
Classification: certain natural reaction or premature infants, Drowsiness, acute allergic
Pharmacotherapeutic substance 2. Motion sickness breast-feeding. dizziness, muscle reaction, obtain
: Ethanolamine (histamine) 3. Parkinson’s disease weakness, history of recently
Clinical: ↓ 4. Antitussive hypotension, urinary ingested foods,
Antihistamine, That your body 5. Nighttime sleep aid retention, thickening drugs, environmental
anticholinergic, makes during an 6. Pruritus of bronchial exposure, emotional
antipruritic allergic reaction secretions, dry stress. Monitor B/P
antitussive, mouth, nose, throat, rate, depth, rhythm,
antiemetic, lips; in elderly: type of respiration;
antidyskinetic sedation, dizziness, quality, rate of pulse.
hypotension. Assess lung sounds
Dosage route and Occasional: Epigastric for rhonchi,
frequency: distress, flushing, wheezing, and rales.
PO: 25-50 mg 14-6h. visual/hearing
Maximum: 300 disturbances, Intervention/
mg/day paresthesia, Evaluation:
IM, IV: 50 mg; may diaphoresis, chills. Monitor B/P, esp. in
repeat in 20-30 min. elderly (increased risk
Adverse effects: of hypotension).
Hypersensitivity Monitor children
reactions (eczema, closely for
pruritus, rash, cardiac paradoxical reactions.
disturbances,
photosensitivity) may Patient/Family
occur. Overdose teaching:
symptoms may vary Tolerance to
from CNS depression antihistamines effect
(sedation, apnea, generally does not
hypotension, occur; tolerance to
cardiovascular sedative effects may
 collapse, death) to occur. Avoid tasks
severe paradoxical that require
reactions alertness, motor skills
(hallucinations, until response to
tremors, seizures). drug is established.
Children, infants, and Dry mouth,
neonates may drowsiness, dizziness
experience may be an expected
paradoxical reactions response to drugs.
(restlessness, Avoid alcohol.
insomnia, euphoria,
nervousness,
tremors). Overdose in
children may result in
hallucinations,
seizures, and death.

Paracetamol - Analgesia and - Severe hepatic Side effects: Baseline assessment:

A central analgesic Antipyresis impairment or severe Rare: Hypersensitivity If given for analgesia,
Classification: effect that is active liver disease. reaction. assess onset, type,
Pharmacotherapeutic mediated location, duration of
: Central analgesic ↓ Adverse effect: pain. Effect of
Clinical: Through activation of Early signs of medication is
Non-narcotic descending Acetaminophen reduced if full pain
analgesic, antipyretic serotonergic Toxicity: Anorexia, response recurs prior
pathways nausea, diaphoresis, to the next dose.
Dosage route and ↓ fatigue within the Assess for fever.
frequency: Reduces fever first 12-24 hrs. Assess alcohol usage.
IV: 1,000 mg q6h or ↓ Later signs of Toxicity:
650 mg q4h By affecting an area Vomiting, right upper Intervention/
PO: 325-650 mg of the brain quadrant tenderness, Evaluation:
q4-6h or 1 g 3-4 ↓ elevated hepatic Assess for clinical
times a day. That regulated our function tests within improvement and
Rectal: 325-650 mg body temperature 48-72 hrs after relief of pain fever.
q4-6h. ingestion. Therapeutic serum
Antidote: level: 10-30 mcg/ml;
Acetylcysteine. Toxic serum level:
Greater than 200
mcg/ml. Do not
exceed maximum
daily recommended
dose: 4 g/day.

Patient/Family
teaching:
Consult a physician
for use in children
younger than 2 yrs,
oral use longer than 5
days (children) or
longer than 10 days
(adults), or fever
lasting longer than 3
days.
Severe/recurrent
pain or
high/continuous
fever may indicate
 serious illness. Advise
not to take more
than 4 g/24-hr
period. Many
non-prescription
combination
products contain
acetaminophen.
Avoid alcohol use.

Nicardipine 1. Chronic stable - Advanced aortic Side effects: Baseline assessment:

Inhibits the angina stenosis. Frequent: Headache, Concurrent therapy
Classification: transmembrane 2. Essential facial flushing, of sublingual
Pharmacotherapeutic influx of calcium ions hypertension peripheral edema, nitroglycerin may be
: Calcium channel ↓ 3. Short-term light-headedness, used for relief of
blocker Into cardiac muscle treatment of dizziness. angina pain. Record
Clinical: ↓ hypertension Occasional: Asthenia onset, type (sharp,
Antianginal, And smooth muscle 4. Hepatic (loss of strength, dull, squeezing),
antihypertensive ↓ impairment energy), palpitations, radiation, location,
Without changing 5. Renal impairment angina, tachycardia. intensity, duration of
Dosage route and serum calcium Rare: Nausea, anginal pain,
frequency: concentrations abdominal cramps, precipitating factors
IV: 1,000 mg q6h or ↓ dyspepsia (exertion, emotional
650 mg q4h Controls chest pain (heartburn, stress).
PO: 325-650 mg ↓ indigestion, epigastric
q4-6h or 1 g 3-4 By increasing the pain), dry mouth, Intervention/
times a day. supply of blood rash. Evaluation:
Rectal: 325-650 mg ↓ Monitor B/P during
q4-6h. And oxygen to the Adverse effect: and following IV
heart Overdose produces infusion. Assess for
confusion, slurred peripheral edema
speech, drowsiness, behind medial
marked hypotension, malleolus. Assess skin
bradycardia. for facial flushing,
dermatitis, rash.
Question for asthenia
(loss of strength,
energy), headache.
Monitor serum
hepatic enzyme
results. Assess EKG,
pulse for tachycardia.

