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Student Name: Week: Date: Pt. Initials: Page: of Medication (Generic & Brand Names) Cl as s (Therape utic & Pharmac ologic) Indicatio ns (Why is pt. taking this drug?) Dose Route Frequency Contraind ications Nursing Considerations Side Effects Pt. Teaching ranitidine hydrochloride (Zantac) Therapeutic: antiulcer agents Pharmacologic: histamine H antagonists Management of GERD. Treatment of heartburn, acid indigestion Adults 40 mg/day at bedtime or 20 mg twice daily for up to 8 wk. Hypersensiti vity Those with renal impairment Assess for epigastric or abdominal pain or occult blood in the stool, emesis, or gastric aspirate. confusion, dizziness, drowsiness, hallucinations, headache. constipation, diarrhea, Even after they start to feel better, instruct the patient to take their medication as instructed for the course of their treatment. Missed doses should be taken as soon as remembered, but not if the following dose is almost due. Do not take two doses at once. Take note of the maximum dosages. omeprazole (Prilosec) Therapeutic: antiulcer agents Pharmacologic: proton-pump inhibitors Short-term treatment of active benign gastric ulcer. PO Adults 20 mg once daily. Hypersensiti vity; Breastfeedin g Assess patient routinely for epigastric or abdominal pain and frank or occult blood in the stool, emesis, or gastric aspirate. Monitor CBC dizziness, drowsiness, fatigue, headache, weakness. Chest pain, abdominal pain, acid regurgitation, constipation, Even if they feel better, tell the patient to take their medication as prescribed for the duration of their therapy. When the next dose is almost
Student Name: Week: Date: Pt. Initials: Page: of diarrhea, flatulence, nausea, vomiting. due, skip the missed dose and take it as soon as you remember. Never give two doses. sucralfate (Carafate) Therapeutic: antiulcer agents Pharmacologic: GI protectants management of duodenal ulcers Management of gastric ulcer or gastroesophage al reflux. to treat ulcers: 1 g 4 times daily, given 1 hr before meals and at bedtime; or 2 g twice daily, on waking and at bedtime Prevention of Ulcers: PO (Adults): 1 g twice daily, given 1 hr before a meal. Hypersensiti vity. Use Cautiously in: Renal failure because of the accumulatio n of aluminum Assess patient routinely for abdominal pain or occult blood in the stool dizziness, drowsiness. constipation, diarrhea, dry mouth, gastric discomfort, indigestion , PO: Administer on an empty stomach, 1 hr before meals and at bedtime. Tablet may be broken or dissolved in water before ingestion. Shake suspension well before administration. Advise patient that increase in fluid intake, dietary bulk, and exercise may prevent drug-induced constipation. aluminum hydroxide (Amphojel) Therapeutic: antiulcer agents, hypophosphate Pharmacologic: antacids, phosphate binders Lowering of phosphate levels in patients with chronic renal failure. Adjunctive therapy in the treatment of peptic, duodenal, and gastric ulcers. PO (Adults): 1.9โ4.8 g (30โ40 mL of regular suspension or 15โ20 mL of concentrated suspension) 3โ4 times daily. PO (Children): 50โ mg/kg/24 hr in 4โ divided doses; titrate to normal serum phosphate Severe abdominal pain of unknown cause. Those with Hypercalce mia; Hypophosph atemia; Assess location, duration, character, and precipitating factors of gastric pain constipation. It is recommended that patients not take aluminum hydroxide for 1- hours after taking other prescriptions without first speaking with a healthcare provider.
