!!
Brand!name!
Generic!Name!
Cardiovascular!drugs!
1.!Antihypertensive!(ACE!inhibitor)!
!!!
Zestril!p.560!
Lisinopril!
!
Capoten!
captopril!
Pharmacological!
Classification! !
Outcome!/!Indication!
Action! !
Side!Effect!
Special!Precaution!
Antihypertensive!–!(ACE!
inhibitor)!
Decreased!BP!in!HT,!
decreased!preload,!
afterload!in!CHF.!Mild!to!
moderate!HT,!adjunctive!
therapy!of!systolic!CHF!
and!acute!MI.!
Decreased!BP!in!HT,!
decreased!preload,!
afterload!in!CHF.!
Selectively!suppresses!
reninRangiotensionR!aldosterone!
systemS!inhibits!ACES!prevents!
conversion!of!angiotension!I!to!
angiotension!IIS!results!in!dilatation!of!
arterial,!venous!vessels.! !
Selectively!suppresses!
reninRangiotensionR!aldosterone!
systemS!inhibits!ACES!prevents!
conversion!of!angiotension!I!to!
angiotension!II!
Stroke,!proteinuria,!renal!
insufficiency,!angioedema,!chest!
pain,!hypotension.!Skin!rash!
Monitor!BP,!edema!in!feet!and!
legs!dailyS!I/O!ratio.!Not!to!
discontinue!the!drug!abruptly!or!
withdrawal!symptoms!may!
occurs.! !
CV:!hypotension,!tachycardia!
RESP:!dyspnea,!cough! !
Crushed!and!mixed!with!foodS! !
Monitor!blood!studies:!if!
3
neutrophils!<1000/mm S!monitor!
BP,check!for!orthostatic!
hypotension,!syncopeS!check!for!
edema!in!feet,!legs!dailyS!monitor!
weight!daily!in!CHF!
Decreased!BP!in!
hypertension!
Stimulates!central!alpha2Radrenergic!
receptors!in!the!CNS,!resulting!in!
decreased!sympathetic!outflow!from!
the!brain!with!decreased!peripheral!
resistance!
Monitor!BP,!edema!in!feet!and!
legs!dailyS!I/O!ratio.!Not!to!
discontinue!the!drug!abruptly!or!
withdrawal!symptoms!may!
occurs.! !
Mild!to!moderate!HT,!CHF,!
BPH!
Block!alphaRmediated!
vasoconstriction!of!adrenergic!
receptors,!inducing!peripheral!
vasodilatation.! !
Myocarditis,!CHF,!hepatic!
dysfuncation,!pancreatitis,!
leucopenia,!thrombocytopenia!and!
hemolytic!anemia!and!
granulocytopenia!
!
[Hypotension,!sedative,!decrease!in!
LOC]!
Hypotension,!headache,!
drowsiness,!weakness,!nausea!and!
vomiting.! !
Decrease!BP,!heart!rate,!
AV!conduction.!Mild!to!
moderate!HT,!acute!MI!to!
reduce!cardiovascular!
mortality,!angina!pectoris!
Decrease!blood!pressure,!
heart!rate.!Chronic!stable!
angina!pectoris,!HT,!MI,! !
Competitively!blocks!stimulation!of!
beta1Radrenergic!receptor!within!
vascular!smooth!muscleS!produces!
chronotropic,!inotropic!activity!
(decrease!rate!of!SA!node!discharge,!
increase!recovery!time),!slows!
conduction!of!AV!node,!decrease!
heart!rate,!which!decrease!O2!
consumption!in!myocardiumS!also!
decrease!reninR!angiotensionR!
aldosterone!system!at!high!dose.! !
Depression,!CHF,!cardiac!arrest,!AV!
block,!bradycardia,!pulmonary!
edema,!chest!pain.!Agranulocytosis,!
eosinophilia,!thrombocytopenic!
purpura.!Bronchospasm.! !
Bradycardia,!CHF,!pulmonary!
edema,!dysrhythmias,!
laryngospasm,!Agranulocytosis,!
thrombocytopenia!
Monitor!BP,!edema!in!feet!and!
legs!dailyS!I/O!ratio.!Not!to!
discontinue!the!drug!abruptly!or!
withdrawal!symptoms!may!
occurs.! !
!
Do!not!give!to!asthma!patient.!
CNS:!insomnia,!fatique,!dizziness,!
mental!changes!
CHF:!cold!extremities,!postural!
nd
rd
hypotension,!2 !or!3 !degree!heart!
block!
Check!BPS!check!for!edema!in!
feet,!legs!dailyS!monitor!I/O,!daily!
weight!in!CHF! !
Inhibits!calcium!ion!influx!across!cell!
membrane!during!cardiac!
depolarization,!produces!relaxation!of!
coronary!vascular!smooth!muscle,!
dilates!coronary!vascular!arteries,!
increase!myocardial!oxygen!delivery!
in!patient!with!vasospastic!angina!
!
Headache,!dizziness,!
lightheadedness,!nausea,!flushing,!
StevensRJohnson!syndrome.! !
Monitor!BP,!edema!in!feet!and!
legs!dailyS!I/O!ratio.!Not!to!
discontinue!the!drug!abruptly!or!
withdrawal!symptoms!may!
occurs.! !
CHF,!headache,!drowsiness,!
Encourage!fluid!intake!and!fibre!
Antihypertensive!–!(ACE!
inhibitor)!
1.!Antihypertensive!(alphaRadrenergic!blocker)!
!!!
Aldomet!
Methyldopa!
Antihypertensive!–!
centrally!acting!
alphaRadrenergic!
inhibitor!
!!
! Minipress!
Prazosin!
Antihypertensive!–!(ACE!
inhibitor!/!vasodilator)!
1.!Antihypertensive!(betaRadrenergic!blocker)!
!! ! Betaloc!p.617!
Metoprolol!
Antihypertensive!–!
(beta1Radrenergic!
blocker),!antianginal!
!!
!
! Inderal!p.791!
!
Propranolol! !
Atenolol!
Antihypertensive!–!
(beta1Radrenergic!
blocker)!antianginal,!
antidysrhythmic!(class!
III)!
Antihypertensive!–!
(beta1Radrenergic!
blocker)!
1.!Antihypertensive!(calcium!channel!blocker)!
!! ! Adalat! !
Nifedipine!
Antihypertensive!
(calcium!channel!
blocker),!antianginal! !
!!
! Isoptin! !
Verapamil!
Decrease!BP,!heart!rate,!
prevention!of!angina!
pectoris!
Decreased!angina!pectoris,!
decreased!BP!in!HT!
Decreased!angina!pectoris,!
First!dose!syncope!(
S
)!=!
postural/standup!hypotension!
decreased!BP!in!HT!
dysrhythmias!
2.!Antianginal!(betaRadrenergic!blocker)!
!! ! Betaloc!p.617!
Metoprolol!
!!
! Inderal!p.791!
Propranolol! !
2.!Antianginal!(calcium!channel!blocker)!
!! ! Adalat! !
Nifedipine!
Antihypertensive!–!
(beta1Radrenergic!
blocker),!antianginal!
Antihypertensive!–!
(beta1Radrenergic!
blocker)!antianginal,!
antidysrhythmic!(class!
III)!
Antihypertensive!
(calcium!channel!
blocker),!antianginal! !
Competitively!blocks!stimulation!of!
beta1Radrenergic!receptor!within!
vascular!smooth!muscleS!produces!
chronotropic,!inotropic!activity!
(decrease!rate!of!SA!node!discharge,!
increase!recovery!time),!slows!
conduction!of!AV!node,!decrease!
heart!rate,!which!decrease!O2!
consumption!in!myocardiumS!also!
decrease!reninR!angiotensionR!
aldosterone!system!at!high!dose.! !
Depression,!CHF,!cardiac!arrest,!AV!
block,!bradycardia,!pulmonary!
edema,!chest!pain.!Agranulocytosis,!
eosinophilia,!thrombocytopenic!
purpura.!Bronchospasm.! !
Bradycardia,!CHF,!pulmonary!
edema,!dysrhythmias,!
laryngospasm,!Agranulocytosis,!
thrombocytopenia!
Monitor!BP,!edema!in!feet!and!
legs!dailyS!I/O!ratio.!Not!to!
discontinue!the!drug!abruptly!or!
withdrawal!symptoms!may!
occurs.! !
!
Do!not!give!to!asthma!patient.!
Decreased!angina!pectoris,!
decreased!BP!in!HT!
Inhibits!calcium!ion!influx!across!cell!
membrane!during!cardiac!
depolarization,!produces!relaxation!of!
coronary!vascular!smooth!muscle,!
dilates!coronary!vascular!arteries,!
increase!myocardial!oxygen!delivery!
in!patient!with!vasospastic!angina!
!
Headache,!dizziness,!
lightheadedness,!nausea,!flushing,!
StevensRJohnson!syndrome.! !
Monitor!BP,!edema!in!feet!and!
legs!dailyS!I/O!ratio.!Not!to!
discontinue!the!drug!abruptly!or!
withdrawal!symptoms!may!
occurs.! !
CHF,!headache,!drowsiness,!
dizziness,!edema,!nausea,!
constipation,!StevensRJohnson!
syndrome.! !
CNS:!headache,!fatique,!drowsiness!
CV:!edema!
GI:!nausea,!constipation!
INTEG:!rash!
Encourage!fluid!intake!and!fibre!
intake!
! Isoptin! !
Verapamil!
!!
! Herbesser!
Diltiazem!HCl!
Antianginal!
Ca!antagonist!
Isosorbide!
dinitrate!
Antianginal,!vasodilator! !
Relief!and!prevention!of!
angina!pectoris!
Nitrate!Vasodilator!
(antiRanginal)!
Treatment!for!angina!
pectoris,!prophylaxis!
AntianginalRRantiplatelet!
AntiRconvulsant/!
antidysrhythmic!
(hydantoins)!
Glyceryl!
Trinitrate!
2.!Antianginal!(antiplatelet)!
!
Persantin!
Dipyridamole!
!!
! Angised!TNG!
3.!Antidysrhythmic! !
!! ! Dilantin!p.752!
Phenytoin!
intake!
Decrease!BP,!heart!rate,!
AV!conduction.!Mild!to!
moderate!HT,!acute!MI!to!
reduce!cardiovascular!
mortality,!angina!pectoris!
Decrease!blood!pressure,!
heart!rate.!Chronic!stable!
angina!pectoris,!HT,!MI,! !
!!
2.!Antianginal!(nitrate)!
!! ! Isordil!p.526!
dizziness,!edema,!nausea,!
constipation,!StevensRJohnson!
syndrome.! !
Decreased!angina!pectoris,!
decreased!BP!in!HT!
dysrhythmias!
