Name of drug
Levodopa/ Carbidopa
Action /uses
PHARMACOLOGIC CATEGORY
Dopaminergic agents  Dopamine replacement
Levodopa is the most effective drug for Parkinson’s Disease.
Levodopa reduces symptoms by increasing dopamine synthesis in the striatum.
It enters the brain via active transport and carries it across the blood-brain
barrier. Once inside the brain, it transforms into dopamine and then helps
restore proper balance between dopamine and acetylcholine.
Both Levodopa and Carbidopa work better as a combination. Carbidopa inhibits
decarboxylation of levodopa in the intestines thereby making more Levodopa
available in the CNS.
Undergoes conversion to DA in the brain and then activates DA receptors
(carbidopa blocks destruction of levodopa in the periphery)
Side effects
Nausea, vomiting, dyskinesias such as involuntary movements, postural
hypotension, psychosis, CNS effects such as anxiety, agitation, memory, and
cognitive impairment, cardiovascular effects, darken sweat and urine.
Drug/food interaction
Antipsychotic drugs block dopamine receptors in the striatum.
MAO inhibitors increase the risk of severe levodopa-induced hypertension.
High protein foods will reduce therapeutic effects.
Avoid High protein meals!!!
Patients with narrow angle glaucoma
Patients taking MAO’s due to the risk of interactions. MAOS’s must be
discontinued about 2 weeks before taking these medications.
N/A
 Advise patients about the sedating effects of these meds.
 Advise patients to speak to their provider if they develop any
symptoms.
 Advise patients to not take alcoholic beverages with this medication.
 Patients should not drive or operate a motor vehicle until they are
knowledgeable of how these medications affect them.
 Patients should rise slowly from a sitting position
 Advise patients to notify their providers if they become pregnant or if
they are lactating.

Burchum, J. R., & Rosenthal, L. D. (2019). Lehne's pharmacology for nursing
care (10th ). Elsevier.
https://www.rxlist.com/stalevo-drug.htm#medguide
Contraindication
Important labs
Nursing implications
and patient education
Source:
Name of drug
Benztropine
Action /uses
PHARMACOLOGIC CATEGORY
Centrally acting anticholinergic drugs.
Used to suppress tremors and rigidity.
Symptomatic treatment of parkinsonism and acts by diminishing excess
cholinergic effects.
Side effects
Drowsiness, dizziness, agitations, irritability, restlessness, nervousness,
insomnia, hallucinations, delirium, psychosis, muscular weakness, ataxia,
palpitations, tachycardia, blurred vision, mydriasis, nausea, vomiting,
constipation, distention, dry mouth, dysuria.
Drug/food interaction
Alcohol, CNS depressants, MAO inhibitors, phenothiazine, procainamide,
quinidine  have additive anticholinergic effects and cause confusion.
Patients with narrow angle glaucoma, Myasthenia gravis, Obstructive diseases
of the GI and GU, Patients with tachycardia, Patients with tardive dyskinesia.
Monitor I&Os
 Give this medication with food to prevent gastric irritation.
 Do not drive or engage in potentially hazardous activities until
response to drug is known. Seek help walking as necessary.
 Avoid alcohol and other CNS depressants because they may cause
additive drowsiness. Do not take OTC cold, cough, or hay fever
remedies unless approved by physician.
 Sugarless gum, hard candy, and rinsing mouth with tepid water will
help dry mouth.
 Avoid doing manual labor or strenuous exercise in hot weather;
diminished sweating may require dose adjustments because of
possibility of heat stroke. This condition is most apt to occur in the
older adults.

Do not breast feed while taking this drug without consulting physician.
Contraindication
Important labs
Nursing implications
and patient education
Source:
Burchum, J. R., & Rosenthal, L. D. (2019). Lehne's pharmacology for nursing
care (10th ). Elsevier.
http://www.robholland.com/Nursing/Drug_Guide/data/monographframes/B016.html
book
Name of drug
Donazepil
Action /uses
PHARMACOLOGIC CATEGORY
Cholinesterase Inhibitors
Indicated for mild, moderate, and severe Alzheimer’s Disease.
They prevent the breakdown of Acetylcholine by AChE and thereby increase
the amount of acetylcholine at cholinergic synapses.
It is well absorbed after oral admin. It is eliminated partly in the urine and
partly in bile.
Side effects
It has a prolong life of 70 hours.
Nausea, vomiting, diarrhea, dyspepsia, bradycardia, headaches, fainting,
bronchoconstriction, falls, and fall-related fractures.
Drug/food interaction
Anticholinergic agents, first-generation antihistamines, Tricyclic
antidepressants, conventional antipsychotics.
