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Acetaminophen Reduces pain and Usual dose: 650 Risk of severe liver Before and during long term therapy, monitor liver
fever through COX1 & mg every 4 to 6 injury if combined with function: AST, ALT, bilirubin, creatinine.
COX2 inhibition hr PRN excessive alcohol use.
Ordered dose: Skin reactions, Ensure that the daily dose from all sources does not
325 mg tablet, 2 Stevens-Johnson exceed maximum daily limits.
tablets PO syndrome, toxic
every 4 hr PRN epidermal necrolysis
Antipyretic, analgesic Abdominal pain, Monitor for signs of hepatotoxicity such as bleeding,
nausea, vomiting easy bruising, malaise
Aspirin (Acetylsalicylic COX inhibitor. Usual dose: 75 - Gastric ulceration Ask for tinnitus. This usually occurs when blood
acid, ASA) 81 mg/day aspirin levels exceed maximum dosage for
therapeutic effects.
Anti-inflammatory, anti- To reduce risk of MI Ordered dose; Renal impairment Take with food or after meals to minimize GI upset.
platelet, antipyretic, and stroke in patients 81 mg
analgesic with chronic coronary 1 tablet PO at
artery disease bedtime
NSAID Prolonged bleeding Monitor for GI bleeding (bloody or tarry stool, coffee
time ground emesis)
Salicylism (tinnitus,
sweating, headache,
dizzy)
Aleve (Naproxen sodium) COX inhibitor Usual dose: 220 GI bleeding and Monitor for GI bleeding. Give with food to minimize
mg every 8 to ulceration risk
12 hr
Analgesic, anti-inflammatory, To relieve mild to Ordered dose: Renal impairment Monitor BUN and serum creatinine
antipyretic moderate 220 mg
musculoskeletal 2 tablets PO
inflammation or pain twice a day
NSAID Heart failure, Monitor blood pressure, and watch for eater retention
Hypertension, fluid due to naproxen’s sodium content
retention
Aricept (Donepezil HCl) Cholinesterase inhibitor Usual dose: GI: Nausea, vomiting For patient with history of gastric irritation, Aricept
- reduces/prevents 10 mg at dyspepsia, diarrhea may aggravate condition. Monitor for gastric bleeding
acetylcholine bedtime (black, tarry stools)
breakdown in brain
tissue, thereby
increasing availability
at cholinergic
synapses.
Antidementia To treat mild to Ordered dose: Bradycardia, fainting, Monitor heart rate, rhythm for bradycardia. Take
moderate Alzheimer’s 10 mg falls, dizziness safety precautions for dizziness
disease 1 tablet at
bedtime
Headache
Namenda (Memantine HCl) NMDA receptor Usual dose: 10 Hepatic failure, Monitor patients with severe hepatic impairment
antagonist – modulates mg daily in two hepatitis because drug may increase risk of adverse reactions,
the effects of glutamate divided doses monitor LFTs.
at NMDA receptors.
The NMDA receptor
regulates Calcium entry
into neurons. Binding of
glutamate to the
receptor promotes
calcium influx. The brief
period of Ca entry
constitutes a “signal” in
the learning and
memory process.
Antidementia Indicated for moderate Ordered dose: Headache Monitor blood pressure.
or severe Alzheimer’s 10 mg
Disease 1 tablet PO in
the morning
Constipation
Dizziness
Vitamin C (Ascorbic Acid) Participates in multiple Usual dose: 25 Nausea Monitor patient for GI disturbances
biochemical reactions to 1000 mg
(synthesis of adrenal
steroids, conversion of
folic acid, regulation of
respiratory cycle in
mitochondria,
production of collagen,
antioxidant, absorption
of dietary iron)
Flushing
Headache
Buspirone HCl MOA not established. Usual dose: Dizziness Institute safety precautions because of possible CNS
Thought to bind with 5, 10, 15 and 30 reactions (position changes, fall risk)
high affinity to mg.
receptors for serotonin Maximum of 60
and with lower affinity mg/day
to receptors for
dopamine.
Headache
CNS: Nervousness,
sedation,
lightheadedness,
excitement
Cipro (Ciprofloxacin HCl) MOA: inhibits two Usual dose: GI: nausea, vomiting, Obtain culture & sensitivity test results as ordered,
bacterial enzymes; 500 mg diarrhea, abdominal before giving ciprofloxacin.
DNA gyrase and pain
topoisomerase IV,
which are needed for
DNA replication and
cell division.
Antibiotic Active against broad Ordered dose: CNS: dizziness, Assess hematologic, hepatic and renal functions
spectrum of bacteria. 500 mg tablet headache, periodically, as ordered.
