MEDICATION WORKSHEET
Trade and Generic Name
Classification, Therapeutic or
Pharmacological Action
Dose/ Route / Time
Side Effects and things to assess prior to
administration
Trade Name: Protonix
Proton-pump inhibitor- blocks
production of acid in the stomach
Adult Dose for Gastroesophageal
reflux disease:
SE: Headache, diarrhea, N/V, constipation,
rash, abdominal pain
Therapeutic: Treats certain
stomach and esophagus
problems; such as GERD. It works
by decreasing the amount of acid
the stomach makes.
Oral: 40 mg once a day
Duration of therapy: 8 weeks
Assess: Bowel sounds
Generic Name: Pantoprazole
Patient Education:
Recommend to take medication approximately 30 minutes prior to
meals for maximal effectiveness. Tablets should be swallowed whole
and should not be crushed, split or chewed.
Report serious side effects; severe diarrhea with watery bloody
stools, abdominal pain. Allergic reaction like skin rash, itching or
hives, swelling of the face, lips or tongue, bone, muscle or joint pain,
irregular heart rate and breathing problems.
Avoid-Alcohol and NSAIDS to prevent GI irritation.
Parenteral: 40 mg IV once a day
given over at least 2 minutes or
over 15 minutes
Duration of therapy: 7 to 10 days
Monitor: In patient on long term therapy
 Magnesium level
 Vitamin B12 levels
 Liver functions test, in patient with
impaired liver function
 Renal functions test.
Nursing Implication (drug to drug interactions, effectiveness/ how do you
know the medication is working?)
Drug-to-drug interactions: avoid the use of methotrexate and St. Johns wart
Effectiveness: Decrease and/or relieves symptoms of heartburn, epigastric
discomfort/pain, bloating, difficulty swallowing and persistent cough caused
by acid reflux. It helps heal acid damage to the stomach and esophagus and
helps in preventing ulcers.