Contraindication
Important labs
Nursing implications
and patient education
Patients with hypersensitivity to Donazepil.
N/A
 Doses should be slowly titrated.
 Take medications as prescribed.
 No alcoholic beverages with medications
Source:
Burchum, J. R., & Rosenthal, L. D. (2019). Lehne's pharmacology for nursing
care (10th ). Elsevier.
https://www.rxlist.com/stalevo-drug.htm#medguide
Name of drug
Memantine
Action /uses
PHARMACOLOGIC CATEGORY
NDMA receptor antagonist
Indicated for moderate to severe AD.
Memantine regulates the effects of glutamate at NMDA receptors, which play
a role in learning and memory.
It blocks the calcium influx when extracellular glutamate is low but permits
calcium influx when extracellular glutamate is high.
Well absorbed after oral dosing with or without food.
Side effects
Drug/food interaction
Contraindication
Important labs
Nursing implications
and patient education
Source:
Dizziness, Headaches, Confusion, Constipation
Combining Memantine with other NMDA antagonist can have undesirable
additive effect.
N/A
Periodic hematocrit and hemoglobin levels, Serum sodium, Alkaline
phosphatase, Blood glucose
 Monitor vital signs
 Monitor mental status
 Monitor respiratory status on patients with preexisting heart disease.
 Monitor diabetics for loss of glycemic control.
 Educate patient on side effects.
Burchum, J. R., & Rosenthal, L. D. (2019). Lehne's pharmacology for nursing
care (10th ). Elsevier.
http://www.robholland.com/Nursing/Drug_Guide/data/monographframes/M025.html
Name of drug
Interferon Beta
Action /uses
PHARMACOLOGIC CATEGORY
Immunomodulator
Uses are for relapsing-remitting multiple sclerosis.
Interferon Beta inhibits the migration of proinflammatory leukocytes across bloodbrain barrier, preventing these cells from reaching neurons of the CNS.
It also suppresses T-helper cell activity.
Side effects
Flu-like symptoms such as fever, chills, malaise, headache, muscle aches, and
stiffness. Hepatoxicity Myelosuppression (suppression of bone marrow function).
Depression Neutralizing antibodies.
Drug/food
interaction
Contraindication
Drugs that suppress bone marrow or cause injury.
Important labs
Liver function test, Renal function test, CBC with differential, Platelet count, Thyroid
function test q6months
 Look out for symptoms of suicide and depression.
 Monitor patients with cardiac disease.
 Take vital signs
 Perform a neurological assessment.
 Educate patient on side effects and signs of toxicity.
 Educate patient to talk to provider if she is planning to get pregnant.
Provider may stop the medication if the patient is planning to get pregnant.
 Do not breast feed while on this medication.
Nursing
implications and
patient education
Source:
Name of drug
Mitoxantrone
Action /uses
Patients with hypersensitivity to Interferon Beta or human albumin.
May cause spontaneous abortion.
Patients that are lactating.
Caution with patients with suicidal tendencies, preexisting psychiatric disorders, and
hepatic impairment.
Burchum, J. R., & Rosenthal, L. D. (2019). Lehne's pharmacology for nursing care
(10th ). Elsevier.
http://www.robholland.com/Nursing/Drug_Guide/data/monographframes/I033.html
PHARMACOLOGIC CATEGORY
Antineoplastics, immune modifiers
Uses are for patients with nonlymphocytic leukemia and patients with
advanced prostate cancer.
Treats patients with multiple Sclerosis
Decreases neurologic disability. It delays the time to relapse and the time to
disability progression.
It works by suppressing the production of immune system cells which prevents
the autoimmune destruction of myelin.
Side effects
Myelosuppression, Cardiotoxicity, Fetal harm, Hair loss, Injury to GI mucosa,
Gi distress, Nausea, Vomiting, Diarrhea, menstrual irregularities, itching, rash
Hypotension, shortness of breath, Blue-green tint to sclera and urine
Drug/food interaction
Yellow fever vaccine  may have an increased risk of infection.
Flu vaccines may impair immune response
Contraindication
Patients with myelosuppression.
Patients who are pregnant and lactating.
Use caution on patients with impaired cardiac function, impaired liver and
kidney function, and patients with systemic infections.
Important labs
CBCs at baseline before each dose and 14 days after each dose.
LFT’s at baseline and before each dose. Liver functions test.
Serum uric acid levels. Pregnancy test before each dose.
Determine LVEF before each dose and whenever signs of heart failure develop.
