Therapeutic Sheet: Date Specific Action Indications Contraindications Side/Adverse Effects Nsg. Responsibilities

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Therapeutic Sheet

Date Specific Action Indications Contraindications Side/Adverse Effects Nsg. Responsibilities


Generic name: Mechanism of action is  Partial seizures (adjunct Contraindicated in: CNS: SUICIDAL THOUGHTS, ▹ Monitor closely for notable changes
Gabapentin not known. May affect treatment) (immediate-  Hypersensitivity confusion, depression, in behavior that could indicate the
transport release only). dizziness, drowsiness, emergence or worsening of suicidal
Brand name: of amino acids across Postherpetic neuralgia. Use Cautiously in: sedation, anxiety, thoughts or behavior or depression.
Gralise, Horizant, and stabilize neuronal Restless legs syndrome  All patients (may ↑ concentration difficulties ▹ Instruct patient to take medication
Neurontin membranes. (Horizant only). risk of suicidal (children), emotional lability exactly as directed. Do not double
thoughts/behaviors); (children), hostility, dose. Do not discontinue abruptly;
Dose: Therapeutic Effects:  Unlabeled Use: Renal insufficiency hyperkinesia (children), may cause increase in frequency of
100 mg/tab ▹ Decreased Neuropathic pain. (↓dose and/or ↑ malaise, vertigo, seizures.
incidence of Prevention of migraine dosing interval if CCr weakness. ▹ Advise patient not to take gabapentin
seizures. Decreased headache. Bipolar ≤ 60 mL/min); OB: EENT: abnormal vision, within 2 hr of
Frequency: postherpetic pain. disorder. Anxiety. Pregnancy; nystagmus. an antacid.
OD Decreased leg Diabetic peripheral Pedi: Children < 18 yr CV: hypertension. ▹ May be administered without regard
restlessness. neuropathy. (sustained-/extended- GI: weight gain, anorexia, to meals.
Route: release) flatulence,
▹ Gabapentin may cause dizziness and
Oral Source: Davis’s Drug or < 3 yr (immediate- gingivitis.
drowsiness. Caution patient to avoid
Guide for Nurses, release) (safety not MS: RHABDOMYOLYSIS,
driving or activities requiring
Drug Classification: p601 established); arthralgia,qcreatine
alertness until response to
 analgesic adjuncts,  Lactation: kinase.
medication is known.
therapeutic, Discontinue drug or Neuro: ataxia, altered
▹ Advise patient and family to notify
anticonvulsants, bottle-feed; reflexes, hyperkinesia,
health care professional if thoughts
mood stabilizers  Geri: May be more paresthesia.
about suicide or dying, attempts to
susceptible to toxicity Misc: MULTIORGAN
commit suicide; new or worse
due to age-related ↓ HYPERSENSITIVITY
depression; new or worse anxiety;
in renal function. REACTIONS,
feeling very agitated or restless; panic
facial edema.
attacks; trouble sleeping; new or
worse irritability; acting aggressive;
being angry or violent; acting on
dangerous impulses; an extreme
increase in activity and talking; or
other unusual changes in behavior or
mood occur.
Date Specific Action Indications Contraindications Side/Adverse Effects Nsg. Responsibilities
Generic name: Bind to bacterial cell  Treatment of the Contraindicated in: CNS: SEIZURES (high doses). ▹ Assess for infection (vital signs;
Cefuroxime wall membrane, causing following infections  Hypersensitivity to GI: CLOSTRIDIUM DIFFICILE- appearance of wound, sputum, urine,
cell death. caused by susceptible cephalosporins ASSOCIATED DIARRHEA and stool; WBC) at beginning and
Brand name: organisms: Skin and skin  Serious (CDAD), diarrhea, cramps, during therapy.
Ceftin, Zinacef Source: Davis’s Drug structure infections, Bone hypersensitivity to nausea, vomiting. ▹ Before initiating therapy, obtain a
Guide for Nurses, p289 and joint infections penicillins. Derm: rashes, urticaria. history to determine previous use of
Dose: Hemat: agranulocytosis, and reactions to penicillins or
750 mg bleeding (↑ with cefotetan cephalosporins. Persons with a
and cefoxitin), eosinophilia, negative history of penicillin
hemolytic anemia, sensitivity may still have an allergic
Frequency: neutropenia, response.
q 8h thrombocytopenia ▹ Obtain specimens for culture and
Local: pain at IM site, phlebitis sensitivity before initiating therapy.