Student Name: Week: Date: Pt. Initials: Page: of Rheumatoid arthritis porphyria urine. or hives to the healthcare provider. The use of this drug may result in a slight orange- yellow discoloration of the skin and urine. may leave a yellow stain on contact lenses. glipizine (Glucotrol) Therapeutic: antidiabetics Pharmacologic: sulfonylureas Control of blood glucose in type 2 diabetes mellitus PO (Adults): 5 mg/day initially, may be by 2.5โ mg/day at weekly intervals as needed (maximum dose 40 mg/day immediate-release), Hypersensiti vity with sulfonamide s Observe for signs and symptoms of hypoglycemic reactions (sweating, hunger, weakness, dizziness, tremor, tachycardia, anxiety) dizziness, drowsiness, headache, weakness. constipation, cramps, diarrhea, drug- induced hepatitis, heartburn, appetite, nausea, vomiting. Explain to patient that this medication controls hyperglycemia but does not cure diabetes. Therapy is long term. Review signs of hypoglycemia and hyperglycemia. If hypoglycemia occurs, advise patient to take a glass of orange juice or 2โ 3 tsp of sugar, honey, or corn syrup dissolved in water or an appropriate number of glucose tablets and notify health care professional
Student Name: Week: Date: Pt. Initials: Page: of repaglinide (Prandin) Therapeutic: antidiabetics Pharmacologic: meglitinides Type 2 diabetes mellitus, with diet and exercise; may be used with metformin, rosiglitazone, or pioglitazone. PO (Adults): 0.5โ4 mg taken before meals (not to exceed 16 mg/day) Lactation; Diabetic ketoacidosis; Type 1 diabetes; Concurrent use of gemfibrozil. Hypersensiti vity Observe patient for signs and symptoms of hypoglycemic reactions (abdominal pain, sweating, hunger, weakness, dizziness, headache, tremor, tachycardia, anxiety) angina, chest pain.: HYPOGLYCE MIA, hyperglycemia. Explain to patient that repaglinide helps control hyperglycemia but does not cure diabetes. Therapy is usually long term. Encourage patient to follow prescribed diet, medication, and exercise regimen to prevent hyperglycemic or hypoglycemic episodes. Review signs of hypoglycemia and hyperglycemia with patient. If hypoglycemia occurs, advise patient to take a glass of orange juice or 2โ 3 tsp of sugar, honey, or corn syrup dissolved in water, and notify health care professional. metformin (Glucophage) Therapeutic: antidiabetics Pharmacologic: biguanides Management of type 2 diabetes mellitus; may be used with diet, insulin, or sulfonylurea PO (Adults and children 17 yr): 500 mg twice daily; may increase by 500 mg at weekly intervals up to 2000 mg/day Hypersensiti vity; Metabolic acidosis; Dehydration, sepsis, hypoxemia, When combined with oral sulfonylureas, observe for signs and symptoms of hypoglycemic reactions (abdominal pain, sweating, hunger, weakness, dizziness, headache, tremor, abdominal bloating, diarrhea, nausea, vomiting, unpleasant metallic taste. hypoglycemia. F Instruct patient to take metformin at the same time each day, as directed. Take missed doses as soon as possible
Student Name: Week: Date: Pt. Initials: Page: of Pharmacologic: alpha- glucosidase inhibitors in conjunction with dietary therapy; may be used with insulin or other hypoglycemic agents. increased q 4โ8 wk as needed/tolerated (range 50โ 100 mg 3 times daily; not to exceed 50 mg 3 times daily in patients Diabetic ketoacidosis; Cirrhosis; Serum creatinine 2 mg/dL; hypoglycemia (sweating, hunger, weakness, dizziness, tremor, tachycardia, anxiety) when taking concurrently with other oral hypoglycemic agents. Monitor serum glucose and glycosylated hemoglobin periodically during therapy to evaluate effectiveness flatulence same time each day. Review signs of hypoglycemia and hyperglycemia Encourage patient to follow prescribed diet Instruct patient in proper testing of serum glucose and urine ketones. sitagliptin (Januvia) Therapeutic: antidiabetics Pharmacologic: enzyme inhibitors Adjunct to diet and exercise to improve glycemic control in patients with type 2 diabetes mellitus improve control of blood glucose. PO (Adults): 100 mg once daily. Type 1 diabetes