1 tablet PO restlessness,
twice a day confusion
(Fluoroquinolone) To treat UTI caused by Geriatric: Assess for signs of rash or other hypersensitivity
susceptible organism. Risk of confusion,
somnolence,
psychosis, visual
disturbance
Co-Enzyme Q10 Antioxidant that serves Usual dose: GI: gastritis, reduced Mild interaction with Pravastatin
vital role in cellular 50 – 200 mg appetite, nausea,
energy production. daily diarrhea
With age CoQ-10
levels decrease.
Dulcolax Suppository Stimulates peristalsis Usual dose: Rectal burning Mild interaction with Potassium chloride
(Bisacodyl) and softens feces by 10 mg sensation
increasing secretion of suppository
water and electrolytes once daily
into the intestine and
decreasing water and
electrolyte absorption
Stimulant laxative To treat constipation Ordered dose: Prolonged use may Monitor for fluid imbalance and increase fluid intake
1 suppository cause proctitis
rectally PRN (at
bedtime)
If no result from
Milk of
Magnesia
Electrolyte and fluid Monitor for electrolyte imbalances, potassium.
imbalance
Abdominal cramping
Nausea
Melatonin Melatonin is a hormone Usual dose: Hangover Monitor for change in mood and behavior.
that helps regulate
circadian rhythm
(melatonin receptors on
the suprachiasmatic
nucleus, the anatomic
site of the circadian
cock, mediate clock
resetting by exogenous
melatonin)
Nightmares
Hypothermia
Transient depression
Milk Thistle One of the active GI: nausea, diarrhea, Monitor LFTs
ingredients in milk indigestion, intestinal
thistle is silymarin, gas, bloating, fullness
which is extracted from or pain, and loss of
the plant's seeds. appetite
Silymarin is a flavonoid
believed to have
antioxidant properties.
Estrogenic effects
Anaphylaxis
Milk of Magnesia Osmotic action retains Usual dose: Loss of fluids Increase fluid intake to avoid dehydration
Suspension (Magnesium water and thereby 15 – 30 mL
hydroxide) softens the feces; fecal daily, increased
swelling promotes to 60 mL if
peristalsis. needed
Osmotic laxative To treat constipation Ordered dose: CNS: confusion, Before giving as laxative, shake oral solution well and
30 mL PO every decreased reflexes give with a large amount of water
72hr PRN
If no bowel
movement for 3
days
GI: flatulence,
vomiting
Muscle cramps
Remeron (Mirtazapine) Benefits derive from Usual dose: Somnolence May lower serum sodium in elderly patients – monitor
increased release of 5- 15 – 45 mg/day serum sodium.
HT and NE. The
mechanism is blockade
of presynaptic alpha2-
adrenergic receptors
that serve to inhibit
release.
Mirtazapine is a
powerful blocker of two
serotonin receptor
subtypes: 5-HT2 and 5-
HT3
Blocks histamine
receptors and thus
promotes sedation and
weight gain.
Antidepressant To treat major Ordered dose: Weight gain, Monitor for signs and symptoms of serotonin
depression 7.5 mg tablet increased appetite, syndrome – alteration in vital signs, GI symptoms,
1 tablet PO at elevated cholesterol mental status changes, neuromuscular abnormalities
bedtime
Potassium chloride ER Acts as a major cation Usual dose: CNS: confusion, Administer with or immediately after meals.
in intracellular fluid, 6.7 – 20 mEq paresthesia,
activating many three times a weakness
enzymatic reactions, day
essential for
physiologic processes,
including nerve impulse
transmission and
cardiac and skeletal
muscle contraction.
Electrolyte To treat hypokalemia Ordered dose: CV: arrythmias Monitor serum potassium level before and during
10 mEq tablet administration
1 tablet PO in
the morning
Hyperkalemia
Pravastatin sodium HMG-CoA Reductase Usual dose: Memory loss Obtain laboratory values for total cholesterol, LDL
Inhibitor, the rate 40 – 80 mg at cholesterol, HDL cholesterol and TGs (VLDLs)
limiting enzyme in bedtime
cholesterol
biosynthesis
Antihyperlipidemic To prevent Ordered dose: hyperglycemia Obtain baseline LFTs and CK level
cardiovascular and 80 mg
coronary events in 1 tablet PO in
patients at risk, to treat the morning
hyperlipidemia
Protonix Delayed Release Proton pump inhibitor – Usual dose: GI: Diarrhea, If treatment lasts more than 3 years, patient may not
(Pantoprazole sodium) interferes with gastric 40 mg/day headache, dizziness, be able to absorb vitamin B12 because of achlorhydria
acid secretion by hypomagnesemia or hypochlorhydria. Treatment for cyanocobalamin
inhibiting the hydrogen- deficiency may be needed.
potassium-adenosine
triphosphate (H+-K+-
ATPase) enzyme
system in gastric
parietal cells.
