Medication Cards: Create a card for each medication your patient currently takes.

Student name: Andrew Lewis Date: 02/21/2018

Patient’s medical diagnoses: Rapis Onset Atrial Flutter (r/t holiday heart and ETOH withdrawal)

Generic & Trade names Dose & dose limits, frequency, route Reason THIS PATIENT takes this medication: Clot
Apixaban (Eliquis) My pt: 5 mg PO Q12H (AFib-Nonvalvular) prevention wrt AFib
General doses: 5 mg PO Q12H for CV accident or
Embolism prophylaxis. 2.5 MG Q12H for DVT
prophylaxis post knee operation. 10 mg PO Q12H
for DVT prophylaxis 7 days after therapy, 5 mg PO
Q12H for next 7 days. 10 mg PO Q12H for PE. 2.5
mg Q12H minimum 6 mo post DVT or PE treatment
How it works, drug class COMMON side effects & adverse reactions Nursing implications for THIS PATIENT: what
-Blocks the activity of clotting factor Xa, resulting in Side effects may include nausea, contusion, assessments, interventions, and teaching do you
decreased thrombin generation and thrombus anemia, syncope, and hemorrhage. Adverse need to do?
formation reactions include contusions, bleeding gums, GI -Must assess HR and BP
-Selective FXa inhibitor hemorrhage, APT elevation, and hematuria. -Must educate on side effects
-must educate on clot signs/symptoms
-must educate on drug/drug and drug/food
Usual uses Contraindications: active pathological bleeding, interactions
-Thrombosis prophylaxis for pts at risk of DVT, pts severe allergic r(x) to apixaban, antithrombotic
w/ AFib, or PE’s agents
Interactions: most other anticoagulants (greatly
increased risk of over treatment and bleeding),
fibrinolytics (greatly increased risk of over
treatment and bleeding), SSNRIs, Grapefruit juice

Generic & Trade names Dose & dose limits, frequency, route Reason THIS PATIENT takes this medication:
Clonazepam (Klonopin) My pt: 1 mg PO Q24H Panic disorder. Rx’d to replace Ativan due to longer
Panic disorder: initial 0.25 mg PO, then titrate up to half life and in an effort to wean pt off of Ativan
target dose of 1 mg PO Q24H. May be titrated up they had been self-administering to combat ETOH
by 0.125 to 0.25 mg PO Q12H Q 3 days to a max withdrawal symptoms
dose of 4 mg daily. Discontinue by decreasing dose
by 0.125 mg Q12H daily every 3 days.
Seizure: initial, 0.5 mg PO Q8HR. Titrate by 0.5 to 1
mg PO Q 3 days to max dose 20 mg daily (divided
into 3 doses)
How it works, drug class COMMON side effects & adverse reactions Nursing implications for THIS PATIENT: what
Benzodiazepine w/ no definite MOA, although Side effects may include excessive salivation, assessments, interventions, and teaching do you
believed to be related to enhanced GABA activity ataxia, dizziness, impaired cognition, seizure, need to do?
which is the major CNS neurotransmitter. aggravation, somnolence, depression, nervousness, -must assess anxiety level
Classes: Antianxiety, Anticonvulsant or respiratory depression. Pt should avoid activities -must assess pt cooperation with taking drug once
requiring mental alertness or coordination until discharged, in order to negate effects of sudden
drug effects are realized. withdrawal
-must teach about side effects and their
signs/symptoms
Usual uses Contraindications: Do not use with ETOH. Do not
Panic disorders, seizures withdrawal suddenly. Contraindicated in pts with
acute narrow angle glaucoma, benzo
hypersensitivity and significant liver disease.
Interactions: do not use with narcotics, other
antidepressants, or with ETOH. Obese pts must be
monitored for half-life accumulation with
clonazepam.

Generic & Trade names Dose & dose limits, frequency, route
Famotidine (Pepcid) My pt: 20 mg PO Q24H
General: GERD: 20 to 40 mg Q12H for 12 weeks;
Gastric hypersecretion: 10 to 160 mg Q6H OR 20
mg IV Q12H; Stress Ulcer Prophylaxis/indigestion:
10 to 20 mg PO Q12H
How it works, drug class COMMON side effects & adverse reactions
-Inhibits the concentration and volume of gastric Side effects: may cause constipation, diarrhea, or
secretions dizziness.
-Antiulcer, Gastric Acid Secretion Inhibitor Adverse rxns: Anaphylaxis, Rhabdomyolysis,
pneumonia, seizure, Stevens-Johnson Syndrome
Reason THIS PATIENT takes this medication: Stress
ulcer prophylaxis
Nursing implications for THIS PATIENT: what
assessments, interventions, and teaching do you
need to do?
-must teach about side effects and their
signs/symptoms
-must assess for signs and symptoms of side effects
Usual uses
GERD, Gastric hypersecretion, sort term gastric
ulcer treatment, indigestion NON FDA: Stress ulcer
prophylaxis
Contraindications: Hypersensitivity to any
compounds in famotidine
Interactions: Negative interaction w/ QT interval
prolonging agents, enterically coated meds and
NSAIDs

