Drug Cards
Name
Drug Name
1 Dronabinol
Trade name: Marinol
Capsules PO 2.5mg, 5mg,
10mg
Prevention of chemotherapyinduced nausea/vomiting:
Adults/Children: PO Initially,
5mg/m2 1-3h before
chemotherapy, then q2-4h
after chemo for total of 4-6
doses/day. May increase by
2.5mg /m2 up to 15mg/m2
per dose.
Appetite Stimulant: PO:
Adults: Initially, 2.5mg BID
(before lunch and dinner).
Range: 2.5-20mg/day.
Brittany Ducote
Therapeutic/
Pharmacologic Class
Indication/ Use
Adverse/ Side Effects
Nursing Considerations
Pharmacotherapeutic:
Controlled substance
(schedule III)
Action: Inhibits vomiting
control mechanisms in
medulla oblongata
Assess dehydration status if excessive
vomiting occurs (skin turgor, mucous
membranes, urinary output)
Clinical: Antinausea,
antiemetic, appetite
stimulant
Uses:
Prevention, treatment
of nausea/vomiting due
to cancer
chemotherapy; appetite
stimulant in AIDS.
Common S/E: Euphoria, dizziness,
paranoid reaction, drowsiness,
asthenia, ataxia, confusion, abnormal
thinking, depersonalization
Rare: diarrhea, depression,
nightmares, speech difficulties,
headache, anxiety, tinnitus, flushed
skin
Adverse effects:
Mild: May produce increased sensory
awareness (taste, smell, sound),
altered time perception, reddened
conjunctiva, dry mouth, tachycardia.
Moderate: memory impairment,
urinary retention. Severe: lethargy,
decreased motor coordination,
slurred speech, orthostatic
hypotension
Monitor mood, behavior responses
esp in patients with psychiatric
history.
Monitor BP and heart rate
Teach: change positions slowly,
nausea relief generally occurs within
15 mins of medication, avoid alcohol
and barbiturates, avoid tasks that
require motor skills and alertness
until response is known from drug, if
taken for appetite stimulant: take
before lunch and dinner.
Drug Name
2 Methadone
Trade name: Dolophine,
Metadol, Methadone Disket,
Methadone Intensol,
Methadose
Dosage: PO: Adults: Initially,
2.5mg -10mg q4-12h.
Children: 0.1-0.2mg/kg/dose
q4-8h for 2-3 doses then q612 h as needed. Maximum
dose: 10mg
IV, IM, Subcutaneous: Adults:
Initially, 2.5mg q8-12h, then
titrate slowly to desired
effect.
Children: 0.1mg/kg q4-8h for
2-3 doses, then q4-12h.
Maximum: 10mg/dose
Therapeutic/
Pharmacologic Class
Indication/ Use
Adverse/ Side Effects
Nursing Considerations
Pharmacotherapeutic:
Narcotic agonist
(Schedule II)
Action: Binds with
opioid receptors in the
CNS
Assess type, location, intensity of
pain.
Clinical: Opioid
analgesic.
Uses: Relief of severe
pain, detoxification,
temporary maintenance
treatment of narcotic
abstinence syndrome
Frequent S/E: Sedation, decreased
BP, diaphoresis, facial flushing,
constipation, dizziness, n/v.
Occasional S/E: Confusion, urinary
retention, palpitations, abdominal
cramps, visual changes, dry mouth,
headache, decreased appetite,
anxiety, insomnia
Rare S/E: Allergic reaction (rash,
pruritis)
Therapeutic effect:
Alters processes
affecting analgesia,
emotional responses to
pain; reduces
withdrawal symptoms
from other opioid drugs
Adverse Effects: Respiratory
depression, skeletal muscle flaccidity,
cold/clammy skin, cyanosis, extreme
drowsiness progressing to seizures,
stupor, coma.
Cardiac toxicity: Prolonged QT,
torsade de pointes.
Antidote: Nalaxone
Detoxification: PO: Adults:
Initial dose should not exceed
30mg. An additional 5-10mg
may be added if withdrawal
symptoms exist, or return in
2-4h. Total daily dose not to
exceed 40mg. Maintenance
range: 80-120mg/day with
careful titration.
Monitor VS, pain, respiratory status:
rate, rhythm, depth after
administration
Assess adequate voiding in case of
urinary retention
Monitor for withdrawal symptoms,
serum amylase and lipase for
increases.
Begin a bowel program to avoid
constipation
Teach: Avoid alcohol and other CNS
depressants, methadone may
produce drug dependence, potential
for abuse, may cause dry mouth and
drowsiness, avoid tasks that require
motor skills until response to drug is
established.