Antiulcer, gastric acid proton To treat GERD and Ordered dose: GU: Elevated serum Monitor urine output and signs of blood in urine
pump inhibitor hypersecretory states 40 mg creatinine, interstitial because pantoprazole may cause acute interstitial
1 tablet PO nephritis nephritis
once daily
MS: arthralgia, Monitor for diarrhea from C. difficile which can occur
myalgia with or without antibiotics in patients taking
pantoprazole
Risperidone Risperidone binds to Usual dose: Agranulocytosis, Warning: Be aware that risperidone should not be
multiple receptors. It is Initial: 0.5 mg anemia, leukopenia, used to treat elderly patients with dementia
a powerful 5-HT2 twice daily for neutropenia, related psychosis because it increases risk of
receptor antagonist and elderly patients, thrombocytopenia death in these patients
a less powerful D2 increased by 0.5
receptor antagonist. mg twice daily
Antagonism at both every wk as
sites underlies needed.
therapeutic effects.
Maximum: 3 mg
daily
Antipsychotic Relieves positive and Ordered dose: Hyperglycemia Monitor for orthostatic hypotension especially in
negative symptoms of 0.5 mg patients with cardiac or cerebrovascular disease
schizophrenia and 1 tablet PO
improves cognitive twice a day
function.
Orthostatic
hypotension
Senna Plus (Sennosides – Surfactant action Usual dose: Diarrhea, discolored Monitor for fluid imbalance and increase fluid intake
Docusate sodium) softens the stool by 2 tablets once urine, nausea,
facilitating penetration daily – 4 tablets vomiting, stomach
Docusate sodium 50 mg of water. twice daily cramps, throat
Sennosides 8.6 mg Stimulant laxatives irritation
stimulate peristalsis
and soften feces by
increasing secretion of
water into the intestine.
Stimulant laxative Relieves occasional Ordered dose: Allergic reactions (skin Increase fiber intake
constipation generally 2 tablets PO rash, itching, hives,
produces bowel twice a day swelling of the face,
movement in 6-12 lips, or tongue)
hours
Trospium chloride Antagonizes the effects Usual dose: Dry mouth, blurred Administer 1 hr before meals or on empty stomach,
of acetylcholine on 20 mg twice vision as food delays absorption
muscarinic receptors in daily
the bladder. Trospium’s
parasympatholytic
action reduces the
tonus of smooth
muscle in the bladder.
Bladder antispasmodic To treat an overactive Ordered dose: GI: Stomach upset, May decrease GI motility; assess for constipation
bladder with symptoms 20 mg tablet constipation
of urge urinary 1 tablet PO
incontinence, urgency every morning
and urinary frequency and at bedtime
Vitamin B12 ER Vitamin B12 is essential Usual dose: Hypokalemia (muscle Monitor CBC
(Cyanocobalamin ER) for the synthesis of 1000 – 10,000 weakness,
DNA, and so is mcg/day arrhythmia)
required for the growth
and division of virtually
all cells.
Vitamin B12 helps
catalyze the conversion
of folic acid to its active
form. Active folic acid
then participates in
several reactions
essential for DNA
synthesis.
To treat Vitamin B12 Ordered dose: Increased erythrocyte Monitor plasma levels of Vitamin B12
deficiency. 1000 mcg ER production
tablet
1 tablet PO in
the morning
Because stomach acid A Schilling test may be ordered to assess Vitamin B12
is required to release absorption.
Vitamin B12 from foods,
the vitamin cannot be
absorbed if acid
secretion is significantly
reduced, as often
happens for older
adults taking acid-
suppressing drugs.
To treat Vitamin D Ordered dose: Hypervitaminosis D: In severe hypercalcemia, monitor for polyuria,
deficiency Capsule 5000 Early symptoms – nocturia, proteinuria, seizures, confusion, ataxia
UNIT weakness, fatigue,
1 capsule PO in nausea, vomiting,
the morning anorexia, abdominal
cramping and
constipation
Nephrolithiasis
Osteoporosis (very
large doses)
Zyrtec (Cetirizine HCl) Second generation H1 Headache Administer with food to minimize GI upset
antagonist.
Antagonizes the effects
of histamine at H1-
receptor sites; does not
bind to or inactivate
histamine.
Anticholinergic effects
are minimal, and
sedation is dose-
related.
Antihistamine To treat mild allergies Ordered dose: Fatigue Assess lung sounds and character of bronchial
10 mg tablet secretions.
1 tablet PO in
the morning
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