Inhibits!calcium!ion!influx!across!cell!
membrane!during!cardiac!
depolarization,!produces!relaxation!of!
coronary!vascular!smooth!muscle,!
dilates!coronary!vascular!
arteries,slows!SA/AV!node!
conduction!times,!dilates!peripheral!
arteries!
1.If!BP<30mmHg!"stop!
3!
2.If!platelets<150000/mm "!stop!
3.!Swallow!the!whole!tab!
4.!Store!in!airtight!container!at!rm!
temp!
Relaxation!of!vascular!smooth!
muscle!which!lead!to!decreased!
preload,!after!load,!thus!decreasing!
left!ventricular!endRdiastolic!pressure,!
systemic!vascular!resistance!and!
reducing!cardiac!O2!demand!
Vascular!headache,!flushing,!
dizziness,!weakness!and!faintness.!
Postural!hypotension,!nausea,!
vomiting!,!tachycardia.!
Hypotension*
Apply!through!SL!
Create!nitrateRfree!period!to!
minimize!tolerance!
Prevention!of!
thromboembolism!in!client!
with!heart!valves,!
combination!therapy!with!
warfarin!sodium,!coronary!
artery!disease!
Inhibit!clotting!mechanismS!prevent!or!
disrupt!the!aggregation!(an!
accumulation!of!substances!in!the!
blood!that!form!a!group!or!cluster)!of!
platelets!needed!to!form!a!clot!
LightRheadedness!
Administer!75R100mg!PO!QID!
with!warfarin!to!prevent!
thromboembolism!in!Pt!with!
prosthetic!heart!valves!
General!tonicRclonic,!
seizures,!epilepticus,!
nonepileptic!seizures!after!
Reye’s!syndrome!
Inhibits!spread!of!seizure!activity!in!
motor!cortex!by!altering!ion!transport,!
increase!AV!condiction!to!decrease!
dysrhythmias!
Ventricular!fibrillation,!drowsiness,!
dizziness,!insomnia,!depression,!
hepatitis,! ! nephritis,!anemia,!
thrombocytopenia,!StevenRJohnson!
syndrome!
Check!serum!phenytoin!level!"!
malfunction!of!immunization!and!
gum!hyperplasia!may!be!resulted!
Cannot!relief!MI!
!!
! Lanoxin!p.313!
Digoxin!
Inotropic!
antidysrhyhmic,!cardiac!
glycoside!
!!
! Cordarone!
Amiodarone!
Amiodarone!
AntiRdysrhythmic!
Gastrointestinal!drugs!
1.!Antiulcer!(antacid)!
!
Gelusil!
Decreased!edema,!pulse,!
respiration!and!crackles.!
Rapid!digitalization!in!acute!
and!chronic!CHF,!atrial!
flutter,!atrial!tachycardiaS!
cardiogenic!shock,!
paroxysmal!atrial!
tachycardia!
Decrease!amount!and!
severity!of!ventricular!
dysrhymias,!ventricular!
tachycardia,!
supraventricular!fibrillation,!
atrial!fibrillation!not!
st
controlled!by!1 !line!
Inhibits!sodiumRpotassium!ATPase,!
which!makes!more!calcium!available!
for!contractile!proteins,!resulting!in!
increased!cardiac!output,!increase!
force!of!contractionS!decrease!heart!
rate!and!decrease!AV!conduction!
speed.! !
Dysrhythmias,!AV!block,!headache,!
drowsiness,!nausea!and!vomiting,!
anorexia,!abdominal!pain.! !
Assess!AR!1!min!before!giving!
drugS!withhold!if!AR<60!
Prolongs!action!potential!duration!
and!effective!refractory!period,!slow!
sinus!rate!with!increasing!PR!and!QT!
intervals,!decrease!peripheral!
vascular!resistance!
CNS:!headache,!dizziness!
CV:!hypotension!
1.!
GI!ulcer,!relieve!heartburn,!
sour!stomach!and!acid!
indigestion.!
Relief!upset!stomach!by!
hyperacidity!
AlOH!&!MgOH:!Neutralise!gastric!
acid,!inhibit!the!proteolytic!activity!of!
pepsin!(MgOH),!increase!secretion!of!
cholecystokinin!from!duodenum!and!
stimulate!fluid!secretion!and!intestinal!
mobility!(MgOH)!
Simethicone:!Remove!excess!gases!
in!digestive!tract!
Neutralise!gastric!acid!
Constipation!or!diarrhea,!
hypocalcaemia!
2.!
turn!bluish!on!neck,!face,!
arms!when!used!for!long!
periods!(reversible)!
pulmonary!toxicity"!
discontinue!(including!
pulmonary!fibrosis,dysnea,!
fatique,!cough,!fever,!chest!
pain,!ARDs)!
Gelusil!Active!
Ingredients:! !
aluminum!
hydroxide,!
magnesium!
hydroxide,!
simethicone!
Antacid,!antiulcerant.!
Adsorbent,!antiflatulent!
! Mucaine! !
Aluminum!
Hydroxide!
Antacid!
Relieve!mild!heartburn!and!
ingestion.! !
! Oscal!
Caltrate!
CaCO3!
Antacid,!Ca!supplement!
Not!for!chronic!therapy!
Neutralizes!gastric!acidity!
1.!Antiulcer!(proton!pump!inhibitor)!
!! ! Pariet!
Rabeprazole!
PPI!
duodenal!ulcersS!
decreased!
gastroesophageal!reflux! !
!
PPI!
Suppresses!gastric!secretion!by!
inhibiting!H/K!ATPase!enzyme!
system!in!the!gastric!parietal!cellS!
characterized!as!a!gastric!acid!pump!
inhibitor,!since!it!blocks!the!final!step!
of!acid!production!
CNS:!headache,!dizzsiness,!
asthenia!
GI:!diarrhea,!abdominal!pain,!
vomiting,!nausea,!constipation,!
flatulence,!acid!regurgitation!
MISC:!back!pain!
RESP:!upper!respiratory!tract!
infection,!cough!
1.!
2.!
3.!
1.!
2.!
3.!
4.!
Healing!of!duodenal!ulcers!
or!gastric!ulcersS!
prevention!of!duodenal!
ulcersS!decrease!symptoms!
of!gastroesophageal!reflux!
disease!(GERD),!
heartburn,!gastritis!
Inhibits!histamine!at!H2Rreceptor!site!
in!gastric!acid!secretion! !
Headache,!dizziness,!depression,!
anxiety,!insomnia,!dysrhythmias,!
thrombocytopenia,!aplastic!anemia,!
Rash! !
Inhibits!histamine!at!H2!receptor!site!
in!the!gastric!parietal!cells!which!
inhibits!gastric!acid!secretion!
Seizures,!dysrhythmias,!paralytic!
ileus!jaundice,!thrombocytopenia,!
exoliative!dermatitis,!gyneomastia!
(longRterm)!
Headache,!sleeplessness,!
dizziness,!confusion,!hepatotoxicity,!
rash,!constipation,!abdominal!pain,!
diarrhea!
Assess!patient!with!ulcers,!gastric!
pH!(~5).!Monitor!I/O!ratio.!Give!
antacid!1!hr!before!and!2!hrs!
after,!with!food!and!liq.! !
!
Assess!patient!with!ulcers,!gastric!
pH!(~5).!Monitor!I/O!ratio!
!!
!!
! Triact!
Losec!
Omeprazole! !
1.!Antiulcer!(H2Rreceptor!antagonist)!
!! ! Pepcidine!p.399!
Famotidine!
!!
! Tagamet!p.234!
Cimetidine!
! Zantac!p.812!
Ranitidine!
AlOH:!antacid!
MgOH:!antacid,!laxative!
Simethicone:!
antiRflatulent!
H2Rhistamine!receptor!
antagonist,!antiulcer!
agent!
Inhibit!the!action!of!histamine!on!
parietal!cells!of!stomach!and!basal!
and!triggering!gastric!acid!secretion!
AlOH:!comstipation!
MgOH:!diarrhea!
Simethicone:diarrhea!
(Latter!two!counteract!the!S/E!of!
AlOH)!
Constipation!or!diarrhea,!nausea!
and!vomiting,!confusion!and!
excessive!tiredness.! !
GI:!constipation!(laxatives!or!stool!
softeners!can!be!given)!
Shake!well!before!use.!
!
!
Triact:!chew!before!swallowing!
!
Antacid:1hr!pc!and!at!bed!time!
Ca!supplement:!1/2!pc!and!at!bed!
time!
assess!bowel!sound!q8h!
Swallow!the!whole!tab!
diarrhea"discontinue!
assess!bowel!sound!q8h!
Swallow!the!whole!tab!
diarrhea"discontinue!
acS!may!give!with!antacids!
Assess!patient!with!ulcers,!gastric!
pH!(~5).!Monitor!I/O!ratio!
1.!Antiulcer!(protectant)!
!
Carafate/!
sulcrate!
2.!Antiemetic
!
Sucralfate!
antiulcer(protectant)!
Duodenal!ulcer,!oral!
mucositis,!stomatitis!after!
radiation!of!head!or!neck!
Form!a!complex!that!adhere!to!ulcer!
site,!absorbs!pepsin!
GI:!dry!mouth,!constipation!
1.!
2.!
Swallow!the!whole!tab!
give!on!empty!stomach!1hr!
ac!and!at!bedtime!
3.! avoid!antacids!1/2hr!b4!ot!
1hr!after!taking!this!drug!
4.!not!to!use!over!8!wks,!avoid!
smoking!
Hydroxyzine!
AntiRanxiety,!sedative,!
hypnotic,!antihistamine,!
antiemetic!
Anxiety!preoperatively,!
postoperatively!to!precent!
nausea,!vomiting,!to!
potentiate!opioid!
analgesicsS!sedationS!
pruritusS!prevention!of!
alcohol,!drug!withdrawalS! !
Absence!of!allergy!
symptoms,!rhinitis!pruritus,!
absence!of!nausea/!
vomiting,!sedation,!
absence!of!anxiety!
Vomiting,!secretion!
(preROT),!involuntary!
movement!
Depresses!subcortical!levels!of!CNS,!
including!limbic!system,!reticular!
formation,!anticholinergic,!antiemetic,!
antihistaminic!response,!competes!
with!H1Rreceptor!sites.!
Dizziness,!drowsiness,!seizures,!dry!
mouth.! !
Take!1!hr!pc!or!2!hrs!pc!
Inhibits!acetycholine!at!receptor!sites!
in!autonomic!nervous!system,!which!
controls!secretions,!free!acids!in!
stomachS!block!central!mescarinic!
receptors,!which!decrease!
involuntary!movementS!blocks!
response!of!iris!sphincter!muscle,!
muscle!of!accommodation,!resulting!
in!dilation,!paralysis!of!
accommodation!
Enhances!response!to!acetylcholine!
of!tissue!in!upper!GI!tract,!which!
causes!contraction!of!gastric!muscle,!
relaxes!pyloric,!duodenal!segments,!
increases!peristalsis!without!
stimulating!secretions,!block!
dopamine!in!chemoreceptor!trigger!
zone!of!CNS!