Nursing implications
and patient education




Source:
Assess patient’s vital signs
Monitor the skin around IV because it may cause a bluish
discoloration in the skin.
Educate patient on the adverse effects.
Educate patient of the possibility that their urine, sclera and skin may
have a bluish tint with this medication.
Burchum, J. R., & Rosenthal, L. D. (2019). Lehne's pharmacology for nursing
care (10th ). Elsevier.
http://www.robholland.com/Nursing/Drug_Guide/data/monographframes/M078.html
Name of drug
Phenytoin
Action /uses
PHARMACOLOGIC CATEGORY
Anticonvulsant
phenytoin causes selective inhibition of sodium channels. Specifically, the drug slows
recovery of sodium channels from the inactive state back to the active state.  this
causes the sodium to not enter the neurons.
Uses are to control tonic-clonic seizures, psychomotor and nonepileptic seizures
(Reyes syndrome). Treatment for trigeminal neuralgia.
Side effects
Drug use is accompanied by reduced voltage, frequency, and spread of electrical
discharges within the motor cortex.
Effects on the CNS, Gingival Hyperplasia, dermatologic effects, effects in pregnancy,
Cardiovascular effects, purple glove syndrome
Drug/food
interaction
Alcohol, Other anticonvulsants, Oral anticoagulants, CNS depressants,
Corticosteroids  increases metabolism.
Oral contraceptives  decreases their effectiveness.
Antituberculosis agents  decrease phenytoin levels.
Folic acid, calcium, and vitamin D  absorption may be decreased by phenytoin.
phenytoin absorption may be decreased by enteral nutrition supplements.
Herbal: Ginkgo may decrease anticonvulsant effectiveness.
Contraindication
Hypersensitivity to hydantoin products, Rash, seizures due to hypoglycemia, sinus
bradycardia, complete or incomplete heart block, Adams-Stokes syndrome.
Important labs
Periodic serum phenytoin concentration, CBC with differential, platelet count,
hematocrit, hemoglobin, serum glucose, serum calcium, serum magnesium, and liver
function tests.
Nursing
implications and
Patient education
Source:
Name of drug
Oxcarbazepine
Action /uses
Burchum, J. R., & Rosenthal, L. D. (2019). Lehne's pharmacology for nursing care
(10th ). Elsevier.
http://www.robholland.com/Nursing/Drug_Guide/data/monographframes/P043.html
PHARMACOLOGIC CATEGORY
Anticonvulsant
Used to control certain types of seizures
Decreases nerve impulses that cause seizures and pain.
Blockage of anti-voltage sensitive sodium channels which results in stabilization of
overactive neural membranes
Side effects
Drug/food
interaction
Inhibits repetitive neuronal firing and decreased propagation of neuronal impulses.
N/A
Phenobarbital, Carbamazepine, Verapamil, Valproic acid,
Calcium channel blockers may decrease medication levels
Oral contraceptives.
Herbal Ginkgo may decrease anticonvulsant effectiveness.
Evening primrose oil  may decrease the seizure threshold.
Contraindication
Patients with hypersensitivity to Oxcarbazepine, Pregnant patients, Patients who are
lactating.
Caution use:
Patients with renal impairment
Important labs
Nursing
implications and
patient education
Source:
Periodic serum sodium, T4 levels, Plasma levels
Take vitals
Assess neurological status of patient
Look out for any side effects
Educate patient to not breast feed while on this medication.
Do not take while pregnant
Add a barrier contraceptive since the drug may render hormonal methods ineffective.
Burchum, J. R., & Rosenthal, L. D. (2019). Lehne's pharmacology for nursing care
(10th ). Elsevier.
http://www.robholland.com/Nursing/Drug_Guide/data/monographframes/O022.html
Name of drug
Baclofen
Action /uses
PHARMACOLOGIC CATEGORY
Muscle relaxer  Autonomic system relaxer
Used to treat pain and other types of spasticity.
Acts within the spinal cord to suppress hyperactive reflexes involved in muscle
movements.
Side effects
The exact mechanism is unknown.
depression, dizziness, headache, nausea, vomiting, constipation, urinary
retention. **overdose can cause respiratory depression
Drug/food interaction
Contraindication
CNS inhibitors MOA inhibitors Antihistamines
Can cause Urinary retention
May exacerbate psychotic conditions and confusion.
Can cause respiratory depression if taken with alcohol, opioids, or
benzodiazepines.
Important labs
Nursing implications
and patient education
*Blood glucose levels, AST levels, Serum alkaline phosphate
 Supervise ambulation
 Vitals


Monitor for adverse neuropsychiatric
Administer with or without foods
Source:
Burchum, J. R., & Rosenthal, L. D. (2019). Lehne's pharmacology for nursing
care (10th ). Elsevier.