mellitus; Diabetic ketoacidosis; Hypersensiti vity. History of pancreatitis Monitor for signs of pancreatitis (nausea, vomiting, anorexia, persistent severe abdominal pain, Assess for rash periodically during therapy Headache nausea, diarrhea. acute renal failure. Upper respiratory tract infection, nasopharyngitis. Patient should take as directed , patient should be educated that medication is not a cure, if symptoms of hypersensitivity reactions (rash; hives; swelling of face, lips, tongue, and throat; difficulty in breathing or swallowing) or pancreatitis occur lispro (Humalog), Regular (Humulin R), NPH (Humulin N), insulin glargine (Lantus) Therapeutic: antidiabetics, hormones Pharmacologic: pancreatics Control of hyperglycemia in patients with type 1 or type 2 diabetes mellitus. Subcutaneous 0.5โ unit/kg/ Day Hypoglycem ia; Allergy or hypersensiti vity to a particular type of insulin symptoms of hypoglycemia restlessness; tingling in hands, feet, lips, or tongue; chills; cold sweats; confusion; cool, pale skin; difficulty in concentration; drowsiness; excessive hunger; headache; irritability; nightmares or trouble sleeping; nausea; nervousness; tachycardia;
HYPOGLYCE
MIA
Instruct patients on proper technique for administration. Include type of insulin, equipment (syringe, cartridge pens, alcohol swabs), storage, and place to
Student Name: Week: Date: Pt. Initials: Page: of tremor; weakness; unsteady gait) and hyperglycemia (confusion, drowsiness; flushed, dry skin; fruit-like breath odor; rapid, deep breathing, polyuria; loss of appetite; nausea; vomiting; unusual thirst) periodically during therapy. discard syringes. Discuss the importance of not changing brands of insulin or syringes, selection and rotation of injection sites pramlintide (Symlin) Therapeutic: antidiabetics Pharmacologic: hormones management of diabetics whose blood sugar cannot be controlled by optimal insulin therapy Subcut (Adults): 60 mcg, immediately prior to major meals initially, if no significant nausea occurs, dose may increase 120 mcg. Type 1 Diabetes Subcut (Adults): 15 mcg, immediately prior to major meals initially, if no significant nausea occurs, dose may increase 15 mcg every 3 days up to 60 mcg. Hypersensiti vity; Inability to identify hypoglycemi a; Gastroparesi s or need for medications to stimulate gastric motility Assess hemoglobin A1c, recent blood glucose monitoring data, history of insulin-induced hypoglycemia, current insulin regimen, and body weight prior to initiation of therapy. Assess for signs and symptoms of hypoglycemia (hunger, headache, sweating, tremor, irritability, difficulty concentrating, loss of consciousness, coma, seizure) dizziness, fatigue, headache. Resp: cough. GI: nausea, abdominal pain, anorexia, vomiting HYPOGLYCE MIA. Instruct patient in proper use of pramlintide (injection technique, timing of doses, storage, and disposal of equipment). Make sure patient understands dosing and preparation of the correct dose. meal planning, physical activity, recognition, and management of hypoglycemia and hyperglycemia exenatide (Byetta) Therapeutic: antidiabetics Pharmacologic: incretin mimetic agents Management of type 2 diabetes as an adjunct to diet and exercise. Subcut (Adults): 5 mcg within 60 min before morning and evening meal; after 1 mo, dose may increase 10 mcg Hypersensiti vity; Type 1 diabetes or diabetic ketoacidosis; Severe renal impairment or end-stage renal disease Observe for signs and symptoms of hypoglycemic reactions (abdominal pain, sweating, hunger, weakness, dizziness, headache, drowsiness, tremor, tachycardia, anxiety, confusion, irritability, jitteriness), especially when combined dizziness, headache, jitteriness, weakness. PANCREATITI S, diarrhea, nausea, vomiting, Take it at least sixty minutes prior to eating. Teach the patient how to administer medication correctly, including when to take concurrent oral medications,
Student Name: Week: Date: Pt. Initials: Page: of
Reference:
Vallerand A. H. Sanoski C. A. & Deglin J. H. (2013). Davis's drug guide for nurses (13th ed.). F.A. Davis