Depresses!cerebral!cortex,!
hypothalamus,!limbic!system,!which!
control!activity!aggression,!blocks!
neurotransimission!produced!by!
DOPamine!at!synapseS!exhibits!a!
strong!alphaRadrenergic,!
anticholinergic!blocking!actionS!
mechanism!for!antipsychotic!effects!
is!unclear.S!act!centrally!by!blocking!
chemoreceptor!trigger!zone,!which!in!
turns!acts!on!vomiting!centre.! !
Acts!on!blood!vessels,!GI,!respiratory!
system!by!competing!with!histamine!
Pupil!dilation,!photophobia,!blurred!
vision,!headache,!drowsiness,!dry!
mouth,!constipation,!urinary!
hesitancy!and!retention,!nasal!
congestion,!decrease!sweating!
Provide!adequate!hydration!
Prevent!hyperpyrexia!by!
controlling!the!surrounding!
temperature!
Encourage!Pt!to!void!before!drug!
administration!due!to!urine!
retention!of!its!S/E!
Sedation,!fatigue,!restlessness,!
sleeplessness,!suicide!ideation,!
seizures,!supraventricular!
tachycardia!
Monitor!BP!if!through!IV!
Monitor!extrapyramindal!
reactions!and!those!with!diabetes!
"!change!dose!of!insulin!
Depression,!entrapyramidal!
symptoms!(EPS),!neuroleptic!
malignant!syndrome.!Circulatory!
failure,!tachycardia.!Respiratory!
depression.!
Identify!neuroleptic!malignant!
syndrome:!hyperpyrexia,!muscle!
rigidity,!increase!CPK!etcS!notify!
prescriber!immediatelyS!drug!
should!be!discontinued.!Monitor!
bilirubin,!CBC,!liver!function!
studies!monthly,!hepatotoxicity!
may!occur.! !
Dizziness,!drowsiness,!neuroleptic!
malignant!syndrome,!constipation,!
Administer!through!IM,!no!SC!due!
to!tissue!necrosis!
!
Atarax!p.487!
!!
! Holopon!/!
Buscopan!
Hyoscine!
methybromide/!
hyosineRNR!
butylbromide!
Antiemetic,!
anticholinergic,!mydriatic!
!!
! Maxolon!p.613!
Metoclopramide!
Antiemetic!and!
Cholinergic!
Decreased!symptoms!of!
delayed!gastric!emptying,!
decreased!nausea!and!
vomiting.!Prevention!of!
nausea!vomiting!induced!
by!chemotherapy,!delayed!
gastric!emptying!&!GER!
!!
! Stemetil!p.781!
Prochlorperazine!
meleate!
Antiemetic/!antipsychotic!
Nausea,!vomiting,!
psychosis.! !
Decreased!nausea,!
vomiting,!decreased!S/S!of!
psychosis!
!!
! Phenergan!p.785!
Promethazine!
HCl!
Antihistamine,!
H1Rreceptor!antagonist,!
Motion!sickness,!rhinitis,!
allergy!symptoms,!
antiemetic,!
sedative/hypnotic!
sedation,!nausea,!
preoperative!and!
postoperative!sedationS!
Absence!of!allergy!
symptoms!and!rhinitis,!
absence!of!vomiting,!
nausea!and!sedation.! !
for!H1Rreceptor!siteS!decrease!allergic!
response!by!blocking!histamineS!also!
acts!on!chemoreceptor!trigger!zone!
to!decrease!vomiting,!increase!CNS!
stimulation,!has!anticholinergic!
response!
urinary!retentionapnea!in!pediatric!
patient.! !
Bisacodyl!
Laxative,!stimulant!
Constipation(short!term),!
bowel/rectal!preparation!of!
surgery/examination!
Increase!motor!activity!of!intestineS!
irritate!colonic!intramural!plexusS!
increase!H2O!in!the!colon!
GI:!nausea,!vomiting,!anorexia,!
cramps!
Decreased!constipation,!
decreased!blood!ammonia!
level.!
Chronic!constipation,!
portalRsystemic!
encephalopathy!in!patients!
with!hepatic!disease.! !
Decreased!constipation!
and!decreased!diarrhea!in!
colitis!for!chronic!
constipation,!ulcerative!
colitis,!irritable!bowel!
syndrome!
Decreased!constipation!for!
acute!constipation,!bowel!
preparation!for!surgery!or!
exam!
Increase!osmotic!pressureS!draws!
fluid!into!colonS!prevents!absorption!
of!ammonia!in!colon,!increase!water!
in!stool.! !
Nausea,!vomiting,!anorexia,!
abdominal!cramp,!diarrhea,!
flatulence,!distention,!belching! !
Promotes!peristalsis!by!combining!
with!water!in!the!intestine!to!form!a!
gelRlike!substance!that!is!easily!
evacuated!
Nausea!and!vomiting,!anorexia,!
diarrhea,!cramps,!
intestinal/esophageal!blockage.! !
Decrease!constipation!in!12R24!
hours.!Give!with!8oz!of!water!or!
juice!followed!by!another!8oz!of!
juice.!
Check!BO!before!given.! !
Stimulates!peristalsis!by!action!on!
Auerbach’s!plexusS!softens!feces!by!
increasing!water!and!electrolytes!in!
large!intestine!
Nausea!and!vomiting,!anorexia,!
abdominal!cramps,!tetany!(
)!
Decrease!constipation!in!8R10!
hrsS!check!BO!before!use.! !
Decreased!diarrhea!for!
diarrhea!(cause!
undetermined,!mild!to!
moderate!
diarrhea!
Decreases!gastric!motility,!water!
content!of!stool!and!adsorbent,!
demulcent.! !
Constipation!(chronic!use)!
Check!BO!before!used!
!
!
Decreased!loose!stools!for!
diarrhea!
Inhibits!gastric!motility!by!acting!on!
mucosal!receptors!responsible!for!
peristalsisS!related!to!opioid!
analgesics!as!adjunct!
Abdominal!pain,!nausea,!vomiting,!
tiredness,!dizziness,!drowsiness,!
dry!mouth!
Dizziness,!drowsiness,!
lightheadedness,!headache,!fatigue,!
nausea!and!vomiting,!dry!mouth,!
paralytic!ileus,!anaphylaxis,!
angioedema,!respiratory!depression!
3.!Laxative! !
!
Dulcolax!
!!
! Lactulose!p.536!
Lactulose!
Laxative!(hyperosmotic/!
ammonia!detoxicant)!
!!
! Metamucil!p.797!
Psyllium!
Laxative,!bulkRforming!
!!
! Senokot!p.845!
Senna,!
sennosides!
LaxativeRstimulant!
! Kaopectate!
p.121!
Kaolin!&!pectin!
mixture!
Antidiarrheal!
! Imodium!
Loperamide!HCl! !
antidiarrheal!
! Lomotil!p.324!
Diphenoxylate!
with!atropine!
Antidiarrheal!
1.!
2.!
Swallow!the!whole!tab!
give!water!for!better!
absorption!
3.! don’t!take!within!1hr!of!
antacids,!milk!
4.! for!rectal!route,!retain1/2hr!
5.! don’t!use!in!presence!of!
abdominal!pain,!nausea,!
vomitting!
Increase!fluid!intake!to!2L/D,!can!
give!with!fruit!juice,!water,!milk!
and!normal!ammonia.! !
4.!AntiRdiarrheal!
!!
!!
Respiratory!drugs!
1.!Bronchodilator!
Check!response!after!48!hrs,!if!no!
response,!drug!should!be!
discontinued.!Check!BO!before!
used.! !
!!
! Atrovent!
Ipratropium!
Anticholinergic,!
bronchodilator!
inhalation!for!the!treatment!
of!obstructive!lung!
diseases!(COPD!induced!
Bronchospasm,!rhinorrhea!
in!children)!
Prevention!of!
exerciseRinduced!asthma,!
acute!Bronchospasm,!
bronchitis,!emphysema,!
bronchiectasis,!reverse!
airway!obstruction.! !
Inhibits!interaction!of!acetylcholine!at!
receptor!sites!on!the!bronchial!
smooth!muscle,!resulting!decreased!
cyclic!guanosine!monophosphate!
(cGMP)!and!bronchodilatation.! !
Causes!bronchodilatation!by!action!
on!ß2!(pulmonary)!receptors!by!
increasing!levels!of!cyclic!adenosine!
monophosphate!(cAMP)!which!relax!
smooth!muscleS!produce!
pronchodilatationS!CNS,!cardiac!
stimulation,!increased!diuresis!and!
increased!gastric!acid!secretionS!
longer!acting!than!isproterenol.!
Relaxes!bronchial!smooth!muscle!by!
direct!action!on!ß2Radrenergic!
receptors!through!accumulation!of!
cAMP!at!ßRadrenergic!receptors!
sitesS!results!are!bronchodilation,!
diuresis,!and!CNS,!and!cardiac!
stimulationS!relaxes!uterine!smooth!
muscle!
Relaxes!smooth!muscle!of!respiration!
system!by!blocking!
phosphodiesterase,!which!increase!
cAMP!which!increase!
bronchodilation,!diuresis,!circulation,!
CNS!stimulation!
Nausea!and!vomiting,!GI!cramp,!
cough,!worsening!of!symptoms,!
dizziness,!headache,!anxiety,!dry!
mouth.! !
Absence!of!wheezing!after!1!hr!
!!
! Ventolin!p.52!
Albuterol!sulfate!
Bronchodilator!
(adrenergic!
beta2Ragonist)!
Antasthmatic!
Sympathomimetic!
Tremors,!anxiety,!restlessness,!
palpotations,!tachycardia,!
hypertension,!heartburn,!nausea!
and!vomiting,!bromchospasm!
Apply!with!minimal!doses!for!
minimal!period!of!time!and!no!
prolonged!use!due!to!
development!of!drug!tolerance!
Maintain!a!betaRadrenergic!
blocker!on!standby!in!case!of!
cardiac!arrhythmias! !
!!
! Bricanyl!durule!
p.893!
Terbutaline!
sulfate!
Selective!beta2RagonistS!
Bronchodilator!
Antasthmatic!
Sympathomimetic!
Tocolytic!drug!
Bronchospasm,!
bronchodilation!with!ease!
of!breathing!
!!
! Theodur! !
Nuelin!SR!p.898!
Theophylline!
Spasmolytic,!
Bronchodilator!
Xanthine!
Ability!to!breathe!without!
difficulties.!Bronchial!
asthma,!Bronchospasm!of!
COPD,!chronic!bronchitis!
Anxiety,!restlessness,!isomnia,!
dizziness,!seizures,!headache,!
lightRheadedless,!palpitations,!sinus!
tachycardia,!dysrhythmias,!nausea,!
vomiting,!anorexia,!diarrhea.! !