Avoid CYP3A4 inducers and inhibitors
that may reduce or increase
methadone effects. (phenobarbital,
charithromycin, etc)
Report severe drowsiness,
respiratory depression.
Drug Name
Therapeutic/
Pharmacologic Class
3 Lidocaine (Topical)
Trade name: Lidoderm,
Xylocaine
Topical: Adults: Apply to
affected areas as needed
Topical (dermal patch):
Adults: Apply to intact skin
over most painful area (up to
3 applications once for up to
12 hours in a 24h period)
Pharmacotherapeutic:
Amide anesthetic.
Clinical: Antiarrhythmic,
anesthetic.
Therapeutic effect:
Causes temporary loss
of feeling/sensation
Inhibits ventricular
arrhythmias.
Indication/ Use
Adverse/ Side Effects
Nursing Considerations
Action: Inhibits
conduction of nerve
impulses
Occasional S/E: Burning, stinging,
tenderness at application site.
Rare S/E: Generally associated with
high dose: Drowsiness, dizziness,
disorientation, light-headedness,
tremors, apprehension, euphoria,
sensation of heat/cold/numbness,
blurred/double vision, tinnitus,
nausea.
Obtain baseline VS, EKG, serum
electrolytes.
Monitor LOC.
Monitor EKG, VS for cardiac
performance.
-If EKG shows arrhythmias,
prolongation of PR interval or QRS
complex, inform physician
immediately.
Adverse Effects: Cardiovascular
depression, bradycardia, hypotension,
arrhythmias, heart block, CV collapse,
cardiac arrest.
Assess HR for rate, rhythm, quality.
BP for hypotension.
Uses: Topical
Anesthetic: local skin
disorders (minor burns,
insect bites, prickly
heat, skin
manifestations of
chickenpox, abrasions).
Mucous membranes
(local anesthesia of oral,
nasal, laryngeal mucous
membranes; local
anesthesia of
respiratory, urinary
tracts; relief of
discomfort pruritis ani,
hemorrhoids, pruritis
vulvae.
Dermal patch: relief of
chronic pain in postherpetic neuralgia,
allodynia (painful
hypersensitivity)
Teach: Report irritation, pain,
numbness, swelling, blurred vision,
tinnitus, respiratory difficulty.
Drug Name
4 Acetaminophen
Trade name: Abenol,
Acephen, Atasol, Feverall,
Mapap, Ofirmev, Tempra,
Tylenol
IV: Adults, adolescents
weighing 50kg or more:
1000mg q6h or 650mg q4h.
Adults, adolescents weighing
less than 50kg: 15mg/kg q6h
or 12.5mg/kg q4h.
Children 2-12: 15mg/kg q6h
or 12.5mg/kg q4h.
Infants/children less than 2:
7.5-15mg/kg q6h.
PO: Adults, children 13 and
older: 325-650mg q4-6h or 1g
3-4 times a day.
Children 12 and younger: 1015mg/kg/dose q8h.
Neonates: 30mg/kg/once,
then 20mg/kg/day.
Rectal: Adults: 325-650mg
q4-6h.
Children: 10-20mg/kg/dose
q4-6h. Neonates:
30mg/kg/once, then
20mg/kg/dose q6-8h.
Therapeutic/
Pharmacologic Class
Indication/ Use
Adverse/ Side Effects
Nursing Considerations
Pharmacotherapeutic:
Central analgesic.
Clinical: Non-narcotic
analgesic, antipyretic.
Action: Appears to
inhibit prostaglandin
synthesis in the CNS and
block pain impulses
through peripheral
action. Acts centrally o
hypothalamic heatregulating center,
producing peripheral
vasodilation (heat loss,
skin erythema,
diaphoresis)
Rare S/E: Hypersensitivity reaction.
Assess onset, location, duration, type
of pain. Assess for fever. Assess
alcohol usage.
Adverse Effects:
Early signs of toxicity: Anorexia,
nausea, diaphoresis, fatigue within
first 12-24 hours.
Later signs of toxicity: Vomiting, right
upper quadrant tenderness, elevated
hepatic function tests within 48-72
hours after ingestion.
Assess for relief of pain, fever.
Assess risk for bleeding if also taking
Warfarin or St. John’s wort.
Monitor AST, ALT, bilirubin,
prothrombin levels for indication of
hepatotoxicity
Antidote: Acetylcysteine
Uses: Relief of mild to
moderate pain, fever. IV
Use: management of
moderate to severe
pain when combined
with opioid analgesia.
Report to physician if use is longer
than 5 days in children and longer
than 10 days in adults.
Report fever lasting longer than 3
days to physician
Teach: Not to exceed more than 4g in
24 hour period. Be aware of other
over the counter meds that may
contain acetaminophen. Avoid
alcohol. Take with a full glass of
water.