Name of drug
Cyclobenzaprine
Action /uses
PHARMACOLOGIC CATEGORY
Muscle relaxer
Side effects
Drowsiness Dizziness Fatigue
Cardiac rhythm disturbances
Drug/food interaction
SSRI’s, MAO inhibitors  leads to serotonin syndrome.
SSRIs, SNRIs, and tricyclic antidepressants.
Alcohol
Contraindication
Important labs
Nursing implications
and patient education
Source:
Name of drug
Procaine
Action /uses
Side effects
Drug/food interaction
Contraindication
Important labs
Nursing implications
and patient education
Source:
Name of drug
Lidocaine
Action /uses
Centrally acting skeletal muscle relaxant.
Activity takes place in the brain stem and results in the reduction of tonic
motor activity.
Educate patient to avoid alcohol.
Burchum, J. R., & Rosenthal, L. D. (2019). Lehne's pharmacology for nursing
care (10th ). Elsevier.
PHARMACOLOGIC CATEGORY
Local Anesthetic
Acts by inhibiting sodium influx through voltage gated sodium channels in the
neuronal cell membrane of peripheral nerves. Action potential cannot arise
when the sodium influx is interrupted.
It is used as a local or reginal anesthesia.
PO: Heartburn, migraines, systemic lupus. IM: safe, local rash at the injection
site.
Digoxin, Muscle relaxants, Succinylcholine, Aminosalicylic acid, antibiotics
Patients with Myasthenia gravis, During pregnancy and breastfeeding.
Monitor vital signs
Monitor any symptoms of allergic reactions
Educate patient on the side effects, and drug interactions.
Burchum, J. R., & Rosenthal, L. D. (2019). Lehne's pharmacology for nursing
care (10th ). Elsevier.
PHARMACOLOGIC CATEGORY
Antiarrhythmic, Local anesthetic
Has been shown to be effective in suppressing PVC’s, treating Ventricular
tachycardia, Ventricular fibrillation, and in increasing the fibrillation threshold
in AMI.
Side effects
Drug/food interaction
Contraindication
Important labs
Nursing implications
and patient education
Source:
Name of drug
Isoflurane
Action /uses
Side effects
Drug/food interaction
Contraindication
Important labs
It works by depressing depolarization and automaticity in the ventricles.
Metabolized in liver and excreted in urine. Can be passed along in breastmilk.
Bradycardia, cardiac arrest, drowsiness, heart blocks, hypotension, nausea,
respiratory seizures, and vomiting
Beta blockers, barbiturates
Hypersensitivity to lidocaine, Third degree heart block medications,
idioventricular rhythms, sinus bradycardia with escape PVCs
Liver AST and ALT levels, BUN, creatinine levels, CBC, serum electrolyte levels.
 Monitor EKG and respiratory status.
 Assess for signs of lidocaine toxicity.
 Make sure patient has good swallowing reflexes.
 Fall risk precautions.
 O2 therapy if needed.
 Educate patient to follow up with primary care physician.
Burchum, J. R., & Rosenthal, L. D. (2019). Lehne's pharmacology for nursing
care (10th ). Elsevier.
PHARMACOLOGIC CATEGORY
Inhalational halogenated anesthetic
Undergoes minimal biotransformation in the body.
Can be used for the induction and maintenance of general anesthesia.
Respiratory depression, shivering, nausea, vomiting, ileus.
Muscle relaxants
Known sensitivity to isoflurane, or patients with suspected genetic
susceptibility to malignant hyperthermia.
Caution: Isoflurane can cause perioperative hyperkalemia, and malignant
hyperthermia,
Blood glucose levels, serum creatinine, BUN, Serum cholesterol and alkaline
phosphate levels
Nursing implications
and patient education
Sources:
Burchum, J. R., & Rosenthal, L. D. (2019). Lehne's pharmacology for nursing
care (10th ). Elsevier.
Name of drug
Propofol
Action /uses
PHARMACOLOGIC CATEGORY
General Anesthetic
Used to sedate patients undergoing mechanical ventilation, radiation therapy,
or diagnostics procedures.
Propofol promotes the release of GABA which leads to generalized CNS
depression.
Crosses the placenta. Metabolizes in liver and excreted in the urine and
breastmilk.
Side effects
Respiratory depression, hypotension, headaches, twitching, jerking, clonic or
myoclonic movements, ventricular asystole, vomiting, abdominal cramping,
cough, and pain at the injection site.