No!chewing!or!crushing!of!
entericRcoated!drugs!
Do!not!use!during!pregnancy!
Monitor!vital!signs!carefully!for!
adverse!effects,!if!serum!
theophylline!levels!are!not!
available!
Keep!diazepam!ready!for!seizure!
Prednisolone!
Corticosteroid,!synthetic!
Severe!inflammatory,!
immunoR!suppression,!
neoplasmsS!decrease!
inflammation,!decreased!
adrenal!insufficiency!
Depression,!HT,!circulatory!collapse,!
embolism,!diarrhea,!nausea,!abd!
pain,!pancreatitis,!hemorrhage.!
Administer!QD!before!0900!to!
mimic!normal!peak!corticosteroid!
blood!level!
Place!orally!disintegrating!tablet!
in!mouth!"!dissolve!"!swallow!
!
Decrease!inflammation!by!
suppressing!migration!of!
polymorphonuclear!leukocytes,!
fibroblastsS!reversal!to!increase!
capillary!permeability!and!lysosomal!
stabilization,!minimal!
mineralocorticoid!
!
hydrocortisone!
!
!
!
HT,!tachycardia,!cardiac!arrest,!
nausea!and!vomiting,!tremors,!
anxiety,!insomnia,!headache!
2.!Corticosteroid!
!!
!
! Prednisolone!
p.772!
!
3.!Mucolytic!agent!
!!
! Bisolvon!
Bromhexine!HCl!
Mucolytic!agent!(muscus!
expectorant)!
!
!
Nausea,!GI!disturbance,!loss!of!
appetite,!abd.!pain!
!
!!
! flumucil!
acetylcysteine!
mucolytic!agent!
Decrease! viscosity! of!
secretions! in! respiratory!
tract! by! breaking! disulfide!
links!of!munoproteins!
Decrease!
hepatotoxicity!
from!
aceraminophen! overdose,! decrease!
the! toxicity! of! mucous! in! respiratory!
disorder!
Dizziness! drowsiness,! rhinorrhea,!
nausea!
Only! if! suction! machine! is!
available,!encourage!fluid!intake!if!
no!contraRindication!
4.!Expectorant! !
!
MES!
Ammonia!
carbonate!&!
ipecacuanha!
tincture!mixture! !
Expectorant!sputum!
expel!
Productive!cough!and!cold!
remedy!
Increase!bronchio!secretion,!reduce!
viscosity!of!sputum,!easier!to!expel.!
!
!
Dextromethorph
an!HCl!
Pseudoephedrin
e!HCl!
Triprolidine!HCl!
Dextromethorphan:!
nonopioid!antitussive!
Pseudoephedrine:!
Nasal!decongestant,!
sympathomimetic!amine!
Triprolidine:*
Dextromethorphan:!
nonproductive!cough!
Pseudoephedrine:!
nasal!congestion!by!cold,!
fever!and!allergies,!
eustachian!tube!congestion!
Triprolidine:*
Dextromethorphan:*
lacks!analgesic!and!addictive!
properties,!control!cough!spasms!by!
depressing!the!cough!center!in!
medulla,!analogue!of!codeine!
nonproductive!cough!
Pseudoephedrine:*
cause!vasoconstriction!in!mucous!
membranes!of!nasal!passages!"!
shrinkage!"!promotes!drainage!and!
improve!ventilation!
Triprolidine:*
Dextromethorphan:*
respiratory!depression!(overdose)!
Pseudoephedrine:*
Fear,!anxiety,!tenseness,!
restlessness,!headache,!
lightRheadedness,!dizziness,!
drowsiness,!tremors,!seizuresS!HT,!
arrhythmiasS!pallorS!n/v!
!
[Dizziness,!anxiety,!palpitation,!
nervousness]!
Monitor!vital!signs!
Drug!may!mask!the!S/S!of!
serious!diseases!
Cough! may! be! S/S! of! serious!
underlying!disorders!
No!prolonged!use!
Monitor!CV!effects!carefully!
Act!by!inhibiting!the!spread!of!seizure!
activity!in!the!motor!cortex!by!
increasing!levels!of!
gammaRaminobutyric!acid!(GABA)!in!
brain.! !
Inhibits!spread!of!seizure!activity!in!
motor!cortex!by!altering!ion!transport,!
increase!AV!condiction!to!decrease!
dysrhythmias!
Bone!marrow!depression.!GI!
symptoms,!slurred!speech,!
confusion! !
Check!serum!valproic!level!"!
thrombopenia!if!too!high!in!level!
Ventricular!fibrillation,!drowsiness,!
dizziness,!insomnia,!depression,!
hepatitis,! ! nephritis,!anemia,!
thrombocytopenia,!StevenRJohnson!
syndrome!
Paralysis,!worsening!of!seizures,!
HT,!CHF,!AV!block,!hepatitis,!renal!
failure,!thrombocytopenia,!
leukocytosis,!ansmia,!eosinophilia,!
StevenRJohnson!syndrome.! !
Dizziness,!drowsiness,!confustion,!
headache,!orthostatic!hypotension,!
ECG!changes,!tachycardia,!blurred!
vision,!neutropenia,!respiratory!
depression.!
Check!serum!phenytoin!level!"!
malfunction!of!immunization!and!
gum!hyperplasia!may!be!resulted!
Dryness!of!mouth,!constipation!
Decrease!perspiration,!increase!
susceptibility!to!stroke.! !
5.!Nonopioid!antitussive!
!!
! Actified!
compound!
Neurologic!and!neuromuscular!drugs!
1.!AntiRconvulsant!
!!
! Epilim!p.995!
Valproate!
AntiRconvulsant!
(hydantoins)!
Seizures,!convulsion!
!!
! Dilantin!p.752!
Phenytoin!
AntiRconvulsant/!
antidysrhythmic!
(hydantoins)!
General!tonicRclonic,!
seizures,!epilepticus,!
nonepileptic!seizures!after!
Reye’s!syndrome!
!!
! Tegretol!
Carbamazepine!
Anticonvulsant!
TonicR!chonic,!
complexRpartial,!mixed!
seizures,!trigeminal!
neuralgia,!bipolar!disorder!
Exact!mechanism!unknown,!appears!
to!decrease!polysynaptic!responses!
and!block!postetanic!potentiation!
!!
! Valium!p.305!
Diazepam!
Antianxiety,!
anticonvulsant,!skeletal!
muscle!relaxant,!central!
acting! !
Anxiety,!acute!alcohol!
withdrawal,!adjunct!in!
seizure!disorders,!
preoperative!skeletal!
muscle!relaxation,!rectally!
for!acute!repetitive!
seizuresS!
Decreased,!anxiety,!
restlessness,!insomnia!
Potentiates!the!actions! ! GABA,!esp,!
in!limbic!system,!reticular!formation,!
enhance!presympathetic!inhibition,!
inhibits!sponal!polysynaptic,!afferent!
paths.! !
Trihexyphenidyl!
HCl!
Antiparkinson!/!
cholinergic!blocker!
Parkinsonian!symptoms,!
drugRinduced!
entrapyramidal!symptoms,!
decrease!involuntary!
movement!
Blocks!central!muscarinic!receptors,!
which!decrease!involuntary!
movements,!sweating,!salivation.! !
Access!BP,!RR,!orthostatic!BP,!
size!of!lymph!nodes.! !
Urine,!sweat!may!be!darken!
DDA!
2.!Antiparkinsonium! !
!!
! Artane!
1mg!/!TDS!
!!
! Sinemet! 25/100! ! Carbidopa!(25)!–!
p.179!
Levodopa!(100)!
*note:&two&drug&
together&form&
sinemet!
Antiparkinson!agent!
Parkinsonism,!restless!legs!
syndrome,!chronic!
manganese!intoxication,!
cerebral!arteriosclerosisS! !
Absence!of!involuntary!
outcome!
Decarbocylation!of!levodopa!to!
periphery!is!inhibited!by!carbidopaS!
more!levodopa!is!made!available!for!
transport!to!brain!and!conversion!to!
dopamine!to!the!brain!
Involuntary!choreiform!movement,!
hand!tremors(
),!fatigue,!
headache,!anxiety,!twitching,!
numbness(
),!weakness,!
confusion,!agitation,!insomnia,!
nightmare,!orthostatic!hypotension,!
nausea,!vomiting,!anorexia,!abd!
pain,!dry!mouth,!flatulence!(
),!dysphagia,!bitter!taste,!diarrhea,!
constipation!
Urine,!sweat!may!be!darken!
Type!2!diabetes,!NIDDM!
Inhibiting!ATPRsensitive!potassium!
channels!in!pancreatic!beta!cells!
which!stimulate!insulin!secretion!
Stimulates!insulin!secretion!by!the!
pancreas,!normalizes!fasting!and!
postprandial!blood!sugar!
!
Hypoglycemia,!fatigue,!drowsiness,!
weakness!and!diarrhea!
Check!glucose!level!before!given!
take!30!minutes!before!meals.! !
Hypoglycemia,!gastrointestinal!
disturbance,!skin!reactions!(rare),!
hematological!disorders!(rare)!
!
Check!L/R/T!function!
Taken!with!food!
Inhibits!hepatic!glucose!production!
and!increase!sensitivity!of!peripheral!
tissue!to!insulin!
Delays!the!digestion!of!ingested!
carbohydrates!"!smaller!increase!in!
blood!glucose!"!decrease!in!
glycosylated!Hgb!
Does!not!enhance!insulin!secretion!
Lactic!acidosis,!gastrointestinal!
(diarrhea,!cramps,!nausea,!nausea!
and!vomiting),!hormonal! !
Endocrine:!hypoglycemia!
GI:!abdominal!pain,!flatulence,!
diarrhea!
Hematologic:!leucopenia,!
thrombocytopenia!
Regularly!check!blood!glucose!
level!before!and!after!meals!
Decrease!edema!in!lung!tissue!
EENT:!loss!of!hearing!
ELECT:!hypokalemia,!
hypochloremic!alkalosis,!
hypomagnesemia,!hyperuricemia,!
hypocalcemia,!hyponatremia!
Endo:!hypoglycaemia!
GI:!nausea! !
GU:!polyuria!
Integ:!rash,!pruitus,!purpura!
1.!
Endocrine!drugs!
1.!Antidiabetic!
!!
! Daonil!
Glibenclamide! !
!!
! Diamicron!
Gliclazide!
! Tolbutamine!
!
Antidiabetic!drug,!
hypoglycemic!
(sulfonylurea)!
Antidiabetic!drug,!
hypoglycemic!
(sulfonylurea)!
!
!!
! Glucophage!
Metformin!
Antidiabetic!drug!
!!
! Glucobay!
Acarbose!
AlphaRglucosidase!
inhibitor!
Antidiabetic!
Furosemide! !
Loop!diurectic!
!
Monitor!serum!glucose!levels!
frequently!
Genitourinary!drugs!