Route: at IV site. First dose may be given before
IVTT Misc: allergic reactions receiving results.
including ANAPHYLAXIS ▹ Observe patient for signs and
Drug Classification: and SERUM SICKNESS, symptoms of anaphylaxis (rash,
- second-generation superinfection. pruritus, laryngeal edema, wheezing).
cephalosporins Discontinue the drug immediately if
- anti-infectives these symptoms occur. Keep
epinephrine, an antihistamine, and
resuscitation equipment close by in
the event of an anaphylactic reaction.
▹ Monitor bowel function. Diarrhea,
abdominal cramping, fever, and
bloody stools should be reported to
health care professional promptly as
a sign of Clostridium difficile-
associated diarrhea (CDAD). May
begin up to several weeks following
cessation of therapy.
▹ Instruct patient to take medication
around the clock at evenly spaced
times and to finish the medication
completely, even if feeling better.
Take missed doses as soon as
possible unless almost time for next
dose; do not double doses. Use
calibrated measuring device with
liquid preparations.
▹ Advise patient that sharing of this
medication may be dangerous.
▹ Advise patient to report signs of
superinfection (furry overgrowth on
the tongue, vaginal itching or
discharge, loose or foul-smelling
stools) and allergy.
▹ Instruct patient to notify health care
professional if fever and diarrhea
develop, especially if stool contains
blood, pus, or mucus. Advise patient
not to treat diarrhea without
consulting health care professional.
Date Specific Action Indications Contraindications Side/Adverse Effects Nsg. Responsibilities
Generic name: Inhibits synthesis of  Mild to moderate pain,  Previous CNS: agitation (↑ in children) ▹ Assess overall health status and
Acetaminophen prostaglandins that may Moderate to severe pain hypersensitivity (IV), anxiety (IV), alcohol usage before administering
serve as mediators of with opioid analgesics  Products containing headache (IV), fatigue (IV), acetaminophen. Patients who are
Brand name: pain and fever, primarily  Fever. alcohol, aspartame, insomnia (IV). malnourished or chronically abuse
Paracetamol in the CNS. Has no saccharin, sugar, or Resp: atelectasis (↑ in alcohol are at higher risk of
significant anti- tartrazine (FDC yellow children) (IV), dyspnea (IV). developing hepatotoxicity with
Dose: inflammatory properties dye #5) should be CV: hypertension chronic use of usual doses of this
250 mg or GI toxicity. avoided in patients (IV), hypotension (IV). drug.
who have GI: HEPATOTOXICITY ▹ Assess amount, frequency, and type
Source: Davis’s Drug hypersensitivity or (↑DOSES), constipation (↑in of drugs taken in patients self-
Frequency: Guide for Nurses, p100 intolerance to these children) (IV),↑ liver enzymes, medicating, especially with OTC
q 4h now then for compounds nausea (IV), vomiting (IV). drugs. Prolonged use of
T>38C°  Severe hepatic F and E: hypokalemia (IV). acetaminophen increases risk of
impairment/ active GU: renal failure (high adverse hepatic and renal effects. For
Route: liver disease. doses/chronic use). short-term use, combined doses of
IVTT Hemat: neutropenia, acetaminophen and salicylates
pancytopenia. should not exceed the recommended
Drug Classification: MS: muscle dose of either drug given alone. Do
- Antipyretics spasms (IV), trismus (IV). not exceed maximum daily dose of
- NSAIDs Derm: ACUTE GENERALIZED acetaminophen when considering all
EXANTHEMATOUS routes of administration and all
PUSTULOSIS, STEVENS- combination products containing
JOHNSON SYNDROME, acetaminophen.
TOXIC EPIDERMAL ▹ Advise patient to take medication
NECROLYSIS, rash, urticaria. exactly as directed and not to take
more than the recommended
amount.
▹ Advise patient to discontinue
acetaminophen and notify health
care professional if rash occurs.
▹ Advise patient to consult health care
professional if discomfort or fever is
not relieved by routine doses of this
drug or if fever is greater than 39.5°C
(103°F) or lasts longer than 3 days.