Generic & Trade names
Folic acid
How it works, drug class
-converts to tetrahydrofolic acid, is necessary for
normal erythropoiesis, synthesis of purine and
thymidylates, metabolism of amino acids such as
glycine and methionine, and the metabolism of
histidine.
-Nutriceutical, Nutritive agent
Dose & dose limits, frequency, route
My pt: 1 mg PO Q24H
Folic acid deficiency/ Megaloblastic anemia: up to 1
mg PO Q24H unless extremely deficient
COMMON side effects & adverse reactions
Side effects: Bad taste in mouth, loss in appetite,
nausea, confusion, irritability, sleep pattern
disturbances.
Adverse r(x)s: Anaphylaxis
Reason THIS PATIENT takes this medication: Folic
acid is a B vitamin that is not created by the body
and must be consumed. ETOH destroys B vitamin
stores, and most ETOH abusers do not consume
adequate nutrition, and folic acid must be
supplemented.
Nursing implications for THIS PATIENT: what
assessments, interventions, and teaching do you
need to do?
-must teach about side effects and their
signs/symptoms
-must assess for signs and symptoms of side effects
-really press in on ETOH counseling
-counsel on B Vitamin necessity w/ ETOH pts

Usual uses Contraindications: hypersensitivity to folic acid

Folic acid deficiency, megaloblastic anemia products

Interactions: do not take with dasabuvir (Hep C

anti-viral)

Generic & Trade names
Metoprolol Succinate (Toprol XL)
How it works, drug class
-Beta 1 adrenergic blocker that selectively blocks
beta-1 adrenoreceptors located mainly in cardiac
muscles. These are receptive to epinephrine and to
neural stimulation.
-Adrenergic, adrenergic blocker
Dose & dose limits, frequency, route Reason THIS PATIENT takes this medication: Afib
My pt: 200 mg PO Q24H cardioversion and HTN
Angina: Initial, 100 mg orally once daily,
discontinuing therapy, gradually reduce dosage
over 1 to 2 weeks
CHF: Initial, 25 mg orally once daily for 2 weeks.
Titration by doubling every 2 weeks to highest
tolerated dose or up to 200 mg daily.
HTN: Initial, 25 to 100 mg orally once daily. Titrate
up increasing slowly over 1 week until effect
desired is exhibited.
COMMON side effects & adverse reactions Nursing implications for THIS PATIENT: what
Side effects: diarrhea, fatigue, headache, or assessments, interventions, and teaching do you
depression. need to do?
Adverse reactions: Arterial insufficiency, -Assess HR and BP; hold for Rx’d contraindications
exacerbation of heart failure, hyperthyroidism, -must teach about side effects and their
hypoglycemia, withdrawal symptom signs/symptoms
-must assess for signs and symptoms of side effects
-really press in on ETOH counseling
Usual uses Contraindications: severe bradycardia. 2nd or 3rd
Angina pectoralis, CHF, HTN degree heart block, sick sinus syndrome
NON-FDA: AFib cardioversion

Interactions: do not use with other Beta blockers,

lidocaine,

Generic & Trade names Dose & dose limits, frequency, route Reason THIS PATIENT takes this medication:
Theragran (multivitamin) My pt: 1 tablet PO Q24 H dietary insufficiency due to ETOH addiction
Usual dosage: 1 tablet daily, 2 hours before meal
PO

How it works, drug class COMMON side effects & adverse reactions: side Nursing implications for THIS PATIENT: what
-Multivitamin used to supplement daily vitamin effects include nausea, diarrhea, upset stomach. assessments, interventions, and teaching do you
intake Adverse r(x)s: allergic rxn need to do?
-dietary supplement -monitor pt I&Os
-counsel on food-based diet to limit use of vitamins
upon discharge
-monitor for allergic rxn

Usual uses Contraindications: known allergy

-dietary supplement

Interactions: Bisphosphonates, levodopa,

antibiotics, thyroid medications

Generic & Trade names Dose & dose limits, frequency, route
Potassium Chloride (K-Dur) My pt: 40 mEq PO Q24H
Usual dose: 40 to 100 mEq PO Q24H taken as
needed in doses of no more than 20mEq w/ meals
and full glass of liquid. Max 400 mEq/day
Reason THIS PATIENT takes this medication:
nutritional deficit due to ETOH abuse and
withdrawal

How it works, drug class
-electrolyte replenisher, participates in several
physiological processes in the body including the
transmission of nerve impulses, the maintenance of
normal renal function and intracellular tonicity, and
the contraction of skeletal, cardiac and smooth
muscle
-Nutriceutical, Nutritive agent
COMMON side effects & adverse reactions
Side effects: diarrhea, flatulence, nausea, vomiting,
or abdominal pain.
Adverse reactions: Cardiac arrest, abnormal EKG,
hyperkalemia, GI ulcer, abdominal pain
Nursing implications for THIS PATIENT: what
assessments, interventions, and teaching do you
need to do?
-monitor pt I&Os
-counsel on food-based diet to limit use of vitamins
upon discharge
-monitor for allergic rxn
-must teach about side effects and their
signs/symptoms
-must assess for signs and symptoms of side effects
-really press in on ETOH counseling