!!
! Lasix! !
Acts!on!ascending!loop!of!
Henle!and!inhibit!
reabsorption!of!electrolytes!
and!waterS!increase!
excretion!of!K!in!distal!
tubules!
Slight!antihypertensive!
effect!and!peripheral!
vasodilation!
2.!
3.!
4.!
5.!
6.!
!
Natrilix! !
Indapamide! !
Diuretic,!
antihypertensive(mild!to!
moderate)! !
Decrease!BP!and!edema!in!
lung!tissues,!peripherally!
Acts!on!the!distal!tubule!and!thick!
ascending!loop!o!f!Henle!in!the!
kidney,!increasing!the!secretion!of!
Na,!H2O,!Cl,!Mg,!K,!HCO3!
CNS:!headache,!dizziness,!fatique,!
weakness,!nervousness,!agitation!
ELECT:!hypokalemia,!
hypercalcemia,!hyponatremia,!
hypochloremic,!alkalosis,!
hypomagnesemia!
GI:!nausea!
GU:!polyuria,!nocturia,!frequency!
!
1.!
2.!
3.!
4.!
!
periodic!testing!of!hearing!if!
high!dose!is!given!by!IV!
route!
monitor!I/O!ratio!
caution!to!orthostatic!
hypotension!
Take!in!day!to!prevent!
ncturia! !
report!if!weight!loss!of!>5lb!
within!1!week!
Avoid!OTC!medication!and!
alcoho!
take!the!medication!early!in!
the!day!to!prevent!nocturia!
report!if!weight!loss!of!>5lb!
within!1!week!
meal!rich!in!K!due!to!K!loss!
caution!to!orthostatic!
hypotension!
INTEG:!pruritus!
!
Aldactone! !
Spironlactone! !
KRsparing!diuretic! !
Diuretic!and!
antihypertensive!effect!
while!retainging!KS!lowered!
aldosterone!levelsS!for!
edema!of!CHF,!
hypertension,!
diureticRinduced!
hypokalemia,!primary!
hyperaldosteronism,!
edema!of!nephritic!
syndrome,!cirrhosis!of!the!
liver!with!ascites!
Compete!with!aldosterone!at!receptor!
sites!in!the!distal!tubule!in!the!renal!
system,!resulting!in!excretion!of!Na,!
Cl,!H2O,!HCO3!and!CaS!retain!K,!
PO3!and!H!
CNS:!confusion,!drowsiness!
ELECT:!hyperkalemia!
INTEG:!rash,!pruritus!
1.!
May!block!pain!impulse!peripherally!
that!occur!in!response!to!inhibition!of!
prostaglandin!synthesisS!does!not!
possess!inflammatory!propertiesS!
antipyretic!action!results!from!
inhibition!of!prostaglandins!in!the!
CNS!(hypothalamic!heatRregulating!
centre)! !
Acts!as!agonist!at!specific!opioid!
receptors!in!CNS!to!produce!
analgesic!effect.! !
Both!panadol!and!doloxene!action.! !
Hepatotoxic,!hepatic!seizure,!
decrease!platelets!
!
Toxicity:!Cyanosis,!anemia,!
jaundice,!rash,!convulsion,!coma,!
death!
Pregnancy!B,!anemia,!hepatic!
disease,!renal!disease,!chronic!
alcoholism,!elderly!and!lactation.! !
GI!disturbance,!drowsiness,!
dizziness,!fatigue! !
DDA!
drowsiness,!dizziness,!
fatigue!,constipation!or!diarrhea,!
nausea!and!vomiting!
CHF,!laryngeal!edema,!cholestatic!
hepatitis,!hepatotoxicity,!,!dysuria,!
hematuria,!oliguria,!UTI,!
bronchospasm!
Check!L/R!function!
2.!
3.!
!
!
take!the!medication!early!in!
the!day!to!prevent!nocturia!
report!if!weight!loss!of!>5lb!
within!1!week!
avoid!meal!with!high!K!
Pain!medication! !
!!
! Panadol!p.38!
Paracetamol!
acetaminophen!
Analgesic,!antipyretic!
Mild!to!moderate!pain!and!
fever!
!!
! Doloxene!
Dextropropoxyph
ene!
Analgesic!(opioid)! !
Mild!to!moderate!pain!and!
as!an!antiRtussive! !
!!
! Dologesic! !
Analgesic!
Mild!to!moderate!pain!
!!
! Voltaren!p.308!
Paracetamol!&!
Dextropropoxyph
ene!
Diclofenac!
sodium!
NSAID,!nonopioid!
analgesic!
Decrease!pain!and!
inflammation!
!!
! Indocid!p.507!
Indomethacin!
NASID!Antirheumatic!
Decrease!pain!and!
inflammation,!or!closure!of!
patent!ductus!arteriosus!
!!
! Aspirin!p.111!
Acetylsallcylic!
acid! !
Analgesic,!antiRpyretic,!
antiR!inflammatory,!antiR!
platelets!
Decrease!pain,!
inflammation,!fever,!
absence!of!MI,!transient!
ischemic!attacks,!
thrombosis!
Inhibits!prostaglandin!synthesis!by!
decreasing!enzyme!needed!for!
biosynthesisS!analgesic,!
antiRinflammatory,!antipyretic!
properties! !
Inhibits!prostaglandin!synthesis!by!
decreasing!enzyme!needed!for!
biosynthesisS!analgesic,!
antiRinflammatory!and!antipyretic! !
!
Blocks!pain!impulses!in!CNS,!
reduces!inflammation!by!inhibition!of!
prostaglandins!synthesisS!antipyretic!
action!results!from!vasodilatation!of!
peripheral!vessels,!decrease!platelet!
aggregation.! !
Cholestatic!hepatitis,!ulceration,!
perforation,!GI!bleeding!
nephrotoxicity!(dysuria,!hematuria,!
oliguria)!
Seizures,!coma,!GI!bleeding,!
hepatitis,!leucopenia,!neutropenia,!
hemolytic!anemia,!Reye’s!
syndrome,!anaphyaxis!and!
laryngeal!edema!
!
[Reye’s!syndrome:!affect!organs,!
e.g.!brain!and!liver!"!fatal]!
R!must!be!continued!for!
prescribed!time,!avoid!aspirin,!
NSAID.! !
R!take!a!full!glass!of!water!to!
enhance!full!absorption.! !
RGive!food/milk!to!decrease!
gastric!symptoms!and!prevent!
ulceration.! !
RDo!not!break,!crush!and!chew.! !
.!
RMonitor!renal!(I/O),!liver,!blood!
studies.!
R!assess!hepatotoxicity!(dark!
urine,!clay!coloured!stool),!
allergic!reaction.!
R!take!w/!8oz!of!water!&!sit!up!for!
30!mins!to!facilitate!drug!passing!
to!stomach.! !
!
!!
DF!118!
! Ultram!
Dihydrocodeine!
Analgesic!(synthetic!
opioid)!
Postoperative!(moderately!
to!severe)!pain,!severe!
dyspnea,!antiRtussive!
Tramadol!
Central!anagesic!
Bind!to!opioid!receptors!
and!inhibits!reuptake!of!
norepinephrine,serotoninS!
does!not!cause!histamine!
release!or!affect!heart!rate!
!
!
morphine!
Opioid!analgesic!
Severe!painS!given!after!or!
during!an!MI!
!
!
methadone!
Opioid!analgesic!
Severe!pain!
!
Naprosyn!
Naproxen!
Nonsteroidal!
antiinflammatory,!
nonopioid!analgesic!
Decrease!pain!and!
inflammation,S!mild!to!
moderater!pain,,!acute!gout!
!
Ponstan!
Mefenamic!acid! !
NSAID!
Moderate!pain,!rheumatoid!
arthritis!
Erythromycin!
!
AntiRinfective!
Mild!to!moderate!
respiratory!tract,!skin,!soft!
tissue!infections!
Depress!pain!impulse!transmission!at!
the!spinal!cord!level!by!interaction!
with!opioid!receptors,!produce!CNS!
depression,!decrease!cough!reflex,!
increase!the!pain!tolerance,!
respiratory!suppress.! !
Relief!of!pain!
GI!disturbance,!respiratory!
suppress,!constipation,!dryness!
mouth,!dependence,!intolerance.! !
DDA!
Orthostatic!hypotension!
Decreae!pain!impulse!transmission!at!
the!spinal!cord!level!by!interacting!
with!opioid!receptors,!produces!CNS!
depression!
CNS:!confusion,!sedation!
Precautions!to!pregnancy!C,!
seizure!disorder,!lactation,!
children,!elderly!
!
Avoid!OTC!medication!and!
alcohol!
1.!PO:!swallow!thw!whole!tab!
!
Inhibit!prostaglandin!synthesis!by!
decreasing!enzyme!needed!for!
biosynthesisS!analgesic,!
antiinflammatory! !
AntiRinflammatory,!analgesic!and!
antipyretic!activities!related!to!
Inhibition!of!prostaglandin!synthesis!
CNS:!drowsiness,!confusion,!
sedation,!dizziness,!headache!
GI:!nausea,!vomiting,!anorexia,!
constipation,!cramps!
INTEG:!rash!
!
1.!
Diarrhoea,!skin!rashes,!
bronchospasm!
Aspirin!in!nature!"!carefully!
administer!x!peptic!ulcer,!GIB,!HT,!
HF!Pt.!
GI:!nausea,!vomiting,!diarrhea!
GU:!vaginitis,!moniliasis!
1.!
2.!
monitor!BP!and!bowel!
change!
caution!to!orthostatic!
hypotension!
Check!for!edema!in!feet,!ankle,!
legs!
!
AntiRinfective!
1.!AntiRinfective!
!
!
Binds!to!50S!ribosomal!subunits!of!
susceptible!bacteria!and!suppresses!
protein!synthesis!
2.!
3.!
4.!
5.!
6.!
!
Klacid!
Clarithromycin!
Antiinfective!
!
Bactericidal!actionS!mild!to!
moderate!infections!of!
upper!respiratory!tract,!
lower!respiratory!tractS!
uncomplicated!skin!and!
skin!structure!infection!
!
1.!
2.!
3.!
4.!
severe!diarrhea"!
discontinue!
decreased!urine!output"!
maybe!nephrotoxicity!
Take!all!the!medications!
prescribed!for!the!length!of!
time!ordered!
Caution!to!superinfection:!
vaginal!itching,!loose!
foulRsmelling!stools!
at!least!1hr!ac!or!2hr!pc,!
take!with!full!glass!of!water!
crushed,!not!swallow!the!
whole!tab,!except!the!
entericRcoat!tab!
assess!bowel!pattern.!If!
severe!
diarrhea"discontinue!
Take!all!the!medications!
prescribed!for!the!length!of!
time!ordered!
Caution!to!superinfection:! !
Swallow!the!whole!tab! !
5.!
!
Zinnal! !