Date Specific Action Indications Contraindications Side/Adverse Effects Nsg. Responsibilities
Generic name: Appears to inhibit DNA-  Active tuberculosis (with  Hypersensitivity CNS: ataxia, confusion, ▹ Perform mycobacterial studies and
Rifampicin dependent RNA other agents).  Concurrent use of drowsiness, fatigue, susceptibility tests prior to and
polymerase in atazanavir, darunavir, headache, periodically during therapy to detect
Brand name: susceptible organisms. fosamprenavir, weakness. possible resistance.
Famtricin Forte saquinavir, tipranavir, Derm: rash, pruritus. ▹ Monitor hepatic function at least
Source: Davis’s Drug or ritonavir-boosted monthly during therapy. May cause ↑
EENT: red discoloration
Dose: Guide for Nurses, p1087 saquinavir. BUN, AST, ALT, and serum alkaline
200 mg/5 ml of tears.
phosphatase, bilirubin, and uric acid
GI: abdominal pain,
concentrations.
diarrhea, flatulence,
▹ Administer medication on an empty
Frequency: heartburn, nausea, stomach at least 1 hr before or 2 hr
OD, 30 mins before vomiting,qliver enzymes, after meals with a full glass (240 mL)
meals red discoloration of water. If GI irritation becomes a
of saliva. problem, may be administered with
Route: GU: red discoloration of food
Oral urine. ▹ Advise patient to take medication
Hemat: hemolytic anemia, once daily, as directed, and not to
Drug Classification: skip doses or double up on missed
thrombocytopenia.
- Anti-tuberculosis doses.
MS: arthralgia, muscle
weakness, myalgia.
Misc: flu-like syndrome.
Date Specific Action Indications Contraindications Side/Adverse Effects Nsg. Responsibilities
Generic name: Inhibits mycobacterial  First-line therapy of  Hypersensitivity CNS: psychosis, seizures. ▹ May be administered with food or
Isoniazid cell wall synthesis and active tuberculosis, in  Acute liver disease EENT: visual disturbances. antacids if GI irritation occurs,
interferes combination with other  History of hepatitis GI: DRUG-INDUCED although antacids containing
Brand name: with metabolism. agents from previous use. HEPATITIS, nausea, aluminum should not be taken within
INH 1 hr of administration.
vomiting.
Isotamine Source: Davis’s Drug
Derm: rashes. ▹ Advise patient to notify health care
Guide for Nurses, p719 professional promptly if signs and
Dose: Endo: gynecomastia.
symptoms of hepatitis (yellow eyes
200mg/20mg/5ml Hemat: blood dyscrasias.
and skin, nausea, vomiting, anorexia,
Neuro: peripheral dark urine, unusual tiredness, or
Frequency: neuropathy. weakness) or peripheral neuritis
OD, 30 mins before Misc: fever. (numbness, tingling, paresthesia)
meals occur.
▹ Advise patient to take medication as
Route: directed. Take missed doses as soon
Oral as possible unless almost time for
next dose; do not double up on
Drug Classification: missed doses. Emphasize the
- Anti-tuberculosis importance of continuing therapy
even after symptoms have subsided.
▹ Emphasize the importance of regular
follow-up physical and
ophthalmologic exams to monitor
progress and to check for side effects
Date Specific Action Indications Contraindications Side/Adverse Effects Nsg. Responsibilities
Generic name: Converted to pyrazinoic  Used in combination with  Hypersensitivity GI: HEPATOTOXICITY, ▹ Advise patient to take medication as
Pyrazinamide acid in susceptible other agents in the  Cross-sensitivity with anorexia, diarrhea, nausea, directed and not to skip doses or
strains of treatment of active ethionamide, vomiting. double up on missed doses. Take
Brand name: Mycobacterium which tuberculosis. isoniazid, niacin, or GU: dysuria. missed doses as soon as remembered
Pyramin lowers the pH of the nicotinic acid may unless almost time for next dose.
Derm: acne, itching,
environment. exist Emphasize the importance of
photosensitivity,
Dose:  Severe liver continuing therapy even after
250 mg/5 ml Source: Davis’s Drug rash.
impairment symptoms have subsided. Length of
Guide for Nurses, p1057 Hemat: anemia, therapy depends on regimen being
thrombocytopenia. used and underlying disease states.
Frequency: Metab: ▹ Advise patients to notify health care
TID, 30 mins before hyperuricemia. professional if no improvement is
meals MS: arthralgia, gouty noticed after 2–3 wk of therapy or if
arthritis fever, anorexia, malaise, nausea,
Route: vomiting, darkened urine, yellowish
IVTT discoloration of the skin and eyes,
pain, or swelling of the joints occurs.