Drug/food interaction
Contraindication
CNS depressants
Patients with hypersensitivity to propofol, patients with increased intracranial
pressure or impaired cerebral circulation.
Caution patients with severe cardiac or respiratory disorders or history of
epilepsy or seizures.
N/A
 Monitor vitals
 Monitor hemodynamic status and assess for dose-related
hypotension.
 Take seizure precautions.
 Provide comfort measures.
Important labs
Nursing implications
and patient education
Sources:
Name of drug
Morphine
Action /uses
Burchum, J. R., & Rosenthal, L. D. (2019). Lehne's pharmacology for nursing
care (10th ). Elsevier.
PHARMACOLOGIC CATEGORY
Narcotic/ Opioid analgesic
Binds with opioid receptors withing the CNS.
It alters processes affecting pain perception, emotional response to pain, and
produces CNS depression.
If toxicity happens  administer Naloxone
Side effects
Drug/food interaction
Contraindication
Important labs
Nursing implications
and patient education
Sources:
Drowsiness, respiratory depression, constipation, urinary retention, orthostatic
hypotension, emesis, intracranial pressure, euphoria, dysphoria.
CNS depressants, barbiturates, benzodiazepines, alcohol, general anesthetics,
agonist-antagonist opioids, MAO’s inhibitors, hypotensive agents,
antihistamines, phenothiazines, anticholinergic drugs, atropine-like drugs,
tricyclic antidepressants.
Patients with head injury, pregnant patients, and patients with respiratory
depression and a history of asthma.
Plasma amylase and lipase levels





Monitor vital signs periodically during administration.
Educate patient that prolonged use can lead to physical dependence.
Assess bowel function routinely.
Educate patients on side effects.
Advise patient to change positions slowly to minimize orthostatic
hypotension.
Burchum, J. R., & Rosenthal, L. D. (2019). Lehne's pharmacology for nursing
care (10th ). Elsevier.
Name of drug
Naloxone
Action /uses
PHARMACOLOGIC CATEGORY
Opioid antagonist
Reversal of CNS depression and respiratory depression due to opiod overdose.
Works by blocking the effects of opioids with out producing any agonist effects.
o Metabolized in liver and excreted in urine.
Side effects
Hypertension, hypotension, ventricular fibrillation, ventricular tachycardia,
nausea, vomiting, anxiety, aggression, diarrhea, abdominal pain, and
rhinorrhea
Drug/food interaction
Contraindication
Important labs
Nursing implications
and patient education
Narcotic agonist, narcotic agonist-antagonist
Hypersensitivity to Naloxone
n/a
Sources:



Crosses the placenta.
Monitor vital signs
Monitor respirations
Burchum, J. R., & Rosenthal, L. D. (2019). Lehne's pharmacology for nursing
care (10th ). Elsevier.
Name of drug
Sumatriptan
Action /uses
PHARMACOLOGIC CATEGORY
Selective Serotonin Receptor Agonist
Side effects
Transient: pein or tightness in chest or throat, tingling, flushing, weakness,
dizziness, abdominal discomfort, sweating, nasal irritation, injection site
reactions.
Caution: patients with a hx of high blood pressure
MAO’s Inhibitors
Drug/food interaction
Contraindication
Important labs
Nursing implications
and patient education
Sources:
Name of drug
Ergotamine
Action /uses
Used for acute treatment of migraine headaches with it without an aura in
adults.
Burchum, J. R., & Rosenthal, L. D. (2019). Lehne's pharmacology for nursing
care (10th ). Elsevier.
PHARMACOLOGIC CATEGORY
Alpha Adrenergic Antagonist
As single agent or in combination with caffeine to prevent or abort migraine,
cluster headache, and other vascular headaches.
Crosses blood brain barrier. Eliminated in feces and excreted in milk.
Side effects
Drug/food interaction
Contraindication
Important labs
Nursing implications
and patient education
Sources:
Muscle pains, weakness, numbness, coldness, and Raynaud’s syndrome.
Grapefruit juice! Beta-adrenergic blockers, sympathomimetics, azole
antifungals
Patients with liver and kidney disease, history with MI, coronary artery disease,
hypertension, anemia, malnutrition, pregnancy, and the use in children.
N/A






Monitor for GI side effects.
Watch out for overdose symptoms.
Educate patient to take medication as prescribed.
Begin drug therapy as soon as onset of migraine attack occurs.
Lie down in a quiet dark room.
Educate patient to not breastfeed while taking this drug.
Burchum, J. R., & Rosenthal, L. D. (2019). Lehne's pharmacology for nursing
care (10th ). Elsevier.