Cefuroxime!
axetil! !
AntiRinfective!
Cephalosorin!(second!
generation)!
Streptococcus,!
Haemophilus,!Moraxella,!
E.!coli,!Klebsiella!
Inhibit!bacterial!cell!wall!synthesis,!
render!cell!wall!osmotically!unstable,!
leadint!to!cell!death!by!binding!to!cell!
wall!membrane!
!
!
Penicillin! !
Broad!spectrum!
antiRinfective!
Respiratory!tract!infections,!
pneumonia,!skin!and!soft!
tissue!infections,!
prevention!of!rheumatic!
fever,!glomerulonephritis!
Interferes!with!cell!wall!replication!of!
susceptible!organisms,!osmotically!
unstable!cell!wall!swells,!and!bursts!
from!osmotic!pressure,!resulting!in!
cell!death!
!!
!!
Ampicillin!
BroadRspectrum!
AntiRinfective!
Infections!of!respiratory!
tract,!skin,!skin!structure,!
genitourinary!tractS!otitis!
media,!meningitis,!
septicemia,!sinusitis,!and!
endocarditis!prophylaxis!
GI:!diarrhea,!NV,!anorexia,!
abdominal!pain,!flatulence,!
pseudomembranous*colitis*
Hematologic:!bone*marrow*
depression!
Hypersensitivity:!rash!to!fever!to!
anaphylaxis!
GI:!nausea,!vomiting,!diarrhea!
GU:!vaginitis,!moniliasis!
Coma,!seizures,!nausea,!vomiting,!
diarrhea,!vafiniris,!moniiasis,!
anemia,!rash.! !
2L!fluid!intake!during!
diarrhea!episode!
6.! give!q12h!to!maintain!serum!
level! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! !
Cautiously!on!renal!failure!Pt.!
Prepare!Vit.!K!in!case!of!
hypoprothrombinemia!
1.!
2.!
3.!
4.!
5.!
1.!
2.!
3.!
4.!
5.!
6.!
7.!
!!
! Amoxil!
Amoxicillin!
Antiinfective!
Antiulcer!
GI:!nausea,!vomiting,!diarrhea!
INTEG:!urticaria,!rash!
1.!
2.!
3.!
4.!
5.!
6.!
7.!
!!
!!
cloxacillin!
Broad!spectrum!
AntiRinfective!
BetaRlactamase!resistant!
penicillin!
PenicillinaseRproducing!
staphylococci,!streptococci,!
respiratory!tract,!skin,!skin!
structure!infectionsS!
sinusitis!
Interferes!with!cell!wall!replication!of!
susceptible!organisms,!the!cell!wall,!
rendered!osmotically!unstable,!
swells,!and!bursts!from!osmotic!
pressureS!resists!penicillinase!action!
that!inactivates!penicillins!
GI:!nausea,!vomiting,!diarrhea!
GU:!vaginitis,!moniliasis!
1.!
2.!
3.!
4.!
5.!
6.!
7.!
8.!
evere!diarrhea"!discontinue!
decreased!urine!output"!
maybe!nephrotoxicity!
Caution!to!superinfection!
Take!10R14!days!
shake!susp!
severe!diarrhea"!
discontinue!
decreased!urine!output"!
maybe!nephrotoxicity!
Take!all!the!medications!
prescribed!for!the!length!of!
time!ordered!
Caution!to!superinfection! !
may!be!crushed!
Take!for!10R14!days!to!
ensure!organism!deathand!
prevent!superinfection!
shake!well!b4!each!dose,!
store!in!refrigerator!for!2wk!
or!1wk!at!rm!temp!
severe!diarrhea"!
discontinue!
decreased!urine!output"!
maybe!nephrotoxicity!
Caution!to!superinfection!
Take!for!10R14!days!to!
ensure!organism!death!and!
prevent!superinfection!
store!in!tight!container!
shake!well!b4!use.!
ac!"!due!to!food!absorption!
disturbance!
severe!diarrhea"!
discontinue!
decreased!urine!output"!
maybe!nephrotoxicity!
Take!10R14!days! !
Caution!to!superinfection!
swallow!the!whole!tab!
store!in!tight!container!
shake!well!b4!use.!
ac!"!due!to!food!absorption!
disturbance!
!!
! Flagyl!p.619!
Metronidazole!
Trichomonacide!
Amebicide!
Antiinfective!
Intestinal!amediasis,!
amebic!abscess,!
(refractory)!trichomoniasis,!
bacterial!anaerobic!
infections,!giardiasis,!
septicemia,!endocarditis,!
bone,!joint!and!lower!
respiratory!tract!infections.! !
DrectRacting!amebicide/!
trichomonacideS!binds,!degrades!
DNA!in!organism.! !
GI:!nausea,!vomiting,!diarrhea,!
anorexia!
1.!
2.!
3.!
4.!
5.!
6.!
7.!
!
!
!
Cipro! !
!
!
Ciprofloxacin! !
Ofloxacin! !
Streptomycin!
Urinary!antiRinfectives,!
broad!spectrum!
AntiRinfective!
AntiRinfective,!
antiRtuberculosis!
Adult!UTIS!chronic!bacterial!
prostatitisS!acute!sinusitisS!
lower!respiratory,!skin,!
joint,!bone!infectionsS!
infectious!diarrhea,!
exposure!to!inhalation!
anthraxS!conjunctivitis,!
corneal!ulcers!
Interferes!with!conversion!of!
intermediate!DNA!fragments!into!high!
molecular!weight!DNA!in!bacteriaS!
DNA!gyrase!inhibitor!
CNS:!headache!
GI:!diarrhea!
INTEG:!rash!
Treatment!of!lower!
respiratory!tract!
infections(pneumonia,!
bronchitis),!genitourinary!
infections!(prostatitis,!
UTIs),!skin!and!skin!
structure!infections,!
conjunctivitis!
Interferes!with!conversion!of!
intermediate!DNA!fragments!into!high!
molecular!weight!DNA!in!bacteria!
Active!TB!
Interferes!with!protein!synthesis!in!
bacterial!cell!by!binding!to!ribosomal!
subunit,!causing!inaccurate!peptide!
sequence!to!form!in!protein!chain,!
resulting!in!bacterial!death!
EENT:!Ototoxicity!
GI:!nausea,!vomiting,!anorexia!
INTEG:!rash!
Inhibits!RNA!synthesis,!decrease!
tubercle!bacilli!replication!
Peripheral!neuropathy,!dizziness,!
nausea,!vomiting,!jaundice,!fatal!
hepatitis,!seizures!
Nausea,!vomiting,!anorexia,!
diarrhea,!heartburn,!hematuria,!
acute!renal!failure.! !
Headache,!confusion,!
disorientation,!abd!distress,!
anorexia,!nausea,!vomiting,!
elevated!uric!acid,!acute!gout!
1.!
2.!
3.!
4.!
5.!
!
1.!
2.!
3.!
4.!
5.!
!
1.!
2.!
!
severe!diarrhea"!
discontinue!
decreased!urine!output"!
maybe!nephrotoxicity!
Caution!to!superinfection!
give!with!or!after!meal!
store!in!light!resistant!
container,!but!not!
refrigerator!
The!drug!has!a!metallic!
taste,!and!urine!may!turn!
dark!
ac!"!due!to!food!absorption!
disturbance!
severe!diarrhea"!
discontinue!
decreased!urine!output"!
maybe!nephrotoxicity!
Take!all!the!medications!
prescribed!for!the!length!of!
time!ordered!
Caution!to!superinfection! !
rinse!mouth!frequently,!use!
sugarless!candy!or!gum!for!
dry!mouth!
severe!diarrhea"!
discontinue!
Take!all!the!medications!
prescribed!for!the!length!of!
time!ordered!
increase!fluid!to!2L/day!to!
avoid!crystalluria!
give!with!8oz!of!water!
don’t!give!with!Fe,!Al,!Zn!
products!or!antacids!which!
decrease!the!absorption!and!
form!insoluble!chelate!
decreased!urine!output"!
maybe!nephrotoxicity!
caution!to!superinfection!
2.!AntiRtubercular! !
!!
! Rimifon!p.524!
Isoniazid!
Antitubercular!
!!
! Rifadin,!
Rimactane!p.821!
Rifampicin!
(Rifampin)!
Antitubercular!
!!
! Myambutol!p.390!
Ethambutol!
Antitubercular!
Pulmonary!TB!as!an!
adjunctS!other!infections!
caused!by!mycobacteria!
Pulmonary!TB,!
meningococcal!carriers!
(prevention)!
Pulmonary!TB,!as!an!
adjunct!other!
mycobacterial!infections!
Inhibits!DNARdependent!polymerase,!
decreases!replication!
Inhibits!RNA!synthesis,!decreases!
tubercule!bacilli!replication!
Better!to!take!with!empty!
stomach.!1hr!ac!or!2hrs!pc!
Better!to!take!with!empty!
stomach.!1hr!ac!or!2hrs!pc!
Give!with!meal,!give!2!hrs!before!
antacid.! !
!!
! Tebrazid!p.798!
Pyrazinamide!
Antitubercular!agent!
Tuberculosis,!as!an!adjunct!
when!other!drugs!are!not!
feasible!
Bactericidal!interference!with!liquidS!
nucleic!acid!biosynthesis!is!possible!
Headache,!increased!uric!acid,!
hepatotoxicity!
Check!L!function!(AST,!ALT)!prior!
to!and!every!2R4!wks!during!
therapy!
Liver!damage!/!hyperuricemia!
with!acute!gouty!arthritis!"!stop!
acyclovir!
AntiRviral!
Decreased!amount!and!
time!of!healing!of!lesions!
Interferes!with!DNA!synthesis!by!
conversion!to!acyclovir!triphosphate,!
causing!decreased!viral!replication,!
time!of!lesional!healing!
CNS:!dizziness,!headache!
1.!
2.!
3.!
3.!AntiRviral! !
!
!
4.!
5.!
Swallow!the!whole!tab!
may!give!with!8oz!of!water! !
store!at!rm!temp!with!dry!
place!
may!take!b4!infection!occur!
or!when!itching!and!pain!
occur!
shake!susp!b4!use!
4.!AntiRfungal!
!
Mycostatin! !
Nystatin! !
AntiRfungal! !
Fungicidal!against!Candida!
organisms!
Interferes!with!fungal!DNA!replicationS!
bind!sterols!in!fungal!cell!membrane,!
which!increase!permeability,!resulting!
in!leaking!of!cell!nutrients!
!
1.!
2.!
shake!the!susp!b4!use! !
store!oral!susp!in!
refrigerator,!tab!in!airRtight,!
light!resistant!container!at!
rm!temp!
Allergy!symptoms,!rhinitis,!
allergic!dermatoses,!nasal!
allergies,!hypersensitive!
reactions!inc.!blood!
transfusion,!reactions,!
anaphylaxis!