Usual uses Contraindications: anticholinergic agents, pts w

Hypokalemia esophageal compression, pts w risk for cardiac
arrest

Interactions: limit high potassium foods

Generic & Trade names Dose & dose limits, frequency, route Reason THIS PATIENT takes this medication:
Pravastatin (pravachol) My pt: 40 mg PO Q24H Hyperlipidemia
Any use: initially 40 mg PO Q24H, then 40 to 80 mg
PO Q24H
How it works, drug class
-Competitive, specific coenzyme inhibitor that
decreases intracellular cholesterol levels through
reversible inhibition of coenzyme activity, thereby
decreasing LDL synthesis and absorption.
-Antihyperlipidemic, Cardiovascular agent
Usual uses
-Hyperlipidemia, cerebrovascular accident
(prophylaxis), coronary arteriosclerosis
(prophylaxis), familiar hypercholesterolemia
Generic & Trade name
Tamsulosin Hydrochloride (Flomax)
How it works, drug class
-Alpha 1A adrenoceptor antagonist, selectively
blocks SNS stimulation of the receptor, resulting in
relaxation of prostate, urethra and bladder neck
smooth muscle.
-Adrengergic, adrenergic blocker.
Usual uses
BPH
Generic & Trade names
Thiamine tablet
How it works, drug class
-Combines with ATP to form a coenzyme necessary
for carbohydrate metabolism
-Nutriceutical, Nutritive agent -
COMMON side effects & adverse reactions
Side effects: rash, diarrhea, musculoskeletal pain,
nausea and vomiting, headache, cough, rhinitis,
upper respiratory infxn
Adverse r(x)ns: pancreatitis, increased liver
enzymes, rhabdomyolysis, tendon rupture
Contraindications: pts with active liver disease,
pregnancy, nursing mothers, serum transaminases
Interactions: antifungals, antacids, digoxin,
diltiazem, erythromycin, blood thinners, ETOH
Dose & dose limits, frequency, route
My pt: 0.4 mg PO Q24H
BPH: 0.4 mg PO Q24H, titrate up to 0.8 mg if no
response in 2 to 4 days
COMMON side effects & adverse reactions
Side effects: backache, infectious disease, dizziness,
headache, somnolence, abnormal ejaculation,
rhinitis
Adverse rxns: Retinal detachment, Priapism
Contraindications: hypersensitivity to any of the
products or ingredients
Interactions: Grapefruit juice, alpha/beta agonists,
protease inhibitors, mycin class antibiotics,
nefazodone, ketoconazole
Dose & dose limits, frequency, route
My pt: 100 mg PO Q24H
IV Dextrose: 100 mg in each of the first few liters of
IV fluid
Beriberi: 10-20 mg IM OR slow IV infusion 3x/day
for 2 weeks, then oral maintenance w/ 5-10 mg
daily
Vomiting during pregnancy- 100 mg PO Q24H
Wernicke-Korsakoff syndrome: little known about
true standard; really a pt driven Rx. Titrate 100 mg
IV to 50-100 mg IM daily. Adjust to pt malnutrition
status upon dx.
COMMON side effects & adverse reactions: Side
effects: Injection site reaction
Adverse reactions: hypersensitivity reaction
Nursing implications for THIS PATIENT: what
assessments, interventions, and teaching do you
need to do?
--must teach about side effects and their
signs/symptoms
-must assess for signs and symptoms of side effects
-counsel on cardiac diet
-assess blood labs in order to titrate up or down
Reason THIS PATIENT takes this medication: hx of
BPH
Nursing implications for THIS PATIENT: what
assessments, interventions, and teaching do you
need to do?
-Assess GU fxn
-monitor for allergic rxn
-must teach about side effects and their
signs/symptoms
-must assess for signs and symptoms of side effects
Reason THIS PATIENT takes this medication:
Wernicke-Korsakoff syndrome. WKS is associated
with ETOH abuse and extremely low thiamine
levels. Signs and symptoms include
ophthalmoplegia, confusion, ataxia, aphasia,
anterograde amnesia, retrograde amnesia, apraxia,
agnosia, cognitive issues
Nursing implications for THIS PATIENT: what
assessments, interventions, and teaching do you
need to do?
- Full mental status checks

Usual uses: IV dextrose administration, Beriberi,
severe vomiting during pregnancy, thiamine
deficiency, Wernicke-Korsakoff syndrome
- Educate pt on side effects and adverse
rxns
- Educate pt on ETOH dietary deficits
- Educate pt on substance abuse
prevention
Contraindications: known allergic reaction
Interactions: fluorouracil