Drug Classification: ▹ Advise patients to use sunscreen and
- Anti-tuberculosis protective clothing to prevent
photosensitivity reactions.
▹ Emphasize the importance of regular
follow-up exams to monitor progress
and check for side effects
Date Specific Action Indications Contraindications Side/Adverse Effects Nsg. Responsibilities
Generic name: Inhibits the growth of  Active tuberculosis or  Hypersensitivity CNS: confusion, dizziness, ▹ Assessments of visual function should
Ethambutol mycobacteria. other mycobacterial  Optic neuritis. hallucinations, headache, be made frequently during therapy.
diseases (with at least malaise. Advise patient to report blurring of
Brand name: Source: Davis’s Drug one other drug). EENT: optic neuritis. vision, constriction of visual fields, or
Hambutol Guide for Nurses, p530 changes in color perception
GI: HEPATITIS, abdominal
immediately. Visual impairment,
pain, anorexia, nausea,
Dose: if not identified early, may lead to
400mg/tab vomiting.
permanent sight impairment.
Metab: hyperuricemia.
▹ Instruct patient to take medication as
MS: joint pain. directed. Take missed doses as soon
Frequency: Neuro: peripheral neuritis. as possible unless almost time for
OD, before meals Resp: pulmonary infiltrates. next dose; do not double up on
Misc: anaphylactoid missed doses. A full course of therapy
Route: reactions, fever. may take mo to yr. Do not
Oral discontinue without consulting health
care professional, even though
Drug Classification: symptoms may disappear.
- Anti-tuberculosis ▹ Instruct patient to notify health care
professional if no improvement is
seen in 2–3 wk. Health care
professional should also be notified if
unexpected weight gain or decreased
urine output occurs.
▹ Emphasize the importance of routine
exams to evaluate progress and
ophthalmic examinations if signs of
optic neuritis occur.
Date Specific Action Indications Contraindications Side/Adverse Effects Nsg. Responsibilities
Generic name: Inhibits synthesis of  Mild to moderate pain,  Previous CNS: agitation (↑ in children) ▹ Assess overall health status and
Prednisone prostaglandins that may Moderate to severe pain hypersensitivity (IV), anxiety (IV), alcohol usage before administering
serve as mediators of with opioid analgesics  Products containing headache (IV), fatigue (IV), acetaminophen. Patients who are
Brand name: pain and fever, primarily  Fever. alcohol, aspartame, insomnia (IV). malnourished or chronically abuse
Biopred in the CNS. Has no saccharin, sugar, or Resp: atelectasis (↑ in alcohol are at higher risk of
significant anti- tartrazine (FDC yellow children) (IV), dyspnea (IV). developing hepatotoxicity with
Dose: inflammatory properties dye #5) should be CV: hypertension chronic use of usual doses of this
20mg/tab (1 tab) or GI toxicity. avoided in patients (IV), hypotension (IV). drug.
who have GI: HEPATOTOXICITY ▹ Assess amount, frequency, and type
Source: Davis’s Drug hypersensitivity or (↑DOSES), constipation (↑in of drugs taken in patients self-
Frequency: Guide for Nurses, p100 intolerance to these children) (IV),↑ liver enzymes, medicating, especially with OTC
OD after meals for 2 compounds nausea (IV), vomiting (IV). drugs. Prolonged use of
weeks  Severe hepatic F and E: hypokalemia (IV). acetaminophen increases risk of
impairment/ active GU: renal failure (high adverse hepatic and renal effects. For
Route: liver disease. doses/chronic use). short-term use, combined doses of
Oral Hemat: neutropenia, acetaminophen and salicylates
pancytopenia. should not exceed the recommended
Drug Classification: MS: muscle dose of either drug given alone. Do
- Corticosteroids spasms (IV), trismus (IV). not exceed maximum daily dose of
- Antiasthmatics Derm: ACUTE GENERALIZED acetaminophen when considering all
EXANTHEMATOUS routes of administration and all
PUSTULOSIS, STEVENS- combination products containing
JOHNSON SYNDROME, acetaminophen.
TOXIC EPIDERMAL ▹ Advise patient to take medication
NECROLYSIS, rash, urticaria. exactly as directed and not to take
more than the recommended
amount.
▹ Advise patient to discontinue
acetaminophen and notify health
care professional if rash occurs.