Motion!sickness,!rhinitis,!
allergy!symptoms,!
sedation,!nausea,!
preoperative!and!
postoperative!sedationS!
Absence!of!allergy!
symptoms!and!rhinitis,!
absence!of!vomiting,!
nausea!and!sedation.! !
Anxiety!preoperatively,!
postoperatively!to!precent!
nausea,!vomiting,!to!
potentiate!opioid!
analgesicsS!sedationS!
pruritusS!prevention!of!
alcohol,!drug!withdrawalS! !
Absence!of!allergy!
symptoms,!rhinitis!pruritus,!
absence!of!nausea/!
vomiting,!sedation,!
absence!of!anxiety!
Acts!on!blood!vessels,!GI,!respiratory!
system!by!competing!with!histamine!
for!H1Rreceptor!siteS!decrease!allergic!
response!by!blocking!histamine.! !
Dizziness,!drowsiness,!urinary!
retention,!thrombocytopenia,!
hemolytic!anemia,!dry!nose,!throat,!
mouth!
Do!not!cut,!chew!or!crush!SR!
tablets!
Check!blood!periodically!during!
prolonged!therapy!
Acts!on!blood!vessels,!GI,!respiratory!
system!by!competing!with!histamine!
for!H1Rreceptor!siteS!decrease!allergic!
response!by!blocking!histamineS!also!
acts!on!chemoreceptor!trigger!zone!
to!decrease!vomiting,!increase!CNS!
stimulation,!has!anticholinergic!
response!
Dizziness,!drowsiness,!neuroleptic!
malignant!syndrome,!constipation,!
urinary!retentionapnea!in!pediatric!
patient.! !
Administer!through!IM,!no!SC!due!
to!tissue!necrosis!
Depresses!subcortical!levels!of!CNS,!
including!limbic!system,!reticular!
formation,!anticholinergic,!antiemetic,!
antihistaminic!response,!competes!
with!H1Rreceptor!sites.!
Dizziness,!drowsiness,!seizures,!dry!
mouth.! !
Take!1!hr!pc!or!2!hrs!pc!
No!parenteral!solution!should!be!
administered!through!IV,!SC,!
intraRarterially!
Determine!and!treat!underlying!
cause!of!vomiting!
Drug!masks!S/S!of!serious!
conditions!
AntiRinflammatory!
1.!AntiRhistamine!
st
!!
! Piriton!p.223!
Chlorpheniramin
e!maleate!
Antihistamine!(1 !
generation,!
nonRselective)!
!!
! Phenergan!p.785!
Promethazine!
HCl!
Antihistamine,!
H1Rreceptor!antagonist,!
antiemetic,!
sedative/hypnotic!
Hydroxyzine!
Antianxiety,!sedative,!
hypnotic,!antihistamine,!
antiemetic!
!
Atarax!p.487!
2.!Corticosteroid! !
!!
!
! Prednisolone!
p.772!
!
Prednisolone!
Corticosteroid,!synthetic!
Severe!inflammatory,!
immunoR!suppression,!
neoplasmsS!decrease!
inflammation,!decreased!
adrenal!insufficiency!
Decrease!inflammation!by!
suppressing!migration!of!
polymorphonuclear!leukocytes,!
fibroblastsS!reversal!to!increase!
capillary!permeability!and!lysosomal!
stabilization,!minimal!
mineralocorticoid!
!
Depression,!HT,!circulatory!collapse,!
embolism,!diarrhea,!nausea,!abd!
pain,!pancreatitis,!hemorrhage.!
Administer!QD!before!0900!to!
mimic!normal!peak!corticosteroid!
blood!level!
Place!orally!disintegrating!tablet!
in!mouth!"!dissolve!"!swallow!
Hydrocortisone!
!
!
!
!
Lorazepam! !
Sedative,!antiRanxiety!
agent!
Decrease!anxiety,!
relaxationS!anxiety,!
irritability!in!psychiatric!or!
organic!disorders,!
preoperatively,!insomnia!
Potentiates!the!actions!of!GABA,!an!
inhibitory!neurotransmitter,!esp!in!
limbic!system!and!reticular!formation,!
which!depresses!the!CNS!
CNS:!dizziness,!drowsiness!
CV:!orthostatic!hypotension!
EENT:!blurred!vision!
1.!
2.!
Decrease!sign!and!
symptoms!of!psychosis!
Depress!cerebral!cortex,!
hypothalamus,!limbic!system,!which!
control!activity!and!aggressionS!
blocks!neurotransmission!produced!
by!dopamine!at!synapseS!exhibits!
strong!alperRadrenergic,!
anticholinergic!blocking!action.!
CNS:!EPS,!pseudoparkinsnism,!
akathisia,!dystonia,!tardive!
dyskinesia,!drowsiness,! !
headache,!confusion!
CV:!Orthostatic!hypotension,! !
GI:!Dry!mouth,!nausea,!vomiting,!
anorexia,!constipation,! !
INTEG:! ! Rash,! !
Inhibit!the!synthesis!of!DNA!primarilyS!
derived!from!Stretomyces!peuceticus!
replication!is!decreased!by!binding!to!
DNA,!which!causes!strand!splittingS!
active!throughout!entire!cell!cycleS!a!
vesicant!
INTEG:!rash,!necrosis!at!inj!site!
AntiRpsychotic!drugs!
1.!AntiRanxiety! !
!
!!
Ativan! !
! Haldol!
haloperidol!
Antipsychotic,!
Neuroleptic!
3.!
1.!
2.!
3.!
Can!be!crushed!
provide!sugarless!gum,!hard!
candy,!frequent!sips!of!water!
for!dry!mouth!
not!for!everyday!
stress(longer!than!4!
mo)"habit!forming!
Contraindication:!
Parkinson’s!disease*
Take!antacids!2!hrs!be4!and!
after!the!drugs*
store!in!tight,!light!resistant!
container*
!
2.!AntiRneoplastic!drug!
!
!
Doxil!
Blenoxane! !
Doxorubicin!
Bleomycin!
(SC/IM/IV)! !
AntiRneoplastic,!
antiRbiotic! ! !
AntiRneoplastic,!
antiRbiotic! ! !
Prevention!of!rapid!growing!
malignant!cellsS!Wilm’s!
tumorS!bladder,!breast,!
cervical,!head,!neck,!liver,!
lung,!overian,!prostatic,!
stomach,!testicular,!thyroid!
cancerS!Hodgkin’s!disease,!
acute!lymphoblastic!
leukaemiaS!myeloblastic!
leukaemiaS!
neuroblastomasS!
lymphomasS!sarcomas! !
Prevention!of!rapid!growing!
malignant!cellsS!cancer!of!
head,!neck,!penis,!cervis,!
vulva!of!squamous!cell!
origin,!Hodgkin’s!disease,!
lymphosarcoma,!reticulum!
cell!sarcoma,!testicular!
carcinoma,!malignant!
pleural!effusion!
1.!
2.!
3.!
4.!
5.!
6.!
Inhibit!the!synthesis!of!DNA,!RNA,!
proteinS!derived!from!Stretomyces!
verticillusS!replication!is!decreased!by!
binding!to!DNA,!which!causes!strand!
splittingS!phase!specific!in!the!G2!and!
M!phaseS!a!nonvesicant!
GI:!nausea,!vomiting,!weight!loss,!
anorexia,!stomatitis!
INTEG:!rash,!hyperkeratosis,!nail!
changes,!alopecia!
1.!
2.!
3.!
avoid!contact!with!skin!
give!fluid!b4!chemotherapy!
to!hydrate!pt!
can!provide!antiRemetic!
30R60mins!b4!giving!drug!to!
prevent!vomiting!and!prn!
give!antiRbiotics!for!
prophylaxis!of!infection!
urine!and!other!body!fluid!
may!turn!redRorange!for!48hr!
may!lose!hair!
use!protective!clothing!duing!
handling,!preparationS!avoid!
contact!with!skin!
avoid!brestfeeding!
monitor!blood!glucose!level!
for!diabetic!
!
!
Carboplatin!(IV)!
AntiRneoplastic!alkylating!
agent!
!
Ifex!
Ifosfamide!
AntiRneoplastic!alkylating!
agent!
!
!
!
!
!
!
!
!
cisplatin!
Methotrexate! !
AntiRneoplastic,!
antiRmetabolite! !
fluorouracil!
Tamoxifem!
AntiRneoplastic! !
Prevention!of!rapid!growing!
malignant!cellsS!initial!
treatment!of!ovarian!cancer!
in!combination!with!other!
agentsS!palliative!treatment!
of!recurrent!ovarian!
carcinoma!after!treatment!
with!other!antiRneoplastic!
agents,!including!cisplatin!
Prevention!of!rapid!growing!
malignant!cellsS!
Testicular!cancer,!
softRtissue!sarcoma,!
Ewing’s!sarcoma,!
nonRHodgkin’s!lymphoma,!
lung,!pancreatic!cancer,!
sarcoma!
Prevention!of!rapid!growing!
malignant!cellsS!advanced!
bladder!cancerS!adjunctive!
in!metastatic!teaticular!
cancer!and!metastatic!
ovarian!cancer,!head,!neck,!
oesophageal,!prostatic,!
lung,!and!cervical!cancerS!
lymphoma!
Prevention!of!rapid!growing!
malignant!cellsS!
Acute!lymphocytic!
leukaemia,!in!combination!
for!breast,!lung,!head,!neck!
carcinoma,!
lymphosarcoma,!
gestational!
choriocarcinoma,!
hydatidiform!mole,!
psoriasis,!rheumatoid!
arthritis,!mycosis!fungoides!
Prevention!of!rapid!growing!
malignant!cellsS!
Systemic:!cancer!of!breast,!
colon,!rectum,!stomach,!
pancreasS!multiple!active!
keratoses!
Topical:basal!cell!
carcinoma!
Prevention!of!rapid!growing!
malignant!cellsS!
Advanced!breast!
carcinoma!that!has!
Produce!interstrand!DNA!crosslink!
and!to!a!lesser!extent!DNA!protein!
crosslinksS!activity!is!not!cell!cycle!
phase!specific!
EENT:!vestibular!toxicity!
1.!can!provide!antiRemetic!
30R60mins!b4!giving!drug!to!
prevent!vomiting!and!prn!
Alkylates!DNA,!RNAS!inhibits!
enzymes!that!allow!synthesis!of!
amino!acids!in!proteinsS!activity!is!not!
cell!cycle!phase!specific!
CNS:!somnolence,!confusion,!
hallucinations!
Dermatologic:!alopecia!
GI:!anorexia,!n/v!
GU:!hemorrhagic!cystitis,!hematuria,!
potentially*fatal*hemorrhagic*
cystitis*
Hematologic:!leukopenia!
1.!
EENT:!Tinnitus,!hearing!loss,!
vestibular!toxicity!
GI:!severe!nausea,!vomiting,!
diarrhea,!weight!loss!