Patient/Family
teaching:
May take without
regard to food.
Sustained-release
capsule taken whole;
do not break, chew,
crush, or divide.
Avoid alcohol,
grapefruit juice, and
limit caffeine. Inform
physician if angina
pains not relieved or
palpitations,
shortness of breath,
 swelling, dizziness,
constipation, nausea,
hypotension occur.
Avoid tasks requiring
motor skills, alertness
until response to
drug is established.

Dulcolax - Treatments of - Abdominal pain, Side effects: Baseline assessment:

Used to treat Constipation appendicitis, Frequent: Some Observe for evidence
Classification: constipation intestinal degree of abdominal of constipation.
Pharmacotherapeutic ↓ obstruction, nausea, discomfort, nausea, Assess pattern of
: GI stimulant Used to clean out the undiagnosed rectal mild cramps, bowel activity, stool
Clinical: intestines before a bleeding, vomiting, faintness. consistency.
Laxative bowel pregnancy, lactation. Occasional: Rectal
examination/surgery administration: Intervention/
Dosage route and ↓ burning of rectal Evaluation:
frequency: Known as a stimulant mucosa, mild Encourage adequate
PO: 5-15 mg as laxative proctitis. fluid intake. Assess
needed. ↓ bowel sounds for
Rectal, Enema: One Works by increasing Adverse effects: peristalsis. Monitor
1.25-oz bottle in a the movement of the Long-term use may daily pattern of
single daily dose. intestines result in laxative bowel activity, stool
Rectal, Suppository: ↓ dependence, chronic consistency; record
10 mg to induce Helping the stool to constipation, loss of time of evacuation.
bowel movement. come out normal bowel Assess for abdominal
function. Chronic use disturbances.
or overdose may Monitor serum
result in electrolyte electrolytes in those
 or metabolic exposed to
disturbances, prolonged, frequent,
persistent diarrhea, or excessive use of
vomiting, muscle medication.
weakness,
malabsorption, Patient/Family
weight loss. teaching:
Institute measures to
promote defecation:
increase fluid intake,
exercise, high fiber
diet. Do not take
antacids, milk, or
other medication
within 1 hr of taking
medication. Report
unrelieved
constipation, rectal
bleeding, muscle pain
or cramps, dizziness,
weakness. Do not
crush or chew
tablets.

Heparin 1. Line flushing - Pts at risk for Side effects: Baseline assessment:
Inhibits reactions 2. Unstable angina, bleeding (e.g., Occasional: Pruritus, Cross-check dose
Classification: ↓ NSTEMI, Acute bacterial burning caused by with co-worker.
Pharmacotherapeutic That lead to the coronary syndrome endocarditis, vasospastic reaction. Determine aPTT
: Sulfated clotting of blood 3. Thromboembolic uncontrolled Rare: Pain, cyanosis before administration
polysaccharide; ↓ disorders hypertension, of extremity 6-10 and 24hrs following
blood modifier platelet defects), days after initial initiation of therapy,
Clinical: And formation of severe therapy lasting then q24-48hrs for
Anticoagulant fibrin clots thrombocytopenia, 4-6hrs, first wk of therapy or
↓ uncontrolled hypersensitivity until maintenance
Dosage route and Both in vitro and in bleeding. reaction. dose is established.
frequency: vivo Follow with aPTT
IV: 100 units q6-8h. ↓ Adverse effects: determinations 1-2
IV Infusion: 60-70 Used to prevent Bleeding times weekly for 3-4
units/kg bolus, then blood clots complications wks. In long-term
12-15 units/jg/hr. ↓ ranging from local therapy, monitor 1-2
Subcutaneous: 5,000 From forming in ecchymoses to major times a mo.
units q8-12h. people who have hemorrhage occur
medical conditions more frequently in Intervention/
↓ high-dose therapy, Evaluation:
That increase the intermittent IV Monitor aPTT
chance that clots will infusion, women 60 diligently. Assess Hct,
form yrs and older. platelet count, AST,
ALT. Monitor urine
and stool for occult
blood. Assess for
decrease in B/P,
increase in pulse rate,
complaint of
abdominal/back pain,
severe headache.
Question for increase
in amount of
discharge during
menes. Assess
peripheral pulses;
skin for ecchymosis,
petechiae. Check for
excessive bleeding
from minor cuts,
scratches. Assess
gums for erythema,
gingival bleeding.
Assess urine output
for hematuria. Avoid
IM injections due to
potential for
hematomas. When
converting to
warfarin therapy,
monitor PT results.

Patient/Family
teaching:
Use an electric razor,
soft toothbrush to
prevent bleeding.
Report any sign of
red or dark urine,
black or red stool,
coffee-ground
vomitus,
blood-tinged mucus
from cough. Do not
use any OTC
medication without
physician approval.
Wear or carry
identification that
notes anticoagulant
therapy. Inform
dentist, other
physicians of heparin
therapy. Limit
alcohol.