▹ Advise patient to consult health care
professional if discomfort or fever is
not relieved by routine doses of this
drug or if fever is greater than 39.5°C
(103°F) or lasts longer than 3 days.
Date Specific Action Indications Contraindications Side/Adverse Effects Nsg. Responsibilities
Generic name: Hyoscine Butylbromide  relief of smooth muscle  Previous  dryness of the mouth, ▹ Be alert for adverse reactions and
Hyoscine butylbromide is a quaternary spasm of the hypersensitivity with difficulty in drug interactions.
ammonium gastrointestinal and  Products containing swallowing
Brand name: antimuscarinic agent. genitourinary system alcohol, aspartame,  thirst ▹ Assess for eye pain
Paracetamol Hyoscine butyl bromide saccharin, sugar, or  dilation of the pupils with
does not readily pass tartrazine (FDC yellow loss of accommodation ▹ Assess for urinary hesitancy
Dose: the blood-brain barrier. dye #5) should be and photophobia
250 mg It’s a competitive avoided in patients  increased intra-ocular ▹ Assess for constipation
antagonist of the who have pressure
actions of acetylcholine hypersensitivity or  flushing and dryness of ▹ Monitor urine output
Frequency: and other muscarinic intolerance to these the skin
q 4h agonists. The receptors compounds  bradycardia followed by ▹ Encourage patient to void.
affected are those of  Severe hepatic tachycardia, with
Route: peripheral structures impairment/ active palpitations and
IVTT that are either ▹ Monitor BP for possible
liver disease. arrhythmias
hypertension.
stimulated or inhibited  urinary urgency with the
Drug Classification: by muscarine, ie. inability to do so, as well
- Antispasmodic exocrine glands, smooth as reduction in the tone
and cardiac muscle. and motility of the gastro-
intestinal tract, leading to
Source: Davis’s Drug constipation
Guide for Nurses, p100  occasionally
vomiting, giddiness
and staggering may
occur
 restrosternal pain may
occur due to
increasedgastric reflux.
Date Specific Action Indications Contraindications Side/Adverse Effects Nsg. Responsibilities
Generic name: A coenzyme that  Secondarily infected  Contraindicated with  Headache ▹ Monitor vital signs
Multivitamins + Vitamin stimulate metabolic traumatic skin lesions hypersensitivity to  Paresthesia
B complex function and is needed caused by Staphylococcus Vit. B1, Vit. B2, Vit. B3  Blurred vision ▹ Give the drug with meals.
for cell replication, aureus and Streptococcus or any component of  Rashes
Dose: hematopoiesis, and pyogenes theformulation.  Wheezing ▹ Administer liquid preparations in
250 mg nucleoprotein and  Active peptic ulcer  Diarrhea water or juice to mask the taste and
myelin synthesis  Severe hypotension  Flatulence prevent staining of teeth.
 Nausea andvomiting
Frequency: Source: Nursing Drug  Irritation ▹ Warn the patient that stool may be
q 4h Guide 2016, Wolters  Agitation dark or green
Kluwer, p1577  Slightly drop of blood
Route: pressure. ▹ Be alert for adverse reactions and
IVTT
drug interactions.
Drug Classification:
- Vitamins and Minerals

Date Specific Action Indications Contraindications Side/Adverse Effects Nsg. Responsibilities


Generic name: Inhibits bacterial  Secondarily infected  Hypersensitivity to CNS: headache ▹ Assess lesions before and daily during
Mupirocin protein synthesis traumatic skin lesions mupirocin or EENT: cough, itching, therapy.
caused by Staphylococcus polyethylene glycol. GI: nausea; altered taste. ▹ Wash affected area with soap and
Dose: Source: Nursing Drug aureus and Streptococcus Derm: burning, itching, water and dry thoroughly. Apply a
250 mg Guide 2016, Wolters pyogenes small amount of mupirocin to the
pain, stinging.
Kluwer, p1577 affected area 3 times daily and rub in
gently. Treated area may be covered
Frequency: with gauze if desired.
q 4h ▹ Instruct patient on the correct
application of mupirocin.Advise
Route: patient to apply medication exactly as
Topical directed for the full course of
therapy. If a dose is missed, apply as
Drug Classification: soon as possible unless almost time
- Anti-infectives for next dose. Avoid contact with
eyes.
▹ Patient should consult health care
professional if
symptoms have not improved in 3–5
days.

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