INTEG:!alopecia!
Inhibit!the!enzyme!that!reduces!folic!
acid,!which!is!needed!for!nucleric!
acid!synthesis!in!all!cellsS!cell!cycle!
specific!(S!phase)S!
immunosuppression!
GI:!nausea,!vomiting,!diarrhea,!
anorexia,!ulcerative!stomatitis!
INTEG:!rash,!alopecia!
2.!
3.!
4.!
5.!
6.!
1.!
2.!
1.!
2.!
3.!
4.!
5.!
6.!
7.!
Inhibit!DNA,!RNA!synthesisS!
interferes!with!cell!replication!by!
competitively!inhibiting!thynidylate!
synthesis,!cell!cycle!specific(S!
phase),!a!vesicant!
GI:!anorexia,!stomatitis!
INTEG:!rash!
1.!
2.!
3.!
4.!
5.!
Inhibit!cell!division!by!binding!to!
cytoplasmic!estrogen!receptorsS!
resembles!to!normal!cell!complex!but!
inhibit!DNA!synthesis!and!estrogen!
CNS:!hot!flushes,!headache,!
lightRheadedness!
GI:!nausea,!vomiting!
INTEG:!rash!
6.!
7.!
1.!
2.!
3.!
give!fluids!b4!chemotherapy!
to!hydrate!pt!
can!provide!antiRemetic!
30R60mins!b4!giving!drug!to!
prevent!vomiting!and!prn!
avoid!using!aspirin,!NSAIDs!
avoid!crowds!or!person!with!
known!infection!
avoid!vaccination!
hair!loss!
hydrated!pt!with!NS!over!
8R12hr!b4!treatment!
avoid!IM!if!
3
platelets<10000/mm ! !
avoid!contact!with!skin!
can!provide!antiRemetic!
30R60mins!b4!giving!drug!to!
prevent!vomiting!and!prn!
give!antiRbiotics!for!
prophylaxis!of!infection!
give!in!am!
avoid!use!of!aspirin,!NSAIDs!
hair!loss!
avoid!vaccination!
Avoid!contact!with!skin!
can!provide!antiRemetic!
30R60mins!b4!giving!drug!to!
prevent!vomiting!and!prn!
give!antiRbiotics!for!
prophylaxis!of!infection!
avoid!using!aspirin,!NSAIDs!
avoid!crowds!or!person!with!
known!infection!
avoid!vaccination!
hair!loss!
swallow!the!whole!tab!
store!in!lightRresistant!
container!at!rm!temp!
hair!loss!
!
!
Vinblastine! !
AntiRneoplastic!
!
!
Vincristine! !
AntiRneoplastic—miscell
aneous! !
responded!to!other!therapy!
in!estrogen!recptor!positive!
pt,!prevention!of!breast!
cancer,!after!breast!
surgery/radiation!in!ductal!
carcinoma!in!situ!
Prevention!of!rapid!growing!
malignant!cellsS!
ImmunosuppressiveS!
breast,!testicular!cancerS!
lymphomasS!
neuroblastomaS!Hodgkin’s,!
nonRHodgkin’s!lymphomasS!
mycosis!fungoidesS!
histiocytosisS!Kaposi’s!
sarcoma!
Prevention!of!rapid!growing!
malignant!cellsS!
ImmunosuppressiveS!
breast,!lung!cancerS!
lymphomasS!
neuroblastomaS!Hodgkin’s!
diseaseS!acute!
lymphoblastic!and!
leukemiasS!
rhabdomyosarcoma,!
Wilm’s!tumorS!oesteogenic!
and!other!sarcoma! !
response!to!target!tissue!
Decreasing!serum!uric!
acid,!reducing!uric!acid!
synthesis.!(Chronic!gout!
)!
Decrease!pain!and!joint!
inflammation.!Gout!and!
gouty!arthritis! !
Inhibits!the!enzyme!xanthine!oxidase,!
reducing!uric!acid!synthesis! !
Interferes!blood!clotting!
Inhibit!mitotic!activity,!arrest!cell!cycle!
at!metaphaseS!inhibit!RNA!synthesis,!
blocks!cellular!use!of!glutamic!acid!
needed!for!purine!synthesis,!a!
vesicant!
4.!
rash!or!lesion!become!large!
at!the!beginning!of!the!
therapy!but!temporary!
GI:!anorexia,!nausea,!vomiting,!
stomatitis!
INTEG:!rash!
!
1.!
2.!
3.!
4.!
avoid!contact!with!skin!
avoid!use!of!aspirin,!NSAIDs!
hair!loss!
avoid!vaccination!
CNS:!decreased!reflexes,!
numbness,!weakness,!motor!
difficulties!
GI:!nausea,!vomiting,!anorexia,!
stomatitis,!constipation!
INTEG:!alopecia!
1.!
avoid!the!use!of!aspirin,!
NSAIDs!
hair!loss!
avoid!vaccination!
2.!
3.!
AntiRgout! !
!!
!!
! Zyloric!p.60!
! Colgout!p.263!
Allopurinol!
Antigout,!xanthine!
enzyme!inhibitor.!
Colchicine! !
Antigout!agent!
Warfarin!sodium!
Anticoagulants!
!
CNS:!Headache!
GI:!nausea,!vomiting,!anorexia,!
malaise! !
1.!
Inhibits!microtubule!formation!of!lactic!
acid!in!leukocytes!which!decreases!
phagocytosis!and!inflammation!in!
joints.! !
GI:!nausea,!vomiting,!anorexia,!
malaise!
!
Monitor!serum!cholesterol,!LDLs,!
triglycerides!and!glucose!before!
drug!administration!
Hyperlipidemia!"!administer!with!
meal!
NIDDM!"!QD!/!BID!
Bowel!program!"!reduce!
constipation!
Monitor!nutritional!status!
Prevent!blood!clotting!
Fever,diarrhea,!rash!
1.!
2.!
2.!
increase!fluid!to!2L!a!day!to!
prevent!stone!formation!
can!be!crashed!
Hematologic!drugs!
AntiRcoagulants! !
!!
! Warfarin!Norton!
3.!
4.!
Teach!pt.!to!avoid!injury,!
Do!not!give!Intramuscular!
injections!to!patients!
dosage!change!q1R2wk!
limited!intake!of!vit!K!food!to!
maintain!consistent!
prothrombin!levels!
!
!
Heparin! !
Anticoagulants,!
antithrombotic! !
Prevention!of!thrombi!
Prevents!the!conversion!of!fibrinogen!
to!fibrin!and!prothrombin!by!
enhancing!inhibitory!effects!of!
antithrombin!III!
CNS:!fever!
INTEG:!rash!
1.!
2.!
Teach!pt.!to!avoid!injury,!
Do!not!give!Intramuscular!
injections!to!patients!
Needed!for!fat,!protein!and!
carbohydrates!metabolismS!enhances!
glycogen!release!from!liver!and!
muscle!tissues,!needed!as!coenzyme!
for!metabolic!transformations!of!a!
variety!of!amino!acid!
Neutralizes!gastric!acidity!
Paresthesia,!flushing,!pain!at!
injection!site!
!
GI:!constipation!(laxatives!or!stool!
softeners!can!be!given)!
Antacid:1hr!pc!and!at!bed!time!
Ca!supplement:!1/2!pc!and!at!bed!
time!
1.!chew!the!tab!
!
Vitamine! ! !
!!
!
Pyridoxine!
Vitamin!B6!
Vitamin!B6!and!water!
soluble!
Vitamin!B6!deficiency!a/s!
with!inborn!error,!seizure,!
therapy!(isoniazid),!oral!
contraceptives,!alcoholism,!
polyneuritis!
!!
!
Oscal!
Caltrate!
CaCO3!
Antacid,!Ca!supplement!
Not!for!chronic!therapy!
!!
!!
MultiRvitamin!
Vitamin!
Prevention!and!treatment!
of!vitamine!deficiencies!
Needed!for!adequate!metabolism! !
!
Simvastatin!
Antilipidemic!
Decreasing!cholesterol!
levels!and!LDLs,!increased!
HDLsS!As!an!adjunct!in!
primary!hypercholesR!
terolemia,!(types!IIa,!IIb),!
mixed!hyperlipidemia,!
CAD,!isolated!hypertriR!
glyceridemia,!and!type!III!
hyperR!lipoproteinemia!
Inhibits!HMGRCoA!reductase!
enzymes,!which!reduces!cholesterol!
synthesis,!this!enzyme!is!needed!for!
cholesterol!production.!
CNS:!headache!
GI:!flatulence,!diarrhea,!abdominal!
pain,!cramps,!constipation,!nausea,!
liver*failure!
Other:!rhabdomyolysis,!acute*
renal*failure!
Give!30!min!before!AM!and!PM!
meal!
Antilipidemic!
!!
! Zocor!p.848!
Throat!preparation!
!
Dequadin!
Dequalinium!Cl!
Throat!preparation!
Common!infection!of!mouth!
and!throat!
Reduce!infection!and!relief!pain!
!
Max:!8!lozenges!
!
strepsils!
!
!
!
!
!
!
Diphenhydramin
e! !
Antihistamine! !
Uses:!allergy!symptoms,!
rhinitis,!motion!sickness,!
antiparkinsonism,!nighttime!
sedation,!infant!colic,!
nonRproductive!cough,!
anaohylaxis,!nasal!
allergies,!allergic!
dermatoses,!dystonic!
reaction!
Acts!on!blood!vessels,!GI,!respiratory!
system!by!competing!with!histamine!
for!H1Rreceptor!siteS!decrease!allergic!
response!by!blocking!histamineS!
cause!increased!heart!rate,!
vasodilation,!secretion!
CNS:!dizziness,!drowsiness!
GU:!retention!
!
Tranexamic!acid,!
Cyklokapron!
haemostatic!
To!impair!the!blood!clot!
dissolution!
"!prevent!a!further!
bleeding!by!forming!blood!
Peptic!ulcer!
Anorexia*
Nausea*
vomiting!
Caution!to:!thrombosis!
(Transamin!may!stabilize!the!
thrombosis),!pregnancy.!
(Transamin!can!diffuse!to!baby!
URTI!remedy!
!
Benadryl! !
Haemostatic!drug! !
!!
! Transamin!
clot!on!the!wound!
from!placenta)!
Patient!education:!chew!tablets!
well!before!swallowing!and!then!
drink!a!full!glass!of!water!
Contraindication:!hypersensitivity!
to!aluminum!salt!or!magnesium!
salt!
Antidote,!detoxifying!agent!
!!
! Resonium!A!
Na!polystyrene!
sulphonate!
Antidote,!detoxifying!
agent!
Hyperkalemia!
Removes!potassium!by!exchanging!
sodium!for!potassium!in!body,!occurs!
primarily!in!large!intestine!
Constipation,!fecal!impaction!
Potassium!level!3.5R5!mg/dl!